Istoria contraceptiei

#7.
Mercury

Ah, delicious, hot mercury. From the old days when it was considered a cure for
almost everything, to the future when we'll make terminators out of it, mercury
never goes out of style.
Several thousand years ago in China, somebody logically came up with the idea
of using mercury as birth control. Why not? After sex, women would do some
shots of mercury, and we like to think they called it "Riding the Quicksliver
Pony," then voila, no pregnancy. There may have been some sterility, brain
damage and kidney failure, of course, but stopping the baby was the main thing.
This was China, after all.

Read more: http://www.cracked.com/article_16039_historys-10-most-

Diafragme din opiu
Contraceptia hormonala
Contraceptivele orale combinate
Pilula numai cu progesteron
Combinate
Implante subcutanate
Inele vaginale
Diu
 Contraceptia hormonala combinata
Etinil estradiol 50 , 35 ,30 ,20 ,15 EE
Progestageni sunt derivati de 17 alfa hidroxi progesteron sau 19 nor
testosteron:
-prima generatie noretisteron
-a doua generatie (gonani)
-a treia generatie levonorgestrel:desogestrel , gestoden , norgestimat
Monofazice sau multifazice in functie de raportul de estro geni si
progesteron
Gonadotropin releasing How hormonal
hormone (GnRH) triggers
release of gonadotropins contraceptives
FSH & LH
work
FSH & LH trigger
ovulation


Estrogen & progesterone in
hormonal contraceptives
inhibit LH, FSH, and GnRH
secretion, preventing ovulation

 Progesterone also:
•thickens cervical mucus to prevent
Passage of sperm into the uterus
•changes uterine lining to inhibit implantation
 Efectele estrogenilor
-caractere primare si secundare feminine
-trofic genital
-creste libidou
-cresterea cantitatii si filantei mucusului
cervical
-scade lipemia , creste HDL
-creste retentia de sodiu si apa
-favorizeaza colestaza
-creste sinteza hepateica de SHBG
 Efectele progesteronice
-Maturarea endometrului
-cresterea vascozitatii mucusului cervical
-pierderea cililor tubari
-scaderea libidoului
-cresterea temperaturii bazale
-efect androgenizant (desogestrel si nor
gestimat au efecte reduse)
 Avantajele COC
• Scade durata si fluxul mestrual
• Normalizeaza ciclurile
• Protectie fata de cancer de endometru si de
ovar si boli benigne san si ovar
• Scade incidenta artritei reumatoide
• Scade incidenta SEU si BIP
 Dezavantaje minore COC
• Spotting
• Amenoree
• Greturi si varsaturi
• Crestere in greutate
• Cefalee vertij
• Scadere libidou
• Candidoza vaginala
• Galactoree
 Dezavantaje majore COC
• Trombo embolie , ATS
• Litiaza biliara
• San?
 Contraindicatii permanente ale COC
• Boli circulatorii prezente sau in antecedente :
-tromboze,hiperlipemii, interventii pe pelvis, os ,
imobilizari, boli valvulare, antecedente avc
.boli ale ficatului
.sarcina
.sangerari nediagnosticate
.neoplasme estrogen dependente
.frica
 Contraindicatii temporare ale coc
• Factori de risc izolati pt boli cv.hta ,fumat,
obezitate, dz, varsta inaintata
• Migrena
• Imobilizare partiala prelungita
• Hiperprolactinemia
• Depresia severa
• Conditii care impiedica absorbtia coc
• Boli cronice.chron, dz, boli renale
 Pop-progesteron only pills
• Indicatii-contraindicatii coc, alaptare,
obesitate, migrene, hta,fumatoare
• Mod de actiune:atrofie endometru , inhiba
ovulatia, modifica glera
• Contraindicatii :cancer de san, sangerari
anormale,suspiciune de cancer san, hta,ciroza,
boli cv sau coronariene,varice
• Dezavantaje:sangerari,amenoree,eficienta
scazuta
 Contraceptive injectabile cu
progesteron
• Depo-provera, noretisteron
• Indicatii:alaptare, ieftin,uita,peste 35,
fumatoare
• Contraindicatii:cancer san sau genital,
sangerari anormale, ficat, bcv, dz cu afectare
vasculara
Contraceptive injectabile combinate
 Implante subdermale
• Norplant –levonorgestrel 5 ani
 Inele vaginale

