Instructions for Animated Graphs Some animated graphs in this presentation require you to select the Play option before the animation will run. This allows you to decide when you run the animated graph and gives you the facility to play it again (use Rewind). The flash icon ( ) is adjacent to any animation that requires you to select play. Move your cursor over the blue rectangle and select play from your right mouse menu... Biology (14 - 16) Birth Control © SSER Ltd. Choosing the Right Contraceptive Once a couple have decided it is the right time to enter into a sexual relationship, it is vital that before any sexual penetration takes place, they discuss the most appropriate form of contraception. Abstinence is classed as a form of birth control. Contraception means: a method of preventing an unwanted pregnancy. The Condom Choosing the right method of contraception depends on a couples’ religious and personal beliefs. There are many different methods of contraception available, e.g. the condom A condom is a rubber sheath rolled down over the penis before intercourse. During intercourse, the condom prevents sperm entering the vagina. The Condom After intercourse, the penis has to be withdrawn carefully, and the condom (together with the semen), disposed of in a sensible manner. Care has to be taken to ensure that the condom is not torn or split, as this may cause the sperm to escape into the vagina, possibly resulting in pregnancy. Condoms and 15 Year Olds Study the following graph to find out more about the use of condoms by 15 year old teenagers in Europe… Schools give condoms to 14 year olds! I n some counties around the country, as part of a sex education programme, schools are offering boys and girls, as young as 14, access to condoms. One local Headteacher said “the aim is to reduce teenage pregnancies and to protect teenagers from sexual infections”. However, some local parents are appalled by the scheme... What do you think? The Diaphragm (Cap) The diaphragm is a rubber cap which is placed inside the vagina, and moved up over the cervix. The first time a diaphragm is used it should be fitted by a nurse. The diaphragm must be inserted some time before sexual intercourse, and remain in the vagina for 6 to 8 hours after a man’s last ejaculation. A diaphragm should be used together with a spermicide, which kills sperm. Spermicides can be in a gel or cream form. Spermicides can also be used with a condom. The IUD (Coil) The Intrauterine device (IUD or coil) is 98% effective and sits in the woman’s uterus for up to 10 years and prevents her from getting pregnant in three main ways... prevents sperm from getting through to the womb and into the fallopian tubes alters the secretions (mucus) in the cervix, so creating a further barrier to the sperm irritates the womb lining - it is unable to ‘accept’ an embryo. An IUD used with hormones is called an Intrauterine system (IUS), is 99% effective and this combined system can be used for up to 5 years. IUDs and IUSs must be administered by a doctor and whereas an IUD can cause heavy periods the IUS can cause tender breasts and acne. The Femidom The femidom can be likened to a female condom, hence its name. A femidom is a rubber sheath inserted into the vagina. The closed end goes inside the vagina and the open end is left outside the vagina. During intercourse the femidom physically prevents sperm entering the vagina. After intercourse, the femidom containing the semen has to be removed carefully, and disposed of in a sensible manner. Care has to be taken to ensure that the femidom is not torn or split, as this may cause the sperm to escape into the vagina, possibly resulting in pregnancy. Using Sex Hormones as Contraceptives Oral contraceptives, usually known as ‘the pill’ prevent sperm from fertilising ova, i.e. they prevent conception. They may contain oestrogen and/or progesterone which prevent conception in several ways: Oestrogen prevents ovulation by inhibiting the production of follicle-stimulating hormone (FSH) by the pituitary gland. No ova will develop. Oestrogen causes a sticky substance to block the uterus entrance at the cervix, preventing sperm from entering. Progesterone makes the uterus lining so thick that an embryo (if conception occurred) cannot implant. Using Sex Hormones as Contraceptives Oestrogen is so effective at inhibiting the production of FSH and thereby the production of ova that a section through the ovary of a female taking the combined pill reveals only immature follicles. Notice that in this sectional view of an ovary, mature follicles and the corpus luteum are absent – this is enough to act as a contraceptive as ovulation cannot occur. Ovary The Pill There are two main types of contraceptive pill - each is defined by the hormones they contain... 