Midterm 2: Chapter 7, 11, 12, 13

Chapter 7: Contraception and Abortion
179-208

Contraceptives
Use was illegal until 1969 when Trudeau amended the laws pertaining to sexual behavior
Variety of uses: both babies and mothers are healthier if pregnancies are spaces 3-5 yrs apart
Most couples want to limit their family size
Single people typically want to avoid pregnancy
Some people know through genetic counseling that they have a high rate of having a baby with a birth defect
Adolescent Pregnancy
In 2001 there were 37622 teen pregnancies, 541 below age of 15
Don’t need consent from parents for birth control
Overpopulation is a serious problem
The Pill, the Patch and the Ring combination birth control pills: birth control pills that contain a combo of estrogen and progestin- called oral contraceptives
Alesse, Yasmin
Takes a pill with doses higher than normal levels for 21 days then no pill for 7 days, and then repeat
Some are for longer time frames ie. Seasonale; 84 days of combined hormones- aka only have 1 period every three months
How it works
Mainly by preventing ovulation
In natural cycle, low levels of estrogen during and after menstrual period trigger the pituitary to produce FSH, which then stimulates the ovulation process
Estrogen levels are made high which inhibits the production and so the signal to start ovulation never gets there
Progestin provides additional back up effects; keeps cervical mucus very thick so sperm has a difficult time getting through
Changes the lining of the uterus in such a way so that even if a fertilized egg were to arrive, it would unlikely to be able to be fertilized
Effectiveness
If 100 women are taking birth control for 1 year, the amount of women that get pregnant in that group are called the failure rate
If 5/100 become pregnant, there is a 5% failure rate.
Effectiveness is the opposite; aka it would be 95%.
Two kinds of failure rate; failure rate for perfect users and a failure rate for typical users
Combo pills are one of the most effective methods
Perfect user rate is 0.1% and typical is 3%
Typical; failing to take a pill for 2 or more days and not taking it at the same time every day
Side Effects
Slight but significant increases in certain diseases of the circulatory system
Blood clotting
Higher chance of developing blood clots particularly in women over 35 who smoke
Headaches, sever leg or chest pains, shortness of breath
May aggravate pre-existing cancer like breast cancer
Taken the pill for more than 5 years are at risk of benign liver tumor increases
Increases amount of vaginal discharge and susceptibility to vaginitis because it alters chemical comp of vaginal flora
Increased vulnerability to chlamydia and gonorrhea
May cause nausea
May cause weight gain
Increased irritability and depression
Becomes worse with length of time used
Sexual desire decrease, vaginal lubrication and arousal
Maybe increase
Advantages and Disadvantages
Advantages
Close to 100% effective if used properly
Doesn’t interfere with intercourse
Regulating menstruation, clearing up acne, protection against pelvic inflammatory disease
Disadvantages
Side effects
Cost
Taking correctly is complicated
Entire burden of contraception on women
Reversibility
as soon or 2-3 mo after stopping the cycle pregnancy is possible rates are same for women who never took the pill
Drug interactions
Some anti-tuberculosis meds decrease effectiveness, 30 others that may also interact
Important to check w doctor before starting any new drugs
May increase metabolism of some drugs, making them more potent; anti anxiety drugs, corticosteroids
Other Kinds of pills
Combo pills vary from one brand to the nect the dosages of estrogen and progestin- the higher estrogen dose the more likely to get blood clots
Most women do well on 30-35 mg such as Alesse, Minestrin
High progestin brands are related to high rates of depression and vaginitis
Triphasic