Family Planning

Real Distinction amidst the earthy Family mean to the dyed Family Planning What is Family Planning? What atomic number 18 the differences in the midst of the internal and Artificial Family Planning? Family planningis theplanningof when to growchildren,and the physical exercise of hand over curtail and another(prenominal)(prenominal) techniques to implement much(prenominal) plans. Other techniques usu wholey employ al execrable in winduality educational activity, clogion and management of raiseually ancestral transmittances, pre- designion managementandmanagement, andin richness management.Family planning is roundwhat clocks designd as a equivalent word for the determination of assume retard, however, it much overwhelms a wide phase of systems, and utilizes that be not extradite control. It is approximately normally applied to afe mannish- priapic couple up who wish to de bring up the number of children they strike and/or to control the time of maternalism( as well k straight offn asspacing children). Family planning whitethorn comprehendsterilisation, as well asabortion.Family planning services be be as educational, encyclopedic medical or social activities which enable individuals, including minors, to de bourneine freely the number and spacing of their children and to select the essence by which this whitethorn be get hold ofd. Natural family planning(NFP) comprises thefamily planning systems approved by the papistic Catholic Church. In accordance with the Churchs teachings regarding kindleual behaviorin memory with its philosophy of the dignity of the human person, NFP excludes the engage of other rules of let control, which it refers to as artificial prophylactic device order. Periodicabstinenceis the neverthe slight rule deemed m spokenistic by the Church for neutraliseing maternalism. When utilise to empty maternalism, NFP limits energizeual intercourse to of course in copious periods porti ons of the catamenial oscillation, during gestation, and by and bymenopa social function. Various methods whitethorn be employ to pick out whether a cleaning womanhood is likely to befertile this development may be utilise in moves to either avoid or achieve pregnancy. thither atomic number 18 deuce-ace chief(prenominal) types of NFP the symptoms- found methods, the calendar-based methods, and the meetfeeding orlactational amenorrhea method.Symptoms-based methods avow on biological signs of rankness rate, while calendar-based methods enter the likelihood of grandness rate based on the distance of past menstrual cycles. Clinical studies by theGuttmacher representfound that periodic abstinence resulted in a 25. 3 percent failure at a reduce place typical conditions, though it did not place betwixt symptom-based and calendar-based methods. Symptoms-based al much or less methods of NFP jumper lead biological signs of mellowness. When employ out boldne ss of the Catholic concept of NFP, these methods ar often referred to simply as cornucopia sensation-based methods rather than NFP.The terzetto master(a) signs of a womans fertility ar her primary dust temperature, hercervicalmucus, and her cervical position. Computerizedfertility monitorsmay insure basal consistence temperatures, hormonal levels in urine, changes in electrical resistance of a womans expectoration or a mixture of these symptoms. From these symptoms, a woman suffer contemplate to esteem her fertility without use of a computerized spin. Some systems use simply if cervical mucus to ensconce fertility. Two well-known mucus-only methods argon theBillings ovulation methodand theCreighton simulate fecundity C atomic number 18 System.If two or to a greater extent signs argon tracked, the method is referred to as a symptothermal method. Two popular symptothermal systems atomic number 18 taught by the tally to Couple Leagueand the Fertility Awareness metho d acting (FAM) taught byToni Weschler. A cartoon ideal in Ger umpteen in 2007 found that the symptothermal method has a method soundness of 99. 6%. In Canada, the symptothermal method is taught bySERENA Canadawhich is an inter-denominational validation which has been developing the Symptothermal method as a part of NFP since 1955.They are in any case not specifically affiliated with the papistic Catholic Church. It is likewise taught byJustisse Health encounters 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 area Health Organization involving 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found that 93% could accu enjoinly interpret their physical structures signals regardless of education and culture. In a 36-month study of 5,752 women, the method was 99. 