1. Combined pills.
(i)Suppression of ovulation (occurs in 80% of cases or cycles).
• Suppress ovulation by altering the cyclical hypothalamic pituitary ovarian secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (I.H)
• No FSH, therefore no follicular maturation.
• No LH, therefore the normal midcycle LH surge that triggers ovulation is inhibited.
• They make the cervical mucus hostile to spermatozoa.
• Change in the character of the endometrial lining to inhibit implantation of the fertilized ovum.
• They may interfere with capacitation ogspermatozoa and the function of the corpus luteum.
Mechanism of action of Condom
• It acts as a barrier methods
• It prevents spread of infection
Mechanism of action of IUCDs
• IUCDS in some way prevent implanation of the blastocyst. To do this, they must cover the whole endometriums.
• Implantation is inhibited as a result of the local inflammatory reaction to the IUCD as a foreign body.
Mechanism of action Postcoital or "Morning After" PILL:
Prevent Pregnancy by :
• Suppressing ovulation or
• Altering transport of the ovum through the fallopian tube.
(1)Indication of Condom :
• Prevention of conception
• Prevention of infection
Sexually transmissible diseases
(2)Indications of oral pills.
• To reduce premenstrual tension
• Abnormal uterine bleeding.
• Dysfunctional uterine bleeding
• Functional ovarian cyst.
• Benigh breast disease
Advantages of oral pill:
1) Once the pill is acquired the method is simple.
2) This is the best method of contraceptive for those women who have no serious side effect.
3) There is no interference with sexual act.
4) The women enjoy a self controlled regular menstrual cycle.
Disadvantages of oral pill:
- Bleeding irregularities.
- Weight gain, skin changes, acne.
- Nausea vomiting, migrain.
- Breast tenderness, fullnes.
(1)Contraindications of Condom.
• Some men or women who experience on allergic reaction to the rubber of spermicide.
• When using of condom reduces the erection of penis.
(2)Contraindications of oral pills
• Thromboembolic disease or history of thrombophlebitis.
• Cerebrovascular accident
• Ischaemic heart disease
• Breast cancer
• Liver disease (liver tumor or impaired liver function).
• Estroqen-independent neoplasm.
• Vaginal bleeding of unknown cause
• History of pregnency obolestasis.
(3)Contraindications of IUCD
• Active pelvic infection
ii) Relative Contraindications.
• Women have irregular and heavy periods, uterine fibroids or other pelvic disease.
• Present or past pelvic infection of any kind.
• Anatomic uterine anomaly.(e.g. bicornuate uterous)
• Nulliparous women.
• History of previous casearean section of hysterotomy of any kind.
(1)Most common side effects
• Skin changes, acne, and chloasma
• Breast tenderness or fullness.
• Benign liver tumors(adenomas)
• Depression or mood changes
• Bleeding irregularities, including missed periods (amenorrea), scanty bleeding, spotting, or breakthrough bleeding
(2)More serious but less common side effects
• Thrombotic disease.
• Cancers of breasts, uterus and lower genial tract.
• Nausa and vomiting
• Loss, of libido(due to dryness of vagina and emotional changes)
• Candida vulvits and vagintis.
• Leukorrhea (increases cervical secretion)