Your SlideShare is downloading. ×
0
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Contraception& family planning nm.final
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Contraception& family planning nm.final

3,397

Published on

useful for nursing students.

useful for nursing students.

Published in: Health & Medicine
0 Comments
6 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
3,397
On Slideshare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
0
Comments
0
Likes
6
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1.    The human male reproductive system consists of a number of sex organs that form a part of the human reproductive process. In this type of reproductive system, these sex organs are located outside the body, around the pelvic region. The main male sex organs are the penis and the testicles which produce semen and sperm, which, as part of sexual intercourse, fertilize an ovum in the female's body; the fertilized ovum (zygote) develops into a fetus, which is later born as a child.
  • 2.  The penis is the male copulatory organ. It has a long shaft and an enlarged bulbous-shaped tip called the (glans penis), which supports and is protected by the foreskin. When the male becomes sexually aroused, the penis becomes erect and ready for sexual activity.
  • 3.  Erection occurs because sinuses within the erectile tissue of the penis become filled with blood. The arteries of the penis are dilated while the veins are passively compressed so that blood flows into the erectile cartilage under pressure.  The scrotum is a pouch-like structure that hangs behind the penis. It holds and protects the testes. It also contains numerous nerves and blood vessels.  The scrotum remains connected with the abdomen or pelvic cavity by the inguinal canal.
  • 4.  The vas deferens, also known as the sperm duct, is a thin tube approximately 30 centimetres (0.98 ft) long that starts from the epididymis to the pelvic cavity.  Three accessory glands provide fluids that lubricate the duct system and nourish the sperm cells. They are the seminal vesicles, the prostate gland, and the bulbourethral glands (Cowper glands).
  • 5.  Seminal vesicles are sac-like structures attached to the vas deferens at one side of the bladder. They produce a sticky, yellowish fluid that contains fructose. This fluid provides sperm cells energy and aids in their motility. 70% of the semen is its secretion.  The prostate gland surrounds the ejaculatory ducts at the base of the male urethra, just below the bladder. The prostate gland is responsible for the proof semen, a liquid mixture of sperm cells, prostate fluid and seminal fluid
  • 6.  The female genital system contains two main parts: the uterus, which hosts the developing fetus, produces vaginal and uterine secretions, and passes the male's sperm through to the fallopian tubes; and the ovaries, which produce the female's egg cells
  • 7.  The vagina is a fibro-muscular tubular tract leading from the uterus to the exterior of the body in female mammals .  The vagina is the place where semen from the male penis is deposited into the female's body at the climax of sexual intercourse, a phenomenon commonly known as ejaculation.  The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body. It also is known as the birth canal.
  • 8.  The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina.  It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall.  Approximately half its length is visible to the naked eye, the remainder lies above the vagina beyond view.  The vagina has a thick layer outside and it is the opening where the fetus emerges during delivery. The cervix is also named the neck of the uterus.
  • 9.  The uterus or womb is the major female reproductive organ of humans. The uterus provides mechanical protection, nutritional support, and waste removal for the developing embryo (weeks 1 to 8) and fetus (from week 9 until the delivery).  The uterus is a pear-shaped muscular organ. Its major function is to accept a fertilized ovum which becomes implanted into the endometrium, and derives nourishment from blood vessels which develop exclusively for this purpose.
  • 10.  The Fallopian tubes or oviducts are two tubes leading from the ovaries of female mammals into the uterus. On maturity of an ovum, the follicle and the ovary's wall rupture, allowing the ovum to escape and enter the Fallopian tube.  There it travels toward the uterus, pushed along by movements of cilia on the inner lining of the tubes. This trip takes hours or days. If the ovum is fertilized while in the Fallopian tube, then it normally implants in the endometrium when it reaches the uterus, which signals the beginning of pregnancy.
  • 11.  The ovaries are small, paired organs that are located near the lateral walls of the pelvic cavity.  These organs are responsible for the production of the ova and the secretion of hormones.
