The document discusses various methods of contraception. It begins by defining contraception as the intentional prevention of conception through devices, practices, chemicals, drugs or surgery. It then describes several major types of contraceptives that are effective at preventing pregnancy, including barrier methods like condoms and diaphragms, hormonal methods like pills and implants, and long-acting reversible methods like IUDs. The document also discusses fertility awareness methods and emergency contraception, as well as permanent sterilization methods.

1. CONTRACEPTIVECONTRACEPTIVE

2. The intentional prevention of conception through the use of
various devices, sexual practices, chemicals, drugs, or
surgical procedures is called contraceptive.
This means that something (or some behavior) becomes a
contraceptive if its purpose is to prevent a woman from
becoming pregnant.
There are several types of contraceptives that have been
officially labeled as such because they have shown reliability
in preventing conception from occurring.
Contraception

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4. Need for contraception….
World’s population expected to reach 9
billion by 2050.
India accounts for 17% of world’s
population.

5. Need for contraception….
Annually, 529,000 maternal deaths & 50 million morbidity.
• In India, contraceptive prevalence is 48.3%
21% of all pregnancies resulting live births are unplanned.
If unmet need for contraception
was met, we can avoid
52 million unwanted pregnancies
25-50% of maternal deaths

6. Ancient PracticesAncient Practices
Ancient writings noted on the Kahun papyrus datingAncient writings noted on the Kahun papyrus dating
to 1850 BCE refer to contraceptive techniques using ato 1850 BCE refer to contraceptive techniques using a
vaginal pessary of crocodile dung and fermentedvaginal pessary of crocodile dung and fermented
dough, which most likely created a hostiledough, which most likely created a hostile
environment for sperm.environment for sperm.
The Kahun papyrus also refers to vaginal plugs ofThe Kahun papyrus also refers to vaginal plugs of
gum, honey, and acacia. During the early secondgum, honey, and acacia. During the early second
century in Rome, Soranus of Ephesus created a highlycentury in Rome, Soranus of Ephesus created a highly
acidic concoction of fruits, nuts, and wool that wasacidic concoction of fruits, nuts, and wool that was
placed at the cervical os to create a spermicidalplaced at the cervical os to create a spermicidal
barrier. (barrier. (Omnia M Samra-Latif, MDOmnia M Samra-Latif, MD ))

7. Birth Control MethodsBirth Control Methods

PhysiologicPhysiologic

Mechanical Barriers/Chemical BarriersMechanical Barriers/Chemical Barriers

Hormonal ContraceptivesHormonal Contraceptives

SterilizationSterilization

8. What are the available methods of
contraception?

Condoms (male and female)

Combined pill

Progestogen-only pill (mini-pill)

Intrauterine Systems (IUS)

Contraceptive implants

Vaginal ring

Contraceptive injections

Contraceptive patches

Intrauterine device (IUD)

Diaphragms and caps plus spermicide
Natural family planning (e.g. temperature method)

Sterilisation (male and female)

9. Male & female
condoms
What are they?
Latex or polyurethane sheaths which fit over a man's penis (male condom) or inside a woman’s
vagina (female condom)
How do they work?
Prevent sperm from entering the woman's vagina
Prevent sexually transmitted infections (STIs) from passing from person to person if used
properly.

10. Contraceptive
patches
What are they?
Stick-on patches, which slowly release estrogen and progestogen hormones through the skin
Stuck onto your bottom, thigh, stomach or upper body
Changed weekly – with no patch used on the fourth week of your cycle.
How do they work?
Prevent ovulation
Thicken the mucus around the neck of the womb, making it difficult for sperm to enter

11. Contraceptive
patches
What are their main advantages?
Do not have to be used daily (replaced every week)
Do not interrupt sex
Easy to use
Efficacy unaffected by vomiting or diarrhoea
What are their main disadvantages?
Not suitable for women aged over 35 years who smoke, or women who are breastfeeding
Visible to others (e.g. partner)
May rarely cause skin irritation
Do not protect against STIs
May evoke temporary side-effects such as headaches, breast tenderness, bleeding between
periods..

