useful for nursing students.

3. 


The human male reproductive system consists of a number
of sex organs that form a part of the human
reproductive process.
In this type of reproductive system, these sex organs are
located outside the body, around the pelvic region.
The main male sex organs are the penis and
the testicles which produce semen and sperm, which, as
part of sexual intercourse, fertilize an ovum in the female's
body; the fertilized ovum (zygote) develops into a fetus,
which is later born as a child.

4.  The penis is the male copulatory organ. It has
a long shaft and an enlarged bulbous-shaped
tip called the (glans penis), which supports
and is protected by the foreskin. When the
male becomes sexually aroused, the penis
becomes erect and ready for sexual activity.

5.  Erection occurs because sinuses within the erectile tissue
of the penis become filled with blood. The arteries of the
penis are dilated while the veins are passively
compressed so that blood flows into the
erectile cartilage under pressure.
 The scrotum is a pouch-like structure that hangs behind
the penis. It holds and protects the testes. It also
contains numerous nerves and blood vessels.
 The scrotum remains connected with the abdomen or
pelvic cavity by the inguinal canal.

6.  The vas deferens, also known as the sperm
duct, is a thin tube approximately 30
centimetres (0.98 ft) long that starts from the
epididymis to the pelvic cavity.
 Three accessory glands provide fluids that
lubricate the duct system and nourish the
sperm cells. They are the seminal vesicles, the
prostate gland, and the bulbourethral glands
(Cowper glands).

7.  Seminal vesicles are sac-like structures attached to the
vas deferens at one side of the bladder. They produce a
sticky, yellowish fluid that contains fructose. This fluid
provides sperm cells energy and aids in their motility.
70% of the semen is its secretion.
 The prostate gland surrounds the ejaculatory ducts at the
base of the male urethra, just below the bladder. The
prostate gland is responsible for the proof semen, a liquid
mixture of sperm cells, prostate fluid and seminal fluid

9.  The
female genital system contains two
main parts: the uterus, which hosts the
developing fetus, produces vaginal and
uterine secretions, and passes the
male's sperm through to the fallopian tubes;
and the ovaries, which produce the female's
egg cells

10.  The vagina is a fibro-muscular tubular tract leading
from the uterus to the exterior of the body in female
mammals .
 The vagina is the place where semen from the male
penis is deposited into the female's body at the
climax of sexual intercourse, a phenomenon
commonly known as ejaculation.
 The vagina is a canal that joins the cervix (the lower
part of uterus) to the outside of the body. It also is
known as the birth canal.

11.  The cervix is the lower, narrow portion of the uterus
where it joins with the top end of the vagina.
 It is cylindrical or conical in shape and protrudes
through the upper anterior vaginal wall.
 Approximately half its length is visible to the naked
eye, the remainder lies above the vagina beyond
view.
 The vagina has a thick layer outside and it is the
opening where the fetus emerges during delivery.
The cervix is also named the neck of the uterus.

12.  The uterus or womb is the major female
reproductive organ of humans. The uterus provides
mechanical protection, nutritional support, and waste
removal for the developing embryo (weeks 1 to 8) and
fetus (from week 9 until the delivery).
 The uterus is a pear-shaped muscular organ. Its major
function is to accept a fertilized ovum which becomes
implanted into the endometrium, and derives
nourishment from blood vessels which develop exclusively
for this purpose.

13.  The Fallopian tubes or oviducts are two tubes leading
from the ovaries of female mammals into the uterus.
On maturity of an ovum, the follicle and the ovary's
wall rupture, allowing the ovum to escape and enter
the Fallopian tube.
 There it travels toward the uterus, pushed along by
movements of cilia on the inner lining of the tubes.
This trip takes hours or days. If the ovum is fertilized
while in the Fallopian tube, then it normally implants
in the endometrium when it reaches the uterus,
which signals the beginning of pregnancy.

14.  The ovaries are small, paired organs that are
located near the lateral walls of the pelvic
cavity.
 These organs are responsible for the
production of the ova and the secretion of
hormones.

