CONTRACEPTIVES

DRUGS
Prepared By Dr Saima Siddiqui
CONCEPTION
• It is the fertilization of a female ovum by a male sperm.
Every 28 days, in an adult female, one ovum leaves the
ovary and is directed into fallopian tube by the fimbriael
end, which passes along with the tube.
CONTRACEPTIVES
• Contraception=against conception
• it is the voluntary prevention of pregnancy, a process with
individual and social implications. Contraception (birth
control) prevents pregnancy by interfering with the normal
process of ovulation, fertilization, and implantation. There
are different kinds of birth control preventive methods to
help women avoid unwanted pregnancies are called
contraceptive methods, that act at different points in the
process.
Need for contraception
• To avoid unwanted pregnancies
• To regulate the timing of pregnancy
• To regulate the interval between pregnancy
Ideal contraceptive???
• Safe
• Effective
• Acceptable
• Reversible
• Inexpensive
• Long lasting
• Requires little or no medical supervision
 Methods Of Contraception
1)Behavioral
2)Hormonal
3)Barrier/ Spermicides
4)Terminal methods/ Long-Term
Behavioral Methods

• Predicting fertility:
• Basal Body Temperature & Calendar method
• Withdrawal/Coitus Interrupts
• Basal Body Temperature
• lowest temp of the body at rest
• Ovulation raises body temp ½ - 1 degree F, and temp will
drop if fertilization does not occur
• Calendar method
• Predicting fertility based on menstrual cycles
• Women chart previous menstrual cycles to predict the
days they are fertile and infertile
• Withdrawal/Coitus Interruptus
• The man takes his penis out of the vagina before he
ejaculates
• Depends on a male’s self knowledge and self control
Hormonal Methods
• The Pill (OCP)
• The Patch
• Vaginal Ring
• The Shot
• Implant
• IUD (Intra Uterine Device)
• Emergency Contraception
• These methods add chemicals similar to hormones to
stop the release of an egg and weaken the sperm.  The
hormones change your cervical mucus and uterine lining,
slow sperm, and reduce ability of fertilized egg to implant
into uterine wall.
Hormonal contraceptives
• Combined pill: -combination of estrogen and
progestogen -MALA-N,MALA-D(0.15mg levonorgestrel &
0.03mg ethinyl estradiol)
• Prgestogen only pill :-used in people above 40 years of
age & CVS problem
• Post coital contraception: -Levonorgestrel -Ullipristal -
Mifepristone
• The Pill (OCP):-A pill taken orally every day at about the
same time, Your period can occur monthly, every 3
months, or not at all effectiveness 91-99.7%.
• The Patch:-
• A bandage-like patch that sticks to your skin changed
weekly hormones (progestin and estrogen) are absorbed
through the skin less effective if your weigh over 198
pounds.
• Vaginal Ring:- A clear, soft, flexible 2 inch circle
worn in the vagina , the vaginal ring contain same
hormone (progestin and estrogen) The body
absorbs hormones from the ring through vaginal
wall. The ring is inserted and left in the vagina for
3 weeks , effectiveness 91-99.7%.
• The Shot (Depo-Provera)
• A long acting hormone injection it contain
progestin female is given a shot one time every 3
months
• Not reversible- once the injection occurs, the
hormones are in the woman for at least 3 months.
It may take a long time to get pregnant after the
shot. More chance of weight gain than any other
method, effectiveness 94-99.8%.
• Implant :-A soft rod 1 ½ inches long placed under
the skin in your upper arm. Slowly releases
hormones into your system.it contains the form of
the hormone progesteron called etonogestrel.
• Prevents pregnancy for 3 years, but can be taken
out at any time effectiveness: 99.95%.
• Intra Uterine Device (IUD):-
• A small plastic “T” with a string inserted into the uterus .
Releases synthetic progestin hormone that changes
cervical mucus, fallopian tubes and the uterine lining.
Stops or slows sperm and egg. Lasts 5 years. Insertion
can cause a few minutes of pain, but removal is fast and
easy effectiveness: 99.8%.
• Timing Of IUD Insertion:-
• At the time of menstruation
• Post Partum, Post Puerperal
• Side Effects:
• 1)Bleeding
• 2)Pain
• 3)PID
• 4)Perforation of uterus
• 5)Ectopic pregnancy
• Emergency Contraception:-
• ( EC-Morning After Pill)
• A pill or combination of pills take after sex to prevent
pregnancy . High doses of combined oral contraceptive
containing ethylestradiol and levonorgestrol of the same
hormones found in regular birth control pills , Won’t stop
an existing pregnancy. Effectiveness: Approx. 95% if
taken within first 24 hours of unprotected sex.
Adverse effects
• Cardiovascular effects
• Carcinogenesis
• Metabolic effects
• Liver adenomas
• Weight gain
• Breast tenderness
Barrier methods
• Male condoms
• Female condoms
• Diaphragm / Cervical Cups
• Spermicides
• Male condoms
• A thin covering that unroll over an erect penis.
• Made of latex or animal membrane ( protect against
STD). Effectiveness: 82-98%
• Female condoms
• A soft, loose pouch that is inserted in the vagina. Flexible
rings at each end hold it in place. Can be put in up to 8
hours before sex.
• Effectiveness: 79-95%
• Diaphragm / Cervical Cups
• A soft, silicone dome that covers the cervix w/ a flexible
rim that holds spermicide. Effectiveness: 82-94%
Spermicides
• Spermicides are surface active agents which attach
themselves to spermatozoa and kill them. Effectiveness:
72 -91 %.
• Available in various forms like
• 1. Foams
• 2. Creams
• 3. Suppositories
• 4. Soluble films
Terminal methods-Long Term
• Permanent methods
• One time method

• Guidelines
• Husbands age:25-50 years
• Wife’s age:20-45
• 2 living children at the time of operation

• Types:-
• 1)Male Vasectomy
• 2)Female Tubal Ligation
• Tubal Ligation (Female)
• A small incision is made in the abdomen to access the
fallopian tubes. Fallopian tubes are blocked, burned, or
clipped shut to prevent the egg from traveling through the
tubes. Recovery usually takes 4-6 days
• Vasectomy (Male)
• A small incision is made to access the vas deferens, the
tube the sperm travels from the testicle to the penis, and
is sealed, tied, or cut. After a vasectomy, a male will still
ejaculate, but there won’t be any sperm present
Thank You