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GENERAL |
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What are the contraceptive choices
available for males?
The contraceptive choices available
for males include: condoms for
temporary protection and vasectomy for
permanent protection.
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What are the contraceptive choices
available for females?
The contraceptive choices available
for females include: (i) Female condom
(ii) Spermicides (iii) Oral pills (iv)
Injectable contraceptives (v) Intra
uterine device (vi) Tubectomy.
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What is the range of contraceptives
available depending upon the need?
The range of contraceptives depending
upon the need may be presented as
follows:
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SITUATION |
CONTRACEPTIVE CHOICE |
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Teens/ Young married
couples- having no children |
Condom: Male/ Female
Combined hormonal
contraceptive pills
Progestin only pills
Centchroman (Saheli)
Depo- Provera
Norplant |
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Married Couples having
children but willing for more;
desirous of spacing pregnancy |
Condom: Male/ Female
Combined hormonal
contraceptive pills
Progestin only pills
IUD
Depo- Provera
Norplant |
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Married couples who
have completed their family |
Progestin only pills
Depo- Provera
Norplant
IUD
Sterlization-
male/female |
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Breastfeeding mothers |
Condom: Male/ Female
Progestin only pills
Depo- Provera
Norplant
IUD
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MALE CONDOM |
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What is a male condom?
A male condom is a sheath made to fit
over a man’s erect penis.
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What material is a condom made of?
Most condoms are made of latex
rubber.
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What are the advantages in using a
condom?
Using a condom may have the following
advantages: ( I) Condoms are one of
the most reliable methods of birth
control when use properly and
consistently.(ii) Condoms are user
friendly. With a little practice, they
can also add confidence to the
enjoyment of sex. (iii) Condoms are
only needed when you are having sex
unlike some other contraceptives which
require you to take or have them all
of the time.(iv) Condoms are the only
contraceptive that also helps prevent
the spread of sexually transmitted
diseases (STDs) including HIV when
used properly and consistently. (v)
Can be used by men of any age. (vi)Usually
easy to obtain and sold at most
places.
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What are the disadvantages of using a
condom?
The disadvantages of using a condom
are as follows: (i) May cause itching
for a few people who are allergic to
latex.(ii)There is a small possibility
that the condom might slip off or
break during sexual intercourse. (iii)
If used with oil based lubricants such
as vaseline or oil, condoms can go
weak and break.
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What is the effectiveness of a condom
in protection against pregnancy?
If the partners of 100 women start
using condoms, coreectly and
consistently, there are 3 pregnancies
per 100 women in the first year of
use. With irregular or inconsistent
use, there is a likelihood of 14 of
these women getting pregnant in the
first year of use of condoms.
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What could be the possible reasons for
incorrect or improper usage?
Improper or incorrect usage may result
due to reasons such as- wearing the
condom before complete erction, not
wearing the condom upto the shaft etc.
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What is the technique of correct usage
of a condom?
The technique of correct usage of a
condom is as follows: (i) Make sure
the package and condom appear to be in
good condition, and check that if
there is an expiry date that the date
has not passed. (ii) Open the condom
package at one corner being careful
not to tear the condom with your
fingernails, your teeth, or by being
too rough. (iii) Place the rolled
condom over the tip of the hard penis.
(iv) Roll the condom all the way down
to the base of the penis, and smooth
out any air bubbles. (Air bubbles can
cause a condom to break).(v) Leave a
space of atleast half an inch at the
tip of the condom for the semen to
accumulate.(vi) If you want to use
some extra lubrication, put it on the
outside of the condom. But always use
a water-based lubricant (such as KY
Jelly - available at all leading
chemist shops). Do not use an an
oil-based lubricant such as vaseline
/baby oil/coconut oil since will
cause the latex to break.
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What is to be done if the condom does
not unroll?
The condom should unroll smoothly and
easily from the rim on the outside. If
you have to struggle or if it takes
more than a few seconds, it probably
means that you are trying to put the
condom on upside down. To take off the
condom, don't try to roll it back up.
Hold it near the rim and slide it off.
Then start again with a new condom.
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When should the condom be removed ?
Pull out before the penis softens, and
hold the condom against the base of
the penis while you pull out, so that
the semen doesn't spill.
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How should a condom be disposed?
Condom should be disposed properly for
example wrapping it in a paper or
tissue and throwing it away. It's not
good to flush condoms down the toilet
– as they are non biodegradable and
can block the sewer drain.
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What should be done if the condom
breaks during intercourse?
If a condom breaks during sexual
intercourse, then pull out quickly and
replace the condom. Whilst you are
having sex, check the condom from time
to time, to make sure it hasn't split
or slipped off. If the condom has
broken and you feel that semen has
come out of the condom during sex, you
should consider getting emergency
contraception such as the morning
after pill.
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Are two condoms more effective than
one?
Don't use two condoms at once, the
latex rubbing against each other may
cause the latex to tear.
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Please give some tips for caring for
condoms.
1.Condoms should be stored in a cool
dark place if possible.
2.Avoid exposure of the condom to
excessive heat, light and humidity.
3.Handle condoms carefully.
Fingernails and rings can damage
condoms.
4.Do not unroll condom befor use, this
may weaken them.also an unrolled
condom is difficult to put on.
