Family Planning

Real Distinction between the Natural Family cookery to the Artificial Family prep bedness What is Family cookery? What be the differences between the Natural and Artificial Family Planning? Family meanis theplanningof when to extraditechildren,and the use of extradite instruction and early(a)wise techniques to implement much(prenominal) plans. Other techniques commonly utilise take on kindleuality education, checkion and man development ofsexually transmitted infections, pre-conception counselingandmanagement, andin fruitfulness management.Family planning is roughlytimes utilise as a synonym for the use of blood falsify, however, it lots includes a wide variety of forms, and practices that argon non consanguinity nurse. It is just nigh ordinarily applied to afe masculine-malecouple who wish to limit the upshot of children they check and/or to confine the timing of motherliness( as well as cognise asspacing children). Family planning whitethorn enco mpasssterilization, as well asabortion.Family planning services be defined as educational, comprehensive medical or social activities which modify individuals, including minors, to consider freely the number and spacing of their children and to select the meat by which this may be achieved. Natural family planning(NFP) comprises thefamily planningmethods approved by the roman Catholic Church. In accordance with the Churchs teachings regardingsexual behaviorin keeping with its philosophy of the dignity of the human person, NFP excludes the use of other methods ofbirth enclose, which it refers to as near hitch method. Periodic temperanceis the only method deemed lesson by the Church for curtailing motherliness. When utilise to nullify pregnancy, NFP limits sexual intercourse to naturally infertile periods portions of thecatamenial cycle, during pregnancy, and subsequentlymenopause. Various methods may be employ to identify whether a adult pistillate is likely to b efertile this in imageation may be used in attempts to either evacuate or achieve pregnancy. There argon three main types of NFP the symptoms-based methods, the calendar-based methods, and the lookfeeding orlactational amenorrhoea method.Symptoms-based methods rely on biological signs of natality, while calendar-based methods musical theme the likelihood of cornucopia based on the aloofness of ult menstrual cycles. Clinical studies by theGuttmacher comprise entrap that periodic abstinence resulted in a 25. 3 percentage failure under typical conditions, though it did non differentiate between symptom-based and calendar-based methods. Symptoms-based Some methods of NFP line biological signs of birth rate. When used out stead of the Catholic concept of NFP, these methods argon a good deal referred to simply asfertility cognizance-based methodsrather than NFP.The three immemorial signs of a womans fertility argon herbasal consistence temperature, hercervicalmucus, and he r cervical position. Com deputeerizedfertility monitorsmay track basal bole temperatures, hormonal levels in urine, changes in electrical resistance of a womans saliva or a mixture of these symptoms. From these symptoms, a woman wad learn to assess her fertility without use of a computerized device. Some transcriptions use only cervical mucus to de landmarkine fertility. cardinal well-k immediatelyn mucus-only methods are theBillings ovulation methodand theCreighton Model Fertility Care System.If two or more signs are tracked, the method is referred to as a symptothermal method. Two popular symptothermal systems are taught by theCouple to Couple Leagueand the Fertility Awareness rule (FAM) taught byToni Weschler. A study completed in Germany in 2007 found that the symptothermal method has a method efficaciousness of 99. 6%. In Canada, the symptothermal method is taught bySERENA Canadawhich is an inter-denominational organization which has been maturation the Symptothermal s ystem as a discussion section of NFP since 1955.They are likewise not specifically affiliated with the Roman Catholic Church. It is likewise taught byJustisse wellnessworks for Women, a pro-choice feminist organization that allows and supports women to combine other methods of birth control with their fertility awareness practice. A study by the man Health constitution involving 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found that 93% could accurately interpret their bodys signals heedless of education and culture. In a 36-month study of 5,752 women, the method was 99. 86% impressive. Calendar-basedCalendar-based methods determine fertility based on a record of the length of previous menstrual cycles. They include the Rhythm Method and the regulation Days Method. The Standard Days method was developed and proven by the researchers at the Institute for Reproductive Health of Georgetown University. round of drinksBeads, unaffiliated wi th religious teachings, is a visual tool based on the Standard Days method. According to the Institute of Reproductive Health, when used as birth control, CB has a 95% hard-hittingness rating. Computer programs are gettable to avail track fertility on a calendar.Lactational amenorrhea Thelactational amenorrhea method(LAM) is a method of avoiding pregnancy based on the naturalpostpartuminfertilitythat occurs when a woman isamenorrheicand fullybreastfeeding. The rules of the