Birth Control

Methods
Table of contents
Hormonal
Menstruation Cycle
01 03
Contraception
Follicular phase Combined COC
Ovulatory phase Progestin only
Leuteal phase Intrauterine Devices

Non-Hormonal 04 Abortion Pills

02 contraception Definition and how to use
Periodic Abstinence
spermicides
Conclusion
Physical barriers
05
Effectiveness of
contraception methods
Introduction
Contraception can be used to prevent
pregnancy and some types will also protect
you from sexually transmissible infections
(STIs).

You might find yourself asking: Which

method will be best for me and my lifestyle?
Which method protects against STIs?

What about convenience of use? Possible side-

effects? Cost? How effective will it be?
 01
Menstrual Cycle
Menstrual Cycle
What is menstruation?
● Menstruation is the monthly
shedding of the lining of the
uterus.
Menstrual Cycle
What is menstrual cycle?
The menstrual cycle is a term to describe the
sequence of events that occur in women’s body as it
prepares for the possibility of pregnancy each month.

menstrual cycle is the time from the first day of the

menstrual period until the first day of your next
menstrual period.
Menstrual Cycle
How long is a normal menstrual How long does a normal
cycle? period last?

The average length of a Most people have their

menstrual cycle is 28 period (bleed) for between
days three and seven days
Menstrual Cycle
Stages of menstrual cycle

1-Follicular phase

2- Ovulation

3- Luteal phase
 Menstrual Cycle

menses Proliferative hase Ovulation Luteal phase

is the time when the from days six to 14. During this time, occurs roughly at lasts from about day 15 to
lining of the uterus sheds the level of the hormone estrogen rises, about day 14 in a 28- day 28. The egg leaves
through the vagina if which causes the lining of the uterus to day menstrual cycle. ovary and begins to travel
pregnancy hasn’t grow and thicken A sudden increase in through fallopian tubes to
occurred another hormone FSH causes follicles in another hormone LH uterus. The level of the
the ovaries to grow. During days 10 to causes the ovary to hormone progesterone
14, one of the developing follicles will release its egg rises to help prepare
form a fully mature egg. uterine lining for
pregnancy.
If the egg becomes fertilized by
sperm and attaches itself to the uterine
wall (implantation), the woman
becomes pregnant. If pregnancy
doesn’t occur, estrogen and
progesterone levels drop and the thick
lining of the uterus sheds during the
period
 03
Non hormoal
Contraception
 Non hormonal
Contraception

Periodic Barrier's
spermicides
abstinences techniques

Basal body Cervical

condom Diaphragm sponges
temperature mucus
Periodic Abstinences
● WHAT IS FERTILITY AWARENESS-BASED CONTRACEPTION?

FAB methods involve identifying the fertile days of the menstrual.

How??
a woman is fertile from five days before ovulation to the 24 hours after
ovulation.

FAB methods rely on the following:

●The periodicity of fertility and infertility
●A single ovulation each cycle
●The limited duration of viability of the ovum, which can only be
fertilized 12 to 24 hours after release
●The limited duration of viability of sperm
●A woman's ability to monitor cycle length and/or cycle-related
symptoms and signs, such as changes in cervical mucus
Periodic Abstinences
Contraindication:
● Patients who desire a highly reliable
contraceptive
● do not have regular menses
● unable to track their menses or physiologic
changes
● do not have a supportive partner
Periodic Abstinences
2-Basal body temperature
1-Cervical secretions
Abundant, clear, wet, stretchy In a normal menstrual cycle, BBT is
cervical secretions occur approximately 0.5°F (0.3°C) higher
immediately before, during, in the luteal phase than in the
and immediately after follicular phase. The temperature
ovulation; rise begins 1 or 2 days after the
thus, the day of ovulation can surge in luteinizing hormone and the
be predicted by observing rise in progesterone concentrations
changes in vaginal discharge and persists for at least 10 days.
that occur over a typical 28-day
menstrual cycle
Periodic Abstinences
How Effective Is Natural Family Planning?
Typical use: 76% effective

Pros
● Inexpensive or free
● Does not involve drugs or medical procedures

Cons
● No STD protection
● Keeping track of your cycle is required
● Spontaneity is limited
● Low effectiveness rate
Spermicide
Spermicides are chemicals that How to use?!
kill sperm and prevent them from
fertilizing the egg. Spermicides must be inserted
deep into the vagina
They are available in different before sexual activity.
forms such as foams, creams,
jellies, or films.
Spermicide
Note
Mechanism of action:
They are most commonly used in
Spermicide blocks the cervix and keeps combination with other birth
the sperm from moving, which prevents control methods, rather than
the sperm from reaching the eggs. alone
Spermicide
Pros Cons
Low cost (about $8 per package) No STD protection
Easy to use May be messy
Extremely easy to purchase May irritate the penis or vagina
Can be used during breastfeeding Low effective rate if used alone

Effectiveness?
Typical use: 72% effective
Barrier’s Techniques
Barrier methods of contraception
block the sperm’s access to a women’s uterus, in order to prevent
pregnancy.

