Family Planning

Real 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 planning  is the  planning  of when to have  children,  and the use of  birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education,  prevention and management of  sexually transmitted infections, pre-conception counseling  and  management, and  infertility management.Family planning is sometimes used as a synonym for the use of  birth control, however, it often includes a wide variety of methods, and practices that are not birth control. It is most usually applied to a  female-male  couple who wish to limit the number of children they have and/or to control the timing of  pregnancy  (also known as  spacing children). Family planning may encompass  sterilization, as well as  abortion.Family plann ing services are defined as â€Å"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 the  family planning  methods approved by the Roman Catholic Church. In accordance with the Church's teachings regarding  sexual behavior  in keeping with its philosophy of the dignity of the human person, NFP excludes the use of other methods of  birth control, which it refers to as â€Å"artificial contraception. Periodic  abstinence  is 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 the  menstrual cycle, during pregnancy, and after  menopause. Various methods may be used to identify whether a woman is likely to be  fertile; this information may be used in attempts to either avoid or achieve pregnancy. There are three main types of NFP: the symptoms-based methods, the calendar-based methods, and the breastfeeding or  lactational 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 the  Guttmacher Institute  found 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 as  fertility awareness-based methods  rather than NFP.The three primary signs of a woman's fertility are her  basal body temperature, her  cervical  mucus, and her cervical position. Computerized  fertility m onitors  may track basal body temperatures, hormonal levels in urine, changes in electrical resistance of a woman's 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 the  Billings ovulation method  and the  Creighton 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 the  Couple to Couple League  and the Fertility Awareness Method (FAM) taught by  Toni 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 by  SERENA Canada  which is an inter-denominational organization which has been developing the Symptothermal Method as a part of NFP since 1955.They are als o not specifically affiliated with the Roman Catholic Church. It is also taught by  Justisse Healthworks 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 World Health Organization involving 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found that 93% could accurately interpret their body's 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. Accordi ng to the Institute of Reproductive Health, when used as birth control, CB has a 95% effectiveness rating. Computer programs are available to help track fertility on a calendar.Lactational amenorrhea The  lactational amenorrhea method  (LAM) is a method of avoiding pregnancy based on the natural  postpartum  infertility  that occurs when a woman is  amenorrheic  and fully  breastfeeding. The rules of the method help a woman identify and possibly lengthen her infertile period. A strict version of LAM is known as  ecological breastfeeding. Artificial Family Planning/Birth Control, also known as  contraception  and  fertility control, refers to methods or devices used to prevent  pregnancy. Planning and provision of birth control is called  family planning.Safe sex, such as the use of male or  female condoms, can also help prevent transmission of  sexually transmitted diseases. Contraceptive use in  developing countries has cut the number of  materna l deaths  by 44% (about 270,000 deaths averted in 2008) but could prevent 73% if the full demand for birth control were met. Because  teenage pregnancies  are at greater risk of adverse outcomes such as  preterm birth,  low birth weight and  infant mortality, adolescents need comprehensive  sex education  and access to reproductive health  services, including contraception.By lengthening the time between pregnancies, birth control can also improve adult women's delivery outcomes and the survival of their children. Effective birth control methods include  barriers  such as  condoms,  diaphragms, and the contraceptive sponge;  hormonal contraception  including  oral pills,  patches,  vaginal rings, and injectable contraceptives; and  intrauterine devices  (IUDs). Emergency contraception  can prevent pregnancy after unprotected sex. Long-acting reversible contraception  such as implants, IUDs, or vaginal rings are recommended to reduce  tee nage pregnancy.Sterilization  by means such as  vasectomy  and  tubal ligation  is permanent contraception. Some people regard  sexual abstinence  as birth control, but  abstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sex  and  oral sex  are also 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 increases  economic growth  because of fewer dependent children, more women participating in the work force, and less consumption of scarce resources. Women's earnings, assets,  body mass index , and their children's schooling and body mass index all substantially improve with greater access to contraception. Methods of Artificial Family Planning Artificial