Post on 02-Feb-2016
description
11
Contraception and Contraception and antifertilityantifertility
Renata VeselaRenata Vesela
renata.vesela@pharm.gu.serenata.vesela@pharm.gu.se
Methods:Methods:
HormonalHormonal Natural methodsNatural methods Barrier methodsBarrier methods Chemical methodsChemical methods Intrauterine device (IUD)Intrauterine device (IUD) SterilizationSterilization CondomCondom
HormonalHormonal Three main mechanisms of action:Three main mechanisms of action:
1. inhibition of ovulation1. inhibition of ovulation2. thickening of cervical mucus 2. thickening of cervical mucus 3. an alteration of the endometrium 3. an alteration of the endometrium
Progestins (gestoden, desogestrel,…) Progestins (gestoden, desogestrel,…) and estrogens (ethinylestradiol or and estrogens (ethinylestradiol or mestranol)mestranol)
Mono-phaseMono-phase CombinedCombined
HormonalHormonal
Effects of progestin:Effects of progestin: Inhibition of ovulation by suppressing Inhibition of ovulation by suppressing
luteinizing hormone (LH) luteinizing hormone (LH) Thickening of cervical mucus, thus Thickening of cervical mucus, thus
hampering the transport of sperm hampering the transport of sperm Possible inhibition of sperm capacitation Possible inhibition of sperm capacitation
Effects of estrogen:Effects of estrogen: Alteration of secretions and cellular Alteration of secretions and cellular
structures of the endometrium within the structures of the endometrium within the uterus uterus
Hormonal- types:Hormonal- types: OralOral
Monthly injectionMonthly injection
Transdermal patchTransdermal patch
Vaginal ring Vaginal ring (the hormones are (the hormones are absorbed by the vagina)absorbed by the vagina)
Hormonal- progestin onlyHormonal- progestin only
Oral: Mini-pill, exact same time of pill Oral: Mini-pill, exact same time of pill administration requiredadministration required
Injection: Injection: Emergency contraception (morning Emergency contraception (morning
“after” pill)- usually progestin only, but “after” pill)- usually progestin only, but can be also a combinationcan be also a combination
Natural methodsNatural methods
Intermittent Intermittent intercourseintercourse
Counting of fertile Counting of fertile and infertile daysand infertile days
Control of the mucusControl of the mucus Method of sexual Method of sexual
abstinenceabstinence Measuring of basal Measuring of basal
temperaturetemperature
Barrier methodsBarrier methods
Vaginal diaphragmVaginal diaphragm
Cervical capCervical cap
Chemical methodsChemical methods
Spermicide gels, creams and foamsSpermicide gels, creams and foams Mechanism: inserted into a woman's Mechanism: inserted into a woman's
vagina to kill or disable sperm thus vagina to kill or disable sperm thus preventing a sperm from fertilizing an egg preventing a sperm from fertilizing an egg
Intrauterine device (IUD)Intrauterine device (IUD) Mechanism of action: two types: a copper IUD Mechanism of action: two types: a copper IUD
progestin-impregnated progestin intrauterine progestin-impregnated progestin intrauterine system (IUS)system (IUS)
have multiple mechanisms of action that have multiple mechanisms of action that provide for contraceptive protectionprovide for contraceptive protection
Both IUDs can alter the uterine lining so that it Both IUDs can alter the uterine lining so that it becomes unfavorable for implantationbecomes unfavorable for implantation
Release of copper ions- alters fluid in the Release of copper ions- alters fluid in the uterine cavity in a manner that impairs the uterine cavity in a manner that impairs the viability of sperm, thereby inhibiting fertilization. viability of sperm, thereby inhibiting fertilization. This mechanism may be responsible for the This mechanism may be responsible for the high efficacy of copper IUDs as emergency high efficacy of copper IUDs as emergency contraception. contraception.
Intrauterine device (IUD)Intrauterine device (IUD)
Female sterilizationFemale sterilization
Male sterilizationMale sterilization
CondomsCondoms
Usually made from latexUsually made from latex Protection against Sexually Transmitted Protection against Sexually Transmitted
DiseasesDiseases (STDs)!!!(STDs)!!!
Thank you for your attentionThank you for your attention
Pictures adapted from: Pictures adapted from: http://www.google.se/imgres?imgurl=http://www.mhhe.com/socscience/sex/http://www.google.se/imgres?imgurl=http://www.mhhe.com/socscience/sex/common/ibank/ibank/0117.jpg&imgrefurl=http://www.mhhe.com/socscience/sex/common/ibank/ibank/0117.jpg&imgrefurl=http://www.mhhe.com/socscience/sex/common/ibank/set-6.htm&usg=__EClGEzM73xP3fSc-common/ibank/set-6.htm&usg=__EClGEzM73xP3fSc-0rIo8vdXxic=&h=480&w=640&sz=86&hl=sv&start=5&itbs=1&tbnid=a0aI3AdHdKS0rIo8vdXxic=&h=480&w=640&sz=86&hl=sv&start=5&itbs=1&tbnid=a0aI3AdHdKSReM:&tbnh=103&tbnw=137&prev=/images%3Fq%3Dvaginal%2Bdiaphragm%26hlReM:&tbnh=103&tbnw=137&prev=/images%3Fq%3Dvaginal%2Bdiaphragm%26hl%3Dsv%26sa%3DG%26gbv%3D2%26tbs%3Disch:1%3Dsv%26sa%3DG%26gbv%3D2%26tbs%3Disch:1