12. Contraceptive injections
What are they?
• Injection containing progestogen only, given by a trained doctor or nurse
every three months
How do they work?
• Prevent ovulation and / or
• Thicken mucus around the neck of the womb making it difficult for sperm to
enter

13. Contraceptive injections
What are their main advantages?
• Semi-long-acting hormonal method without the need for a daily dose
• Do not interfere with sex
• Can be used during breastfeeding and for those women who do not tolerate
estrogen
What are their main disadvantages?
• Periods and fertility may take up to a year to return after stopping injections
• May induce headaches, dizziness, spotty skin, tender breasts, mood
swings, weight gain and bloating. As the injection cannot be removed from
the body, side effects may continue during the time it is inserted and for
some time afterwards
• Do not protect against STIs

14. Contraceptive implants
What are they?
• Tiny flexible tubes impregnated with a progestogen hormone, and inserted
just under the surface of the skin on the inside of your upper arm by a trained
doctor or nurse. The implant is effective for three years
How do they work?
• Thicken the mucus in the neck of the womb to make it difficult for sperm to
enter
• Change the lining of the womb
• Prevent ovulation

15. What are their main advantages?
• Can be fitted and forgotten
• Does not interfere with sex
• Can be used while breastfeeding
• Is useful for women who cannot take estrogens
• May reduce heavy, painful periods
What are their main disadvantages?
• May cause irregular bleeding for the first few months
• Can cause side effects such as headaches, tender breasts, changes in
mood and sex drive, and bloating
• Do not protect against STIs
• It may take a while until fertility is vestured
Contraceptive implants

16. Vaginal ring
What are they?
• Contains estrogen and progestogen, and is inserted into the vagina. It is kept
in place for three weeks, and then removed for a one week break. A new ring
is inserted following the week break.
How do they work?
• Prevent the female body from releasing an egg each month
• Thicken the mucus of the entrance to the womb, making it difficult for sperm
to get through

17. What are their main advantages?
• An alternative form of hormonal contraception which is used only once every
four weeks
• May make a woman’s periods more regular, lighter and may reduce cramping
What are their main disadvantages?
• Can cause vaginal irritation, discomfort or discharge
• May cause nausea and breast tenderness
• Some women may be able to feel it
• Do not protect against STIs
Vaginal ring

18. Intra-uterine systems (IUS,
also known as hormonal
coil)What are they?
• Plastic T-shaped device with a cylinder containing progestogen.
Inserted in the cavity of the womb by a trained Health
Professional. Is effective for up to five years
How do they work?
• Thicken the mucus in the neck of the uterus, making it difficult for
sperm to enter
• Keeps the lining of the womb thin. Makes the uterus hostile to
sperm

19. IUS
What are their main advantages?
• Can be fitted and forgotten - effective for up to five years
• Do not interrupt sex
• Option for women who cannot tolerate estrogens and those breast-feeding
• Periods usually become much lighter and shorter, and less painful
• Can offer protection against pelvic infections and cancer of the uterine lining
• Normal fertility returns quickly when the IUS is removed
• Not affected by other medicines
What are their main disadvantages?
• Can cause irregular bleeding for the first three months
• May cause temporary side-effects such as headaches, breast tenderness and
nausea
• Do not protect against STIs
• Can be expelled or displaced by the womb
• May rarely perforate the womb or cervix

20. Intra-uterine devices
(IUD)
What are they?
• Small plastic and copper T-shaped devices,
which are inserted into the cavity of the womb
by a trained Health Professional
How do they work?
• Prevents sperm and eggs from meeting by immobilizing the sperm on their way to
fallopian tubes and changing the line of the womb so that it cannot accept an egg

21. IUD
What are their main advantages?
• Can be fitted and forgotten - effective for three to ten years
• Do not interrupt sex
• Normal fertility returns as soon as it is removed
What are their main disadvantages?
• May cause heavier, longer or more painful periods, increased cramping and
dizziness
• Can increase the risk of pelvic infections
• Do not protect against STIs
• Can be expelled or displaced by the womb
• Can perforate the womb or cervix

