The Impotence of Contraception - Essay Example

The Impotence of Contraception Pregnancy brings immeasurable happiness and a blessing to those couples or individuals who are ready and capable to raise a child. However, in today’s rapid population growth and challenging way of life, not all couples have sufficient source of income to sustain the demands of having many children and not all individuals are ready for the demands of parental responsibilities. Thus, contraception, also called birth control, was discovered as an option for prevention of pregnancy. I am one of the many individuals who are not yet ready to have a child because of the more important priorities in life. In this paper, I will share my personal analysis of my health status as a consistent user of Depo-Provera contraceptive for more than five years now in relation to the information I have gathered from published literatures about the different methods of contraception. To start with, the practice of contraception is as old as human existence evidenced by the ancient writings on Kahun papyrus in 1850 BCE with ancient Egyptian techniques related to prevent pregnancy (Samra, Wood, and Cowan 1). Nowadays, government’s promotion for contraception is high as this is the means to hasten the rapidly-growing population and prevent the spread of sexually transmitted diseases or STDs (applicable for condoms). Using contraception is a matter of choice for couples or individuals, however, Doctor Andrew M. Kaunitz of University of Florida Health Science Center, emphasizes its importance in reducing unintended pregnancies and abortions and in facilitating family planning or birth spacing. Furthermore, there are different types contraception (barrier, mechanical, hormonal, natural methods, and emergency and permanent methods) for men and women, depending on their age, health, and personal situation (Stoppler and Shiel Jr. 2). It is a must to consult a health care professional (except in abstinence) prior to using any contraceptive for complete evaluation of any medical concerns and review of family history for potentials risks to rule out any medical contraindications. (Chisholm-Burns, Schwinghammer, Wells, Malone, Kolesar, and Dipiro 843). Though most contraceptives are highly effective, however, according to family planning specialist Dawn Stacey, there are factors that may influence its effectiveness including the user’s motivation, accessibility, fertility levels, and properly following directions. The following are the different types of contraceptives summarized according to what it is, who is meant to use, how it works, its efficacy, and the associated risks and side effects: ABSTINENCE The American Pregnancy Association considers abstinence as a means of contraception by voluntary refraining from sexual activity and this is the only method considered 100% effective in pregnancy prevention and transmissions of STDs (“Overview: Types of Birth Control”). There are no side effects or health-related risks associated with abstinence method. FERTILITY AWARENESS METHOD: NATURAL FAMILY PLANNING (NFP) NFP is another nonpharmacological means of pregnancy prevention; however, failure rates of such methods can be high. There are three types of NFP: (1) The calendar or rhythm method involves counting the days in the menstrual cycle and then using a mathematical equation to determine the fertile window; (2) The temperature method involves monitoring changes in the woman’s basal body temperature using a basal thermometer each day; and (3) The cervical mucus or Billings ovulation method involves observing the cervical mucus secretions throughout the cycle (Chisholm, et al. 852). No side effects and health-related risk associated. HORMONAL METHODS These methods are in the form of pill, patch, shot, ring, or implant, all of which contain estrogen and/or progesterone hormones. Hormonal methods work in one of three ways: (1) preventing a woman’s ovaries from releasing an egg each month; (2) thickening of the cervical mucus making it harder for sperm to reach and penetrate the egg; and (3) thinning the uterus lining which reduces the likelihood of a fertilized egg to implant in the uterus wall. However, the user is not protected against STD transmission (“Overview: Types of Birth Control”). Birth Control Pills. The three types of birth control pills taken orally and inhibit ovulation are the: (1) standard birth control pill (99.9% effective) containing a combination of synthetic estrogen and one of several steroids; (2) mini pill (95% effective) containing progestin hormone only and may be prescribed for breastfeeding women; and (3) extended-cycle pill or the Seasonale (99.9% effective) taken in a longer cycle to reduce the number of yearly menstrual period from 13 periods to 4 periods a year (Nihira 1). All pills