Contraceptive and birth control presentation

1. Birth Control Methods
Contraceptive
Done by: Dr JASIM MAKI (R1)

2. - There are many types of contraception widely used now days for
family planning purposes.
- The Centers for Disease Control and Prevention recommends that
all women be counseled about her full range and effectiveness of
contraceptive methods for which they are medically eligible.
- No method of contraception is perfect, each woman must balance
the advantages of each method against the disadvantages and
side effects, and decide which method she prefers.

3. Benefits of family planning / contraception
- Preventing pregnancy-related health risks in women
- Helping to prevent HIV/AIDS
- Reducing infant mortality
- Empowering people and Enhancing education
- Reducing adolescent pregnancies
- Slowing population growth

4. Contraception types
01 02
04
03
05
Behavioral
methods
Barrier Methods Hormonal
Sterilization Emergency
contraception

6. Behavioral
methods
01
METHODS BASED ON INFORMATION

7. Withdrawal
Also known as COITUS INTERRUPTUS
or pull-out method. It is one of the
oldest contraceptive methods
described.
Advantages: Readily available. Inexpensive. Free of systemic side effects.
Fertility awareness-based
methods
Also known as PERIODIC ABSTINENCE
This method is based on avoiding
sexual intercourse around the time
of predicted ovulation.
Disadvantages: High failure rates.
Inaccurate prediction of ovulation.
Disadvantages: High failure rates.
No protection against STDs. High
degree of discipline required. Semen
can enter vagina and cervical mucus
prior to ejaculation.

8. Barrier Methods
02
These are locally active devices preventing entry
of sperm in through the cervix, thus preventing
pregnancy

9. Spermicides Male Condom Female
Condom
Diaphragm
Barrier Methods
Cervical Cap

10. Mechanisms of Action:
These devices preventing entry of sperm in through the cervix (blocks the egg and
sperm from meeting), thus preventing pregnancy.
Advantages:
• They do protect against some STDs
• They do not have systemic side effects (No hormonal exposure)
• safe and reversible
Disadvantages:
• Failure rate is high
• The diaphragm, cervical cap and sponge do not protect against STDs it Increased
risk of HIV transmission.
• site irritation, burning, itching, rash

11. Spermicides
- Chemicals kill sperm in the vagina
- Different forms:
-Jelly -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

12. Male Condom
They are the most common and effective barrier contraceptive
method when used properly
➢ Latex is the most common used type worldwide
➢ Condom the only method decrease the risk of STDs and the most
protective type is High-quality latex condoms.
➢ A new condom must be used each time a couple has intercourse.
➢ Male condoms can also help to prevent early ejaculation.

13. Female Condom
- Made as an alternative to male condoms
- Physically inserted in the vagina

14. Diaphragm
- This is a dome-shaped device placed in the anterior and posterior
vaginal fornices holding spermicidal jelly against the cervix.
Contraindication:
• notable cervical abnormality
• history toxic shock syndrome
• HIV infection

15. Cervical Cap
- Cup that is described as looking like a sailor's hat.
- Fill with spermicidal jelly prior to use
Contraindication:
• Same as diaphragm
• cervical intraepithelial neoplasia (CIN)
• cervical cancer

16. Sponge
disposable female barrier contraceptive
Contraindication:
• toxic shock

17. Hormonal
Contraceptive
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18. Types of Hormonal Contraceptive
Combined Hormonal
Contraception
 Pills
 Patches
 Vaginal rings
Progesterone only
Contraception
 Pills
 Long-acting Reversible
Contraceptive
• Injection
• Implant
• IUD

19. Mechanism of action
- Suppression of ovulation by inhibiting FSH and LH .
- Effects on the endometrium
- Thickening of cervical mucus.
- Impairment of normal tubal motility and peristalsis.

