Family planning delfin

Editor's Notes

• #6: There are many types of birth control, including barrier methods, hormonal methods, IUDs, fertility awareness, and sterilization. Couples may find some methods of birth control meet their needs better than others. Here are some things to think about when choosing a method: * How well the method works and the side effects * How likely you are to use it according to the directions * Your age and overall health * How often you have sex * Whether a prescription is needed * Whether you want to have children later * Whether it helps protect against STDs Certain types of birth control also offer added health benefits. Discuss the pros and cons of each method with your doctor so you can choose the best method for you.
• #35: Condoms come in male and female versions. The male condom is a thin sheath made of latex (rubber), polyurethane (plastic), or animal membrane that is worn by the man over his erect penis. Latex condoms also protect against STDs, including HIV. The female condom is a thin plastic pouch that lines the vagina. It is held in place by a closed inner ring at the cervix and an outer ring at the opening of the vagina. The female condom can be difficult to insert, so it is best suited for women who cannot be sure their partner will use a male condom every time they have sex. The female condom can be inserted up to 8 hours before sex and reduces the risk of STDs. When sperm is released, it stays inside the condom and does not pass into the woman's vagina. Both types of condoms are more effective when used with a spermicide. To be effective, condoms must be used every time you have sex and must be put on correctly (see box). A condom should be used only once and only one should be used at a time. A female condom should not be used with a male condom because both are more likely to break.
• #41: Spermicides often are used in suppositories, foam, cream, jelly, and film (thin sheets that contain spermicide) to kill sperm or make them inactive. Before each act of sex, spermicide is placed in the vagina close to the cervix. Some types of spermicide need to be placed in the vagina before sex so they have time to melt and become active. Be sure to follow the instructions supplied with the product. Frequent use of some spermicides may irritate vaginal tissue and increase the risk of STDs. Spermicide can be used with all barrier methods except the sponge, which already contains a spermicide.
• #42: The sponge is a doughnut-shaped device made of soft foam coated with spermicide. To use the sponge, it must be moistened with water. Once inserted in the vagina, it covers the cervix and blocks sperm from entering the uterus. The sponge may be put in up to 24 hours before sex and should be left in place for at least 6 hours, but not more than 24 hours, after sex. During this time, it is good for more than one act of sex. The sponge should not be used during menstruation.
• #43: The diaphragm is a small, latex, dome-shaped device that fits inside the vagina and covers the cervix. It is used with spermicide. A diaphragm requires a prescription and needs to be fitted by a doctor. The diaphragm can be inserted up to 6 hours before sex. After sex, the diaphragm must be left in place for about 6 hours, but not more than 24 hours. Once inserted, the diaphragm stays in place and, if it is properly placed, cannot be felt. A diaphragm is not reliable without spermicide. More spermicide should be used before each act of sex, no matter how closely timed they are. This can be inserted while the diaphragm is still in place. Women using a diaphragm should practice how to insert and remove it. Before the diaphragm is inserted, spermicidal cream or jelly should be applied around the rim and inside the dome of the diaphragm. It is then folded and inserted into the vagina. When the diaphragm is pushed up as far as it will go, the front part of the rim should be up behind the pubic bone. After the diaphragm is in place, the cervix should be completely covered by the rubber dome. You can feel to check if it is placed correctly. To remove the diaphragm, pull gently on the front rim. Women using a diaphragm also should learn how to care for it. To wash the diaphragm, use mild soap and water. Rinse the soap off well (it can damage the rubber), dry it, and put it back in its case. It should be checked monthly for holes. A diaphragm should be replaced about every 2 years. Using the diaphragm may reduce the risk of some STDs. When the diaphragm is used with the male condom, it provides added protection from pregnancy and STDs. The diaphragm should not be used during menstruation.
• #45: The cervical cap is a small, thin, dome-shaped device made of latex or plastic. It fits tightly over the cervix and stays in place by suction. A cervical cap must be fitted and prescribed by a doctor. Like the diaphragm, the cap works better with a spermicide. Inserting a cervical cap is like inserting a diaphragm. Spermicide is placed inside the cap, which then is squeezed and inserted into the vagina. The cap is then pressed onto the cervix until the cervix is completely covered. Before each act of sex, the cervix should be checked to make sure it is covered. This is done by pressing on the dome of the cap. Spermicide does not need to be reapplied before each act of sex. After sex, the cap should be left in place for 6 hours but not longer than 48 hours. Care for the cervical cap also is similar to that of the diaphragm. It must be checked regularly for wear or holes and needs to be replaced yearly. Refitting may be needed after having a baby or after weight gain or loss. A cervical cap may reduce the risk of some STDs, particularly if it is used with a spermicide. The cervical cap should not be used during menstruation.