Barrier methods include:

-Condoms(M,F)
-Diaphragm
-Sponge-Spermicide
-Cervical Cap
Barrier’s Techniques
1- Condoms: made up of very thin
latex, polyurethane or polyisoprene,
prevent sperm from meeting an egg
also prevents STIs.

Advantages: Disadvantages:
-Prevents pregnancy -Latex sensitivity
-Cheap and convenient -Not foolproof
-No permanent fertility changes -Condoms may break or leak
-Decrease sexual sensation
Barrier’s Techniques
2- Diaphragm: it is a circle of silicone It is placed over the cervix with
spermicide before sex and left in place for at least six hours after sex.

Advantages:
-Immediately effective and Disadvantages:
reversible form of birth control -It is not effective as other
-No serious side effects or health types of contraception
risks -It take time to learn how to
-You can put it in at a convenient use it
time before having sex
 Barrier’s Techniques
3- Sponge: It is one size, disposable
piece of polyurethane foam, also it
contains nonoxynol-9 which is a
chemical that kills the sperms.

Advantages: -Available without

prescription Disadvantages:
-Doesn’t contain hormones -Less effective than other contraceptives
-Safe to use while breastfeeding -Doesn’t protect against STIs
-Doesn’t affect your menstrual cycle -May cause allergic reaction because it
-Costs less than hormonal types of birth contains spermicide
control -Not comfortable
Barrier’s Techniques
4- Cervical Cap: It is a small cup that is made up of silicone, it is placed over
the cervix to prevent sperms from entering.

Advantages: Disadvantages:
-Safe to use while -Difficult to learn how to
breastfeeding insert and remove than
-Doesn’t contain hormones diaphragm
-Doesn’t affect menstrual -Mild allergic reactions
cycle -It is not effective as others
-Costs less than others -It doesn’t provide reliable
protection against STIs.
 03
Hormonal
Contraception
 COC

Combined Transdermal
contraceptive patch

Hormonal Contraception
Vaginal ring

pop

Progestin only injectable

Implanted rod

Copper IUD
Intrauterine
Progestin
containing IUD
Progestin Only
1- Pop contraceptive
Definition:
It's an oral contraceptive that contains only
progestin hormone.

Mechanism of action:
a. by thickening cervical mucus--> sperm can't
reach an egg easily
b. by suppressing ovulation

It can be a suitable option for people who can't take estrogen-based

contraceptives due to health reasons.
Progestin Only
1- Pop contraceptive
Doses:

-Stared doses: on any day or on first day of period.

There are no free days with the POPs

-Missed dose: Doses of POPs must be taken at the

SAME time every day; a missed dose of POPs
means more than 3 hours.
Progestin Only
Pros Cons
-Decreased menstrual -Progestin related adverse
blood loss, cramps, pain effects (e.g, weight gain, acne)
-reversible -Irregular menses
-Preferable in lactating -Adherence
women

Contraindication?
• Suspected or demonstrated pregnancy
• Active hepatitis, hepatic failure, jaundice
Progestin Only
2- Injectable:
A 1-mL crystalline suspension of 150 mg of depot
medroxyprogesterone acetate (DMPA) injected intramuscularly
into deltoid or gluteal muscle every 11–13 weeks

Start methods:
i. Preferred start: First 5 days of menses. No backup needed
ii. Alternative start: Any time in cycle if not pregnant. Use
backup for 7
days.
iii. Breastfeeding: May start immediately or wait 4–6 weeks
iv. Switching methods: Any time patient not known to be
pregnant. Use backup if necessary
Progestin Only
2- Injectable:

Adverse events:
– Progressive significant weight gain
– Severe depression (rare)
– Black box warning—Loss of bone
Progestin Only
3- Implanted Rod:
Subcutaneous injection of 104 mg of
DMP

