Understanding Birth Control Methods: Preventing Pregnancy and STIs

1. Birth Control (Contraception) Prepared by : Dr. LatifaMari’e

2. Objective: • Review of reproductive systems • To learn about the various methods of contraception or birth control to prevent pregnancy and STIs

3. Reproductive system: female

4. Fallopian tube: connects ovaries to the uterus, creating passageway for the egg to be transported from the ovaries to the uterus Ovary: main reproductive organ. They produce hormones and eggs Uterus: connects all the organs. This is where a baby develops. Cervix: neck of the vagina Vagina: muscular tube leading from external genitals to the cervix. Menstrual blood leaves the body through this passageway. A penis is inserted in to the vagina during vaginal sex. A baby is delivered from the uterus through the cervix and vaginal opening.

5. Reproductive system: female

6. Menstrual cycle

7. Review menstrual cycle. • Girls are born with hundreds of thousands of tiny eggs, called ova – one is called an ovum. • These egg cells are only half formed. • At puberty, hormones tell the ovaries it is time to start releasing ova. • Usually one egg at a time matures (develops) and is released from an ovary. • At the same time, the uterus starts to grow a thick lining on the inside wall. • The lining has lots of tiny blood vessels. • The lining is there to protect and feed an egg that has combined with a sperm to form a fertilized egg.

8. If an egg does not meet a sperm, the lining is not needed. • It breaks up. • Mixed with some blood it comes out the uterus into the vagina and then out the vaginal opening. • This is called menstruation. • If a woman is not pregnant then her ovary will release another egg, the lining build up and, if the egg is not fertilized, she has another period. • This is called the menstrual cycle.

9. Reproductive system: male

10. Reproductive system: male

11. STIs and Pregnancy Prevention • Hormonal Methods • Non-hormonal Methods

12. What is the most effective method of preventing pregnancy and STIs? Abstinence

14. Hormonal methods of birth control

15. The pill • A hormonal method that contains: • Combined : estrogen and progesterone or • Mini pill :progesterone only pills

16. cocp • .It includes a combination of an estrogen (usually ethinylestradiol) and a progestogen (specifically a progestin). When taken correctly, it alters the menstrual cycle to eliminate ovulation and prevent pregnancy.

17. Combined oral contraceptive pills are a type of oral medication that is designed to be taken every day, at the same time of day, in order to prevent pregnancy. • When taken correctly, the pill is over 99% effective at preventing pregnancy.

18. Benefits • The hormones in the pill have also been used to treat other medical conditions, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, acne, hirsutism, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation).Besides acne, no oral contraceptives have been approved by the U.S. FDA for the previously mentioned uses despite extensive use for these conditions.

19. contraindications • Thrombophlebitis or thromboembolic disorders • Cerebro-vascular or coronary artery disease • Carcinoma of the breast or other estrogen-dependent neoplasia • Undiagnosed abnormal genital bleeding • Known or suspected pregnancy • Benign or malignant liver tumor

22. Cocp and cancer • Combined oral contraceptive use reduces the risk of ovarian cancer by 40% and the risk of endometrialcancer by 50% compared with never users • But they increase a woman's risk of breast and cervical cancer

23. pop • The "traditional" progestogen-only pill (POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg. • The desogestrel progestogen-only pill can also stop ovulation. • You need to take the progestogen-only pill reliably every day.

24. If you take the minipills on time, they are 99% effective. 

25. Benefits • It may be suitable for women who cannot take the combined pill because of the oestrogen it contains. For example, those with heart disease, high blood pressure, a history of stroke, those at risk of blood clots, and women who experience certain types of migraine headaches. • It can be used when you are breast feeding. • It doesn’t interfere with sexual spontaneity. • It allows fertility to return without delay after you stop taking it • Menstrual bleeding may be reduced or stopped

26. Side effects • breast tenderness; • possible mood changes; • headaches; • bloating; • acne; • decreased or increased libido (sex drive); and • nausea.

27. contraindicated in suspected pregnancy, breast cancer and undiagnosed vaginal bleeding. Relative contraindications are active viral hepatitis and severe chronic liver disease.