Family Planning/Birth control includes  barrier methods,  hormonal contraception,  intrauterine devices  (IUDs), sterilization, and behavioral methods.Hormones can be  delivered by injection, by mouth (orally),  placed in the vagina, or implanted under the skin. The most common types of oral contraception include the  combined oral contraceptive pill  and the  progestogen-only pill. Methods are typically used before sex but  emergency contraception  is 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 a  pelvic examination  or medical tests.The  World Health Organization publishes a detailed list of medical eligibility criteria for each type of contraception. Birth control methods * An unrolled male  latex condom * A polyurethane  female condom * A  diaphragm  vaginal-cervical  barrier, in its case with a  quarter U. S. coin  to show scale * A  contraceptive sponge  set inside its open package * Three varieties of  birth control pills  in calendar oriented packaging * A transdermal contraceptive patch * A  Nuva Ring  vaginal ring * A hormonal  intrauterine device  (IUD) against a background showing placement in the  uterus *A copper IUD next to a dime  to show scale * A split dose of two emergency contraceptive pills (most morning after pills now only require one) Barrier Barrier contraceptives  are devices that attempt to prevent  pregnancy  by physically preventing  sperm  from entering the  uterus. They include: male  condoms,  female condoms,  cervical caps,  diaphragms, and  contraceptive sponges  with  spermicide. The condom is mos t commonly used during  sexual intercourse  to reduce the likelihood of  pregnancy  and of spreading  sexually transmitted diseases  (STDs—such as  gonorrhea,  syphilis, and  HIV).It is put on a man's erect  penis  and physically blocks ejaculated semen from entering the body of a sexual partner. Modern condoms are most often made from  latex, but some are made from other materials such as  polyurethane,  polyisoprene, or lamb intestine. A  female condom  is also available, most often made of  nitrile. Male condoms have the advantage of being inexpensive, easy to use, 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 the  cervix  to 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 of  yeast infections  and  urinary tract infections. Leaving the sponge in for more than 30 hours can result in  toxic shock syndrome. Hormonal Hormonal contraceptives  inhibit  ovulation  and  fertilization.These include  oral pills,  subdermal  implants, and  injectable contraceptivesas well as the  patch,  hormonal IUDs  and the  vaginal ring. The most commonly used hormonal contraceptive is the  combined oral contraceptive pill—commonly known as â€Å"the pill†Ã¢â‚¬â€which includes a combination of an  estrogen  and a  progestin  (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 of  venousand  arterial thrombosis. However, the benefits are greater than the risk.Oral contraceptives reduce the risk of  ovarian cancer  and  endometrial cancer  without increasing the risk for  breast cancer. They can lower body weight by reducing  water retention  (not loss of fat), and several are used to treat mild to moderate  acne. Between 2% and 10% of women of childbearing age experience emotional and physical symptoms associated with  premenstrual syndrome  (PMS) andpremenstrual dysphoric disorder  (PMDD). Combination hormonal contraceptives often ameliorate or effectively treat these problems and can effectively treat heavy menstrual bleeding and  dysmenorrhea  (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 tend erness,  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 s  dysmenorrhea,  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 reporting  amenorrhea  (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 progestin-only pills, injections, and implants include headache, breast tenderness, mood effects, and  dysmenorrhea, but those symptoms often resolve with time.Newer progestins, such as drospirenone and desogestrel, minimize the  androgenic  side effects of their predecessors. Intrauterine devices The modern  intrauterine 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 of  long-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 provide  emergency contraception  up 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 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 for  heavy periods.Levonorgestrel-releasing IUDs may be used during breastfeeding whether or not they also include copper. Sterilization Surgical sterilization  is available in the form of  tubal ligation  for women and  vasectomy  for men. There are no significant long term side effects and tubal ligation decreases the risk of  ovarian 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 from  sexually transmitted nfections. Although sterilization is considered a permanent procedure, it is possible to attempt a  tubal reversal  to reconnect the  Fallopian tubes  in females or a  vasectomy reversal  to reconnect the  vasa deferentia  in males. The ra te of success depends on the original technique, tubal damage, and the person's age. Behavioral Behavioral methods involve  regulating the timing  or 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. The  lactational amenorrhea method, or LAM, outlines guidelines for determining the length of a woman's period of breastfeeding infertility. For women who meet the criteria, LAM is highly effective during the first six months