Contracep*on IUC s, Steriliza*on, & More
Intrauterine Contracep*ves (IUC s) IUC s are made of flexible plas*c, available only through prescrip*on Three types ParaGard (copper) Mirena (hormone) Skyla (hormone)
IUC s: ParaGard ParaGard contains copper Copper prevents sperm from fer*lizing an ovum Copper also makes implanta*on of fer*lized ovum difficult Amount of copper released is less than needed in daily diet Copper intolerance or insensi*vity would preclude use of ParaGard
IUC s: Paragard Requires inser*on into uterus by healthcare provider Takes only a few minutes Inser*on may cause cramping, dizziness Once inserted, may remain in place for ten years Pa*ent should not feel IUD Since no hormones present, monthly cycle should remain unchanged Effec*veness: 99%+ against pregnancy Requires monthly checking for IUD slippage
IUC s: ParaGard Side effects: heavier and longer periods, cramping, spotng in between periods May lessen auer a few months on ParaGard Complica*on risks: pelvic inflammatory disease shortly auer inser*on, perfora*on of uterus, expulsion Copper may provide protec*ve benefit against endometrial cancer Cost: $0-1000 (Planned Parenthood)
Proges*n- only intrauterine contracep*ve Lasts for five years Mirena: Prevents sperm from fer*lizing ovum Prevents release of egg Changes uterine lining IUC s: Mirena
IUC s: Mirena Inser*on: Similar to ParaGard Effec*veness: 99%+ against pregnancy Cost: $0-400 (Consumer Reports) Side effects: Abdominal cramping (10% of users during first few months), acne, breast tenderness, headache, mood changes, back pain May lessen auer a few months As use con*nues, less menstrual bleeding Complica*on effects: ovarian cysts, pelvic inflammatory disease shortly auer inser*on, perfora*on of uterus, expulsion
IUC: Skyla FDA approved in 2013 Hormone Smaller than Mirena Lasts three years instead of five Marketed to women who have not had kids Mirena marketed to women with child (research done only on this group) IUC s appropriate for all women
IUC s Internal Birth Control- IUD s (via Youtube) Paragard inser*on (via YouTube, 0-0:53) Mirena inser*on (via YouTube, for healthcare providers) Inser*on of IUC (Medialvideos.us)
Steriliza*on
Steriliza*on Steriliza*on = permanent contracep*on Women undergo tubal liga*on Men undergo vasectomy The second most common contracep*ve method used in the United States, behind the pill No formalized data collec*on system exists Data retrieved from surveys, ques*onnaires
Steriliza*on: Tubal Liga*on Surgical technique Close fallopian tubes, preven*ng egg from traveling to uterus, preven*ng sperm from reaching egg Neither organs nor glands are removed Effec*veness: 99%+ Considered irreversible
Steriliza*on: Tubal Liga*on Tubal steriliza*on: Tubal coagula*on/ cauteriza*on Tubes can be *ed and cut (Pomeroy & Parkland techniques) Tubes can be clipped, clamped These incision methods ouen performed auer childbirth/abor*on Anima*on (SMART imagebase)
Steriliza*on: Tubal Liga*on Cost: $1000-3000 Side effects: thought by many to be rare; hormonal imbalance may lead to increased menstrual bleeding, cramping; adhesions Complica*ons: infec*on, internal bleeding, ectopic pregnancy Before/aUer photos (private Flickr account)
Steriliza*on: Implants Non- incision method No general anesthesia Under an hour Coils inserted into fallopian tubes In following months, coils and *ssue grow together, forming barrier to prevent sperm from reaching egg Essure implants and insurance ques*ons
Steriliza*on: Implants Side effects: expulsion of coil inserts, risk for ectopic pregnancy, cramping, menstrual changes, nausea/vomi*ng Anima*on (essure.com)
Steriliza*on: Vasectomy Vasectomy blocks sperm from traveling through vas deferen*a, preven*ng sperm from mixing into semen No glands or organs are removed Effec*veness: 99%+ Considered irreversible
Steriliza*on: Vasectomy Vas deferens must be isolated Similar to tubal liga*on, the vas deferens can be cut and *ed, clamped, cauterized; no scalpel technique Another form of contracep*on must be used for a few months
Steriliza*on: Vasectomy Cost: $0-1000 (plannedparenthood.com) Not currently covered via Affordable Care Act (arhp, 1/14) Side effects: bruising, sensi*vity/pain, sperm leaking from tubes may lead to small lump (usually clears on its own), an*bodies to sperm may develop, reducing chances of fer*lity in a reversal Complica*ons: rare, usually associated with infec*on (fever, pus/blood from incision site, swelling, pain); ends of tubes may grow back together (very rare); decreased sexual desire (4 out of 1000 cases per Planned Parenthood) - no apparent physical cause
Steriliza*on: Vasectomy Anima*on (Medical PoliCs via YouTube) Video (vasectomymedical.com)
Contracep*on in the Future: Nestorone Estrogen and proges*n Gel Spray Popula*on Council Announcement, 2010 Phase III trials (Antares Pharma)
Contracep*on: The Future RISUG Reversible Inhibi*on of Sperm Under Guidance Contracep*ve method for men Clinical trials in India Injec*on into vas deferens of male (video, wired.com, :34) RISUG disrupts membranes of sperm so they cannot fer*lize One injec*on to last 10 years Reversibility not well tested, though reports on primates appear posi*ve (requires another injec*on) Marke*ng challenges
Contracep*on: The Future Male hormonal contracep*ve: monthly testosterone injec*on 5/ 2009: China clinical trials 1 in 100 fathered a child Reversible six months auer stopping injec*ons 1/3 of 1000 par*cipants did not complete; no reason provided Few side effects reported (acne, weight gain), but more research needed Photo from BBC
Contracep*on: The Past Male Contracep*ve: Heat Prolonged heat exposure can impair sperm produc*on in testes Ancient method Effec*veness? 116 degree bath 45 minutes Every day Three weeks
Contracep*on: Impact of Heat on Sperm
Contracep*on: Impact of Heat on Sperm Dada, R, Gupta, NP, & K. Kucheria. Deteriora*on of Sperm Morphology in Men Exposed to High Temperature. Journal of the Anatomical Society of India. Vol. 50, No. 2 (2001-07- 2001-12)
Contracep*on: Impact of Heat Upper leu: coiled tail Upper right: bent tail Lower leu: double head Lower right: triple head on Sperm Dada, R, Gupta, NP, & K. Kucheria. Deteriora*on of Sperm Morphology in Men Exposed to High Temperature. Journal of the Anatomical Society of India. Vol. 50, No. 2 (2001-07- 2001-12)