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What is to be done if a condom or
lubricant causes itching or rash on
genitals.
If condom or lubricant causes itching
or rash on genitals, the following may
be done: (i) Try using water as a
lubricant. (ii) Consult a doctor to
rule out itching or allergy.
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What is to be done if a man cannot
maintain an erection while putting on
or using a condom?
In such a case, the following may be
done: (i) Try using a dry condom
without spermicide. (ii) Female
partner can be asked to try putting on
the condom for the man, which would
help to make its use more enjoyable.
(iii) An extra amount of water or
water based lubricant such as KY jelly
may be used on the penis and extra
lubricant on the outside.
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FEMALE CONDOM |
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What is a female condom?
The female condom is a polyurethane
sheath or pouch about 17 cm (6.5
inches) in length. It is worn by a
woman during sex. It entirely lines
the vagina and it helps to prevent
pregnancy and sexually transmitted
diseases (STDs) including HIV.
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What are the features of the female
condom?
At each end of the condom there is a
flexible ring. At the closed end of
the sheath, the flexible ring is
inserted into the vagina to hold the
female condom in place. At the other
open end of the sheath, the ring stays
outside the vulva at the entrance to
the vagina. This ring acts as a guide
during penetration and it also stops
the sheath bunching up inside the
vagina. The condom is already smeared
with a silicone based lubricant on its
inner side.
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What are the benefits of using a
female condom?
The benefits of using a female condom
are: (i) Opportunity for women to
share the responsibility for the
condoms with their partners (ii) A
woman can use the female condom if her
partner refuses to use the male condom
(iii)The polyurethane, the material
the female condom is made of, is less
likely to cause an allergic reaction
than a male latex condom. (iv)The
female condom will protect against
most STDs and pregnancy if used
correctly .(v)It can be inserted up to
8 hours before intercourse so it does
not interfere with the moment (vi)The
polyurethane is thin and conducts heat
well so sensation is preserved (vii)The
female condom can be used with
oil-based lubricants (v) No special
storage requirements are needed
because polyurethane is not affected
by changes in temperature and
dampness. The expiry date for female
condoms is 5 years from the date of
manufacture.
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What is the effectiveness of the
female condom in preventing pregnancy
?
When used correctly and consistently,
effectiveness of the female condom is
up to the extent of 98 %. If not used
correctly or consistently, the
effectivenss rate drops.
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What is the correct technique in using
female condom?
The correct technique in using a
female condom is as follows: (i) Open
the package carefully. Choose a
position that is comfortable for
insertion - squat, raise one leg, sit
or lie down. (ii) Squeeze the inner
ring with thumb and middle finger (so
it becomes long and narrow), and then
insert the inner ring and sheath into
the vaginal opening.(iii) Place the
index finger inside of the condom and
push the inner ring as far as it will
go. (iv) Make sure the condom is
inserted straight, and is not twisted
inside the vagina. The outer ring
should remain on the outside of the
vagina.(v) The penis should be guided
into the condom in order to ensure
that the penis does not slip into the
vagina outside the condom.
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How easy to use are female condoms?
Female condoms are not difficult to
use, but you may want to practice to
get used to them. Women should
practice putting it in and removing
it, prior to using it for the first
time during sexual intercourse. It is
recommended that FC may need to be
tried up to three times before users
become confident and comfortable using
it.
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Can a lubricant be used with female
condoms and, if so, what kind of
lubricant can be used?
Female condoms come pre-lubricated
with a silicone-based, non-spermicidal
lubricant. This lubrication helps
assist in the insertion of the device
and allows easy movement during
intercourse. The lubricant may make
FC a little slippery at first. If the
outer ring of FC gets pushed in or
pulled out of the vagina, more
lubricant may be needed. Also, if FC
makes noise during sex, simply add
more lubricant. Female condoms can be
used with both water-based such as KY
jelly and oil-based lubricants such as
Vaseline and baby oil.
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What is to be done if the condom
slips/ gets torn during the
intercourse?
If the condom slips during
intercourse, or if it enters the
vagina, then you should stop
immediately and take the female condom
out. Then insert a new one and add
extra lubricant to the opening of the
sheath or on the penis.
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How should the condom be removed and
disposed off?
To remove the condom, twist the outer
ring gently and then pull the condom
out keeping the sperm inside. Wrap the
condom in the package or in tissue and
throw it away. Do not put it into the
toilet.
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Can a female condom be re-used?
No, a female condom should not be
re-used.
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What are the disadvantages in using a
female condom?
The disadvantages encountered in using
the female condom are as follows: (i)The
outer ring is visible outside the
vagina, which can make some women feel
self-conscious (ii)The female condom
can make noises during intercourse.
Adding more lubricant can help this
problem. (iii) Some women find the
female condom hard to insert and to
remove (iv)It has a higher failure
rate in preventing pregnancy than
non-barrier methods such as the pill.
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Can a female condom and a male condom
be used at the same time?
You should not use two condoms at the
same time. Using the condoms
simultaneously may cause friction
resulting in either or both condoms
slipping or tearing, and/or the
displacing of the outer ring of FC to
the inside of the vagina.
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SPERMICIDES |
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What is a spermicide?
Spermicides are chemical products
inserted in a woman's vagina before
sex that inactivate or kill sperm. is
available in a variety of
contraceptive preparations, including
creams, film, foams, jellies,
and suppositories
which are liquids or solids that melt
after they are inserted.
