Contraception

Contraception :-

Contraception is the intentional prevention of pregnancy by artificial or nature means.contraception allows people to attain their desired number of children and to determine the spacing of pregnancies by delaying or preventing childbearing. 

Methods of contraception :- 

There are two methods of contraception 

1.Temporary method

2.Permanent method

TEMPORARY METHODS 

1.Barrier methods

1.1 Physical barrier

A. Condom :- condom are made of polyurethane or latex. Polyurathane condoms are thinner and suitable to those who are sensitive to latex rubber. It's used by the male. 

B. Femidom :- It's a pouch made of polyurathane which lines the vagina and also the external genitalia. 

C. Diaphragm :- It is an intravaginal device made of latex with flexible metal or spring ring at the margin. 

1.2. Chemical methods 

Spermicide -microbicide combination supports the natural defense maintaining the acidic pH and acts as antimicrobial. The agents containing surfactant , destroy the sperm membrane and also the outer envelops of the virus and bacteria. 

1.3.Combined

2. Natural contraceptives

3. Intrauterine contraceptives devices ( IUDs) 

Classification :-

 1.Non-medicated IUCDs : lippes loop 2.Medicated copper containing IUCDs :

Cu T -380 :- It's a medicated device containing copper. It carries 380mm square of copper in total. The device is replaced every 10 years. 

Multiload -375:- It has 375mm square surface area of copper wire wound around it's vertical stem. Replacement is every 5 years. 

Cu T-200 :- This device is to be replaced every 3 years 

  3.Hormone containing IUCDs : levonorgesterol intrauterine system (LNG-IUS) (Mirena) :- it's induces strong and uniform suppression of endometrium. Cervical mucus becomes very scantly. It decrease tubal motility. 

4. Hormonal contraception :-

A. Oral contraceptives :- 

Oral contraceptives are medicine taken by mouth to help prevent pregnancy . They are also known as’’ birth control pills”

Types:-

1.Progesteron only pills

2. Estrogen only pills

B. Depots

(i) Injectable DMPA

Mechanism :- 

1.Inhibition of ovulation by suppressing the mid cycle LH peak

2. Making cervical mucus thick and viscous thereby prevent sperm penetration. 

3.Endometrium is atropic preventing blastocyst implantation

Advantages :-

1.It eliminates regular medication as imposee by oral pills

2.Menstrual symptoms eg. Menorrhagia, dysmenorrhea are reduced 

3. It can be used safely during lactation. It probably increase the milk secretion without altering it's composition.

 

Disadvantages :-

Loss of bone mineral density has been observed with long term use of depot provera. 

(ii) Implants 

Advantages :-  Highly effective for long term use and rapidly reversible. 

2.Permanent methods

A. Tubectomy :- It is an operation where resection of a segment of both the fallopian tubes is done to achieve permanent sterilization. 

B. Vasectomy  :- it's a permanent sterilization operation done in the male where a segment of bas deferens of both the sides are resected and the cut ends are ligated.