require a doctor’s prescription. Common side effects of pills include nausea, weight gain, sore or swollen breasts, spotting between periods, lighter periods, and mood changes. Less common but more serious side effects include abdominal pain, chest pain, headaches, and eye problems. Pills can be taken by most women but not recommended for women over 35 years old; smoking; those with blood clots, heart or liver disease, and cancer of the breast or uterus (3). Depo-Provera or Birth Control Shot. According to Doctor Mikio A. Nihira of WebMD, Depo-Provera is a hormone (similar to progesterone) injected to a woman intramuscularly within 5 days of the menstrual cycle for 3 months protection from pregnancy. This is 99% effective but does not protect the user from STDs. Most women can use Depo-Provera but contraindicated for those who have unexplained vaginal bleeding, liver disease, breast cancer, and blood clots. Common side effects are irregular menstrual period or no period at all and irregular bleeding or spotting, while the less common side effects are headaches, nervousness, depression, dizziness, acne, weight gain, hair loss, and loss of bone and mineral density. Risk for osteoporosis is high for those who have been taking Depo-Provera for 2 years and longer, thus physicians advise to take adequate calcium and vitamin D through diet and/or supplements (Nihira). NuvaRing or Vaginal Ring. According to YoungWomensHealth.org, NuvaRing is a flexible plastic ring device containing hormones estrogen and progestin inserted into the woman’s vagina and worn for 3 weeks and allowing 1 week unworn for menstruation to occur. This is safe for most women and teenagers and 99% effective in preventing pregnancy with no protection from STDs. Contraindicated to those with blood clots, heart problems, hypertension, or severe migraine headaches with aura. Side effects are occasional headaches, nausea, and breast tenderness, vaginal infection and irritations, and weight gain (“The Vaginal Hormonal Ring”). Ortho Evra Patch or Birth Control Patch. Doctor Vanessa Cullins of Planned Parenthood discussed birth control patch as a thin, beige, plastic patch stick to the skin once a week, 3 weeks in a row, to prevent pregnancy then a patch-free week to regulate menstruation. The patch also releases hormones estrogen and progestin and works like a pill. This method is 99% effective if used as directed, can be used by most women, but contraindicated to those who are pregnant, who smoke and are 35 and older, have migraines with aura, blood-clotting disorders, vein inflammation, breast or liver cancer, heart diseases, lupus, and severe diabetes. Side effects are bleeding between periods, breast tenderness, and nausea and vomiting. Intrauterine Device or IUD. This is a small plastic device containing copper or hormones that is inserted into the uterus by a medical professional. IUD changes the cervical mucus decreasing the probability of fertilization and changes the lining of the uterus preventing implantation in case fertilization occurs. This is 99% effective for most women but contraindicated to those who have cancer in the uterus or cervix, pelvic inflammatory disease, unexplained vaginal bleeding, pregnant, history of ectopic pregnancy, and not in a mutually monogamous relationship. Side effects include mood changes, acne, headaches, breast tenderness, pelvic pain, cramping, and increased bleeding during menstruation (“Intrauterine Devices”). BARRIER METHODS: DEVICES Though barrier contraceptives have fewer adverse effects and their efficacy is highly user-dependent, these methods are, however, associated with much higher accidental pregnancy rates (Chisholm, et al. 851). Diaphragm and Cervical Caps. These are dome-shaped rubber caps filled with spermicidal cream or jelly placed over the cervix (6 hours prior and 6 hours after intercourse but not be left longer than 24 hours) to provide barrier protection during intercourse (851). Spermicides. These are chemicals (available as foam, jelly, foaming tablets, and vaginal suppositories) designed to kill sperm. Nonoxynol-9 is the most commonly used spermicide in the United States. This is most effective if placed in the vagina not longer than one hour prior to intercourse and their efficacy are enhanced when used in combination with a barrier method. However, spermicide does not provide protection against STDs (852). Condoms. Available for both male and female, these act as physical barriers to prevent sperm from coming in contact with the ova. Condoms are easy to use, available without prescription, inexpensive, and can be very effective in prevention of unwanted pregnancies when used correctly. Condoms are usually made of latex or synthetic material which reduces the transmission of STDs by 90% (852). Sponge. This is a small, pillow-shaped