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Contraceptive ChoicesEmergency ContraceptionHormonal Progesterone-only - Levonelle 1500 (Free from Family Planning Clinics.) Progesterone-only - Levonelle one step (You can buy this for £25:00 over the counter from some chemists.) Copper Intra-Uterine Device (IUD) - the copper coil Hormonal Methods of ContraceptionCombined Pill Depo-Provera Contraceptive Injection Progesterone-Only-Pill (POP) or Mini Pill Contraceptive ImplantsImplanon Intrauterine ContraceptionIntra-Uterine System (IUS) - Mirena Copper Intra-Uterine Device (IUD) - the copper coil Barrier MethodsMale condoms Female Condoms - Femidom Diaphragm Natural Family PlanningSterilisationMale Vasectomy Female Sterilisation/Essure Contraceptive PatchEmergency ContraceptionTHIS SHOULD NOT BE USED ON A REGULAR BASIS AS AN ALTERNATIVE TO A MORE EFFECTIVE METHOD OF CONTRACEPTION Progesterone Only Emergency Contraception Levonelle 1500• It is most effective if started within 24hrs of risk of pregnancy • Has a time limit of 72hrs • Take the one pill as soon as possible after episode of risk • Vomiting within 3 hours of taking it will interfere with it working properly • You should not have any more sex/intercourse until your next period • You should have a normal period within 3 weeks of taking Levonelle - if not, have a pregnancy test • It is most effective (95%) when taken within 24 hours of the risk of pregnancy and has a time limit of 72 hours Levonelle One Step Available from some chemists over the counter - Cost £25:00. Copper Intra-Uterine Device (IUD) - the copper coil • Needs to be fitted by a specially trained doctor • Is more than 99% effective as a method of emergency contraception • Is especially useful for women already considering the copper coil as an on-going method of contraception, but it could be removed with the next normal period and a different method of contraception chosen, if the women only wants it for emergency contraception Hormonal MethodsCombined Pill• Contains two hormones • Is taken for 21 days and then stopped for 7 days (seven is the magic number - the first seven pills of every packet are always critical no matter how long you have been taking the combined pill) • It is the only method to give regular bleeding and contraception • Taken well, it is 99.6% safe as a method of contraception How It Works• It prevents ovulation (prevents an egg being produced). Main Side Effects • For various reasons, it is not suitable for all women, especially those who are not at risk of developing clots in their legs or lungs or smokes over the age of 35 years old. Depo-Provera Contraceptive Injection• It is an injection of hormone that is given by intra-muscular injection in the hip every 12 weeks • It is over 99% safe, it is an incredibly effective method of contraception How It Works • It prevents ovulation (prevents an egg being produced). Main Side-Effects• Can mean irregular periods or complete loss of periods (not a cause for concern) • Can cause weight changes because of increased appetite • A unique feature is that, when the injections are stopped, there can be a delay before a woman becomes fertile again. This is not permanent • All women using Depo-provera should be make aware that Depo-Provera may affect the strength of their bones Progesterone-Only-Pill (POP) or Mini Pill – The Newer one is called Cerazette• Contains only one hormone • It is taken every day • It is 96-98% safe as a method of contraception but any pill that is taken more than 12 hours later than usual can result in failure, i.e. can result in pregnancy. Antibiotics do not interfere with it How It Works • It prevents ovulation (prevents an egg being produced). • It thickens the cervical mucus which then traps sperm and prevents them from fertilising an egg. Main Side-Effects• Can mean irregular periods or complete loss of periods. • It is a good method for insulin-dependant diabetics or women who are breast-feeding, or women who are overweight, or who are over 35 and smoke. Other POP’s are not quite so effective and have to be taken at the same time every day, never more than 3 hours late. Contraceptive ImplantsImplanon• The newest implant is Implanon • Only contains one hormone • Is a very effective method of contraception (more than 99% safe) • Must be inserted by a specially trained doctor • Consists of a single rod • Is slipped under the skin of the upper arm PLEASE NOTE - NORPLANT IS NO LONGER AVAILABLE How It Works • It prevents ovulation (prevents an egg being produced). Main Side Effects • Can mean irregular periods or complete loss of periods • Is effective for 3 years • It must be removed by a specially trained doctor (rarely it may need to be removed by a surgeon under general anaesthetic). Back To Top Intra-Uterine System (IUS)Mirena• This releases one hormone. It is a cross between the mini pill and a intra-uterine device (IUD) - it is a mini pill coating built on an IUD frame. • It must be inserted into the womb (uterus) by a specially trained doctor. • It is a very effective method of contraception (more than 99% safe). How it Works• It thickens the cervical mucus which then traps sperm and prevents them from fertilising an egg. It does not prevent ovulation in all women. It thins the lining of the womb so makes periods much lighter. Many women find their periods stop altogether which is completely safe and very convenient. Main Side Effects • Can mean frequent very light bleeding for the first 4-6 months. • On rare occasions it can fall out. • It sometimes moves through the wall of the womb (perforates the uterus) – this is very rare. • There is a slight risk of uterine (womb) infection, especially immediately after insertion • It cannot completely protect against an ectopic pregnancy. Copper Intra-Uterine Device (IUD) - the copper coil• This is the only effective method of contraception that is non-hormonal. • It’s 98-99% safe as a method of contraception. This can also be used as a method of emergency contraception. How It Works Copper is gradually released, killing sperm before they find the egg and fertilisation occurs. It is most important with the copper IUD that you are in an absolutely steady, monogamous sexual relationship - this also applies to the male partner. Main Side Effects• Expulsion (can fall out). • It sometimes moves through the wall of the womb (perforates the uterus) – this is very rare • There is a slight risk of uterine (womb) infection