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Birth Control - ¡Ò� �¤ØÁ¡Óà¹Ô´
1. Emergency contraception ÂÒ¤� �Á¡Óà¹Ô´áºº ©Ø¡à©Ô¹
-- also called postcoital contraception -- is a form of birth control that may be used by women within 72 hours of having unprotected sex. The treatment generally is reserved for emergency situations and is not a regular method of birth control. Emergencies include being raped, having a condom break or slip off during sex, missing two or more birth control pills during a monthly cycle, and having unplanned sex.  

How Does It Work?
Emergency contraception may prevent pregnancy by temporarily blocking eggs from being produced, by stopping fertilization, or keeping a fertilized egg from becoming implanted in the uterus.  

Emergency contraception can be provided in two ways: using hormonal contraceptive pills or inserting a copper-releasing IUD (intrauterine device).  

Emergency Contraceptive Pills (ECP) are most commonly used and are taken in two doses. The first dose should be taken within 72 hours of unprotected intercourse, and the second dose 12 hours later.  

An IUD can be inserted to prevent pregnancy up to five days after unprotected intercourse  

How Effective Is Emergency Contraception?  

It is about 75% effective when taken within 72 hours of unprotected sex.  

Where Can I Get Emergency Contraception?  

ECP are available at Planned Parenthood; college, public, and women's health centers; private doctors; and some hospital emergency rooms.  

Some doctors will prescribe ECP over the phone and call the prescription in to a pharmacy. ECP are available directly from some pharmacists in Washington state.  

Who Should Not Use Emergency Contraception?
Emergency contraception should not be used by women who are already pregnant because it is ineffective at terminating established pregnancies.  

Are There Any Side Effects Associated With Emergency Contraception?
The most common side effects associated with emergency contraception include:
- Nausea
- Abdominal pain
- Fatigue
- Headache
- Menstrual changes
Ask your doctor or pharmacist about ways to reduce nausea. They may prescribe some anti-nausea medicine for you to take before you take ECP.  

Does It Protect Against Sexually Transmitted Diseases?
No. Emergency contraception will not protect you from contracting an STD, such as HIV, the virus that causes AIDS. The best way to avoid getting STDs is to limit sexual contact with one uninfected partner. If that is not an option, use a condom correctly every time you have sex.  

2. Condom
Birth control is a way for men and women to prevent pregnancy. There are many different methods of birth control; some types also protect against sexually transmitted diseases. Condoms are one type of birth control that in addition to preventing pregnancy also prevent the spread of STDs.  

There are two types of condoms, the male condom and the female condom.
What Is a Male Condom?
The male condom, or "rubber," is a thin covering made of latex, plastic, or animal membrane that is rolled over an erect penis. The covering prevents semen, the fluid that contains sperm, from entering a woman's vagina.  

What Are Male Condoms Made of?
Most condoms are made of a type of rubber called " latex." Recently, condoms made of polyurethane (a type of plastic) have become available. These are more expensive than latex condoms and seem to break more easily. They are mainly useful for people who are allergic to latex. There are also " natural" condoms, which are made of animal membranes. These are expensive and probably not effective in preventing the spread of sexually transmitted diseases.  

What Types of Latex Condoms Are There?
Condoms come in all shapes, sizes, and materials. Here are some characteristics to consider when buying condoms.  

Size The standard size will fit most men. Extra-large condoms are available, as well as " snug" sizes that are a little smaller and fit tighter than the standard size.
Shape Some condoms come with a nipple in the end to hold the fluid when the man ejaculates. Others have a rounded end.
Thickness Extra- strength condoms are available. These are stronger and are especially useful for rectal sex and for men who have problems with condom breakage. Extra thin condoms also are available, but these are not recommended because they may break more easily.
Lubrication Many condoms come pre- lubricated with a substance that kills sperm (spermicide) and many disease- causing germs. Lubrication may give some extra protection, especially if the condom breaks. Lubricated condoms taste bad and are not recommended for oral sex.
Flavored These condoms are meant for the male to wear when receiving oral sex. They are not lubricated and have a mild flavor (usually mint).
Color Condoms come in many colors. The color of the condom doesn't make it any more or less effective.
When Should a Man Use a Condom?  

