CONTRACEPTIVE METHODS

Introduction.
DEFINITION :-
• Prevention Of Pregnancy.
AIMS:-
• Family Planning
• Prevents STD’S – AIDS.
• Medical Grounds – To control stress of
pregnancy, labour & lactation.
 The characteristics of an ideal
contraceptive
• Highly effective.
• No side effects.
• Independent of intercourse.
• Rapidly reversible.
• Cheap.
• Widespread availability.
• Acceptable to all cultures and religions.
Administration and healthcare personnel not required
 Types of Birth Control
• Hormonal
• Barrier
• IUD
• Methods based on
information
• Permanent sterilization
 Hormonal Methods
• Oral Contraceptives
(Birth Control Pill)
• Injections (Depo-Provera)
• Implants (Norplant I & II)
 Birth Control Pills

• Pills can be taken to prevent pregnancy

• Pills are safe and effective when taken properly
• Pills are over 99% effective
• Women must have a pap smear to get a prescription for birth
control pills
• Pills DO NOT prevent STD’s
 How does the pill work?
• Stops ovulation
• Thins uterine lining
• Thickens cervical mucus
 Positive Benefits of Birth Control Pills

Decreases
Prevents incidence of
pregnancy ovarian cysts
Eases menstrual Prevents ovarian
cramps and uterine cancer
Shortens period Decreases acne
Side-effects
Regulates period
• Breast tenderness
• Moodiness
• Nausea
• Weight change
• Increase in
• Spotting
headaches
 Taking the Pill
• Once a day at the same time everyday
• Use condoms for first month
• Use condoms when on antibiotics
• Use condoms for 1 week if miss a pill or take
one late
• The pill offers no protection from STD’s
 Depo-Provera
• Birth control shot given once every three
months to prevent pregnancy
• 99.7% effective preventing pregnancy
• No daily pills to remember
 How does the shot work?
• The same way as the Pill!
• Stops ovulation
• Stops menstrual cycles!!
• Thickens cervical mucus
 SIDE EFFECTS
• Extremely irregular menstrual bleeding and
spotting for 3-6 months!
• NO PERIOD after 3-6 months
• Weight change
• Breast tenderness
• Mood change

*NOT EVERY WOMAN HAS SIDE-EFFECTS!

The Patch
 IMPLANTS
• Implants are placed in the body filled with
hormone that prevents pregnancy
• Physically inserted in simple 15 minute
outpatient procedure
• Plastic capsules the size of paper matchsticks
inserted under the skin in the arm
• 99.95% effectiveness rate
Norplant I vs. Norplant II
• Six capsules • Two capsules
• Five years • Three years
The pill works in several ways to prevent pregnancy. The
pill suppresses ovulation so that an egg is not released
from the ovaries, and changes the cervical mucus, causing
it to become thicker and making it more difficult for sperm
to swim into the womb. The pill also does not allow the
lining of the womb to develop enough to receive and
nurture a fertilized egg. This method of birth control offers
no protection against sexually-transmitted diseases.
Norplant Implant
 Norplant Considerations
• Should be considered long term birth
control
• Requires no upkeep
• Extremely effective in pregnancy
prevention > 99%
Emergency Contraception
Emergency contraception pills can reduce
the chance of a pregnancy by 75% if
taken within 72 hours of unprotected sex!
Emergency Contraception (ECP)

• Must be taken within 72 hours of the act of

unprotected intercourse or failure of
contraception method
• Must receive ECP from a physician
• 75 – 84% effective in reducing pregnancy
 ECP
• Floods the ovaries with high amount of
hormone and prevents ovulation
• Alters the environment of the uterus, making it
disruptive to the egg and sperm
• Two sets of pills taken exactly 12 hours apart
 BARRIER METHODS
• Spermicides
• Male Condom
• Female Condom
• Diaphragm
• Cervical Cap
 BARRIER METHOD
• Prevents pregnancy blocks the egg and
sperm from meeting
• Barrier methods have higher failure rates
than hormonal methods due to design and
human error
 SPERMICIDES
• Chemicals kill sperm in the vagina
• Different forms:
-Jelly -Film
-Foam -Suppository
• Some work instantly, others require pre-insertion
• Only 76% effective (used alone), should be used in combination
with another method i.e., condoms
 MALE CONDOM

• Most common and effective barrier method when used properly

• Latex and Polyurethane should only be used in the prevention
of pregnancy and spread of STD’s (including HIV)
 FEMALE CONDOM
• Made as an alternative to male condoms
• Polyurethane
• Physically inserted in the vagina
• Perfect rate = 95%
• Typical rate = 79%
• Woman can use female condom if partner
refuses
 The Female Condom
The female condom is a lubricated polyurethane
sheath, similar in appearance to a male condom.
It is inserted into the vagina. The closed end
covers the cervix. Like the male condom, it is
intended for one-time use and then discarded.
The sponge is inserted by the woman into the
vagina and covers the cervix blocking sperm
from entering the cervix. The sponge also
contains a spermicide that kills sperm. It is
available without a prescription.
 Vaginal Ring (NuvaRing)
• 95-99% Effective A new ring is inserted into the vagina
each month
• Does not require a "fitting" by a health care provider,
does not require spermicide, can make periods more
regular and less painful, no pill to take daily, ability to
become pregnant returns quickly when use is stopped.