method help a woman identify and possibly lengthen her infertile period. A strict version of LAM is known asecological breastfeeding. Artificial Family Planning/Birth Control, also known ascontraceptionandfertility control, refers to methods or devices used to preventpregnancy. Planning and provision of birth control is calledfamily planning.Safe sex, such as the use of male orfemale rubbers, can also help prevent transmission ofsexually transmitted diseases. Contraceptive use indeveloping countries has cut th e number ofmaternal deathsby 44% (about 270,000 deaths averted in 2008) but could prevent 73% if the full demand for birth control were met. Because juvenile pregnanciesare at great peril of adverse outcomes such aspreterm birth,low birth weight andinfant mortality, adolescents need comprehensivesex educationand rag to reproductive healthservices, including contraception.By lengthening the time between pregnancies, birth control can also improve adult womens delivery outcomes and the survival of their children. Effective birth control methods includebarrierssuch ascondoms,diaphragms, and the hinderance spongehormonal contraceptionincluding oral exam pills,patches,vaginal rings, and injectable preventives andintrauterine devices(IUDs). indispensability contraceptioncan prevent pregnancy after open sex. Long-acting reversible contraceptionsuch as implants, IUDs, or vaginal rings are recommended to reduceteenage pregnancy.Sterilizationby agent such asvasectomyandtubal ligatio nis permanent contraception. Some people regardsexual abstinenceas birth control, butabstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sexandoral sexare also sometimes con cheekred contraception. Birth control methods have been used since ancient times, but effective and safe methods only became available in the 20th century. For some people, contraception involves moral issues, and many cultures limit addition to birth control due to the moral and political issues involved.About 222 million women who want to avoid pregnancy in developing countries are not using a modern contraception method. Birth control increaseseconomic growthbecause of fewer dependent children, more women participating in the work force, and less consumption of scarce resources. Womens earnings, as formats,body visual sense index, and their childrens schooling and body mass index all substantially improve with greater access to contrac eption. Methods of Artificial Family Planning Artificial Family Planning/Birth control includesbarrier methods,hormonal contraception,intrauterine devices(IUDs), sterilization, and behavioral methods.Hormones can bedelivered by injection, by mouth (orally),placed in the vagina, or implanted under the skin. The intimately common types of oral contraception include the have oral contraceptive pilland theprogestogen-only pill. Methods are typically used before sex but fate contraceptionis effective shortly after intercourse. Determining whether a woman with one or more illnesses, diseases, seek factors, or abnormalities can use a particular strain of birth control is a complex medical question sometimes requiring apelvic examinationor medical tests.TheWorld Health Organization publishes a detailed list of medical eligibility criteria for each type of contraception. Birth control methods * An unrolled malelatex condom * A polyurethanfemale condom * Adiaphragmvaginal-cervicalbarrier, in its case with aquarter U. S. cointo show scale * Acontraceptive spongeset inside its blustering package * Three varieties ofbirth control pillsin calendar oriented packaging * A transdermal contraceptive patch * ANuva Ringvaginal ring * A hormonalintrauterine device(IUD) against a background showing placement in theuterus *A strapper IUD adjacent to a dimeto show scale * A split dose of two touch contraceptive pills (most morning after pills now only bespeak one) Barrier Barrier contraceptivesare devices that attempt to preventpregnancyby physically preventing spermfrom entering theuterus. They include malecondoms,female condoms,cervical caps,diaphragms, andcontraceptive spongeswithspermicide. The condom is most commonly used duringsexual intercourseto reduce the likelihood ofpregnancyand of spreadingsexually transmitted diseases(STDssuch asgonorrhea,syphilis, andHIV).It is put on a mans erectpenisand physically blocks ejaculated semen from entering the body of a sexual part ner. Modern condoms are most often do fromlatex, but some are made from other materials such aspolyurethane,polyisoprene, or lamb intestine. Afemale condomis also available, most often made ofnitrile. Male condoms have the advantage of being inexpensive, easy to use, and having few side effects. Contraceptive sponges combine a barrier with spermicide. give care diaphragms, they are inserted vaginally forward to intercourse and must be placed all over thecervixto be effective.Typical effectiveness during the introductory year of use is about 84% overall, and 68% among women who have already given birth. The sponge can be inserted up to 24 hours before intercourse and must be left in place for at least six hours afterward. Some people are allergic to spermicide used in the sponge. Women who use contraceptive sponges have an increase pretend of barm infectionsandurinary tract infections. Leaving the sponge in for more than 30 hours can result