METHODS OF CONTRACEPTIONS

CONTRACEPTIVE METHODS

Contraceptive measures are methods used to prevent conception (pregnancy).They include all temporary and permanent measures to prevent pregnancy   resulting from coitus (sexual intercourse).

             Methods of Contraception:-

1.     NATURAL  METHODS

2.     BARRIER  METHODS

3.     CHEMICAL  METHODS

4.     LONG-TERM / PERMANENT METHOD

1.NATURAL METHOD- It is also  known as fertility-based awareness methods. This  is the method that uses the body’s natural physiological changes and symptoms to identify the fertile and infertile phases of the menstrual cycle.

                                  

 TYPES:-

A.  BASAL BODY TEMPERATURE METHOD

B.  CALENDER METHOD OR  SAFE PERIOD METHOD

C.  LACTATIONAL  AMENORRHEA  METHOD

D.  WITHDRAWAL METHOD

                                           

A).BASAL BODY TEMPERATURE METHOD:- Ovulation raises body temperature by ½ - 1 degree F And temperature  will drop if fertilization does not occurs.

 B).CALENDER METHOD :-Couple avoid or abstain coitus from day 10 to 17  of menstrual cycle when ovulation could  be expected  and the chances of fertilisation are very high during the period , it is called fertility period.

C).LACTATIONAL AMENORRHEA:-Ovulation and menstrual cycle does not occur during intense lactation following parturition. Increased level of prolactin inhibit production and secretion of GnRH.  Thus decreases the level of oestrogen in body .Ovulation cannot occur without a surge in oestrogen level. These methods add   chemicals similar to  hormones to stop the  release of an egg and      weaken the sperm. The hormones change  your cervical mucus  and uterine lining, slow  sperm, and reduce  ability of fertilized egg to implant into  uterine wall

D).WITHDRAWAL METHOD:- The man takes his penis out of the vagina before  ejaculation.  Male needs to ejaculate away from  female; sperm on legs and labia can still  travel into vagina. Effectivity  of this method depends on a male’s self knowledge  and self control. Effectiveness: 78-96%.

2..BARRIER  METHODS:-Barrier  method  of contraceptive prevent the meeting   of ovum and sperms after coitus. These includes

                           I.        Mechanical Barrier

a.   Male condom

b.   Female condom

c.   Diaphragm

d.   Cervical cap

                         II.        Chemical Barrier

a.   Spermicides

                     III.        Combined

a).Male condom:-  A thin covering that you unroll over an erect  penis. Made of  latex, polyurethane, or animal membrane. Put on before any genital contact. At withdrawal, hold the rim in place at the base of  the penis so it doesn’t slip off. It may decrease the sensation for  men.

Lubrication makes condom less likely to break. Effectiveness: 82-98%. Have no side effect and protect against STD.

b).Female condom:- A soft, loose pouch that is inserted in the  vagina. Flexible rings at each end hold it in  place. Insert the small ring in vagina, large ring  stays outside partially covering labia. It can be put in up to 8 hours before sex. It can be used if you are allergic to latex  (made of nitrite).Men usually feel no reduction  in sensation. Effectiveness: 79-95%

c).Diaphragm &Cervical cap:- A diaphragm or Cervical  cap is a barrier method of contraception that  inside the  vagina and prevents sperm passing through the cervix (the entrance of  womb). A gel that kills sperm (spermicide)  need to use with it.

II).Chemical Barrier:-  (Spermicides)- A chemicals that go in the vagina before sex and they  immobilize or kills sperm. It is mostly  work for one hour . Put in vagina following   packaging directions.It need to be put in 10  minutes  before intercourse. Nanoxynol-9 and Octoxynol-3 are chemical used as spermicidal agent .Effectiveness: 72-91%.

It may be

·           Cream

·           Gel

·           Foam

·           Film

·           Suppository

·           Sponge

3.CHEMICAL  METHOD:-In this methods chemicals similar to  hormones added to stop the  release of an egg and     weaken the sperm. The hormones  change   cervical mucus  and uterine lining, slow  sperm, and reduce   ability of fertilized egg to implant into  uterine wall.

               TYPES OF CHEMICAL  METHODS

                       A).STEROIDAL DRUGS

                        1).The Oral Contraceptive Pills.

                                  1.COMBINED PILLS

                                  2.SEQUENTIAL PILLS

                                  3.MINI PILL OR MICRO PILL

                                  4.PROGESTERONE ANTAGONIST

                         2).Depot Preparation.

1.      The Patch

2.      Vaginal Ring

3.      The Shot

4.      Sub-dermal Implants.

                      B).NON STEROIDAL DRUGS

                                           

                               1).Centchroman

                     C).INTRAUTERINE CONTRACEPTIVE DEVICES

                        D).EMERGENCY CONTRACEPTIVE

A).ORAL CONTRACEPTIVE PILLS :- The Contraceptive pills  (also called  birth control pill or "the Pill") is a  daily pill  that contains hormones, who  prevent the pregnancy by changing  the  the body function . Hormones are chemical substances that control the functioning of the body's organs. In this case, the hormones in the Pill control the ovaries and the uterus.

