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Married couple in early 40s seek out contraceptive options. Do not want…

- - - - The testicles are housed in the scrotum just behind the penis. They have two functions that are very important to the male reproductive system: they produce gametes (sperm) and they secrete hormones, primarily testosterone.
        
        The penis is the external male sex organ, reaching its full size during puberty. In addition to its sexual function, the penis acts as a conduit for urine to leave the body. The penis is made of several parts: Glans (head) of the penis, corpus cavernosum, corpus spongiosum, and urethra. An erection results from changes in blood flow in the penis. When a man becomes sexually aroused, nerves cause penis blood vessels to expand. More blood flows in and less flows out of the penis, hardening the tissue in the corpus cavernosum.
      - The female reproductive system includes the ovaries, Fallopian tubes, uterus, vagina, accessory glands, and external genital organs.
        
        The ovaries have two main reproductive functions in the body. They produce oocytes (eggs) for fertilization and they produce the reproductive hormones, estrogen and progesterone.
        
        The Fallopian tubes are the female structures that transport the ova from the ovary to the uterus each month. In the presence of sperm and fertilization, the uterine tubes transport the fertilized egg to the uterus for implantation.
        
        Functions of the uterus include nurturing the fertilized ovum that develops into the fetus and holding it till the baby is mature enough for birth. The fertilized ovum gets implanted into the endometrium and derives nourishment from blood vessels which develop exclusively for this purpose.
  - - - Copper IUD: This IUD uses copper to prevent pregnancy. Copper is spermicidal, so the IUD makes it almost impossible for sperm to fertilize the egg
      - The hormones in hormonal IUDs prevent pregnancy in two ways: 1) they thicken the mucus that lives on the cervix, which blocks and traps the sperm, and 2) the hormones can also stop ovulation, meaning there’s no egg for a sperm to fertilize.
        
        Common IUD side effects include irregular bleeding for several months, symptoms of premenstrual syndrome (PMS), which include headaches, nausea, breast tenderness, and skin blemishes. There is also a risk of ectopic pregnancy, ovarian cysts, uterine perforation, or pelvic inflammatory disease.
      - A birth control implant is placed in the upper arm of a woman. It releases progesterone and acts in a very similar fashion to the hormonal IUD. 99% effective.
        
        Side effects include irregular bleeding, long-term spotting, or periods get longer and heavier. More rare side effects include headaches, breast pain, weight gain, ovarian cysts, pain or bruising where the implant was inserted, or an infection where the implant was inserted.
        
        Birth control pills are a kind of medicine with hormones that are taken by women. Birth control pills come in a pack, and 1 pill is taken every day. The pill is safe, affordable, and effective as long as the pill is taken on time. 91% effective.
        
        Some find that remembering to take the pill can be difficult. The hormones in the pill can change the levels of sexual desire or induce spotting. Smoking while using certain kinds of the pill can be dangerous. Medical history has an impact on which types of pills are prescribed.
        
        Tubal ligation is surgical procedure to prevent pregnancy, also called female sterilization. Sterilization is 99% effective and permanent. Reversals are possible but have a 50% success rate and are expensive and complicated surgeries.
        
        Though rare, it is possible to become pregnant after tubal ligation. Usually, this occurs if the Fallopian tubes have grown back together over time. In some cases, pregnancy is possible because the surgeon performed the procedure incorrectly. Women who become pregnant after undergoing tubal ligation have an increased risk of ectopic pregnancy.
        
        Vasectomy is minor surgery (for men) to block sperm from reaching the semen that is ejaculated from the penis. Semen still exists, but it has no sperm in it. After a vasectomy the testes still make sperm, but they are soaked up by the body. This method is 99% effective.
        
        Vasectomies are meant to be permanent. Even if the vasectomy is reversed, fertility may never come back. Vasectomy reversal surgery is complicated and expensive, and doesn’t always work. Side effects include redness, swelling, possible cysts.
        
        Condoms are 85% effective. Spermicide is 71% effective. The pull-out method is surprisingly more effective than spermicide, coming in at 78% effective.