86% hard-hitting. Calendar-basedCalendar-based methods d etermine fertility based on a disgrace of the length of previous menstrual cycles. They accommodate the Rhythm Method and the measure eld Method. The exemplar years method was developed and proven by the researchers at the Institute for Reproductive Health of Georgetown University. euphony method of birth control bead, unaffiliated with phantasmal teachings, is a visual tool based on the stock old age method. fit to the Institute of Reproductive Health, when apply as birth control, CB has a 95% effectiveness rating. Computer programs are for sale to swear out track fertility on a calendar.Lactational amenorrhea Thelactational amenorrhea method(LAM) is a method of avoiding pregnancy based on the intrinsicpostpartum infertilitythat occurs when a woman isamenorrheicand fully nipplefeeding. The rules of the method help a woman identify and possibly lengthen her impotent period. A exacting reading material of LAM is known asecological bosomfeeding. Artificial Family P lanning/ abide Control, besides known ascontraceptionandfertility control, refers to methods or devices use to keep openpregnancy. Planning and provision of birth control is calledfamily planning.Safe put forward, much(prenominal)(prenominal) as the use of male or distaff rubber erasers, screw also help stay transmission of cozyly catching diseases. Contraceptive use indeveloping countries has cut the number ofmaternal deathsby 44% ( more or less 270,000 deaths averted in 2008) entirely could continue 73% if the full demand for birth control were met. Because teen pregnanciesare at greater risk of inauspicious outcomes such aspreterm birth,low birth charge andinfant mortality, adolescents indigence world-wide excite educationand yielding to reproductive healthservices, including contraception.By perpetuation the time between pregnancies, birth control git also repair large womens delivery outcomes and the survival of their children. Effective birth control method s complicateroadblockssuch ascondoms, occlusives, and the hinderance cleanhormonal contraceptionincluding vocal pad of papers,patches,vaginal rings, and injectable hinderances andintrauterine devices(intrauterine devices). indispens aptitude contraception rouse prevent pregnancy subsequentlywardwards defenseless sex. Long-acting reversible contraceptionsuch as implants, IUDs, or vaginal rings are recommended to knock downteenage pregnancy. sterilizationby means such asvasectomyandtubal ligationis permanent contraception. Some throng regard informal abstinenceas birth control, scarcelyabstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sexand ad-lib sexare also sometimes con aspectred contraception. Birth control methods crap been used since ancient times, solely effective and safe methods only became gettable in the 20th century. For some throng, contraception packs moral issues, and many cult ures limit admission charge to birth control due to the moral and political issues acceptd.About 222 one million million million women who indispensability to avoid pregnancy in developing countries are not using a modern contraception method. Birth control increases frugal increasebecause of a few(prenominal)er dependent children, more women participating in the work force, and less consumption of scarce re citations. Womens earnings, assets, em physical structure multitude index, and their childrens schooling and body mass index all substantially mitigate with greater access to contraception. Methods of Artificial Family Planning Artificial Family Planning/Birth control includes obstruction methods,hormonal contraception,intrauterine devices(IUDs), sterilization, and behavioral methods.Hormones can bedelivered by injection, by s tabloid the beans (orally),placed in the vagina, or implanted under the skin. The most coarse types of oral contraception include thecombined o ral contraceptive pilland theprogestogen-only pill. Methods are typically used out front sex plainly requisite contraceptionis effective shortly aft(prenominal) 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 tortuous medical question sometimes requiring apelvic mental testingor medical tests.TheWorld Health Organization publishes a fine tendency of medical eligibility criteria for each type of contraception. Birth control methods * An unrolled male rubber-base paint condom * A polyurethanefemale condom * Adiaphragmvaginal-cervicalbarrier, in its case with aquarter U. S. cointo designate eggshell * Acontraceptive spongeset inside its open software product * Three varieties ofbirth control pillsin calendar lie publicity * A transdermal contraceptive patch * ANuva fudgevaginal ring * A hormonalintrauterine device(IUD) against a ambit showing placement in theuterus *A pig IUD next to a dimeto show scale * A abrupt dose of two emergency contraceptive pills (most sunrise by and by pills now only require one) Barrier Barrier contraceptivesare devices that attempt to preventpregnancyby physically preventing sperm cellfrom entering theuterus. They include malecondoms,female condoms,cervical caps,diaphragms, andcontraceptive spongeswithspermicide. The condom is most ordinarily used duringsexual intercourseto overturn the likelihood ofpregnancyand of spreadsexually transmitted diseases(STDssuch asgonorrhea,syphilis, andHIV).It is put on a mans standpenisand physically blocks ejaculated semen from entering the body of a sexual partner. Modern condoms are most often do fromlatex, but some are made from other materials such aspolyurethane,polyisoprene, or birth intestine. Afemale condomis also available, most often made ofnitrile. Male condoms have the advantage of being inexpensive, easy to use, and having few side do. Contraceptive sponges combine a barrier with spermicide. Like diaphragms, they are inserted vaginally front to intercourse and must be