A man should wear a condom any time he inserts his penis into the body of another person, if there is even the slightest risk that either person has a sexually transmitted disease. Men frequently become infected with STDs when receiving oral sex, so a condom should be worn then, too. The condom should be put on before there is any contact, and should be removed and thrown away promptly after the man has ejaculated.  

How Is the Male Condom Used?
The condom is rolled over the erect penis before sexual activity begins. If the condom does not have a built-in nipple, leave 1/4- inch of the condom free at the tip of the penis so that semen has a place to collect. A new condom must be used each time you have sex. For the best protection, condoms should be used with a spermicidal foam or jelly. The condom must be in place before the penis gets near the vagina. If you use lubricants with a condom, be sure to only use water-based lubricants, such as K-Y Jelly. Oil-based lubricants, such as Vaseline, can cause condoms to leak or break.  

What Causes Male Condoms to Break?
Condoms too old Modern condom wrappers have a date after which the condom should not be used.
Improper storage Heat damages latex condoms, so they should not be kept in a hot place, such as a car glove compartment or wallet.
Not enough lubrication Additional lubrication is always needed for rectal sex. It may also be needed for vaginal sex. The lubricant should be water-soluble, such as KY jelly.
The wrong kind of lubricant Lubricants that contain oil -- such as Vaseline, baby oils and vegetable oils -- should not be used with latex condoms since they weaken the rubber.
Condom too small Try a larger size.
Partner too tight Use an extra strength condom and more lubricant.
What Causes Condoms to Come Off During Sex?  

Condom too large Try a snug condom.
Loss of erection Remove your penis, holding on to the rolled edge of the condom, as soon as you begin to lose your erection.  

Where Can I Get Male Condoms?
Condoms can be purchased at most drug stores. Condoms also are sold in vending machines in public restrooms.  

How Effective Are Male Condoms at Preventing Pregnancy?
Condoms are about 85 % effective. With careful use, they are even more effective. Keep in mind that the best way to avoid getting pregnant is to not have sex (abstinence).  

How Do Male Condoms Prevent STDs?
Latex condoms provide protection from sexually transmitted diseases by preventing the infected area from coming into contact with the partner.  

Should Foam be Used With Male Condoms?
Contraceptive foam can offer added protection against pregnancy and STDs in case a condom breaks.  

How Effective Are Foam and Male Condoms?
When used together and properly, foam and condoms are about 97% effective in preventing pregnancy.  

What Is a Female Condom?
The female condom is a lubricated polyurethane (plastic) tube that has a flexible ring at each end. One end of the tube is closed.  

How Is the Female Condom Used?
Before sexual activity begins, the woman inserts the condom into her vagina so that the closed end of the tube covers the cervix, and the other end slightly covers the labia (lips on the outside of the vagina). The condom blocks sperm from entering the womb. Female condoms should be discarded after one use.  

Where Can I Get Female Condoms?
Like the male condom, the female condom is available at drug stores without a prescription.  

How Effective Is the Female Condom at Preventing Pregnancy?
The female condom is about 75% effective.  

Do Female Condoms Protect Against STDs?
Female condoms provide some protection against sexually transmitted diseases, but the male condom provides the best protection if you have sex.  

3. Spermicides
Spermicides are foams, jellies, tablets, or suppositories used by women to prevent pregnancy. Chemicals within the spermicide destroy the sperm, preventing it from implanting an egg. Spermicides may also help prevent STDs.  

How Effective Are Spermicides?
Although spermicides in the foam or jelly form can be used alone, they are more effective when combined with a condom or diaphragm. Spermicide used alone is 79% effective, but when used together and properly, foam and condoms are about 97% effective in preventing pregnancy.  

Does Contraceptive Foam Protect Against Sexually Transmitted Diseases?
Contraceptive foam may not protect against some sexually transmitted diseases, including HIV (the virus that causes AIDS). The male condom provides the best protection from most STDs. But, contraceptive foam can offer added protection against pregnancy and STDs in case a condom breaks.  

Where Can I Get Contraceptive Foam?
Contraceptive foam is available without a prescription at most drug stores and supermarkets.  