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What is its effectiveness?
Its efficacy ranges from 80 % to 85
%. Efficacy is improved if spermicides
are used in conjunction with
mechanical barrier methods, most
commonly condom.
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What is its mode of action?
Spermicides destroy or immobilize the
sperm.
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Are spermicides protective against
STIs and HIV/AIDS?
Spermicides are somewhat protective,
but are not recommended for
protection. On the contrary, using
the spermicide called nonoxynol-9
many times a day,by people at risk for
HIV, or for anal sex, may irritate
tissue and increase the risk of HIV
and other sexually transmitted
infections.
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How is a spermicide supposed to be
used ?
Detailed instructions for correct use
are included in the packaging. Be sure
to read and understand them before you
use any of these products. Usually, a
woman lies down or squats, then gently
inserts the spermicide deep into her
vagina. Contraceptive foams, creams,
jellies, film, and suppositories
usually require waiting 10 minutes
after insertion before intercourse can
begin. These methods typically only
remain effective for one hour after
insertion. More spermicide must be
inserted each time vaginal intercourse
is repeated.
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COMBINED ORAL CONTRACEPTIVE PILLS (COCs) |
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What are combined oral contraceptive
pills?
The combined oral contraceptive pill,
often referred to as "the Pill", is a
combination of an oestrogen and a
progesterone , taken by females by
mouth to inhibit normal fertility.
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How does the combined oral pill work?
The pill works mainly by (i) changing
the body's hormone balance so that you
do not ovulate (you do not release an
egg each month from your ovary). (ii)
It causes the mucus made by the cervix
to thicken and form a 'mucus plug' in
the cervix. This makes it difficult
for sperm to get through to the uterus
(womb) to fertilise an egg. (iii) The
pill also makes the lining of the
uterus thinner. This makes it unlikely
that a fertilised egg will be able to
attach to the uterus.
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How effective is the combined oral
pill?
It is over 99% effective if used
correctly. Correct use means not
missing any pills and taking the pill
at the scheduled time.
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What are the advantages of the pill?
The advantages of the pill are as
follows: (i) It is very effective. (ii)It
does not interfere with sex. (iii)
Periods are often lighter, less
painful, and more regular. It may
relieve pre-menstrual tension. (iv) It
helps to protect against some benign
(non cancerous) breast disease. (v) It
reduces the risk of developing certain
types of cysts in the ovary. (vi)It
reduces the risk of developing cancers
of the ovary and uterus (womb).
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Does the pill protect against
Sexually transmitted infections or
HIV/AIDS?
No, the pill does not offer any
protection.
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What are side effects when taking the
pill?
Most women who take the pill do not
develop any side-effects. However,
some women develop minor side effects
like (i) nausea (feeling sick), (ii)
headaches, (iii) sore breasts (iv)
tiredness (v) change in sex drive (vi)
skin changes like acne and oily skin
and skin pigmentation (vii) mood
changes. (viii) bleeding/spotting
between periods. There are certain
side effects which call for immediate
attention. These include: (i) severe
headache,(ii) bad pains in the chest
or leg,(iii) leg swelling, (iv)
breathing difficulty, (v) if you cough
up blood, (vi) sudden problems with
sight or speech,(vii) weakness or
numbness in an arm or leg.
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Under what circumstances is the pill
not advised?
The pill may not be advised in these
circumstances. (i) if you have had
previous blood clot in a blood vessel
(ii) severe obesity (iii) immobility (eg
wheelchair bound) (iv) poorly
controlled diabetes .(v) high blood
pressure (vi) if you have a close
family member who has had a
thrombosis, heart attack, or stroke
before the age of 45 (viii) severe
migraine (viii) History of smoking -
particularly if you are over 35
years.(ix) Breast feeding mothers. (x)
Those with history of migraine.
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How are the pills used?
The combined pills usually come in a
package of 28 pills. The first pill
has to be taken on the 5th day of
the menstrual cycle (counting the
first day of bleeding as first day of
the menstrual period).
Start taking the tablets from that
side where START is written.
Continue to take one pill everyday at
the same time for 21 days.
The last 7 pills contain iron. During
this time one’s menstrual period
occurs.
Start with a new pack again.
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What if one forgets to take a pill?
If one forgets to take one pill,
-----------it is necessary to take it
as soon as one remembers and take the
next pill at the usual time.
If one misses 2 consecutive pills,
-----------one should take 2 pills
each day for 2 days and then go back
to the regular schedule.
If one misses 3 or more pills,
----------stop taking the pills and
use a different birth control method
until the next menstrual cycle starts.
If the menstrual cycle does not start
on schedule, it is necessary to get in
touch with a doctor.
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What is to be done if one has nausea
when taking the pills?
The pills may be taken at night or
with food.
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How is one supposed to deal with minor
headache as a side effect of taking
the pill?
A painkiller such as Ibuprofen,
paracetamol or other painkiller may be
taken.
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PROGESTIN ONLY ORAL CONTRACEPTIVES
(MINI PILL) |
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What are progestin only pills?
Progestogen Only Pills or Progestin
Only Pills (POP) are contraceptive
pills that only contain synthetic
progestins and do not contain
oestrogen. They are also known as
mini pills.