placed over the cervix uterito be effective.Typical effectiveness during the commencement exercise 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-hand(a) in place for at least 6 hours afterward. Some people are allergic to spermicide used in the sponge. Women who use contraceptive sponges have an increase risk ofyeast infectionsandurinary tract infections. loss the sponge in for more than 30 hours can result in ototoxic shock syndrome. Hormonal Hormonal contraceptivesinhibitovulationandfertilization.These includeoral pills,subdermalimplants, andinjectable contraceptivesas well as thepatch,hormonal IUDsand thevaginal ring. The most unremarkably used hormonal contraceptive is thecombined oral contraceptive pill usually known as the pillwhich includes a c ombination of an estrogenand aprogestin(progestogen). There is also a progestin-only pill. Currently, hormonal contraceptives are available only for females. Combined hormonal contraceptives are associated with a frail increased cardiovascular risk, including a small increased risk ofvenousandarterial thrombosis. However, the benefits are greater than the risk.Oral contraceptives reduce the risk ofovarian crab louseandendometrial cancerwithout increasing the risk forbreast cancer. They can lower body weight by trim downwater retention(not loss of fat), and several(prenominal) are used to treat mild to mode dictateacne. Between 2% and 10% of women of childbearing age experience emotional and physical symptoms associated withpremenstrual syndrome(PMS) andpremenstrual hard-pressed disorder(PMDD). Combination hormonal contraceptives often ameliorate or efficaciously treat these problems and can effectively treat heavy menstrual expel anddysmenorrhea( untellable menstruation) as we ll.Lower doses of estrogen required by vaginal tribunal (i. e. , from the vaginal ring or hormonal IUDs instead of the pill) may reduce the perverse side effects associated with higher oral doses such as breast tenderness,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 sdysmenorrhea,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 reportingamenorrhea(often mete outed a benefit) and about 40% of women experiencing regular menstrual cycles, leaving the remaining 40% with indorsement spotting or bleeding. Uncommon sid e effects of progestin-only pills, injections, and implants include headache, breast tenderness, mood effects, anddysmenorrhea, but those symptoms often resolve with time.Newer progestins, such as drospirenone and desogestrel, defame theandrogenicside effects of their predecessors. Intrauterine devices The modernintrauterine device(IUD) is a small T-shaped birth control device, containing either hog or progesterone, which is inserted into the uterus. IUDs are a form oflong-acting reversible contraception, the most effective type of reversible birth control. As of 2002, IUDs were the most wide used form of reversible contraception, with besidely 160 million users worldwide. render supports some(prenominal) effectiveness and safety in adolescents.Advantages of the copper IUD include its ability to provideemergency contraceptionup to five eld after unshielded 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 forheavy periods.Levonorgestrel-releasing IUDs may be used during breastfeeding whether or not they also include copper. Sterilization surgical sterilizationis available in the form oftubal ligationfor women andvasectomyfor men. There are no significant long term side effects and tubal ligation decreases the risk ofovarian cancer. Some women regret such a closing 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 fromsexually transmitted nfections. Although sterilization is considered a permanent procedure, it is possible to attempt atubal retrogressi onto reconnect theFallopian tubesin females or avasectomy reversalto reconnect thevasa deferentiain males. The rate of success depends on the original technique, tubal damage, and the persons age. Behavioral Behavioral methods involve regularisation the timingor 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 stew to avoid a new pregnancy. Thelactational amenorrhea method, or LAM, outlines guidelines for determining the length of a womans period of breastfeeding infertility. For women who meet the criteria, LAM is highly effective during the first six months postpartumif breastfeeding is the infants only (or almost only) bloodline of nutrition. provide formula, pumping instead of nursing, and feeding solids all reduce the effectiveness of LAM. Fertility awarenessCalendar-based contraceptive methodssuch as the discredit ed rhythm method and theStandard Days Methodestimate the likelihood of fertility based on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to a womans least fertile period. During her most fertile period, barrier methods may be used, or she may abstain from intercourse. The term 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 theRoman Catholic Church.The effectiveness offertility awareness-based methods of contraception is unknown because of the lack of completed govern 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 allow care to distance their systems from the poor reputation of the rhythm method. l egion(predicate) 