1 / 22

Hormonal and Surgical Contraception

Hormonal and Surgical Contraception. Tod C. Aeby, MD John A. Burns School of Medicine Department of Obstetrics, Gynecology and Women’s Health. Learning Objectives. Combination Oral Contraceptive Pills Progestin Only Contraceptive Pills Injections and Implants Patches and Rings

dixon
Download Presentation

Hormonal and Surgical Contraception

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hormonal and Surgical Contraception Tod C. Aeby, MD John A. Burns School of Medicine Department of Obstetrics, Gynecology and Women’s Health

  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 0.05 Male sterilization 0.15 Female sterilization 0.5 Depo-Provera (injectable progestogen) 0.3 Oral contraceptives 5 IUD Progesterone 2.0 Copper T 380A 0.8 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

  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 0.15 Female sterilization 0.5 Depo-Provera (injectable progestogen) 0.3 Oral contraceptives 5 IUD Progesterone 2.0 Copper T 380A 0.8 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

More Related