1. Progesterone Only Pill - contains only progesterone 2. The Combined Pill contains both oestrogen and progesterone Both types of pill have to be taken every day. Progesterone Only Pill The ‘progesterone only’ pill (mini-pill) prevents the release of an egg cell, and makes it more difficult for an embryo to be implanted in the womb. It is 99% effective and easy to take. It also alters the cervical mucus so that sperm cannot move easily through it. Both types of pill can have side effects such as feeling sick and gaining weight. Some reports even suggest that long term use of the contraceptive pill could increase the risk of cervical cancer. The Combined Pill The ‘combined pill’ contains two hormones (a progestogen and an oestrogen) and prevents ovulation (production of an egg cell). The combined pill also makes it difficult for the embryo, should one be produced, to be implanted in the womb. Medical Concerns About the Combined Pill Evidence suggests that the oestrogen levels in the combined pill can interfere with the blood clotting mechanism and increase the risk of thrombosis, heart attacks and strokes. Therefore, oestrogen levels in A blood clot forming inside a capillary – this could lead to the combined pill are kept as low major clot (thrombosis) as possible and a different kind of pill, the mini-pill, has been developed. The mini-pill is a progesterone-only pill that appears to act by interfering with development of the egg cell. The Morning After Pill The morning after pill is taken after unprotected sexual intercourse has taken place. The pill has to be taken within 72 hours after intercourse has taken place. It contains a high dose of progesterone, and prevents an embryo from being implanted. The initial high level of progesterone in the female body stimulates development of the lining of the womb. The sudden drop in progesterone in the days after the pill has been taken, prevents implantation of a potential embryo into the lining of the womb. Injection - Progesterone The progesterone injection can last for 2-3 months and is 99% effective. The injection prevents implantation of the embryo in the uterus wall. The progesterone injection must be administered by a doctor and can cause irregular or heavy periods. Contraceptive Implant The contraceptive implant is a rod the size of a thin matchstick and it contains a hormone called etonorgestrel. The implant is nearly 100% effective and lasts for up to 3 years. A local anaesthetic is injected into your skin, and then the rod is pushed in using a special needle. The implant should be put in about 8-10 cm above the elbow. The whole procedure takes just three minutes and the patient can go home immediately afterwards. After the procedure about 3.6% of women, get bruising, swelling, redness or soreness at the site of insertion. The Withdrawal Method At the moment he is about to have an orgasm, the male removes his penis from the female’s vagina, ensuring that no semen (containing the sperm) enters the vagina. However, this moment is not always clear and errors can result in pregnancy. Sperm are often released in lubricant fluid prior to ejaculation. The Rhythm Method The female has to work out the time in her menstrual cycle when ovulation is due. At about this time, the couple refrain from having vaginal intercourse. As ovulation is not always clear, any errors in the female’s calculations can lead to pregnancy. Male Sterilisation - Vasectomy In this minor surgical operation the sperm ducts are both cut so that semen will not contain active sperm. It can be reversed in many cases. This operation should not be undertaken if there is any chance you may want children in the future. Sperm duct (vas deferens) Cut here x x Cut here Female Sterilisation - Tubal Ligation In this major surgical operation the oviducts are both cut, clipped or cauterized so that sperm cannot reach an ovum. It can be reversed with some degree of success. This operation should not be undertaken if there is a chance the woman may want children in the future. Fallopian tube (oviduct) x Cut here tubal clip A hysterectomy is the surgical removal of the uterus - it permanently prevents pregnancy and diseases such as uterine cancer. x Cut here Reliability of Different Contraceptives Run the following graph to find out more about the failure rates of different types of contraceptive… Copyright © 2009 SSER Ltd. and its licensors. All rights reserved. All graphics are for viewing purposes only.