Contraception - Overview

Contraception

The term contraception refers to the process of avoiding

pregnancy while engaging in sexual intercourse.

The main aim of contraception is family planning.

Mostly used to prevent overpopulation and STD’s.

Also recommended in women suffering from heart diseases

Contraceptives methods in females:- Spacing methods

◦ Rhythm method◦ Barrier method◦ Chemical methods◦ IUCDS

Terminal methods◦ Surgical methods

Tubectomy Laparoscopic occlusion

◦ Medical termination of pregnancy Dilatation and Curettage Vaccum aspiration Administration of prostaglandins

Rhythm method

Barrier method Mechanical barriers

Female condoms

Vaginal Ring (NuvaRing)

NuvaRing is a flexible plastic (ethylene-vinyl acetate copolymer) ring that releases a low dose of a progestin and an estrogen over 3 weeks.

DIAPHRAGM The diaphragm is a flexible rubber cup that is filled with spermicide and self-inserted over the cervix prior to intercourse. The device is left in place several hours after intercourse. The diaphragm is a prescribed device fitted by a health care professional and is more expensive than other barrier methods, such as condoms

Cervical Cap

The cervical cap is a flexible rubber cup-like device that is filled with spermicide and self-inserted over the cervix prior to intercourse. The device is left in place several hours after intercourse. The cap is a prescribed device fitted by a health care professional and can be more expensive than other barrier methods, such as condoms.

Chemical barriers

Creams, Gels,Foams

Film,Sponge

◦Chemical methods◦ Oral contraceptives are the drugs

taken by mouth (pills) to prevent pregnancy.

◦ These pills prevent pregnancy by inhibiting maturation of follicles and ovulation.

◦ The menstrual cycle becomes the anovulatory cycle.

◦ These pills contain synthetic estrogen and progesterone.

◦ Contraceptive pills are of three types:

◦ 1. Classical or combined pills◦ 2. Sequential pills◦ 3. Minipills or micropills.◦ 4. Post – coital pills

Oral pills

Combined pill

Most commonly used contraceptive method throughout the

world. It contain 21 tablets of estrogens & progestrones.

Marketed in India as Mala N and Mala D.

Beginning on the 5th day of first cycle it is taken for 21 days at

the same time of day. Then 7 days gap is given. During this

time there will be estrogen withdrawl bleeding which is scanty.

Then another fresh packet is started.

To avoid confusion of one week gap government supplied

packets contain 28 tablets. 21 are steroid 7 are placebos (may

contain ferrons fumarate).

Risks Risk of excess mortality due to cardiovascular causes

(CAD, strokes, thrombo embolism). Increase in the incidence of endometrial and breast

cancers. Liver disorders, lactational problems. Breast tenderness, weight gain, headache and

bleeding disorders.

Benefcial effects: Include protection from benign breast diseases, ovarian

cysts, iron deficiency anemias, pelvic inflammatory disease, ectopic pregnancy, ovarian cancers.

Progesterone only pill- Mini pill

Prescribed in older women in whom combined pills are

contra indicated due to cardiovascular disorders.

Postcoital contraception (Morning after

pill)

With in 72 hours After a unprotected intercourse women

takes 2 tablets of combined oral pills immediately,

followed by another 2 tablets after 12 hours.

How does the pill work? Stops ovulation Thins uterine lining Thickens cervical mucus

Prevents pregnancyEases menstrual crampsShortens periodRegulates period

Positive Benefits of Birth Control Pills Decreases

incidence of ovarian cysts

Prevents ovarian and uterine cancer

Decreases acne

• Breast tenderness• Nausea• Increase in

headaches

• Moodiness• Weight change• Spotting

Side-effects

Depot preparationsDepo-Provera

Birth control shot given once every three months to prevent pregnancy

99.7% effective preventing pregnancy No daily pills to remember

The Patch

Six capsules Five years

Norplant I vs. Norplant II Two capsules Three years

Norplant Implant

IUCDS Intra Uterine Device (IUCD)

Tubal Ligation- Tubectomy Surgical procedure performed on a woman Fallopian tubes are cut, tied, cauterized, prevents eggs

from reaching sperm Failure rates vary by procedure, from 0.8%-3.7%

LAPAROSCOPY-’BAND-AID’ STERILIZATION

Contraceptives methods in males:-

Spacing methods

◦ Natural methods or coitus interruptus

◦ Barrier method

◦ Chemical methods

Terminal methods

◦ Surgical methods

Vasectomy

No scalpel vas occlusion

◦ Miscellaneous methods

Hot bath

Tight fitted dresses

Natural methods or coitus interruptus

Barrier methods - MALE CONDOM• Most common and effective barrier method when used

properly• Latex and Polyurethane should only be used in the

prevention of pregnancy and spread of STD’s (including HIV)

Condom It is the most widely known and used barrier device by

males around the world. In Indai it is better known by its trade name ‘NIRODH’ a

sanskrit word. It is applied over the erect male gential organ just before

intercourse. Application of spermicidal jelly to vagina is more effective. The sperms do not meet the ovum. For each sex act a new condom is to be used.

It is reliable, cheap, easy to use, reversible with no complications.

It also protects from sexually transmitted diseases (STD).

Male contraceptive pillGossipol

Terminal methods

Thank you