1h0 lNlI) FIlj h0Ih00I

$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos

Method Brief Description/ Usage Advantages Disadvantages Side Effects/
Contraindications
1. Natural Methods ( lnvolves no lnLroducLlon of chemlcal
or forelgn maLerlal lnLo Lhe body or
susLalnlng from sexual lnLercourse
durlng a ferLlle perlod
( @hese meLhods do noL lnLerrupL or
alLer ferLlllLy regnancy ls posslble
as soon as Lhls meLhod ls
abandoned

a. Abstinence ( efralnlng from sexual relaLlons
( as LheoreLlcal 0 fallure raLe
( -o cosL
( ,osL effecLlve way Lo prevenL S@s
( no medlcal or hormonal slde effecLs
( lgh moLlvaLlon needed hlghly
unrellable


b. Calendar Metbod ( equlres a couple Lo absLaln from
colLus (sexual relaLlons) on Lhe days
of mensLrual cycle when Lhe woman
ls mosL llkely Lo concelve(34 days
before unLll 34 days afLer ovulaLlon)
( @o plan for Lhls woman keeps a
dlary of slx mensLrual cycles
( @o calculaLe safe" days she
subLracLs 18 from Lhe shorLesL cycle
documenLed (Lhls represenLs her
flrsL ferLlle day) She subLracLs 11
from her longesL cycle (Lhls
represenLs her lasL ferLlle day)
( @o avold pregnancy she would avold
colLus durlng ferLlle days
( -o cosL
( oesn'L expose a woman Lo
synLheLlc hormones
( equlres moLlvaLlon and
cooperaLlon
( @lme lnLenslve and requlrlng efforL
Lo esLabllsh perlods of ferLlllLy
( -oL a good blrLh conLrol meLhod for
women who have lrregular perlods
or shorL cycles (less Lhan LwenLy
seven days)
( lmlLs Lhe number of days LhaL
lnLercourse ls safe wlLhouL rlsklng
pregnancy
( as Lhe hlghesL fallure raLe of any
form of blrLh conLrol

c. Basal Body
Temperature
( usL before Lhe day of ovulaLlon
LemperaLure of a woman's body
falls abouL 03H AL ovulaLlon her
88@ rlses a full degree
( @o use Lhls meLhod Lhe woman
Lakes her LemperaLure each
mornlng lmmedlaLely afLer waklng
wlLher orally or audlLory before she
Lakes any acLlvlLy (Lhls ls her 88@)
( As soon as she noLlces a sllghL dlp ln
LemperaLure followed by an
lncrease she knows LhaL she has
ovulaLed She refralns from havlng
colLus for Lhe nexL Lhree days
( -o cosL and ls easy Lo measure
( erfecL use of Lhls meLhod resulLs ln
a 2 per year pregnancy raLe

( equlres moLlvaLlon and cooperaLlon
( 88@ may be affecLed by many facLors
such as Laklng an anLlpyreLlc sLarLlng
an aeroblc program and worklng aL
nlghL shlfLs
( ouples wlll need Lo absLaln from
lnLercourse for a number of days
lncludlng Lhose lmmedlaLely around
ovulaLlon Lo be safe


1h0 lNlI) FIlj h0Ih00I
2$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
e. Symptotbermal
Metbod
( omblnes cervlcal mucus and 88@
meLhods
( Joman Lakes her LemperaLure dally
waLchlng for Lhe rlse ln LemperaLure
LhaL marks ovulaLlon She also
analyzes her cervlcal mucus
everyday and observes for oLher
slgns of ovulaLlon such as
mlLLelschmerLz (mldcycle abdomlnal
paln)
( @he couple musL absLaln from
lnLercourse unLll 3 days afLer Lhe rlse
ln LemperaLure or Lhe 4
Lh
day afLer
Lhe pea of mucus change because
Lhese are Lhe woman's ferLlle days
( ,ore effecLlve Lhan elLher Lhe 88@ or
Lhe cervlcal mucus meLhod alone
( @hls meLhod does noL cosL anyLhlng
and Lhere ls no need for medlcaLlons
or surgery
( @hls meLhod does noL lnLerrupL or
alLer ferLlllLy regnancy ls posslble as
soon as Lhls meLhod ls abandoned
( equlres moLlvaLlon and cooperaLlon


f. Lactation
Amenorrbea
( As long as a woman ls breasLfeedlng
an lnfanL Lhere ls a naLural
suppresslon of ovulaLlon
( ffecLlve for shorL Lerm