intoxic shock syndrome. hormonal Horm onal contraceptives subdueovulationandfertilization.These includeoral pills,subdermalimplants, andinjectable contraceptivesas well as thepatch,hormonal IUDsand thevaginal ring. The most commonly used hormonal contraceptive is thecombined oral contraceptive pillcommonly known as the pillwhich includes a combination of anestrogenand aprogestin(progestogen). There is also a progestin-only pill. Currently, hormonal contraceptives are available only for females. Combined hormonal contraceptives are associated with a slight increased cardiovascular risk, including a small increased risk ofvenousandarterial thrombosis. However, the benefits are greater than the risk.Oral contraceptives reduce the risk ofovarian cancerandendometrial cancerwithout increasing the risk forbreast cancer. They can lower body weight by reducingwater retention(not loss of fat), and several are used to finesse mild to moderateacne. Between 2% and 10% of women of childbearing age experience emotional and physical s ymptoms associated withpremenstrual syndrome(PMS) andpremenstrual dysphoric disorder(PMDD). Combination hormonal contraceptives often ameliorate or in effect treat these problems and can effectively treat heavy menstrual exhaust anddysmenorrhea(painful menstruation) as well.Lower doses of estrogen required by vaginal administration (i. e. , from the vaginal ring or hormonal IUDs kind of of the pill) may reduce the untoward side effects associated with higher oral doses such as breast tenderness,nausea, and headache. Progestogen-only pills and intrauterine devices are not associated with an increased risk of thromboses and may be used by women with previous venous thrombosis, or hepatitis. In those with a history of arterial thrombosis, non-hormonal birth control should be used. Progestogen-only pills may improve menstrual symptoms such sdysmenorrhea,menorrhagia, premenstrual syndrome, and anemia, and are recommended for breast-feeding women because they do not affect lactation. Ir regular bleeding can be a side effect of progestin-only methods, with about 20% of users reportingamenorrhea(often pick uped a benefit) and about 40% of women experiencing regular menstrual cycles, leaving the remaining 40% with irregular espial or bleeding. Uncommon side effects of progestin-only pills, injections, and implants include headache, breast tenderness, mood effects, anddysmenorrhea, but those symptoms often resolve with time.Newer progestins, such as drospirenone and desogestrel, minify theandrogenicside effects of their predecessors. Intrauterine devices The modernintrauterine device(IUD) is a small T-shaped birth control device, containing either copper or progesterone, which is inserted into the uterus. IUDs are a form oflong-acting reversible contraception, the most effective type of reversible birth control. As of 2002, IUDs were the most widely used form of reversible contraception, with nearly one hundred sixty million users worldwide. Evidence supports both effectiveness and safety in adolescents.Advantages of the copper IUD include its ability to provideemergency contraceptionup to quintet days after unprotected sex. It is the most effective form of emergency contraception available. It contains no hormones, so it can be used while breast feeding, and fertility returns quickly after removal. Disadvantages include the possibility of heavier menstrual periods and more painful cramps. Hormonal IUDs do not increase bleeding as copper-containing IUDs do. Rather, they reduce menstrual bleeding or stop menstruation altogether, and can be used as a treatment forheavy periods.Levonorgestrel-releasing IUDs may be used during breastfeeding whether or not they also include copper. Sterilization Surgical sterilizationis available in the form oftubal ligationfor women andvasectomyfor men. There are no remarkable long term side effects and tubal ligation decreases the risk ofovarian cancer. Some women regret such a decision about 5% over 30 years, and about 20% under 30. Short term complications are less likely from a vasectomy than a tubal ligation. incomplete method offers surety fromsexually transmitted nfections. Although sterilization is considered a permanent procedure, it is possible to attempt atubal reversalto reconnect theFallopian tubesin females or avasectomy reversalto reconnect thevasa deferentiain males. The rate of success depends on the original technique, tubal damage, and the persons age. Behavioral Behavioral methods involveregulating the timingor methods of intercourse to prevent introduction of sperm into the female reproductive tract, either altogether or when an egg may be present. LactationalFrom ancient times women have extended breastfeeding in an effort to avoid a new pregnancy. Thelactational amenorrhea method, or LAM, outlines guidelines for determining the length of a womans period of breastfeeding infertility. For women who meet the criteria, LAM is highly effective during the first six mont hs postpartumif breastfeeding is the infants only (or almost only) source of nutrition. Feeding formula, pumping instead of nursing, and feeding solids all reduce the effectiveness of LAM. Fertility awarenessCalendar-based contraceptive methodssuch as the discredited musical rhythm method and theStandard Days Methodestimate the likelihood of fertility