Different Types of Contraceptive Methods

Contraceptive methods are, by definition, preventive methods to help women avoid unwanted pregnancies. they include all temporary and permanent measures to prevent pregnancies resulting from coitus. The last few years have witnessed a contraceptive revolution, that is, man trying to interfere with the ovulation cycle.

The various methods are:

[A]SPACING METHODS:


1.BARRIER METHODS

(a)Physical methods
(b)Chemical methods
(c)Combined methods

2.INTRA-UTERINE DEVICES
3.HORMONAL METHODS
4.POST CONCEPTIONAL METHODS

[B]TERMINAL METHODS

1.MALE STERILIZATION
2.FEMALE STERILIZATION


BARRIER METHODS
The aim of these methods is preventing the live sperm from meeting the ovum. These methods require a high degree of motivation from the part of the user.  They are less effective than pill or loop. [3]They are only effective if they are used consistently and carefully.

Physical methods

1.CONDOM
Condom is the most widely used barrier  device by the males around the world. In India it is better known by its trade name NIRODH, a Sanskrit word, meaning prevention. . Condom is receiving new attention today as an effective, simple “spacing” method of contraception, without side effects. In addition to preventing pregnancy, condom protects both men and women from sexually transmitted diseases.
Condoms are manufactured in India by HINDUSTAN LATEX in Trivandrum, and London rubber industries in madras. It has been estimated that 72 condoms per year may be needed to protect a couple.
Surveys have reported pregnancy rates varying from 2-3 per 100 women-years to more than 20 on using condoms.
Also 72 condoms per year may be required to protect a couple.
 
2. DIAPHRAGM
The diaphragm is a vaginal barrier. It was invented by a german physician in 1882. also known as ‘Dutch cap’ , the diaphragm is a shallow cup made of synthetic rubber or plastic material. It ranges in diameter from 5-10 cm. It has a flexible rim made of spring or metal .It is important that a woman be fitted with a diaphragm of the proper size which is determined by inser two fingers into the posterior fornix and noting how far on the finger the symphysis pubis comes. This distance indicates the approximate diameter of the diaphragm needed. [6] In the correct position , it lie snugly between  the symphsis pubis and the sacrum. It is held in the position partly by the spring tension and partly y the vaginal muscle tone. This means, for successful use, the vaginal tone must be reasonable. Otherwise in the case of a severe degree of cyctocele, the rim may slip down. A spermicidal jelly is always used along with it.

Variations of the diaphragm include the cervical cap, vault cap and vimule cap. These devices ae not recommended in the National Family Planning Programme.

3. VAGINAL SPONGE

Another barrier device employed for hundreds of years is the sponge in vinegar or olive oil, but it is only recently one has been commercially marketed in USA under the trade name TODAY for the sole purpose of preventing contraception. It is a small polyurethane foam sponge measuring 5cm by 2.5cm, saturated with the spermicide, nonoxynol-9. The sponge is far less effective than the diaphragm, but it is better than nothing.

b. CHEMICAL METHODS

In the 1960s, before the advent of iuds and oral contraceptives, spermicides were widely used. They comprise four categories

Foams: foam tablets, foam aerosols.
Creams, jellies and pastes-squeezed from a tube.
Suppositories-inserted manually
Soluble films-C.film inserted manually.

The spermicides contain a base into which a spermicide is incorporated.
Commonly  used  modern spermicides are “surface active agents” which attach themselves to spermatozoa and inhibit oxygen uptake and kill sperms.

INTRA UTERINE DEVICES

IUDs are obtained only by prescription and must be introduced correctly by a health care professional. A pelvic exam is essential for an IUD insertion. The IUDs can be inserted into the uterus at any time when you are not pregnant.
You may have limited side effects with IUD such as cramps, spotting, heavy menstrual flow, infection, and infertility. Complications occur in rare case such as perforation, heavy bleeding, abnormal spotting, and smelly discharge. You should see the doctor immediately if any of these symptoms occur.

Also, you need to check your IUD in the uterus every month because the uterus sometimes expels the IUD. It is also important to check the birth control device (IUD) periodically by your doctor.

What is an IUD?

The letters "IUD" stand for "intrauterine device." IUDs are small, "T-shaped" contraceptive devices made of flexible plastic and are surgically implanted into a women's uterus. Intrauterine Device (IUD) is a kind of birth control method used by women. The IUD is a “T” shaped device made-up of molded polyethylene plastic coated with barium, which can be seen on X-ray.

Generally it is placed into the uterus where the base of the T will be placed over the cervix and the arms extend horizontally across the uterus. When the device is placed into the uterus, the arms of the “T” are folded down but they then open out to form the top of the “T”.
There will be a short plastic string attached to the IUD, which will extend through the cervix into the vagina. This string ensures that the IUD (birth control device) is still in the uterus.