postpartum  if breastfeeding is the infant’s 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 methods  such as the discredited rhythm method and the  Standard Days Method  estimate the likelihood of fertility bas ed on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to a woman's least fertile period. During her most fertile period, barrier methods may be used, or she may abstain from intercourse. The term â€Å"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 the  Roman Catholic Church.The effectiveness of  fertility 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  Cycle Beads  birth control chain, used for a rough estimate of fertility based on days since menstruation The  Standard Days Method  has 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 called  Cycle Beads  was 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 woman's 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 woman's observation and charting of her body's fertility sign s, to determine the fertile and infertile phases of her cycle. Charting may be done by hand or with the assistance of  fertility monitors. Most methods track one or more of the three primary fertility signs:  changes in  basal 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 â€Å"symptothermal. † Other bodily cues such as  mittelschmerz  are considered secondary indicators. Unplanned pregnancy rates have been reported from 1% to 20% for typical users of the symptothermal method. Withdrawal Coitus interruptus  (literally â€Å"interrupted sexual intercourse†), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse (â€Å"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 states that â€Å"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 total  sexual 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 education  does not reduce  teen 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 (su ch as condoms or emergency contraceptive pills).Non-penetrative  and  oral sex will generally avoid pregnancy, but pregnancy can still occur with  Intercrural sex  and other forms of penis-near-vagina sex (genital rubbing, and the penis exiting from  anal intercourse) where semen can be deposited near the entrance to the vagina and can itself travel along the vagina's lubricating fluids. Emergency (after sex) Emergency contraceptives, or â€Å"morning-after pills,† are drugs taken after sexual intercourse intended to prevent pregnancy. Levonorgestrel  (progestin) pills, marketed as â€Å"Plan B† and â€Å"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(â€Å"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. Pharmacists  are 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 (6–12 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. Family Planning Real 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 planning  is the  planning  of when to have  children,  and the use of  birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education,  prevention and management of  sexually transmitted infections, pre-conception counseling  and  management, and  infertility management.Family planning is sometimes used as a synonym for the use of  birth control, however, it often includes a wide variety of methods, and practices that are not birth control. It is most usually applied to a  female-male  couple who wish to limit the number of children they have and/or to control the timing of  pregnancy  (also known as  spacing children). Family planning may encompass  sterilization, as well as  abortion.Family plann ing services are defined as â€Å"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 the  family planning  methods approved by the Roman Catholic Church. In accordance with the Church's teachings regarding  sexual behavior  in keeping with its philosophy of the dignity of the human person, NFP excludes the use of other methods of  birth control, which it refers to as â€Å"artificial contraception. Periodic  abstinence  is 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 the  menstrual cycle, during pregnancy, and after  menopause. Various methods may be used to identify whether a woman is likely to be  fertile; this information may be used in attempts to either avoid or achieve pregnancy. There are three main types of NFP: the symptoms-based methods, the calendar-based methods, and the breastfeeding or  lactational 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 the  Guttmacher Institute  found 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 as  fertility awareness-based methods  rather than NFP.The three primary signs of a woman's fertility are her  basal body temperature, her  cervical  mucus, and her cervical position. Computerized  fertility m onitors  may track basal body temperatures, hormonal levels in urine, changes in electrical resistance of a woman's 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 the  Billings ovulation method  and the  Creighton 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 the  Couple to Couple League  and the Fertility Awareness Method (FAM) taught by  Toni 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 by  SERENA Canada  which is an inter-denominational organization which has been developing the Symptothermal Method as a part of NFP since 1955.They are als o not specifically affiliated with the Roman Catholic Church. It is also taught by  Justisse Healthworks 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 World Health Organization involving 