CONTRACEPTIVE

METHODS
PRESENTED BY:
S.ADHIRAI,
M.Sc (N) I-YEAR,
VMCON,
KARAIKAL.
INTRODUCTION:
Contraception is defined
as the intentional prevention of
conception through the use of
various devices, sexual practices,
chemicals, drugs, or surgical
procedures.
AIMS:
Pregnancy Prevention
Choices for Birth Control
Prevents STD'S - AIDS.
The characteristics of an ideal contraceptive are
listed below:
Highly effective.
Widespread availability.
No side effects.
Independent of intercourse.
Acceptable to all cultures and religions.
Rapidly reversible.
Administration and healthcare personnel not
required.
Cheap.
Easily distributed.
EFFECTIVENESS:
 TYPES OF CONTRACEPTIVE
METHODS:
1. SPACING METHODS
A) BARRIERS METHODS
B) INTRA UTERINE DEVICES

C) HORMONAL METHODS
D) POST CONCEPTIONAL METHODS
E) MISCELLANEOUS

2. TERMINAL METHODS
A) MALE STERILIZATION
B) FEMALE STERILIZATION
 I.SPACING METHOD:
1.BARRIER METHODS:
A variety of barrier methods, suitable for both
men and women are available. The aim of these
methods is to prevent live sperm from meeting the
ovum. Barrier method under that subdivided into
three type like.,

☆Physical methods
☆chemical methods
☆combined methods
☆Physical methods
MALE CONDOM:
Condoms are a "barrier" method of
contraception. They are made of very thin
latex (rubber), polyurethane or polyisoprene
and are designed to prevent pregnancy by
stopping sperm from meeting an egg.
ADVANTAGES:
They are easily available.
To prevent pregnancy
 To protecting both partners from STIs
No side effects from using condoms.
Do not require any medical supervision.
DISADVANTAGES:
 Condoms are very strong but may split or tear if
not used properly.
 Some people may be allergic to latex
FEMALE CONDOM:
Female condoms are a barrier method of
contraception worn inside the vagina. They
prevent pregnancy by stopping sperm
meeting an egg.
ADVANTAGES:
 Female condoms help to protect both
partners from STIs, including HIV.
When used correctly, they're a reliable
method of preventing pregnancy.
It's a form of contraception you only need to
use when you have sex.
There are no serious side effects.
DISADVANTAGES:
They're not as widely available
Some couples find that putting in a condom
interrupts sex.
DIAPHRAGM:
A contraceptive diaphragm or cap is a
circular dome made of thin, soft silicone
that's inserted into the vagina before sex. It
covers the cervix, sperm cannot get into the
womb (uterus) to fertilise an egg.
ADVANTAGES:
 There are usually no serious associated health risks

or side effects.

DISADVANTAGES:
 It can take time to learn how to use it

 Putting it can interrupt sex

 cystitis (bladder infection) can be a problem for

some women who use a diaphragm or cap

 latex and spermicide can cause irritation in some

women and their sexual partners.

VAGINAL SPONGE:
The birth control sponge is a small,
round sponge made from soft, squishy plastic.
You put it deep inside your vagina before sex.
The sponge covers your cervix and
contains spermicide to help prevent
pregnancy. Each sponge has a fabric loop
attached to it to make it easier to take out.
☆chemical methods
Chemical methods of contraception are
spermicidal agents various foams, creams,
jellies, suppositories, and douches that
contain spermicidal agents make the vagina
and cervix unfavorable for sperm survival and
are available without a prescription.
☆combined methods
Birth control pills, the birth control
patch, and the vaginal birth control ring are
combined hormonal birth control methods.
They contain two hormones: estrogen and
progestin.
2.INTRAUTERINE DEVICE:
Intra uterine devices are medicated
device intended to release a small quantity of
drug into uterus in a sustained manner over
prolonged period of time.\

