Contraception

Contraception

1. Contraceptive Injection

   • Effectiveness: >99%. (<1 in 100 pregnancys/year)
   • MOA: Releases Progesterone, Prevents ovulation, Thickens cervical mucus preventing spern reaching the egg, Thins lining of uterus prevents egg mplantation
   • Advantages: Lasts 12 weeks (depo-provera) or 8 weeks (Noristerat), Protects against uterine cancer & PID
   • Disavantages: Periods may stop, be irregular or longer (takes time for fertility to return), weight gain, may suffer from headaches, acne,mmood changes, breast tenderness
   • Comments: Cannot be removed from body once administered. (side effects will continue as long as injection lasts)

2. Implant

   • Effectiveness: >99%. (<1 in 1000 pregnancys/year)
   • MOA: Inserted subcutaneously, Releases Progesterone, Prevents ovulation, Thickens cervical mucus preventing spern reaching the egg, Thins lining of uterus prevents egg mplantation
   • Advantages: Lasts 3 years. fertility returns to normal once implat removed
   • Disavantages: Periods may stop, be irregular or longer (takes time for fertility to return), weight gain, may suffer from headaches, acne,mmood changes, breast tenderness
   • Procedure needed to fit/remove, tenderness, brusing around sight. Some medicines may stop it working

3. Contraceptive Vaginal Ring

4. Contraceptive Patch

5. Pill

   • Combined Pill (COC)
     • Contains oestrogen and progesterone
     • 99% effective if taken correctly
       • Can be effected by D+ & V+
     • prevents ovulaion
     • contraindications
       • smoking
       • High BP
       • Strong Fmily history of Breast cancer
       • FH of clotting problems
   • Progeserone Pill (POP)

6. Condom

   • Male Condom
     • Barrier Method
     • 98% effective
     • Protects against STIs
     • Putting on can involve interruption of sex
     • Can split/rupture
   • Female Condom
     • 95% Effective
     • Barrier method
     • Good for those wishing to avoid taking hormones
     • Putting them on involves intteruption of intercourse
     • Condom can be pushed aside
     • Offers protection agaisnt STIs

7. Sterilisation

   • Female Sterilisation (Tubal Occlusion)
     • Effectiveness: Failure rate 1/200
     • MOA: Fallopian tubes cut, sealed/blocked, prevents egg and sperm meeting.
     • Advantages: Doesnt interrupt sex, No long/short term side effects, periods uuunaffected
     • Disadvantage: Small increased risk of ectopic pregnanc if sterilisation fails, GA needed, PERMENANT.
   • Male Sterilisation (Vasectomy)
     • Failure rate: 1/2000
     • MOA: Vas deferens cut/sealed/blocked
     • Advantages: Doesnt interrupt sex, No long/short term side effects
     • Disadvantages: Contraception must be used until semen tests show no sperm resent. (can take 2 months), may experience some testicular pain
     • Permenant, shouldnt be chosen if any doubt. Important to rest/ avoid strenuous activity post op.

8. Intrauterine

   • Intrauterine System (IUS)
     • Effectiveness: >99% effective. 1/100 pregnancies per 5 years
     • MOA: T-shaped plastic deivce that releases progesterone causing stopping of ovulation, Thickens cervical mucus preventing spern reaching the egg, Thins lining of uterus prevents egg mplantation
     • Advantages: Lasts 5 years (can be removed any time), fertility returns to normal once removed, periods become lighter/shorter/less painful
     • Disadvantages: Irregular bleeding/spotting 1st 6 months, acne, headaches, breast tenderness, risk of infection 1st 20 days, risk of ovarian cysts
     • Fitted after 45 can remain in until post menapause, women taught to check IUS in place,
   • Intrauterine Device (IUD) COIL
     • Effectiveness: >99% effective. 1/100 pregnancies per 1 year
     • Fitted after 40 can remain in until post menapause, women taught to check IUD in place,
     • Advantages: Lasts 5-10 years (can be removed any time), fertility returns to normal once removed
     • Disadvantages: Not suitable for those at risk of STIs, Periods may be heavier/longer more painful, risk of ectopic pregnancy, risk of infection 1st 20 days
     • Small plastic & copper device acts as a barrier stops sperm reaching the egg, stops egg implanting

9. Diaphragm/Cap with spermicide

10. Natural Family Planning