22. Diaphragms & caps
What are they?
• Dome-shaped circles made of rubber or silicone that
is inserted into the vagina, requires initial fitting by
a doctor or nurse
• Coated with spermicidal cream for extra protection
• Must be left in for at least six hours after intercourse (and no more than 24
hours)
How do they work?
• Forms a barrier between the sperm and the entrance of the womb

23. Diaphragms & caps
What are their main advantages?
• Necessary only when having sex
• No serious health risks
• Can be inserted at any convenient time before sex
What are their main disadvantages?
• Insertion can interrupt sex
• Spermicide can be messy
• Insertion and expulsion need to be practiced
• Can cause vaginal irritation

24. Natural family planning
What are they?
• Withdrawal method - penis is withdrawn from the vagina prior to ejaculation
• Natural method – sex is avoided at fertile times of the month. Fertility is
monitored using the following methods
– Keep a daily record of your body temperature using a special
fertility thermometer
– Look for changes in the stickiness of the mucus around the
entrance to the womb
– Calculate when ovulation is most likely to take place by counting
the number of days from your last period (this only works if your
periods are regular)
– Look for other signs such as mood changes and breast tenderness
which tend to happen in the second half of your menstrual cycle
(measured from the start of one period to the beginning of the
next)

25. Natural family planning
What are its main advantages?
• Can be used to plan as well as avoid a pregnancy
• Does not involve any chemical agents or physical devices
• No physical side-effects
• Allows women to become more aware of their fertility
• Helps women communicate about their fertility and sexuality
• Acceptable to all faiths and cultures
What are its main disadvantages?
• The withdrawal method is highly unreliable because small drops of sperm can escape
from the penis into the vagina before the man ejaculates
• Fertile periods not confirmed until three to six cycles are completed
• Necessary to keep daily records
• Events such as illness, stress and travel may make fertility indicators harder to interpret
• Necessitates intercourse avoidance during the fertile time
• Both partners need to be very committed to the method
• Does not protect against STIs

26. Emergency contraception
What is it?
• Emergency method that can be used after unprotected sex or when another
contraception method has failed (e.g. split of condom)
• Only intended as a back-up, not to be used regularly
How does it work?
• Emergency contraception works mainly by preventing ovulation and fertilisation
• It also has a local effect on the uterus
• It will not interrupt an established pregnancy

27. Emergency contraception
• Emergency Contraceptive (or morning after) pills - can be taken up
to 72 hours or three days after intercourse. However, the sooner you
take them, the more effective they are. They contain progestogen
only, and can be taken up to 72 hours after unprotected intercourse

28. Sterilisation
What is it?
• Permanent method of contraception for people who do not want children
now or in the future
How does it work?
Male sterilisation
• The tubes that carry sperm are cut, so that
while a man can still ejaculate, no sperm is present
Female sterilisation
• The fallopian tubes are cut or blocked so that
the egg cannot travel down to meet sperm

29. Sterilisation
What are its main advantages?
• Almost 100% effective
• Does not interrupt sex
• Can be performed and forgotten
What are its main disadvantages?
• Cannot be reversed (except by using complex and dangerous surgery which is
not successful in all cases)
• Do not protect against STIs

30. What is the progestogen-only (mini) pill?
• Oral pills that contain a progestogen hormone
How do they work?
• Thicken the mucus at the entrance to the womb, which makes it difficult for sperm
to get through
• Change the lining of the womb
• May also prevent ovulation in some women
Oral contraceptive pills

31. Mini (progestogen-only)
pills
What are their main advantages?
• Few serious side-effects
• Do not interrupt sex
• Can be used while breastfeeding
• Are useful for women who cannot take estrogens
• Can be used at any age
What are their main disadvantages?
• May cause irregular periods
• Do not protect against STIs
• Must be taken at the same time everyday
• May initially induce temporary side-effects such as: spotty skin, breast
tenderness, bloating, and headaches

33. Combined oral contraceptives
Trying to reduce the dose of estrogen to the lowest
possible without reducing efficacy
And by combination