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preventing pregnancy
refrain from intercourse during the woman’s fertile period,
starting a few days before ovulation and ending a few
days after. Her fertile period is identified and tracked by
keeping records of the length of her menstrual cycles and
sometimes by examining her cervical secre tions. A woman
who uses this method may also take her temperature each
morning when she wakes up, because core body tempera-
ture rises by one-half to one degree just after ovulation
(Figure 16.11). The method is not very reliable (Table 16.3).
Ovulation can be irregular, and it can be easy to miscalcu-
late. Also, sperm already in the vaginal tract may survive
until ovulation.
Withdrawal, removing the penis from the vagina before
ejaculation, also is not very effective because fluid released
from the penis before ejaculation may contain sperm.
Douching, or rinsing out the vagina with a chemical right
after intercourse, is next to useless. It takes less than 90 sec-
onds for sperm to move past the cervix into the uterus.
surgery and barrier methods
are the most effective options
Controlling fertility by surgery is less chancy but is usually
an irreversible step. In vasectomy, a physician makes a tiny
incision in a man’s scrotum, then severs and ties off each
vas deferens (Figure 16.12A). Afterward, sperm can’t leave
the testes and so can’t be present in the man’s semen. A
vasectomy does not change a man’s sex hormones or sex
drive. An alternative is the Vasclip, a device about the size
of a rice grain that simply closes off the vas deferens.
In tubal ligation, a woman’s oviducts are cauterized
or cut and tied off (Figure 16.12B), so sperm cannot reach
ovulated oocytes.
Spermicides kill sperm. They are packaged inside an
applicator and placed in a woman’s vagina just before inter-
course. Neither is reliable unless used with another device,
such as a diaphragm or condom.
A diaphragm is a flexible, dome-shaped device that is
positioned over the cervix before intercourse. It must be
fitted by a doctor, used with foam or jelly, and inserted
correctly with each use. A cervical cap is a similar but
smaller device and can be left in place for up to 3 days.
The contraceptive sponge is a disposable disk that contains a
spermicide and covers the cervix. After being wetted, it is
inserted up to 24 hours before intercourse. No prescription
or special fitting is required.
The intrauterine device, or IUD, is a plastic or metal device
that is placed into the uterus, where it hampers implanta-
tion of a fertilized egg. Available by prescription, IUDs
have been associated with a variety of complications and
should be discussed fully with a physician.
Condoms are thin, tight-fitting sheaths of latex or animal
skin worn over the penis during intercourse. Good brands
may be as much as 95 percent effective when used with
n People who choose to control whether their sexual activity
produces a child have a variety of options.
The most effective method of birth control is complete
abstinence—no sexual intercourse whatsoever. A modified
form of abstinence is the rhythm method, also called the “fer-
tility awareness” or sympto-thermal method. The idea is to
16.7
Method Mechanism of Action Pregnancy Rate*
Abstinence Avoid intercourse entirely 0% per year
Rhythm method Avoid intercourse 25% per year
when female is fertile
Withdrawal End intercourse before 27% per year
male ejaculates
Vasectomy Cut or close off male’s <1% per year
vasa deferentia
Tubal ligation Cut or close off <1% per year
female’s oviducts
Condom Enclose penis, block 15% per year
sperm entry to vagina
Diaphragm, Cover cervix, block 16% per year
cervical cap sperm entry to uterus
Spermicides Kill sperm 29% per year
Intrauterine device Prevent sperm entry <1% per year
to uterus or prevent
implantation
Oral contraceptives Prevent ovulation <1% per year
Hormone patches, Prevent ovulation <1% per year
implants, or
injections
Emergency Prevent ovulation 15–25% per use**
contraception pill
Table 16.3 Common Methods of Contraception
Figure 16.11 Ovulation coincides with a slight rise in
body-core temperature.
© iStockphoto.com/Ever.
*Percent of users who get pregnant despite consistent, correct use
**Not meant for regular use
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