TYPES:-

1.COMBINED PILLS

2.SEQUENTIAL PILLS

3.MINI PILL OR MICRO PILL

PROGESTERONE ANTAGONIST

1.COMBINED PILLS: - It contains orally active progesterone (nor-ethioesterone , norethynodrel, chromodinone) combined with small amount of oestrogen (ethinyl oestradiol).eg-MALA-D ,MALA-N

 2. SEQUENTIAL PILL:-High dose of estrogen for 15 days followed by 5     days of oestrogen + progesterone . This inhibits ovulation by suppressing the release of both FSH and LH.

3. MINI PILL OR MICRO PILL:-Low dose of progesterone.

   eg- POP (PROGESTIN ONLY PILLS)

4. PROGESTRONE ANTAGONIST:-Producing abortion following the conception  Inhibiting the progestational effect on uterus.

 eg – MIFEPRISTONE

  Mode of action of pills:-Pills makes cervical mucus thick and renders the cervical mucus hostile  (unfriendly ) to sperm penetration.  It induces endometrial changes which prevent implantation of blastocyst. By an action or hypothalamus which inhibits secretion of LH.

DEPOT PREPARATION:-  Depot  preparations are long acting drugs and highly effective. These are available in four  forms:

1.  The Patch

2.  Vaginal Ring

3.  The Shot or Injectable preparation.

4.     Subdermal Implants

1.The Patch:- A bandage-like patch that sticks to  skin and it changed weekly. no patch required on 4th week of menstrual cycle. Hormones are absorbed through the skin .It is less effective body  weight over 198  pounds.It may causes skin irritation. Prescription needed for its application.Effectiveness: 91-99.7%

2.Vaginal Ring:-  Vaginal rings containing norgestrel are implanted intravaginally .The body absorbs hormones from the  ring through vaginal wall.The ring is  inserted and left in the vagina for 3 weeks. Effectiveness: 91-99.7%

3.The Shot: - A long acting hormone injected intramuscularly. Female is given a shot one time every 3 months. It is non reversible- and once the injection  given , the hormones are in the woman for at  least 3 months. It may take a long time to get  pregnant after the shot. More chance of weight gain than any  other method. Effectiveness: 94-99.8%.It may be two types

i).Oily progestrin preparation

ii).Combined injectable preparation

4.Subdermal Implant:- A soft rod 1 ½ inches long placed  under the skin in your upper arm which  are slowly releases hormones into your  body These are two types

I).Norplant-six flexible silastic tube ,each containing 35mg progesterone (Levonorgestrel).

ii).Norplant(R)2-two rod of (Levonorgestrel).Implant  prevents pregnancy for 3 years, but  can be taken out at any time.Effectiveness: 99.95%

B).NON STEROIDAL DRUGS

    1).Centchroman:- The new oral contraceptive for the females contain a non-steroidal  preparation developed by CDRI    Lucknow marketed under the trade name SAHELI.  It is once a week pill” with very few side effects  and  high contraceptive value.

C).INTRAUTERINE CONTRACEPTIVE DEVICES:- Implantation of foreign body into uterine cavity for contraceptive purposes.

1.NON-MEDICATED IUCDs- eg-Lippes loop

2.MEDICATED IUCDs-These are two types

a).Second generation IUCDs-

 eg-Copper T, Coper T200,NOVA-7,NOVA-T,

                multi-loaded devices.

b).Third generation IUCDs-Harmone releasing IUCDs

    eg- PROGESTASERT, LNG 20

D).EMERGENCY CONTRACEPTIVE :- It is also known as Post coital pill or Morning after pills.A pill or combination of pills which are recommended within 72 hours of unprotected intercourse. It contains a higher dosage (DOUBLE DOSE of combined pills )of the same  hormones found in regular birth control. It won’t stop an existing pregnancy .Available at pharmacy for girls  17+, prescription is needed if less than 17 .Effectiveness is  Approx 95% if taken within first  24 hours of unprotected sex, rape or contraceptive failure.

4).LONG-TERM / PERMANENT METHOD:-  These procedures are permanent, and  are usually done by people 35+ years, Both procedures are done in a doctor’s  office.

1. Female- Tubal  ligation

2. Male- Vasectomy

Female- Tubal  ligation :-A small incision is made in the abdomen to  access the fallopian tubes. Fallopian tubes are  blocked, burned, or clipped shut to prevent the  egg from traveling through the tubes  . Recovery usually takes 4-6 days.

Male- Vasectomy:-A small incision is made to access the vas  deferens, (the tube through which sperm travels from the  testicle to the penis) and is sealed, tied, or  cut.After a vasectomy, a male will still  ejaculate, but there won’t be any sperm present.