  • 12.  Ovaries are the place inside the female body where ova or eggs are produced. The process by which the ovum is released is called ovulation. The speed of ovulation is periodic and impacts directly to the length of a menstrual cycle.  Ovaries are the place inside the female body where ova or eggs are produced. The process by which the ovum is released is called ovulation. The speed of ovulation is periodic and impacts directly to the length of a menstrual cycle.
  • 13.  After ovulation, the ovum is captured by the oviduct, after traveling down the oviduct to the uterus, occasionally being fertilized on its way by an incoming sperm, leading to pregnancy and the eventual birth of a new human being.
  • 14. Family planning services are defined as "educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved".
  • 15. Raising a child requires significant amounts of resources:  time,  social,  financial, and  environmental.  Planning can help assure that resources are available.   The purpose of family planning is to make sure that any couple, man, or woman who has the desire to have a child has the resources that are needed in order to complete this goal.
  • 16.  Family welfare – a state of well – being of the family as a whole and the individual. Means a level of satisfaction of the basic needs of family (adequate food, water, shelter, employment, health and education).  Responsible Parenthood – the essence of family planning. Pregnancy is planned and a child us desired and is assured of parent's love, protection, etc.
  • 17. Health and Benefits For the Mother  Help mother to fully recover from physical strain of child bearing. Those more than 4 children – considered high risk. Help reduce number of maternal death due to abortion.   For the Father Family Planning helps the father shoulder his responsibility and enables him to give his children equal attention. It also lightens his load because he will not be obliged to provide for and support too many children.
  • 18. Health and Benefits For the Children: Through Family Planning, the children are better taken care of. The parent could meet the basic needs of the children For the Family: Health help the family enjoy the better kind of life. For the Community: Family Planning can provide a peaceful, orderly, and selfsustaining community with fewer problems, like juvenile delinquency. For the Country and the World: For the World , overcrowding can be minimized, and governments can focus their economic efforts on production rather than consumption. 
  • 19. The deliberate use of artificial methods or other techniques to prevent pregnancy .
  • 20. World Contraception Day  September 26 is designated as World Contraception Day, devoted to raising awareness of contraception and improving education about sexual and reproductive health, with a vision of "a world where every pregnancy is wanted".
  • 21.  CONTRACEPTION HELPS IN PREVENTING PREGNANCY  CONTRACEPTION METHOD LIKE CONDOM GIVES PROTECTION AGAINST STD’S…….
  • 22. IDEAL CONTRACEPTIVE          Safe Effective Acceptable Inexpensive Reversible Simple to administer Independent of coitus Long lasting to avoid frequent administration Requiring little or no medical supervision
  • 23. Classification of contraceptive methods I. SPACING METHODS (temporary) Natural or Fertility Awareness Method Barrier Methods Hormonal Methods Intrauterine Devices II. TERMINAL METHODS (permanent) Female sterilization Male sterilization
  • 24. A.Natural or Fertility Awareness Method 1. Standard Days Method 2. Calendar Rhythm Method 3. Symptoms Based Method a. Temperature Rhythm Method b.Cervical Mucus Rhythm Method c. Sympthotermal Method B.Lactation Amenorrhea C.Artificial Method
  • 25. A. Medical (Hormonal) a. Short Acting 1. Combined Oral Pills 2. Progestin Only Pills b. Long Acting 1. Combined Patch 2. Progesterone Implants 3. Injectables 4. Transvaginal Ring B. Barrier Method a. Condom b. Diaphragm & Cervical Cap c. Spermicide cream & jelly d. Sponge e. Intra-uterine Device C. Permanent Methods a. Vasectomy b. Tubal Ligation
  • 26. • Natural Family Planning (NFP) – Sexual abstinence during fertile period • Fertility Awareness Combined Method (FACM) – Using barrier method during the fertile time
  • 27. • Fertility Awareness – Fertile time of the menstrual cycle starts and ends – Ovum is fertilized 12 to 24 hours after ovulation – Ovulation may oocur 6 weeks post partum •Periodic Abstinence • Natural Family Planning 