29. Implanon • implanon NXT is a contraceptive implant preloaded in a disposable applicator. The implant contains 68 mg of the active substance etonogestrel. Etonogestrel is a synthetic female hormone resembling progesterone. A small amount of the hormone etonogestrel is continuously released into the bloodstream for three years. The rod itself is made of ethylene vinylacetate copolymer, a plastic that will not dissolve in the body. It also contains small amounts of barium sulfate (which renders it visible under X-ray) and magnesium stearate.

30. Although the implant may be removed at any time, it must be removed no later than three years after insertion.

31. It prevents the release of an egg cell from the ovaries (ovulation) • It causes changes to cervical mucus that makes it difficult for sperm to enter the womb

34. advantages • High effectiveness of up to 99 percent within seven days of implant insertion • Safe in the majority of women • Efficacy for three years without further intervention • Easily removed in most cases to allow pregnancy to occur naturally • Independent of user memory or schedule, and of sexual intercourse, as it provides continuous contraception • Safe for use during lactation • Relieves menorrhagia and dysmenorrhea in many cases • Amenorrhea in one of every five women on the implant, which is often perceived to be a benefit • Reduces the risk of pelvic inflammatory disease • Suitable in conditions which preclude the use of combined hormonal contraception • Quick return of fertility within 21 days of implant removal

35. Side effects • changes in your menstrual periods; • vaginal itching or discharge; • acne, mood changes, weight gain; • breakthrough bleeding, menstrual cramps; • nausea, stomach pain; • breast tenderness; • dizziness • flu-like symptoms, sore throat.

36. contraindications • Pregnancy. • Liver disease, including severe cirrhosis or liver tumors. • Personal history of breast cancer. • Undiagnosed abnormal vaginal bleeding. • Allergy or hypersensitivity to any of the implant materials.

37. Transdermal patch • A patch that releases hormones through the skin • Thin, smooth and beige patch • Prevents the release of a mature egg • Thickens cervical mucous • Changes the lining of the uterus • Typical effectiveness rate is 91%

39. What are the advantages? 1. A reversible and highly effective birth control method 2. Once-a-week regimen; no daily contraceptive routine required,used for 3 weeks/ m 3. Simple and easy to use 4. Regulates menstrual cycle and reduces cramps 5. Does not interfere with intercourse 6. Expected to provide other benefits similar to oral contraceptives; research is needed

40. What are the disadvantages? 1. May cause irregular bleeding or spotting 2. May cause breast sensitivity or headache 3. Does not protect against STIs 4. Patch may detach from skin (less than 2%) 5. Possible skin irritation at the application site

41. Nuva Ring (vaginal ring) • Soft and flexible ring, inserted into the vagina • The ring slowly releases hormones while in the vagina for 3 weeks • Prevents the release of a mature egg • Thickens cervical mucous • Changes the lining of the uterus • Typical effectiveness rate is 91%

43. What are the advantages? 1. A reversible and highly effective birth control method 2. Once-a-month regimen; no daily contraceptive routine required 3. Regulates menstrual cycles 4. Does not interfere with intercourse 5. Does not require daily attention

44. What are the disadvantages? 1. Does not protect against STIs 2. May cause irregular bleeding or spotting 3. May cause side effects such as headache, nausea, or breast tenderness 4. May cause vaginal discomfort 5. The ring may be expelled from the vagina but this is uncommon

45. Depo Provera – Injectable contraceptive • An injection of progestin administered every 12 to 13 weeks • Prevents the release of a mature egg • Thickens cervical mucous • Changes the lining of the uterus • Typical effectiveness rate is 94%

48. What are the disadvantages? 1. Initially, irregular bleeding is the most common side effect 2. Decrease in bone mineral density which may be reversible when a woman stops taking the injection. Calcium supplementation is advised. 3. May be associated with weight gain in some women 4. Takes an average of nine months after the last injection for the ovaries to start releasing eggs again 5. Does not protect against STIs 6. The lack of a monthly period may be bothersome for some women

49. Not given for more than 2 years ,risk of osteoporosis.

50. Intrauterine Contraception -IUC • T-Shaped device that is inserted in the uterus by a Doctor or Nurse Practitioner • Two types of IUC: • the Copper intrauterine device (no hormone) • the levonorgestrel-releasing intrauterine system (contains a progestin) • Typical effectiveness rate is 99.8% • IUD prevent pregnancy by preventing fertilization