Ob-Gyne Course

1. CONTRACEPTION Dr. Mona A. Almushait Dean, Girl’s Centre Associate Professor, Medical College Consultant, Obstetrics & Gynaecology King Khalid University Abha, Saudi Arabia

2. Methods of Contraception

3. I.Combined Hormonal Products and Progestin–Only Injection and Pills

5. Monthly injections

6. Transdermal patches

9. Thickening of the cervical mucus (to prevent sperm entering the upper genital tract)

10. Other mechanisms:-> slowing of tubal transport -> atrophy of the endometrium

12. Post pill amenorrhea

13. Cerebrovascular accidents

14. Increased in Cholelithiasis (cholestatic jaundice)

15. HTN

16. Benign hepatic tumors (Hepatoma)

18. Venous thrombus (Thromboembolism)

19. Pulmonary embolism

20. Coronary vascular disease, IHD -> cardiomyopathy, vascular heart disease

21. Past cerebrovascular accident

22. Pulmonary HTN

23. Current pregnancy

25. Hepatic tumor or abnormal liver function, Dubin–Johnson or Rotor syndrome, known gallstones

26. Unexplained abnormal uterine bleeding

27. Age >35 and cigarette smoking

28. Uncontrolled hypertension

29. History of melanoma

30. Hyperlipidaemia, focal and crescendo migraine

32. Complicated prolonged Diabetes -> F.H. of DM

33. Estrogen–dependent neoplasm

34. Depression, Hyperprolactinemia

35. Severe varicose veins

36. Hypertriglyceridemia

39. Few women inhibit ovulation

41. Taken at the same time each day

42. Irregular bleeding in the first few months

44. Older women

45. Smokers, immediately post–partum, breastfeeding, risk of DVT, hypertension, migraine, or diabetes, PMS

47. ↑ risk of ectopic pregnancy

48. Acne, headache, breast tenderness, nausea, irregular bleeding

49. Weight change

52. Failure rates of 3% to 9%

55. Serum level of DMPA is higher than with implants and IUDs

56. DMPA

57. Suppresses gonadotropins to inhibit ovulation

58. Change cervix mucus (thickening)

59. Twining endometrium

60. Good for women using anticonvulsants which increased hepatic clearance of sex steroids

61. The majority of women develop Amenorrhea

62. Ovarian suppression

64. No need to remember to take a pill

65. Use when oestrogen contraindicates

67. ↑ risk of Osteoporosis due to long term Medroxy progesterone acetate

69. Severe arterial disease

70. Undiagnosed vaginal bleeding

73. The patch releases 150 mcg of norelgestromin and 20 mcg of ethinylestradiol to the bloodstream daily to inhibit ovulation.

75. Rapidly reversible

76. Excellent cycle control by 3 months of use

77. Easy to use, start, and stop

79. Concern about visibility of patch for some women

80. Possible skin reactions

81. Slight increase in risk of VTE compared with COCs

84. The ring is 92% to 99% effective for pregnancy prevention (typical to perfect use).

85. It stops ovulation and thickens the cervical mucus.

87. Can be worn for three weeks

89. Spotting

90. Increased vaginal discharge

95. ↓transmission of STD, HIV, Chlamydia and Gonorrhea

97. Loss of sensation or pleasure

100. They must be filled and coated with spermicide and inserted before intercourse.

101. 84% to 94% effective for pregnancy prevention.

103. Protection from sexually transmitted infections

105. Skin irritation

106. Increased risk of bladder infection (diaphragm only)

109. No hormonal side effects

110. Can be used by people with latex sensitivities

112. Friction/noise during intercourse

113. Loss of sensation

116. Jellies come in tubes and are usually used with a diaphragm or cervical cap.

121. It has two effects:

122. It kills or destroys sperm which is why it is called spermicidal.

127. The film is placed in the vagina on or near the cervix where it dissolves in seconds.

130. Major components:Nonoxynol–9

131. Traits: White or milky white torpedo suppository

133. Tracking basal body temperature ↑0.5% (7 days before and 2 days after)

136. Implanon

138. Have low circulatory levels of progestin

139. Constant serum level -> contraceptive effects

140. Suppress ovulation and change cx mucus

141. Twining endometrium

143. Weight gain

144. Hair or skin changes

145. Headaches

146. Depression

149. 20 µg of Levenogestrel every 24-hr.

150. T–shape

152. Twins the endometrium->atrophic endometrium

153. Inhibition of ovulation

154. Amenorrhea for 2–3 months after irregular bleeding

155. Fertility returns immediately on removal

156. ↓ Dysmenorrhea

157. ↓ PID

158. ↓ E.P.

160. ↑ functional ovarian cyst

162. Active liver disease

163. Severe arterial disease

164. Undiagnosed irregular bleeding

165. Mechanical heart valves

166. Untreated STD

169. Motility is severely compromised and the ability of the sperm to fertilize the egg is inhibited by the presence of copper ions.

170. Inflammatory changes to prevent implantation.

171. I.U.C.D. inserted in the first 7 days of cycle

172. With antibiotics cover Azithromycin 1g single dose and Doxycyclone 100g

173. Pregnancy with I.U.C.D.

176. ↑ PID

177. Perforation and expulsion

178. Actinomycosis->cx smear

180. Labile hypertension

181. Advanced diabetes

182. Hepatic failure

183. Migraine with aura

186. Mini laparotomy sterilization

188. Requires surgery

189. Has risks associated with surgery

190. May not be reversible

191. Possible regret

193. Immediately effective

194. Requires no daily attention

195. Not messy

197. Bleeding

198. Scrotal pain or swelling at the time of the procedure There are no long–term hormonal, metabolic, or autoimmune effects associated with Vasectomy.

199. Thank You !