  • 28. • Avoid unprotected intercourse – Day 8 to 19 • • Regular monthly cycles of 26 to 32 days Use of cycle beads
  • 29. CALENDAR METHOD ( RHYTHM ) Chances of Pregnancy by Day of Intercourse day zero is ovulation -5 4 -3 -2 -1 0 0% 15% 26% 15% - 11% 20% 1 2 3 9% 5% 0%
  • 30. • Billings Method – Cervical Mucus Method or Ovulation Method • Cervical secretions or feeling of wetness • Basal Body Temperature (BBT) – Slight body temperature rise after released of a fertilized egg – Temperature remains elevated until the start of next cycle • Symptothermal Method – Combination of BBT and Billings Method • 2 Day Method
  • 31. • Avoid unprotected sex when secretions begin until 4 days after the peak day. • PEAK DAY - last day where the secretions are clear, slippery, stretchy and wet
  • 32. - Rise in temperature of 0.40F of morning BBT (OVULATION) - Abstain from unprotected intercourse from 1st day up to 3rd day after increase in BBT
  • 33. • • Change in cervical mucus ➡️onset of fertility Increase in BBT ➡️end of fertility
  • 34. • Presence of any type of secretion ➡️ considered fertile for that day and the following day
  • 35. Temporary method • Ovulation is not possible during the first 10 weeks postpartum • Effects of breastfeeding with fertility • 3 criteria for effectiveness • 1. Monthly menstruation has not returned 2. Exclusive or nearly exclusive breastfeeding 3. Baby is less than 6 months old
  • 36. • Prevents release of egg during ovulation • Prevents release of ovulatory hormones
  • 37. Artificial Methods
  • 38. BARRIER Barrier methods of birth control block sperm from entering the uterus. Using a spermicide with a barrier method gives you the best possible barrier method protection.
  • 39.    The spermicide kills most of the sperm that enter the vagina. The barrier method then blocks any remaining sperm from passing through the cervix to fertilize an egg. Unlike other methods of birth control, barrier methods are used only when you have sexual intercourse.
  • 40. CONDOM  A condom is a barrier device commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases such as HIV.  It is put on an erect penis and physically blocks ejaculated semen from entering the body of a sexual partner.
  • 41.  Lubricants used should be water based – condom must be used with every coital act – place before contact of the penis with the vagina – Withdrawal must occur with the penis still erect – The base of the condom must be held during withdrawal – Either an intravaginal spermicide or a condom lubricated with spermicide should be employed  >Failure rate:  3 or 4 couple-years of exposure
  • 42.   Condoms are also used for collection of semen for use in infertility treatment. Because condoms are waterproof, elastic, and durable. As a method of birth control, male condoms have the advantage of being inexpensive, easy to use, having few side effects
  • 43.  Condoms may slip off the penis after ejaculation, break due to improper application or physical damage (such as tears caused when opening the package), or break or slip due to latex degradation (typically from usage past the expiration date, improper storage, or exposure to oils
  • 44. • • Pregnancy rate higher than male condom Polyurethane sheath with one flexible polyurethane ring at each end – Open ring remains outside the vagina – Closed internal ring is fitted under symphysis  DO NOT USE SIMULTANEOUS WITH MALE CONDOM SINCE FRICTION LEADS TO SLIPPING, TEARING & DISPLACEMENT
  • 45.     95% effective Protects against some STDs Noisy Use extra lubrication 51
  • 46.     Most people can use female condoms with no problems for themselves or their partners. Some women and men may not like the female condom because it may cause irritation of the vagina, vulva, penis, or anus slip into the vagina during vaginal intercourse, or into the anus during anal intercourse
  • 47. •Soft latex cup that covers the cervix •Spring along the rim to keep it in place •Used with spermicidal creams/jelly or sponge for effectiveness •Inserted few hours before intercourse ➡️add spermicide •Should not be remove <6hrs, and not stay >6hours . •Increase rate UTI
  • 48.  It does not affect future fertility for either the woman or the man.  It is used only at the time of sexual intercourse.  It is safe to use while breast-feeding.  It is less expensive than hormonal methods of birth control.  It can be used by women who have health problems that would make estrogen use dangerous, and by women who smoke.
