This document summarizes various contraceptive methods including barrier methods like condoms and diaphragms, hormonal methods like oral contraceptive pills and injectables, intrauterine devices, and permanent sterilization methods. It describes how each method works to prevent pregnancy and lists the advantages and disadvantages of each. Reversible long-acting methods like IUDs and implants are highly effective but have potential side effects while barrier methods are less effective but have fewer health risks. Permanent sterilization via tubal ligation or vasectomy is intended to be very effective but cannot be reversed.

2. WAJIHA SAJID
BATCH L

3. • Contraception, birth control or fertility control refers
to the methods or devices used to prevent
pregnancy.
• Planning and provision of birth control is called
family planning.

4. Reversible methods
– Barrier Methods
– Hormonal Methods
1. Oral Contraceptive Pills
2. Injectable
Contraceptives
3. Contraceptive patch
4. Vaginal Ring
– Intrauterine Devices
– Emergency methods
– Miscellaneous methods
Irreversible/permanent
methods/sterilization
• Tubal ligation
• Vasectomy

5.  Aim of the method is to prevent the sperm from
meeting the ovum.
• Condoms
• Female Condoms
• Cervical Cap
• Diaphragm
• Vaginal sponge
• Spermicides

6. preventthedepositionof semenintovagina
• Advantages
• Protect against STDs
• Readily available
• Inexpensive
• Allow male partner to
be involved in
contraception
• Disadvantages
• Failure rate is 2% with
perfect use
• Require responsible
attitude on the part of
male

7. • Polyurethane sheath
intended for one-time
use with two flexible
rings.
• Acts as a barrier to
passage of semen into
vagina

8. Advantages
• Protects against STDs
• Can be inserted up to 8
hrs before intercourse
• Sheath coated on inside
with silicone based
lubricant
Disadvantages
• More expensive than
condoms
• Low acceptability,
difficult to place
• Failure rate: 5% perfect
use21% typical use

9. • Cup-shaped latex device
fits over the base of the
cervix
• Spermicide required
• May be inserted up to 8
hrs prior to intercourse
and left in place for 48
hrs.

10. • Shallow cap with spring
mechanism in rim to
hold in place in vagina
• Spermicide required
• Must be left in place
6hrs following
intercourse

11. Advantages
• Non-hormonal
contraception controlled
by woman
Disadvantages
• High failure rate: perfect
use 6%, typical use 16%
• Prolonged use can
increase risk of UTIs
• Requires professional
fitting and training
• Can develop odor if not
properly cleaned
• Can cause vaginal
erosions
• Toxic shock syndrome
• Requires additional
spermicide for repeated
use in case of diaphragm

12. Foam
• Surface active agents
• 80-85% effective
• Works immediately
• Effective for an hour
• 20% have burning (reaction)
Vaginal Sponge

13. • Combined Oral Contraceptive Pills
• Progestin-Only Contraceptive Pills
• Extended cycle combined oral contraceptive
pills
• Post coital pills for Emergency Contraception
• Once a month pills (quinestrol+progestogen)

14. • Contain estrogen(30-35mcg)
• and progestin(0.5-1mg)
• Block ovulation, alter cervical mucus, stimulate
atrophic change in endometrium
• 21 days of hormone followed by 7 days of placebo to
allow withdrawal bleeding

15. Advantages:
• Failure rate less than 0.3%
with perfect use (8% typical
use)
• Fertility returns rapidly
• Bleeding is decreased
• Greater cycle predictability
• Decreased risk of benign
breast disease, PID, ovarian
and endometrial cancers,
ectopic pregnancy
Disadvantages:
• Increased risk of stroke,
acute MI, venous
thromboembolic disease
• Increased risk of hepatic
adenoma, cervical cancer,
breast cancer
• Do not protect against STDs
• When used with antibiotics
or anticonvulsants, efficacy
may be decreased

16. • Nausea
• Headache
• Weight gain
• Suppress lactation
• Vomiting
• Dizziness
• Mastalgia
• Hypertension
• Mood changes
• Decreased libido
• Increased triglycerides
• Severe depression
• Spotting, breakthrough
bleeding

17. • Abnormal vaginal
bleeding of unknown
etiology
• Cerebrovascular disease
• Congenital hyperlipidemia
• History of breast cancer
• Ischemic heart disease
• Migraine
• Active viral hepatitis
• Diabetes >20 years OR
with severe vascular
disease, nephropathy,
retinopathy, neuropathy
• Severe hypertension
• Hepatic neoplasm
• Thrombophlebitis,
thromboembolic disease,
known thrombogenic
mutations

18. • Suppresses ovulation, has variable dampening effect
on mid cycle peaks of LH and FSH, increases cervical
mucus viscosity, leads to atrophic endometrium,
reduces cilia motility in the fallopian tube
**MUST BE TAKEN AT THE SAME TIME EVERY DAY**

19. Advantages:
• Risk of serious
complications to which
estrogen contributes is
greatly reduced
• Decreased
dysmenorrhea,
menstrual blood loss
• Fertility returns
immediately after
cessation
Disadvantages:
• Does not protect
against STDs

20. • these are COCPs packaged to reduce or eliminate
the withdrawal bleeding that occurs once every
28 days in traditionally packaged COCPs.
Extended cycle use of COCPs may also be called
menstrual suppression
• vaginal ring and the contraceptive patchhave
been studied for extended cycle use, and the
monthly combined injectable contraceptive may
similarly eliminate bleeding

21. • Menorrhagia
• Dysmenorrhea
• Endometriosis
• Menstrual migraines
• Irregular periods
• Iron-deficiency anemia
• Some seizure disorders
• Menstrual flares of rheumatoid arthritis
• Coagulation defects
• Vasomotor symptoms of perimenopause
• Acne
• Hirsutism
• Polycystic ovary syndrome