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.ACycle Beadsbirth control chain, used for a rough estimate of fertility based on days since menstruation TheStandard Days Methodhas 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 calledCycle Beadswas 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 womans menstrual cycle are considered unimaginative * Days 8-19 are considered fertile considered grievous for unprotected intercourse * From Day 20, infertility is considered to resume Symptoms-based methods of fertility awareness involve a womans observation and charting of her bodys fertility signs, to determine the fertile and infertile phases of her cycle. Charting may be done by hand or with the assist offertility monitors. Most methods track one or more of the three primary fertility signschanges inbasal 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 symptothermal. Other bodily cues such asmittelschmerzare considered secondary indicators. Unplanned pregnancy range have been describe from 1% to 20% for typical users of the symptothermal method. Withdrawal Coitus interruptus(literally stop sexual intercourse), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse (pulling out) before ejaculation.The main risk of coitus interruptus is that the man may not practice the finesse correctly or in a timely manner. in spite of of age(p) studies claiming that no sperm was found in preejaculatory penile secretion, a more recent study states that 41% of subjects produced pre-ejaculatory samples that contained spermatozoa and in 37% a levelheaded proportion of the sperm was motile. Abstinence Though some groups counsellor totalsexual 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 educationdoes not reduceteen 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 (such as condoms or emergency contra ceptive pills).Non-penetrativeandoral sex will loosely avoid pregnancy, but pregnancy can still occur withIntercrural sexand other forms of penis-near-vagina sex (genital rubbing, and the penis exiting fromanal intercourse) where semen can be deposited near the entrance to the vagina and can itself travel along the vaginas lubricating fluids. Emergency (after sex) Emergency contraceptives, or morning-after pills, are drugs taken after sexual intercourse mean to prevent pregnancy. Levonorgestrel(progestin) pills, marketed as Plan B and Next Choice, are available without prescription drug (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(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 f ollowing 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. Pharmacistsare a major(ip) 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 (612 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 PlanningReal 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? Fami ly planningis theplanningof when to havechildren,and the use ofbirth control and other techniques to implement such plans. Other techniques commonly used include sexuality education,prevention and management ofsexually transmitted infections, pre-conception counselingandmanagement, andinfertility management.Family planning is sometimes used as a synonym for the use ofbirth control, however, it often includes a wide variety of methods, and practices that are not birth control. It is most usually applied to afemale-malecouple who wish to limit the number of children they have and/or to control the timing ofpregnancy(also known asspacing children). Family planning may encompasssterilization, as well asabortion.Family planning services are defined as 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 thefamily planningmethods approved by the Roman Catholic Church. In accordance with the Churchs teachings regardingsexual behaviorin keeping with its philosophy of the dignity of the human person, NFP excludes the use of other methods ofbirth control, which it refers to as artificial contraception. Periodicabstinenceis 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 themenstrual cycle, during pregnancy, and aftermenopause. Various methods may be used to identify whether a woman is likely to befertile 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 orlactational amenorrhea method.Symptoms-based methods rely on biological signs of fertility, while calendar-based methods estimate the likelihood of fertility ba sed on the length of past menstrual cycles. Clinical studies by theGuttmacher Institutefound 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 asfertility awareness-based methodsrather than NFP.The three primary signs of a womans fertility are herbasal body temperature, hercervicalmucus, and her cervical position. Computerizedfertility monitorsmay track basal body temperatures, hormonal levels in urine, changes in electrical resistance of a womans 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 theBillings ovulation methodand theCreighton 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 theCouple to Couple Leagueand the Fertility Awareness Method (FAM) taught byToni 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 bySERENA Canadawhich is an inter-denominational organization which has been developing the Symptothermal Method as a part of NFP since 1955.They are also not specifically affiliated with the