Birth Control ; methods and advantages

Fertility control is the use of any method or device to prevent pregnancy. It is also called birth control, family planning or contraception. Fertility control techniques may be temporary or permanent. Several methods are available for fertility control.

Birth Control
 

RHYTHM METHOD (SAFE PERIOD)

Rhythm method of fertility control is based on the time of ovulation. After ovulation, i.e. on the 14th day

of menstrual cycle, the ovum is fertilized during its passage through fallopian tubes. Its viability is only for

2 days after ovulation and should be fertilized within this period. Sperms survive only for about 24 to 48 hours after ejaculation in the female genital tract. If sexual intercourse occurs during this period, i.e. between few days before and few days after ovulation, there is chance of pregnancy. This period is called the dangerous period. Pregnancy can be avoided if there is no sexual intercourse during this period. The prevention of pregnancy by avoiding sexual mating during this period is called rhythm method.

The periods, when pregnancy does not occur are 4 to 5 days after menstrual bleeding and 5 to 6 days

before the onset of next cycle. These periods are together called safe period.

Advantages and Disadvantages

It is one of the most successful methods of fertility control provided the woman knows the exact day

of ovulation. However, it is not a successful method because of various reasons. Basic knowledge aboutthe menstrual cycle is necessary to determine the day of ovulation. Self-restraint is essential to avoid sexual intercourse. Because of the practical difficulties, this method is not popular.

MECHANICAL BARRIERS – PREVENTION

OF ENTRY OF SPERM INTO UTERUS

Mechanical barriers are used to prevent the entry of sperm into uterine cavity. These barriers are called condoms. The male condom is a leak proof sheath, made of latex. It covers the penis and does not allow entrance of semen into the female genital tract during coitus. In females, the commonly used condom is cervical cap or diaphragm. It covers the cervix and prevents entry of sperm into uterus.

CHEMICAL METHODS

Chemical substances, which destroy the sperms, are applied in female genital tract before coitus. Destruction of sperms is called spermicidal action. The spermicidal substances are available in the form of foam tablet, jelly, cream and paste.

ORAL CONTRACEPTIVES (PILL METHOD)

Oral contraceptives are the drugs taken by mouth (pills) to prevent pregnancy. These pills prevent pregnancy by inhibiting maturation of follicles and ovulation. This leads to alteration of normal menstrual cycle. The menstrual cycle becomes the anovulatory cycle. This method of fertility control is called pill method and pills are called contraceptive pills or birth control pills. These pills contain synthetic estrogen and progesterone.

Contraceptive pills are of three types:

1. Classical or combined pills

2. Sequential pills

3. Minipills or micropills.

1. CLASSICAL OR COMBINED PILLS

Classical or combined pills contain a moderate dose of synthetic estrogen like ethinyl estradiol or mestranol and a mild dose of synthetic progesterone like norethindrone or norgestrol. Pills are taken daily from 5th to 25th day of menstrual cycle. The withdrawal of the pills after 25th day causes menstrual bleeding. The intake of pills is resumed again after 5th day of the next cycle.

Mechanism of Action

During the continuous intake of the pills, there is relatively large amount of estrogen and progesterone in the blood. It suppresses the release of gonadotropins, FSH and LH from pituitary by means of feedback mechanism. Lack of FSH and LH prevents the maturation of follicle, and ovulation. In addition, progesterone increases the thickness of mucosa in cervix, which is not favorable for transport of sperm. When the pills are withdrawn after 21 days the menstrual flow starts.

2. SEQUENTIAL PILLS

Sequential pills contain a high dose of estrogen along with moderate dose of progesterone. These pills also prevent ovulation.

Sequential pills are taken in two courses:

i. Daily for 15 days from 5th to 20th day of the menstrual cycle and then

ii. During the last 5 days, i.e. 23rd to 28th day.

3. MINIPILLS OR MICROPILLS

Minipills contain a low dose of only progesterone and are taken throughout the menstrual cycle. It

prevents pregnancy without affecting ovulation. The progesterone increases the thickness of cervical

mucosa, so that the transport of sperms is inhibited. It also prevents implantation of ovum.

DISADVANTAGES AND ADVERSE EFFECTS OF ORAL CONTRACEPTIVES

About 40% of women who use contraceptive pills may have minor transient side effects. However, long term use of oral contraceptives causes some serious side effects. Some of the side effects are rare, but may be dangerous.

Following are the disadvantages and adverse effects of oral contraceptives:

1. Major practical difficulty is the regular intake of the pills

2. May not be suitable for women having disorders such as diabetes, cardiovascular diseases or liver

diseases

3. Clotting tendency of blood due to suppressed production of anticoagulants in liver

4. Hypertension and heart attack

5. Increases the risk of stroke

6. Tenderness of breast and risk of breast cancer (but may decrease the risk of ovarian and uterine cancer).

LONG-TERM CONTRACEPTIVES

To avoid taking pills daily, the long-term contraceptives are used. These contraceptives are in the form of

implants containing mainly progesterone. The implants, which are inserted beneath the skin release the drug slowly and prevent fertility for 4 to 5 years. Though it seems to be effective, it may produce amenorrhea.

INTRAUTERINE CONTRACEPTIVE DEVICE (IUCD) – PREVENTION OF FERTILIZATION

AND IMPLANTATION OF OVUM

Fertilization and the implantation of ovum are prevented

by inserting some object made from metal or plastic

into uterine cavity. Such object is called intrauterine

contraceptive device (IUCD). 

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