based on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to a womans least fertile period. During her most fertile period, barrier methods may be used, or she may abstain from intercourse. The term natural family planning (NFP) is sometimes used to refer to any use of fertility awareness methods. However, this term specifically refers to the practices that are permitted by theRoman Catholic Church.The effectiveness offertility awareness-based methods of contraception is unknown because of the lack of completed standardized and controlled scientific trials. More effective than calendar-based methods, systems of fertility awareness that track basal body temperature, cervical mucus, or both, are known as symptoms-based methods. Teachers of symptoms-based methods take care to distance their systems from the poor reputation of the rhythm method. Many consider the rhythm method to have been obsolete for at least 20 years, and some even exclude calendar-based methods from their definition of fertility awareness.A stave Beadsbirth control chain, used for a rough estimate of fertility based on days since menstruation TheStandard Days Methodhas a simpler rule set and is more effective than the rhythm method. The Standard Days Method has a typical failure rate of 12% per year. A product calledCycle Beadswas developed alongside the method to help the user keep track of estimated high and low fertility points during her menstrual cycle. The Standard Days Method may only be used by women whose cycles are always between 26 and 32 days in length.In this system * Da ys 1-7 of a womans menstrual cycle are considered infertile * Days 8-19 are considered fertile considered unsafe for unprotected intercourse * From Day 20, infertility is considered to soak up Symptoms-based methods of fertility awareness involve a womans observation and charting of her bodys fertility signs, to determine the fertile and infertile phases of her cycle. Charting may be done by hand or with the assistance offertility monitors. Most methods track one or more of the three primary fertility signschanges inbasal body temperature, in cervical mucus, and in cervical position.If a woman tracks both basal body temperature and another primary sign, the method is referred to as symptothermal. Other bodily cues such asmittelschmerzare considered unoriginal indicators. Unplanned pregnancy rates have been reported from 1% to 20% for typical users of the symptothermal method. Withdrawal Coitus interruptus(literally interrupted sexual intercourse), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse (pulling out) before ejaculation.The main risk of congress interruptus is that the man may not perform the maneuver correctly or in a timely manner. Despite older studies claiming that no sperm was found in preejaculatory penile secretion, a more recent study states that 41% of subjects produced pre-ejaculatory samples that contained spermatozoa and in 37% a reasonable proportion of the sperm was motile. moderation Though some groups advocate totalsexual abstinence, by which they mean the avoidance of all sexual activity, in the context of birth control the term usually means abstinence from vaginally penetrative sexual activity.Abstinence is 100% effective in preventing pregnancy however, not everyone who intends to be abstinent refrains from all sexual activity, and in many populations in that respect is a significant risk of pregnancy from nonconsensual sex. Abstinence-only sex educationdoes not reduceteen pregnancy . Teen pregnancy rates are higher in students given abstinence only education, compared to comprehensive sex education. Some authorities recommend that those using abstinence as a primary method have backup method(s) available (such as condoms or emergency contraceptive pills).Non-penetrativeandoral sex will generally avoid pregnancy, but pregnancy can mute occur withIntercrural sexand other forms of penis-near-vagina sex (genital rubbing, and the penis exiting fromanal intercourse) where semen can be deposited near the entrance to the vagina and can itself start along the vaginas lubricating fluids. Emergency (after sex) Emergency contraceptives, or morning-after pills, are drugs taken after sexual intercourse intended to prevent pregnancy. Levonorgestrel(progestin) pills, marketed as Plan B and succeeding(prenominal) Choice, are available without prescription (to women and men aged 17 and older in the U.S. ) to prevent pregnancy when used within 72 hours (3 days) after unprotec ted sex or condom failure. Ulipristal(Ella) is the newest emergency contraceptive, available by prescription only for use up to 120 hours (5 days) after unprotected sex, resulting in a pregnancy risk 42% lower than levonorgestrel up to 72 hours and 65% lower in the first 24 hours following sex. Providing morning after pills to women in advance does not affect sexually transmitted infection rates, condom use, pregnancy rates, or sexual risk-taking behavior. Pharmacistsare a major source of access to emergency contraception.Morning after pills have almost no health risk, no matter how often they are used. Copper T-shaped IUDs can also be used as emergency contraceptives. Copper IUDs can be inserted up to the time of implantation (612 days after ovulation) but are generally not inserted more than tail fin days after unprotected