The INS and OUTS of Contraception

THE INS AND OUTS OF CONTRACEPTION LABELS: NO DOCTOR'S S PRICE, AVAILABILITY FOR MEN EFFICIENCY PROS VISIT NEEDED DOCTOR'S VISIT NEEDED QUOTE FROM INTERVIEW GO WITH MAKA GEGECHKOI, METHOD FOR WOMEN O CONS DESCRIPTION REPRODUCTOLO0GIST, MD.PH.D STDS - SEXUALLY TRANSMITTED DISEASES IUD - INTRAUTERINE DEVICE "A person should choose a method of contraception by themselves, individually, according to their age, financial ability, health, ideology and beliefs. It is important to discuss the method with a doctor, as a doctor can assess the patient's health and either support the choice or caution against it." BARRIER METHODS MALE CONDOM FEMALE CONDOM 82-98% 79-95% Worn on the penis and designed to stop a man's semen from coming into contact with his sexual partner. Worn inside the vagina to prevent semen from getting to the womb. It can be put in up to eight hours before sex. • Needs to only be used when having sex • No medical or hormonal side effects • Can be used as additional contraception • Widely available • No prescription or doctor's visit needed • Protects against • Needs to only be used when having sex • Does not affect woman's natural hormones • Not inconvenient during sex if inserted earlier • Can be used while breastfeeding • Protects against STDS • Cannot be reused • Inconvenient during sex if not inserted earlier • Might reduce sensitivity during sex • Might cause irritation or slip out during sex • Cannot be reused • Inconvenient during sex • Can tear or come off • Can cause allergic reaction and skin irritation • Might reduce sensitivity during sex • Needs to follow storage and usage rules Not available in Georgia 2.85 - 9 GEL (3 per box) Widely available in shops and pharmacies Use is simple and convenient • Can act additionally as a lubricant • Does not affect woman's natural hormones • Can be used with other methods SPERMICIDES 72-82% • Can cause allergic reaction and skin irritation • Inconvenient and uncomfortable during sex Needs to be reinserted for repeated sexual acts • Does not protect against STDS Substance that contains chemicals which stop sperm from moving. Available in different forms, including creams, film, foams, gels, and suppositories. Can be used together with other birth control methods. Spermicides are inserted deep into the vagina shortly before intercourse. S Suppository - 14.50 GEL (10 per box) Cream - 13.25 GEL (72 g) Available in pharmacies DIAPHRAGM OR CERVICAL CAP SPONGE 84-94% 84-91% Inserted into the vagina before sex to cover the cervix. More effective when used togeth- er with spermicide. Inserted into the vagina before intercourse to block sperm from entering uterus. A sponge contains spermicide to stop sperm from joining with an egg. • Can be reused (lasts up to 2 years) • No discomfort • Can be worn for several hours • Does not affect woman's natural hormones • Cannot be felt • Can be reused • Can be inserted before sex and be worn up to 24 hours • Does not affect woman's natural hormones • Can be difficult to insert properly • Can be pushed out during intercourse • Less effective for women who have given birth • Does not protect against STDS • Can be difficult to insert properly • May cause vaginal irritation or dryness • Less effective for women who have given birth • Does not protect against STDS Not available in Georgia S Not available in Georgia INTRAUTERINE CONTRACEPTION COPPER IUD HORMONAL IUD 99% 99% T-shaped copper device that is inserted in the uterus by a doctor. Copper, as a natural spermicide, prevents fertilization. IUD lasts 5-10 years. T-shaped plastic device that is insterted in the uterus by a doctor. Releases progesteron daily and lasts up to 5 years. • Can be used as emergency contraception if inserted within 5 days of unprotected sex • Effective and long-lasting • Does not affect woman's natural hormones • Can be used while breastfeeding • Reproductive function easily regained •Can be used as emergency contraception • Effective and long-lasting • Can reduce period • Can be used while breastfeeding • Reproductive function easily regained • Needs medical procedure • Possible infections and side effects • Possible waist and stomach pain • Can cause irregular, longer, and heavier periods • Does not protect against STDS • Needs medical procedures • Is relatively expensive • Possible infections and side effects • Possible waist and stomach pain . Can cause irregular period • Does not protect against STDS From 17 GEL Medical procedures - 60-100 GEL Available in clinics and pharmacies Up to 350 GEL Medical procedures - 60-100 GEL Available in clinics and pharmacies HORMONAL METHODS "The older generations distrust hormonal contraceptions since the first methods of contraceptions contained large doses of hormones which caused many side effects. Today the technology has improved. The first contraceptives were created in 1960. Since then vast improvements have been made." PILLS PATCH 91-99% 91-99% Taken by a woman at the same time for 21 days straight every month. Available as a combination of estrogen and progestin or progestin only pills (mini pills). Delivers hormones into the body through the skin to prevent ovulation and sperm getting to the egg. A new patch is placed on the skin once a week for three weeks in a row, followed by a patch-free week. • Period becomes lighter, more regular, and less painful • May help prevent acne, ovarian cancer, iron deficiency anemia, cysts, and bone thinning • Mini pill has fewer side effects than combination pills • Use is safe and simple • Same effects as pills • Requires following a precise routine • Not advised for women who are smoking and above 35 years old • May increase risk of heart attack, stroke, blood clot, and high blood pressure • Does not protect against STDS Can cause skin irritation • Can be visible • Less effective for overweight women • Same side effects as pills • Does not protect against STDS Not available in Georgia 4-20 GEL (21 