15.  Ovaries are the place inside the female body where ova
or eggs are produced. The process by which the ovum is
released is called ovulation. The speed of ovulation
is periodic and impacts directly to the length of a menstrual
cycle.
 Ovaries are the place inside the female body where ova
or eggs are produced. The process by which the ovum is
released is called ovulation. The speed of ovulation
is periodic and impacts directly to the length of
a menstrual cycle.

16.  After ovulation, the ovum is captured by the
oviduct, after traveling down the oviduct to
the uterus, occasionally being fertilized on its
way by an incoming sperm, leading to
pregnancy and the eventual birth of a new
human being.

17. Family planning services are defined as
"educational, comprehensive medical or
social activities which enable individuals,
including minors, to determine freely the
number and spacing of their children and to
select the means by which this may be
achieved".

18. Raising a child requires significant amounts of resources:
 time,
 social,
 financial, and
 environmental.
 Planning can help assure that resources are available.


The purpose of family planning is to make sure that any
couple, man, or woman who has the desire to have a child
has the resources that are needed in order to complete this
goal.

19. 
Family welfare – a state of well – being of the family as
a whole and the individual. Means a level of
satisfaction of the basic needs of family (adequate
food, water, shelter, employment, health and
education).

Responsible Parenthood – the essence of family
planning. Pregnancy is planned and a child us desired
and is assured of parent's love, protection, etc.

20. Health and Benefits
For the Mother
 Help mother to fully recover from physical strain of
child bearing. Those more than 4 children – considered
high risk. Help reduce number of maternal death due
to abortion.


For the Father
Family Planning helps the father shoulder his
responsibility and enables him to give his children
equal attention. It also lightens his load because he will
not be obliged to provide for and support too many
children.

21. Health and Benefits
For the Children:
Through Family Planning, the children are better taken care
of. The parent could meet the basic needs of the children
For the Family:
Health help the family enjoy the better kind of life.
For the Community:
Family Planning can provide a peaceful, orderly, and selfsustaining community with fewer problems, like juvenile
delinquency.
For the Country and the World:
For the World , overcrowding can be minimized, and
governments can focus their economic efforts on production
rather than consumption.


22. The deliberate use of
artificial methods or
other techniques to
prevent pregnancy .

23. World Contraception Day

September 26 is designated as World
Contraception Day, devoted to raising
awareness of contraception and improving
education about sexual and reproductive health,
with a vision of "a world where every pregnancy
is wanted".

24. 
CONTRACEPTION HELPS IN PREVENTING
PREGNANCY

CONTRACEPTION METHOD LIKE CONDOM
GIVES PROTECTION AGAINST STD’S…….

25. IDEAL CONTRACEPTIVE









Safe
Effective
Acceptable
Inexpensive
Reversible
Simple to administer
Independent of coitus
Long lasting to avoid frequent administration
Requiring little or no medical supervision

26. Classification of contraceptive methods
I. SPACING METHODS
(temporary)
Natural or Fertility
Awareness
Method
Barrier Methods
Hormonal
Methods
Intrauterine
Devices
II. TERMINAL METHODS
(permanent)
Female
sterilization
Male
sterilization

27. A.Natural or Fertility Awareness Method
1. Standard Days Method
2. Calendar Rhythm Method
3. Symptoms Based Method
a. Temperature Rhythm Method
b.Cervical Mucus Rhythm Method
c. Sympthotermal Method
B.Lactation Amenorrhea
C.Artificial Method

28. A.
Medical (Hormonal)
a. Short Acting
1. Combined Oral Pills
2. Progestin Only Pills
b. Long Acting
1. Combined Patch
2. Progesterone Implants
3. Injectables
4. Transvaginal Ring
B.
Barrier Method
a. Condom
b. Diaphragm & Cervical Cap
c. Spermicide cream & jelly
d. Sponge
e. Intra-uterine Device
C. Permanent Methods
a. Vasectomy
b. Tubal Ligation

29. •
Natural Family Planning (NFP)
– Sexual abstinence during fertile period
•
Fertility Awareness Combined Method (FACM)
– Using barrier method during the fertile time

