Educator resources 200105

New Contraceptives and
Other Advances in Reproductive Health
Emergency Contraception
Plan B and Preven are two emergency contraceptive pill products (also called “dedicated products”)currently available to women with a doctor’s prescription. While the ingredients in these productsdiffer, both Plan B and Preven should be taken within 72 hours of unprotected intercourse. Thesooner that emergency contraception is started, the more effectively it prevents pregnancy. Whileboth products are considered safe and will not harm a developing fetus, neither product should beused as a routine form of birth control, since other forms of contraception are more effective and canprovide protection from sexually transmitted infections (STIs).
Preven, which appeared on the market in 1997, is a kit containing four pills (which combineestrogen and progestin) and a pregnancy test. Users may experience some side effects when usingthis contraceptive, including nausea and vomiting. Plan B, more recently approved by the FDA, is apackage with only two pills which contain progestin only. Plan B is more effective and may causefewer side effects for users than Preven since it does not contain estrogen.
Information on the emergency contraceptive pill products can be found at: http://www.plannedparenthood.org/ec/http://gynpages.com/ACOL/category/mat.htmlhttp://www.cais.com/agm/main/news/fdadoc.htmhttp://www.path.org/cecOr call the toll free number: 888-Not-2-Late The Female Condom
A safe, effective barrier method for preventing pregnancy and STIs, including HIV/AIDS. It is alubricated polyurethane sheath shaped like the male condom, but has flexible rings at each end. Theclosed end is inserted into the vagina, while the open end remains outside, partially covering thewoman’s labia. Like the male condom, the female condom is available without a prescription and isintended for one-time use. Although it takes more practice to use than the male condom, the femalecondom provides women with more control in protecting themselves.
Information on the female condom can be found at: http://www.femalecondom.orghttp://www.femalehealth.comhttp://safersex.org/condoms/femalecondoms/http://www.avert.org/femcond.htmhttp://www.emory.edu/WHSC/MED/FAMPLAN/reality.htmlhttp://www.psi.org/psi_ops/pfs/50_fcon.htmOr call the Female Health Company at: 845-353-8298 (this is not a toll free number) Reprinted from ReCAPP — ETR Associates’ Resource Center for Adolescent Pregnancy Prevention www.etr.org/recapp Copyright2004 ETR Associates A contraceptive injection which was approved by the FDA in late 2000. It differs in several waysfrom Depo Provera, the other injected birth control option which has been available for many years.
Lunelle is injected more often, once a month, compared to Depo Provera, injected once every threemonths. Lunelle contains both estrogen and progestin whereas Depo Provera contains only syntheticprogesterone. The added estrogen in Lunelle mimics a more natural hormonal mix, so Lunelleusually helps to maintain regular menstrual periods, while Depo Provera can cause very irregularcycles, or no bleeding at all. Finally, women who use Lunelle return to fertility relatively quickly,usually within two to four months; Depo Provera can take from six months to two years. As withcontraceptives taken orally, Lunelle can cause side effects such as breast tenderness, acne, weightgain or loss, and/or mood swings. Also, like all hormonal contraceptives — both oral and injected— Lunelle will not protect against STIs.
http://www.pharmacia.com/http://www.jademagazine.com/10iss_lunelle.htmlOr call Pharmacia UpJohn’s toll free number: 800-253-8600 Male Contraception (pills, shots, and implants)
Male contraception is collecting worldwide support according to recent studies. Last year’sEuropean journal Human Reproduction showed that 80% of women favored male contraception,and 66% of men said they would use a pill. (Source: Popline, March-April 2000 as reported in theReligious Consultation Report, Nov. 2000, Volume 4 No. 2.) Unfortunately, despite the need andpublic interest, options for male contraception are still limited to the traditional methods ofcondoms, vasectomy, withdrawal and abstinence. While several innovations are being studied, itmay take another 5-10 more years before new options become widely available.
Researchers are studying a variety of approaches. Scientists in England and Scotland have found acombination of synthetic hormones that stop sperm production without affecting a man’s sex drive.
A small pellet of testosterone is implanted into the man’s abdomen every 12 weeks. This approachkeeps libido active and also avoids unpopular testosterone shots. However, this implant must becombined with a daily progesterone pill. The pill is taken to stop sperm production, which occurs intwo to three months. Additional studies are being conducted in which both hormones may beimplanted in the body, which would eliminate the need for a daily pill.
Scientists in the U.S. are looking into male contraceptives that do not rely on hormones. Some arestudying ways to block the chemicals which enable sperm to reach the egg. Still other scientists aredeveloping compounds that prevent the sperm cells from maturing without affecting theirproduction. However, neither of these approaches have been tested on human subjects yet.
Information on advances in male contraception can be found at: http://www.healthsurfing.com/health/2000/04/04/http://www.rti.org/news/bc_male_new.cfm Reprinted from ReCAPP — ETR Associates’ Resource Center for Adolescent Pregnancy Prevention www.etr.org/recapp Copyright2004 ETR Associates Medical Abortion
A term that describes the use of a combination of drugs, or abortifacients, to terminate a pregnancy.
