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Contraception

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  • 1. CONTRACEPTIVECONTRACEPTIVE
  • 2. The intentional prevention of conception through the use ofvarious devices, sexual practices, chemicals, drugs, orsurgical procedures is called contraceptive.This means that something (or some behavior) becomes acontraceptive if its purpose is to prevent a woman frombecoming pregnant.There are several types of contraceptives that have beenofficially labeled as such because they have shown reliabilityin preventing conception from occurring.Contraception
  • 3. Slide Master• Your Text here• Lorem ipsum dolor sit amet, consectetuer adip iscing elit, sed diam no n ummy nibh euismod tincidunt ut laoreet do lore magna aliquam er at v olutpat. Ut wisi enim ad mi ni m venia m, quis nostrud exerci tatio n ulla mcorper susc ip it lobor tis nisl ut aliquip ex ea commodo cons equat.• Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse mo lestie consequat, vel illum dolore eu feugiat nulla fac ilisis at vero eros et accumsan et iusto odio dign issim qui bla ndit praesent lup tatum zzril delenit augue duis dolore te fe ug ait nulla facilisi
  • 4. Need for contraception….World’s population expected to reach 9billion by 2050.India accounts for 17% of world’spopulation.
  • 5. Need for contraception….Annually, 529,000 maternal deaths & 50 million morbidity.• In India, contraceptive prevalence is 48.3%21% of all pregnancies resulting live births are unplanned.If unmet need for contraceptionwas met, we can avoid52 million unwanted pregnancies25-50% of maternal deaths
  • 6. Ancient PracticesAncient PracticesAncient writings noted on the Kahun papyrus datingAncient writings noted on the Kahun papyrus datingto 1850 BCE refer to contraceptive techniques using ato 1850 BCE refer to contraceptive techniques using avaginal pessary of crocodile dung and fermentedvaginal pessary of crocodile dung and fermenteddough, which most likely created a hostiledough, which most likely created a hostileenvironment for sperm.environment for sperm.The Kahun papyrus also refers to vaginal plugs ofThe Kahun papyrus also refers to vaginal plugs ofgum, honey, and acacia. During the early secondgum, honey, and acacia. During the early secondcentury in Rome, Soranus of Ephesus created a highlycentury in Rome, Soranus of Ephesus created a highlyacidic concoction of fruits, nuts, and wool that wasacidic concoction of fruits, nuts, and wool that wasplaced at the cervical os to create a spermicidalplaced at the cervical os to create a spermicidalbarrier. (barrier. (Omnia M Samra-Latif, MDOmnia M Samra-Latif, MD ))
  • 7. Birth Control MethodsBirth Control MethodsPhysiologicPhysiologicMechanical Barriers/Chemical BarriersMechanical Barriers/Chemical BarriersHormonal ContraceptivesHormonal ContraceptivesSterilizationSterilization
  • 8. What are the available methods ofcontraception?Condoms (male and female)Combined pillProgestogen-only pill (mini-pill)Intrauterine Systems (IUS)Contraceptive implantsVaginal ringContraceptive injectionsContraceptive patchesIntrauterine device (IUD)Diaphragms and caps plus spermicideNatural family planning (e.g. temperature method)Sterilisation (male and female)
  • 9. Male & femalecondomsWhat are they?Latex or polyurethane sheaths which fit over a mans penis (male condom) or inside a woman’svagina (female condom)How do they work?Prevent sperm from entering the womans vaginaPrevent sexually transmitted infections (STIs) from passing from person to person if usedproperly.
  • 10. ContraceptivepatchesWhat are they?Stick-on patches, which slowly release estrogen and progestogen hormones through the skinStuck onto your bottom, thigh, stomach or upper bodyChanged weekly – with no patch used on the fourth week of your cycle.How do they work?Prevent ovulationThicken the mucus around the neck of the womb, making it difficult for sperm to enter
  • 11. ContraceptivepatchesWhat are their main advantages?Do not have to be used daily (replaced every week)Do not interrupt sexEasy to useEfficacy unaffected by vomiting or diarrhoeaWhat are their main disadvantages?Not suitable for women aged over 35 years who smoke, or women who are breastfeedingVisible to others (e.g. partner)May rarely cause skin irritationDo not protect against STIsMay evoke temporary side-effects such as headaches, breast tenderness, bleeding betweenperiods..
