Chapter 11 Contraception

Our Sexuality, 9th Edition, Robert L. CrooksChapter 11: Contraception

Chapter 11

Contraception


Historical and Social Perspectives

• Evidence of contraception since the beginning of recorded history

• U.S. contraceptive efforts– 1800s Comstock laws – 1915: Margaret Sanger's – U.S. Supreme Court rulings

• Griswold vs. Connecticut• Eisenstadt vs. Baird


Historical and Social Perspectives (cont.)

• Contemporary issues– planning for wanted children– physical health of mother– insurance coverage of contraceptives– population growth– cultural gender-role expectations– wide diversity of views among cultures and religious

leaders


Historical and Social Perspectives (cont.)

Fig. 11.1 Average number of children, by mother’s education level and race/ethnicity in the United States.


Sharing Responsibility and Choosing a Birth Control Method

• How to share responsibility– ask about BC before intercourse– read & discuss options together– attend a class or clinic together– share expenses


Choosing a Birth Control Method

• Choosing a BC method– consider effectiveness and cost– consider ease of use and side effects– characteristics of ineffective use

• guilt• negative attitudes about sex• self-view


Contraceptive Effectiveness• Failure Rate

– consistent use failure rate– typical use failure rate


Contraceptive Effectiveness

Fig. 11.2 Factors to consider when choosing a birth control method.


Choosing a Birth Control Method (cont.)

• Hormone-Based Contraceptives– combination pill– Triphasic pill– Constant-dose– Progestin-only pill



Table 11.3 Possible side effects with the birth control pill.



– Vaginal ring– Transdermal patch– Depo-Provera



• Barrier Methods– Condom: sheath fits over erect penis



Fig. 11.5b A condom with a reservoir tip does not need to be twisted at the top as it is put on the penis.



• Barrier Methods (cont.)– Female condom: sheath fits in vagina



Fig. 11.6b A female condom consists of two flexible polyurethane rings and a soft, loose-fitting polyurethane sheath



• Vaginal spermicides: – foam– sponge– suppositories – creams– film



• Barrier Methods (cont.)– Diaphragm: latex dome – Cervical cap– Fem Cap– Lea’s Shield



• Barrier Methods (cont.)– Diaphragm: latex dome



Fig. 11.8e These figures illustrate the insertion and checking of a diaphragm.



• Intrauterine Devices– affects sperm motility & viability– thicken cervical mucous – alter endometrial lining– impair tubal motility



• Emergency contraception– Hormonal: birth control pills taken within 72 hours of

unprotected intercourse– Copper-T IUD: inserted up to five days after

unprotected intercourse– Access issues



• Fertility Awareness Methods– Standard days method

– Mucus method: based on cyclical changes

– Calendar method: self- knowledge of fertility– Basal body-temperature


Choosing a Birth Control Method (cont.) • How to compute basal body temperature

Fig. 11.11 An example of a basal body temperature during a model menstrual cycle.



• Sterilization (female)– tubal sterilization

• Minilaparotomy• Laparoscopy• Culpotomy• Transcervical sterilization


Choosing a Birth Control Method (cont.)• Sterilization (female)

Fig. 11.2 Female sterilization by laparoscopic ligation. Front view shows tubes after ligation.


Choosing a Birth Control Method (cont.)• Sterilization (cont.)

– Male vasectomy

Fig. 11.14 Male sterilization by vasectomy.


Less than Effective Methods

• Nursing– amenorrhea is common for a brief period after birth

while breastfeeding– 80% ovulate before first period– unreliable


Less than Effective Methods (cont.)

• Withdrawal before ejaculation– difficult to judge when to withdraw– anxiety may lower pleasure– Cowper's gland fluid may carry sperm– any sperm on vulva may travel into vagina/uterus;

unreliable


Less than Effective Methods (cont.)

• Douching– sperm reach uterus in 1-2 minutes– douching may speed sperm along– irritates vaginal tissue– very ineffective


New Directions in Contraception

• For men– Testosterone & progestin may lower sperm count– GRH inhibitor (LHRH agonist) may lower number &

motility of sperm– Medications used for other purposes


New Directions in Contraception (cont.)

• For women– implants – new IUDs– new female condoms– spermicides with microbicides– immunocontraceptives


New Directions in Contraception (cont.)

• For women (cont.)– one-sized & disposable diaphragms & cervical caps– spermicides containing microbicides, developed to

prevent STD’s– IUDs with different shapes & hormones

Chapter 11 Contraception

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