( @emporary measure noL rellable ls
lnfanL Lakes supplemenLal feedlngs
( 8ecause women may ovulaLe
however buL noL mensLruaLe a
woman may sLlll be ferLlle even lf she
has noL had a perlod slnce chlldblrLh

g. CoitusInterruptus
{Witbdrawal]
( ne of Lhe oldesL known meLhods of
conLracepLlon
( @he couple proceeds wlLh colLus unLll
Lhe momenL of e[aculaLlon Lhen Lhe
man wlLhdraws and spermaLozoa are
emlLLed ouLslde Lhe vaglna
( [aculaLlon may occur before
wlLhdrawal ls compleLe and desplLe
Lhe care used some spermaLozoa may
be deposlLed ln Lhe vaglna
( 8ecause Lhere may be a few
spermaLozoa presenL ln pree[aculaLlon
fluld ferLlllzaLlon may occur even lf
wlLhdrawal seems conLrolled

b. Post-Coital
Doucbing
( ouchlng followlng lnLercourse ( lneffecLlve as a conLracepLlve measure
as sperm may be presenL ln cervlcal
mucus as qulckly as 90 seconds afLer
e[aculaLlon




1h0 lNlI) FIlj h0Ih00I
3$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
Method Brief Description/ Usage Advantages Disadvantages Side Effects/
Contraindications
. Artificial Methods
a.se of Hormones
i. Pills {Ural],
UC{Ural Contraceptives,
CUC{Combination Ural
Contraceptives]
( omposed of varylng amounLs of
synLheLlc esLrogen comblned wlLh a
small amounL of synLheLlc
progesLerone (progesLln)
( @he esLrogen acLs Lo suppress S
and Lhereby suppresslng
ovulaLlon
( @he progesLerone acLlon
complemenLs LhaL of esLrogen by
causlng a decrease ln Lhe
permeablllLy of cervlcal mucus
Lhereby llmlLlng sperm moLlllLy and
access Lo ova rogesLerone also
lnLerferes wlLh Lubal LransporL and
endomeLrlal prollferaLlon Lo such
degrees LhaL Lhe posslblllLy of
lmplanLaLlon ls slgnlflcanLly
decreased
( s musL be prescrlbed by a
physlclan nurse pracLlLloner or nurse
mldwlfe afLer a pelvlc examlnaLlon
and a apanlcolau(ap) Smear
( @here ls decreased lncldences of
ysmenorrhea because of lack of
ovulaLlon
remensLrual dysphorlc syndrome
and acne because of Lhe
lncreased progesLerone levels
lron deflclency anemla because
of Lhe reduced amounL of
mensLrual flow
AcuLe pelvlc lnflammaLory dlsease
(l) and Lhe resulLlng Lubal
scarrlng
ndomeLrlal and ovarlan cancer
ovarlan cysLs and ecLoplc
pregnancles
lbrocysLlc breasL dlsease
osslbly osLeoporosls
endomeLrlosls uLerlne myomaLa
(flbrols uLerlne Lumors) and
progresslon of rheumaLold
arLhrlLls
olon cancer
( 8ecause esLrogen lnLerferes wlLh llpld
meLabollsm lL may lower Lhe
concenLraLlon of lowdenslLy
llpoproLelns () and lncrease Lhe
hlgh denslLy llpoproLeln () levels
( lf used correcLly Lhey are 997
effecLlve ln prevenLlng concepLlon
( ,usL be Laken conslsLenLly and
consclenLlously
( an lnLerfere wlLh glucose meLabollsm
( @he reLurn of ferLlllLy ls Lo be awalLed
for 12 monLhs
( ormonal meLhods Lhlcken cervlcal
secreLlons and Lrap bacLerla buL Lhey
cannoL proLecL Lhe ouLer genlLal skln
and vaglna agalnsL vlral or bacLerlal
lnfecLlons @hls means LhaL you are
sLlll aL rlsk of sexually LransmlLLed
dlseases
( ral conLracepLlves have lmporLanL
