1. 1 Contraception and antifertility Renata Vesela renata.vesela@pharm.gu.se

2. Methods:  Hormonal  Natural methods  Barrier methods  Chemical methods  Intrauterine device (IUD)  Sterilization  Condom

3. Hormonal  Three main mechanisms of action: 1. inhibition of ovulation 2. thickening of cervical mucus 3. an alteration of the endometrium  Progestins (gestoden, desogestrel,…) and estrogens (ethinylestradiol or mestranol)  Mono-phase  Combined

4. Hormonal Effects of progestin:  Inhibition of ovulation by suppressing luteinizing hormone (LH)  Thickening of cervical mucus, thus hampering the transport of sperm  Possible inhibition of sperm capacitation Effects of estrogen:  Alteration of secretions and cellular structures of the endometrium within the uterus

5. Hormonal- types:  Oral  Monthly injection  Transdermal patch  Vaginal ring (the hormones are absorbed by the vagina)

6. Hormonal- progestin only  Oral: Mini-pill, exact same time of pill administration required  Injection:  Emergency contraception (morning “after” pill)- usually progestin only, but can be also a combination

7. Natural methods  Intermittent intercourse  Counting of fertile and infertile days  Control of the mucus  Method of sexual abstinence  Measuring of basal temperature

8. Barrier methods  Vaginal diaphragm  Cervical cap

9. Chemical methods  Spermicide gels, creams and foams  Mechanism: inserted into a woman's vagina to kill or disable sperm thus preventing a sperm from fertilizing an egg

10. Intrauterine device (IUD)  Mechanism of action: two types: a copper IUD progestin-impregnated progestin intrauterine system (IUS)  have multiple mechanisms of action that provide for contraceptive protection  Both IUDs can alter the uterine lining so that it becomes unfavorable for implantation  Release of copper ions- alters fluid in the uterine cavity in a manner that impairs the viability of sperm, thereby inhibiting fertilization. This mechanism may be responsible for the high efficacy of copper IUDs as emergency contraception.

11. Intrauterine device (IUD)

12. Female sterilization

13. Male sterilization

14. Condoms  Usually made from latex  Protection against Sexually Transmitted Diseases(STDs)!!!  Protection against Sexually Transmitted Diseases (STDs)!!!

15. Thank you for your attention  Pictures adapted from: http://www.google.se/imgres?imgurl=http://www.mhhe.com/socscience/sex/commo n/ibank/ibank/0117.jpg&imgrefurl=http://www.mhhe.com/socscience/sex/common/i bank/set-6.htm&usg=__EClGEzM73xP3fSc- 0rIo8vdXxic=&h=480&w=640&sz=86&hl=sv&start=5&itbs=1&tbnid=a0aI3AdHdKS ReM:&tbnh=103&tbnw=137&prev=/images%3Fq%3Dvaginal%2Bdiaphragm%26hl %3Dsv%26sa%3DG%26gbv%3D2%26tbs%3Disch:1