polyurethane sponge impregnated with nonoxynol-9 which is available over-the-counter but has proven to be generally less effective at preventing pregnancy than diaphragms (852.) EMERGENCY CONTRACEPTION (EC) EC is used to prevent pregnancy after known or suspected unprotected sexual intercourse. Plan B is the FDA-approved EC currently available and approved for nonprescription sale to patients 17 and older (Chisholm-Burns, et al. 853). The first dose of Plan B, which contains 0.75 mg levonorgestrel, is taken within 72 hours after unprotected sexual intercourse and the second dose is taken 12 hours later. Side effects include nausea and vomiting (853). WITHDRAWAL AND STERILIZATION Neither withdrawal nor sterilizations prevent transmission of STDs. Withdrawal. This involves the removal of the erect penis from the vagina prior to ejaculation. Sterilization. This is considered as the permanent method of birth control (Samra, Trupin, Talavera, Shulman 1). In females, the procedure involves the surgical closing of the fallopian tubes which carry the eggs from the ovaries to the uterus, called tubal ligation. In males, the procedure involves the surgical closing of tubes that carry sperm, called vasectomy (1). This method is 99.9% effective in preventing pregnancy, except in case of partial removal in tubal ligation, and does not protect the person from STD transmission (2). The advantage of this method is that it does not involve hormones, does not change libido, menstrual cycle, or breastfeeding ability, and no side effects. However, the procedure involves general or regional anesthesia, and since this is permanent, the person may regret the decision later (2). The implication of this study to my personal situation is the awareness on my health status which calls initiative for consultation to a health care professional as I have been using Depo-Provera contraception for more than 5 years now. Personally, I prefer this contraceptive method because I have already proven its efficacy without worrying about the daily schedule of monitoring or regular intake (required by the pill and NFP) which I find burdensome. Also, I have never experienced any adverse side effect for the past 5 years, except for the common side effects that are minimal and manageable. I always make sure that I take calcium supplements but nevertheless, I still feel the need to consult the physician knowing that I have been using this method way far more than the supposedly 2 years considerable length of usage noted in one of the literatures I have searched and utilized in this study. As all of the authors suggests, I also put a big emphasis on consulting a physician prior to using any form of contraceptive, except in abstinence, in order not to suffer the more serious complications that may possibly be brought about by the interaction of contraceptive to the body. With using contraception, I can carefully plan for my future and make my contribution of social responsibility to the society. Works Cited Chisholm-Burns, Marie A., Terry L. Schwinghammer, Barbara G. Wells, Patrick M. Malone, Jill M. Kolesar, and Joseph T. Dipiro. Pharmacotherapy Principles & Practice. 2nd ed. United States of America: The McGraw-Hill Companies, Inc. , 2010. Print. Cullins, Vanessa. “Birth Control Patch (Ortho Evra).” Planned Parenthood Health Info & Services. Planned Parenthood Federation of America Inc. 2011. Web. 14 June 2011. . “Intrauterine Devices”. AmericanPregnancy.org. American Pregnancy Association, Aug 2008, Web. 14 June 2011. . Kaunitz, Andrew M. “The Impotence of Contraception.” The Global Library of Women’s Medicine, ISSN: 1756-2228 (2008): n. pag. GLOWM.com. Web. 13 June 2011. . Nihira, Mikio A. “Birth Control and Depo-Provera.” WebMD Birth Control Health Center. WebMD LLC, 24 Mar. 2010. Web. 14 June 2011. . ---. “Birth Control Pills.” WebMD Birth Control Health Center. WebMD LLC, 24 Feb. 2010. Web. 14 June 2011. . “Overview: Types of Birth Control.” American Pregnancy Association Promoting Pregnancy Wellness. AmericanPregnancy.org. July 2008. Web. 13 June 2011. . Samra, Omnia M., Suzanne R. Trupin, Francisco Talavera, and Lee P. Shulman. “Birth Control Permanent Methods.” eMedicineHealth. WebMD, Inc., 8 Oct. 2005. Web. 14 June 2011. . Samra, Omnia M. , Ellen Wood, and Bryan D. Cowan. “Contraception.” Medscape Reference. WebMD LLC, 16 May 2011. Web. 13 June 2011. . Stacey, Dawn. “Before You Choose A Birth Control Method.” About.com: Contraception. About.com, 16 Oct. 2009. Web. 13 June 2011. . Stoppler, Melissa C., and William C. Shiel Jr. “Birth Control Types and Options.” MedicineNet.com. MedicineNet, Inc., 16 July 2010. Web. 13 June 2011. . “The Vaginal Hormonal Ring (NuvaRing).” YoungWomensHealth.org. Center for Young Women’s Health, Children’s Hospital Boston, 11 Apr. 2009. Web. 14 June 2011. . Read More