lnLeracLlons wlLh some selzure drugs
anLlbloLlcs anLlfungal agenLs and
oLher medlcaLlons decreaslng Lhe
blrLh conLrol effecLlveness ?ou should
Lalk Lo your docLor or pharmaclsL Lo be
sure LhaL oLher medlcaLlons you are
Laklng wlll noL decrease Lhe
effecLlveness of your blrLhconLrol
pllls
( Slde effecLs LhaL women may
experlence are
-ausea
JelghL galn
eadache
8reasL @enderness
8reakLhrough bleedlng (spoLLlng
ouLslde Lhe mensLrual perlod)
,onlllal vaglnal lnfecLlons
,lld hyperLenslon
epresslon
( onLralndlcaLed for women wlLh
8reasLfeedlng and less Lhan 6
weeks' posLparLum
Age 33 years or older and
smoklng 13 or more clgareLLes
per day
,ulLlple rlsk facLors for arLerlal
cardlovascular dlsease such as
older age smoklng dlabeLes
hyperLenslon
levaLed blood pressure of 160
mm g sysLollc or above or 100
mmg dlasLollc or above
urrenL or hlsLory of deep veln
Lhrombosls or pulmonary
embollsm
,a[or surgery LhaL requlres
prolonged lmmoblllzaLlon
urrenL or hlsLory of lschemlc
hearL dlsease
SLroke
ompllcaLed valvular hearL
dlsease
,lgralne wlLh focal neurologlc
1h0 lNlI) FIlj h0Ih00I
4$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
sympLoms (mlgralne wlLh aura)
,lgralne wlLhouL focal
neurologlc sympLoms and age 33
years or older
urrenL breasL cancer
labeLes wlLh nephropaLhy
reLlnopaLhy neuropaLhy
vascular dlsease or dlabeLes of
more Lhan 20 years duraLlon
Severe clrrhosls
lver Lumors
ii. In|ectable ( A slngle lnLramuscular ln[ecLlon of
medroxyprogesLerone aceLaLe (epo
rovera ,A) a progesLerone
glven every 12 weeks LhaL lnhlblLs
ovulaLlon alLers Lhe endomeLrlum and
changes Lhe cervlcal mucus
( o noL massage Lhe ln[ecLlon slLe afLer
admlnlsLraLlon as you wanL Lhe drug Lo
be absorbed by Lhe muscle slowly
( @he effecLlveness raLe ls almosL 100
maklng lL an lncreaslngly popular
conLracepLlve meLhod
( Slnce lL ls pure progesLerone lL can be
used durlng pregnancy endomeLrlal
cancer endomeLrlosls and for
unknown reasons reducLlon ln Lhe
frequency of slckle cell crlses
( as long Lerm rellablllLy
( @here ls no vlslble slgn LhaL a blrLh
conLrol measure ls belng used
( eporovera ls especlally useful for
women wlLh selzure dlsorders
because lL can be used wlLh selzure
medlcaLlons
( eporovera also decreases Lhe rlsk
of uLerlne cancer and pelvlc
lnflammaLory dlsease (l)
( ls noL prescrlbed Lo adolescenLs Lo
proLecL Lhelr bone mlneral denslLy
( Joman musL reLurn Lo a healLh care
provlder for a new ln[ecLlon every 4
12 weeks for Lhe meLhod Lo remaln
rellable
( @he reLurn of ferLlllLy ls ofLen delayed
by 612 monLhs
( erLlllLy may Lake slx Lo 18 monLhs Lo
reLurn afLer you dlsconLlnue use of
eporovera
( eporovera does noL proLecL agalnsL
lv/AlS or oLher sexually LransmlLLed
dlseases
( oLenLlal slde effecLs lnclude
lrregular mensLrual cycle
eadache
JelghL galn
epresslon
welghL galn
bloaLlng
halr loss
decreased sex drlve and
( ,ay lmpalr glucose Lolerance ln
women aL rlsk for dlabeLes
( @here may be an lncreased rlsk for
osLeoporosls from loss of bone
mlneral denslLy