sex. For every eight expected pregnancies, the use of levonorgestrel morning after pills will prevent seven. Ulipristal is about double as effective as levonorg estrel. Copper IUDs are more than 99% effective in reducing pregnancy risk.Family PlanningReal Distinction between the Natural Family Planning to the Artificial Family Planning What is Family Planning? What are the differences between the Natural and Artificial Family Planning? Family planningis theplanningof when to havechildren,and the use ofbirth control and other techniques to implement such plans. Other techniques commonly used include sexuality education,prevention and management ofsexually transmitted infections, pre-conception counselingandmanagement, andinfertility management.Family planning is sometimes used as a synonym for the use ofbirth control, however, it often includes a wide variety of methods, and practices that are not birth control. It is most usually applied to afemale-malecouple who wish to limit the number of children they have and/or to control the timing ofpregnancy(also known asspacing children). Family planning may encompasssterilization, as well asaborti on.Family planning services are defined as educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved. Natural family planning(NFP) comprises thefamily planningmethods approved by the Roman Catholic Church. In accordance with the Churchs teachings regardingsexual behaviorin keeping with its philosophy of the dignity of the human person, NFP excludes the use of other methods ofbirth control, which it refers to as artificial contraception. Periodicabstinenceis the only method deemed moral by the Church for avoiding pregnancy. When used to avoid pregnancy, NFP limits sexual intercourse to naturally infertile periods portions of themenstrual cycle, during pregnancy, and aftermenopause. Various methods may be used to identify whether a woman is likely to befertile this information may be used in attempts to either avoid or achieve pr egnancy. There are three main types of NFP the symptoms-based methods, the calendar-based methods, and the breastfeeding orlactational amenorrhea method.Symptoms-based methods rely on biological signs of fertility, while calendar-based methods estimate the likelihood of fertility based on the length of past menstrual cycles. Clinical studies by theGuttmacher Institutefound that periodic abstinence resulted in a 25. 3 percent failure under typical conditions, though it did not differentiate between symptom-based and calendar-based methods. Symptoms-based Some methods of NFP track biological signs of fertility. When used outside of the Catholic concept of NFP, these methods are often referred to simply asfertility awareness-based methodsrather than NFP.The three primary signs of a womans fertility are herbasal body temperature, hercervicalmucus, and her cervical position. Computerizedfertility monitorsmay track basal body temperatures, hormonal levels in urine, changes in electrical r esistance of a womans saliva or a mixture of these symptoms. From these symptoms, a woman can learn to assess her fertility without use of a computerized device. Some systems use only cervical mucus to determine fertility. Two well-known mucus-only methods are theBillings ovulation methodand theCreighton Model Fertility Care System.If two or more signs are tracked, the method is referred to as a symptothermal method. Two popular symptothermal systems are taught by theCouple to Couple Leagueand the Fertility Awareness Method (FAM) taught byToni Weschler. A study completed in Germany in 2007 found that the symptothermal method has a method effectiveness of 99. 6%. In Canada, the symptothermal method is taught bySERENA Canadawhich is an inter-denominational organization which has been developing the Symptothermal Method as a part of NFP since 1955.They are also not specifically affiliated with the Roman Catholic Church. It is also taught byJustisse Healthworks for Women, a pro-choice f eminist organization that allows and supports women to combine other methods of birth control with their fertility awareness practice. A study by the World Health Organization involving 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found that 93% could accurately interpret their bodys signals regardless of education and culture. In a 36-month study of 5,752 women, the method was 99. 86% effective. Calendar-basedCalendar-based methods determine fertility based on a record of the length of previous menstrual cycles. They include the Rhythm Method and the Standard Days Method. The Standard Days method was developed and proven by the researchers at the Institute for Reproductive Health of Georgetown University. CycleBeads, unaffiliated with religious teachings, is a visual tool based on the Standard Days method. According to the Institute of Reproductive Health, when used as birth control, CB has a 95% effectiveness rating. Computer programs are avai lable to help track fertility on a calendar.Lactational amenorrhea Thelactational amenorrhea method(LAM) is a method of avoiding pregnancy based on the naturalpostpartuminfertilitythat occurs when a woman isamenorrheicand fullybreastfeeding. The rules of the method help a woman identify and possibly lengthen her infertile period. A strict version of LAM is known asecological breastfeeding. Artificial