Family Planning Hormonal contraceptives.pptx

Family Planning Hormonal contraceptives.pptx

• 1.
  Family Planning Method Hormonalcontraceptives
• 2.
  Introduction • Methods thatact on the endocrine system. • There actions varies from one type to another. • They contain either a progesterone combined with oestrogen or progesterone alone. • These methods include oral pills, Injectables and implant. • There are also newer hormonal contraceptives methods like the skin patch and vaginal rings, which are less well known and not used as much • In this study session, you will be introduced to different forms of oral contraceptives, injectables forms of hormonal contraceptive and the implants
• 3.
  Objectives At the endof the class, you will be able to: • Enumerate classifications of hormonal contraceptives • Explain in details different forms of oral contraceptive device • Discuss injectable forms of hormonal contraceptive • Explain the mechanism of action of implants
• 4.
  1.0 Oral Contraceptives •Prescription medications that prevent pregnancy. • Medications contain hormone: • Oestrogen and progesterone (combined, COC) • Progestin only (progestin-only pills (POPs) • They may also be prescribed to reduce menstrual cramps or prevent anaemia.
• 5.
  Combined Oral Contraceptives(COCs) • COCs contains low doses of two important hormones. • They are also called “the Pill,” low-dose combined pills, OCPs, and OCs. • Work primarily by preventing the release of eggs from the ovaries (ovulation). • Risk of pregnancy is greatest when a woman starts a new pill pack 3 or more days late, or misses 3 or more pills near the beginning or end of a pill pack.
• 6.
  Combined Oral Contraceptives(COCs) Three types of pills 1. Monophasic pills • Contains same amount of estrogen and progestin all through the cycle. • Consumed for 21days followed by a break of 7days when no pills are taken. • It allows a woman to have a monthly period. 2. Biphasic pills • Have same content of estrogen all through the cycle of 21days • What varies is the amount of progestin • First half of the cycle has a lower amount of progestin to allow the endometrium to thicken • Second half of the cycle uses a higher level of progestin so that endometrial ripening can take place.
• 7.
  Combined Oral Contraceptives(COCs) 3. Triphasic pills • Pills have either constant or changing estrogen throughout the cycle while progestin varies all through the cycle. • Meaning that the dosage must be taken accurately each day for the birth control pills to work effectively as contraceptives. COCs are available in packets of: a) 21 pills, where a pill is taken for 21 days and a break from pill-taking occurs for 7 days before starting a new packet. b) 28 pills, where a hormonal pill is taken every day for 21 days and the break occurs when seven placebo pills are taken as the last pills in each packet.
• 8.
  Combined Oral Contraceptives(COCs) • Preparations of synthetic estrogen and progesterone which are highly effective in preventing pregnancy. Different forms of COCs • Microgynon • Lo-feminal • Duofem Effectiveness of COCs • Depends on user compliance Who can use COC? • All women of reproductive age who desire to use COCs
• 9.
  1.1 Combined OralContraceptives (COCs) Mechanism of action • Suppress ovulation • Thicken cervical mucus, preventing sperm penetration. • Make the endometrium less favorable for implantation. • Reduce sperm transport in upper genital tract (fallopian tubes) Contraceptive Advantages and Non contraceptive benefits • Cause periods to be regular and predictable • Reduces menstrual blood loss which prevents anemia • Protect against ovarian and endometrial cancer, and PID • Reduce risk of functional ovarian cysts, benign breast cysts, fibro-adenoma, and ectopic pregnancy
• 10.
  1.1 Combined OralContraceptives (COCs) Disadvantages • Some nausea, dizziness, mild breast tenderness or headaches as well as spotting or light bleeding • Forgetfulness increases failure • Serious side effects (e.g., heart attack, stroke, blood clots in lung or brain, liver tumors), though rare, are possible. Contraindications • Pregnancy • Complications or side effects that a service provider is not capable of handling • Breast feeding mothers less than 6 months
• 11.
  1.1 Combined OralContraceptives (COCs) Common Side Effects • Amenorrhea • Nausea/Dizziness/Vomiting • Vaginal bleeding/Spotting • Other gynaecological conditions Client Instructions •Read about it
• 12.