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How do progestogen only pills work?
This contraceptive does three things.
(i) First, like regular birth control
pills, the progestin-only pill makes
your body "think" that you are
pregnant and stops your ovary from
releasing an egg.
(ii) Second, the mini-pill causes
changes in your uterus (where a baby
grows) that makes your uterus is less
likely to let a pregnancy get started
even if an egg is released. (iii) And
third, the progestin-only pill
thickens the mucus between your uterus
and your vagina. (The vagina is the
passageway from the uterus to the
outside of the body.) Sperm have a
hard time getting through the thick
mucus to reach the egg.
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For whom is the Progestin only Pill
suitable?
The progestin-only pill is better than
regular birth control pills (i) if
you are breast-feeding because the
mini-pill will not change your milk
production. (ii) Women who are older
than 35. (iii) Women who smoke. (iv)
Those with history of high blood
pressure.(v) Overweight (vi) A
history of blood clots
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Who shouldn't take the Progestin only
Pill?
Doctors may refuse to prescribe the
Progestin only Pill for you: (i)If
you have already had an abnormal
pregnancy in which the foetus was
lying outside the uterus.(ii) If you
have severe artery disease, or an
abnormally
high cholesterol or other
blood fats. (iii) If you have
breast cancer.(iv) If you
have unexplained vaginal bleeding.
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If I use the progestin-only pill, can
I still get pregnant?
Two or three of every 100 women who
use the progestin-only pill correctly
and consistently could still get
pregnant.
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Does the progestin-only pill have any
disadvantages?
Progestin only pill may have the
following side effects like : (i)
Bleeding or spotting between the
periods. This can be inconvenient, but
it is not a health risk. If the
bleeding seems heavy or if it bothers
you, you can talk to your doctor about
it. (ii) Weight gain (iii)Breast
tenderness.
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How is the mini pill to be taken?
Each pill package contains 28 pills.
Every pill contains hormones. The mini
pill can be started of the fifth day
of bleeding. However, if you are sure
that you are not pregnant, you can
start POPs at any time during your
cycle.
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What are the side effects which may
arise immediately following start of
the pill?
When you first start POPs, as your
body gets used to them, you could have
minor side-effects like 'breakthrough'
bleeding (bleeding between the
periods) and headaches. They're not
dangerous and usually go away in the
first two months. If you have symptoms
that persist longer, or seem severe
consult a doctor.
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What if pills are missed or taken
late?
(i) If you are three or more hours
late or you miss one POPs; take the missed
pill as soon as you remember that you
missed it; THEN go back to taking your
POPs at your regular time. Be sure to
use a backup method such as
condom every time you have sex for
the next 48 hours.
(ii) If you miss two or more POP's in
a row; restart
your POP's right away and take two
pills a day for two day. Immediately
start using a back-up method.If your
period does not begin in 4-6 weeks,
consult a doctor.
(iii) If you have unprotected sex,
intercourse without a backup method,
after missed or late POPs;
ask your clinician about an emergency
contraceptive If your period does not
begin in 4-6 weeks after missing
pills, consult a doctor.
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EMERGENCY CONTRACEPTION |
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What is emergency contraception (or
emergency birth control)?
Emergency contraception, or emergency
birth control, is used to help keep a
woman from getting pregnant after she
has had unprotected sex (sex without
using birth control).
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Which are the situations that warrant
use of emergency contraception?
A woman who had an unprotected sex and
wants to prevent pregnancy can use
emergency contraception in the
following circumstances : (i) She did
not expect to have sex and was not
using any contraception (ii) Sex was
forced upon her without her consent
(iii) A condom broke or slipped (iv)
She ran out of contraceptives or
missed two to three birth control
pills in a row.
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How does emergency contraception work?
Emergency contraception can keep you
from becoming pregnant by : (i)
Keeping the egg from leaving the ovary
(ii) Keeping the sperm from meeting
the egg. (iii) Keeping the fertilized
egg from attaching to the uterus
(womb)
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How long after sexual intercourse can
emergency contraceptive pills be
taken?
Emergency contraceptive measures can
be taken within the first 72 hours
after unprotected sexual intercourse.
However it is advisable to take it as
soon after unprotected sex.
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What are the types of emergency
contraception?
There are two types: (i) Emergency
contraceptive pills (ECPs) (ii)
Intrauterine devices (IUDs)
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What is an Emergency Contraceptive
Pill and how is it used ?
Pills containing a compound known as
Levonrgestrel are made for use as
emergency contraception. The two pills
can be taken in two doses (one pill
right away, and the next pill 12 hours
later), or both pills can be taken at
the same time.
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How does an IUD function as an
emergency contraceptive?
The IUD is a T-shaped, plastic device
placed into the uterus (womb) by a
doctor within five days after having
sex. The IUD works by: (i) Keeping
the sperm from meeting the egg (ii)
Keeping the egg from attaching to the
uterus (womb) . Your doctor can remove
the IUD after your next period. Or,
it can be left in place for up to 10
years to use as your regular birth
control.
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Are there any side effects when taking
Emergency contraceptive pills?
The most common side effects
experienced when taking EC are the
following: (i) nausea and vomiting
(ii) irregular vaginal bleeding (iii)
fatigue (iv) headache (v) dizziness
(vi) breast tenderness
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How is to one deal with nausea when
taking the pill?