iii. Transdermal
Contraception
( efers Lo paLches LhaL slowly buL
conLlnuously release a comblnaLlon of
esLrogen and progesLerone
( aLches are applled each week for 3
weeks and no paLch ls applled for Lhe
4
Lh
weeks
( urlng Lhe week on whlch Lhe woman
ls paLch free a mensLrual flow wlll
occur and afLer Lhe paLchfree week a
new cycle of 3 weeks on/ 1 week off
beglns agaln
( aLches can be worn ln Lhe shower
whlle baLhlng or whlle swlmmlng
( ave Lhe poLenLlal Lo lncrease
adherence because Lhe woman does
noL need Lo remember Lo Lake a dally
plll
( ess effecLlve ln women who welgh
more Lhan 90 kg (198 lb)
( lf paLch becomes loose for more Lhan
24 hours Lhe woman should remove lL
and lmmedlaLely replace lL wlLh a new
paLch whlch wlll sLarL a new 4week
cycle A back up conLracepLlon
meLhod ls needed Lo be used for Lhe
flrsL week of Lhls new cycle
( erLlllLy wlll noL reLurn for one Lo
Lhree monLhs afLer use of Lhe paLch ls
( ,lld breasL dlscomforL and lrrlLaLlon
aL Lhe appllcaLlon slLe may occur
( 8ecause Lhey conLaln esLrogen Lhey
have Lhe same rlsk for
LhromboembollLlc sympLoms
( annoL be placed on any area where
makeup loLlons or creams wlll be
applled aL Lhe walsL where bendlng
mlghL loosen Lhe paLch or any parLs
where Lhe skln ls red or lrrlLaLed or
has an open leslon
1h0 lNlI) FIlj h0Ih00I
S$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
( aLches may be applled Lo one of Lhe
followlng areas upper ouLer arm
upper Lorso (fronL or back excludlng
Lhe breasLs) abdomen or buLLocks
dlsconLlnued
( @he paLch does noL proLecL agalnsL
sexually LransmlLLed dlseases


iv. aginal Insertion {Nuva
Ring]
( ls a slllcone rlng LhaL surrounds Lhe
cervlx and conLlnually releases a
comblnaLlon of esLrogen and
progesLerone
( lL ls lnserLed vaglnally by Lhe woman
and lefL ln place for 3 weeks Lhen
removed for 1 week ,ensLrual
bleedlng occurs durlng Lhe rlng free
week
( @he hormones released are absorbed
dlrecLly by Lhe mucous membrane of
Lhe vaglna Lhereby avoldlng a flrsL
pass" Lhrough Lhe llver
( ffecLlveness ls equal Lo LhaL of s
( ffecL ls local and ls bypasslng Lhe llver
Lhereby avoldlng damage Lo Lhe organ
( erLlllLy reLurns lmmedlaLely afLer
dlsconLlnulng uslng Lhe rlng
( @he rlng flLs securely lnslde Lhe vaglna
rarely becomes dlslodged durlng
lnLercourse and does noL lrrlLaLe Lhe
vaglnal or cervlcal Llssue
( Jomen may need Lo make a calendar
LhaL Lhey posL consplcuously Lo
remlnd Lhemselves Lo remove and
replace Lhe rlng
( Jomen may need Lo be encouraged
Lo use vaglnal rlngs as lnLroduclng a
rlng vaglnally may aL flrsL seem
compllcaLed Lhan Laklng a plll
everyday
( ould lnLerfere wlLh sexual en[oymenL
( @he vaglnal rlng does noL proLecL
agalnsL sexually LransmlLLed dlseases
( Some women experlence vaglnal
dlscomforL
( Jomen who cannoL LoleraLe
esLrogens should noL use Lhe vaglnal
rlng for blrLh conLrol
v. Implantation ( lve subdermal lmplanLs rods Lhe slze
of pencll lead are embedded [usL
under Lhe skln on Lhe lnslde of Lhe
upper arm
( @he rods conLaln eLonogeLrel Lhe
meLabollLe of desogesLrel Lhe same
progesLln LhaL ls used ln Lhe -uvalng
( nce embedded Lhe lmplanLs appear
as lrregular llnes on Lhe skln
slmulaLlng small velns ver Lhe nexL
33 years Lhe lmplanLs slowly release
Lhe hormone suppresslng ovulaLlon
sLlmulaLlng Lhlck cervlcal mucus and
changlng Lhe endomeLrlum so LhaL
lmplanLaLlon ls dlfflculL
( @he lmplanLs are lnserLed wlLh Lhe use
of a local anesLheLlc durlng Lhe menses
or no laLer Lhan day 7 of Lhe mensLrual
cycle Lo be cerLaln LhaL Lhe woman ls
noL pregnanL aL Lhe Llme of lnserLlon
( an be lnserLed lmmedlaLely afLer an
elecLlve LermlnaLlon of pregnancy or 6
weeks afLer Lhe blrLh of a baby
( allure raLe ls less Lhan 1
( lL ls long Lerm and ls reverslble
( ffers an effecLlve and rellable
alLernaLlve Lo Lhe esLrogenrelaLed
slde effecLs of s
( Sexual en[oymenL as noL lnhlblLed as
may happen wlLh condoms
spermlcldes dlaphragms and naLural
famlly plannlng meLhods
( an be used durlng breasLfeedlng
wlLhouL effecL on mllk producLlon
( an be safely used by adolescenLs
( apld reLurn of ferLlllLy (3 monLhs
afLer removal) ls an advanLage for
women who wlsh Lo have chlldren
( An lmplanL may reduce Lhe rlsk of
ma[or pelvlc lnfecLlons
( lL cosLs $300 on average
( Scarrlng aL Lhe lnserLlon slLe
( -eed for removal
( lmplanLs do noL proLecL agalnsL
sexually LransmlLLed dlseases
( Slde effecLs lnclude
JelghL galn
lrregular mensLrual cycle such as
spoLLlng break Lhrough bleedlng
amenorrhea or prolonged perlods
epresslon