NuvaRing is a flexible
plastic (ethylene-vinyl
acetate copolymer) ring
that releases a low dose of
a progestin and an
estrogen over 3 weeks.
 DIAPRAGHM
• Perfect Effectiveness Rate = 94%
• Typical Effectiveness Rate = 80%
• Latex barrier placed inside vagina during
intercourse
• Fitted by physician
• Spermicidal jelly before insertion
• Inserted up to 18 hours before intercourse and
can be left in for a total of 24 hours
 DIAPHRAGM
The diaphragm is a flexible rubber cup that is filled with
spermicide and self-inserted over the cervix prior to
intercourse. The device is left in place several hours after
intercourse. The diaphragm is a prescribed device fitted by
a health care professional and is more expensive than
other barrier methods, such as condoms
 CERVICAL CAP
• Latex barrier inserted in vagina before
intercourse
• “Caps” around cervix with suction
• Fill with spermicidal jelly prior to use
• Can be left in body for up to a total of 48 hours
• Must be left in place six hours after sexual
intercourse
• Perfect effectiveness rate = 91%
• Typical effectiveness rate = 80%
Cervical Cap

The cervical cap is a flexible rubber cup-like device that is filled with
spermicide and self-inserted over the cervix prior to intercourse. The
device is left in place several hours after intercourse. The cap is a
prescribed device fitted by a health care professional and can be more
expensive than other barrier methods, such as condoms.
Sponge

The sponge is inserted by the woman into the vagina and covers the
cervix blocking sperm from entering the cervix. The sponge also
contains a spermicide that kills sperm. It is available without a
prescription
 INTRAUTERINE DEVICES
(IUD)
• T-shaped object placed in the
uterus to prevent pregnancy
• Must be on period during
insertion
• A Natural childbirth required to
use
IUD
• Extremely effective without
using hormones > 97 %
• Must be in monogamous
relationship
 Copper T vs.. Progestasert
• 10 years • 1 year
• 99.2 % effective • 98% effective
• Copper on IUD acts as • T shaped plastic that
spermicide, IUD blocks releases hormones over
a one year time frame
egg from implanting
• Thickens mucus, blocking
• Must check string before egg
sex and after shedding of • Check string before sex &
uterine lining. after shedding of uterine
lining.
 STERILIZATION
• Procedure performed on a man or a
woman permanently sterilizes
• Female = Tubal Ligation
• Male = Vasectomy
 TUBAL LIGATION
• Surgical procedure performed on a woman
• Fallopian tubes are cut, tied, cauterized, prevents eggs from
reaching sperm
• Failure rates vary by procedure, from 0.8%-3.7%
• May experience heavier periods
 VASECTOMY
• Male sterilization procedure
• Ligation of Vas Deferens tube
• No-scalpel technique available
• Faster and easier recovery than a tubal
ligation
• Failure rate = 0.1%, more effective than
female sterilization
During a vasectomy (“cutting the vas”) a urologist cuts
and ligates (ties off) the ductus deferens. Sperm are still
produced but cannot exit the body. Sperm eventually
deteriorate and are phagocytized. A man is sterile, but
because testosterone is still produced he retains his sex
drive and secondary sex characteristics.
 METHODS BASED ON
INFORMATION
• Withdrawal
• Natural Family Planning
• Fertility Awareness Method
• Abstinence
 WITHDRAWAL
• Removal of penis from the vagina before ejaculation occurs
• NOT a sufficient method of birth control by itself
• Effectiveness rate is 80% (very unpredictable in teens, wide variation)
• 1 of 5 women practicing withdrawal become pregnant
• Very difficult for a male to ‘control’
 Natural Family Planning &
Fertility Awareness Method
• Women take a class on the menstrual cycle to
calculate more fertile times
• Requires special equipment and cannot be self-
taught
• NFP abstains from sex during the calculated
fertile time
• FAM uses barrier methods during fertile time
• Perfect effectiveness rate = 91%
• Typical effectiveness rate = 75%
• No 100% safe day-irregular periods