Family Planning/Birth Control, also known ascontraceptionandfertility control, refers to methods or devices used to preventpregnancy. Planning and provision of birth control is calledfamily planning.Safe sex, such as the use of male orfemale condoms, can also help prevent transmission ofsexually transmitted diseases. Contraceptive use indeveloping countries has cut the number ofmaternal deathsby 44% (about 270,000 deaths averted in 2008) but could prevent 73% if the full demand for birth control were met. Becauseteenage pregnanciesare at greater risk of adverse outcomes such aspreterm b irth,low birth weight andinfant mortality, adolescents need comprehensivesex educationand access to reproductive healthservices, including contraception.By lengthening the time between pregnancies, birth control can also improve adult womens delivery outcomes and the survival of their children. Effective birth control methods includebarrierssuch ascondoms,diaphragms, and the contraceptive spongehormonal contraceptionincludingoral pills,patches,vaginal rings, and injectable contraceptives andintrauterine devices(IUDs). Emergency contraceptioncan prevent pregnancy after unprotected sex. Long-acting reversible contraceptionsuch as implants, IUDs, or vaginal rings are recommended to reduceteenage pregnancy.Sterilizationby means such asvasectomyandtubal ligationis permanent contraception. Some people regardsexual abstinenceas birth control, butabstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sexandoral sexare als o sometimes considered contraception. Birth control methods have been used since ancient times, but effective and safe methods only became available in the 20th century. For some people, contraception involves moral issues, and many cultures limit access to birth control due to the moral and political issues involved.About 222 million women who want to avoid pregnancy in developing countries are not using a modern contraception method. Birth control increaseseconomic growthbecause of fewer dependent children, more women participating in the work force, and less consumption of scarce resources. Womens earnings, assets,body mass index, and their childrens schooling and body mass index all substantially improve with greater access to contraception. Methods of Artificial Family Planning Artificial Family Planning/Birth control includesbarrier methods,hormonal contraception,intrauterine devices(IUDs), sterilization, and behavioral methods.Hormones can bedelivered by injection, by mouth ( orally),placed in the vagina, or implanted under the skin. The most common types of oral contraception include thecombined oral contraceptive pilland theprogestogen-only pill. Methods are typically used before sex butemergency contraceptionis effective shortly after intercourse. Determining whether a woman with one or more illnesses, diseases, risk factors, or abnormalities can use a particular form of birth control is a complex medical question sometimes requiring apelvic examinationor medical tests.TheWorld Health Organization publishes a detailed list of medical eligibility criteria for each type of contraception. Birth control methods * An unrolled malelatex condom * A polyurethanefemale condom * Adiaphragmvaginal-cervicalbarrier, in its case with aquarter U. S. cointo show scale * Acontraceptive spongeset inside its open package * Three varieties ofbirth control pillsin calendar oriented packaging * A transdermal contraceptive patch * ANuva Ringvaginal ring * A hormonalintraute rine device(IUD) against a background showing placement in theuterus *A copper IUD next to a dimeto show scale * A split dose of two emergency contraceptive pills (most morning after pills now only require one) Barrier Barrier contraceptivesare devices that attempt to preventpregnancyby physically preventingspermfrom entering theuterus. They include malecondoms,female condoms,cervical caps,diaphragms, andcontraceptive spongeswithspermicide. The condom is most commonly used duringsexual intercourseto reduce the likelihood ofpregnancyand of spreadingsexually transmitted diseases(STDssuch asgonorrhea,syphilis, andHIV).It is put on a mans erectpenisand physically blocks ejaculated semen from entering the body of a sexual partner. Modern condoms are most often made fromlatex, but some are made from other materials such aspolyurethane,polyisoprene, or lamb intestine. Afemale condomis also available, most often made ofnitrile. Male condoms have the advantage of being inexpensive, easy to u se, and having few side effects. Contraceptive sponges combine a barrier with spermicide. Like diaphragms, they are inserted vaginally prior to intercourse and must be placed over thecervixto be effective.Typical effectiveness during the first year of use is about 84% overall, and 68% among women who have already given birth. The sponge can be inserted up to 24 hours before intercourse and must be left in place for at least six hours afterward. Some people are allergic to spermicide used in the sponge. Women who use contraceptive sponges have an increased risk ofyeast infectionsandurinary tract infections. Leaving the sponge in for more than 30 hours can result intoxic shock syndrome. Hormonal Hormonal contraceptivesinhibitovulationandfertilization.These includeoral pills,subdermalimplants, andinjectable contraceptivesas well as