  • 12. Contraceptive injectionsWhat are they?• Injection containing progestogen only, given by a trained doctor or nurseevery three monthsHow do they work?• Prevent ovulation and / or• Thicken mucus around the neck of the womb making it difficult for sperm toenter
  • 13. Contraceptive injectionsWhat are their main advantages?• Semi-long-acting hormonal method without the need for a daily dose• Do not interfere with sex• Can be used during breastfeeding and for those women who do not tolerateestrogenWhat are their main disadvantages?• Periods and fertility may take up to a year to return after stopping injections• May induce headaches, dizziness, spotty skin, tender breasts, moodswings, weight gain and bloating. As the injection cannot be removed fromthe body, side effects may continue during the time it is inserted and forsome time afterwards• Do not protect against STIs
  • 14. Contraceptive implantsWhat are they?• Tiny flexible tubes impregnated with a progestogen hormone, and insertedjust under the surface of the skin on the inside of your upper arm by a traineddoctor or nurse. The implant is effective for three yearsHow do they work?• Thicken the mucus in the neck of the womb to make it difficult for sperm toenter• Change the lining of the womb• Prevent ovulation
  • 15. What are their main advantages?• Can be fitted and forgotten• Does not interfere with sex• Can be used while breastfeeding• Is useful for women who cannot take estrogens• May reduce heavy, painful periodsWhat are their main disadvantages?• May cause irregular bleeding for the first few months• Can cause side effects such as headaches, tender breasts, changes inmood and sex drive, and bloating• Do not protect against STIs• It may take a while until fertility is vesturedContraceptive implants
  • 16. Vaginal ringWhat are they?• Contains estrogen and progestogen, and is inserted into the vagina. It is keptin place for three weeks, and then removed for a one week break. A new ringis inserted following the week break.How do they work?• Prevent the female body from releasing an egg each month• Thicken the mucus of the entrance to the womb, making it difficult for spermto get through
  • 17. What are their main advantages?• An alternative form of hormonal contraception which is used only once everyfour weeks• May make a woman’s periods more regular, lighter and may reduce crampingWhat are their main disadvantages?• Can cause vaginal irritation, discomfort or discharge• May cause nausea and breast tenderness• Some women may be able to feel it• Do not protect against STIsVaginal ring
  • 18. Intra-uterine systems (IUS,also known as hormonalcoil)What are they?• Plastic T-shaped device with a cylinder containing progestogen.Inserted in the cavity of the womb by a trained HealthProfessional. Is effective for up to five yearsHow do they work?• Thicken the mucus in the neck of the uterus, making it difficult forsperm to enter• Keeps the lining of the womb thin. Makes the uterus hostile tosperm
  • 19. IUSWhat are their main advantages?• Can be fitted and forgotten - effective for up to five years• Do not interrupt sex• Option for women who cannot tolerate estrogens and those breast-feeding• Periods usually become much lighter and shorter, and less painful• Can offer protection against pelvic infections and cancer of the uterine lining• Normal fertility returns quickly when the IUS is removed• Not affected by other medicinesWhat are their main disadvantages?• Can cause irregular bleeding for the first three months• May cause temporary side-effects such as headaches, breast tenderness andnausea• Do not protect against STIs• Can be expelled or displaced by the womb• May rarely perforate the womb or cervix
  • 20. Intra-uterine devices(IUD)What are they?• Small plastic and copper T-shaped devices,which are inserted into the cavity of the wombby a trained Health ProfessionalHow do they work?• Prevents sperm and eggs from meeting by immobilizing the sperm on their way tofallopian tubes and changing the line of the womb so that it cannot accept an egg
  • 21. IUDWhat are their main advantages?• Can be fitted and forgotten - effective for three to ten years• Do not interrupt sex• Normal fertility returns as soon as it is removedWhat are their main disadvantages?• May cause heavier, longer or more painful periods, increased cramping anddizziness• Can increase the risk of pelvic infections• Do not protect against STIs• Can be expelled or displaced by the womb• Can perforate the womb or cervix
