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Contraception OBG Presentation

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17 views15 pages

Contraception OBG Presentation

Uploaded by

fawkesrox03
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Contraception: Natural,

Hormonal, and Post Coital


Methods
MANAV SINGH (72)
Introduction to Contraception

 Contraception = against conception


 The preventive methods to help avoid unwanted pregnancies are known as
contraceptive methods

 NEEDS:
 To avoid unwanted pregnancies
 To time regular pregnancies
 To regulate interval between pregnancies
Contraceptive methods

Spacing methods Terminal methods

• Barrier method • Vasectomy


• Hormonal method • Tubectomy
• Emergency Contraception
Objectives of this presentation

• To explore the various methods of contraception with a focus on


mechanism of action.
• To identify examples of each method, highlighting Indian brands for
hormonal contraceptives.
• To understand the contraindications associated with different
contraceptive methods.
Natural Barrier Method
Act by physically preventing sperm from reaching the ovum or by helping couples identify and
avoid intercourse during fertile periods.

Condoms (Male and Female):


• Provide a physical barrier to sperm. Male condoms are typically made of latex or polyurethane and worn
over the erect penis, while female condoms are inserted into the vagina. They also offer protection against
STIs.

Diaphragms and Cervical Caps:


• Inserted into the vagina to cover the cervix. Diaphragms are larger and have a spring
mechanism for support, whereas cervical caps are smaller and rely on suction. Both should be
used with spermicide to increase efficacy.

Fertility Awareness Methods (FAMs):


• Involve tracking the menstrual cycle, observing cervical mucus, and measuring basal body
temperature to estimate the fertile window.
• Abstinence or other contraceptive methods are used during the fertile period.
Contraindications for Natural Barrier
Method
 Condoms:
 Few, typically associated with latex allergies (polyurethane condoms used)
 Failure rate: 12-15%
 Diaphragms and Caps
 Poor fit especially in parous women
 Failure Rate: As high as 32% in parous women and 16% in nulliparous women
 Patient must leave in place at least 8 hours after intercourse before removing
 Withdrawal (Coitus Interruptus):
 Lack of self-control, premature ejaculation
 Pre-ejaculate fluid to contain sperm  low reliability
 Fertility Awareness Methods (FAMs):
 Irregular menstrual cycles can make this method less effective
Male & Female Condoms Cervical cap (with method of insertion)
Hormonal Methods:
 Oral Contraceptives:
1. Combined Oral Contraceptives (COCs):
• Contain estrogen and progestin, which inhibits LH and FSH release, preventing ovulation.
• Thicken cervical mucus and alter the endometrial lining.
• Examples: Mala-D, Femilon.
2. Progestin-Only Pills (POPs):
• Contain only progestin. Primarily work by thickening the cervical mucus and thinning the endometrial lining.
• Suitable for breastfeeding women and those who cannot take estrogen.
• Example: Cerazette
• Contraceptive Patch and Vaginal Rings:
• These methods deliver the same hormones as COCs but through different routes.
• Patch is applied to the skin. Ring inserted into the vagina
• Offer a weekly or monthly alternative to daily pills.
Hormonal Methods Cont’d:

• Injectables:
• Depot medroxyprogesterone acetate (DMPA, Depo-Provera) is an injection given
every three months
• Suppresses ovulation and thickens cervical mucus.
• Implants:
• Rods that release progestin when inserted under the skin of the arm
• Prevent ovulation and thicken cervical mucus
• Examples: Implanon and Nexplanon
Intrauterine Devices (IUDs):
Copper IUD (Paragard T 380 A) Mirena (Levonorgestrel)
• Copper is a spermicide that • Increases thickness of cervical
inhibits sperm motility and mucus to inhibit sperm migration
acrosomal enzyme action
• Lasts up to 7 years
• Lasts 10-12 years
• Improves menorrhagia by 90% in
• May increase bleeding and most patients
dysmenorrhea
• Causes amenorrhea in many users
• Typical use failure rate is 0.8%
• Typical use failure rate is 0.1%
Contraindications for Hormonal Methods

 Oral Contraceptives:
• Combined Oral Contraceptives (COCs):
• History of thromboembolic disorders, stroke, or heart disease; breast cancer; liver disease; uncontrolled hypertension;
smoking in women > 35 years old; migraine with aura.
• Progestin-Only Pills (POPs):
• Fewer than COCs, but include breast cancer and significant liver disease.
 Contraceptive Patch and Vaginal Rings:
• Similar to COCs, including history of thromboembolic disorders, stroke, heart disease, uncontrolled hypertension,
and smoking in women > 35 years.
 Injectables (Depo-Provera):
• Known or suspected pregnancy; active thromboembolic disorders or history of these conditions; significant liver
disease; known or suspected breast cancer.
 Implants:
• Similar to injectables and POPs, including known or suspected breast cancer and significant liver disease.
Cerazette (POP)
Post Coital Methods:
 used to prevent pregnancy after unprotected sexual intercourse or contraceptive failure
• Emergency Contraceptive Pills (ECPs):
• Levonorgestrel (LNG) pills:
• Single-dose (1.5 mg) or two doses (0.75 mg each, 12 hours apart) taken within 72 hours after unprotected intercourse.
• Examples: Unwanted-72 and iPill
• Ulipristal Acetate (UPA) Pills:
• Single dose (30 mg) can be taken within 5 days after unprotected intercourse.
• More effective than LNG, especially on the third day post-intercourse.
• Copper-T Intrauterine Device (IUD):
• The copper IUD can be inserted up to five days after unprotected sex and provides an efficacy rate of over
99% in preventing pregnancy.
• Acts by inhibiting sperm motility and viability, preventing fertilization, and may also prevent implantation if
fertilization occurs.
Contraindications of Post Coital Methods:

 Emergency Contraceptive Pills (ECPs):


 Very few contraindications, other than allergies.
 Copper-T Intrauterine Device (IUD):
• Wilson’s disease (due to copper), active pelvic
infection, known or suspected pregnancy, uterine
anomalies that distort the uterine cavity, and
unexplained vaginal bleeding.
Thank you!

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