To reduce nausea: (i) try to eat
something before taking the pills
(ii) take an over-the-counter
anti-nausea drug before the second set
of pills (iii) take the pills with
milk not water
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Is emergency contraception always
effective?
Yes, emergency contraception s quite
effective. If all 100 women use
emergency contraception then only one
is likely to become pregnant.
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What are the danger signs one should
be alert with when taking emergency
contraceptive pills?
Women who experience any of the
following symptoms while taking EC
should call the clinic immediately: (i)
Abdominal pains (severe) (ii)
Unusually light bleeding in the
subsequent period. (iii) If next
period does not occur.
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PROGESTIN ONLY INJECTABLES |
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What are Progestin only injectables?
Progestin only injectables injections
containing a progesterone preparation.
They are available in two varieties:
DMPA. depot (Depo-Provera) which is
injected every 3 months and NET-EN (Norethidrone
enanthate) which is injected every 2
months.
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How do Progestin only injectables
work?
Progestin only injectables injections
work by (i) inhibiting ovulation (ii)
Cause thickening of the cervical mucus
to prevent upward passage to the sperm
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What are the advantages of using DMPA?
The advantages are as follows: (i) It
is very effective (ii) Provides long
term pregnancy protection and is
reversible (iii) Convenient to use:
avoids the hassles of daily intake of
pills. (iv) Free from the side effects
of estrogen such as danger of
formation of blood clot in blood
vessels. (v) Helps prevent ectopic
pregnancies (pregnancy outside the
uterus) and ovarian cancer.
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Are there any side effects of DMPA?
Most women have some changes in their
menstrual periods while using DMPA,
including (i) irregular and
unpredictable bleeding or spotting,
(ii) an increase or decrease in
menstrual bleeding, or no bleeding at
all. Other possible side effects
include weight gain, headaches,
nervousness, abdominal discomfort,
dizziness and weakness or fatigue.The
absence of periods is not harmful, and
periods usually return to normal after
DMPA is stopped. If unusually heavy or
continuous bleeding occurs, you should
see your doctor.
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How effective is DMPA?
DMPA is as effective as tubal ligation
(having your tubes tied) and more
effective at preventing pregnancy than
several other methods, including birth
control pills, condoms and diaphragms.
It does not, however, protect against
AIDS or any other sexually transmitted
diseases.
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Is the effect of DMPA permanent?
No. DMPA only works for about 3
months. The shot must be repeated
every 3 months to prevent pregnancy.
After a woman stops using DMPA, her
normal ovarian function returns after
a short time. However, it takes an
average of 9 to 10 months to get
pregnant after getting the last shot.
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How is DMPA administered?
DMPA is given as 1 shot in the buttock
or upper arm every thee months.
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When should DMPA be started?
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Situation |
When to start |
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Having regular menstrual cycles |
Any time, preferable during the
first 7 days after menstruation. |
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After child birth, if
breastfeeding |
As early as six weeks after child
birth |
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After child birth, if not
breastfeeding |
Immediately or at any time in the
first 6 weeks after child birth |
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After miscarriage or abortion |
Within first 7 days after first or
second trimester miscarriage or
abortion. |
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Who are eligible to use DMPA?
DMPA can be used safely by women who:
(i) Are breastfeeding (ii) Smoke
cigarettes (iii) Have no children (iv)
Any age group- from adolescents to
those over 40 years of age (v) have
benign breast disease (vi) have mild
to moderate blood pressure
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Who should not use DMPA?
Women who have any of the following
should not use DMPA: a history of
jaundice, blood clots, vaginal
bleeding without a known reason,
cancer of the breast or reproductive
organs, known or suspected pregnancy,
or allergy to the medication in DMPA.
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INTRA UTERINE DEVICE |
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What is an intrauterine device?
An intrauterine device, called an IUD
for short, is a small, plastic,
T-shaped device with a string attached
to the end. The IUD is placed inside
the uterus to prevent pregnancy. This
placement can be done during an office
visit. Once in place, the IUD stays in
your uterus until your doctor removes
it.
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How does it work?
The IUD prevents sperm from joining
with an egg. It does this by making
the sperm unable to go into the egg
and by changing the lining of the
uterus
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What are the types of IUDs?
The different types of IUDs are: (i)
Copper bearing IUDs- These contain a
copper wire inserted inside a plastic
tube (ii) Hormone releasing IUDs
(newer form of IUDs) : These are made
of plastic and contain small amounts
of hormone progesterone.
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What are the advantages of a
hormonal IUD over Copper IUD?
Hormonal IUDs are: (i) More effective
than Copper bearing IUDs. (ii) Make
the menstrual period lighter.
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What are the disadvantages of a
hormonal IUD over Copper IUD?
Hormonal IUDs are (i) costlier as
compared to Copper IUD (ii) Can cause
irregular bleeding or spotting in the
first six months of use.
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What are the advantages of an IUD?
The IUD has many advantages: (i) It's
very effective in preventing
pregnancy, (ii )Convenient
–no
hassle of taking the pill is involved.
(iii)
It's inexpensive. (iv) An IUD can be
removed by your doctor at any time.
(v) It starts working right away. (vi)There's
a low risk of side effects. (vii)
Mothers who use an IUD can breast-feed
safely.
