contraception, hormonal contraceptive, IUD, Subdermal implants, sterilization, emergency contraception, lactational amenorrhea, natural methods, injectable contraceptive, COCs, POPs

1. BY
Magdy Abdelrahman Mohamed
2015

2.  1- Natural ( physiological).
 2- Mechanical.
 3- Chemical.
 4- Hormonal.
 5- Surgical (sterilization).
Barrier
Except
IUD

4.  Safe.
 100% effective.
 Free of side effects.
 Easily obtainable & cheap.
 Acceptable to the user and sexual
partner.
 Free of effects on future pregnancies.

6.  Abstinence.
 Coitus interruptus (withdrawal).
 Periodic abstinence ( fertility awareness
based methods, safe period).
 Lactational amenorrhea ( LAM ).

7.  Very old.
 Disadvantage:
 Lack of self control.
 Pre-ejaculatory fluid contains sperm.
 High failure rate ( 20% in typical use & 5 % in
perfect use).

8.  Based on understanding ovulatory cycle.
 Cooperation is very important.
 Free, safe, and acceptable to all religions.
 25% of women will experience unintended
pregnancy in first year (typical use).
 Some women combine with barrier methods
(use during fertile periods).

9.  Bellagio consensus (1989).
 Exclusive breastfeeding.
 Lactational amenorrhea.
 1st 6 months postpartum.

10. Mechanism
 Increase prolactin.
 Supression of gonadotrophin & anovulation.
 Luteal phase insufficiency.

12.  Barrier methods.
 Male condom.
 Female condom.
 Vaginal diaphragm.
 Cervical cap.
 Intrauterine contraceptive device (IUCD).

15.  Advantage:
 Protect against sexually transmitted disease.
 No systemic side effects.
 Disadvantage:
 High failure rate.
 Interfere with sexual intercourse.

16. IUD is the world's most widely used
method of reversible birth control.
1- Inert ( no longer recommended because
of painful and heavy periods).
2-Copper Releasing.
3-Progesterone Releasing (IUS):
A-Progestasert (progesterone T) 1976 -
2001.
B-Mirena (levonorgestrel).

17. -Suspected pregnancy.
-Post partum puerperal sepsis.
-Immediately post-septic abortion
-Undiagnosed abnormal vaginal bleeding.
-Suspected gynecological malignancy.
(Cervical cancer, Endometrial cancer)
-Current STDs.
-Current PID.
-Anatomical abnormalities.

18.  Causes:
 Detached threads or hidden in the cervix.
 Expulsion.
 Perforation.
 Pregnancy.
 Investigations:
 TVS.
 X-ray.

20.  In the form of tablets, creams, jellies--- etc.
 Contains a spermicidal agent like nonoxynol-9.
 Applied 15-30 min before intercourse and not
washed before 6 hrs. postcoital.
 Can be used alone or with other barrier methods
to enhance their effectiveness.

23.  Oral:
 Combined oral contraceptives (COCs).
 Progesterone only pills (POPs).
 Injectable:
 Progesterone only ( depo-provera).
 Combined.
 Subdermal implant.
 Vaginal rings.

25.  Start on the 1st 5 days of the cycle
regularly every day.
 21 days 0n, 7 days off.

26.  Highly effective if used correctly.
 Rapid return of fertility after stoppage.
 Suitable for nulligravida and newly
married couples.
 Completely controlled by the woman
and can be stopped at any time unlike
other methods (IUD & Implants).
 Not interfere with sexual intercourse.

27. 1-The need for daily use.
2- GIT:
 Nausea and vomiting.
 Increased incidence of gall bladder stones).
3-Central nervous system:
 Headache and migraine.
 Mood changes: depression, irritabilty.
4- Not suitable for breast feeding.

28.  < 6 months postpartum if breastfeeding.
 Smoker over the age of 35.
 Hypertension (systolic ≥ 160mm Hg or diastolic
≥ 100mm Hg).
 Current or past history of venous
thromboembolism (VTE).
 Ischemic heart disease.
 History of cerebrovascular accident.

29.  Start on the 1st 5 days of the cycle or
after 6 weeks postpartum.
 Daily tablet at the same time every day
without discontinuation.
 Woman consider herself fertile for the
first week of use.

31.  Suitable when breast feeding.
 Suitable when estrogen is
contraindicated.
 Immediate return of fertility.
 Less likely to cause metabolic
disturbances.

32.  Must be taken daily at the same time.
 Less effective than COCs.
 More likely to cause menstrual
irregularities.

33. Progesterone only ( Depo-provera).
 Every 3 months.
 Advantage:
 Highly effective.
 No daily use
 Not interfere with sexual intercourse.
 Disadvantages.
 Delayed return of fertility.
 Wt gain.
 Osteoporosis ( esp. in long term use)

35. Mesigyna:
 Norethinderone
enanthate 50 mg +
estradiol valerate 5
mg.
 Used every month.

36.  Need trained personal for insertion and
removal.
 Out patients procedure.
 99.5% effectiveness rate.
 good compliance.
 Amennorhoea is common.

37.  Types:
 Norplant (6 rods).
 Implanon (one rod).

40.  Vasectomy in males.
 Tubal ligation in females.

42.  Can be used within 72 hour after
unprontected intercourse:
 Examples:
 Levonorgestrel 0.75 mg.
 IUCD.
 Mifepristone ( progesterone antagonist).