CLASSIFICATIONS OF IUDS:
There are two basic types of IUD non
medicated and medicated IUDS. Both are
usually made of polyethylene or other
polymers in addition the medicated IUDS
release either metal ions or hormones.
The first-generation devices:
Include the Lippes loop and Saf-T coil made of
plastic, the M-device and the Y-device made of
stainless steel, the Dalkon shield made of polyvinyl
acetate, the copper 7 (Gravigard) and copper-T 200.
The second-generation medicated IUDs of the 1970s
and 1980s had primarily copper added to them.
The second-generation IUDs:
Include the Nova-T (Noncard) and multiload
250. The basic difference in the copper devices is in
the shape and the amount of copper.
The third-generation IUDs:
Commonly in use now include copper T380A,
380S, 380Ag, multiload 375, copper-safe 300 (Cu-
safe 300), copper Fix 330 or Flexigard 330 and
levonorgestrel releasing IUD (Levonal)
The third-generation IUDs are improvement
on the second-generation devices, and some
are impregnated with progestogen.
Recently, an intrauterine system containing
levonorgestrel (released at 20 µg/day) has
been approved for use. It provides
contraception for up to 5 years.
Medicated IUDS:
Ist generation IUCD.
Lippes Loop- serpentine or S shaped.
Made up of Plastic.
Non-medicated IUDS:
2nd generation Cu made, 2 types.
cu T 380 A and cu T 200
Newer like NOVA-7, NOVA-T
3rd generation.
Hormone releasing containing progesterone reservoir
release continuously for 1 yr.
MECHANISM OF ACTION:
The IUD works by preventing fertilization.
The copper IUD releases copper ions into the
uterine cavity which are toxic to the sperm
entering the uterus and fallopian tubes. The
hormonal IUD releases 20 micrograms of
levonorgestrel each day which thickens the
cervical mucus and inhibits sperm movement
and viability. Both IUDs affect the
endometrial lining and may prevent
implantation of a fertilized egg.
SIDE EFFECTS:
 spotting between periods.
 irregular periods.
 heavier or longer periods.
 more or worse cramping during your periods.
 pain when your IUD is put in, and cramping or back
aches for a few days after.
 Headache.
 Acne.
 Breast tenderness.
 Irregular bleeding, which can improve after six
months of use.
 Mood changes.
 Cramping or pelvic pain.
ADVANTAGES:
Extremely good at preventing pregnancy
Easy to use and maintain
Long-lasting and cost-effective
Immediately reversible if you decide you want
to get pregnant
The hormonal IUD also makes periods lighter
and less painful.
DISADVANTAGES:
A small risk of problems after insertion, such
as pelvic infection
They can move out of place
IUDS can cause side effects such as irregular
bleeding and sore breasts
Copper IUDS can initially make periods
heavier and more painful
C) HORMONAL METHODS
Hormonal methods of birth
control (contraception) contain either
estrogen and progestin or progestin only;
they are a safe and reliable way to prevent
pregnancy for most people. Hormonal
methods include an implant, injections, pills,
vaginal rings, and skin patches.

CLASSIFICATION:
Oral pills
Depot formulation
A) ORAL PILLS:
Combined pill
Progestogen only pill
Post-coital pill
Once a month pill
Male pill

B) DEPOT FORMULATIONS:
Injectables
Subcutaneous implants
Vaginal ring
COMBINED PILL:
The combined oral contraceptive pill is often
just called "the pill". It contains artificial
versions of female hormones oestrogen and
progesterone, which are produced naturally
in the ovaries.
It contain Oesterogen (ethyl estradiol/
mestranol) 20-50mg. Progesterone
(norethisterone/ norgestrel) 0.5-2mg.
It is taken once a day, most commonly for 21
days followed by a seven-day break, although
other regimens are also used.
AVAILABILITY:
MALA –N 21 TAB
MALA-D 28 TAB 7 Ferrous fumerate.

PROGESTOGEN ONLY PILL:

With "typical use" of the progestogen-only pill (the way
it's taken by a lot of women in real life), it's only about
91% effective.
You take a pill every day, with no break between packs of
pills.
The progestogen-only pill can be used if you cannot use
contraception that contains oestrogen.
POSTCOITAL CONTRACEPTION:
A method used to prevent
pregnancy after unprotected sexual
intercourse, is a highly effective but
underutilized birth control option. Two
hormone regimens, ethinyl estradiol (100 μg)
with levonorgestrel (0.5 mg) or high-dose
levonorgestrel (0.75 mg), given within 72
hours of intercourse and repeated 12 hours
later, are available for this purpose.
ONCE A MONTH PILL:
Researchers have developed a once-a-
month oral contraceptive pill that they say
would offer women more choice and control
over their fertility.
B) DEPOT FORMULATIONS:
INJECTABLES:
Oily solutions given intramuscularly.
Progestrin -
Medroxyprogesterone acetate (DMPA) - IM
every 3-6 months, 150-400mg.
Norethindrone enanthate (NET-EN) - IM
every 3 months , 200 mg.
Combined -
Both estrogen & progesterone
IM , monthly .
MODE OF ACTION:
Prevent ovulation & alter cervical mucosal
secretions.
SUB-DERMAL IMPLANTS:
A subdermal implant refers to a body
modification that is placed underneath the
skin
Types -
Norplant - 6 flexible silastic (silicon) tubes 35
mg progesterone.
Norplant 2 - 2 rods of levonorgesterol
Location - beneath skin of arm or forearm.
Contraction - 5-6 rs.
VAGINAL RING:
The vaginal ring (NuvaRing) is a small soft,
plastic ring that you place inside your vagina.
It releases a continuous dose of the hormones
oestrogen and progestogen into the
bloodstream to prevent pregnancy.
4.POST CONCEPTIONAL METHODS
Menstrual regulation
Menstrual induction
Oral abortifacient
Abortion

