in thsi ppt student able to puberty and mestrual cycle and mestrual disordre and contraception

1. PUBERTY
• Development of secondary sexual characteristics.
• Convert childhood to adulthood .
• Age –
• Female 10-16 years
• Male 12-16 years

2. SIGN OF PUBERTY
• Tanner or marshal.
1.-Thelarchae- development of breast.
2.-Adrenarchae – development of axillary hair.
3.-pubarchae – development of pubic hair .
4.- increase hight.
5.- menarche - 1st menstrual cycle

8. TYPES OF PUBERTY
Puberty is two types
1.Precocious puberty- secondary sexual characteristics develop of before 10 year
age.
2. Delayed puberty - secondary sexual characteristics develop after 16year age.

9. MENSTRUAL CYCLE
It is the visible manifestation of cyclic physiological
uterine bleeding due to shedding of endometrium
out flow through the vagina followed by the
invisible interplay of hormones. Mainly HPO axis.

10. 13 YEARS AGE START MENARCHE
• Repeat in 28 days
• Range – 21 to 35 days
• 1 years – 13 menstrual cycle
• Reproductive age (15-45= 30) 400 menses.
• Average blood loss – 35 ml.
• Range – 20-80 ml blood loss in 1 cycle
• Bleeding phase – 1 to 5 days
• Bleeding duration – 2 to 7 days .

11. HPO AXIS
• H- Hypothalamus
Gonadotrophin releasing hormone(GNRH)
P- anterior pituitary
FSH and LH
O- OVERY
Estrogen and progesterone

12. CRITERIA FOR NORMAL MENSTRUAL CYCLE
Normal menstrual cycle is called eumenorrhea
1.HPO axis should be coordinate
2.Uterine endometrium must be responsive for ovarian hormone.
3.Out flow track must be patent.

13. • If the female have some condition
• Vaginal agenesis – lack of development of vagina
• Atresia – lack of opening of vagina.
• Crytomenoharrhoea ( it is the types of amenorrhoea )

14. CHANGE IN MENSTRUAL CYCLE

15. ABNORMALITY OF MENSTRUAL CYCLE
• Amenorrhoea
• Dysmenorrhoea
• Polymenorrhoea
• Oligomenorrhoea
• Hypermenorrhoea
• Hypomenorrhea
• Menorrhagia
• P.M.S

16. AMENORRHOEA
• Absent of menstrual cycle. It may be physiological and pathological.
• Types of amenorrhoea.
1.Physiological amenorrhoea.
2. Pathological amenorrhoea.

17. PHYSIOLOGICAL AMENORRHOEA
1.physiological amenorrhoea - absent of disease
Physiological amenorrhoea is 2 types
1. Primary physiological amenorrhoea 2. secondary physiological amenorrhoea.
• Primary physiological amenorrhoea-.
• Before puberty.
• History of menarche absent

18. • Secondary physiological amenorrhoea.
• History of menarches present.
• Menstrual cycle absents due to physiological region.
A- pregnancy.
B. – lactation.
C.- menopause.

19. PATHOLOGICAL AMENORRHOEA
• Trauma , infection , inflammation , adhesion
• pelvic pathology is present.

20. TYPES OF PATHOLOGICAL AMENORRHOEA
• Concealed / hidden - menstrual blood fail to expell out through the vagina.
• Hematometra. (blood in uterus)
• Cryptomenorrhea (fail to expell out through the vagina)

21. CONTRACEPTION
• Delay 1st postpone 2nd and prevent 3rd
• Contraception = against conception

22. CONTRACEPTION
• Contraception is also known as birth control and fertility control is methods or device to use prevent
pregnancy,
• Contraception
Contraception is an artificial method or other techniques, mainly used to prevent pregnancy as a
consequence of sexual intercourse

23. NEED FOR CONTRACEPTION
• To avoid unwanted pregnancies.
• To regulate the timing of pregnancy.
• To regulate the interval between pregnancy

24. CONTRACEPTION METHODS
1-Temporally methods .
• Barriers methods
• Hormonals methods
• iucd methods
• Natural methods
2- Permanent methods
. Male – vasectomy
Female – tubectomy

25. BARRIERS METHODS
Barriers methods Hormonals methods IUCD Natural methods
physical methods chemical methods combined methods
- -Male condoms
-Female condoms Foam / tablet
-Diaphragm spermicidal jelly & cream
- cervical cap suppository

26. INTRAUTERINE DEVICE
• Intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a
small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs
are one form of long-acting reversible birth control (LARC).

27. ICUD
• Nonmedicated
1st generation IUCD
E.g. Lippes loop
• Medicated
1. 2nd generation IUCD
• Cu-T 200 ,250 (3years)
• Nova T ( 5 year)
• Multiload copper T 375,380( 10 years)
2- 3rd generation
• Progestasert ( 2yr)
• LNG- 20 (10 yr.)

32. HORMONAL CONTRACEPTION
• Combination pill;
Combination of oestrogen and progesterone
Mala –N ,mala-D ( 0.15 mg levonorgestrel &
0.03mg ethinyl estadiol )
Progesterone only pill= used in people above
40 yr..
Post coital contraception( emergency
contraception )
1.Levonorgestole ( 1.5 mg which should we
use in 72 hours. Unprotected intercourse)
• Depa preparation
• Injectable ;
• DMPA (depo medroxyprogesterone) 150mg
Im injection every 3 yr.
• Subdermal impants ;
• Norplant -6 silastic capsules each containing
35 mg of levonorgestrol . ( 5yr.)
•
•

33. HORMONAL CONTRACEPTION
• Combination pill;
Combination of oestrogen and progesterone
Mala –N ,mala-D ( 0.15 mg levonorgestrel & 0.03mg ethinyl estadiol )
Progesterone only pill= used in people above 40 yr..
Post coital contraception( emergency contraception )
1.Levonorgestole ( 1.5 mg which should we use in 72 hours. Unprotected
intercourse)

34. CONDOMS
• Definitions.-
• Condoms are a method of preventing pregnancy in which a plastic, latex, or
animal-skin sheath creates a physical barrier preventing sperm from entering the
woman’s uterus. They are the most widely-used examples of barrier methods,

35. • Male and female condoms work Both male and female condoms work by
forming a mechanical barrier that keeps sperm out of the vagina, preventing
pregnancy. They also help prevent infections present in semen, on the penis, or
in the vagina from infecting the sexual partner. Condoms and other barrier
methods require correct use with every act of intercourse.

36. CONDOMS
• Male condoms are the most common barrier method. They are made of latex,
polyurethane, or lamb skin. They may be coated with silicone, water-based gel, or
spermicide. Condoms fit over the penis and block semen from getting into the
vagina. Male condoms help reduce the spread of STIs.

38. FEMALE CONDOMS
• female condom is a thin insert that is placed inside of the vagina 8 hours before
sex. It should not be used with a male condom. Female condoms help prevent
the spread of STIs.

41. • Diaphragms
• A bowl-shaped latex cup with a flexible rim that is inserted into the vagina to
cover the cervix before intercourse. It requires fitting by a specifically trained
provider.

43. • Cervical cap - A soft, deep, latex or plastic cup that is placed over the cervix
before intercourse. It snugly covers the cervix. Requires fitting by a specifically
trained provider.

48. NATURAL METHODS
• Natural method is 3 types
• Periodic abstinence
• Withdrawal methods
• Lactation

51. MTP
• Medical termination of pregnancy – intentional or voluntary termination of
pregnancy before full term is called is called medical termination of pregnancy.