• e/p 21 zile nuvaring

• P 3 luni alaptare
 Contraceptia de urgenta

• Pilula combinata 72 ore

• Insertia diu. 5zile
• Progesteron postinor,
• escapelle
• Antiprogesteronic –ulipristat acetat- escapelle
 Contraceptia intrauterina
• Cupru ,aur,argint,mirena ,plastic
• Spirale, cercuri ,t
• Moment insertie: menstra, 6-8 sapt
postpartum
• Indicatii:
• contraindicatii
 Contraindicatii diu
• Bip
• Sarcina
• Fibroame
• Sangerari, dureri anormale
• Nuligeste
• Boli cv sau de hipocoagulabilitate
• Corticoterapia
• Dz
• Alergii
• imunocompromise
 Complicatii diu
• Sangerari
• Dureri 10%
• Expulzia
• Sarcina
• Bip
• perforatia
 Contraceptia de bariera
• Prezervativul masculin<latex, poliuretan
avantaje:oricand, oriunde, ieftin , protectie de
bts,scade riscul ejacularii precoce
Dezavantaje:alergii,
• Prezervativul feminin
• Diafragma
• Cupola cervicala
• Spermicide nonoxinol
• Burete vaginal
 Planificarea familiala naturala
• Metoda calendarulul
• Temperatura bazala
• Mucus cervical
• simptotermala
 Metoda calendarului
• Indicatii :ciclu regulat ,cuplu stabil
• 12-16+-4
 Metoda temperaturii bazale
• Efect hipertemiant al progesteronului
• Dezavantaj:durata mare , conditii de viata
• Grafic
• 3zile de temperatura crescuta cu 0,2-0,5 grade
 Metoda mucusului cervical
• Indicatii:fara bip,
• Dezavantaje:disconfortul la propria explorare
• Modificarea consistentei si cantitatiimucusului
cervical
no unprotected
intercourse

Early Transitional Highly Fertile

Mucus Mucus Mucus

• Slight amount • Increasing • Profuse

• Thick amounts • Thin
• White • Thinner • Transparent
• Sticky • Cloudy • Stretchy
• Holds its shape • Slightly stretchy
 Metoda simptotermala =combinate
• N-20
 Metode fiziologice
• Alaptarea
• Coit intrerupt
• Nursing
– amenorrhea is common for a brief period after birth while
breastfeeding
– 80% of women ovulate before first period (and so do not know
that they are fertile)
• Withdrawal before ejaculation
– difficult to judge when to withdraw
– anxiety may lower pleasure for both partners
– Cowper's gland fluid may carry sperm
– any sperm on vulva may travel into vagina/uterus
• Douching
– sperm reach uterus in 1-2 minutes
– douching may speed sperm along
– irritates vaginal tissue
 Amenoree de lactatie
• In primele 2-3 luni postpartum
• Daca se alapteaza fara supliment
• Inhiba ovulatia
• Amenoree
• Nu e sigura
 Coit intrerupt
• 20% rateu
• Cooperare partener
• Avantaj –ieftin
• Dezavantaj:nu protejeaza de bts
 Contraceptia chirurgicala
• Indicatii:medicale, obstetricale,genetice
• Dezavantaje:definitiva
• Timp:postpartum sau la interval
• Complicatii:psihologice,sarcina
Vasectomia – sterilizarea masculina
Vasectomia este o procedura chirurgicala ce presupune realizarea unei mici incizii in partea
superioara a scrotului unui barbat.
Noi directii in contraceptia masculina

The “male pill”: Testosterone & progestin may

lower sperm count
New forms of reversible vasectomy
Injection of a blocking gel into vas
deferens; gel is dissolved to reverse the
procedure
Insertion of two plugs into each vas
deferens--can be removed later