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found that 93% could accurately interpret their body's 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. Accordi ng to the Institute of Reproductive Health, when used as birth control, CB has a 95% effectiveness rating. Computer programs are available to help track fertility on a calendar.Lactational amenorrhea The  lactational amenorrhea method  (LAM) is a method of avoiding pregnancy based on the natural  postpartum  infertility  that occurs when a woman is  amenorrheic  and fully  breastfeeding. The rules of the method help a woman identify and possibly lengthen her infertile period. A strict version of LAM is known as  ecological breastfeeding. Artificial Family Planning/Birth Control, also known as  contraception  and  fertility control, refers to methods or devices used to prevent  pregnancy. Planning and provision of birth control is called  family planning.Safe sex, such as the use of male or  female condoms, can also help prevent transmission of  sexually transmitted diseases. Contraceptive use in  developing countries has cut the number of  materna l deaths  by 44% (about 270,000 deaths averted in 2008) but could prevent 73% if the full demand for birth control were met. Because  teenage pregnancies  are at greater risk of adverse outcomes such as  preterm birth,  low birth weight and  infant mortality, adolescents need comprehensive  sex education  and access to reproductive health  services, including contraception.By lengthening the time between pregnancies, birth control can also improve adult women's delivery outcomes and the survival of their children. Effective birth control methods include  barriers  such as  condoms,  diaphragms, and the contraceptive sponge;  hormonal contraception  including  oral pills,  patches,  vaginal rings, and injectable contraceptives; and  intrauterine devices  (IUDs). Emergency contraception  can prevent pregnancy after unprotected sex. Long-acting reversible contraception  such as implants, IUDs, or vaginal rings are recommended to reduce  tee nage pregnancy.Sterilization  by means such as  vasectomy  and  tubal ligation  is permanent contraception. Some people regard  sexual abstinence  as birth control, but  abstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sex  and  oral sex  are also 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 increases  economic growth  because of fewer dependent children, more women participating in the work force, and less consumption of scarce resources. Women's earnings, assets,  body mass index , and their children's schooling and body mass index all substantially improve with greater access to contraception. Methods of Artificial Family Planning Artificial Family Planning/Birth control includes  barrier methods,  hormonal contraception,  intrauterine devices  (IUDs), sterilization, and behavioral methods.Hormones can be  delivered by injection, by mouth (orally),  placed in the vagina, or implanted under the skin. The most common types of oral contraception include the  combined oral contraceptive pill  and the  progestogen-only pill. Methods are typically used before sex but  emergency contraception  is 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 a  pelvic examination  or medical tests.The  World Health Organization publishes a detailed list of medical eligibility criteria for each type of contraception. Birth control methods * An unrolled male  latex condom * A polyurethane  female condom * A  diaphragm  vaginal-cervical  barrier, in its case with a  quarter U. S. coin  to show scale * A  contraceptive sponge  set inside its open package * Three varieties of  birth control pills  in calendar oriented packaging * A transdermal contraceptive patch * A  Nuva Ring  vaginal ring * A hormonal  intrauterine device  (IUD) against a background showing placement in the  uterus *A copper IUD next to a dime  to show scale * A split dose of two emergency contraceptive pills (most morning after pills now only require one) Barrier Barrier contraceptives  are devices that attempt to prevent  pregnancy  by physically preventing  sperm  from entering the  uterus. They include: male  condoms,  female condoms,  cervical caps,  diaphragms, and  contraceptive sponges  with  spermicide. The condom is mos t commonly used during  sexual intercourse  to reduce the likelihood of  pregnancy  and of spreading  sexually transmitted diseases  (STDs—such as  gonorrhea,  syphilis, and  HIV).It is put on a man's erect  penis  and physically blocks ejaculated semen from entering the body of a sexual partner. Modern condoms are most often made from  latex, but some are made from other materials such as  polyurethane,  polyisoprene, or lamb intestine. A  female condom  is also available, most often made of  nitrile. Male condoms have the advantage of being inexpensive, easy to use, 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 the  cervix  to 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 of  yeast infections  and  urinary tract infections. Leaving the sponge in for more than 30 hours can result in  toxic shock syndrome. Hormonal Hormonal contraceptives  inhibit  ovulation  and  fertilization.These include  oral pills,  subdermal  implants, and  injectable contraceptivesas well as the  patch,  hormonal IUDs  and the  vaginal ring. The most commonly used hormonal contraceptive is the  combined oral contraceptive pill—commonly known as â€Å"the pill†Ã¢â‚¬â€which