b. ID ( Small plasLlc ob[ecL LhaL ls lnserLed
lnLo Lhe uLerus Lhrough Lhe vaglna
( nly one lnserLlon ls necessary so
Lhere ls no conLlnulng expense
( Jomen have Lo regularly check lu
afLer each mensLrual flow Lo make
( Slde effecLs are as follows
spoLLlng or uLerlne cramplng 23
1h0 lNlI) FIlj h0Ih00I
6$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
( @houghL Lo prevenL ferLlllzaLlon as well
as creaLlng a local sLerlle lnflammaLory
condlLlon LhaL prevenLs lmplanLaLlon
Jhen copper ls added Lo Lhe devlce
sperm moblllLy appears Lo be affecLed
as well and Lhls decreases Lhe
posslblllLy LhaL sperm wlll successfully
cross Lhe uLerlne space and for lL Lo
reach Lhe ovum
( lu musL be flLLed by a physlclan
nurse pracLlLloner or nurse mldwlfe
who performs a ap LesL and pelvlc
examlnaLlon
( @he devlce ls lnserLed ln a collapsed
poslLlon and Lhen enlarged Lo lLs flnal
shape ln Lhe uLerus when Lhe lnserLer
ls wlLhdrawn
( @he progesLerone ln Lhe drug reservolr
gradually dlffuses lnLo Lhe uLerus
Lhrough Lhe plasLlc lL boLh prevenLs
endomeLrlum prollferaLlon and
Lhlckens cervlcal mucus
( lus may be effecLlve for 310 years
and musL be removed and replaced
afLer
( @he devlce does noL requlre dally
aLLenLlon or lnLerference wlLh sexual
en[oymenL
( lL ls approprlaLe for women who are aL
rlsk for compllcaLlons assoclaLed wlLh
s or who wlsh Lo avold some of
Lhe sysLemaLlc hormonal slde effecLs
( ,ay creaLe llghLer or fewer perlods
( erLlllLy reLurns as soon as Lhe lu ls
removed
( ?our healLhcare provlder can remove
your lu qulckly and easlly aL your
requesL
( @he lu ls hlghly effecLlve ln
prevenLlng pregnancy even more so
Lhan Lhe blrLhconLrol plll
sure LhaL Lhe lu sLrlng ls ln place and
Lo obLaln a yearly pelvlc exam
( SomeLlmes Lhe lu can move ouL of
poslLlon and pass ouL of Lhe vaglna
Lhls ls known as expulslon arely Lhe
devlce puncLures Lhe uLerlne wall
passlng parLlally or compleLely
Lhrough lL
( SomeLlmes a sharp Llp ls creaLed aL
Lhe end of Lhe sLrlng and may be
boLhersome Lo your sexual parLner
durlng lnLercourse
( lus do noL proLecL agalnsL sexually
LransmlLLed dlseases (S@s) Jomen
aL rlsk of S@s should use a dlfferenL
meLhod of blrLh conLrol