  • 22. Diaphragms & capsWhat are they?• Dome-shaped circles made of rubber or silicone thatis inserted into the vagina, requires initial fitting bya doctor or nurse• Coated with spermicidal cream for extra protection• Must be left in for at least six hours after intercourse (and no more than 24hours)How do they work?• Forms a barrier between the sperm and the entrance of the womb
  • 23. Diaphragms & capsWhat are their main advantages?• Necessary only when having sex• No serious health risks• Can be inserted at any convenient time before sexWhat are their main disadvantages?• Insertion can interrupt sex• Spermicide can be messy• Insertion and expulsion need to be practiced• Can cause vaginal irritation
  • 24. Natural family planningWhat are they?• Withdrawal method - penis is withdrawn from the vagina prior to ejaculation• Natural method – sex is avoided at fertile times of the month. Fertility ismonitored using the following methods– Keep a daily record of your body temperature using a specialfertility thermometer– Look for changes in the stickiness of the mucus around theentrance to the womb– Calculate when ovulation is most likely to take place by countingthe number of days from your last period (this only works if yourperiods are regular)– Look for other signs such as mood changes and breast tendernesswhich tend to happen in the second half of your menstrual cycle(measured from the start of one period to the beginning of thenext)
  • 25. Natural family planningWhat are its main advantages?• Can be used to plan as well as avoid a pregnancy• Does not involve any chemical agents or physical devices• No physical side-effects• Allows women to become more aware of their fertility• Helps women communicate about their fertility and sexuality• Acceptable to all faiths and culturesWhat are its main disadvantages?• The withdrawal method is highly unreliable because small drops of sperm can escapefrom the penis into the vagina before the man ejaculates• Fertile periods not confirmed until three to six cycles are completed• Necessary to keep daily records• Events such as illness, stress and travel may make fertility indicators harder to interpret• Necessitates intercourse avoidance during the fertile time• Both partners need to be very committed to the method• Does not protect against STIs
  • 26. Emergency contraceptionWhat is it?• Emergency method that can be used after unprotected sex or when anothercontraception method has failed (e.g. split of condom)• Only intended as a back-up, not to be used regularlyHow does it work?• Emergency contraception works mainly by preventing ovulation and fertilisation• It also has a local effect on the uterus• It will not interrupt an established pregnancy
  • 27. Emergency contraception• Emergency Contraceptive (or morning after) pills - can be taken upto 72 hours or three days after intercourse. However, the sooner youtake them, the more effective they are. They contain progestogenonly, and can be taken up to 72 hours after unprotected intercourse
  • 28. SterilisationWhat is it?• Permanent method of contraception for people who do not want childrennow or in the futureHow does it work?Male sterilisation• The tubes that carry sperm are cut, so thatwhile a man can still ejaculate, no sperm is presentFemale sterilisation• The fallopian tubes are cut or blocked so thatthe egg cannot travel down to meet sperm
  • 29. SterilisationWhat are its main advantages?• Almost 100% effective• Does not interrupt sex• Can be performed and forgottenWhat are its main disadvantages?• Cannot be reversed (except by using complex and dangerous surgery which isnot successful in all cases)• Do not protect against STIs
  • 30. What is the progestogen-only (mini) pill?• Oral pills that contain a progestogen hormoneHow do they work?• Thicken the mucus at the entrance to the womb, which makes it difficult for spermto get through• Change the lining of the womb• May also prevent ovulation in some womenOral contraceptive pills
  • 31. Mini (progestogen-only)pillsWhat are their main advantages?• Few serious side-effects• Do not interrupt sex• Can be used while breastfeeding• Are useful for women who cannot take estrogens• Can be used at any ageWhat are their main disadvantages?• May cause irregular periods• Do not protect against STIs• Must be taken at the same time everyday• May initially induce temporary side-effects such as: spotty skin, breasttenderness, bloating, and headaches
  • 32. Combined oral contraceptivesTrying to reduce the dose of estrogen to the lowestpossible without reducing efficacyAnd by combination

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