Contraception

1. Contraception

2. • Contraception=against conception
• The preventive methods to help women avoid
unwanted pregnancies are called contraceptive
methods.

3. Need for contraception
• To avoid unwanted pregnancies
• To regulate the timing of pregnancy
• To regulate the interval between
pregnancy

4. Ideal contraceptive
• Safe
• Effective
• Acceptable
• Reversible
• Inexpensive
• Long lasting
• Requires little or no medical supervision

5. Contraceptive methods
Spacing methods
• Natural
• Barrier
• IUDs
• Emergency
contraception
Terminal methods
• Male fertilisation
• Female
fertilisation

6. Natural Methods
• Coitus interuptus / withdrawal
• Rhythm Method
• Lactational Amenorrhoea

7. Barrier Methods
Mechanical
• Male : Condom
• Female : Condom, Diaphragm, Cervical cap
Chemical
• Creams - Deleen
• Jelly – Koromex, Volpar paste
• Foam tablets – Aerosol foams, Chlorimin T
Combination
• Combined use of Chemical and Mechanical.

8. Male condom
• Most commonly known and used contraceptive.
• Better known in India as NIRODH.

9. Female condom

10. Diaphragm

11. Spermicides
Spermicides are surface active agents which attach
themselves to spermatozoa and kill them.
Available in various forms like
1. Foams
2. Creams
3. Suppositories
4. Soluble films

12. Intrauterine Contraceptive Devices
Types
• Open Lippe’s loop, Cu T, Cu 7, Multiload
• Closed Grafenberg Ring, Birnberg Bow
• Hormone
IUD
Progestasert,LNG-IUS

13. Cu T200
• T shaped device Polyethylene frame.
• 215 mm2 surface area of Cu wire.
• Contains 124 mg of copper.
• Lifetime 4 years.

14. Cu T 380A Multiload Cu 250
• Life time 10 years. Life time 3 Years
• 380 mm square surface
area of copper wire.

15. Multiload - 375
• Surface area of Cu wire 375 mm2.
• Replacement 5 years.

16. Mode of
action
• Biochemical and histological changes in
endometrium.
• Increased tubal motility.
• Endometrial inflammatory response.
• Prevents implantation.

17. Time of insertion
Interval
• 2-3 days after menstrual phase.
• During lactational amenorrhoea.
Postabortal
• Done immediately following termination of
pregnancy.
Postpartum
• After 6 weeks of delivery.
Postplacental delivery
• Post delivery of placenta.

18. Complications
• Immediate
• Cramp-like Pain
• Syncopal attack
• Partial or complete perforation
• Pain
• Abnormal menstrual bleeding
• PID
• Spontaneous expulsion

19. Combined pill:
-combination of estrogen and progestogen
-MALA-N,MALA-D(0.15mg levonorgestrel & 0.03mg ethinyl
estradiol)
Prgestogen only pill
-used in people above 40 years of age & CVS problem
Post coital contraception:
-Levonorgestrel
-Ullipristal
-Mifepristone
Hormonal contraceptives

20. Levonorgestrel IUS (LNG-
IUS)
Levonorgestrel 52 mg
Replacement 7 years.

21. Adverse effects
• Cardiovascular effects
• Carcinogenesis
• Metabolic effects
• Liver adenomas
• Weight gain
• Breast tenderness

22. Depot formulations
Injectables:
DMPA-150 mg IM inj every 3 monthly
Subdermal impants:
Norplant-6 silastic capsules, each containing
35 mg of levonorgestrol
-protection for 5 years

23. Emergency Contraception
• Hormones
• IUD
• Anti-
progesterone

24. Terminal methods
Guidelines
• Husbands age:25-50 years
• Wife’s age:20-45
• 2 living children at the time of operation

25. A segment of vas deferens of both the sides are
resected and both the ends are ligated.
Methods:
No-Scalpel Vasectomy.
Electrocoagulation.
Male sterilisation(Vasectomy)

26. Male sterilisation

27. Female sterilisation
• Occlusion of fallopian tubes.
Methods of female sterilisation:
1. Tubectomy
2. Minilaparotomy

28. THANK YOU
SHINIL
LENIN
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