The document details various contraceptive methods, including natural, mechanical, chemical, hormonal, and surgical options, highlighting their effectiveness, safety, and user acceptance. It discusses the advantages and disadvantages of each method, including barriers, IUDs, oral contraceptives, injectable options, and emergency contraception. Additionally, it emphasizes the importance of understanding ovulatory cycles and user compliance for successful contraceptive use.

1. BY
Magdy Abdelrahman Mohamed
2015

2.  1- Natural ( physiological).
 2- Mechanical.
 3- Chemical.
 4- Hormonal.
 5- Surgical (sterilization).
Barrier
Except
IUD

4.  Safe.
 100% effective.
 Free of side effects.
 Easily obtainable & cheap.
 Acceptable to the user and sexual
partner.
 Free of effects on future pregnancies.

6.  Abstinence.
 Coitus interruptus (withdrawal).
 Periodic abstinence ( fertility awareness
based methods, safe period).
 Lactational amenorrhea ( LAM ).

7.  Very old.
 Disadvantage:
 Lack of self control.
 Pre-ejaculatory fluid contains sperm.
 High failure rate ( 20% in typical use & 5 % in
perfect use).

8.  Based on understanding ovulatory cycle.
 Cooperation is very important.
 Free, safe, and acceptable to all religions.
 25% of women will experience unintended
pregnancy in first year (typical use).
 Some women combine with barrier methods
(use during fertile periods).

9.  Bellagio consensus (1989).
 Exclusive breastfeeding.
 Lactational amenorrhea.
 1st 6 months postpartum.

10. Mechanism
 Increase prolactin.
 Supression of gonadotrophin & anovulation.
 Luteal phase insufficiency.

12.  Barrier methods.
 Male condom.
 Female condom.
 Vaginal diaphragm.
 Cervical cap.
 Intrauterine contraceptive device (IUCD).

15.  Advantage:
 Protect against sexually transmitted disease.
 No systemic side effects.
 Disadvantage:
 High failure rate.
 Interfere with sexual intercourse.

16. IUD is the world's most widely used
method of reversible birth control.
1- Inert ( no longer recommended because
of painful and heavy periods).
2-Copper Releasing.
3-Progesterone Releasing (IUS):
A-Progestasert (progesterone T) 1976 -
2001.
B-Mirena (levonorgestrel).

17. -Suspected pregnancy.
-Post partum puerperal sepsis.
-Immediately post-septic abortion
-Undiagnosed abnormal vaginal bleeding.
-Suspected gynecological malignancy.
(Cervical cancer, Endometrial cancer)
-Current STDs.
-Current PID.
-Anatomical abnormalities.

18.  Causes:
 Detached threads or hidden in the cervix.
 Expulsion.
 Perforation.
 Pregnancy.
 Investigations:
 TVS.
 X-ray.

20.  In the form of tablets, creams, jellies--- etc.
 Contains a spermicidal agent like nonoxynol-9.
 Applied 15-30 min before intercourse and not
washed before 6 hrs. postcoital.
 Can be used alone or with other barrier methods
to enhance their effectiveness.

23.  Oral:
 Combined oral contraceptives (COCs).
 Progesterone only pills (POPs).
 Injectable:
 Progesterone only ( depo-provera).
 Combined.
 Subdermal implant.
 Vaginal rings.

25.  Start on the 1st 5 days of the cycle
regularly every day.
 21 days 0n, 7 days off.

26.  Highly effective if used correctly.
 Rapid return of fertility after stoppage.
 Suitable for nulligravida and newly
married couples.
 Completely controlled by the woman
and can be stopped at any time unlike
other methods (IUD & Implants).
 Not interfere with sexual intercourse.

27. 1-The need for daily use.
2- GIT:
 Nausea and vomiting.
 Increased incidence of gall bladder stones).
3-Central nervous system:
 Headache and migraine.
 Mood changes: depression, irritabilty.
4- Not suitable for breast feeding.

28.  < 6 months postpartum if breastfeeding.
 Smoker over the age of 35.
 Hypertension (systolic ≥ 160mm Hg or diastolic
≥ 100mm Hg).
 Current or past history of venous
thromboembolism (VTE).
 Ischemic heart disease.
 History of cerebrovascular accident.

29.  Start on the 1st 5 days of the cycle or
after 6 weeks postpartum.
 Daily tablet at the same time every day
without discontinuation.
 Woman consider herself fertile for the
first week of use.

31.  Suitable when breast feeding.
 Suitable when estrogen is
contraindicated.
 Immediate return of fertility.
 Less likely to cause metabolic
disturbances.

32.  Must be taken daily at the same time.
 Less effective than COCs.
 More likely to cause menstrual
irregularities.

33. Progesterone only ( Depo-provera).
 Every 3 months.
 Advantage:
 Highly effective.
 No daily use
 Not interfere with sexual intercourse.
 Disadvantages.
 Delayed return of fertility.
 Wt gain.
 Osteoporosis ( esp. in long term use)

35. Mesigyna:
 Norethinderone
enanthate 50 mg +
estradiol valerate 5
mg.
 Used every month.

36.  Need trained personal for insertion and
removal.
 Out patients procedure.
 99.5% effectiveness rate.
 good compliance.
 Amennorhoea is common.

37.  Types:
 Norplant (6 rods).
 Implanon (one rod).

40.  Vasectomy in males.
 Tubal ligation in females.

42.  Can be used within 72 hour after
unprontected intercourse:
 Examples:
 Levonorgestrel 0.75 mg.
 IUCD.
 Mifepristone ( progesterone antagonist).