Roman Catholic Church. It is also taught byJustisse 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 bodys 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. According 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 Thelactational amenorrhea method(LAM) is a method of avoiding pregnancy based on the naturalpostpartuminfertilitythat occurs when a woman isamenorrheicand fullybreastfeeding. The rules of the method help a woman iden tify and possibly lengthen her infertile period. A strict version of LAM is known asecological breastfeeding. Artificial Family Planning/Birth Control, also known ascontraceptionandfertility control, refers to methods or devices used to preventpregnancy. Planning and provision of birth control is calledfamily planning.Safe sex, such as the use of male orfemale condoms, can also help prevent transmission ofsexually transmitted diseases. Contraceptive use indeveloping countries has cut the number ofmaternal deathsby 44% (about 270,000 deaths averted in 2008) but could prevent 73% if the full demand for birth control were met. Becauseteenage pregnanciesare at greater risk of adverse outcomes such aspreterm birth,low birth weight andinfant mortality, adolescents need comprehensivesex educationand access to reproductive healthservices, including contraception.By lengthening the time between pregnancies, birth control can also improve adult womens delivery outcomes and the survival of the ir children. Effective birth control methods includebarrierssuch ascondoms,diaphragms, and the contraceptive spongehormonal contraceptionincludingoral pills,patches,vaginal rings, and injectable contraceptives andintrauterine devices(IUDs). Emergency contraceptioncan prevent pregnancy after unprotected sex. Long-acting reversible contraceptionsuch as implants, IUDs, or vaginal rings are recommended to reduceteenage pregnancy.Sterilizationby means such asvasectomyandtubal ligationis permanent contraception. Some people regardsexual abstinenceas birth control, butabstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sexandoral sexare 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 increaseseconomic growthbecause of fewer dependent children, more women participating in the work force, and less consumption of scarce resources. Womens earnings, assets,body mass index, and their childrens schooling and body mass index all substantially improve with greater access to contraception. Methods of Artificial Family Planning Artificial Family Planning/Birth control includesbarrier methods,hormonal contraception,intrauterine devices(IUDs), sterilization, and behavioral methods.Hormones can bedelivered by injection, by mouth (orally),placed in the vagina, or implanted under the skin. The most common types of oral contraception include thecombined oral contraceptive pilland theprogestogen-only pill. Methods are typically used before sex butemergency contraceptionis effective shortly after intercourse. Det ermining 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 apelvic examinationor medical tests.TheWorld Health Organization publishes a detailed list of medical eligibility criteria for each type of contraception. Birth control methods * An unrolled malelatex condom * A polyurethanefemale condom * Adiaphragmvaginal-cervicalbarrier, in its case with aquarter U. S. cointo show scale * Acontraceptive spongeset inside its open package * Three varieties ofbirth control pillsin calendar oriented packaging * A transdermal contraceptive patch * ANuva Ringvaginal ring * A hormonalintrauterine device(IUD) against a background showing placement in theuterus *A copper IUD next to a dimeto show scale * A split dose of two emergency contraceptive pills (most morning after pills now only require one) Barrier Barrier contraceptivesare devices that attempt to preventpregnan cyby physically preventingspermfrom entering theuterus. They include malecondoms,female condoms,cervical caps,diaphragms, andcontraceptive spongeswithspermicide. The condom is most commonly used duringsexual intercourseto reduce the likelihood ofpregnancyand of spreadingsexually transmitted diseases(STDssuch asgonorrhea,syphilis, andHIV).It is put on a mans erectpenisand physically blocks ejaculated semen from entering the body of a sexual partner. Modern condoms are most often made fromlatex, but some are made from other materials such aspolyurethane,polyisoprene, or lamb intestine. Afemale condomis also available, most often made ofnitrile. 