How Does It Work?
Foam should be inserted into the woman's vagina immediately before sex (up to 20 minutes before). It is effective immediately. Make sure the foam is inside the vagina before the penis gets close to the vagina.
To insert the foam, remove the canister of foam and the plastic applicator from the package. Shake the canister of foam about 30 times.
Attach the open end of the applicator to the aerosol top of the foam canister and push down until the clear part of the applicator is full. This should take about two seconds.
Separate the full applicator from the canister, and get into a comfortable position. Lie on your back, sit on a toilet or stand with one foot resting on a chair or bed. Hold the full applicator in one hand and gently guide it into your vagina with your other hand. Slowly push the plunger back into the applicator until the plunger can't go any farther.
If you have sex again soon after, use another applicator full of foam and a new condom.
Rinse the foam applicator in warm water with mild soap, if necessary.
Throw out the used condom.
Do not douche for at least eight hours after sex when using a spermicide. You can wear a feminine pad to absorb spermicide that comes out.  

4. The Pill - ÂÒàÁç ´¤ØÁ¡Óà¹Ô´
The Pill is a form of birth control used by women that is taken by mouth to prevent pregnancy. When taken correctly, it is 98% effective. However, the Pill does not protect against sexually transmitted diseases, including HIV (the virus that causes AIDS). The male condom provides the best protection from most STDs.  

How Does the Pill Work?
Normally a woman becomes pregnant when an egg released from her ovary (the organ that holds her eggs) is fertilized by a man's sperm. The fertilized egg attaches to the woman's womb (uterus), where it receives nourishment and develops into a baby. Hormones in the woman's body control the release of the egg from the ovary and prepare the body to accept the fertilized egg.  

The Pill contains a small amount of man- made hormones. These hormones work with the natural hormones to prevent pregnancy. Some forms of the Pill stop the body from releasing an egg from the ovary. Others work by making the lining of the womb too thick or too thin to accept the fertilized egg.  

Where Can I Get Birth Control Pills?
Birth control pills are only available with a doctor's prescription.  

How Are the Pills Packaged?
You will receive a set of pills packaged in a thin case. Pill packs contain either 21 or 28 pills. Twenty-one-day pill packs contain 21 active pills. Twenty-eight day pill packs contain 21 active pills and seven sugar pills. The pill packs are marked with the days of the week to remind you to take a pill every day. The seven sugar pills in the 28-day pill pack are added so that you are reminded to start a new pill pack after 28 days.  

How Do I Take the First Pill Pack?
You must wait until your period begins to start taking the Pill. Ask your doctor when you should start your pill pack. You will begin your pill pack after you have your period. If you still have your period on the day that you have been told to start your pill pack, go ahead and start the pill pack. You will get your next period about 25 days after starting the pill pack.  

It's best to take the pills at the same time every day. Take the pill each day either before breakfast or at bedtime.  

When Do I Start Another Pill Pack?
You will start each new pill pack on the same day of the week. For example, if you start your first pill pack on a Sunday, you will start you next pill pack on a Sunday.  

If you are on the 21- day pill pack, start the new pill pack 7 days after you finished the old pill pack. If you are on the 28- day pill pack, begin the new pack after taking the last pill in the old pack.  

Start your new pill pack as scheduled above, whether or not you get your period or are still having your period.  

How Soon Does the Pill Work?
Your body will need about 1-3 months to adjust to the Pill. Use another form of birth control, such as condoms (rubbers) and foam, during the first month. After the first month, you can just use the Pill for birth control.  

What If I Forget to Take a Pill?
If you forget to take a pill, take it as soon as you remember. If you don't remember until the next day, go ahead and take 2 pills that day. If you forget to take your pills for 2 days, take 2 pills the day you remember and 2 pills the next day. You will then be back on schedule. If you miss more than 2 pills, wait for your next period and start a new pill pack as did when you first started taking the pill.  

Any time you forget to take a pill, you must use another form of birth control until you finish the pill pack. When you forget to take a pill, you increase the chance of releasing an egg from your ovary. If you miss your period and have forgotten to take one or more pills, get a pregnancy test. If you miss 2 periods even though you have taken all your pills on schedule, get a pregnancy test.  