  1.2 Progestin OnlyPills (POPs) • pill only contains progestin, no oestrogen. • May be used during the breast-feeding period, as they do not reduce milk flow. • Tablets must be taken at the same time each day without interruption or else contraceptive safety will be reduced. • Due to lack of oestrogen in the pill, menstruating women have increase chance of spotting. Mechanism of action of Progestin Only Pills (POPs) • Thickens cervical mucus, preventing sperm penetration • Suppresses ovulation • Makes the endometrium less favourable for implantation • Reduces sperm transport in upper genital tract
• 13.
  1.2 Progestin OnlyPills (POPs) Contraceptive advantage • Effective when taken at the same time every day • Immediately effective • Does not interfere with intercourse • Does not affect breast-feeding • Immediate return of fertility when stopped. Non-contraceptive • May decrease menstrual cramps • May decrease menstrual bleeding and may improve iron deficiency anaemia • Decreases ectopic pregnancy • Protects against some causes of PID
• 14.
  1.2 Progestin OnlyPills (POPs) Disadvantages • Cause changes in menstrual bleeding pattern (irregular bleeding/spotting initially) in most women • Some weight gain or loss may occur • User-dependent (require continues motivation and daily use) • Must be taken at the same time every day • Forgetfulness increases failure Contra-indications • Pregnancy (known or suspected) • Known or suspected cancer of the reproductive tract and breast • Undiagnosed genital tract bleeding • Taking drugs like Rifampin, Phenytoin, and Barbiturates
• 15.
  Injectable contraceptives • Injectablecontraceptives are systemic progestin preparations administered by intramuscular injection. • most common type is Depo-Provera/DMPA( which is a progestin-only injectable contraceptive (PICs) given every 12weeks). • The other type is Noristerat( given every 8weeks). Mechanism of action • Thickens cervical mucus, preventing sperm penetration • Make the endometrium less favourable for implantation • Reduces sperm transport in upper genital tract (fallopian tubes) • Suppresses ovulation (release of eggs from ovaries)
• 16.
  Injectable contraceptives Contraceptive Advantages •Highly effective • Rapidly effective • Pelvic examination not required prior to use • Does not interfere with intercourse • Does not affect breast-feeding • No oestrogenic side effects Non-contraceptive Advantage • May decrease menstrual cramps • May decrease menstrual bleeding and may improve iron deficiency anaemia
• 17.
  Injectable contraceptives Disadvantages • Changesin menstrual bleeding pattern are likely • Amenorrhea after first year of use is normal. • User-dependent (must return for injection every 2 or 3 months) • Must always be in stock • Excessive vaginal bleeding in rare instances • Do not protect against STIs
• 18.
  Injectable contraceptives Side Effect •Amenorrhea • Vaginal bleeding/Spotting • Weight gain or loss Client Instructions • Return to the health clinic for an injection every 12 weeks (DMPA) or every 8 weeks (NETEN)
• 19.
  Contraceptive implants • Threetypes of Implants are available i. Norplant Implant ii. Implanol iii. and Jadell. Mechanisms of Action • Thickens cervical mucus, preventing sperm penetration • Make the endometrium less favourable for implantation • Reduces sperm transport in upper genital tract (fallopian tubes) • Suppress ovulation
• 20.
  Contraceptive implants Contraceptive Advantages •Highly effective • Long-term method • Pelvic examination not required prior to use • Does not interfere with intercourse • Does not affect breast-feeding • Immediate return of fertility on removal • Does not interfere with intercourse • Does not affect breast-feeding • Immediate return of fertility on removal
• 21.
  Contraceptive implants Effectiveness • Implantsare very (1 in every 1,000) may occur in the first year of use. • Pregnancy rates have been slightly higher among women weighing more than 70kg. Advantages and noncontraceptive benefits Very effective even in heavier women.  Advantages • Effective within 24 hours after insertion • No delay in return to fertility after removal • Long acting; needs replacement after three years • No repeated clinic visits required • Helps to prevent: iron deficiency, anaemia, ectopic pregnancy, endometrial cancer • Makes sickle cell crisis less frequent and less painful • No effect on breast milk
• 22.
  Contraceptive implants Disadvantages/ Commonside effects • Changes in menstrual bleeding • Spotting • Heavy bleeding (rare) • Amenorrhea • Minor surgical procedure required for insertion and removal • Discomfort in the arm after insertion
• 23.
  Conclusion • Hormonal contraceptivesare methods that are systemic in nature and contain either a progesterone combined with oestrogen or progesterone alone. • This methods include oral pills, Injectables and implant. • Hormonal contraceptives are a very reliable way to prevent pregnancy when used properly.