Contraception. IUC s, Sterilization

Transcription

1 Contraception IUC s, Sterilization

2 Intrauterine Contraceptives (IUC s) IUC s are made of flexible plas4c, available only through prescrip4on Three types ParaGard (copper) Mirena (hormone) Skyla (hormone)

3 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

4 IUC s: Paragard Requires inser4on into uterus by healthcare provider Takes only a few minutes Inser4on may cause cramping, dizziness Once inserted, may remain in place for ten years Pa4ent should not feel IUD Since no hormones present, monthly cycle should remain unchanged Effec4veness: 99%+ against pregnancy Requires monthly checking for IUD slippage

5 IUC s: ParaGard Side effects: heavier and longer periods, cramping, sposng in between periods May lessen ater a few months on ParaGard Complica4on risks: pelvic inflammatory disease shortly ater inser4on, perfora4on of uterus, expulsion Copper may provide protec4ve benefit against endometrial cancer Cost: $ (Planned Parenthood)

6 Proges4n- only intrauterine contracep4ve Lasts for five years Mirena: Prevents sperm from fer4lizing ovum Prevents release of egg Changes uterine lining IUC s: Mirena

7 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

8 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

9 IUC s Internal Birth Control- IUD s (via Youtube) Paragard inser4on (via YouTube, 0-0:53) Mirena inser4on (via YouTube, for healthcare providers) Inser4on of IUC (Medialvideos.us)

10 IUCs: Advantages & Disadvantages Effectiveness Cost Frequency of application Safety & side effects Religion STI risk Availability Conspicuousness Duration

11 Sterilization

12 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

13 Female reproductive anatomy

14 Male reproductive anatomy

15 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

16 Sterilization: Tubal Ligation Tubal steriliza4on: Tubal coagula4on/ cauteriza4on Tubes can be 4ed and cut (Pomeroy & Parkland techniques) Tubes can be clipped, clamped These incision methods oten performed ater childbirth/abor4on Anima4on (SMART imagebase)

17 Sterilization: Tubal Ligation Cost: $ Side effects: thought by many to be rare; hormonal imbalance may lead to increased menstrual bleeding, cramping; adhesions Complications: infection, internal bleeding, ectopic pregnancy

18 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

19 Sterilization: Implants Side effects: expulsion of coil inserts, risk for ectopic pregnancy, cramping, menstrual changes, nausea/vomiting Demo

20 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

21 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

22 Sterilization: Vasectomy Cost: $ (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

23 Sterilization: Vasectomy Open-ended (no scalpel) vasectomy (medicalvideos.us) Video (vasectomymedical.com)

24 Sterilization: Advantages & Disadvantages Effectiveness Cost Frequency of application Safety & side effects Religion STI risk Availability Conspicuousness Duration