1. By Emma Brazier and Harvey Davies
Contraception
By Emma Brazier and Harvey Davies

2. Outline Types of contraception How each type works
The advantages and disadvantages to each type

3. Why do people want contraception?
Reproductive choice – when or if to have a child
Can prevent STIs
Population control

4. Types of Contraception
Natural
Barrier
Hormonal
Other
Surgical
IUD

5. Natural Rhythm Coitus interruptus Lactation
Avoid intercourse in the fertility window – 4-5 days prior and 1-2 days after ovulation (can be predicted with watery spinnbarkeit mucus, raise in morning temperature etc.)
Pros: cheap, no side effects, nothing extra needed, Pope approved
Cons: 9% failure rate per year, no protection against STIs
Coitus interruptus
Penile withdrawal before ejaculation
Pros: cheap, no side effects, nothing extra needed
Cons: significant failure rate, no protection against STIs
Lactation
Requires REGULAR breast feeding (every 4-6 hours). Prolactin suppresses HPO axis, thus no ovulation, and works for up to 6 months)

6. Barrier All act to prevent living sperm entering the uterus Condom
Pros: cheap, easily available, STI protection
Cons: some sensation loss, latex allergies
Diaphragm and Cervical Cap
Pros: don’t alter sensation, reusability
Cons: requires professional fitting first time (needs uterus orientation checking), needs to be washed and cleaned between uses
Spermicide
Good at aiding other forms of contraception
Shouldn’t really be used in isolation

7. Hormonal Combined Oral Contraceptive Pill
Contains oestrogen → stops ovulation and thins uterus, and progesterone → thickens cervical mucus
Pros: makes periods lighter, regular, and less painful; >99% effectiveness; lowers ovarian, uterine, and colon cancer risk
Cons: hormonal side effects (acne, breast tenderness, mood changes, weight gain etc.), not suitable for overweight or smokers, increased clotting risk
Progesterone-Only Pill (Mini Pill)
Progesterone thickens the cervical mucus, and in 20% HPO inhibition (stopping ovulation)
Pros: >99% effectiveness; can use while breast feeding, overweight, smokers, or when CI to oestrogen; reduces PMS
Cons: hormonal side effects (acne, breast tenderness, weight change and headaches), increased risk of ovarian cysts, taken same time every day

8. Hormonal Injections Implant
Depot of slow releasing progesterone injected
Pros: >99% effectiveness, no worry about compliance, lasts 12 weeks, breastfeeding friendly, may relieve some symptoms of PID/PMS
Cons: hormonal side effects
Implant
Implanted rod containing slow release progesterone
Pros: >99% effectiveness, reduces dysmenorrhoea, can cause amenorrhoea, lasts up to 3 years
Cons: hormonal side effects, minor invasive procedure, irregular bleeding

9. Hormonal Patches Rings
Adhesive patch contain oestrogen and progesterone (same as COC Pill)
Pros: >99% effectiveness, lowers menstrual symptoms, can improve acne, not affected by D&V
Cons: requires weekly change, skin irritation, not suitable for overweight people or smokers, clotting risk
Rings
Vaginal ring containing oestrogen and progesterone (same as COC Pill)
>99% effectiveness, lowers menstrual symptoms, can improve acne, not affected by D&V, can be left in for 21 days
Cons: need to be comfortable inserting them, not suitable for overweight people or smokers, clotting risk

10. Other IUCD (Intrauterine Contraceptive Device) Sterilisation
Two main types: copper coil, Mirena (progesterone coated coil)
Act to prevent implantation via irritation of the uterus, ± progesterone effects
Pros: long lasting (1-10 years), no compliance problems, best form of emergency contraception
Cons: can cause bleeding or more cramping, requires checking for string, no protection against STIs
Sterilisation
Tubal ligation or vasectomy
Pros: ‘irreversible’ contraception
Cons: Can fail, invasive, very costly

11. Emergency
May be needed in times of contraceptive failure, human failure, rape etc.
Main mechanism is to prevent implantation:
High dose progesterone
IUCD

12. Thank you for listening
Questions?
Thank you for listening