weeks afLer lu lnserLlon
woman ls aL a hlgherLhanusual
rlsk for pelvlc lnflammaLory dlsease
(l)
@here may be heavler Lhan usual
flow for 2 or 3 monLhs and more
dysmenorrhea Lhan oLher women
@oxlc Shock Syndrome (a
sLaphylococcal lnfecLlon from Lhe
use of Lampons)
( onLralndlcaLed for women wlLh
an lncreased rlsk for conLracLlng
S@s such as Lhose who have
mulLlple sexual parLners
who have never been pregnanL
(Lhelr small uLerus could be
puncLured wlLh lnserLlon)
hlsLory of l
dlsLorLed uLerus (devlce mlghL
perforaLe an abnormally shaped
uLerus)
severe dysmenorrhea
menorrhagla (bleedlng beLween
mensLrual perlods)
hlsLory of ecLoplc pregnancy
valvular hearL dlsease
anemla
c.Barrier Metbods ( orms of blrLh conLrol LhaL work by Lhe
placemenL of a chemlcal or oLher
barrler beLween Lhe cervlx and
advanclng sperm so LhaL sperm cannoL
enLer Lhe uLerus or falloplan Lubes and
ferLlllze Lhe ovum
( @hey lack Lhe hormonal slde effecLs
assoclaLed wlLh s
( use of a Lhese barrlers does noL
lnLerfere wlLh a mans or a womans
chance of concelvlng a chlld ln Lhe
fuLure regnancy ls posslble
whenever sexual lnLercourse occurs
wlLhouL a condom
( @helr fallure raLes are hlgher and
sexual en[oymenL may be lessened

i. Mecbanical ( Jork by blocklng Lhe enLrance of
sperm lnLo Lhe cervlx

D|aphragm a clrcular rubber dlsk
LhaL ls placed over Lhe cervlx before
lnLercourse prescrlbed and flLLed by a
( Allows sexual relaLlons durlng menses
( ,ay offer some proLecLlon agalnsL
S@s
( rescrlpLlon ls needed
( lncreases Lhe rlsk for urlnary LracL
lnfecLlon
( onLralndlcaLed for women wlLh
rolapsed reLroflexed or
anLeflexed uLerus Lo such a degree
1h0 lNlI) FIlj h0Ih00I
$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
physlclan nursepracLlLloner or nurse
mldwlfe Lo ensure a correcL flL should
remaln ln place for aL leasL 624 hours
afLer colLus
( lf woman becomes pregnanL whlle
uslng a dlaphragm Lhere ls no rlsk of
harm Lo feLus
( an be used for several days lf deslred

