This document discusses various contraceptive methods including barrier methods like condoms and diaphragms, hormonal methods like oral contraceptive pills and implants, intrauterine devices, natural family planning, and permanent sterilization methods. It describes features of ideal contraception and provides details about different contraceptive options like mechanism of action, effectiveness in preventing pregnancy and sexually transmitted diseases, advantages and disadvantages.

1. Contraception

2. Features of an Ideal Contraceptive
• Safe
• Inexpensive
• Reversible
• Simple to administer
• No side effects
• effective for preventing STD’s

3. Contraceptive methods
TEMPORARY PERMANENT
 Barrier
 IUD’s
 Hormonal
 Emergency contraception
 Natural
 Vasectomy
 Tubectomy

4. Barrier method
– They prevent sperm from entering a woman's uterus.
– They include:
 Condom
 Diaphragm
 Cervical cap
 Sponge
 Spermicide- cream, gel, foam & suppositories

5. Barrier contraceptives
sponge
Male condom
diaphragm
Cervical cap spermicide

6. Intrauterine devices
– A small device that is inserted and left inside the uterus to
prevent pregnancy.
– also known as intrauterine contraceptive device (IUCD)
– the world's most widely used method of reversible birth control
MOA:
Prevent fertilization by creating a local sterile inflammatory
condition- prevent implantation

7. Types of intrauterine device
Non-medicated IUD
Hormone releasing
IUD
Copper IUD
Eg: lippes loop
 Double S-shaped device made up of polythene, non-toxic,
non-tissue reactive
 Not used nowadays
Eg: Copper-T(T-Cu 220C; T-Cu 380A; T-Cu 380Ag)
 T-shaped device
 Acts by altering the composition of cervical mucus
 Decreases sperm motility
Eg: progestasert & Levonorgestrel-20 ( LNG-20)
 T-shaped device
 Acts by increasing the viscosity of cervical mucus
 Makes the endometrium unfavourable for implantation

8. Lippes loop
LNG IUD
Copper- T
MIRENA
IUCD

9. ADVANTAGES DISADVANTAGES
 Inexpensive
 Reversible
 Long-lasting
 Easy to insert
 Inserted at the time of menses
 Does not interfere with lactation
 Bleeding
 Pain
 Pelvic infection
 Uterine perforation
 Expulsion
 Ectopic pregnancy
IUCD

10. Hormonal contraceptives
1) Oral Contraceptive Pills ( OCPs)
– Combined pill
– Progestogen only pill
– Post-coital pill
2) Depots ( slow releasing formulation)
– Injectable preparations
– Subcutaneous implants
– Vaginal rings

11. Combined pills
 Contain ethinyloestradiol & a progestogen (nor-ethioesterone, norethynodrel)
 eg: MALA-N & MALA-D
• Intake
21 days: 1 pill/day
Last 7 days: Iron tablets
MOA:
 inhibition of ovulation
 thickening of cervical mucus
 Thinning of endometrium
S/E- Thrombosis, HTN, migraine

12. PROGESTOGEN ONLY PILL
( MINI PILL )
– It has a lower dose of progestin. And because it doesn’t have estrogen, the mini
pill may have fewer side effects.
– Used for 28 days; no breaks
– take one pill at the same time every day
Advantages:
– Used in above 35years of age
– Do not inhibit ovulation
– Prescribed in lactating women

13. Post-coital pill
– Referred to as ‘morning after’ pill ( emergency contraception )
– Used to prevent unplanned pregnancy
– Recommended within 48 -72hours of an unprotected intercourse
– They work primarily by delaying or preventing ovulation.
– ECPs contain either levonorgestrel or ulipristal

14. Mifepristone
– Progesterone antagonist
– Helpful in producing abortion following the conception
– Acts by inhibiting the progestational effects on the uterus
– Vaginal bleeding usually starts 1-2 days after taking mifepristone

15. Depot formulations
Injectables:
 DMPA ( Depot Medroxyprogesterone Acetate ) -150 mg IM inj every 3 months
 Works by stopping the ovaries from releasing an egg ( ovulation )
Subdermal implants:
 Norplant -6 silastic capsules, each containing 35 mg of levonorgestrel
 Protection for 5 years

16. Vaginal ring
• It is a small, flexible, plastic ring
• prevents pregnancy by continuously releasing synthetic estrogen and progestin.
• Placed in vagina for 21 days and remove 7 days to allow withdrawal
bleedings
• Easy to use
• It has fewer side effects than oral contraceptives
NuvaRing

17. Natural method
– Abstinence
– Coitus interruptus
– Rhythm method
– BBT
– Cervical mucus
– Lactational amenorrhea

18. The calendar ( rhythm ) method
 This method is based on the identification of fertile period of a cycle and to
abstain from sexual intercourse during that period

19. Basal body temperature ( BBT)
– Monitor resting body temperature each day before ovulation ( women’s
temperature is slightly low)
– After ovulation temperature slightly raises
– If temperature slightly rises, abstain from intercourse for 3 days.
Lactational amenorrhea method:
– Exclusive breastfeeding
– Lactational amenorrhea
– 1st 6 months postpartum

21. Permanent method of contraception
Vasectomy:
• It is a surgical procedure for male sterilization
(bilateral ligation of the vas deferens)
• It does not affect the testes and it does not affect
sexual ability.
• Advantages: safe & convenient method
• Disadvantages: some patients develop antibodies
against sperm after vasectomy

22. Tubectomy
– This is also known as voluntary surgical contraception
or tubal ligation or minilap.
– It consist of blocking both the fallopian tubes.
– It is simple, safe, very effective, convenient and
permanent method of contraception for women
– Does not protect against STD’s

23. Sterilization by laparoscopy

24. Thank You