Contraception

So you've decided to think about contraception. Congratulations on taking this important step for protecting your current and future health! On this page, you'll find a condensed version of the information on contraception that can be found in the paper version of the Women's Guide. This page differs from the paper version in that some of the more detailed explanations of how the specific contraceptive methods work have been reduced. But in their place are Internet links with more information than we could ever possibly include in the paper version. There's a lot of information out there, and just like with any other choice, healthcare or otherwise, one has to ultimately decide for themselves based on their lifestyle, beliefs, and comfort level.

It's always a good idea to talk to a professional about your specific needs and questions. For further information about specific forms of contraception, questions about pricing, or requests for referral, call Planned Parenthood's hotline at (312) 427 2275 from 9:00 A.M. to 5:00 P.M., Monday through Friday, or make an appointment with a Student Care Center (SCC) Womancare nurse practitioner. To make a Womancare appointment, call (773) 702-4156.

Hormonal Methods of Contraception

These methods function by releasing hormones into the body that prevent the release of an egg from the ovaries and also make the uterus an "unfriendly" environment for sperm. This is based on your body's hormonal menstrual cycle. Maybe this is something you've heard before, but just in case.

A Brief Review of Middle School Health Class

Menstruation is the process whereby the body discharges the uteran tissue if you are not pregnant. Menstruation, or your "period," occurs usually once a month. For an overview and more detailed information about menstruation, visit http://www.4woman.org/faq/menstru.htm. Sometimes women don't have a period, or "skip," even when they're not pregnant. There are several reasons why this might occur, and this site can tell you more about them.

Hormonal birth control works by stopping ovulation. Also, the hormones causes cervical mucus to stay thick and sticky, making it difficult for sperm to penetrate the cervix. Since hormonal methods interact with the body's natural processes and can affect them significantly, a prescription is required after a doctor has performed an examination, which usually includes a Pap smear. These methods protect only against pregnancy, and not against infection.

The Pill

What It Is:
The Pill is just that: a pill that delivers hormones to your body that stop ovulation and thicken cervical mucus.

How It Works:
This cute little movie can tell you all about the specifics and how your menstrual cycle works before and after the Pill.

Effectiveness:
One pill must be taken every day at about the same time every day for greatest effectiveness. If the Pill is used perfectly for one year by 100 woman, fewer than 1 will become pregnant. The actual rate of failure, however, can be as high as ten out of 100 because of incorrect usage. A typical rate of failure for the first year of use is three percent. Skipping more than two pills in a cycle can greatly increase a user's chances of becoming pregnant. If you think this might be a problem for you, then try taking your pill during a part of your daily routine, like brushing your teeth. Or try something like this ingenious Pill case that comes with an alarm to remind you.

Benefits:
One of the main benefits of the Pill is that it's highly effective if used properly. There are many other benefits related to the hormonal changes that the Pill causes.

Side Effects:
Nausea, weight gain, and changes in body hair are some of the side effects of Pill use. Usually these symptoms clear up after the first few months of regular use. People with some health conditions are not good candidates for the Pill, and you should speak openly with your doctor about your health when seeking the Pill.

Planned Parenthood offers further discussion of the benefits and side-effects of the Pill.

Cost:
The cost of the Pill depends on where it is obtained. From a personal physician, the expense is about $12 to $30 monthly. The Pill is less expensive if it is obtained from a clinic or an organization such as Planned Parenthood. Some brands of the Pill are available from $6 to $10 per pack from the U of C Hospital pharmacy with a student ID.

The MiniPill

What It Is:
The MiniPill is taken every day of the month, and unlike combination Pills, does not have "off" or placebo pills. It contains small amounts of progesterone only, and can be safely started after childbirth, miscarriage, or abortion. It is primarily recommended for lactating women, older women, women who do not want estrogen-related side effects, and diabetic women. Wondering about the difference between the Pill and the MiniPill?

Effectiveness:
The failure rate of the MiniPill if it is taken perfectly is about two to three percent (slightly higher than combination pill). Just like the Pill, the MiniPill needs to be taken everday, at the same time, for maximum effectiveness.

Benefits:
In addition to some of the benefits the Pill offers, some of the hormone-related side effects of the Pill are reduced, since the MiniPill has lower hormone dosages.

Side Effects:
In addition to similar side effects observed with the pill, sometimes the MiniPill can disrupt the menstrual cycle. In addition, women who use the MiniPill have increased risk of ectopic (tubal) pregnancies if they become pregnant while using the pill and an increased risk of ovarian cysts.

This site discusses the benefits, side-effects, and risks of the MiniPill.