and this can affect future fertility • It cannot completely protect against an ectopic pregnancy • Pregnancy which occurs with an IUD in place can result in miscarriage Barrier MethodsMale CondomsRemember - 'boys aren't born knowing how to use them'• This is a latex/polyurethane sheath for the penis • They are disposable and a new one should be worn each time you have sexual intercourse • They have a failure rate of 1 in 10 (i.e. there is a 1 in 10 chance of becoming pregnant) - that is, it is only 90% safe as a method of contraception. To put this into perspective, if there was a 1 in 10 chance of winning the lottery, would you buy a ticket? • They are available free from Family Planning Clinics Go Double Dutch - all persons under 25 years old should use a condom as well as a more effective method to protect them against infection and cervical cancer Female Condoms - Femidom• This is a cross between the male condom and a diaphragm • It is made of polyurethane and is about as effective as a male condom Diaphragm• This is a round, rubber, dome-shaped device, that is inserted into the vagina before sex. The woman inserts and removes the diaphragm (like a tampon) each time • It must stay in place for 6 hours after sexual intercourse and should always be used with spermicide • They come in different sizes and are initially fitted by a specially trained doctor • it is 96% effective as a method of contraception in women over 25 years old (it is less effective for women under 25 years old) How It WorksSperm are trapped in the vagina and killed by the spermicide Back To Top Natural Family PlanningNatural Family Planning combines three methods: • Calendar - looking at menstrual cycles to ascertain the 'average' length of a cycle • Temperature measurement - a special fertility thermometer is used to detect a 0.2 degree rise in temperature, and this is very hard to do accurately • Mucus - the woman looks at her cervical mucus to establish whether she has ovulated (and is therefore at risk of becoming pregnant) or not • It is approximately 85% effective as a method of contraception Persona • This is a device that is marketed by Boots • Its effectiveness varies and it is not available from Family Planning Clinics at present Back To Top SterilisationMale Vasectomy• It is a permanent method of contraception and needs to be done by a specially trained doctor How it Works• The vas deferens (tubes) which carries the sperm from where the are made to where they are added to the ejaculate, and located and cut - It is not effective immediately - It needs 2 follow-up specimens (usually at 3 and 4 months post-operatively) before other methods of contraception are abandoned Main Side Effects• There is no substantial long term risk associated with vasectomy • anaesthetic risk (it can be done under local anaesthetic) • Recanalisation - the tubes (vas deferens) effectively heal which puts the woman at risk of pregnancy again • Post-operative pain - this is usually associated with bruising and infection • Failure rate: 1 in 2000 (very low) Female Sterilisation• It is a permanent method of contraception and needs to be done, in hospital, by a specially trained doctor (usually an obstetrician/gynaecologist) How It Works • Blocks the fallopian tubes to prevent the egg and sperm meeting. Main Side Effects• Anaesthetic risk • Operation risk • Does not prevent against an ectopic pregnancy • Lifetime failure rate: 1 in 200 (ten times higher than vasectomy) ESSURE• Is a new method of female sterilisation • It does not always require a general anaesthetic • A micro-insert made of a stainless steel inner coil, an outer coil made from Nitinol and P.E.T. and Dacron fibres • Mode of Action - Once in place the micro-inserts cause tissue growth, permanently blocking the tubes. Main Side Effects• Takes 3 months for the procedure to work - you must use other contraception for the first 3 months • Really is permanent • Failure rate: Seems very effective method of female sterilisation - but too new for definitive figure for failure rate just yet (NOT KNOWN) Back To Top Contraceptive PatchWhat it is The contraceptive patch, also called Evra, is a small beige patch applied to the skin like a sticky plaster, which protects against pregnancy. How it works The patch releases two hormones, oestrogen and progestogen into the bloodstream through the skin. Like the combined pill it stops the ovaries from releasing an egg for fertilisation every month. It also thickens the mucus around the cervix, which makes it difficult for sperm to get into the womb. Patches can be worn discreetly on most areas of the body, including the upper arm, shoulder or buttocks, but should not be applied to the breasts or to broken or irritated skin. The patch should be started on the first day of your period and should be worn for seven days. On the eighth day it needs to be changed, by removing it, throwing it away carefully and immediately putting on a new patch. The patch should be changed every week for three weeks. After three weeks you don’t wear a patch for seven days. During the patch free week you may bleed as in a normal period. After seven patch-free days a new patch is applied and the four week cycle of three weeks of a patch, one week without starts again. Advantages Does not interrupt sex Can be worn while swimming, having a bath or exercising. Protection from pregnancy starts on the first day the patch is worn. Disadvantages Does not protect against sexually transmitted infections (STIs). Can cause headaches and skin problems. Contains the same hormones as the combined pill, which in a small number of women can cause serious side effects such as blood clots and breast cancer. How effective is it? The patch is 99% effective when used properly. This means that one in every 100 women who use the patch get pregnant every year. It is less effective if not used according to the instructions. What makes it less effective? Forgetting to change the patch after seven days. If the patch falls off and is not reapplied or if a new one is not put on immediately. Use of some prescription and complementary medicines. Can anyone use this method? The contraceptive patch is not suitable for all women. A doctor or nurse will need to know about a woman’s medical history and any illnesses suffered by immediate members of her family to find out if there are any medical reasons why it might not be suitable. |
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