It has FDA indication for endometriosis

What is endometriosis??
Endometriosis :a condition resulting
from the appearance of endometrial
tissue outside the uterus and causing
pelvic pain
Intrauterine devices
Definition: Types :
Long term prevention of pregnancy
1-Copper (ParaGard T 380A)
Recommended for Women Who:
- Have at least one child 2- Progestin
- Have no history of pelvic
inflammatory disease (PID) or
ectopic pregnancy
- Have heavy menses, cramps, anemia,
or dysfunctional uterine bleeding
(Mirena only)
Intrauterine devices
1- Copper IUD
Copper IUD inserted into the uterus by a health care
professional

Mechanism of action:
i. Primary action: Spermicide
ii. Copper ions inhibit sperm motility and acrosomal
enzyme activation so that sperm seldom reach
fallopian tube and are unable to fertilize the ovum.
iii. A sterile inflammatory reaction created in
endometrium phagocytizes sperm
iv. Does not interfere with ovulation and is not an
abortifacient
Intrauterine devices
1- Copper IUD
Contraindications:
-Pregnancy
-Genital bleeding of unknown etiology
-Untreated acute cervicitis or vaginitis
-Acute liver disease or liver tumor
-Immunocompromised
-Hypersensitivity to any component of this product
-Known or suspected carcinoma of the breast
- History of ectopic pregnancy or condition that
would predispose to ectopic pregnancy
 Combined Contraceptives
1. COC
Definition:
is a tablet that contains two hormones, progestogen and
estrogen, and is taken daily to prevent pregnancy.

Mechanism of action:
The hormones in the pill work by preventing the ovaries from
releasing an egg each month (ovulation).

Miss dose:
If you miss a pill and are not sure what to do, continue to take
your pill, use another method of contraception and seek advice
as soon as possible.
Combined Contraceptives

1. COC
Advantages: Disadvantages:
-Less painful period -increase in blood clots
-keep acne under control - increase risk of breast cancer
-Noninvasive method - The pill may not be effective if used in
-Reversible conjunction with other medication
- Remembering to take the pill everyday
may be difficult
 Combined Contraceptives
2. Transdermal patch:
Definition:
The patch releases a daily dose of hormones through the
skin into the bloodstream to prevent pregnancy. It contains
the same hormones as the combined pill.

Mechanism of action:
works in the same way by preventing the release of an
egg each month.

How to use:
Each patch lasts for 1 week. You change the patch every
week for 3 weeks, then have a week off without a patch.
 Combined Contraceptives
2. Transdermal patch:

Disadvantages:
Advantages: -skin irritation
-faster results -No protection against STI,
-improved compliance including HIV
-Easy application -Interacts with some medications
such as rifampin
A very small number of people
using the patch may develop a
blood clot in a vein or an artery.
Don't use the patch if you've had
a blood clot before.
 Combined Contraceptives

3. Vaginal Ring:
Definition:
The vaginal ring (NuvaRing) is a small soft, plastic ring that
is placed inside the vagina.
You can start using the vaginal
ring 42 days after giving birth if
Mechanism of action: you are breastfeeding. You will
It releases a continuous dose of the hormones oestrogen and need to use additional
progestogen into the bloodstream to prevent pregnancy. contraception for 7 days

Unique feature:
the ring still works if you have sickness (vomiting) or
diarrhea.
 04
Abortion Pills
 Abortion pills
• is a medication that ends a pregnancy.
• A medical abortion requires the pregnant
person to take two different medications.
 How to use?
The abortion pill requires a pregnant person to take
two different medications in the following
order:
1. Mifepristone stops the pregnancy from
growing. It blocks the body from producing
the progesterone hormone, which is necessary
for a pregnancy to continue.

2. Misoprostol, taken 1–2 days later, induces

cramping and bleeding to cause the uterus to
empty.
 How effective the
medication is?
The abortion pill is very effective. In the first 9
weeks of pregnancy, has a success rate
of 95-98%

the effectiveness drops progressively from

weeks 9 through 11
There are some situations when a medication
abortion is not an option

Ectopic Pregnancy Intrauterine device a condition that

requires long-term
steroid therapy.

Chronic adrenal Blood thinner uses Aallergy to one of

failure the active
ingredients
 05
Basis of Comparison
What birth control is best?
Which contraception method is better?

• Ease of use or comfort level using the

method.
• Effectiveness at preventing pregnancy.
• Protection against (STIs).
• Your age and overall health.
• Plans for pregnancy.
• Side effects or risks.
• Privacy (how important it is to keep
your birth control method a secret).
Thanks
Do you have any questions?