Myths & Facts about Contraception
Department of Obstetrics & Gynaecology
Who Needs Contraception? All women who have not achieved menopause and are sexually active need contraception. Menopause is defined as cessation of menstruation for 1 year
Know more about the following : Contraceptive Pills 4th generation OCPs available now. Causes no weight gain, takes care of Blood pressure & acne too.Taken for 21-24 days in a month with 4-7 days pill free period. 端 When To Start? On the 1st day of period 端 How Long Can Be Taken? As long as required 端 Who Should Not Take? h/o epilepsy, on ATT, DVT, Coronary
artery disease, Thrombogenic cardiac valvular disease, cardiac arrythmias, diabetes, hypertension, active liver disease 端 Is There Any Problem In Getting Pregnant After Using The Birth Control Pill? No, regular period and ovulation usually start up right away. However girls who were very irregular before starting the pill, may continue to be irregular after they stop the pill.
Advantages
Myths & Facts
Very safe and has only a few minor side effects. PROTECTS AGAINST CANCER of ovaries and cancer of the lining of uterus. Most experts believe that it does not cause any increased risk of Breast cancer. OTHER HEALTH BENEFITS include regulation of menstrual period, decrease in cramps, treatment for acne and PCOS, lower risk of anemia
Intrauterine Devices 1.Multiload /Cu-T 380 A Most misunderstood contraception Has a small T shaped body which bears a coil of copper wire Prevents pregnancy by interference with sperm transport, Ovum transport, fertilization and implantation Incidence Of Complications Heavy periods in 10% cases, can be controlled with medicine, more common with wrong case selection Perforation - 0.5 in 1000 cases (WHO 1987), negligible in experienced hands
Timing of insertion Immediately after periods 6 weeks after normal delivery or caesarean section Immediately after early abortion Lactational Amenorrhea after reasonably excluding pregnancy
As emergency contraception Fertility returns immediately after discontinuation. CU-T 380 A is the best IUCD according to WHO. Its failure rate is almost equal to the permanent method of tubal ligation. It can be kept as long as 10 years.Even those with previous caesarean can go for it. 2.MIRENA Mirena is a small flexible plastic device, inserted inside the uterus. It slowly releases progesterone hormone, which stops ovulation, alters the cervical mucus and changes the lining of uterus. 99.9% effective in preventing pregnancy Provides lower and steadier hormones than pills Lasts for up to 5 years or less as per choice Easy to remove Does not cause significant weight gain May also help shorten, lighten or even eliminate periods (Useful for those with heavy periods) Safety Information Designed for women who have had at least one child and have no risk of ectopic pregnancy or PID Ovarian cyst may occur and typically disappear Complications may occur from placement Missing periods or irregular bleeding is common in first few months, followed by shorter, lighter periods
Barrier Method Condom has a high failure rate, mainly because inadequate information regarding technique of use. It is mandatory to use it every time while having sex. This method is the only method to prevent sexually transmitted diseases. Ideally, failure rates would be less than 5% with correct usage. Young couples is advised to use double contraception ie, OCP to prevent pregnancy and Condom to prevent STDs Today Vaginal Pessary Few patients complain of discharge and itching
Breast Feeding As Contraception Exclusive Breast feeding has a failure rate of 5% It is not effective after 6 months or earlier if the menses starts. Additional contraception need to be used after 6 months even if there is no menses.
Injection Depoprovera Contraceptive efficacy comparable with or better than OCPs, given every 3 months. The principal disadvantages are irregular menstrual bleeding & delayed fertility resumption after discontinuation
Emergency Contraception Levonorgestrel pill is available Single tablet has to be used within 72 hours of unprotected coitus. It is effective to the tune of 90%. Every woman and adolescent girl should know about it. However emergency contraceptive cannot replace regular contraceptive for people who are sexually active.
Permanant Methods 1.Tubal Ligation Accomplished by occlusion or division of fallopian tubes. Can be done: Anytime with Laparoscopy Along with caesarean section After vaginal delivery by Mini laparotomy via a 3 cm incision in lower abdomen
2.Male Sterilization or Vasectomy Through a small incision in the scrotum the lumen of the duct (vas deferens) is disrupted to block the passage of sperm from the testes. With local anaesthesia , the procedure is usually performed with in 20 minutes.
Greatest risk of conception for perimenopausal women with irregular cycles At the age of 40-45 years, 75% cycles are ovulatory Even after 46 years, 60% cycles are ovulatory Women should not stop contraceptive measures until 2 years after the last menstrual period
Who can use ? Types of Contraception
Failure Rate
No contraception
85%
Withdrawl method
20-25%
Safe period method
25%
Condom Today vaginal pessary
15-25% 5%
Oral contraceptive pills
<1%
Injection Depoprovera
<1%
Intrauterine devices (Cu-T, Multiload)
<1%
Tubal ligation
0.05%
Vasectomy
0.10%
(Emergency contraception(I - Pill)
10%
Newly Married Couple
Young Young Middle Aged women women & with with PeriIncomplete complete menopausal family family women
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