GYNE How does it work?

Contraception and Sterilization Hormonal contraceptives

Dr. Ababon  Oral contraceptive pills
 Contraceptive patches
Earth: A crowded place  Injectables
 Subdermal implants
Family planning methods  Spray-on contraceptives
 Permanent methods Intrauterine devices
o There are two types of permanent methods or Nuva ring
sterilization, namely: Barrier methods
 Bilateral tubal ligation  Male condoms
 Vasectomy  Diaphragm
 Classic
 No scalpel vasectomy What method is best for me?
 Temporary methods Indications
o The two main temporary methods of  Adolescents
contraception are the following: o Low dose pills at least two years after puberty
 Natural FP methods o Injectables (depo-MPA)
 Fertility-based method o Local spermicides
 Artificial FP methods  Under 35 years old
 Hormonal o All forms or methods may be used but depends
 Barrier on different conditions
 Over 35 years old
What do you think is happening in the reproductive tract of a o Sequential progestins to compensate for luteal
woman every cycle of her life? insufficiency
 Pre-menopausal women
o Continuous progestins to treat luteal
insufficiency, mastopathies, and endometrial
hypertrophies
 Post-partum women
o Minidose combined OCPs
o Injectables (depo-MPA)
o Local spermicides
o Lactational amenorrhea method (LAM) for 6
months only
Contraindications
 Intrauterine device
o Are not recommended for adolescents
o Should not be used when the uterus is
retroverted
o Should be avoided in cases of local infections
o Should not be performed by non-experts

Standard days method How will it affect me?

Symptothermal method ORAL CONTRACEPTIVE PILLS
 Basal body temperature Advantages:
 Billings ovulation method  Very efficient when used correctly
 Does not interrupt sex
Why does continuous breastfeeding prevent pregnancy?  Increased sexual enjoyment
 Light, regular monthly periods
 Reversible
 Can be used by women at any age or parity
 Non-contraceptive benefits, prevents:
o Endometrial cancer
o Ovarian cancer
o Pelvic inflammatory disease
o Benign breast disease
o Iron-deficiency anemia
o Dysmenorrhea
Disadvantages
 Need to take the pill everyday
 Not recommended for breastfeeding women (combined
Lactational amenorrhea method OCP)
 Does not protect against STIs
INJECTABLE CONTRACEPTIVES FERTILITY-BASED METHODS
Advantages Advantages
 Private  No physical side effects
 Can be use by breastfeeding women  Very little or no cost
 No estrogen side effects  Can be used by most couples
 No daily pill-taking  Effective if used correctly and consistently
 Allows some flexibility in return visits (2 weeks early or 2  Immediately reversible
weeks late)  Acceptable to some religious groups
 Does not interrupt sex  Involves men in family planning
 Increased sexual enjoyment Disadvantages
 Long-term pregnancy prevention but reversible  Usually somewhat effective
 Other health benefits, prevents  Will not work without cooperation commitment of both
o Endometrial and ovarian cancer couples
o Uterine fibroids  Requires daily recording and close attention to body
o Iron deficiency anemia changes
o Pelvic inflammatory disease  May require long periods of abstinence
Disadvantage  Does not protect against STIs
 Delayed return of fertility of about 8-10 months after its
contraceptive effects Issues and choices
 Requires regular injections every 3 months (DMPA) or 2
months (Noristerat) Quiz: essay
 Does not protect against STIs including AIDS
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CONDOMS
Advantages
 Private
 No daily pill-taking
 Can be used whenever it is needed
 Cheap and readily available everywhere
 Non-contraceptive benefits, prevents
o STI effectively
o Conditions caused by STIs (PID, ectopic
pregnancy, infertility)
Disadvantages
 Interferes with sex
 Supply must be ready at all times
 Possibility that the condom will slip off or break
 Condom can weaken and tear if not stored properly
 Man's cooperation is needed for the woman to protect
herself from pregnancy and disease
 Embarrassing for some people to buy, ask partner to use,
take or throw away

INTRAUTERINE DEVICE
Advantages
 Effective long-term prevention of pregnancy
 Easy to use and does not interfere with sexual intercourse
 Increased sexual enjoyment because no need to worry
about pregnancy
 Has no systemic, hormonal side effects
 Provides immediate return to fertility upon removal
 Can be used during breastfeeding
 No interactions with medications
Disadvantages
 Client cannot start or discontinue IUD use on her own
 May be expelled
 Need to check the position of the IUD strings from time to
time
 May increase the risk of pelvic inflammatory disease (PID)
 Does not protect against STDs