20. ➢Reversible method
➢Non-contraceptive Advantages:
Protection against:
• Pelvic pain disorders
• Endometriosis
• Dysmenorrhea
• Ovarian cysts.
• Acne and hirsutism.
• Helpful in Perimenopausal
manifestation.
Advantages
➢Spotting
➢Amenorrhea
➢Hormonal side Effect
• Mood change
• Breast tenderness
• Nausea
• Vomiting
➢The pills must be taken every day
➢Increased risk of venous
thrombosis
➢Hepatic adenoma.
Disadvantages

22. Combined Oral Contraceptive pills (OCPs)
 These contain both an
estrogen and a progestin.
 Ethinyl estradiol is the most
commonly used Estrogen
 Once a day at the same time
everyday
 When “off ” the hormones,
withdrawal bleeding will
occur

23. Types of COCPs
Monophasic: contain the same
amounts of estrogen and
progestin for 21 days, followed
by 7 days of placebo pills.
- 21 active + 7 inactive (placebo)
-No breaks between packs
phasic: contain different amounts of
hormones (variable amount) for 21
days, followed by 7 days of placebo
phase.
- All active pills
- 7 days break between packs

25. Combined Contraceptive Patch (Ortho Evra)
• Transdermal skin patch
• Used Once a week for 3 weeks; then a patch-free week.
• Less effective for women who weight more than 90kg.
• Can be applied on buttocks, upper outer arm, lower abdomen or upper
body.
• Should not be applied on breasts, areas of the skin that are red, irritated or
cut.
• Should be applied to skin that's clean and dry.
• Patch contains a higher dose of hormones than the pill; the side effects
may be more than with the pill

26. Vaginal Ring (NuvaRing)
• Inserted into the vagina, contains both an estrogen and a
progestin.
• It is removed after 3 weeks for 1 week ring-free to allow for a
withdrawal bleed.
• A major advantage is relatively stable and constant blood levels
of hormones.

27. Progesterone only contraception

28. ➢ Treat AUB /Dysmenorrhea
➢Decreased risk of endometrial Ca/
PID.
➢Method of choice for breast feeding
➢ Used in contraindication for COCP.
Advantages
➢Breakthrough bleeding
➢Amenorrhea
➢Hormonal side Effect
➢Weight gain (resolves after
discontinuation).
➢Headaches.
➢Acne flares.
➢Follicular ovarian cysts.
Disadvantages

29. Progesterone Only Pills
 They contain only progestins
and are sometimes called
the “minipill.”
 They need to be taken daily
and continuously.
 A frequent side effect is
break-through bleeding.
 Indications:
- Breastfeeding
- When combined OCP is
contraindicated
28 days continuous
24 active pills , 4 inactive pills

30. Progesterone -only injectable
• Depo medroxyprogesterone acetate (DMPA), marketed under the trade
name of Depo-Provera
• Administration: SC or IM injection every 3 months.
• A frequent side effect is break through bleeding. Other side effects are
prolonged time for fertility return and decreased bone mineral density.

31. Progesterone -only injectable
Contraindications
1-Use of aminoglutethimide.
2-Undiagnosed vaginal bleeding
3-Long-term use of corticosteroid
therapy.
FDA recommendation
➢Not to be used as a long term
method.
➢BMD should be evaluated.
➢Women with osteoporosis risk
factors: other methods should be
considered.
➢Calcium supplements and
regular exercise should be
considered.

32. Subdermal Contraceptive Implants
 Marketed under the trade name of Nexplanon, this uses etonogestrel
as the active ingredient.
 The core contains a small amount of barium, making it visible on x-ray.
 The continuous release continues for 3 years.
 A frequent side effect is break-through bleeding.
 Failure rate is <1%.

34. INTRAUTERINE DEVICES (IUD)
 Intrauterine contraception is a long-acting reversible contraceptive
method that involves placement of a small t-shaped object inside the
uterus.

39. Sterilization
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Procedure performed on a man or a woman
permanently sterilizes

40. Female = Tubal Ligation
Fallopian tubes are cut,
tied, cauterized,
prevents eggs from
reaching sperm
Male = Vasectomy
Ligation of Vas
Deferens tube

41. Emergency
contraception
ECP
05

42. ➢Indicated after unprotected intercourse or suspected contraceptive
failure within the previous 120 hours (5 days).
➢Should be initiated ASAP as efficacy declines with increasing delay
between intercourse and treatment
➢Must receive ECP from a physician
➢No clinical exam, testing or follow up is required.
➢Can be used in women with underlying medical conditions (USMEC
category 1l2 ) There are no medical contraindication to the use of ECPs ,
other than allergy or hypersensitivity to the pill components.

43. - 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
- The incidence and severity of nausea and vomiting decrease
when antiemetic agents are taken one hour before the first
contraceptive dose.
- pregnancy test should be done if there is no withdrawal bleed
within 3 weeks.

46. References

47. Thank you