includes a combination of an  estrogen  and a  progestin  (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 of  venousand  arterial thrombosis. However, the benefits are greater than the risk.Oral contraceptives reduce the risk of  ovarian cancer  and  endometrial cancer  without increasing the risk for  breast cancer. They can lower body weight by reducing  water retention  (not loss of fat), and several are used to treat mild to moderate  acne. Between 2% and 10% of women of childbearing age experience emotional and physical symptoms associated with  premenstrual syndrome  (PMS) andpremenstrual dysphoric disorder  (PMDD). Combination hormonal contraceptives often ameliorate or effectively treat these problems and can effectively treat heavy menstrual bleeding and  dysmenorrhea  (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 tend erness,  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 s  dysmenorrhea,  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 reporting  amenorrhea  (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 progestin-only pills, injections, and implants include headache, breast tenderness, mood effects, and  dysmenorrhea, but those symptoms often resolve with time.Newer progestins, such as drospirenone and desogestrel, minimize the  androgenic  side effects of their predecessors. Intrauterine devices The modern  intrauterine 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 of  long-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 provide  emergency contraception  up 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 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 for  heavy periods.Levonorgestrel-releasing IUDs may be used during breastfeeding whether or not they also include copper. Sterilization Surgical sterilization  is available in the form of  tubal ligation  for women and  vasectomy  for men. There are no significant long term side effects and tubal ligation decreases the risk of  ovarian 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 from  sexually transmitted nfections. Although sterilization is considered a permanent procedure, it is possible to attempt a  tubal reversal  to reconnect the  Fallopian tubes  in females or a  vasectomy reversal  to reconnect the  vasa deferentia  in males. The ra te of success depends on the original technique, tubal damage, and the person's age. Behavioral Behavioral methods involve  regulating the timing  or 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. The  lactational amenorrhea method, or LAM, outlines guidelines for determining the length of a woman's period of breastfeeding infertility. For women who meet the criteria, LAM is highly effective during the first six months postpartum  if breastfeeding is the infant’s 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 methods  such as the discredited rhythm method and the  Standard Days Method  estimate the likelihood of fertility bas ed on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to a woman's least fertile period. During her most fertile period, barrier methods may be used, or she may abstain from intercourse. The term â€Å"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 the  Roman Catholic Church.The effectiveness of  fertility 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  Cycle Beads  birth control chain, used for a rough estimate of fertility based on days since menstruation The  Standard Days Method  has 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 called  Cycle Beads  was 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 woman's 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 woman's observation and charting of her body's fertility sign s, to determine the fertile and infertile phases of her cycle. Charting may be done by hand or with the assistance of  fertility monitors. Most methods track one or more of the three primary fertility signs:  changes in  basal 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 â€Å"symptothermal. † Other bodily cues such as  mittelschmerz  are considered secondary indicators. Unplanned pregnancy rates have been reported from 1% to 20% for typical users of the symptothermal method. Withdrawal Coitus interruptus  (literally â€Å"interrupted sexual intercourse†), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse (â€Å"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 states that â€Å"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 total  sexual 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 education  does not reduce  teen 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 (su ch as condoms or emergency contraceptive pills).Non-penetrative  and  oral sex will generally avoid pregnancy, but pregnancy can still occur with  Intercrural sex  and other forms of penis-near-vagina sex (genital rubbing, and the penis exiting from  anal intercourse) where semen can be deposited near the entrance to the vagina and can itself travel along the vagina's lubricating fluids. Emergency (after sex) Emergency contraceptives, or â€Å"morning-after pills,† are drugs taken after sexual intercourse intended to prevent pregnancy. Levonorgestrel  (progestin) pills, marketed as â€Å"Plan B† and â€Å"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(â€Å"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. Pharmacists  are 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 (6–12 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.