  • 49.    Some people are embarrassed to use this method or feel the method interrupts foreplay or intercourse. A couple must be comfortable with using the diaphragm and be prepared to use it every time they have sex. A diaphragm can't be used if either person is allergic to latex.
  • 50. •Soft, deep, latex or rubber cup that covers the cervix •Prevents the sperm to enter the cervix •Best used with spermicides •Compatible to diaphragm
  • 51.     It does not affect future fertility for either the woman or the man. It is used only at the time of sexual intercourse. It is safe to use while breast-feeding. It is less expensive than hormonal methods of birth control.
  • 52.       The cervical cap should not be used by a woman who has ever had toxic shock syndrome. The cervical cap cannot be used during a woman's period. Some women experience odor problems if the cervical cap is left in place longer than 24 hours. The cervical cap can be difficult to place properly or to remove. Use of the cervical cap can irritate the cervix. The cervical cap should not be used by women who currently have a vaginal or cervical infection
  • 53. • • • • • • Physical barrier to sperm penetration Chemical spermicidal - sperm killing substance inserted deep into the vagina, near the cervix prior to sexual intercourse Nonoxynol 9 – most popular benzalkonium chloride, chlorhexidine, menfegol, octoxynol-9, and sodium docusate Duration of Efficacy: 1 hour Non teratogenic
  • 54. • foaming tablets, melting or foaming suppositories, cans of pressurized foam, melting film, jelly, and cream – Jellies, creams, and foam from cans can be used alone, with a diaphragm, or with condoms. – Films, suppositories, foaming tablets, or foaming suppositories can be used alone or with condoms • causing the membrane of sperm cells to break, killing them or slowing their movement
  • 55.      They do not affect future fertility for either the woman or the man. They are used only at the time of sexual intercourse. They are safe to use while breast-feeding (birth control that contains estrogen affects milk supply). They are less expensive than hormonal methods of birth control. They are safe for women who have other health problems (birth control that contains estrogen makes some health conditions worse).
  • 56.     Some people are allergic to nonoxynol-9, the active ingredient in most spermicides. They can develop itching or sores in the vagina or on the penis, which make it more likely that HIV can be passed from an infected person during sex. The nonoxynol-9 in spermicides may also increase the risk of getting HIV/AIDS from an infected partner. Some people are embarrassed to use spermicide and a barrier method or worry that it may interrupt foreplay or intercourse. This can create a problem with using it every time they have sex. Spermicides cause an extra discharge from the vagina
  • 57. • • • • • • • Plastic contains spermicides Inserted 24 hours prior to intercourse, removed 6 hours post intercourse Moistened with water and inserted into the vagina so that it rests against the cervix Used only once not widely available Less effective Nonoxynol 9 impregnated disc – 2.5cm thick, 5.5cm wide May cause irritation and  vaginitis •
  • 58.     It does not affect future fertility for either the woman or the man. It is used only at the time of sexual intercourse. It is safe to use while breast-feeding. It is available in drugstores without a prescription.
  • 59.    Failure rates for the sponge and other barrier methods are higher than for most other methods of birth control. Some people are embarrassed to use this method or feel the method interrupts foreplay or intercourse. The couple must be comfortable with using the sponge and be prepared to use it every time they have sex.
