Methods of Contraceptions

CONTRACEPTIVE METHODS

Contraceptive measures are methods used to prevent conception (pregnancy).They include all temporary and permanent measures to prevent pregnancy   resulting from coitus (sexual intercourse).

             Methods of Contraception:-

  1. NATURAL  METHODS
  2. BARRIER  METHODS
  3. CHEMICAL  METHODS
  4. LONG-TERM / PERMANENT METHOD

1.NATURAL METHOD- It is also  known as fertility-based awareness methods. This is the method that uses the body’s natural physiological changes and symptoms to identify the fertile and infertile phases of the menstrual cycle.

                                  TYPES:-

  1. BASAL BODY TEMPERATURE METHOD
    1. CALENDER METHOD OR  SAFE PERIOD METHOD
      1. LACTATIONAL  AMENORRHEA  METHOD
      1. WITHDRAWAL METHOD

A).BASAL BODY TEMPERATURE METHOD:- Ovulation raises body temperature by ½ – 1 degree F And temperature  will drop if fertilization does not occurs.

     B).CALENDER METHOD :-Couple avoid or abstain coitus from day 10 to 17  of menstrual cycle when ovulation could  be expected  and the chances of fertilisation are very high during the period , it is called fertility period.

C).LACTATIONAL AMENORRHEA:-Ovulation and menstrual cycle does not occur during intense lactation following parturition. Increased level of prolactin inhibit production and secretion of GnRH.  Thus decreases the level of oestrogen in body .Ovulation cannot occur without a surge in oestrogen level. These methods add   chemicals similar to  hormones to stop the  release of an egg and      weaken the sperm. The hormones change  your cervical mucus  and uterine lining, slow  sperm, and reduce          ability of fertilized egg to implant into  uterine wall

D).WITHDRAWAL METHOD:- The man takes his penis out of the vagina before  ejaculation.  Male needs to ejaculate away from  female; sperm on legs and labia can still  travel into vagina.Effectivity  of this method depends on a male’s self knowledge  and self control. Effectiveness: 78-96%.

2..BARRIER  METHODS:-Barrier  method  of contraceptive prevent the meeting   of ovum and sperms after coitus. These includes

  1. Mechanical Barrier
  2. Male condom
  3. Female condom
  4. Diaphragm
  5. Cervical cap
  1. Chemical Barrier
  2. Spermicides
  1. Combined

a).Male condom:-  A thin covering that you unroll over an erect  penis. Made of  latex, polyurethane, or animalmembrane.Put on before any genital contact. At withdrawal, hold the rim in place at the base of  the penis so it doesn’t slip off. It may decrease the sensation for men.Lubrication makes condom less likely to break. Effectiveness: 82-98%.Have no side effect and protect against STD.

b).Female condom:- A soft, loose pouch that is inserted in the  vagina. Flexible rings at each end hold it in  place. Insert the small ring in vagina, large ring  stays outside partially covering labia. It can be put in up to 8 hours before sex. It can be used if you are allergic to latex  (made of nitrile).Men usually feel no reduction  in sensation. Effectiveness: 79-95%

c).Diaphragm &Cervical cap:- A diaphragm or Cervical  cap is a barrier method of contraception that  inside the  vagina and prevents sperm passing through the cervix (the entrance of  womb). A gel that kills sperm (spermicide)  need to use with it.

II).Chemical Barrier:-  (Spermicides)- Achemicals that go inthe vagina before sex and they  immobilize or kills sperm.It ismostly  work for one hour . Put in vagina following   packaging directions.     It need to be put in 10  minutes  before intercourse. Nanoxynol-9 and Octoxynol-3 are chemical used as spermicidal agent .Effectiveness: 72-91%.It may be

  • Cream
  • Gel
  • Foam
  • Film
  • Suppository
  • Sponge

3.CHEMICAL  METHOD:-In this methods    chemicals similar to  hormones added to stop the  release of an egg and  weaken the sperm. The hormones  change   cervical mucus  and uterine lining, slow  sperm, and reduce   ability of fertilized egg to implant into  uterine wall.

                      TYPES OF CHEMICAL  METHODS

                       A).STEROIDAL DRUGS

                        1).The Oral Contraceptive Pills.

                                  1.COMBINED PILLS

                                  2.SEQUENTIAL PILLS

                                  3.MINI PILL OR MICRO PILL

                                  4.PROGESTRON ANTAGONIST

                               2).Depot Preparation.

  1. The Patch
  2. Vaginal Ring
  3. The Shot
  4. Subdermal Implants.

                      B).NON STEROIDAL DRUGS

                                           1).Centchroman

                     C).INTRAUTERINE CONTRACEPTIVE DEVICES

                        D).EMERGENCY CONTRACEPTIVE

A).ORAL CONTRACEPTIVE PILLS :- The Contraceptive pills  (also called  birth control pill or “the Pill”) is a  daily pill  that contains hormones, who  prevent the pregnancy by changing  the  the body function . Hormones are chemical substances that control the functioning of the body’s organs. In this case, the hormones in the Pill control the ovaries and the uterus.

