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:-
- NATURAL METHODS
- BARRIER METHODS
- CHEMICAL METHODS
- 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:-
- BASAL BODY TEMPERATURE METHOD
- CALENDER METHOD OR SAFE PERIOD METHOD
- LACTATIONAL AMENORRHEA METHOD
- WITHDRAWAL METHOD
- CALENDER METHOD OR SAFE PERIOD 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
- Mechanical Barrier
- Male condom
- Female condom
- Diaphragm
- Cervical cap
- Chemical Barrier
- Spermicides
- Combined
a).Male condom:- A thin covering that you unroll over an erect penis. Made of latex, polyurethane, or animalmembrane.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 nitrile).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)- Achemicals that go inthe vagina before sex and they immobilize or kills sperm.It ismostly 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.PROGESTRON ANTAGONIST
2).Depot Preparation.
- The Patch
- Vaginal Ring
- The Shot
- Subdermal 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
4.PROGESTRON 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 oestrogen 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:
- The Patch
- Vaginal Ring
- The Shot or Injectable preparation.
- 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 Postcoital pill or Morning after pills.A pill or combination of pills which are recommended within 72 hour s 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.
- Female- Tubal ligation
- 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.