Cost:
Depending on the brand of MiniPill, the pharmacy used, and the number of pills included, the MiniPill costs from $35 to $45 a month.

The Patch

The Patch acts in the same was as the Pill and the MiniPill to prevent pregnancy, except that it delivers hormones through the skin. It looks like a smoking cessation patch that is put on specific locations on the body and delivers hormones through the adhesive. The benefits and side effects are similar to those of the Pill. Planned Parenthood has a detailed discussion of the patch.

The manufacturer's website also answers some frequently asked questions about the Patch.

Nuva Ring (The Ring)

The Nuva Ring is similar to the Patch in preventing pregnancy, except that it releases hormones through a contraceptive ring placed against the cervix (e.g. inserted vaginally). Benefits and side-effects are similar to those of the Pill. The major advantage of the NuvaRing is that it has less "user error", since it is handled less frequently than the Pill. Planned Parenthood also has a detailed discussion of the Nuva Ring. Some frequently asked questions about Nuva Ring (and their answers, of course!) can be found here.

DepoProvera

What It Is:
DepoProvera is a hormone injection given every three months.

How To Start:
A full medical exam is required to obtain DepoProvera. A doctor will deliver the injections, and injections must occur every three months if the birth control is to remain effective.

Benefits:
DepoProvera prevents pregnancy and requires intake only once every three months, unlike daily pills.

Side Effects:
DepoProvera can cause menstrual irregularity and weight gain. DepoProvera has also been associated with a higher risk of breast cancer for women under 35. You should talk to your doctor about the most current studies regarding DepoProvera or any form of birthcontrol. Planned Parenthood has a detailed discussion of DepoProvera.

Cost:
Not including the expense of a doctor's visit, the cost of DepoProvera is $30 per three month injection.

Barrier Methods

The methods discussed below, which include the male and female condom and the diaphragm, all function by preventing sperm from entering the uterus and reaching the egg.

Condoms

What They Are:
A condom is a sheath of latex or polyurethane (most effective) or animal tissue (least effective) that fits over the male's erect penis.

How To Use Them:
As soon as the penis becomes erect, the man or his partner should put the condom on before any contact between the penis and the vagina occurs, because pre-ejaculatory fluid contains sperm and can contain sexually transmitted infections. Many sites offer clear instructions on condom usage:

Everything you need to know about shopping for condoms
How to put on a condom (with pictures)
Benefits and disadvantages of condoms

The Female Condom

What It Is:
A female condom is a polyurethane tube, which is closed at one end and inserted inside the vagina.

How To Use It:
The female condom is inserted inside the vagina. Two flexible rings keep the condom in place and act as a guide. This site offers instructions for use (with pictures). This one discusses the benefits and disadvantages of female condoms.

The Diaphragm

What It Is:
The diaphragm is a rubber, shallow latex cap with a rim containing a flexible spring that must be filled with a spermicidal jelly and inserted into the vagina. There are three different types of diaphragms; you and your doctor can discuss your options to find the diaphragm that is best for you.

How It Works:
The diaphragm blocks the passage of sperm from the vagina into the cervix. It fits over the cervix (the lower end of the uterus) and is held in place by the pelvic bone. Here are instructions on how to insert a diaphram (no pictures).

How To Start:
The diaphragm must be fitted by health care professionals. Diaphragms are available in different sizes as well as different styles as mentioned above. If the diaphragm is inserted correctly, you will not be able to feel it. You should practise inserting it at the health-care office until you feel comfortable with the process.

Planned Parenthood has a discussion of the benefits and disadvantages of the Diaphragm.

Spermicides and Vaginal Contraceptive Film (VCF)

What It Is:
Spermicides are jellies, foams, and creams that are inserted into the vagina and help to kill sperm. Spermicides do not prevent against sexually transmissited infections or HIV.

How It Works:
Spermicide jellies, foams, and creams are insrted into the vagina using a wand or applicator up to 20 minutes before sexual activity. AVCF sheet is placed in the vagina over the cervical opening, where it dissolves into a gel-like material that acts like a spermicide and clings to the cervical opening.

Frequently asked questions and more information about spermicide can be found here. Planned Parenthood also has a discussion of spermicide.

Alternate Methods of Contraception

The "Rhythm Method"

By knowing her menstrual cycle, a woman can estimate when she will be most fertile. Using this knowledge, she can plan her sexual life accordingly to reduce the risk of pregnancy. There are three primary components to this method:

1. Basal Body Temperature Method: This involves taking body temperature daily to monitor changes.
2. Calendar Method: If your menstrual cycle is predictable, it is possible to keep a calendar and to know when your body ovulates and when it is possible to get pregnant.
3. Cervical Mucus Method: You can also monitor the thickness of your cervical mucus.

