contraception

Dr Husni Samarah
Birth control
To have babies by choice not chance
Birth control
Permenant
Temporary
Birth control
Pearl index = number of failures/
total months of exposure *1200


Life Table Analysis= calculates failure to each
month of use
Birth control
Method effectiveness Best results


Use effectiveness typical results

Oral Contraceptive Pills

Combined oral pills


Mini pills
Oral contraceptive pills
OCP Estrogen Progestins

Mechanism of Action
Ovulation : estrogen inhibits FSH
progestin inhibits LH
Estrogen :potentiates progestin
controls irregular shedding

Containdications : Absolute
Relative

Noncontraceptive Benefits

Use of Minipills

Transdermal and Vaginal Steroid
contraception
Advantages
Avoids first pass through the liver
Safe ?? Awaiting further assesment
Improve compliance
More options provides better family planning

Use
Skin patch once weekly for 3 weeks and 1 week free
Same as OCP concerning all considerations
It delivers E2 20 mcg daily
Norelgestromin 150 mcg daily

Vaginal Steroid contraception
NuvaRing delivers E2 15mcg daily
etonogestil 120 mcg daily

Long-Acting Methods of
Contraception

Implants :Norplant or Implanon

Depot Provera
Indications
Women who desire effective long term
methods
Women in whom estrogen is not accepted
Poor Compliance
Anemia or heavy vaginal bleeding
Breast feeding wanted
Cotraindications
Absolute

ACTIVE Thrombophlebitis
Undiagnosed bleeding
Active liver disease
Liver tumors
Breast cancer
Relative

Smoking heavily
Ectopic pregnancy
Diabetes
Hypercholesterolemia
Hypertension
Stroke
Gallbladder disease
Sever Acne
Migraine headache
Sever Depression
Drugs : hepatic inducers
Intrauterine Device
Historical Background
Types : Unmedicated
Copper IUD
The Hormone-releasing IUD
Mechanism of Action
Mainly uterine cavity
Spermicidal uterine environment
Inflammatory response
Copper effect localy
effect of Progestins
Side Effects
Increased uterine bleeding by 55%
Pain
Amenorhea like Mirena IUD
Patient Selection
IUD Insertion vs removal
Special Situations
Barrier Methods Of Contraception
Historical Background
Risks and Benefits of Barrier Methods
Types
Diaphragm
Cervical Cap
Cotraceptive Sponge
Spermicides
Condoms
Female Condom
contraception

Permenent contraception
Laparatomy
Laprascopy
Hysterscopy