  • 60. The cervical shield, such as Lea's Shield, is similar to the diaphragm and cervical cap. It is thought to be as effective as other female barrier methods (the cervical cap, diaphragm, and sponge).  But only limited studies have been done so far. The cervical shield is made of silicone, so latex allergy is not a problem..  The device comes in one size only, simplifying the fitting process. The shield currently requires a prescription 
  • 61. • • • Reusable, washable barrier made of silicone Placed against the cervix Inserted any time prior to intercourse and must be left in place for at least 8 hours afterwards
  • 62. Barrier Male condom Failure rate* Effectiveness in preventing STDs 15 (spermicide further lowers Most effective this failure rate) Female condom 21 Somewhat effective Diaphragmwith spermicide 16 Limited effectiveness Spermicide 29 Not effective if used alone; may actually increase risk of getting HIV/AIDS Sponge with spermicide 16 (no past vaginalchildbirth) Limited effectiveness 32 (past vaginal childbirth) Cervical capwith spermicide 16 (no past vaginal childbirth) Limited effectiveness 32 (past vaginal childbirth)
  • 63. Classification of hormonal contraceptives Combined pills Progesterone only pills (POP) Oral Pills Once – a – month (long acting) pills Male pill Hormonal contraceptives Post coital pill Injectables Depot Preparations Subdermal Implants Vaginal Rings
  • 64.  COMBINED PILLS The combined oral contraceptive pill (COCP), often referred to as the birth-control pill or colloquially as "the Pill", is a birth control method that includes a combination of an estrogen (estradiol) and a progestogen (progestin)
  • 65.  Benefits Disadvantages Minimal effect on CHO metabolism & coagulation • Do not cause or exacerbates HPN • Contraception failure • Ectopic pregnancy • Irregular uterine bleeding • – Amenorrhea, spotting, breakthrough bleeding, menorrhagia) • Functional ovarian cyst
  • 66. SOME PILLS ARE TAKEN AFTER HAVING UNPROTECTED SEX.  The Morning-After Pill  diethylstilbestrol (DES)  Yuzpe method (1974)  100 g ethinyl estradiol plus 1.0 mg dL-norgestrel  Plan B (1999)  first progestin-only emergency contraceptive
  • 67. • Progestin – Prevents ovulation by suppressing LH – Thickened mucus ➡️retards sperm passage – Endometrium ➡️unfavorable for implantation • Estrogen – Prevents ovulation by suppressing FSH – Stabilize endometrium ➡️prevents breakthrough bleeding
  • 68.  Beneficial Effects • Increase bone density Decrease risk of ectopic pregnancy Fewer premenstrual complaints Reduction on various benign breast disease Improvement of acne Decrease incidence & severity of acute salphingitis Reduce menstrual blood loss & anemia Improved dysmenorrhea for endometriosis Decreased risk of endometrial & ovarian cancer Inhibition of hirsutism progression Prevention of atherogenesis Improvement in rheumatoid arthritis • • • • • • • • • • •
  • 69.  Adverse Effects • T4 and thyroid binding proteins are elevated Plasma cortisol are also increased Increase serum levels of triglycerides and total cholesterol Decrease testoterone Increase risk of cervical dysplasia and cancer Lower plasma level of ascorbic acid, folic acid, vitamin B6, B12, niacin, riboflavin and zinc Increase risk of thromboembolism if used with CVD patient, > 35 years old and smokers Increase risk of Chlamydia trachomatis infection Cervical mucorrhea • • • • • • • •
  • 70. Thrombophlebitis, thromboembolic disease, DVT • CVD, CAD • Thrombogenic cardiac valvulopathies & arrythmias • DM w/ vascular involvement • Uncontrolled HPN • Breast, endometrial, hepatic CA • AUB • Pregnancy • Cholestatic jaundice • Major surgery with prolonged immobilization •