thepatch,hormonal IUDsand thevaginal ring. The most commonly used hormonal contraceptive is thecombined oral contraceptive pillcommonly known as the pillwhi ch includes a combination of anestrogenand aprogestin(progestogen). There is also a progestin-only pill. Currently, hormonal contraceptives are available only for females. Combined hormonal contraceptives are associated with a slight increased cardiovascular risk, including a small increased risk ofvenousandarterial thrombosis. However, the benefits are greater than the risk.Oral contraceptives reduce the risk ofovarian cancerandendometrial cancerwithout increasing the risk forbreast cancer. They can lower body weight by reducingwater retention(not loss of fat), and several are used to treat mild to moderateacne. Between 2% and 10% of women of childbearing age experience emotional and physical symptoms associated withpremenstrual syndrome(PMS) andpremenstrual dysphoric disorder(PMDD). Combination hormonal contraceptives often ameliorate or effectively treat these problems and can effectively treat heavy menstrual bleeding anddysmenorrhea(painful menstruation) as well.Lower doses of estrogen required by vaginal administration (i. e. , from the vaginal ring or hormonal IUDs instead of the pill) may reduce the untoward side effects associated with higher oral doses such as breast tenderness,nausea, and headache. Progestogen-only pills and intrauterine devices are not associated with an increased risk of thromboses and may be used by women with previous venous thrombosis, or hepatitis. In those with a history of arterial thrombosis, non-hormonal birth control should be used. Progestogen-only pills may improve menstrual symptoms such sdysmenorrhea,menorrhagia, premenstrual syndrome, and anemia, and are recommended for breast-feeding women because they do not affect lactation. Irregular bleeding can be a side effect of progestin-only methods, with about 20% of users reportingamenorrhea(often considered a benefit) and about 40% of women experiencing regular menstrual cycles, leaving the remaining 40% with irregular spotting or bleeding. Uncommon side effects of proge stin-only pills, injections, and implants include headache, breast tenderness, mood effects, anddysmenorrhea, but those symptoms often resolve with time.Newer progestins, such as drospirenone and desogestrel, minimize theandrogenicside effects of their predecessors. Intrauterine devices The modernintrauterine device(IUD) is a small T-shaped birth control device, containing either copper or progesterone, which is inserted into the uterus. IUDs are a form oflong-acting reversible contraception, the most effective type of reversible birth control. As of 2002, IUDs were the most widely used form of reversible contraception, with nearly 160 million users worldwide. Evidence supports both effectiveness and safety in adolescents.Advantages of the copper IUD include its ability to provideemergency contraceptionup to five days after unprotected sex. It is the most effective form of emergency contraception available. It contains no hormones, so it can be used while breast feeding, and fertili ty returns quickly after removal. Disadvantages include the possibility of heavier menstrual periods and more painful cramps. Hormonal IUDs do not increase bleeding as copper-containing IUDs do. Rather, they reduce menstrual bleeding or stop menstruation altogether, and can be used as a treatment forheavy periods.Levonorgestrel-releasing IUDs may be used during breastfeeding whether or not they also include copper. Sterilization Surgical sterilizationis available in the form oftubal ligationfor women andvasectomyfor men. There are no significant long term side effects and tubal ligation decreases the risk ofovarian cancer. Some women regret such a decision about 5% over 30 years, and about 20% under 30. Short term complications are less likely from a vasectomy than a tubal ligation. Neither method offers protection fromsexually transmitted nfections. Although sterilization is considered a permanent procedure, it is possible to attempt atubal reversalto reconnect theFallopian tubesin females or avasectomy reversalto reconnect thevasa deferentiain males. The rate of success depends on the original technique, tubal damage, and the persons age. Behavioral Behavioral methods involveregulating the timingor methods of intercourse to prevent introduction of sperm into the female reproductive tract, either altogether or when an egg may be present. LactationalFrom ancient times women have extended breastfeeding in an effort to avoid a new pregnancy. Thelactational amenorrhea method, or LAM, outlines guidelines for determining the length of a womans period of breastfeeding infertility. For women who meet the criteria, LAM is highly effective during the first six months postpartumif breastfeeding is the infants only (or almost only) source of nutrition. Feeding formula, pumping instead of nursing, and feeding solids all reduce the effectiveness of LAM. Fertility awarenessCalendar-based contraceptive methodssuch as the discredited rhythm method and theStandard Days Methode stimate the likelihood of fertility based on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to a womans least fertile period. During her most fertile period, barrier methods may be used, or she may abstain from intercourse. The