30. •
Fertility Awareness
– Fertile time of the menstrual cycle starts and ends
– Ovum is fertilized 12 to 24 hours after ovulation
– Ovulation may oocur 6 weeks post partum
•Periodic Abstinence
• Natural Family Planning


31. •
Avoid unprotected intercourse
– Day 8 to 19
•
•
Regular monthly cycles of 26 to 32 days
Use of cycle beads

32. CALENDAR METHOD ( RHYTHM )
Chances of Pregnancy by Day of Intercourse
day zero is ovulation
-5 4
-3 -2
-1
0
0%
15%
26%
15%
-
11%
20%
1
2
3
9%
5%
0%

33. •
Billings Method
– Cervical Mucus Method or Ovulation Method
• Cervical secretions or feeling of wetness
•
Basal Body Temperature (BBT)
– Slight body temperature rise after released of a fertilized egg
– Temperature remains elevated until the start of next cycle
•
Symptothermal Method
– Combination of BBT and Billings Method
•
2 Day Method

34. •
Avoid unprotected sex when
secretions begin until 4 days
after the peak day.
•
PEAK DAY - last day where
the secretions are clear,
slippery, stretchy and wet

36. - Rise in temperature of 0.40F of morning BBT
(OVULATION)
- Abstain from unprotected intercourse
from 1st day up to 3rd day after increase
in BBT

37. •
•
Change in cervical mucus ➡️onset of fertility
Increase in BBT ➡️end of fertility

38. •
Presence of any type of
secretion ➡️
considered fertile for
that day and the
following day

39. Temporary method
• Ovulation is not possible during the first 10 weeks
postpartum
• Effects of breastfeeding with fertility
• 3 criteria for effectiveness
•
1. Monthly menstruation has not returned
2. Exclusive or nearly exclusive breastfeeding
3. Baby is less than 6 months old

40. •
Prevents release of egg
during ovulation
•
Prevents release of
ovulatory hormones

41. Artificial Methods

42. BARRIER
Barrier methods of birth control block sperm from
entering the uterus. Using a spermicide with a
barrier method gives you the best possible barrier
method protection.

43. 


The spermicide kills most of the sperm that
enter the vagina.
The barrier method then blocks any
remaining sperm from passing through the
cervix to fertilize an egg.
Unlike other methods of birth control, barrier
methods are used only when you have sexual
intercourse.

44. CONDOM
 A condom is a barrier device commonly used
during sexual intercourse to reduce the
probability of pregnancy and
spreading sexually transmitted diseases such
as HIV.
 It is put on an erect penis and physically
blocks ejaculated semen from entering the
body of a sexual partner.

45. 
Lubricants used should be water based
– condom must be used with every coital act
– place before contact of the penis with the vagina
– Withdrawal must occur with the penis still erect
– The base of the condom must be held during
withdrawal
– Either an intravaginal spermicide or a condom
lubricated with spermicide should be employed
 >Failure rate:
 3 or 4 couple-years of exposure

47. 

Condoms are also used for collection of
semen for use in infertility treatment. Because
condoms are waterproof, elastic, and durable.
As a method of birth control, male condoms
have the advantage of being inexpensive, easy
to use, having few side effects

48. 
Condoms may slip off the penis
after ejaculation, break due to improper
application or physical damage (such as tears
caused when opening the package), or break
or slip due to latex degradation (typically
from usage past the expiration date,
improper storage, or exposure to oils

49. •
•
Pregnancy rate higher than male condom
Polyurethane sheath with one flexible
polyurethane ring at each end
– Open ring remains outside the vagina
– Closed internal ring is fitted under symphysis
 DO NOT USE SIMULTANEOUS WITH MALE CONDOM
SINCE FRICTION LEADS TO SLIPPING, TEARING &
DISPLACEMENT

51. 



95% effective
Protects against some STDs
Noisy
Use extra lubrication
51

52. 



