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Hormonal and Surgical Contraception

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Presentation on theme: "Hormonal and Surgical Contraception"— Presentation transcript:

1 Hormonal and Surgical Contraception

2 Learning Objectives Combination Oral Contraceptive Pills
Progestin Only Contraceptive Pills Injections and Implants Patches and Rings Emergency Contraception Surgical Sterilization

3 Average Failure Rates (%) During the First Year of Use of a Contraceptive Method
Methods Average NORPLANT SYSTEM Male sterilization Female sterilization 0.5 Depo-Provera (injectable progestogen) 0.3 Oral contraceptives 5 IUD Progesterone Copper T 380A Condom (male) without spermicide 14 (female) without spermicide 21 Cervical cap Never given birth 20 Given birth Diaphragm with spermicide 20 Spermicides alone 26 Periodic abstinence (all methods) 25 Withdrawal No contraception (planned pregnancy) 85

4 Combination Oral Contraceptive Pills
Components Mechanisms of Action Health Risks Non-contraceptive Benefits

5 Formulations

6 Components through time
Ethinyl Estradiol Norethindrone Levonorgestrel Desogestrel Norgestimate Gestodene

7 Mechanism of Action Inhibition of ovulation Cervical mucus changes
Endometrial changes Tubal motility changes

8 Advantages Reliable Convenient Discreet

9 High Dose OCP Risk Heart Disease Thromboembolic Disease (blood clots)
Glucose intolerance (diabetes) Liver cysts Breast and Cervix Cancer?

10 Modern Health Risks Slight increase in blood clot formation
Gallbladder disease Heart disease in smokers over age 35

11 Non- contraceptive Benefits
Menstrual regulation Protects against cancer Improves acne and hirsutism Decreased breast and ovarian cysts Better sex

12 Non- contraceptive side effects
Nausea Menstrual changes (spotting, amenorrhea) ??weight changes?? Minimal impact on lactation

13 Progestin only Pill “The Mini Pill”
Less cycle control (often periods stop with time) Slightly higher failure rate Fewer health risks

14 Depo Provera 150 mg shot every 12 weeks
Progestin only side effect profile Duration unpredictable

15 Norplant Levonorgesterel Surgically implanted and removed
Good for 5 years Same side effects as other progestin only methods

16 Emergency Contraception
Reduces risk of pregnancy after unprotected intercourse by at least 74% No medical contraindication (except pregnancy) Must be within 120 hours 2 doses, 12 hours apart

17 Preven: estrogen + progestin
Plan B: progestin only

18 IUDs Mirena Progestasert Paragard

19 Male Hormonal Contraception?
Most methods suppress LH/FSH and then replace testosterone GnRH or progestin Implants, shots, pills Inject vas deferens with polymer Anti-sperm compounds Anti-sperm vaccine

20 Male Surgical Sterilization: Vasectomy
Outpatient surgical procedure .1% failure rate No impact on sexual functioning No known long term health risks

21 Female Surgical Sterilization
Electrocautery Silastic band Cut and tie Clip Springs

22 Average Failure Rates (%) During the First Year of Use of a Contraceptive Method
Methods Average NORPLANT SYSTEM 0.05 Male sterilization Female sterilization 0.5 Depo-Provera (injectable progestogen) 0.3 Oral contraceptives 5 IUD Progesterone Copper T 380A Condom (male) without spermicide 14 (female) without spermicide 21 Cervical cap Never given birth 20 Given birth 40 Diaphragm with spermicide 20 Spermicides alone 26 Periodic abstinence (all methods) 25 Withdrawal 19 No contraception (planned pregnancy) 85


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