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Family planning part 1, Mechanism of Action Suppresses ovulation…
Family planning part 1
Characteristics of an Ideal Contraceptive Method
Be cheap, available, accessible, and easy to use.
Not require continuous medical supervision.
Be safe and free from adverse effects or complications.
Be 100% effective in preventing pregnancy (no failure rate).
Not interrupt sexual intercourse or reduce sexual sensation.
Be long-acting (doesn’t require constant motivation).
Prevent sexually transmitted diseases (STDs).
Be culturally and religiously acceptable.
Be suitable for all women, including those with irregular cycles or breastfeeding mothers.
Characteristics of an Ideal Contraceptive Method
Progesterone-Only Contraceptives
pills
Effectiveness: 99% in breastfeeding women, 97-98% in non-breastfeeding women.
Used in: Breastfeeding women, women with estrogen intolerance.
Advantages
No estrogen-related side effects
Prevents ovarian & endometrial cancer.
.
Disadvantages
Less effective than COCs.
Menstrual irregularities.
Doesn’t protect against STDs.
Missed Pills Regimen
- Missed <3 hours: Take immediately, no backup needed.
- Missed >3 hours: Use backup contraception for 2 days.
Contraindications
Unexplained vaginal bleeding (needs medical evaluation first).
Active breast cancer or history of breast cancer.
Severe liver disease or liver tumors.
History of stroke or serious cardiovascular disease.
Severe malabsorption conditions (e.g., Crohn’s disease, as it may reduce effectiveness).
Injectable Contraceptives (Depo-Provera)
Administration: Intramuscular injection every 3 months
Effectiveness: 97%
Advantages
Highly effective and long-acting.
No daily pills needed (good for forgetful users).
Safe for breastfeeding mothers.
No estrogen-related side effects (good for those who can't take estrogen).
May reduce the risk of endometrial cancer and ovarian cysts
Reduces menstrual cramps and heavy bleeding.
Disadvantages
May delay fertility return (up to 2 years after stopping).
Causes menstrual irregularities (spotting, amenorrhea).
Weight gain is common.
Bone density loss with long-term use.
No protection against STDs
Requires a healthcare provider for injection.
breast tenderness
abdominal bloating acne
Indications
Women who want long-term contraception without daily pills.
Suitable for breastfeeding mothers.
Women who cannot use estrogen-based contraceptives.
Helps in cases of heavy periods or endometriosis.
Contraindications
History of osteoporosis or bone disease (due to bone density loss).
Unexplained vaginal bleeding.
History of breast cancer.
Severe liver disease.
Instructions:
Get the first injection within 5 days of menstrual cycle for immediate protection
Repeat every 12-13 weeks (don't delay more than 14 weeks).
May cause irregular bleeding at first but often leads to no periods over time.
Implants (Norplant, Implanon, Nexplanon)
Effectiveness: Over 99%
Administration: Inserted under the skin of the arm, lasts 3-5 years
Indications
Women seeking long-term, reversible contraception.
Safe for breastfeeding mothers.
Suitable for those who cannot use estrogen.
Contraindications
Active liver disease.
History of breast cancer.
Unexplained vaginal bleeding.
Severe migraines with aura.
Instructions
Insert during the first 5 days of the cycle for immediate protection.
If inserted later, use backup contraception for 7 days.
Removal should be done by a healthcare provider when contraception is no longer needed.
postpartum after 6 week from child birth
inserted after 7 days from onset of the mensruation
abortion within 7 days after abortion
Spermicides (Foams, Gels, Suppositories)
Effectiveness: 72-82%
Indications:
Those wanting non-hormonal, on-demand contraception.
Contraindications
Allergy to spermicide components.
Instructions
Apply before every sexual act
Must remain in place for 6-8 hours after sex.
Mechanism of Action
Suppresses ovulation (acts on the hypothalamus and pituitary to block FSH & LH).
Creates an unfavorable endometrial environment (prevents implantation).
Thickens cervical mucus (blocks sperm entry).
Inhibits sperm capacitation (prevents sperm from reaching the egg).
Reduces fallopian tube motility (delays egg transport).
Hormonal Content & Effectiveness
Contain both estrogen and progesterone.
Over 99% effective if used correctly.
Less effective with anticonvulsants & tuberculosis medications.
How to Take COCs
Menstrual cycle: Start within 5 days of menstruation (no backup needed).
Postpartum
Breastfeeding: Start after 6 months or after stopping breastfeeding.
Non-breastfeeding: Start 4 weeks after childbirth.
Post-abortion: Start within 7 days.
Available Packs
21-day pack: Take 1 pill daily for 21 days, then a 7-day break.
28-day pack: Take 1 pill daily for 21 days, then 7 placebo/iron pills (no break).
Advantages of COCs
Contraceptive Benefits
Cheap, accessible, reversible, and easy to use.
Safe and effective when used correctly.
Does not interfere with sexual activity.
Non-Contraceptive Benefits
Regulates menstruation and reduces premenstrual tension.
Treats acne and ovarian cysts.
Protects against ovarian & endometrial cancer.
Reduces the risk of pelvic inflammatory disease (PID).
Disadvantages of COCs
Require strong motivation and memory.
No STD protection.
Interferes with breastfeeding.
Indications for Use
Non-breastfeeding mothers.
Heavy menstrual bleeding.
Women under 35 years old & non-smokers.
Contraindications
Absolute:
History of blood clots, stroke, heart disease, or breast cancer.
Severe liver disease, gallbladder disease, or pregnancy.
Smokers over 35 years old.
Relative
High blood pressure, diabetes, migraines, major surgeries.
Side Effects
Minor: Nausea, breast tenderness, headaches, weight gain, depression.
Major: Stroke, blood clots, hypertension, gallbladder disease, liver tumors.
Missed Pills Regimen
Missed 1 pill (<12 hours): Take immediately, continue pack, no backup needed.
Missed >1 pill (>12 hours): Take immediately, use backup contraception for 7 days.
Danger Signs (ACHES)
Abdominal pain → Liver/gallbladder disease
.
Chest pain → Heart attack, blood clot in the lungs.
Headache → Stroke, hypertension.
Eye problems → Stroke, vision issues.
Severe leg pain → Blood clot in leg.
Combined Contraceptives (Estrogen + Progesterone)