Are There Side Effects Associated With the Pill?
Yes, although the majority are not serious. They include:
- Nausea
- Weight gain
- Sore or swollen breasts
- Small amount of blood, or spotting, between periods
- Lighter periods
- Mood changes
The following side effects, easily remembered by the word "ACHES, " are less common but more serious. If you experience any of these, contact your doctor immediately. If you cannot reach your doctor, go to an emergency room or urgent care center for evaluation. These symptoms may indicate a serious disorder, such as liver disease, gallbladder disease, stroke, blood clots, high blood pressure or heart disease. They include:
- Abdominal pain (stomach pain)
- Chest pain
- Headaches (severe)
- Eye problems (blurred vision)
- Swelling and/or aching in the legs and thighs  

Can Any Woman Take the Pill?
The pill can be taken safely by most women, but is not recommended for women who are over the age of 35 and smoke, but it can be used until menopause, if you don't smoke cigarettes. In addition, you should not take the pill if you have had:  

Blood clots
Inflammation in the veins
Serious heart or liver disease
Unexplained vaginal bleeding
Cancer of the breast or uterus
Sickle cell anemia
If you are not sure if you are affected by one of these conditions, ask your doctor. Also, inform your doctor if you have a first-degree relative (parent, brother, sister, child) who has had blood clots in the legs or lungs.  

Is it OK to Take Other Drugs While Taking the Pill?
Some drugs can stop the Pill from working properly. Tell your doctor about all of the medicines you are taking.  

What are Mini Pills?
These are pills that contain only one hormone (progestin).  

How Do Mini Pills Work?
Mini pills work by thickening the cervical mucus so the sperm cannot reach the egg. The hormone in the pills also changes the lining of the uterus, so implantation of a fertilized egg cannot occur. In some cases, mini pills stop ovulation (the release of an egg). A pill is taken every day.  

How Effective Are Mini Pills?
If Mini Pills are used consistently and correctly, they are about 95% effective.  

Points to Keep in Mind When Taking the Pill
Keep another form of birth control, like foam and condoms, on hand in case you forget to take a pill.
Carry your pills with you if you don't always sleep at the same place.
Get your pill refills soon after you start the last pill pack. Don't wait until the last minute.
Birth control pills are medication. Always tell your doctor or pharmacist you are on the pill if you see him or her for any reason.
You are less likely to forget your pills if you take them in the morning when you get up.  

5. Sterilization - ¡Ò� �·ÓËÁѹ
Sterilization is a permanent form of birth control that is extremely effective at preventing pregnancy. But it is difficult to reverse if you change your mind, and it does not protect against sexually transmitted diseases. Both men and women can be sterilized. For women, a tubal ligation is performed; for men, a vasectomy is performed.  

What Is Tubal Ligation?
Tubal ligation, or female sterilization, is surgery to " tie the tubes" (fallopian tubes) of a woman, which causes permanent sterility by preventing transport of the egg (ovum) to the uterus. This also blocks the passage of sperm up the tube to the ovulating ovary where fertilization normally occurs.  

How Is Tubal Ligation Done?
The procedure is perfomed in a hospital or outpatient surgical clinic while you are anesthetized (put to sleep). One or two small incisions (cuts) are made in the abdomen at the navel, and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted. Using instruments that are inserted through the laparoscope, the fallopian tubes are burned or sealed shut. The skin incision is then stitched closed. The patient is able to return home within a few hours after the procedure. Tubal ligation can be performed immediately after childbirth through a small incision near the navel or during a cesarean delivery.  

How Effective Is Tubal Ligation?
Except in rare cases, this procedure is 100% effective.  

Does Tubal Ligation Protect Against Sexually Transmitted Diseases?
No. Sterilization does not protect against STDs, including HIV (the virus that causes AIDS). Male condoms provide the best protection from most STDs.  

What Is a Vasectomy?
A vasectomy, or male sterilization, is a simple, permanent sterilization procedure for men. The operation, usually done in a doctor's office, requires cutting and sealing the vas deferens, the tubes in the male reproductive system that carry sperm. A vasectomy prevents the transport of sperm out of the testes. This surgery does not affect the man's ability to achieve orgasm or ejaculate. There will still be a fluid ejaculate, but there will be no sperm in this fluid.  

How Effective Is a Vasectomy?
Except in rare cases, this procedure is 100% effective.  