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How effective is an IUD in preventing
pregnancy?
The IUD is one of the most effective
methods of contraception. The IUD has
been found to be as much as 99%
effective when inserted properly.
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How long is an IUD effective?
It depends on the kind your doctor
prescribed to you. The copper IUD –
TCU 380A, which is now available under
the National Family Welfare Programme
can remain in your body as long as 10
years. The hormonal IUD needs to be
replaced every 5 years. Your doctor
can remove either of these at any time
if you decide to get pregnant or if
you no longer want to use it.
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What are the disadvantages?
The disadvantages are as follows : (i)
You may have cramps and backache for
the first few hours after an IUD is
put in your uterus. (ii) Some women
have bleeding for a couple of weeks
after the IUD is inserted, and heavy
periods after that. (iii) Rarely, the
uterus can be injured when the IUD is
put inside. (iv)The IUD doesn't
protect you from AIDS or any other
sexually transmitted diseases. In
fact, these infections can be more
serious in women who have an IUD. In
addition, the more people you have sex
with, the greater your chance of
getting an infection if you have an
IUD.
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Who are eligible to use an IUD for
contraception?
IUD can be used in any circumstances
by women who: (i) are breastfeeding
(ii) Smoke (iii) Have any of the
medical conditions like high blood
pressure, heart disease, liver or gall
bladder disease, diabetes, epilepsy.
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What is the ideal time for insertion
of an IUD ?
The ideal time for insertion of an IUD
is as follows:
1.Having menstrual cycles: Any time
during menstrual cycle within first 12
days after the start of menstrual
bleeding.
2.After child birth / abortion : Any
time within 24 hours after childbirth.
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How is the IUD fitted?
This is usually done towards the end
of a period or shortly after. However,
it can be fitted at any time provided
that you are certain you are not
pregnant. You will need to have a
vaginal examination. The doctor or
nurse will pass a small instrument
into your uterus to check its size and
position. An IUD is then fitted. You
will be taught how to feel the threads
of the IUD so you can check it is in
place. It is best to check the threads
regularly, for example, once a month
just after a period.
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When is a woman advised to check that
her IUD is in place?
A woman is advised to check her IUD :
(I) once a week during the first month
after insertion (ii) After noticing
any unusual symptoms (iii) After a
menstrual period.
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What precautions are to be taken by a
woman to check that her IUD is in
place?
To check her IUD, a woman should: (i)
Wash her hands (ii) Sit in a squatting
position (iii) Insert 1 to 2 fingers
in her vagina as far as she can until
she feels the strings (iv) Wash her
hands again.
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When is a woman who has had her IUD
inserted advised to consult a doctor?
A woman is advised to consult a
doctor if: (i) her sex partner feels
the IUD strings during sex and this
bothers him (ii) Heavy or prolonged
bleeding that bothers the client
(iii) Increasing or severe pain in
the lower abdomen , especially if
associated with fever (iv) Missed a
menstrual period (v) Vaginal
discharge with an unpleasant odour
(v) Wants to opt for some other
family planning method or would like
to have the IUD removed.
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CENTCHROMAN |
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What is Centchroman?
Centchroman is a novel non - steroidal
once - a – week oral contraceptive
unrelated to hormonal oral
contraceptives.
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What are the advantages of using
Centchroman?
Centchroman s safe and free from
typical hormonal side effects such as
nausea, weight gain, fluid retention,
high blood pressure etc
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When must Centchroman NOT be used?
Administration of Centchroman is not
recommended in the following
conditions: (i) Recent history of
clinical evidence of jaundice or liver
diseases. (ii) ovarian disease (iii)
Tuberculosis (iv) Kidney disease.
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How should these pills be taken?
Regimen should be started with 1
tablet of 30 mg twice a week for 3
months followed by one tablet once a
week as long as contraception is
desired. The first tablet has to be
taken on the first day of the
menstrual cycle. Tablet should be
taken on fixed days and at fixed
times. Dosage should be followed
irrespective of subsequent menstrual
periods.
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What are its side effects?
Some of its side effects are: (i)
Prolongation of menstrual cycles (ii)
Delayed menstruation. In case of delay
exceeding 15 days, a doctor should be
consulted to rule out pregnancy.
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FEMALE STERLIZATION - TUBAL LIGATION |
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What is Tubal Ligation?
Tubal ligation, commonly knows as
“getting your tubes tied,” is a
surgical sterilization technique for
women. This procedure closes the
fallopian tubes, and stops the egg
from traveling to the uterus from the
ovary. It also prevents sperm from
reaching the fallopian tube to
fertilize an egg.
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How reliable is female sterilization?
Female sterilization provides
permanent contraception for women who
do not want more children.It is more
than 99% effective. About 1 in 200
women will become pregnant after
sterilization. This is because the
tubes can, rarely, come back together
again after being cut or blocked.
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How is it done?
There are 2 methods of tubal ligation
done under local or spinal anesthesia
: (I) A minilaparotomy involves making
a small incision in the abdomen,
locating the tubes, and cutting and
closing them off. (ii) A laparoscopic
tubal ligation involves inflating the
abdomen with carbon dioxide or nitrous
oxide gas, making a small incision in
the abdominal wall, and inserting a
fiberoptic light and an instrument
that coagulates the tubes with an
electric current or puts a clip or
plastic band around the end of each
tube.
