Contraception

Birth Control
Contraception Contragestion Abortion

Contraception
It refers to a DIRECT and POSITIVE method of preventing conception before, during and after the act of sexual intercourse.

DIRECT METHOD
It is directly willed either as an end of the means or a means to attain another end. Example
Rowena does not want to conceive a child so she takes OCPs Elaine takes OB-GYN Rx for direct motive of healing endometriosis whose S/E is sterility (Double Effect Principle)

POSITIVE METHOD
The means used is deliberately arbitrarily and determinate, and as such, is not part of the natural processes of sexual system, causing frustration of the generative faculty for conception. Example:
Condoms prevent entrance of sperm. It is not part of the natural sexual system

NEGATIVE MTD. VS POSITIVE MTD.

Negative Method
It is which nothing is done that is arbitrarily done to suppress the generative faculty of conception.

Example:
Rhythm Method is a form of periodic abstinence wherein nothing is done to thwart conception.

Different Methods of Contraception

Combined Hormonal
OCPs, Depot Injections, TDDS, Vaginal Rings

Barrier and Behavioral

Condom, Diaphragm, Spermicide

LARCs
Implants and IUD

Sterilization
Vasectomy and Tubal Ligation

Combined Hormonal
Advantages: High efficacy, No need to remember to take a pill (injections), No ed in ovarian cyst or risk of ectopic pregnancy because they inhibit ovulation, rapidly reversible, extra protection built in; serum hormone levels will remain in the contraceptive range for up to 2 additional days (TDDS)

The Pill
Combined Pill
It contains estrogen and progestin

Mini Pill
It contains only progestin taken continuously (used when estrogen is CI

The Pill
MOA:
Suppresses ovulation Thickens the cervical mucus (impenetrable) Alters the endometrium (inhospitable environment)

S/E:
N&V, HA, Weight gain, HPN, impaired vision, increase risk for stroke and heart attack, CA, gallbladder dse., difficulty in conceiving, reduced levels of vitamins, depression

Contraceptive Injection
Depo-Provera
Medroxy-progesterone acetate Couples choice 150 mg injected every 3 to 6 months long acting reversible hormonal contraceptive birth control drug Used in the management of endometriosis

Contraceptive Injection
MOA
Inhibits ovulation by negative feedback on GnRH Prevents implantation

S/E
Disturbs menstrual pattern, delay in occurrence of fertile period, deterioration of carbohydrate tolerance, decrease milk production, depression, reduction of libido, fetal abnormalities

Transdermal Patch
It is a beige-colored patch applied once a week to the abdomen, buttock, upper outer arm, or upper torso (excluding breasts). The patch releases 150 mcg of norelgestromin and 20 mcg of ethinylestradiol to the bloodstream daily to inhibit ovulation. 3 consecutive 7-day patches (21 days) are applied, followed by 1 patch-free week per cycle. The patch contains 9 days of medication.

Transdermal Patch
MOA
Same as the other Hormonal methods

S/E:
Skin reactions, requires thromboembolism Rx, risk for

Vaginal Ring
Vaginal ring is a thin, transparent, flexible ring that contains oestrogen/progestogen hormones that are absorbed through vaginal mucosa. The ring is 92% to 99% effective for pregnancy prevention (typical to perfect use).

Vaginal Ring
MOA:
Same as the other hormonal methods

S/E:
Does not protect against sexually transmitted infections, including HIV/ AIDS, Spotting, Increased vaginal discharge, Nausea

Barrier / Behavioral
This includes condoms, diaphragm/caps, sponge, foams, films, suppositories, coitus interruptus Advantages:
The advantage of these contraceptives is that they need to be used only at the time of intercourse

Condoms
These are thin rubber of latex sheath worn over the erect penis or inserted into the vaginal canal before the intercourse takes place. It is stored in a cool, dry place in order to prevent the deterioration of the rubber It corrodes over at the end of shelf life

Condoms
MOA
It traps ejaculated sperm at the tip thereby preventing it from coursing over the vaginal canal towards the fallopian tube where the ovum is

S/E
Efficiency of 84-85% of the time Failure rate of 36% Condoms have flaws or holes

0.1um

5 um

2.5 um

Diaphragm
A flexible metal ring with rubber in the shape of a shallow dome.

Diaphragm
MOA
Encircles the cervix completely and to prevent the sperm from entering the uterine cavity

S/E
Cystitis, Skin irritation, Increased risk of bladder infection, Toxic shock syndrome

Spermicides
Spermicides are available in many forms including creams, jellies, films, suppositories and aerosol foams.

Spermicides
MOA:
It forms a chemical barrier at the opening of the uterus and prevents the sperm from reaching the egg

S/E
Congenital disorders, Downs syndrome, vaginal irritation and infection

Coitus Interruptus
It is the act of withdrawing the male sex organ from the vagina during sexual intercourse before ejaculation Onanism
Onan spilled his seed upon the groundAnd therefore, the Lord slew him because he did a detestable thing.. Gen. 38:9-10

Coitus Interruptus
MOA
Prevents the sperm form entering the female reproductive system by making ejaculation take place outside of the body.

S/E
Chronic prostate congestion, emotional and psychological imbalances

LARCs
Long-acting reversible contraceptive (LARC) methods are birth control methods that provide effective contraception for an extended period of time without requiring user action.
Implants and IUD

Advantage?

Norplant
Progesterone containing It is implanted under the skin in the upper arm of a woman, by creating a small incision and inserting the capsules in a fanlike shape. Insertion of Norplant usually takes 15 minutes and the capsules can sometimes be seen under the skin, although usually they look like small veins.

Norplant
Norplant
6 rubber rods or capsules; implanted under the skin @ upper arm; lasts for 5 years

Norplant 2
Differs in the size of the rods; lasts for 7 years

Norplant

Norplant
MOA
Suppresses ovulation, thickening of cervical mucus, induces early abortion by barring implantation

S/E:
Lower abdominal pain, vaginal bleeding or ammenorhea, arm pain and infection, migraine, HA, blurred vision, change in lipid metabolism, ovarian cysts, HPN, heart attack, alopecia, liver tumors

IUD
IUD is a plastic device placed in the uterus through the cervical canal which may contain trace metals or hormones to increase efficacy

IUD
MOA
Uncertain Interferes with tubal function

S/E
Chronic endometrial inflammation, perforation of the uterus, fungal infection

Sterilization
This refers to any of a number of medical techniques that intentionally leave a person unable to reproduce. It is a method of birth control.

Sterilization
Surgical
Tubal Ligation Vasectomy Hysterectomy Castration

Transluminal
Essure Procedure