( use of vlbraLor as parL of Lhe foreplay
frequenL penlle lnserLlon or Lhe
womansuperlor poslLlon durlng colLus
may dlslodge Lhe dlaphragm
( Jomen should have Lhe flL of Lhe
dlaphragm regularly checked lf Lhere ls
galn or loss of more Lhan 13 lb or
lncldence LhaL may change Lhe shape
of Lhe cervlx such as pregnancy
mlscarrlage cervlcal surgery or
elecLlve LermlnaLlon of pregnancy
LhaL Lhe cervlx ls also dlsplaced ln
relaLlon Lo Lhe vaglna
lnLruslon on Lhe vaglna by a
cysLocele or recLocele
AcuLe cervlclLls
aplllomavlrus lnfecLlon
lsLory of Loxlc shock syndrome
Allergy Lo rubber spermlcldes
lsLory of recurrenL u@ls
rv|ca|apmade of sofL rubber
are shaped llke a Lhlmble wlLh a Lhln
rlm and a flL snugly over Lhe uLerlne
cervlx musL be flLLed by a healLh care
provlder
( an remaln ln place longer Lhan
dlaphragms because Lhey do noL puL
pressure on Lhe vaglnal walls or
ureLhra (should noL exceed 48 hours
Lo prevenL cervlcal lrrlLaLlon
( an be used for several days lf deslred
( ,ay be dlfflculL Lo lnserL and can
lrrlLaLe cervlx
( @end Lo dlslodge more readlly Lhan
dlaphragms durlng colLus
( onLralndlcaLed for women wlLh
An abnormally shorL or long cervlx
A prevlous abnormal ap smear
A hlsLory of @SS
An allergy Lo laLex or spermlclde
A hlsLory of l cervlclLls or v
lnfecLlon
lsLory of cervlcal cancer
undlagnosed vaglnal bleedlng
,a|ma laLex rubber or
synLheLlc sheaLh LhaL ls placed over
Lhe erecL penls before colLus Lo Lrap
sperm
( @hey are one of Lhe few male
responslblllLy" blrLh conLrol measures
avallable and no healLh care vlslL or
prescrlpLlon ls needed
( ave Lhe addlLlonal poLenLlal of
prevenLlng Lhe spread of S@s and
Lhelr use has become a ma[or parL of
Lhe flghL Lo prevenL lnfecLlon wlLh lv
( A new condom musL be used each
Llme you have lnLercourse
( ,ay lnLerrupL sexual en[oymenL slnce
Lhe penls (wlLh condom held carefully
ln place) musL be wlLhdrawn before lL
beglns Lo become flaccld afLer
e[aculaLlon lf noL wlLhdrawn sperm
may leak
( -o conLralndlcaLlons are presenL
excepL for senslLlvlLy Lo laLex
ma|m laLex sheaLhs made
of polyureLhane and prelubrlcaLed
wlLh a spermlclde @he lnner rlng
(closed end) covers Lhe cervlx and Lhe
ouLer rlng (open end) resLs agalnsL Lhe
vaglnal openlng ,ay be lnserLed any
Llme before sexual acLlvlLy beglns and
removed afLer e[aculaLlon occurs




( ffers proLecLlon agalnsL boLh
concepLlon and S@s
( an be purchased wlLhouL prescrlpLlon
( lnLended for one Llme use only
( ,ore expenslve Lhan male condoms
( -oL used popularly because of Lhelr
bulk and dlfflculLy ln use
( -o conLralndlcaLlons are presenL
excepL for senslLlvlLy Lo laLex
1h0 lNlI) FIlj h0Ih00I
$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
ii. Cbemical ( Spermlclde ls an agenL LhaL causes Lhe
deaLh of spermaLozoa before Lhey can
enLer Lhe cervlx by spermlcldes and
lncreaslng vaglnal p Lo a sLrong acld
level
|srrams lnserLed lnLo Lhe
vaglna no more Lhan 1 hour before
colLus wlLh an appllcaLor and Lo
remaln Lhere for 6 hours afLer
||m|ycr| lmpregnaLed wlLh
spermlcldal agenL folded and
lnserLed vaglnally durlng precolLal
secreLlons Lhe fllm dlssolves and
carbon dloxlde foam forms Lo proLecL
Lhe cervlx
cara|ycr|based
vaglnal SupposlLorles fllled wlLh
spermlclde lnserLed vaglnally 13
mlnuLes before colLus Lhese dlssolve
and release Lhe spermlcldal
lngredlenLs
pgs foamlmpregnaLed
synLheLlc sponges LhaL are molsLened
Lo acLlvaLe Lhe lmpregnaLed
spermlclde and Lhen lnserLed
vaglnally Lo block sperm access Lo Lhe
cervlx should be lefL 6 hours afLer
colLus
( @hey may be purchased wlLhouL a
prescrlpLlon or an appolnLmenL wlLh a
healLh care provlder so Lhey allow for
greaLer lndependence and lower cosLs
( Jhen used ln con[uncLlon wlLh
anoLher conLracepLlve Lhey lncrease
Lhe oLher meLhod's effecLlveness
( varlous preparaLlons are avallable
lncludlng gels creams sponges fllms
foams and supposlLorles
( as noL effecL on breasLfeedlng
( @hey do noL offer proLecLlon agalnsL
S@s
( allure raLe ls abouL 20
( vaglnal leakage afLer use may be
boLhersome
( oam or molsLure may be lrrlLaLlng Lo
vaglnal and penlle Llssue durlng colLus
and Lherefore unable Lo use Lhem
( -oL recommended for women near
menopause as Lhls ls a Llme ln llfe
when vaglnal secreLlons are lessenlng
( onLralndlcaLed for women wlLh acuLe
cervlclLls and Lo couples who musL
prevenL concepLlon
d. Surgical Metbods
{sterilization]
( lncreases sexual en[oymenL because
Lhey largely ellmlnaLe Lhe posslblllLy of
pregnancy
( AdvanLageous for perlmenopausal
women who reallzes LhaL chlldbearlng
for her ls compleLe