  • 71. Hormonal-Long Acting
  • 72. Combined Patch • Continuously release progestin & estrogen directly through the skin to the blood stream • A new patch is worn every week for 3 consecutive weeks • No patch on the 4th week so menstruation ensues • Works primarily by preventing release of ovulated eggs • 150ug progestin norelgestrinon + 20ug ethinyl estradiol • First 2 cycle – dysmenorrhea, breast tenderness & breakthrough bleeding
  • 73. Intravaginal or Transvaginal Hormonal Contraceptive Ring • Flexible polymer ring has an outer diameter 54mm & 4mm cross section • Releases Ethinyl estradiol 15ug and Etonogestrel 120ug/day • Inhibits ovulation • Ring is placed w/in 5 days of onset of menses & removed after 3 weeks of use for 1 week to allow w/drawal bleeding • Ring replaced w/in 3 hours within intercourse • Complications: vaginitis, ring related events, leukorrhea
  • 74. • How to insert/use transvaginal ring
  • 75. Implants • Small rods or capsules placed under the skin of a woman’s upper arm (subdermal) • 3 to 7 years effectiveness • Safe for breastfeeding beginning 6 weeks post partum • Thickens the cervical mucus & delay release of eggs from the ovary • Progestin suppress ovulation • NORPLANT – levonorgestrel (6) • JADELLE (2) • IMPLANON (1) – 68mg Etonogestrel
  • 76. Injectable Medroxyprogesterone Acetate/Estradiol Cypionate • • • • Lunelle 1 injection monthly Inhibits ovulation Supress endometrial proliferation • Estradiol reach peak level 34 days post injection & decline leading to w/drawal bleeding to 20-25days after injection
  • 77.  Benefits • • • Returns to fertility after discontinuance Less breakthrough bleeding Amenorrhea more frequent Disadvantage • Decrease lactation • Weight gain
  • 78.  Benefits • • • Long duration of action Minimal to no impaiment of lactation Decrease ovarian and endoetrial cancer Disadvantage • Irregular menstrual bleeding • Prolonged anovulation after discontinuance • Delayed fertility resumption • Menses may not resume up to 1 year • Increase risk cervical CA • Breast tenderness • Weight gain • Decrease bone density - REVERSIBLE
  • 79. • Contraindication – Thromboembolism – Stroke – Cerebro/Cardio VD – Pregnancy – Undiagnosed vaginal bleeding – Breast CA – Liver Disease
  • 80.   The current intrauterine devices (IUD) are small devices, often 'T'-shaped, often containing either copper or levonorgestrel, which are inserted into the uterus.. They are one form of long-acting reversible contraception which are the most effective types of reversible birth control. Failure rates with the copper IUD is about 0.8%.
  • 81. Classification of Intrauterine Devices (IUD) First Generation Non medicated Eg. Lippe’s loop Second IUD Generation Eg. Copper IUD Medicated Third Generation Eg. Hormonal IUD
  • 82. 1. Medicated IUD: Those IUDs that carry biologically active agents into the uterine cavity like levonorgestrelreleasing device [MIRENA]. It is an intrauterine system (LNG_IUS) that has sleeves of levenorgestril 52mg around its stem releasing 20 microgram/day and lasting for at least five years. The advantage of medicated IUDs is that the carrier part of the devices is smaller and less traumatic.
  • 83.     2. Non-medicated IUD: No drugs are added to the matrix or plate form of the IUD. It consists of plastic polyethylene and copper. There are so many types of this group. The most commonly used are copper T, TCU 380A, Multiload 375 and Nova T.