TYPES:-

1.COMBINED PILLS

2.SEQUENTIAL PILLS

3.MINI PILL OR MICRO PILL

4.PROGESTRON ANTAGONIST

1.COMBINED PILLS: – It contains orally active progesterone (nor-ethioesterone , norethynodrel, chromodinone) combined with small amount of oestrogen (ethinyl oestradiol).eg-MALA-D ,MALA-N

 2. SEQUENTIAL PILL:-High dose of oestrogen for 15 days followed by 5      days of oestrogen + progesterone . This inhibits ovulation by suppressing the release of both FSH and LH.

3. MINI PILL OR MICRO PILL:-Low dose of progesterone.

   eg- POP (PROGESTIN ONLY PILLS)

4. PROGESTRONE ANTAGONIST:-Producing abortion following the conception  Inhibiting the progestational effect on uterus.

 eg – MIFEPRISTONE

  Mode of action of pills:-Pills makes cervical mucus thick and renders the cervical mucus hostile  (unfriendly ) to sperm penetration.  It induces endometrial changes which prevent implantation of blastocyst. By an action or hypothalamus which inhibits secretion of LH.

DEPOT PREPARATION:-  Depot  preparations are long acting drugs and highly effective. These are available in four  forms:

  1. The Patch
  2. Vaginal Ring
  3. The Shot or Injectable preparation.
  4. Subdermal Implants

1.The Patch:- A bandage-like patch that sticks to  skin and it changed weekly. no patch required on 4th week of menstrual cycle. Hormones are absorbed through the skin .It is less effective body  weight over 198  pounds.It may causes skin irritation. Prescription needed for its application.Effectiveness: 91-99.7%

2.Vaginal Ring:-  Vaginal rings containing norgestrel are implanted intravaginally .The body absorbs hormones from the  ring through vaginal wall.The ring is  inserted and left in the vagina for 3 weeks. Effectiveness: 91-99.7%

3.The Shot: – A long acting hormone injected intramuscularly. Female is given a shot one time every 3 months. It is non reversible- and once the injection  given , the hormones are in the woman for at  least 3 months. It may take a long time to get  pregnant after the shot. More chance of weight gain than any  other method. Effectiveness: 94-99.8%.It may be two types

i).Oily progestrin preparation

ii).Combined injectable preparation

4.Subdermal Implant:- A soft rod 1 ½ inches long placed  under the skin in your upper arm which  are slowly releases hormones into your  body These are two types

I).Norplant-six flexible silastic tube ,each containing 35mg progesterone (Levonorgestrel).

ii).Norplant(R)2-two rod of (Levonorgestrel).Implant  prevents pregnancy for 3 years, but  can be taken out at any time.Effectiveness: 99.95%

B).NON STEROIDAL DRUGS

    1).Centchroman:- The new oral contraceptive for the females contain a non-steroidal  preparation developed by CDRI    Lucknow marketed under the trade name SAHELI.  It is once a week pill” with very few side effects  and  high contraceptive value.

C).INTRAUTERINE CONTRACEPTIVE DEVICES:- Implantation of foreign body into uterine cavity for contraceptive purposes.

1.NON-MEDICATED IUCDs– eg-Lippes loop

2.MEDICATED IUCDs-These are two types

a).Second generation IUCDs-

 eg-Copper T, Coper T200,NOVA-7,NOVA-T,

                multi-loaded devices.

b).Third generation IUCDs-Harmone releasing IUCDs

    eg- PROGESTASERT, LNG 20

D).EMERGENCY CONTRACEPTIVE :- It is also known as Postcoital pill or Morning after pills.A pill or combination of pills which are recommended within 72 hour s of unprotected intercourse. It contains a higher dosage (DOUBLE DOSE of combined pills )of the same  hormones found in regular birth control. It won’t stop an existing pregnancy .Available at pharmacy for girls  17+, prescription is needed if less than 17 .Effectiveness is  Approx 95% if taken within first  24 hours of unprotected sex, rape or contraceptive failure.

4).LONG-TERM / PERMANENT METHOD:-  These procedures are permanent, and  are usually done by people 35+ years, Both procedures are done in a doctor’s  office.

  1. Female- Tubal  ligation
  2. Male- Vasectomy

Female- Tubal  ligation :-A small incision is made in the abdomen to  access the fallopian tubes. Fallopian tubes are  blocked, burned, or clipped shut to prevent the  egg from traveling through the tubes  . Recovery usually takes 4-6 days.