The "rhythm method," which is known by many names including Natural Family Planning or Fertility Awareness, requires both partners to be aware and diligent. Those whose religious or personal beliefs prohibit the use of birth control may find the Rhythm method to be an appropriate option.

Our very own Student Care Center has more information on this method.

Abstinence

Abstaining from sex is also another option for many females. There are many reasons to abstain from sex: fear of STI's, religious beliefs, moral beliefs, fear of pregnancy, or emotional immaturity. All of the above are valid reasons to abstain: after all, abstinence is the only 100% effective method to prevent STI's and pregnancy. There are many other ways partners can be intimate without having sexual intercourse. If you feel at all uneasy about having sex, you probably are not ready. You can always wait to have sex, and you can always decide during the relationship that you do not want to have sex. Contrary to popular belief, there is no such thing as "blue balls," a condition that is supposed to occur to a male who is aroused who does not ejaculate. The male, like the female, has the option of masturbation if he needs sexual release but has an unwilling partner.

If you are curious about abstinence, consider checking out the Abstinence Clearinghouse's Library. This site has a great deal of information and resources about an abstinent lifestyle.

Surgical Options

Sterilization

Both the male and the female can undergo surgical sterilization. For the male, the doctor will clip and tie the vas deferens tube to prevent the release of the sperm. For the female, the fallopian tubes are clipped and tied to prevent the release of an egg. Male sterilization (vasectomies) are easier and safer than female sterilization. While females must undergo serious surgery, a vasectomy is usually an outpatient procedure. Also, the male procedure is reversible in most cases, while female sterilization is usually permanent. However, both procedures are almost always 100% effective. Sterilization is a very serious decision, and should be made considering future plans, such as whether or not one wants to have children in the future.

Planned Parenthood has a discussion of sterilization. Click here for important information about the sterilization decision.

Common Misconceptions

Withdrawal

Coitus interruptus, the withdrawal of the penis from the vagina before ejaculation, is one method of "birth control" that is believed by many to be successful. Unfortunately, there are several reasons this method is highly unreliable and dangerous. Besides the fact that it provides no protection of STI's, the risk of pregnancy when using this method is very high for several reasons. Contrary to popular belief, sperm can be released in his pre-ejaculatory fluid before the male withdrawals . This fluid can contain sperm because it often collects leftover sperm which remained in the penis after the last sex act, including masturbation. Secondly, the male must be trusted to withdraw in time, which is difficult if he is highly excited. Withdrawal does decrease the pleasure derived from the sex act, which can tempt one or both partners to complete the act up to orgasm. The female also loses control over the situation, which further may discourage the female from relying on this method. Read more at the American Pregnancy Association.

Douching

Douching does not kill sperm. In fact, it may actually propel sperm through the vaginal canal up to the egg. Douching is not an effective form of birth control. More information regarding douching can be found here.

Emergency Contraception

Emergency contraception refers to oral contraception available to women after they have had unprotected sex, a condom broke during sex, a female's regular form of birth control was forgotten, or in the case of sexual assualt/rape. Basically, emergency contraception is for situations when one believes they are at risk of pregnancy. Emergency contraception is available through a hospital ER (cost: up to $400), SCC Womancare practitioner (cost: free), SCC Physician on call (cost: pharmacy @$30), or through 1-888-NOT-2-LATE (cost: pharmacy @$30). Emergency contraception can be taken as many as 150 hours after the sexual encounter, but the sooner it is taken, the more effective it is. Emergency contraception is not for preventing pregnancy before sexual encounters, nor is it an abortion pill. It works by preventing the egg from attaching itself to the uteran lining.

The United States government offers information on emergency contraception.

Planned Parenthood also discusses how emergency contraception differs from abortion. This website discusses the various brands of emergency contraception and how they are taken.

That's Great! Now Where Do I Get It?

If you have more questions or would like to obtain birth control, the Womancare providers located at the Student Care Center are the least expensive and most convenient source for students to obtain information and contraceptives. Individual consultations with a health educator are available upon request.

Student Care Center/Womancare
For information and an appointment 773-702-4156

Planned Parenthood
www.plannedparenthood.org
(312) 427-2275
Additionally, you can find many forms of contraception, including condoms, at most drugstores and pharmacies.

Resources/Websites
To read more about various types of contraceptives and their advantages and disadvantages, check out the following sites:

Planned Parenthood
Interactive Birth Control Questionnaire
Contraception Quiz

This is by no means a comprehensive list. The internet has a great deal of information that is only a few clicks away! But be sure to discuss anything you read with your doctor.