pills per box) Widely available in pharmacies Se "Practically all methods are accessible in Georgia, but not all types of each method are available. For example, the patch is a hormonal method and its equivalent in Georgia is the pill. Because the patch is expensive, it has less chance of being sold in Georgia and, therefore, is not imported." "Some pills have additional functions than just birth-control, thus, those are more expensive. If a woman needs just contra- ception, than she can make a choice according to her financial ability, but if she wants to benefit from additional effects, such as improving skin structure, curing excessive hairiness, greasi- ness, etc., then she should use the more expensive pills." RING IMPLANT 91-99% 99% Inserted in the vagina for 21 days. Prevents ovulation by releasing estrogen and progestin. Can also be used continuously to prevent periods. Inserted in the arm by a doctor. Releases progestin to prevent pregnancy. Lasts up to 3 years. • Use is simple and convenient • Same effects as pills • Can be used while breastfeeding • Is long-lasting • Can be used by women sensitive to estrogen • Reproductive function easily regained • Can increase period • Can cause vaginal irritation or infection • Can reduce woman's sexual pleasure • Not recommended for smokers and those with diabetes or high blood pressure • Can fall out • Same side effects as pills • Does not protect against STDS • Needs medical procedure • Can cause irregular periods • Regulating periods might take 6-9 months • Does not protect against STDS Doctors are being trained. May become available in Georgia soon Not available in Georgia INJECTION MORNING-AFTER PILL 94-99% 58% 85% 95% if taken within 49-72 hours of sex if taken within 25-48 hours of sex if taken within 24 hours of sex Contains progestin hormone that prevents pregnancy for three months. Two strong hormonal pills taken 12 hours apart up to 72 hours after unprotected sex. Can be taken only twice per year. • Does not contain estrogen to which some women are sensitive • Use is simple and convenient • Long lasting • Can help prevent cancer of the lining of the uterus • Emergency contraception • Effective if used soon after unprotected sex • No reports of serious complications • Side effects can include weight gain, irregular periods, and temporary bone thining • Does not protect against STDS • Side effects can include dizziness, tiredness, headache, tender breasts or abdominal pain, nausea or vomiting, and irregular period • Can be less effective for overweight women • Does not protect against STDS 10.45 GEL (500 mg) Available in pharmacies 12 GEL ( 2 pills) Available in pharmacies NATURAL METHODS CALENDAR METHOD Depends on the accuracy of calculation 75-969 HOW TO CALCULATE?! MENSTRUAL CYCLE: number of days from the start of menstrual period till the start of the next menstrual period. 15 16 Abstaining from sex or using protection E while a woman is fertile. Observe the number of days of each menstrual cycle for 6 months and choose the shortest and longest cycles. 22 23 29 30 Start of menstrual cycle • Does not affect woman's natural hormones • Can also be used to plan pregnancy • No medication needed • Smartphone apps available for tracking fertile period • No cost Menstrual period and a few days after Infertile period • Hard to count fertile period • Fertile period can be long • Does not protect against STDS Fertile Longest cycle minus 11 days period Free Shortest cycle minus 18 days WITHDRAWAL BREASTFEEDING 82-96% 98% A man taking his penis out of the vagina before ejaculation to prevent sperm from entering the woman's uterus. The act of breastfeeding naturally changes a woman's hormones so that she does not become pregnant. • Safe for health • Immediately Effective • Can be used to replace other methods • Always available • No cost • No side effects • Immediately effective • No cost • Can reduce sexual pleasure • Requires great self-control • Can cause neurosis • Does not protect against STDS • Can only be used within the first 6 months after giving birth • Only effective if a woman is actively breastfeeding • Only effective if a woman has not had a period since she delivered a baby • Does not protect against STDS Free Free PERMANENT METHODS TUBAL STERILIZATION VASECTOMY 99% 99% Closed Tubes A surgery that closes or blocks a woman's fallopian tubes so eggs cannot reach the uterus. A surgery that closes or blocks the vas deferens tubes so sperm cannot leave a man's body. • No need for additional contraception • Lasts for life • Does not affect woman's natural hormones • Does not affect sexual activity • No need for additional contraception • Lasts for life • Does not affect man's natural hormones • Does not affect sexual activity In rare occasions the tubes may reconnect by themselves • If pregnancy develops in a fallopian tube, it can be serious and life threatening • Reversal is very hard • Needs surgery • Costly • Does not protect against STDS • Not effective for 3 months • In rare occasions the tubes may reconnect by themselves • Reversal is very hard • Needs surgery • Does not protect against STDS No demand in Georgia and clinics do not offer this service Free - included in the price of caesarean section if done together 1650 GEL - if done independently GO "Contraception is not an alternative to giving birth, it's an alternative to abortion." "Taking any contraception per month is much cheaper than an abortion procedure, which, besides high cost, has many other negative effects. Maybe Georgians cannot afford paying much for contraception at once, but if we distribute the cost of an effecitve method to the entire period, price is not that high: for example, IUD, which lasts for 5 years, will cost only 32 Tetri per month." Source: www.nhs.uk www.plannedparenthood.org www.aversi.ge www.gfma.ge www.fpamg.net Interview with Maka Gegechkori, Reproductologist, MD. PH. D (Zhordania Institute of Human Reproduction) JumpStarte 00000