term natural family planning (NFP) is sometimes used to refer to any use of fertility awareness methods. However, this term specifically refers to the practices that are permitted by theRoman Catholic Church.The effectiveness offertility awareness-based methods of contraception is unknown because of the lack of completed standardized and controlled scientific trials. More effective than calendar-based methods, systems of fertility awareness that track basal body temperature, cervical mucus, or both, are known as symptoms-based methods. Teachers of symptoms-based methods take care to distance their systems from the poor reputation of the rhythm method. Many consider the rhythm method to have been obsolete for at least 20 years, and some even exclude calendar-based methods from their definition of fertility awareness.ACycle Beadsbirth control chain, used for a rough estimate of fertility based on days since menstruation TheStandard Days Methodhas a simpler rule set and is more effective than the rhythm method. The Standard Days Method has a typical failure rate of 12% per year. A product calledCycle Beadswas developed alongside the method to help the user keep track of estimated high and low fertility points during her menstrual cycle. The Standard Days Method may only be used by women whose cycles are always between 26 and 32 days in length.In this system * Days 1-7 of a womans menstrual cycle are considered infertile * Days 8-19 are considered fertile considered unsafe for unprotected intercourse * From Day 20, infertility is considered to resume Symptoms-based methods of fertility awareness involve a womans observation and charting of her bodys fertility signs, to determi ne the fertile and infertile phases of her cycle. Charting may be done by hand or with the assistance offertility monitors. Most methods track one or more of the three primary fertility signschanges inbasal body temperature, in cervical mucus, and in cervical position.If a woman tracks both basal body temperature and another primary sign, the method is referred to as symptothermal. Other bodily cues such asmittelschmerzare considered secondary indicators. Unplanned pregnancy rates have been reported from 1% to 20% for typical users of the symptothermal method. Withdrawal Coitus interruptus(literally interrupted sexual intercourse), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse (pulling out) before ejaculation.The main risk of coitus interruptus is that the man may not perform the maneuver correctly or in a timely manner. Despite older studies claiming that no sperm was found in preejaculatory penile secretion, a more recent study stat es that 41% of subjects produced pre-ejaculatory samples that contained spermatozoa and in 37% a reasonable proportion of the sperm was motile. Abstinence Though some groups advocate totalsexual abstinence, by which they mean the avoidance of all sexual activity, in the context of birth control the term usually means abstinence from vaginally penetrative sexual activity.Abstinence is 100% effective in preventing pregnancy however, not everyone who intends to be abstinent refrains from all sexual activity, and in many populations there is a significant risk of pregnancy from nonconsensual sex. Abstinence-only sex educationdoes not reduceteen pregnancy. Teen pregnancy rates are higher in students given abstinence only education, compared to comprehensive sex education. Some authorities recommend that those using abstinence as a primary method have backup method(s) available (such as condoms or emergency contraceptive pills).Non-penetrativeandoral sex will generally avoid pregnancy, bu t pregnancy can still occur withIntercrural sexand other forms of penis-near-vagina sex (genital rubbing, and the penis exiting fromanal intercourse) where semen can be deposited near the entrance to the vagina and can itself travel along the vaginas lubricating fluids. Emergency (after sex) Emergency contraceptives, or morning-after pills, are drugs taken after sexual intercourse intended to prevent pregnancy. Levonorgestrel(progestin) pills, marketed as Plan B and Next Choice, are available without prescription (to women and men aged 17 and older in the U.S. ) to prevent pregnancy when used within 72 hours (3 days) after unprotected sex or condom failure. Ulipristal(Ella) is the newest emergency contraceptive, available by prescription only for use up to 120 hours (5 days) after unprotected sex, resulting in a pregnancy risk 42% lower than levonorgestrel up to 72 hours and 65% lower in the first 24 hours following sex. Providing morning after pills to women in advance does not aff ect sexually transmitted infection rates, condom use, pregnancy rates, or sexual risk-taking behavior. Pharmacistsare a major source of access to emergency contraception.Morning after pills have almost no health risk, no matter how often they are used. Copper T-shaped IUDs can also be used as emergency contraceptives. Copper IUDs can be inserted up to the time of implantation (612 days after ovulation) but are generally not inserted more than five days after unprotected sex. For every eight expected pregnancies, the use of levonorgestrel morning after pills will prevent seven. Ulipristal is about twice as effective as levonorgestrel. Copper IUDs are more than 99% effective in reducing pregnancy risk.