MENSTRUAL REGULATION:
Menstrual regulation (MR) is the
term applied to any treatment which is
administered within 14 days of a missed.
menstrual period* to ensure that a woman
either is not. pregnant or does not remain
pregnant. Because pregnancy.
MENSTRUAL INDUCTION:
Menstrual induction refers to early
uterine evacuation without laboratory
confirmation of pregnancy in women with
delayed menses.

ORAL ABORTIFACIENT:
An abortifacient is a substance that induces
abortion.
This is a nonspecific term which may refer ...
"Oral
Contraceptives and Early-Term Abortifacients
During
Classical Antiquity and the Middle Ages
ABORTION:
Abortion is when a pregnancy is
ended so that it doesn't result in the birth of a
child. Sometimes it is called 'termination of
pregnancy
5.MISCELLANEOUS
Abstinence
Coitus interruptus
Safe period
Natural family planning methods
☆ Basal body temperature
☆ Cervical mucus method
☆ symptothermic method
Breast feeding
Birth control vaccine
ABSTINENCE:
The definition of abstinence is when you
don't have sex. Outercourse is other sexual
activities besides vaginal sex.
COITUS INTERRUPTUS:
Coitus interruptus, also known as
withdrawal, is a traditional family planning
method in which the man completely removes
his penis from the vagina, and away from the
external genitalia of the female partner
before he ejaculates.
SAFE PERIOD:
portion of the menstrual cycle of the
human female during which conception is
least likely to occur and which usually
includes several days immediately before and
after the menstrual period and the period
itself.
NATURAL FAMILY PLANNING METHOD
The term natural family planning is
applied to three methods
BASAL BODY TEMPERATURE:
Describes your temperature when you’re
resting. Your basal body temperature can increase
minimally when you’re ovulating. Women are at
their most fertile in the two to three days prior to
this temperature increase.

CERVICAL MUCUS METHOD

Also called the Billings Ovulation Method, the
cervical mucus method is based on careful
observation of mucus patterns during your
menstrual cycle. Before
ovulation, cervical secretions change — creating an
environment that helps sperm travel through the
cervix, uterus and fallopian tubes to the egg.
SYMPTOTHERMIC METHOD:
Symptothermic Method (basal body
temperature + cervical secretions + other
fertility signs)· Support a woman's choice of a
fertility awareness method.

BREASTFEEDING:
As a natural method of contraception
is termed as lactational amenorrhea method
(LAM). LAM is highly effective i.e.
98%effective
BIRTH CONTROL VACCINE:
contraceptive injection is a shot
that contains hormones, either a progestin
alone, or a progestin and an estrogen
together, that stop your body from releasing
eggs and thickens the mucus at the cervix.
You need one shot either once every month or
once every three months from a healthcare
provider.
PERMANENT METHOD
vasectomy
tubectomy

Vasectomy:
One cm vas deference removed after clamping.
Both ends ligated & sutured.
Mechanism of action entry of sperm into
semen prevented.
Sperm production & hormones not affected.
Post-operative instructions – use contraceptive
measures (condom) as he is not sterile ,after
30 ejaculations semen is free from sperm.
Tubectomy
Tubectomy, also known as tubal sterilization,
is a permanent method of contraception in
women. It is a surgical process that blocks
the fallopian tubes, thereby preventing the
egg released by the ovary from reaching the
uterus.

TYPES:
Tubal ligation
TUBAL LIGATION:
Tubal ligation is a surgical
procedure for female sterilization in which
the fallopian tubes are permanently blocked,
clipped or removed. This prevents the
fertilization of eggs by sperm and thus the
implantation of a fertilized egg.
MINI-LAPAROTOMY:
Mini-laparotomy (also known as a mini-
lap) is one of the three most common
methods of tubal ligation. These elective
forms of surgical contraception are often
referred to as "having your tubes tied." The
other techniques include laparotomy and
laparoscopy. The mini-lap is a less invasive
form of a laparotomy.