Treatment Choices for Slip Disc at Gokuldas Hospital
contraception2.pptx
1. In the name of God
Contraception
Nazanin Rostami
2. Introduction
Types:
1-inhibit the development or release of egg
2-imposing a barrier
3-IUD
Failure:
1-typical use failure rate
2-method or perfectus failure rate
Factors that affect your options:
3.
4. LARC
• Implant: most effective way
Mechanism of action: progestin (etonogestrol) and mucus thickening
3 years
Side effects: irregular vaginal bleeding
5. IUD
1-Hormonal IUD (levonorgestrel)
2-Copper IUD
Insertion: mens, expulsion
Mechanism of action:
Side effects: dysmenorrhea, Amenorrhea, pain of Adenomyosis and Endometriosis
Efficiency:10,5,3years
Risks: 1-infection 20days,3months,screening 2-ectopic pregnancy
Pregnancy: abortion in 3months, preterm labor
Removal:
6. Injected hormonal contraceptives
Depot medroxyprogesterone acetate (DMPA) IV or IM every 13 weeks to 15 weeks- mens,
2 weeks
Mechanism of action: mucus thickening, inhibits ovulation
Side effects: 2 years, BMD, Weight gain, Irregular vaginal bleeding treatment: conjugated
estrogen 1.25 mg/day 7-10 days
7. Hormonal contraceptives :
Types:
benefits: ovarian and uterine cancer, anemia, PID, ectopic pregnancy
Failure:
Mechanism of action: ethinyl estradiol, 19-nortestosterone, or drospirenone
How to use:21-7 days,3 to 12 months
Side effects:3 months of irregular bleeding, amenorrhea, treatment
Contraindications: women over age 35 who smoke or have had thromboembolism, CHF,
coronary artery disease, migraines with aura, and cerebral vascular diseases
Drug interaction: barbiturates, benzodiazepines, phenytoin, carbamazepine, rifampin,
sulfonamides
Antibiotics
Anticoagulants, methyldopa, phenothiazines, TCAs, and reserpine
8.
9. Progestin only oral contraceptives
Mechanism of action:
Indications: breastfeeding, over age 40, when estrogen is contraindicated
How to use:3hours,2days, regular use
10. Patch and ring
Patch: 5d of mens, 3 weeks-1 week
Caution: thrombosis, fat
Apply:
Ring: Monthly
11. Barrier contraceptives:
Condoms: HIV
Sponge: 6-8 hours, 30 hours, moist, spermicide,
Diaphragm: spermicide,24h, different size, UTI
Failure: oil
Spermicide: UTI, E.Coli, 30min, 1 hour, 8 hours, anomaly
12. Fertility awareness methods:
Calendar methods: 18-11 days
Basal body temperature method:3days, 05-1F
Cervical mucus methods: 4 days after peak
Sympththerm method:
Lactational amenorrhea:6months
13. Emergency contraception:
4h to 5 days
Progestin only: (Levonorgestrel q12h) 120hr
Ulipristal acetate 30mg
Cu-IUD: contraindicated in Wilson disease
fat