Categories: All - sterilization - emergency

by R G 15 years ago

1111

Contraception

Various forms of contraception offer different methods and benefits, from hormonal to barrier methods, and even permanent solutions. Hormonal options include the combination pill, the progestin-only minipill, injectables, implants, and the transdermal patch, which work by regulating ovulation and hormonal cycles.

Contraception

Contraception

Other

Lactational Amenorrhea
1st 6 mo post-partum
Guidelines

Exclusively breastfeed

Remain amenorrheic

MOA

Inh. Dopamine

Prolactin

Depress GnRH

Emergency Contraception
IUD

Not good option for nulliparous women

RU-486 (Mifepistrone)

Not indicated in US

Antiprogestin

Plan B (Levonorgestrel)

Prevent implantation

Prevent ovulation

Combo pill (Estradiol & Norgestrel)

Nausea common

75% effective

Periodic Abstinence
Avg: 17 days of abstinence
Symptothermal

Cervical mucus & Basal body temperature

Cervical mucus

Abstain when cervical mucus sticky/moist

Rhythm or Calendar

Predict ovulation

Sterilization
Technical skill
Regret
Permanent
IUDs
Disad

risk of PID

No STI protection

Cost-effective long-term

Reversible, no delay in fertility

Barrier / Vaginal Methods

Spermicides / Foams
Yeast infxn
Nonoxynol-9
Condoms
Female

Cumbersome to use

Male
Diaphragms
DisAd

Toxic Shock

UTIs

Adv

Gonorrhea

Leave in for 6 h after sex
Requires prescription
Requires fitting

Hormonal

Transdermal Patch
Decreased efficacy in females >= 90 Kg
Vaginal Insert
Same as Combo-OCPs
3 wks on, 1 wk off
Injectables / Implants

Progestin-only

Implanon

3 years

Depo-Provera

3 mo.

Medroxyprogesterone acetate

OCPs
Progestin-only Minipill

Take at same time everyday

Irregular bleed

40% will ovulate

Combination

Most common reversible method

DVT/Stroke

Liver cancer