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A healthy, happily married couple in their early 40s has sought your…
A healthy, happily married couple in their early 40s has sought your advice on contraceptive strategies. The woman is concerned about the long-term effects of birth control pills and wants to stop taking them. They have two lids in high school and are certain they do not want more children. They seek your advice on what to do. What do I tell them?
Upstream Causes:
The important factor here is that the mother wants to get off birth control pills. Along with condoms, make a great contraceptive combination.
They also do not want anymore offspring, so suggesting both of them get fixed, would probably be an easy sell.
Background Info:
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Major Contraceptive methods, how do they work to prevent pregnancy, and the potential side effects.
Condoms work by preventing semen from reaching the uterus. Potential side effects are funny noises and added prevention of STDs. That is why they are still a pregnancy prevention mainstay today.
Birth control pills use estrogen or progestin to stop the sperm from joining with the egg. Side effects include spotting, breast tenderness, nausea and low sex drive.
Vasectomy is a small incision in the ductus deferens to prevent semen being transported to the epimydis, There is a small risk of a vasectomy increasing the chance for prostate cancer.
Getting tubes tied involves closing the Fallopian tubes to prevent a woman's eggs from being fertilized. The normal side effects of any surgery comes with getting a woman's tubes tied.
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Downstream Effects:
Condoms for men and women are better than the pull out method but still present their own risks. Men's are about 82 percent effective while women's are about 71 percent.
IUDs are the most effective birth control device. Pregnancy occurs less than 1 in 100 in women that use one. Can be used for 10 years and cant be seen.
I would say barrier methods are a bad way to go as well as they just put the female at too much a risk to infection and inflammation.
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The worst contraception method is the "pull-out" method, pulling out before ejaculation.
The woman getting her tubes tied and the male getting a vasectomy would be the route I recommend for this couple. No fancy contraceptives to worry about, and will have the greatest yield in prevention of pregnancy. I would still try to burn into their mind that the only way that they would 100 percent not have more children is to not have sex.