contraception
DESCRIPTION
Contraception. IUC ’ s, Sterilization. Intrauterine Contraceptives (IUC ’ s). IUC ’ s are made of flexible plastic, available only through prescription Two types ParaGard (copper) Mirena (hormone). IUC ’ s: ParaGard. ParaGard contains copper Copper prevents sperm from fertilizing an ovum - PowerPoint PPT PresentationTRANSCRIPT
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Contraception
IUC’s, Sterilization
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Intrauterine Contraceptives (IUC’s)
• IUC’s are made of flexible plastic, available only through prescription
• Three types– ParaGard (copper)– Mirena (hormone)– Skyla (hormone)
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IUC’s: ParaGard• ParaGard contains copper• Copper prevents sperm
from fertilizing an ovum• Copper also makes
implantation of fertilized ovum difficult
• Amount of copper released is less than needed in daily diet
• Copper intolerance or insensitivity would preclude use of ParaGard
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IUC’s: Paragard• Requires insertion into uterus by healthcare provider
– Takes only a few minutes– Insertion may cause cramping, dizziness
• Once inserted, may remain in place for ten years– Patient should not feel IUD
• Since no hormones present, monthly cycle should remain unchanged
• Effectiveness: 99%+ against pregnancy• Requires monthly checking for IUD slippage
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IUC’s: ParaGard• Side effects: heavier and longer periods,
cramping, spotting in between periods– May lessen after a few months on ParaGard
• Complication risks: pelvic inflammatory disease shortly after insertion, perforation of uterus, expulsion
• Copper may provide protective benefit against endometrial cancer
• Cost: $0-1000 (Planned Parenthood)
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IUC’s: Mirena• Progestin-only
intrauterine contraceptive
• Lasts for five years• Mirena:
– Prevents sperm from fertilizing ovum
– Prevents release of egg– Changes uterine lining
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IUC’s: Mirena• Insertion: Similar to ParaGard• Effectiveness: 99%+ against pregnancy• Cost: $0-400 (Consumer Reports)• Side effects: Abdominal cramping (10% of users
during first few months), acne, breast tenderness, headache, mood changes, back pain– May lessen after a few months– As use continues, less menstrual bleeding
• Complication effects: ovarian cysts, pelvic inflammatory disease shortly after insertion, perforation of uterus, expulsion
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IUC: Skyla• FDA approved in 2013• Hormone• Smaller than Mirena• Lasts three years instead of
five• Marketed to women who have
not had kids– Mirena marketed to women
with child (research done only on this group)
– IUC’s appropriate for all women
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IUC’s
• Internal Birth Control- IUD’s (via Youtube)• Paragard insertion (via YouTube, 0-0:53)• Mirena insertion (via YouTube, for
healthcare providers)• Insertion of IUC (Medialvideos.us)
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IUCs: Advantages & Disadvantages
• Effectiveness• Cost• Frequency of
application• Safety & side effects• Religion
• STI risk• Availability• Conspicuousness• Duration
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Sterilization
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Sterilization
• Sterilization = permanent contraception– Women undergo tubal ligation– Men undergo vasectomy
• The second most common contraceptive method used in the United States, behind the pill– No formalized data collection system exists– Data retrieved from surveys, questionnaires
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Female reproductive anatomy
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Male reproductive anatomy
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Sterilization: Tubal Ligation
• Surgical technique• Close fallopian tubes,
preventing egg from traveling to uterus, preventing sperm from reaching egg
• Neither organs nor glands are removed
• Effectiveness: 99%+• Considered irreversible
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Sterilization: Tubal Ligation• Tubal sterilization:
– Tubal coagulation/cauterization
– Tubes can be tied and cut (Pomeroy & Parkland techniques)
– Tubes can be clipped, clamped
– These incision methods often performed after childbirth/abortion
– Animation (SMART imagebase)
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Sterilization: Tubal Ligation
• Cost: $1000-3000• Side effects: thought by many to be rare;
hormonal imbalance may lead to increased menstrual bleeding, cramping; adhesions
• Complications: infection, internal bleeding, ectopic pregnancy
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Sterilization: Implants
• Non-incision method– No general anesthesia– Under an hour
• Coils inserted into fallopian tubes
• In following months, coils and tissue grow together, forming barrier to prevent sperm from reaching egg
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Sterilization: Implants
• Side effects: expulsion of coil inserts, risk for ectopic pregnancy, cramping, menstrual changes, nausea/vomiting
• Demo
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Sterilization: Vasectomy
• Vasectomy blocks sperm from traveling through vas deferentia, preventing sperm from mixing into semen
• No glands or organs are removed
• Effectiveness: 99%+• Considered irreversible
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Sterilization: Vasectomy
• Vas deferens must be isolated
• Similar to tubal ligation, the vas deferens can be cut and tied, clamped, cauterized; “no scalpel” technique
• Another form of contraception must be used for a few months
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Sterilization: Vasectomy• Cost: $450-700 (vasectomymedical.com)
• Side effects: bruising, sensitivity/pain, sperm leaking from tubes may lead to small lump (usually clears on its own), antibodies to sperm may develop, reducing chances of fertility in a reversal
• Complications: rare, usually associated with infection (fever, pus/blood from incision site, swelling, pain); ends of tubes may grow back together (very rare); decreased sexual desire (4 out of 1000 cases per Planned Parenthood) - no apparent physical cause
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Sterilization: Vasectomy
• Open-ended (no scalpel) vasectomy (medicalvideos.us)
• Video (vasectomymedical.com)
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Sterilization: Advantages & Disadvantages
• Effectiveness• Cost• Frequency of
application• Safety & side effects• Religion
• STI risk• Availability• Conspicuousness• Duration