  • 84. First generation iud They are inert or Nonmedicated devices made up of polyethylene Different shapes and sizes LIPPE’S LOOP:  Double ‘S’ shaped device  Made up polyethylene material  Non toxic, non tissue reactive & extremely durable  Small amount of Barium Sulphate is also added for radiological examination  Available in 4 sizes A,B,C &D
  • 85. Second generation Iud Made up of metal – copper. EARLIER DEVICES Copper - 7 Copper - T 200 NEWER DEVICES Variants of T device  T copper 220C  T copper 380A Nova T Multi load devices ML-Cu250 ML-Cu375 94
  • 86. Third generation iud Hormone releasing IUD Progestastert Most commonly used T shaped device filled with 38mg of progesterone Effective for 1 yr  LNG-20 (Minera) Releases 20µg of levonorgesterol. Effective for 5 yrs Effective rate 99%
  • 87. ADVANTAGES OF IUDs:  Safe, Effective, Reversible  Inexpensive  High continuation rate DISADVANTAGES OF IUDs:  Heavy bleeding and pain  Pelvic Inflammatory diseases  Ectopic pregnancy  May come out accidently if not properly inserted
  • 88. TIMING OF INSERTION:  Inserted with a plunger  Any time during women’s reproductive period Except in pregnancy  Most ideal time is during or within 10 days of the beginning of menstruation the diameter of cervical cavity is greatest at this time. IDEAL IUD CANDIDATE:  Who has borne at least 1 child  Has no history of PID  Has normal menstrual periods  Is willing to check IUD tail  Has an access to follow up and treatment of potential problems  Is in monogamous relationship
  • 89. RELATIVE CONTRAINDICATIONS of Intra uterine contraceptive devices:1. Nulliparity 2. Valvular heart disease and cardiomyopathy 3. Previous ectopic pregnancy 4. Moderate to severe anemia 5. Hypermenorrhea 6. Wilson's liver disease 7. Copper allergy 8. AIDS 9. High risk of STD
  • 90. 1.Cardiomyopathy 2.Recent acute pelvic inflammatory disease 3.Chronic or recurrent PID 4.Recent septic abortion 5.Acute cervical or vaginal infection 6.Congenital uterine anomalies 7.Uterine tumors 8.Undiagnosed uterine bleeding
  • 91. permanent method of contraception
  • 92. Tubectomy also referred to, as Tubal Sterilization is a surgical procedure done on women as a permanent method of contraception. Gynecologists, general surgeons and laparoscopic surgeons perform Tubectomy.
  • 93.  Called tubal sterilization operation (tubal ligation)  Failure rate: 1/2000  Permanence contraception Have the risks of surgery  Pelvic inflammations  Skin (section site) inflammation  Fever (over 37.5 ℃ two times interval 4h during 24 h)  Severe disease couldn’t tolerance operation  Psychological disease 
  • 94.  The Fallopian Tubes are two in number and are attached on either side of the uterus at one end and the other end is open in the abdomen.  The length of each Fallopian tube is about 10cm.When the ovum or egg is released from the ovary, it is picked up by Fallopian tube through which it moves into the uterus.
  • 95.  If sperms are present in the Fallopian tubes, the ovum is fertilized and the resulting embryo is transmitted to the uterus where it is embedded.  In short, we can say that Fallopian tubes are channels through which the eggs from the ovaries travel to the uterus.
  • 96.  There are different surgical approaches for the tubal sterilization operations are:1. Laparoscopy 2. Micro laparoscopy 3. Laparotomy (concurrent with cesarean delivery) 4. Minilaparotomy 5. Hysteroscopy 6. Vaginal approaches.
  • 97.  The most popular is using a laparoscope; where the patient has just a couple of small scars and is discharged home the same day. If laparoscopy is not available an open surgical operation maybe required. Here the tubes are completely divided and a section is excised. 
  • 98.  In Micro-laparoscopy small endoscopes of tiny diameter (5 to 7 mm) are involved using which suprapubic incisions is made. This surgery is the result of improved technology in light transmission and fiber optic bundles.
  • 99.      The advantages that are most common in Tubectomy specifically Laparoscopic (the most popular type of Tubectomy) includes: Small incisions Easy and fast access to the fallopian tubes Recovery is speedy However the difference is so nominal that it could never get very popular despite being available for almost 20 years.