Does Vasectomy Protect Against Sexually Transmitted Diseases?
No. Vasectomy does not protect against STDs, including HIV (the virus that causes AIDS). Male condoms provide the best protection from most STDs.  

How Is a Vasectomy Done?
Vasectomy usually is done in the surgeon's office while the man is awake, but is pain- free since local anesthesia is used. A small incision is made in the upper part of the scrotum, under the penis. The tubes (vas deferens) that carry sperm are tied off and cut apart. The skin incision is stitched closed. The patient is able to return home immediately.  

There is a non- surgical technique that some doctors use. In a "no- scalpel" vasectomy, the doctor feels for the vas deferens under the skin of the scrotum and holds it in place with a small clamp. Then a special instrument is used to make a tiny puncture in the skin and stretch the opening so the vas deferens can be cut and tied. No stitches are needed to close the punctures, which heal quickly by themselves.  

What Happens After the Vasectomy?
After vasectomy, you will probably feel sore for a few days. You should rest for at least one day. However, you can expect to recover completely in less than a week. Many men have the procedure on a Friday and return to work on Monday.  

Are There Side Effects Associated With Vasectomy?
Although complications such as swelling, bruising, inflammation, and infection may occur, they are relatively uncommon and almost never serious. Nevertheless, men who develop these symptoms at any time should inform their doctor.  

When Can Sexual Activity Be Continued?
You can resume sexual activity within a few days after a vasectomy, but precautions should be taken against pregnancy until a test shows that your semen is free of sperm. Generally, this test is performed after you have had 10-20 post-vasectomy ejaculations. If sperm are still present in the semen, you will be asked to return at a later date for a repeat test. Once sperm are absent from the ejaculate, contraception may be discontinued. The chance of pregnancy, however, is not zero. Due to a process known as spontaneous recanalization (tubes rejoining), pregnancies may occur after vasectomy, although this is very rare (1 in 1000).  

What Are the Disadvantages of Vasectomy?
The chief disadvantage of vasectomy is its permanence, although this is also considered the chief advantage. The procedure itself is simple, but reversing it is difficult, expensive, and often unsuccessful. But, it is possible to store semen in a sperm bank to preserve the possibility of producing a pregnancy at some future date. However, doing this is costly, and the sperm in stored semen do not always remain viable (able to cause pregnancy).  

For all of these reasons, doctors advise that vasectomy be undertaken only by men who are prepared to accept the fact that they will no longer be able to father a child. The decision should be considered along with other contraceptive options and discussed with a professional counselor. Men who are married or in a serious relationship should also discuss the issue with their partners.  

Although it is extremely effective for preventing pregnancy, vasectomy does not offer protection against AIDS or other sexually transmitted diseases. Consequently, it is important that vasectomized men continue to use condoms, preferably latex, which offer considerable protection against the spread of disease.  

Another disadvantage is the immune reactions to sperm that some men develop after a vasectomy, although current evidence indicates that these reactions do not cause any harm.  

Ordinarily, sperm do not come in contact with immune cells, so they do not cause an immune response. But vasectomy breaks through the barriers that separate immune cells from sperm, and many men develop anti-sperm antibodies after undergoing the procedure. This has caused concern on the part of doctors and researchers, because immune reactions against parts of one's own body sometimes cause disease. Rheumatoid arthritis, juvenile diabetes, and multiple sclerosis are just some of the illnesses suspected or known to be caused by immune reactions of this type.  

Does Vasectomy Affect Sexuality?
No. Vasectomy does not affect the production or release of testosterone, the male hormone responsible for a man's sex drive, beard, deep voice, and other masculine traits. The operation also has no effect on sexuality. Erections, climaxes, and the amount of ejaculate remain the same.  

Occasionally, a man may experience sexual difficulties after vasectomy, but these almost always have an emotional basis and usually can be alleviated with counseling. More often, men who have undergone the procedure, and their partners, find that sex is more spontaneous and enjoyable once they are freed from concerns about accidental pregnancy.  

Does Vasectomy Increase a Man's Risk of Prostate Cancer?
Some research studies have led to concern about the link between vasectomy and prostate cancer. But, the consensus in the medical community is that vasectomy can safely continue to be used until further research shows otherwise.  

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