hormonal contraceptive types and uses.pptx

hormonal contraceptive types and uses.pptx

• 1.
  BY:- AJAY MOHAN SONKER HORMON AL CONTRAC EPTIVE
• 2.
  HORMONAL CONTRACEPTIVE  Hormonal contraceptivewhen properly used are the most effective spacing method of contraception.  Oral contraceptive of the combined type are almost 100% effective in preventing pregnancy.  They provide the best means of insuring spacing between one child birth & another.  More than 65 million in the world are estimate to be taking the pill of which about 10 million are estimated to be in India.
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  GONADAL STEROIDS  Itgeneral medicine, the term “steroid” refers to adrenocortical hormone, while to those in gynaecology, it implies gonadals steroids, e.g, oesterogen & progesterone.  Synthetic oestrogens: Two synthetic oestrogens use in oral contraceptive are-ethinyl steradiol, mestronol  Synthetic progetogen: they are classified in three groups. a) Pregnanes b) Oestranes c) gananes
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  ORAL PILLS COMBINED PILL PROGESTOGENONLY PILL POST-COITAL PILL ONCE-A-MONTH MALE PILL
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  DEPOT FORMULATION INJECTABLE SUBCUTANEOUS IMPLANTS VAGINALRINGS
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  COMBINED PILLS  Thecombined pills is one of the major spacing method of contraception.  At the present time most formulation of the combined pill containing no more than 30 to 35 mcg of a synthetic oestrogen and about 0.5 to1.0 mg of a progestogen.  The pills is given orally for 21 consecutive days beginning on the 5th day of the menstrual cycle, followed by a break of 7 days during which period menstruation occurs.  Withdrawal bleeding: An episode of uterine bleeding from an incomplete formed endometrium caused by the withdrawal of exogenous hormones.
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   The pillshould be taken everyday at a fixed time. Preferably before going to bed at night.
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  TYPE OF PILL Govt. of India has made available two type of low dose oral pills under the brand name of MALA-N and MALA-D .  It containing Norgestrol 0.3 mg and ethinil oestradiol 0.03 mg.  Mala-N is supplied free of cost through all PHCs, urban family welfare centres, etc.
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  PROGESTOGEN ONLY PILL This pill is commonly referred as “minipill or micro pill". It contains only progestogen.  They could be prescribed to older women for whom the combined pill is contraindicated because of cardiovascular risks.
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  POST COITAL CONTRACEPTION Post coital contraception is recommended within 48 hours of an unprotected intercourse.  Two methods available: a) IUD: The simple technique is to insert an IUD, if acceptable especially a copper device. b) Hormonal: Hormone method may be preferable, in the past a very high dose an oestrogen, the recommended resimen was 2 pills immediately, following by another 2 pill 12 hours later.
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  ONCE A MONTHPILL  Once a month oral pill in which quinesterol, a long action oestrogen is given in combination with a short acting progestogen have been disappointing .  Bleeding tends to be irregular
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  MALE PILL  Itfour line of approach : a) Preventing spermatogenesis b) Interfering with sperm storage & maturation c) Preventing sperm transport in the vas d) Affecting constituents of the seminal fluid
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  MODE OF ACTION 1.Combined oral pill : Prevent the release of the ovum from the ovary by blocking secretion of gonadotropin (ovulatory hormone). 2. Progestogen : cervical mucosa thick & inhibit the sperm penetration, inhibit the tubal motility & delay the transport of the sperm & ovum in uterine cavity.
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  ADVERCE EFFECT  Cardiovasculareffect  Carcinogenesis  Metabolic effect  Other adverse effect: liver disorder , lactation , subsequent fertility etc.
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  CONTRAINDICATION a) Absolute:cancer ofthe breast and genitals,liver disease,thromboembolism,undiagnosed abnormal uterine bleeding. b) Special problem requiring medical surveillance : age over 40 year, smoking & age over 35year….. Mild hypertension, chronic renal disease, epilepsy , migration,diabetes mellitus & gall bladder disease etc.
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  INJECTABLE CONTRACEPTIVE  Twotype of injectable contraceptive a) Progestagen injectable: based on progestogen, this is the older barrier techniques. i. DMPA(depot-methoxy-progesteroneacetate):standered dose intramuscular injection of 150mg every 3 month. ii. NET-EN (nor ethethisterone enantate): it is given I.m in a dose of 200mg every 60 days. a) Combined injectable contraceptive: these injectable containing at monthly intervals, act mainly by suppression of ovulation, cervical mucus is affected & becomes an obstacle to sperm penetration. Cyclofem is highly effective.
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  Subdermal implants  Norplantfor long term contraception  It consist of 6 silastic capsules containing 35 mg of levonorgestrel.  Norplant (R)-2  Implanted beneath the skin of the forearm or upper arm.  Effective contraception is provided for over 5 years.
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  VAGINAL RINGS  Vaginalrings containing levonorgestrel have been effective  Slowly absorbed through vaginal mucosa.  The ring is worn in vagina for 3 weeks of the cycle and removed for the fourth.
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  Thank you