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Prepared by: Mrs Raheegeh Awni 10/5/2014

Prepared by: Mrs Raheegeh Awni 10/5/2014. SPERMICIDES. Spermicides, are available as creams, jellies, foams, vaginal film, and suppositories, are inserted into the vagina before intercourse. They destroy sperm or neutralize vaginal secretions and thereby immobilize sperm.

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Prepared by: Mrs Raheegeh Awni 10/5/2014

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  1. Prepared by: Mrs Raheegeh Awni 10/5/2014

  2. SPERMICIDES • Spermicides, are available as creams, jellies, foams, vaginal film, and suppositories, are inserted into the vagina before intercourse. • They destroy sperm or neutralize vaginal secretions and thereby immobilize sperm.

  3. Spermicides that effervesce((ينفعل in a moist environment offer relatively rapid protection, and coitus may take place immediately after they are inserted.

  4. Suppositories may require up to 30 minutes to dissolve and will not offer protection until they do so. • The woman should be instructed to insert these spermicide preparations high in the vagina and maintain a supine position.

  5. Spermicides are minimally effective when used alone, but their effectiveness increases in conjunction with a diaphragm or condom. The major advantages of spermicides are: • wide availability and low toxicity

  6. disadvantage • allergic reactions to spermicides • Skin irritation • do not offer protection against the organisms that cause gonorrhea and chlamydia, or against the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS) (Centers for Disease Control and Prevention [CDC], 2002).

  7. Intrauterine Devices • The intrauterine device (IUD) is designed to be inserted into the uterus by a qualified healthcare provider and left in place for an extended period, providing continuous contraceptive protection

  8. Traditionally the IUD was believed to act by preventing the implantation of a fertilized ovum. • Thus, the IUD was considered an abortifacient (abortion-causing) method. • This belief is not accurate. • IUDs truly are contraceptives; they trigger a spermicidal type reaction in the body, thereby preventing fertilization. • The IUD is also known to have local inflammatory effects on the endometrium.

  9. Advantages • high rate of effectiveness, • continuous contraceptive protection, • no coitusrelated activity, • and relative inexpensiveness over time.

  10. Possible adverse reactions • discomfort to the wearer, • increased bleeding during menses, • PID, perforation of the uterus, • intermenstrual bleeding, • dysmenorrhea, • and expulsion of the device.

  11. Two IUDs are currently available in the United States. • The copper T380A (ParaGard) is highly effective and can be left in place for up to 10 years. • The levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena), which releases levonorgestrel gradually, is comparable in effectiveness to the copper T and may be left in place for up to 5 years

  12. The primary advantage of the LNG-IUS is that it produces diminished periods or even amenorrhea, which women welcome once they are advised that the absence of menses is safe and not an indication of pregnancy.

  13. IUDs are recommended only for women who have at least one child and are in a monogamous relationship, because these women have the lowest risk of developing a pelvic infection. • It is not recommended for women with multiple sexual contacts, because they are at higher risk for sexually transmitted infections.

  14. insertion • The IUD is inserted into the uterus with its string or tail protruding through the cervix into the vagina. • It may be inserted during a menstrual period or during the 4- to 6-week postpartum check. • After insertion: the clinician instructs the woman to check for the presence of the string once a week for the first month and then after each menses.

  15. She is told that she may have some cramping or bleeding intermittently for 2 to 6 weeks and that her first few menses may be irregular. • Follow-up examination is suggested 4 to 8 weeks after insertion.

  16. Women with IUDs should contact their healthcare providers if: • they are exposed to an STI or if they develop the • late period, • abnormal spotting or bleeding, • pain with intercourse, • abdominal pain, • abnormal discharge, • signs of infection (fever, chills, and malaise), or • missing string.

  17. If the woman becomes pregnant with an IUD in place, the device is generally removed if the string is visible.

  18. Thank you

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