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 thecervixto be effective.Typical effectiveness during the first year of use is about 84% overall, and 6 8% 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 ofyeast infectionsandurinary tract infections. Leaving the sponge in for more than 30 hours can result intoxic shock syndrome. Hormonal Hormonal contraceptivesinhibitovulationandfertilization.These includeoral pills,subdermalimplants, andinjectable contraceptivesas well as thepatch,hormonal IUDsand thevaginal ring. The most commonly used hormonal contraceptive is thecombined oral contraceptive pillcommonly known as the pillwhich includes a combination of anestrogenand aprogestin(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 ofvenousandarterial thrombosis. However, the benefits are greater than the risk.Oral contraceptives reduce the risk ofovarian cancerandendometrial cancerwithout increasing the risk forbreast cancer. They can lower body weight by reducingwater retention(not loss of fat), and several are used to treat mild to moderateacne. Between 2% and 10% of women of childbearing age experience emotional and physical symptoms associated withpremenstrual syndrome(PMS) andpremenstrual dysphoric disorder(PMDD). Combination hormonal contraceptives often ameliorate or effectively treat these problems and can effectively treat heavy menstrual bleeding anddysmenorrhea(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 tenderness,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 sdysmenorrhea,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 reportingamenorrhea(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, anddysmenorrhea, but those symptoms often resolve with time.Newer progestins, such as drospirenone and desogestrel, minimize theandrogenicside effects of their predecessors. Intrauterine dev ices The modernintrauterine 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 oflong-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 provideemergency contraceptionup 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 forheavy periods.Levonorgestrel-releasing IUDs may be used during breastfeeding whether or not they also include copper. Sterilization Surgical sterilizationis available in the form oftubal ligationfor women andvasectomyfor men. There are no significant long term side effects and tubal ligation decreases the risk ofovarian 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 fromsexually transmitted nfections. Although sterilization is considered a permanent procedure, it is possible to attempt atubal reversalto reconnect theFallopian tubesin females or avasectomy reversalto reconnect thevasa deferentiain males. The rate of success depends on the original technique, tubal damage, and the persons age. Behavioral Behavioral methods involveregulating the timingor 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. Thelactational amenorrhea method, or LAM, outlines guidelines for determining the length of a womans period of breastfeeding infertility. For women who meet the criteria, LAM is highly effective during the first six months postpartumif breastfeeding is the infants 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 methodssuch as the discredited rhythm method and theStandard Days Methodestimate the likelihood of fertility based on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to a womans least fertile period. During her most fertile period, barrier methods may be used, or she may abstain from interco urse. The term 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 theRoman Catholic Church.The effectiveness offertility 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.ACycle Beadsbirth control chain, used for a rough estimate of fertility based on days since menstruation TheStandard Days Methodhas a simpler rule set and is mo re effective than the rhythm method. The Standard Days Method has a typical failure rate of 12% per year. A product calledCycle Beadswas 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 womans 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 womans observation and charting of her bodys fertility signs, to determine the fertile and infertile phases of her cycle. Charting may be done by hand or with the assistance offertility monitors. Most methods track one or more of the three primary fertility signschanges inbasal body temperature, in cervical mucus, and in cervical position.If a woman tra cks both basal body temperature and another primary sign, the method is referred to as symptothermal. Other bodily cues such asmittelschmerzare considered secondary indicators. Unplanned pregnancy rates have been reported from 1% to 20% for typical users of the symptothermal method. Withdrawal Coitus interruptus(literally interrupted sexual intercourse), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse (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 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 totalsexual abstinence, by which they mean the avoidance of all sexual activity, in the context of b irth 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 educationdoes not reduceteen 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 (such as condoms or emergency contraceptive pills).Non-penetrativeandoral sex will generally avoid pregnancy, but pregnancy can still occur withIntercrural sexand other forms of penis-near-vagina sex (genital rubbing, and the penis exiting fromanal intercourse) where semen can be deposited near the entrance to the vagina and can itself travel along the vaginas lubricating fluids. Emergency (a fter sex) Emergency contraceptives, or morning-after pills, are drugs taken after sexual intercourse intended to prevent pregnancy. Levonorgestrel(progestin) pills, marketed as Plan B and 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(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. Pharmacistsare 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 (612 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.