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What are the advantages of female
sterilizations?
It is permanent and you don't have to
think of contraception again.
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What are the disadvantages of female
sterilization?
As it is permanent some people may
regret having the operation in future
years, particularly if their
circumstances change. It is also not
as easy to reverse as compared to
male sterlization.
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How soon is it effective?
You must continue to use other forms
of contraception until your next
period occurs after the operation.
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Will sterilization change a woman’s
monthly periods or make her menstrual
bleeding stop?
No, sterilization has no such impact
on a woman’s monthly period.
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Will it reduce my sex drive?
No. Sex may be more enjoyable as the
worry or inconvenience of other forms
of contraception is removed.
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MALE STERLIZATION- VASECTOMY |
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What is a vasectomy?
A vasectomy is an operation that make
a man permanently unable to get a
woman pregnant. It involves cutting
the 2 tubes called vas deferens so
that sperm can no longer get into the
semen.
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How is a vasectomy done?
A vasectomy is usually done as an
outpatient procedure . The operation
takes about half an hour. You'll be
awake during the procedure. Your
doctor will give you a local
anesthetic to numb your scrotum. After
this, your doctor will cut a small
opening (an incision) on one side of
your scrotum and pull out part of the
vas deferens on that side. You may
feel some tugging and pulling. A small
section of the vas deferens is
removed. The ends of the vas deferens
will be sealed by stitching them shut,
by searing them shut with heat, or by
using another method. Your doctor will
then do the same thing on the other
side. Your doctor will close the 2
openings in your scrotum with stitches
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What is no-scalpel vasectomy?
The no-scalpel vasectomy involves
making a very small puncture (a hole)
in the scrotum instead of an incision.
The puncture is so small that it heals
without stitches.
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How
effective is vasectomy in preventing
pregnancy?
Vasectomy may be the safest, most
effective kind of birth control. Only
about 15 out of 10,000 couples get
pregnant the first year after a
vasectomy.
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Are there any reasons why one
shouldn't have a vasectomy?
Don't have a vasectomy unless you're
sure you don't want to have children
in the future. Also you may have delay
in getting a vasectomy done if you
have an infection on or around your
genitals, or you have a bleeding
disorder.
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Can vasectomy be reversed?
Some
vasectomies can be undone, or
"reversed," but the surgery is
expensive and hard to access. Even
though most men can ejaculate sperm
after the reversal surgery, the sperm
are often not able to fertilize an
egg.
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How should I prepare for the
operation?
On the day of the operation, bring a
snug underwear with you and make sure
your genital area is clean. Your
doctor will probably give you
instructions on how to clean the area
before you come in. Your doctor may
suggest you bring someone to drive you
home after surgery.
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What can I expect after the operation?
Right after the operation, your doctor
will have you lie down for a couple of
hours with an ice pack placed on your
scrotum. You may have some bruising in
the area of the surgery. The bruises
should slowly lighten and be gone in
about 2 weeks. You should feel back to
normal within a couple of weeks.
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When can I go back to work?
Rest is to be taken for 2 days. Heavy
work or vigorous exercise should be
avoided for a few days.
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Will the vasectomy work right away?
No. You'll need to ejaculate as many
as 15 to 20 times before the sperm
will be cleared from both the vas
deferens. For that reason, it is
important to use condoms or any other
family planning method for 3 months
after the procedure.
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What are the side effects of a
vasectomy?
Problems that might occur after your
vasectomy include (i)
bleeding,(ii)Pain (iii) infection
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Apart from the usual follow up, which
are the conditions for which a man who
has undergone vasectomy must consult
a doctor?
Call your doctor if: (i) You have a
fever. (ii) You have swelling that
won't go down or keeps getting worse.
(iii) You have trouble urinating. (iv)
You can feel a lump forming in your
scrotum. (v) You have bleeding from an
incision that doesn't stop even after
you've pinched the site between 2
gauze pads for 10 minutes.
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Will a vasectomy affect one’s sex
life?
After you have healed from the
vasectomy, your sex life shouldn't
change at all. You'll still ejaculate
almost the same amount of semen as you
did before, and you won't notice a
change in your sex drive.
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What happens to the sperm after
vasectomy?
Once sperm can't get through the vas
deferens, your testicles will begin
making fewer sperm. Your body will
absorb the sperm that are made.
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Is it better for a man to have a
vasectomy or for a woman to be
sterilized?
Each couple must decide for themselves
which method is best for them. Both
are very effective, safe and
permanent. However, vasectomy is
simpler and safer to perform that
female sterilization. Also it is less
expensive and slightly more effective.
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Does vasectomy increase the risk of
prostrate cancer?
No, vasectomy does not increase the
risk of prostrate cancer.
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Can an HIV infected person undergo
vasectomy?
Yes an HIV infected person can
undergo vasectomy
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NATURAL FAMILY PLANNING
METHODS |
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What are natural family planning
methods?
Natural family planning methods are
methods in which a woman tries to
avoid intercourse during the fertile
time of her menstrual cycle.
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When is a woman said to be fertile?
A woman is fertile when she is
ovulating and for a few days before
ovulation. Ovulation usually occurs
mid cycle. More precisely, ovulation
usually occurs 14 days before the
onset of bleeding.
