Methods of

Contraception
RISUG (Reversible Inhibition of Sperm
Under Guidance)
• A local anaesthetic is applied to the scrotum at
the injection site.
• The vas deferens—the tube that sperm pass
through on their way from the testes to the
penis—is extracted through the scrotum and
injected with a polymer made from styrene
maleic anhydride (SMA) and dimethyl sulfoxide
(DMSO).
• On the market, this non-toxic polymer is
known as Vasalge. The process is then repeated
on the other side with the second vas deferens
 Adiana sterilization system
• A clinician delivers a catheter through a
hysteroscope into the fallopian tube & uses the
cathter to apply low level radio frequency
energy ,followed by an insertion of a matrix
(polymer implant,smaller than grain of rice )
• The matrix is left in the fallopian tube and the
surrounding tissue will grow into it causing
permanent blockage
• Failure rate :0.2 per 100 women years
• US FDA approval recently
 ESSURE
The Essure is a permanent birth control (female
sterilization) by, an occlusion of the fallopian tubes
with the use of trans-cervical bilateral insertion of
blocking coils directly into the lumen of the tubes
• The device itself is made from dual coils that
expand into the tubal lumen when deployed. Its
fibers stimulate occlusive tissue growth over a 3
month period.
• Successful placement and tubal occlusion is
confirmed by hysterosalpingography • It is
irreversible Removal of the micro-inserts requires
surgery. Its hould not be considered 100% effective
 Advantages
• No incision
• No hormones
• No anaesthesia
• outpatient
• Effective The one-year and two-year failure
rates established in the Essure clinical trials were
both 0%.
• Rapid recovery
• High patient satisfaction
 Complications :
• Complications include device expulsion, tubal
perforation, and pregnancy.
• Unlike laparoscopic sterilization, it is not
immediately effective
The highly charged polymer attaches to the inner
walls of the vas deferens, and when it comes in
contact with the negatively charged sperm, ruptures
their tails so that they are incapable of fertilizing eggs
• This is what separates RISUG from a vasectomy—
sperm can still be expelled from the scrotum, but
cannot reach and fertilize an egg
• The procedure typically lasts no more than a few
minutes
• The reversal process is also simple, with a quick
injection of water and baking soda to flush out the
Vasalgel.
• The side effects of the procedure are minimal, and
may including swelling at the injection site.
 What’s New in Contraception
• Factors to consider:
• Innovative methods
• Longer term
• Reduced dosing
• Reduced risks
• Quick reversibility
• Equally as effective as OCP
• Less reliant on the user
 Methods of Contraception

I Combined
Hormonal Oral contraceptive pills Depot
medroxyprogesterone acetate
injections Transdermal patches and
Vaginal rings,
II Barrier and Male condoms, Diaphragms Caps,
Behavioral Female condoms, Spermicides
Withdrawal, Fertility awareness
method, Natural family planning
III Longer Term Progestin implants and Intrauterine
devices
IV Sterilization Female sterilization and Vasectomy
Transdermal patch
• It is a beige-colored patch applied once a
week to the abdomen, buttock, upper outer
arm, or upper torso (excluding breasts).
• The patch releases 150 mcg of
norelgestromin and 20 mcg of ethinyl
estradiol to the bloodstream daily to inhibit
ovulation.
• 3 consecutive 7-day patches (21 days) are
applied, followed by 1 patch-free week per
cycle. The patch contains 9 days of
medication.
 ADVANTAGES

Very effective Rapidly reversible

Excellent cycle control by 3 months of use
Easy to use, start, and stop Extra
protection built in; serum hormone levels
will remain in the contraceptive range for
up to 2 additional days
 DISADVANTAGES:

Requires a prescription
Concern about visibility of patch
for some women Possible skin
reactions Slight increase in risk of
VTE compared with COCs Lack of
protection against STIs
VAGINAL RING (NUVA RING )
• Vaginal ring is a thin, transparent, flexible
ring that contains estrogen/progestogen
hormones that are absorbed through vaginal
mucosa.
• The ring is 92% to 99% effective for
pregnancy prevention (typical to perfect use).
• It stops ovulation and thickens the cervical
mucus.
• Worn continuously for three weeks followed
by a week off, each vaginal ring provides one
month of birth control.
 Advantages
Easy to use Can be worn for three
weeks Effects fertility one month at a
time
Disadvantages
Does not protect against sexually
transmitted infections, including HIV/
AIDS Spotting Increased vaginal
discharge
 ADVERSE EFFECTS

• Vaginitis (14.1%)
• Headache (9.8%)
• URTI (8%)
• Leukorrhea (5.8%)
• Nausea (5.2%)
• Weight gain (4.9%)
• Expulsion & Coital problems (2.6%)
 PROSTOGEN ONLY IMPLANT

• This is a matchstick-size, flexible rod that is

put under the skin of the upper arm.
• It is often called by its brand name, Implanon.
• The rod releases a progestin, which causes
changes in the lining of the uterus and the
cervical mucus to keep the sperm from joining
an egg.
• Less often, it stops the ovaries from releasing
eggs.
 ADVANTAGES
• It is affective for 3 years

DISADVANTAGES
• May cause side effects, including irregular
bleeding. Doesn't protect against STIs.
FEMALE CONDOM
 A lubricated polyurethane pouch that is
inserted inside the vagina during intercourse.
ADVANTAGES
Prevents the transmission of HIV and other
STDs No hormonal side effects Can be used
by people with latex sensitivities Does not
affect future fertility
DISADVANTAGES
Sometimes difficult to insert or use
Friction/noise during intercourse Loss of
sensation Can break or leak
 EMERGENCY CONTRACEPTION
• It is a method of contraception used to prevent
pregnancy ,also known as “morning after pill” or
post coital contraception
• A woman who had an unprotected sex & want to
prevent pregnancy can use emergency
contraception in following circumstances
Unprotected intercourse
Rape ,sexual assault ,incest
Failure of contraceptive method
• this method can save the lady from agony &
embracement of restoring illegal abortion even
suicide
MORNING PILL
 • This method is recommended with in 48 to 72 hrs of
unprotected intercourse
• They act by stopping ovulation or by interfering with
implantation of the ovum
High dose progesterone High dose estrogens Estrogen –
progesterone
combination (yuzpe)

Levonorgestrel 1.5 mg (i-pill) Diethylstilbestrol 50 100 mgm estrogen

One pill to be taken preferably mgm for 5 days &1mgm
with in 12hrs & not later than Ethinyl estradiol progestrogen (Mala-
72 hrs & 2nd pill to be taken 05mgm for 5 days N & mala-D)
witin 12 hrs after the 1st pill

Failure rate < 1% 0.2 to 2%

Side effects Nausea ,vomiting ,headache Severe & high due to Due to high doses of
& breast TENDERENESS high doses of estrogen
estrogen