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• A way of thinking & living that is adapted

voluntarily, upon the basis of the


knowledge, attitudes & responsible
decisions by individuals & couples, in
order to promote the health & welfare of
the family group & thus contribute
effectively to the social devlopment of the
country.
Spacing methods
• Barrier method
Physical method
Chemical method
Combined method
• IUD
• Hormonal method
• Post-conceptional method
• miscellaneous
Terminal methods
Male sterilization
Female sterilization
Barrier methods
PHYSICAL METHODS
• Condom
• Nirodh
• + spermicidal jelly
• PR- 2to3/100
Advantages Disadvantages
• Availability • Slip off or tear
• Safe • Interferes - sensation
• Inexpensive
• No supervision
• No side effects
• Compact &
disposable
• Against STDs
• Polyurethane
• 2 rings
• Silicon
• High cost & acceptibility are the major
problems
• 5/100
2.Diaphragm
• Of proper size should
be used.
• Held in position
• Atleast for 6hrs
• Always spermicidal jelly
• 6-12/100
• TSS
3.Vaginal sponge
• Vinegar/ olive oil
• TODAY
• Saturated with nonoxynol-9
• 20-40/100
Chemical methods
• Foams: foam tablets , foam aerosols
• Creams, jellies and pastes
• suppositories
• Soluble films
• The spermicides contain a base into which
spermicide is incorporated
drawbacks
• High failure rates
• Repeated before each act
• Burning and irritation
IUD’s
• First generation • Second generation
Lippes loop Earlier device
Plastic material • Copper 7
Barium sulphate • Copper T 200
Fine nylon tape Newer device
A,B,C & D • Variants of T device
1. T Cu-220 C
2. T Cu 380 A or Ag
3rd generation
Progestasert
• 65mcg dialy
LNG-20[mirena]
• 20mcg levonorgestrel
• 0.2/100
• MOA
Advantages
• Simplicity
• Time taken
• Stays long
• Inexpensive
• Reversible
• Motivation
contraindications
Absolute Relative
• Pregnancy • Anaemia
• PID • Uterine distortions
• U D vaginal bleeding • Mennorhagia
• Carcinoma • Unmotivated
• Ectopic pregnancy • h/o PID

Timing of insertion
Side effects & complications
• Bleeding
• Pain
• PID
• Uterine perforation
• Pregnancy
• Ectopic pregnancy
• Expulsion 12-20%
• Fertility after removal [70%]
• Cancer & teratogenesis
• Mortality 1/100000
HORMONAL CONTRACEPTIVES
ORAL PILLS
• Combined pills
• POP
• Post-coital pill
• Once a month male pill
• Male pill
DEPOT FORMULATIONS
• Injectables
• SC implants
• Vaginal rings
Combined pill
• 5-21st day
• Withdrawl bleeding not
• MALA-N&-D
• POP
• Norethisterone &
levonorgestrel
• Poor cycle control
• Increased preg rate
• In older women
Post-coital contraception
• IUD
• LNG 0.75mg
• 2 OC pills
• Mifepristone
Once a month pill
• Quinsterol
• A long acting estrogen is given in
combination with a short acting
progesterone..
• MALE PILL
MOA
Adverse effects
Unwanted effects
• CV effects
• Breast tenderness
• Carcinogenesis
• Weight gain
• Metabolic effects
• Head ache & migrane
• Others- liver disorders
• Bleeding disturbances
lactation
subsequent fertility
ectopic pregnancy
foetal devlopment
Depot formulations
Injectables
Progesterone only
injectables
• DMPA
• NET-EN [norethisterone
enantate]
• DMPA-sc104mg
Combined injectable
• Subdermal implants
• Vaginal rings
Post conceptional methods Miscellaneous

• Menstrual regulation • Abstinence


• Menstrual induction • Coitus interruptus
• Abortion • Rhythm method
• Natural family planning
methods
1. BBT
2. Cervical mucus method
3. Symptothermic method
• Breast feeding
• Birth control vaccine
Terminal methods
• Guidelines
1. Husband Age 25-50
2. Wife 20-45
3. Min 2
4. >/= 3, the lower limit of age can be
relaxed
5. Spouse concent
Male sterilization
• In PHC
• Atleast 1cm
• Until 30
• Complications
• Operative
• Sperm granules
• Spontaneous recanalisation
• Auto immune response
• psychological
Female sterilization
• Laproscopy
• Minilap [mass campaigns]
• HW-F 7-10 days
12-18 months
Evaluation
• Pearl index- failures per100 women years
of exposure
• Total accidenal pregnancies
=-------------------------------------X 1200
total months of exposure
• Life-table analysis: calculate failure rate
for each month of use
Contraception & adolescence
• Barriers
• IUD
• Hormonal