Male- Vasectomy:-A small incision is made to access the vas  deferens, (the tube through which sperm travels from the  testicle to the penis) and is sealed, tied, or  cut.After a vasectomy, a male will still  ejaculate, but there won’t be any sperm present.

Polyhydramnios

               Polyhydramnios is a medical condition in which an excess of amniotic fluid is present in the amniotic sac. It is seen in about 1% of pregnancies. It is typically diagnosed when amniotic fluid index (AFI) is greater than 24 cm.

 Polyhydramnios condition may be of two types:

  1. Chronic polyhydramnios where excess amniotic fluid accumulates gradually
  2. Acute polyhydramnios where excess amniotic fluid collects rapidly.

Causes of polyhydramnios may be single or may be multiple and in many cases cause of polyhydramnios may be not known. Some important causes of polyhydramnios are maternal cardiac problems, renal problems, maternal diabetes mellitus, and some viral infection and foetal cause are congenital foetal malformation (tracheao esophageal fistula, anencephaly, open spina bifida, facial cleft and neck masses), twin baby syndrome, Rh blood group incompatibility and chorioangioma of placenta, etc.

In majority of cases the accumulation of amniotic fluid is gradual and the patient is not very much inconvenienced. The patient may suffer from dyspnoea, palpitation, edema of leg, varicosities in the legs or vulva and haemorrhoids.

Investigation by sonography in which AFI is more than 24cm. on the basis of AFI polyhydramnios may be of mild, moderate and severe. If AFI is upto 29cm it is categorised as mild and in between 29 to 35cm it is moderate. When AFI is more than 35cm it is severe type of polyhydramnios. In case of severe polyhydramnios the chance of foetal malformation is more and perinatal mortality rate is high. Radiography is not commonly performed these days.

Polyhydramnios can cause maternal and foetal complication. Maternal complications may be eclampsia, malpresentation, premature rupture of membrane, pre-term labour, accidental haemorrhage, cord prolapse, uterine inertia.

The death of foetus is mostly due to prematurity and congenital abnormality.

Management of polyhydramnios depend on the severity of it. In minor degree amnios usually require no treatment except extra bed rest for few days. In case of severe case of polyhydramnios if there is no foetal abnormality and pregnancy is less than 37 weeks amnio reduction is done.

GOD AND BRAIN 1

प्रस्तर मानव से अंतरिक्ष मानव तक के सफ़र में मानव ने अनेक प्रकार की परिकल्पना की जिसमे से दो जो सबसे आश्चर्यजनक है वो है ईश्वर की परिकल्पना l हमारी कल्पना के अनुसार ब्रह्माण्ड एक व्यवस्थित रूप में विद्यमान है जिसको किसी शक्ति द्वारा रचित किया गया है और इसी शक्ति को हमने ईश्वर का नाम दे दिया और फिर आगे इस सिद्धांत को प्रतिपादित किया गया की संसार का कण कण इस शक्ति द्वारा संचालित होता है l फिर आगे ईश्वर के बारे में संसार के लगभग हर धर्मो में भिन्न भिन्न बाते कही गयी जिनका सारतत्व लगभग यही है की ईश्वर ही इस सृष्टि का कर्ता और संहर्ता l हमारी कल्पना में ईश्वर सर्वशक्तिमान है प्रकृति में होने वाली हर घटनाओं का कारण वाही है l

हमारी जो दूसरी सबसे आश्चर्यजनक परिकल्पना है वो मानव मष्तिस्क l यह माना जाना है की मानव में एक मस्तिष्क होता है जिसके नियंत्रण में मानवशारीर और उसमे घटित होने वाली सारी क्रियाये होती l वस्तुतः मानव मष्तिष्क को संसार का सबसे विकसित वस्तु मानी जाती है और आधुनिक विज्ञानं का मानना है की मनुष्य अपने मस्तिष्क के द्वारा अपनी सभी समस्याओ का हल प्राप्त कर सकता है l आधुनिक विज्ञानं में मस्तिस्क के बारे में बहुत जानकारी नहीं प्राप्त है और ऐसा मन जाता है की मानव अपने मस्तिस्क का 5 प्रतिशत भाग ही प्रयोग कर पता है l

अब हम इस बात पर आते है की इन दोनों परिकल्पनाओ की उत्पति कैसे हुई l ईश्वर की परिकल्पना जहा धर्म की देन है वही मानव मस्तिस्क विज्ञानं की देन है और ये दोनों परिकल्पनाए जहा एक दुसरे की विरोधभासी है वही एक दुसरे का समर्थन भी करती है l ईश्वर की परिकल्पना मानव मस्तिष्क के विकास का चरम है क्योकि मनुष्य का मस्तिस्क जब किसी समस्या को हल करने में अपने को असमर्थ पता है तो इश्वर को सामने लाता है और अपनी समस्या का कारक ईश्वर को बताता है