Medical abortion differs from surgical abortion (such as vacuum aspiration, or dilation andevacuation), and from spontaneous abortion, also known as a miscarriage. The most common drugscurrently used for medical abortion are listed below: Mifepristone (RU-486) was developed by the French in 1980. It blocks the action of
progesterone, a hormone necessary to sustain an early pregnancy, and increases the uterus’
sensitivity to prostaglandins, which cause uterine contractions.
Methotrexate is currently marketed in the U.S. (since 1954) for treatment of certain
cancers and arthritis, and to terminate ectopic pregnancy (where the fetus develops outside
the uterine cavity). It keeps the embryo from developing and implanting in the uterine wall.
Misoprostol has been used in the U.S. to prevent gastrointestinal ulcers since 1988. It can
also be used to cause uterine contractions, which can expel a fertilized egg from the uterus.
This is currently used in combination with mifepristone when used for medical abortion.
The combination of mifepristone and misoprostol has been found effective in terminating earlypregnancies (up to about 65 days). Medical abortion can be performed earlier in the pregnancy thansurgical abortion and is also less invasive. Potential drawbacks include at least two office visits,potential prolonged bleeding, and a slightly higher failure rate than surgical abortion, which canrequire follow-up by a surgical method. The approval of these drugs for use as abortifacientsprovides more options for women wanting an early termination of pregnancy and may increase thenumber of physicians who provide early abortion services.
Information on medical abortion can be found at: http://jamwa.amwa-doc.org/vol55/55_3_ed.htmhttp://www.plannedparenthood.org/library/facts/medabort_fact.htmlOr call the National Abortion Federation’s toll free number: 800-772-9100 Premenstrual Dysphoric Disorder (PMDD)
A severe form of premenstrual syndrome (PMS). Both PMDD and PMS occur the week before theonset of menstruation and can last the length of menstruation. PMDD and PMS share many of thesame symptoms, including breast tenderness, bloating, irritability and mood swings. However,PMDD has much more severe emotional symptoms, including severe mood swings, depressedmood, feelings of hopelessness, anxiety, sleep disturbances, difficulty concentrating, and angryoutbursts. PMDD interferes with a woman’s everyday life and can greatly affect her relationshipswith family and friends. Since symptoms of PMDD may impair social functioning, and in extremecases, lead women to become suicidal or homicidal, it has recently received an official psychiatricdiagnosis.
Reprinted from ReCAPP — ETR Associates’ Resource Center for Adolescent Pregnancy Prevention www.etr.org/recapp Copyright2004 ETR Associates Premenstrual Dysphoric Disorder (continued)
Managing overall health through lifestyle choices can reduce symptoms of PMS and PMDD inmany women. The following healthy practices are therefore recommended: Eat regular meals and a balanced diet low in meat, sugar and salt.
Stop smoking and reduce or eliminate alcohol and coffee consumption.
Reduce stress by adjusting expectations or employing stress reduction activities.
Get aerobic exercise three or four times a week.
Medical treatments are also available for women with PMS or PMDD. PMS is generally treatedwith birth control pills and other medicines to address the symptoms of breast tenderness, bloatingand weight gain, menstrual pain and cramping. PMDD, however, can also be treated with anti-depressants, including selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Effexor orZoloft. Additionally, a new medication called “Sarafem” is also available with a doctor’sprescription. Sarafem helps correct the imbalance of serotonin that many doctors feel contributesto PMDD.
http://www.sarafem.com/about.htmlhttp://www.drdonnica.com/display.asp?article=10086Or call Eli Lilly and Company’s toll free number: 800-545-5979 ThinPrep Test
Human Papilloma Virus (HPV) Testing is an advance which shows promise of decreasing thenumber of women who develop cervical cancer. HPV, the virus associated with abnormal cervicaltissue changes and cervical cancer, infects more than five million people a year, making it the mostcommon STI in the U.S. Some researchers have found HPV prevalence for women under age 25 tobe somewhere between 28% and 46%.
Conventional testing for abnormal or precancerous cells in the cervix (most likely caused by HPV)is the Pap Smear. Now there is a new test called ThinPrep (which is more effective than theconventional Pap Test in detecting abnormal and precancerous cells. This new testing processenables health care providers in the timely removal of these cervical cells before they can progressto the cancerous stage.
Further information about HPV testing and vaccines can be found in the following sources: http://www.ashastd.org/stdfaqs/statistics.htmlhttp://www.abcnews.go.com/sections/science/DailyNews/cervical_vaccine980617.htmlOr call the Herpes and HPV hotline toll free number: 800-230-6039 Reprinted from ReCAPP — ETR Associates’ Resource Center for Adolescent Pregnancy Prevention www.etr.org/recapp Copyright2004 ETR Associates

Source: http://recapp.etr.org/recapp/documents/freebies/edresources200105.pdf