• #46: With hormonal birth control, a woman takes hormones similar to those her body makes naturally. In most cases, these hormones prevent ovulation and change the lining of the uterus. The hormones also cause the cervical mucus to thicken, which makes it hard for the sperm to get through the cervix to the uterus. Hormonal birth control comes in several forms: * Birth control pills * Skin patch * Vaginal ring * Injections * Implant Hormonal methods of birth control do not protect against STDs. For most women, the risk of serious complications is small. However, women with certain medical conditions should discuss them carefully with their doctors. Methods that contain both estrogen and progesterone are not recommended for women older than 35 years who smoke cigarettes. A prescription is required for this type of birth control.
• #47: There are many different brands of pills that use certain hormones or a combination of hormones. This variety allows a woman to find a pill that is right for her. Combination pills contain the hormones estrogen and progestin. Combination birth control pills offer health benefits to some women. They help protect against ovarian and endometrial cancer. Women who take birth control pills have shorter, lighter periods of bleeding (similar to that of a menstrual period). Most pills come in packs of 28 pills. With this type of pill, one pill is taken at the same time each day for 28 days. When all the pills in the pack are finished, a new pack is started the next day. Bleeding occurs during the week when the last 4 or 7 pills are taken, depending on the type of pill. Missing a period is common. If this occurs, the pills should be continued. Using birth control pills during pregnancy does not increase the risk of birth defects. Side effects of the pill include nausea, breast tenderness, and headaches. They often go away after a few months of use. There will likely be fewer side effects if the pill is taken at the same time every day. Progestin-only pills, sometimes called minipills, do not contain estrogen. This type of pill is a better choice for women who have certain health problems and cannot take pills with estrogen. It often is recommended for women who are breastfeeding. The progestin-only pill comes in packs of 28 pills. All the pills in the pack contain hormones. It is important not to miss a pill and to take it at the same time each day.
• #60: The contraceptive skin patch is a small (1.75 inch) adhesive patch that is worn on the skin to prevent pregnancy. With the patch, estrogen and progestin are absorbed through the skin into the bloodstream. The patch may offer many of the same benefits and risks as the combination birth control pill. Once a woman obtains a prescription for the patch, she does not need to visit her doctor to apply or remove it. The patch can be worn on the buttocks, chest (excluding the breasts), upper back or arm, or abdomen. It should be applied to a new place each week to avoid irritation. A patch is worn for a week at a time for a total of 3 weeks in a row. During the fourth week, a patch is not worn, and bleeding occurs. After week 4, a new patch is applied and the cycle is repeated. Although the patch starts working right away, a backup method of birth control, such as a condom, should be used for the first week of the first cycle. The patch may be less effective in women who weigh more than 198 pounds.
• #61: The vaginal ring is a flexible, plastic ring that is placed in the upper vagina. It releases both estrogen and progestin. The ring may have the same benefits and risks as those of the combination birth control pill. The ring is worn for 21 days, removed for 7 days, and then a new ring is inserted. During the week it is out, bleeding similar to that of a menstrual period occurs. A woman does not need to visit her doctor for insertion or removal of the ring, although a doctor must prescribe it. To use the ring, it is folded and inserted into the vagina. This is all that needs to be done to place the ring in the correct position. After 3 weeks, the ring is removed on the same day of the week and around the same time that it was inserted. Bleeding usually will start 2–3 days after the ring is removed. A new ring is inserted 1 week after the last one was removed. Although this rarely happens, the vaginal ring can slip out of the vagina. If it has been out for more than 3 hours, a backup method of birth control should be used for 7 days. If the vaginal ring slips out often, a different method of birth control may be needed. Pregnancy is prevented as it is with other hormonal methods. When a woman begins using the vaginal ring, she should use a backup method of birth control, such as condoms or spermicide, for the first 7 days of use.
• #62: An injection or "shot" of depot medroxyprogesterone acetate (DMPA) provides protection against pregnancy for 3 months. It works the same way as other forms of hormonal birth control. A doctor or nurse gives the injection. After the first injection, a backup method should be used for the next 7 days. Injections may be good for people who find it hard to use daily birth control methods. Injections also may be good for women who cannot use combination birth control pills or IUDs. Some women using this method have irregular bleeding. Over time, many women stop bleeding altogether. Weight gain also may occur in some women. Many women and teenagers also have a decrease in bone density while using hormonal injections. Bone density appears to return to levels that are normal for the woman's age group when the injections are stopped. DMPA injections can be used when a woman is breastfeeding. A woman can start DMPA injections after giving birth. After a woman stops DMPA injections, fertility returns in about 10 months. But for some, it may take much longer. If a woman knows she wants to become pregnant within the next couple of years, she should choose another form of birth control.