22. Progestin-only:
– Levonorgestrel 0.75 mg
– Norgestrel 1.5 mg
Combined:
– Norgestrel 100 mg, ethinyl estradiol 100 mcg
– Levonorgestrel 50 mg, ethinyl estradiol 100 mcg
T Cu
First dose < 72 hours after unprotected
intercourse, second dose 12 hours later

23. Depo-Provera

24. • Injectable Contraceptives
• Progestin-only: Depo-
medroxyprogesterone
acetate (DMPA) 150 mg
IM every 12 weeks
• Alters endometrial
lining, thickens cervical
mucus and blocks LH
surge preventing
ovulation

25. Advantages
• Extremely effective. Failure rate 0.3% with perfect
use, 3% with typical use.
• Efficacy is not altered by varying weight nor use of
concurrent medications nor sickness/diarrhea
• Decreased anemia, dysmenorrhea
• Decreased risk of endometrial and ovarian ca, PID,
ectopics
• Safe for use in breast-feeding mothers

26. • Does not produce serious side effects of estrogen:
OK to use in patients with diabetes, lipid disorders,
complicated migraines, h/o cerebrovascular
accidents/Coronary Artery Disease/Congestive Heart
Failure, SLE, peripheral vascular disease
Disadvantages
• Involves injections and remembering to visit doctor
every 3 months
• Persistent irregular bleeding
• Delayed return to fertility
• Weight gain-about 5 lbs in first year.
• Depression

27. • Apply once weekly for 3
weeks. Placebo is one
patch-free week during
which withdrawal
bleeding occurs
• Blocks LH surge
(preventing ovulation),
thickens cervical mucus,
alters endometrial
lining

28. • Ethyl vinyl acetate ring
• Ethinyl estradiol 0.015
mg/day +etonogestrel
0.12 mg/day
• Inserted intravaginally for
three weeks
• Thickens cervical mucus,
alters endometrial lining,
blocks LH surge
preventing ovulation
– vaginitis

29. • Lippes loop
• Copper T 380 A
• Multiload
• Mirena

30. Copper T IUD
• Causes migration of WBCs into the uterine cavity
resulting in phagocytosis of spermatozoa
• Copper ions seem to have direct toxic effect on
spermatozoa
• Foreign body reaction
• Can be left in place for 10 yrs

31. • Releases 20 mcg LNG (levonorgestrel) per day into
uterine cavity for 5 years
• Inhibits fertilization: anovulation, thickens cervical
mucus, inhibits sperm and ovum motility and
function
• Can be left in place for 5 years

32. Advantages:
 Efficacy. Failure rate w/ perfect use 0.1-0.6%, typical
use 0.1-0.8%
 Long-term
 Reversible
 Most cost-effective
 No systemic side effects
 Mirena only: decreased menorrhagia, dysmenorrhea,
anemia
 Do not interfere with lactation
**

33. • Increased risk of PID (only at insertion)
• Bleeding
• Risk of perforation with insertion
• Cramping and pain at insertion
• May be expelled unnoticed
• No STD protection
• Ectopic pregnancy

34. • Vaginal bleeding of unknown etiology
• Current cervicitis or PID
• Known or suspected pregnancy
• Uterine anatomy interfering w/ placement
• Mirena only: Current DVT
• Copper only: Allergy to copper or Wilson’s disease
• Gynecologic or breast malignancy
• Previous ectopic pregnancy

35. • Within first 10 days of menstrual cycle
• Within first week after delivery
• 6 to 8 weeks after the delivery

36. • Coitus interruptus (literally "interrupted sexual
intercourse"), is the practice of ending sexual
intercourse ("pulling out") before ejaculation
• Symptothermic method
• Safe period (rhythm method)
• Basal body temperature method
• Cervical mucous method

37. Sterilization
 Sterilization :female bilateral tubal ligation and male
vasectomy are permenant method of contraception
and highly effective.
• They are generally chosen by relatively older couple
who are sure that they completed their family.
 Also individual who carry a genetic disorder may
choose to be sterlized.
 Sterilization methods include:
1- Vasectomy in males.
2- Tubal Ligation in females .

38. Bilateral Tubal Ligation
 This involve mechanically blockage of both
fallopian tube to prevent the sperm reaching and
fertilizing the oocyte
 sterilization performed by laparoscopically(under
GA) or through a suprapubic “mini-laparotomy”
During caesarean section
 Failure rate: 0.5%

39. Tubal Ligation

40. Tubal Ligation
Advantages:
• intended to be
permanent
• highly effective
• safe
• quick recovery
• lack of significant long-
term side effects
• cost effective
Disadvantage:
possibility of patient regret
• difficult to reverse
• future pregnancy could
require assisted
reproductive technology
(such as Invitro
Fertilization)
• more expensive than
vasectomy

41. Vasectomy
• Vasectomy involve division of the vas deferens on
each side to prevent the release of sperm during
ejaculation.
• Easier than tubal ligation.
• Usually done under local
• anesthesia.
• Failure rate: 0.1%.

42. Vasectomy
• Advantages:
• permanent,effective,safe, quick recovery
• lack of significant long-term side effects
• cost effective; less expensive than tubal ligation
Disadvantages:
• reversal is difficult, often unsuccessful
• not effective until all sperm cleared from the
reproductive tract (may take up to 12 w)
• no protection from STD

43. Cont.
Complication of vasectomy:
• Immediately bleeding, wound infection
• At the cut of vas deferns small lump will apear as a
result of a local inflammation response this is
called sperm granuloma it needs surgical excision.
• some men develop anti-sperm antibody following
vasectomy

44. THANK YOU