Most people can use female condoms with no
problems for themselves or their partners.
Some women and men may not like the
female condom because it may
cause irritation of the vagina, vulva, penis, or
anus
slip into the vagina during vaginal intercourse,
or into the anus during anal intercourse

53. •Soft latex cup that covers the cervix
•Spring along the rim to keep it in
place
•Used with spermicidal creams/jelly or
sponge for effectiveness
•Inserted few hours before
intercourse ➡️add spermicide
•Should not be remove <6hrs, and not
stay >6hours .
•Increase rate UTI

54.  It does not affect future fertility for either the woman
or the man.
 It is used only at the time of sexual intercourse.
 It is safe to use while breast-feeding.
 It is less expensive than hormonal methods of birth
control.
 It can be used by women who have health problems
that would make estrogen use dangerous, and by
women who smoke.

55. 


Some people are embarrassed to use this
method or feel the method interrupts
foreplay or intercourse.
A couple must be comfortable with using the
diaphragm and be prepared to use it every
time they have sex.
A diaphragm can't be used if either person is
allergic to latex.

56. •Soft, deep, latex or
rubber cup that covers the
cervix
•Prevents the sperm to
enter the cervix
•Best used with
spermicides
•Compatible to diaphragm

57. 



It does not affect future fertility for either the
woman or the man.
It is used only at the time of sexual
intercourse.
It is safe to use while breast-feeding.
It is less expensive than hormonal methods
of birth control.

58. 





The cervical cap should not be used by a woman
who has ever had toxic shock syndrome.
The cervical cap cannot be used during a woman's
period.
Some women experience odor problems if the
cervical cap is left in place longer than 24 hours.
The cervical cap can be difficult to place properly or
to remove.
Use of the cervical cap can irritate the cervix.
The cervical cap should not be used by women who
currently have a vaginal or cervical infection

59. •
•
•
•
•
•
Physical barrier to sperm penetration
Chemical spermicidal - sperm killing substance inserted deep
into the vagina, near the cervix prior to sexual intercourse
Nonoxynol 9 – most popular
benzalkonium chloride, chlorhexidine, menfegol, octoxynol-9, and sodium
docusate
Duration of Efficacy: 1 hour
Non teratogenic

61. •
foaming tablets, melting or foaming suppositories,
cans of pressurized foam, melting film, jelly, and
cream
– Jellies, creams, and foam from cans can be used alone, with a diaphragm, or
with condoms.
– Films, suppositories, foaming tablets, or foaming suppositories can be used
alone or with condoms
•
causing the membrane of sperm cells to break, killing
them or slowing their movement

62. 




They do not affect future fertility for either the woman or the
man.
They are used only at the time of sexual intercourse.
They are safe to use while breast-feeding (birth control that
contains estrogen affects milk supply).
They are less expensive than hormonal methods of birth
control.
They are safe for women who have other health problems
(birth control that contains estrogen makes some health
conditions worse).

63. 



Some people are allergic to nonoxynol-9, the active
ingredient in most spermicides. They can develop itching or
sores in the vagina or on the penis, which make it more likely
that HIV can be passed from an infected person during sex.
The nonoxynol-9 in spermicides may also increase the risk of
getting HIV/AIDS from an infected partner.
Some people are embarrassed to use spermicide and a
barrier method or worry that it may interrupt foreplay or
intercourse. This can create a problem with using it every
time they have sex.
Spermicides cause an extra discharge from the vagina

64. •
•
•
•
•
•
•
Plastic contains spermicides
Inserted 24 hours prior to intercourse, removed 6 hours post intercourse
Moistened with water and inserted into the vagina so that it rests against the cervix
Used only once
not widely available
Less effective
Nonoxynol 9 impregnated disc
– 2.5cm thick, 5.5cm wide
May cause irritation and

vaginitis
•

65. 



It does not affect future fertility for either the
woman or the man.
It is used only at the time of sexual
intercourse.
It is safe to use while breast-feeding.
It is available in drugstores without a
prescription.

66. 


Failure rates for the sponge and other barrier
methods are higher than for most other
methods of birth control.
Some people are embarrassed to use this
method or feel the method interrupts
foreplay or intercourse.
The couple must be comfortable with using
the sponge and be prepared to use it every
time they have sex.