• #63: A contraceptive implant is a single rod that is inserted under the skin of the upper arm. It protects against pregnancy for 3 years. The implant releases a progestin that works similar to other hormonal methods of birth control—it prevents ovulation. The implant can be inserted and removed in a doctor's office in about 5–10 minutes. The area where the implant will be placed is numbed with a local anesthetic. No incision needs to be made. A woman can become pregnant soon after the implant is removed. The most common side effect of using a contraceptive implant is irregular bleeding. This side effect usually goes away in 6–9 months. Some women stop bleeding altogether.
• #64: The IUD is a small, T-shaped, plastic device that is inserted and left inside the uterus to prevent pregnancy. There are two types available in the United States: the hormonal IUD and the copper IUD. The IUD does not protect against STDs. The hormonal IUD releases a small amount of the hormone progestin into the uterus. This thickens the cervical mucus, which blocks sperm from entering the cervix. It also thins the endometrium. The hormonal IUD also may make the sperm less active and make the sperm and the egg less likely to be able to live in the fallopian tube. This keeps a fertilized egg from attaching there or in the uterus. The copper IUD releases a small amount of copper into the uterus. In most cases, this prevents the egg from being fertilized or, in rare instances, from attaching to the wall of the uterus. The copper also prevents sperm from going through the uterus and into the fallopian tubes and reduces the sperm's ability to fertilize an egg. The hormonal IUD must be replaced every 5 years. The copper IUD can remain in your body for as long as 10 years. As soon as the IUD is removed, there is no protection against pregnancy. A doctor must insert and remove the IUD. The insertion procedure may cause discomfort, but once it is in place, you do not have to do anything else to prevent pregnancy. It does not interfere with sex, daily activities, or menstruation. You can use a tampon with it. Physical activity will not move the IUD. You may be asked to return for a routine checkup after the IUD is inserted. Each IUD comes with a string or "tail" made of a thin plastic thread. Placing a finger in the vagina to locate this string can check the placement of the IUD. If you cannot feel the string, call your doctor. Menstrual pain and bleeding often increase with the copper IUD. Women who use the hormonal IUD often have less menstrual pain and bleeding. Some women using hormonal IUDs stop having periods altogether. Some women have cramping and spotting during the first few weeks after the IUD is inserted. Vaginal discharge also can occur. These symptoms are common and should disappear within a month. Serious complications from use of an IUD are rare. However, some women do have problems, usually during or soon after insertion: * Expulsion. The IUD is pushed out of the uterus into the vagina. * Perforation. Although rare, the IUD can pierce the wall of the uterus during insertion. * Infections. Infections in the uterus or fallopian tubes can occur after insertion. This may cause scarring in the reproductive organs, making it harder to become pregnant later. * Pregnancy. Rarely, pregnancy may occur while a woman is using an IUD. If the IUD remains in place, there can be risks to the mother and fetus, including miscarriage, infection, or preterm birth.
• #66: If a woman has sex without any type of birth control or if she thinks her method did not work (for instance, a condom slipped or broke), she may want to use emergency contraception. Emergency contraception reduces the risk that pregnancy will occur. There are two types of emergency contraception available in the United States: Plan B and the IUD. Plan B is a prescription of two pills, like birth control pills, that are taken 12 hours apart. You need to take them within 120 hours (5 days) of unprotected sex. They are 75–89% effective at preventing pregnancy. Plan B usually works by preventing ovulation. Plan B will not work if you are already pregnant and will not affect a pregnancy that has started. If you are aged 18 years or older, Plan B can be bought in pharmacies without a prescription. If you are younger than 18 years and need Plan B, you need a prescription. Call your doctor's office or go to a family planning clinic or hospital emergency room. If you need to find a doctor to get a prescription, call the Emergency Contraceptive Hotline (888-NOT-2-LATE). Some doctors will give you an advance prescription for Plan B. This way, you will have it on hand if you need it. The sooner the treatment begins, the more effective. If you use birth control pills as your regular method of birth control, you can take a certain number of pills for emergency contraception. The amount is different for each type of pill. Ask your doctor or pharmacist what the right number is for the type of pill you are taking. Another option is to have a copper IUD inserted. The IUD must be inserted within 5 days of having unprotected sex. It is about 99% effective. A benefit is that the IUD can then be used for long-term contraception.