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What are some of the common natural
family planning methods?
The common natural family planning
methods include: Rhythm Method,
cervical mucus method, Basal Body
temperature (BBT) Method, Standard
Days Method (SDM).
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What is Rhythm Method?
The rhythm method is based on the
idea that women ovulate 14 days before
menstruation begins. Based on this
assumptions, the rhythm method
requires a woman to count back 14 days
from the first day of her period. This
will presumably be the day on which
she ovulated and will ovulate the
following month. In order to avoid
pregnancy, she will need to abstain
from sex or use another form of birth
control, like condoms around this
time.
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What are the drawbacks of the rhythm
method?
The rhythm method has a high failure
rate of 13 to 20%. It is not
recommended for women who have
irregular cycles or who do not have
menstrual cycles that are exactly the
same number of days every month.
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What is cervical mucus method?
The cervical mucus method is based on
the idea that near the time or at the
time of ovulation, your cervical mucus
will become thinner and stickier your
cervical mucus will be clear, slippery
and very stretchy, similar to a raw
egg white. Thus, If you do not want to
get pregnant, then sex should be
avoided from the time you begin to
notice the slippery, stretchy mucus
until at least two days after it is
gone.
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How can the cervical mucus be tested?
Use your finger or toilet paper to
wipe across the opening of vagina and
then take a look at the mucus. Examine
the consistency and try to stretch the
mucus between your fingers. If you can
stretch it at least three inches
without it breaking, then ovulation is
about to occur.
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What are the drawbacks of the cervical
mucus method?
This method has a high failure rate of
about 20 %.
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What is Basal Body temperature (BBT)
Method?
The BBT Method is based on the fact
that the body temperature rises about
0.5 degree to 1 degree above the body
temperature around the time of
ovulation. Seeing a sustained increase
in your temperature, one that lasts
for at least three days, indicates
that ovulation has taken place. When
you know ovulation has taken place, it
can be assumed that having sex during
the rest of your menstrual cycle will
not result in pregnancy.
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How is the Basal Body temperature (BBT)
Method performed?
A woman needs to take her temperature
every day, first thing in the morning
before she gets out of bed. Once you
have taken your temperature, record
it on a chart so that you can follow
the fluctuations in your temperature
from day to day. Avoid sex during the
days when the body temperature is
steadily high and for 7 days
thereafter.
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What is the effectiveness of the BBT
Method?
On average, the basal body temperature
method has a failure rate of 15% but
as low as 2% per year for perfect
users
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What is the Standard Days Method (SDM)?
The Standard Days Method is a new
natural family planning method for
women with menstrual cycles ranging
between 26 and 32 days. This method
involves identifying the fertile days
during each menstrual cycle. Women
with menstrual cycles between 26 to 32
days can prevent pregnancy by
avoiding unprotected sexual
intercourse on days 8 to 19.
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How is the Standard Days Method
practiced?
The Standard Days Method is fairly
straightforward to use. There are two
methods which can be practiced:
(i) Conventional Method:
Keep track of how long your menstrual
cycle is, in order to determine when
Days 8 through 19 occur. (i) When the
first day of your period arrives, this
is Day1 of your cycle. Mark this on
your calendar. (ii) Between Day 1 and
Day 7, it is highly unlikely that you
will become pregnant, so it is safe to
participate in sexual intercourse
without using birth control. (iii)
Between Day 8 and Day 19, you are at
your most fertile. You and your
partner should
abstain from sex or you
should use an alternate type of birth
control, such as a
condom.
(iv) Between Day 20 and 32 you are
unlikely to get pregnant, so you can
resume sexual intercourse.
(ii) Cycle Beads:.
Cycle Beads are a string of 32
color-coded beads, shaped into a
necklace. There is a rubber ring that
can be placed around individual beads
on the necklace to help identify what
day you are on in your cycle. There
are three colors of beads on the Cycle
Bead necklace:
(a)
Red:
There is one red bead on the Cycle
Bead necklace. This red bead stands
for the first day in your menstrual
cycle. It is on this day that you get
your menstrual period.
(b) Brown: The brown beads
signify the days during your cycle
when it is highly unlikely that you
will get pregnant.
(c) White: The white,
glow-in-the-dark beads represent the
fertile days of your menstrual cycle
(Days 8 to 19). As you move through
each day of your cycle, you slip the
rubber ring on a different bead. When
the rubber ring is moved onto the
white beads, you will know to abstain
from sex or to use a form of
contraception.
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Who Can Use the Standard Days Method?
The Standard Days Method can be used
by the majority of women, however,
before you try the method it is
important that you meet the following
criteria: (i) Your menstrual cycles
are regular (ii) Your cycle is
between 26 and 32 days long (SDM is
less effective if your cycles are
shorter than 26 days or longer than 32
days). (iii) You and your partner are
willing to abstain from intercourse or
use protection during your fertile
days.
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How Effective is the Standard Days
Method?
When used regularly and consistently,
SDM has been shown to be a highly
effective birth control method. When
used perfectly, only five out of every
100 women will get pregnant. This
means that the method is 95% effective
against pregnancy. If you do not
follow the method consistently, or if
your cycle falls outside of the 26 to
32 day range, SDM will be less
effective, that is about 88 %.
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