67. The cervical shield, such as Lea's Shield, is similar to
the diaphragm and cervical cap. It is thought to be
as effective as other female barrier methods (the
cervical cap, diaphragm, and sponge).
 But only limited studies have been done so far. The
cervical shield is made of silicone, so latex allergy is
not a problem..
 The device comes in one size only, simplifying the
fitting process. The shield currently requires a
prescription


68. •
•
•
Reusable, washable barrier
made of silicone
Placed against the cervix
Inserted any time prior to
intercourse and must be left
in place for at least 8 hours
afterwards

69. Barrier
Male condom
Failure rate*
Effectiveness in preventing
STDs
15 (spermicide further lowers Most effective
this failure rate)
Female condom
21
Somewhat effective
Diaphragmwith spermicide
16
Limited effectiveness
Spermicide
29
Not effective if used alone;
may actually increase risk of
getting HIV/AIDS
Sponge with spermicide
16 (no past vaginalchildbirth) Limited effectiveness
32 (past vaginal childbirth)
Cervical capwith spermicide
16 (no past vaginal childbirth) Limited effectiveness
32 (past vaginal childbirth)

71. Classification of hormonal
contraceptives
Combined pills
Progesterone only
pills (POP)
Oral Pills
Once – a – month
(long acting) pills
Male pill
Hormonal
contraceptives
Post coital pill
Injectables
Depot Preparations
Subdermal Implants
Vaginal Rings

72.  COMBINED PILLS
The combined oral contraceptive
pill (COCP), often referred to as
the birth-control pill or
colloquially as "the Pill", is a
birth control method that
includes a combination of
an estrogen (estradiol) and
a progestogen (progestin)

73.  Benefits
Disadvantages
Minimal effect on CHO
metabolism & coagulation
• Do not cause or exacerbates
HPN
• Contraception failure
• Ectopic pregnancy
• Irregular uterine bleeding
•
– Amenorrhea, spotting,
breakthrough bleeding,
menorrhagia)
• Functional ovarian cyst

74. SOME PILLS ARE
TAKEN AFTER HAVING UNPROTECTED SEX.

The Morning-After Pill
 diethylstilbestrol (DES)

Yuzpe method (1974)
 100 g ethinyl estradiol plus 1.0 mg dL-norgestrel

Plan B (1999)
 first progestin-only emergency contraceptive

75. •
Progestin
– Prevents ovulation by suppressing LH
– Thickened mucus ➡️retards sperm passage
– Endometrium ➡️unfavorable for implantation
•
Estrogen
– Prevents ovulation by suppressing FSH
– Stabilize endometrium ➡️prevents breakthrough
bleeding

76. 
Beneficial Effects
•
Increase bone density
Decrease risk of ectopic pregnancy
Fewer premenstrual complaints
Reduction on various benign breast disease
Improvement of acne
Decrease incidence & severity of acute salphingitis
Reduce menstrual blood loss & anemia
Improved dysmenorrhea for endometriosis
Decreased risk of endometrial & ovarian cancer
Inhibition of hirsutism progression
Prevention of atherogenesis
Improvement in rheumatoid arthritis
•
•
•
•
•
•
•
•
•
•
•

77. 
Adverse Effects
•
T4 and thyroid binding proteins are elevated
Plasma cortisol are also increased
Increase serum levels of triglycerides and total cholesterol
Decrease testoterone
Increase risk of cervical dysplasia and cancer
Lower plasma level of ascorbic acid, folic acid, vitamin B6, B12, niacin,
riboflavin and zinc
Increase risk of thromboembolism if used with CVD patient, > 35 years old
and smokers
Increase risk of Chlamydia trachomatis infection
Cervical mucorrhea
•
•
•
•
•
•
•
•

78. Thrombophlebitis, thromboembolic disease, DVT
• CVD, CAD
• Thrombogenic cardiac valvulopathies & arrythmias
• DM w/ vascular involvement
• Uncontrolled HPN
• Breast, endometrial, hepatic CA
• AUB
• Pregnancy
• Cholestatic jaundice
• Major surgery with prolonged immobilization
•