There are two IUDs available on the US market, the Progestasert and the Paragard copper-T. The IUD remains a medically safe method for many women and is the reversible contraceptive method used by more women across the globe.

How does it work to prevent pregnancy?

IUDs work by preventing an egg from being fertilized, although scientists are not exactly sure how this happens. Theories about this process include:

It affects the way the sperm or egg moves
Substances released by the IUD immobilize sperm
It moves the egg through the fallopian tube too fast to be fertilized.
The copper in the ParaGard adds to the effectiveness of the IUD in other ways. It affects the lining of the uterus by not allowing an egg to implant and it stimulates the production of prostaglandins, chemicals that affect the hormones needed to support a pregnancy. The ParaGard can be a long-term method that may be left in for 8 years.
The birth control method of s (IUDs) is of two types: Intrauterine contraceptive device (IUCD) and Intrauterine system (IUS).
IUCD is made of copper and releases copper from a copper wire that is wrapped around the base where as IUS releases the hormone progesterone from the vertical part of the ‘T’.
Still, it is unknown about how IUDs work. However, they prevent birth control by causing a localized inflammation that starts about 24 hours after insertion.

This leads to an inflammatory reaction in the uterus that draws white blood cells, which produce substances that are toxic to sperm. The IUDs that release progesterone cause a slight change in the endometrial environment that harms the implantation of the egg in the uterine wall. It also changes the cervical mucus, which, in turn, controls the sperm from getting into the cervix.

The Progestasert IUD prevents pregnancy by releasing the hormone progestin, which thickens the cervical mucus. This acts as a barrier to prevent sperm from entering the uterus. The Progestasert also affects the lining of the uterus to prevent an egg from being implanted. Because of the hormonal component of the Progestasert, it must be replaced yearly.

Who should not use an IUD?

There are many reasons why you might not want to choose an IUD as a method of contraception. The IUD is not recommended in the following circumstances:

Active pelvic infection or a history of pelvic inflammatory disease (PID)
Known or suspected pregnancy
Multiple sexual partners
Cervicitis (inflamed or infected cervix)
Bleeding disorders
History of ectopic pregnancy (pregnancy developed in fallopian tubes)
Impaired response to infection (AIDS, diabetes, steroid treatment, etc.)
Severe cramping with periods
Heavy menstrual flow
Allergy to copper
Anemia
History of a sexually transmitted infection
Previous pelvic surgery
Plan to have children in the future
Who have more number of sexual partners
Types of IUDs

Medicated IUDs have either copper or hormones added to a plastic frame.

The first generation of copper IUDs, which included the Cu-7, the TCu-200, and the Multiload-250 (MLCu-250), carried copper wire with a surface area of 200 to 250 mm2.

The second generation of copper IUDs introduced several innovations—more copper wire, copper sleeves, and/or a silver core to the copper wire (denoted by Ag in the IUD name). These changes increase effectiveness and extend effective lifespan . The major second-generation IUDs are the TCu-380A, TCu-220C, Nova T, and Multiload-375 (MLCu-375).

Hormone-releasing IUDs constantly release small amounts of steroid hormone into the uterus. The Progestasert, which has been marketed since 1976, contains 38 mg of progesterone released at a rate of 65 micrograms per day for one year. The LNG-20 IUD contains 52 mg of levonorgestrel released at a rate of 20 micrograms per day and lasts at least five years. Since the early 1990s it has been approved for use in Denmark, Finland, Norway, and Sweden. Recently, the LNG-20 has also been approved in Belgium, France, Iceland, Singapore, Switzerland, and the United Kingdom.

The Lippes Loop[16] , made of polyethylene, was the most widely used unmedicated IUD outside China. This IUD is no longer distributed internationally. The other major types of unmedicated IUDs are flexible stainless steel rings (either round or in the shape of the uterine cavity and made with a single or double coil). These rings have been widely used in China but not elsewhere.

Researchers continue to develop and test new IUDs that may reduce expulsion rates and side effects. Among the devices being considered are a smaller, lightweight, and flexible T-shaped copper IUD, the Cu-SAFE 300, which can be inserted without a plunger and is designed to move towards the uterine fundus (the top of the uterus) when the uterus contracts. A frameless IUD consisting of six copper sleeves on a surgical nylon thread is called the FlexiGard 330, GyneFix™, or CuFix PP330. The thread is knotted at one end, which is anchored in the muscle of the fundus. [17] In clinical trials the device has proved to be highly effective and comfortable to use. Researchers in Switzerland have taken yet another approach: a copper-bearing IUD with a T-shaped frame, called the Sof-T. The tip of each end of the arm consists of a soft ball, designed to prevent perforation and to block the openings to the fallopian tubes in order to prevent sperm from entering.