Contraception Methods and Mechanisms Female Contraceptives Hormonal Pill

Contraception – Methods and Mechanisms

Female Contraceptives ► Hormonal § Pill (Combination or Progesterone only) ► Blocks ovulation via negative feedback on LH and FSH, renders uterus non-receptive to pregnancy, maintains thick cervical mucus, prohibiting sperm entry into uterus ► Regulates Menses (usually 7 day “no hormone” pills, allows menstrual flow) ► > 99% effective when taken correctly ► Adverse side effects – mostly due to estrogen content or form (from bloating to increased breast cancer risk) progesterone – breakthrough bleeding, depression ► Beneficial side effects – decrease ovarian, endometrial cancer risks (progesterone only pill does this better, but small amount of estrogen OK)

Female Contraceptives, cont’d § Norplant ► Progesterone implants (levonorgestrel) ► Effective, but difficult to remove (scarring b/c ► Side effects – neurological and physiological ► Long lasting – no need to take daily pills ► Taken off market (side effects and scarring) of placement) § Ortho Evra (Contraceptive patch) ► Weekly § Nuva. Ring (Vaginal release contraceptive) ► Inserted into vagina – silicone ring containing estrogen/progesterone combination ► Highly effective (limited European trials - 1, 145 women used the ring during more than 12, 000 cycles, resulting in six pregnancies) ► Fewer side effects – no disturbance in vaginal flora, no nausea b/c it bypasses oral route ► Inserted 3 weeks, removed for 1 (compliance? ? )

Contraceptives, Female, cont’d ► Mechanical § IUD – Rx required, physician inserted. ► Blocks implantation, reduces sperm viability; impregnated with Progesterone increases effectiveness ► Modern IUD – safer, but still risks for infection ► Highly effective, non-hormonal § Cervical cap (need spermicide) ► Must be removed in timely fashion to avoid cervical irritation and increased susceptibility to hyperplastic changes § Diaphragm ► Physician fitted, female inserts prior to intercourse ► Spermicide recommended ► Fits over cervix, blocks entry of sperm into uterus ► Can irritate vagina, must be removed 12 -16 hours after intercourse