79. Hormonal-Long Acting

80. Combined Patch
• Continuously release progestin &
estrogen directly through the skin to
the blood stream
• A new patch is worn every week for
3 consecutive weeks
• No patch on the 4th week so
menstruation ensues
• Works primarily by preventing
release of ovulated eggs
• 150ug progestin norelgestrinon +
20ug ethinyl estradiol
• First 2 cycle – dysmenorrhea,
breast tenderness & breakthrough
bleeding

82. Intravaginal or Transvaginal
Hormonal Contraceptive Ring
• Flexible polymer ring has an
outer diameter 54mm & 4mm
cross section
• Releases Ethinyl estradiol 15ug
and Etonogestrel 120ug/day
• Inhibits ovulation
• Ring is placed w/in 5 days of
onset of menses & removed
after 3 weeks of use for 1 week
to allow w/drawal bleeding
• Ring replaced w/in 3 hours within
intercourse
• Complications: vaginitis, ring
related events, leukorrhea

83. •
How to insert/use transvaginal ring

84. Implants
• Small rods or capsules placed
under the skin of a woman’s
upper arm (subdermal)
• 3 to 7 years effectiveness
• Safe for breastfeeding
beginning 6 weeks post partum
• Thickens the cervical mucus
& delay release of eggs from
the ovary
• Progestin suppress ovulation
• NORPLANT – levonorgestrel
(6)
• JADELLE (2)
• IMPLANON (1) – 68mg
Etonogestrel

85. Injectable
Medroxyprogesterone
Acetate/Estradiol
Cypionate
•
•
•
•
Lunelle
1 injection monthly
Inhibits ovulation
Supress endometrial
proliferation
• Estradiol reach peak level 34 days post injection &
decline leading to w/drawal
bleeding to 20-25days after
injection

86.  Benefits
•
•
•
Returns to fertility after
discontinuance
Less breakthrough bleeding
Amenorrhea more frequent
Disadvantage
• Decrease lactation
• Weight gain

87.  Benefits
•
•
•
Long duration of action
Minimal to no impaiment of
lactation
Decrease ovarian and
endoetrial cancer
Disadvantage
• Irregular menstrual bleeding
• Prolonged anovulation after
discontinuance
• Delayed fertility resumption
• Menses may not resume up to 1
year
• Increase risk cervical CA
• Breast tenderness
• Weight gain
• Decrease bone density - REVERSIBLE

88. •
Contraindication
– Thromboembolism
– Stroke
– Cerebro/Cardio VD
– Pregnancy
– Undiagnosed vaginal
bleeding
– Breast CA
– Liver Disease

89. 

The current intrauterine devices (IUD) are
small devices, often 'T'-shaped, often
containing either copper or levonorgestrel,
which are inserted into the uterus..
They are one form of long-acting reversible
contraception which are the most effective
types of reversible birth control.
Failure rates with the copper IUD is about
0.8%.

90. Classification of
Intrauterine Devices (IUD)
First
Generation
Non medicated
Eg. Lippe’s loop
Second
IUD
Generation
Eg. Copper IUD
Medicated
Third
Generation
Eg. Hormonal IUD

91. 1. Medicated IUD:
Those IUDs that carry biologically active agents
into the uterine cavity like levonorgestrelreleasing device [MIRENA]. It is an intrauterine
system (LNG_IUS) that has sleeves of
levenorgestril 52mg around its stem releasing 20
microgram/day and lasting for at least five years.
The advantage of medicated IUDs is that the
carrier part of the devices is smaller and less
traumatic.

92. 



2. Non-medicated IUD:
No drugs are added to the matrix or plate form
of the IUD. It consists of plastic polyethylene and
copper. There are so many types of this group.
The most commonly used are
copper T,
TCU 380A,
Multiload 375 and Nova T.