i. Tubal Ligation ( alloplan Lubes are occluded by
cauLery crushlng clamplng or
blocklng Lhereby prevenLlng passage
of boLh sperm and ova
( @he mosL common operaLlon Lo
achleve Lubal llgaLlon ls
( AlLhough Lhe reason ls noL clear Lubal
llgaLlon ls assoclaLed wlLh a decreased
lncldence of ovarlan cancer
( Joman may resume colLus afLer 2 Lo
3 days afLer procedure
( lncreases sexual en[oymenL because
( ompllcaLlons lnclude bowel
perforaLlon hemorrhage and rlsks of
general anesLhesla wlLh Lhe procedure
( Abdomlnal bloaLlng for Lhe flrsL 24
hours and sharp dlaphragmaLlc or
shoulder paln due Lo Lhe 2
( onLralndlcaLed Lo women wlLh
umblllcal hernla
exLenslve obeslLy
( Some women may develop vaglnal
spoLLlng lnLermlLLenL vaglnal bleedlng
and even severe lower abdomlnal
1h0 lNlI) FIlj h0Ih00I
$ a g e SubmIffod by Snfrono Jndo I. Icnm SubmIffod fo Ms. CnroI !ufh !. VnIIos
|aparscpy(lnclslon LhroughL Lhe
umblllcus where elecLrlcal currenL ls
passed Lo coagulaLe Llssue or Lhe Lubes
are clamped by plasLlc meLal or
rubber rlngs)
( Lher ways lnclude c|scpy (a Lube
lnserLed Lhrough Lhe posLerlor fornlx
of Lhe vaglna) c|pmy (lnclslon
Lhrough Lhe vaglna) and essure ( a new
meLhod when lnserLed Lhrough Lhe
vaglna and uLerus lnLo Lhe ouLer end
of a falloplan Lube lL releases a sofL
mlcrolnserL lnLo Lhe Lube LhaL
effecLlvely seals Lhe Lube
lnserLlon
( A permanenL lrreverslble procedure
cramplng afLer Lhe procedure (osL
Lubal llgaLlon syndrome)
ii. asectomy ( A small lnclslon or puncLure wound ls
made on each slde of Lhe scroLum @he
vas deferens aL LhaL polnL ls Lhen
locaLed cuL and Lled cauLerlzed or
plugged blocklng Lhe passage of
spermaLozoa
( an be done under local anesLhesla ln
an ambulaLory seLLlng
( oes noL lnLerfere wlLh sperm
producLlon buL sperm does noL slmply
pass beyond Lhe severed vas deferens
( @he male wlll sLlll have capaclLy Lo
have full erecLlon capaclLy because he
also conLlnues Lo produce semlnal
fluld he wlll e[aculaLe semlnal fluld
lL wlll noL [usL conLaln sperm
( AlLhough colLus can be resumed one
week afLer surgery an addlLlonal blrLh
conLrol meLhod should be used wlLhln
6 monLhs unLll Lwo negaLlve sperm
reporLs have been obLalned
( ompllcaLlons may lnclude hemaLoma
aL Lhe surglcal slLe

( rocedure ls assoclaLed wlLh Lhe
developmenL of urollLhlasls (kldney
sLones)
( A few men may develop chronlc paln
afLer vasecLomy (posL vasecLomy paln
syndrome)
( Some men develop lmmunlLy or
anLlbodles agalnsL sperm so even lf
reconsLrucLlon ls done Lhe sperm
Lhey produce do noL have a good
moblllLy and are lncapable of
ferLlllzaLlon