  • 100.      Uterus may get puncture often Laceration of the cervix Fallopian tube also may get perforated Perforation of major vessels Cardiac arrhythmias because of CO2
  • 101.  The follow-up visit for open or laparoscopic approaches is 1-2 weeks postoperatively.  Notify the health care provider if you develop fever (38°C or 100.4°F), increasing or persistent abdominal pain, or bleeding or purulent discharge from the incision.
  • 102.  Medications should be taken as per the doctor’s prescription.  Ensure to complete the whole course of the antibiotic.  Refrain from sexual intercourse for about a week after surgery or as advised by your doctor
  • 103.        Tubal recanalization Pregnancy Ectopic pregnancy Menstrual irregularity Loss of libido Infection Injury rectum or bladder
  • 104.  If you have delayed periods, vaginal bleeding/spotting, and severe abdominal pain, consult the doctor immediately, as it could be an ectopic pregnancy.
  • 105. Vasectomy is a surgical procedure for male sterilization and/or permanent birth control. During the procedure, the vasa differentia of a man are severed, and then tied/sealed in a manner such to prevent sperm from entering into the seminal stream (ejaculate).
  • 106.  The vas deferens from each testicle is clamped, cut, or otherwise sealed.  This prevents sperm from mixing with the semen that is ejaculated from the penis.  The vas deferens is then replaced inside the scrotum and the skin is closed with stitches that dissolve and do not have to be removed.
  • 107.  Vasectomy is a minor surgery that is safe, highly effective and permanent.  Whether done on men who did not want to have kids.  Vasectomy is cheaper and fewer complications than tubule sterilization.  Men have the opportunity to turn contraception with his wife.
  • 108.  Some men fear a vasectomy will affect his  ability having sex or cause erection problems. There is little pain and discomfort a few days after surgery, this pain can usually be relieved by the consumption of soft drugs.
  • 109.   Often have to do with an ice pack for 4 hours to reduce swelling, bleeding and discomfort and had to wear pants that can support the scrotum for 2 days. Vasectomy does not provide protection against sexually transmitted infections including HIV.
  • 110.  The operation is not effective immediately. Patients were required to wear a condom beforehand to clean the tube from the rest of the existing sperm. To know is sterile or not, microscopic examination is usually performed 20-30 times after ejaculation.  Regret after vasectomy is greater if the man was still under the age of 25 years, there has been a divorce or a child who died.
  • 111.  It takes 1-3 years to really determine whether vasectomy could work effectively 100 percent or not.  The man who wants to open a vasectomy can be done in a way that is reconnect the channel sperm, but the small chances of success
  • 112.  The patients are normally advised to take painkiller or place ice packs over the wound (usually covered with a dressing) for 15 to 20 minutes every one hour, for the next 12 hours. This minimizes pain and reduces the swelling following the surgery.
  • 113.  Bed rest for 24-72 hours following the surgery is preferable. It is important to refrain from shower, bathing for 24 hours following the surgery. This prevents the dressing from getting soaked and hence reduces the possibility of an infection.
  • 114.  The dressing is usually left in place for 2-3 days, to absorb the bleeding if any at the site of incision. It is a good idea to get the dressing changed in a local hospital or at home once in every two days. It is very important that patients abide by the instructions for a speedy recovery.
  • 115.  The patient can resume their normal activities 72 hours after the procedure and are instructed about wearing a scrotal support for a short period (1 week). Some doctors advise patients to resume sexual activity once they feel comfortable. This of course varies from person to person and is dependent on the recovery rate, presence of complications such as infection etc.
  • 116.  The couples must be advised to follow contraceptive precautions until the success of the surgery has been confirmed by semen analysis, (absence of sperms in the ejaculate confirms success of vasectomy) performed 4 to 6 weeks following the procedure.
  • 117.             Spermicides 21% Withdrawal 19% Periodic abstinence 15% Condom female 21% Condom male 12% Pills 3% IUD 2% Implant 0.3% Patch 5% Copper IUD 0.8% Female sterilization 0.4% Male sterilization 0.15%

×