93. First generation iud
They are inert or Nonmedicated devices
made up of polyethylene
Different shapes and sizes
LIPPE’S LOOP:
 Double ‘S’ shaped device
 Made up polyethylene material
 Non toxic, non tissue reactive &
extremely durable
 Small amount of Barium Sulphate is also
added for radiological examination
 Available in 4 sizes A,B,C &D

94. Second generation Iud
Made up of metal – copper.
EARLIER DEVICES
Copper - 7
Copper - T 200
NEWER DEVICES
Variants of T device

T copper 220C

T copper 380A
Nova T
Multi load devices
ML-Cu250
ML-Cu375
94

95. Third generation iud
Hormone releasing IUD
Progestastert
Most commonly used
T shaped device
filled with 38mg of progesterone
Effective for 1 yr
 LNG-20 (Minera)
Releases 20µg of levonorgesterol.
Effective for 5 yrs
Effective rate 99%

96. ADVANTAGES OF IUDs:
 Safe, Effective, Reversible
 Inexpensive
 High continuation rate
DISADVANTAGES OF IUDs:
 Heavy bleeding and pain
 Pelvic Inflammatory diseases
 Ectopic pregnancy
 May come out accidently if not properly inserted

97. TIMING OF INSERTION:
 Inserted with a plunger
 Any time during women’s reproductive period Except in
pregnancy
 Most ideal time is during or within 10 days of the beginning of
menstruation the diameter of cervical cavity is greatest at this
time.
IDEAL IUD CANDIDATE:
 Who has borne at least 1 child
 Has no history of PID
 Has normal menstrual periods
 Is willing to check IUD tail
 Has an access to follow up and treatment of potential
problems
 Is in monogamous relationship

98. RELATIVE CONTRAINDICATIONS of Intra uterine
contraceptive devices:1. Nulliparity
2. Valvular heart disease and cardiomyopathy
3. Previous ectopic pregnancy
4. Moderate to severe anemia
5. Hypermenorrhea
6. Wilson's liver disease
7. Copper allergy
8. AIDS
9. High risk of STD

99. 1.Cardiomyopathy
2.Recent acute pelvic inflammatory disease
3.Chronic or recurrent PID
4.Recent septic abortion
5.Acute cervical or vaginal infection
6.Congenital uterine anomalies
7.Uterine tumors
8.Undiagnosed uterine bleeding

100. permanent method of
contraception

101. Tubectomy also referred to, as
Tubal Sterilization is a surgical
procedure done on women as a
permanent method of
contraception. Gynecologists,
general surgeons and
laparoscopic surgeons perform
Tubectomy.

102. 
Called tubal sterilization operation (tubal ligation)

Failure rate: 1/2000

Permanence contraception
Have the risks of surgery
 Pelvic inflammations
 Skin (section site) inflammation
 Fever (over 37.5 ℃ two times interval 4h during 24 h)
 Severe disease couldn’t tolerance operation
 Psychological disease


104.  The Fallopian Tubes are two in number and
are attached on either side of the uterus at
one end and the other end is open in the
abdomen.
 The length of each Fallopian tube is about
10cm.When the ovum or egg is released from
the ovary, it is picked up by Fallopian tube
through which it moves into the uterus.

105.  If sperms are present in the Fallopian tubes,
the ovum is fertilized and the resulting
embryo is transmitted to the uterus where it
is embedded.
 In short, we can say that Fallopian tubes are
channels through which the eggs from the
ovaries travel to the uterus.

107. 
There are different surgical approaches for the tubal
sterilization operations are:1. Laparoscopy
2. Micro laparoscopy
3. Laparotomy (concurrent with cesarean delivery)
4. Minilaparotomy
5. Hysteroscopy
6. Vaginal approaches.

108. 
The most popular is using a laparoscope; where
the patient has just a couple of small scars and is
discharged home the same day.
If laparoscopy is not available an open surgical
operation maybe required. Here the tubes are
completely divided and a section is excised.


109.  In Micro-laparoscopy small endoscopes of tiny
diameter (5 to 7 mm) are involved using which
suprapubic incisions is made. This surgery is the
result of improved technology in light
transmission and fiber optic bundles.

111. 




The advantages that are most common in
Tubectomy specifically Laparoscopic (the most
popular type of Tubectomy) includes:
Small incisions
Easy and fast access to the fallopian tubes
Recovery is speedy
However the difference is so nominal that it could
never get very popular despite being available for
almost 20 years.

112. 




Uterus may get puncture often
Laceration of the cervix
Fallopian tube also may get perforated
Perforation of major vessels
Cardiac arrhythmias because of CO2

113.  The follow-up visit for open or laparoscopic
approaches is 1-2 weeks postoperatively.

Notify the health care provider if you develop
fever (38°C or 100.4°F), increasing or
persistent abdominal pain, or bleeding or
purulent discharge from the incision.

114.  Medications should be taken as per the
doctor’s prescription.

Ensure to complete the whole course of the
antibiotic.

Refrain from sexual intercourse for about a
week after surgery or as advised by your
doctor

115. 






Tubal recanalization
Pregnancy
Ectopic pregnancy
Menstrual irregularity
Loss of libido
Infection
Injury rectum or bladder

116.  If you have delayed periods, vaginal
bleeding/spotting, and severe abdominal
pain, consult the doctor immediately, as it
could be an ectopic pregnancy.

117. Vasectomy is a surgical procedure
for male sterilization and/or
permanent birth control. During
the procedure, the vasa
differentia of a man are
severed, and then tied/sealed in a
manner such to prevent sperm from
entering into the seminal stream
(ejaculate).

118.  The vas deferens from each testicle is
clamped, cut, or otherwise sealed.
 This prevents sperm from mixing with the
semen that is ejaculated from the penis.
 The vas deferens is then replaced inside the
scrotum and the skin is closed with
stitches that dissolve and do not have to be
removed.

120.  Vasectomy is a minor surgery that is safe,
highly effective and permanent.
 Whether done on men who did not want to
have kids.
 Vasectomy is cheaper and fewer
complications than tubule sterilization.
 Men have the opportunity to turn
contraception with his wife.

121.  Some men fear a vasectomy will affect his

ability having sex or cause erection problems.
There is little pain and discomfort a few days
after surgery, this pain can usually be
relieved by the consumption of soft drugs.

122. 

Often have to do with an ice pack for 4 hours
to reduce swelling, bleeding and discomfort
and had to wear pants that can support the
scrotum for 2 days.
Vasectomy does not provide protection
against sexually transmitted infections
including HIV.

123.  The operation is not effective immediately.
Patients were required to wear a condom
beforehand to clean the tube from the rest of
the existing sperm. To know is sterile or not,
microscopic examination is usually
performed 20-30 times after ejaculation.
 Regret after vasectomy is greater if the man
was still under the age of 25 years, there has
been a divorce or a child who died.

124.  It takes 1-3 years to really determine whether
vasectomy could work effectively 100 percent
or not.
 The man who wants to open a vasectomy can
be done in a way that is reconnect the
channel sperm, but the small chances
of success

125.  The patients are normally advised to take
painkiller or place ice packs over the wound
(usually covered with a dressing) for 15 to 20
minutes every one hour, for the next 12
hours. This minimizes pain and reduces the
swelling following the surgery.

126.  Bed rest for 24-72 hours following the surgery
is preferable. It is important to refrain from
shower, bathing for 24 hours following the
surgery. This prevents the dressing from
getting soaked and hence reduces the
possibility of an infection.

127.  The dressing is usually left in place for 2-3
days, to absorb the bleeding if any at the site
of incision. It is a good idea to get the
dressing changed in a local hospital or at
home once in every two days. It is very
important that patients abide by the
instructions for a speedy recovery.

128. 
The patient can resume their normal
activities 72 hours after the procedure and are
instructed about wearing a scrotal support for
a short period (1 week). Some doctors advise
patients to resume sexual activity once they
feel comfortable. This of course varies from
person to person and is dependent on the
recovery rate, presence of complications such
as infection etc.

129.  The couples must be advised to follow
contraceptive precautions until the success of
the surgery has been confirmed by semen
analysis, (absence of sperms in the ejaculate
confirms success of vasectomy) performed 4
to 6 weeks following the procedure.

130. 











Spermicides 21%
Withdrawal 19%
Periodic abstinence 15%
Condom female 21%
Condom male 12%
Pills 3%
IUD 2%
Implant 0.3%
Patch 5%
Copper IUD 0.8%
Female sterilization 0.4%
Male sterilization 0.15%