62. Contraception

Contraception refers to any artificial method used to prevent pregnancy by interrupting the process of fertilization or implantation. These methods are categorized into hormonal and non-hormonal types.

1. Hormonal Contraception

Hormonal methods use estrogen, progesterone, or both to prevent pregnancy through two main mechanisms:

• Inhibiting FSH: Constant levels of estrogen inhibit FSH production, meaning no eggs mature or are released.

• Thickening Cervical Mucus: Progesterone stimulates the production of thick mucus at the cervix, blocking sperm from entering the uterus.

Common Hormonal Methods:

• Oral Contraceptive Pill:

  • Combined Pill: Contains both estrogen and progesterone (>99% effective).

  • Progesterone-only Pill: Just as effective with fewer side effects.

• Contraceptive Patch: A small sticker changed weekly that releases both hormones.

• Contraceptive Injection: Progesterone injection lasting 2 to 3 months.

• Contraceptive Implant: A small device under the skin of the arm, releasing progesterone for up to 3 years.

• Intrauterine Device (IUD): A plastic device placed in the uterus that releases progesterone for 3+ years.

2. Non-Hormonal Contraception

Non-hormonal methods act as physical barriers or chemical agents to prevent sperm from reaching the egg.

Common Non-Hormonal Methods:

• Barrier Methods:

  • Condoms (Male and Female): The only method that also protects against sexually transmitted diseases (STDs).

  • Diaphragm: A plastic cup fitting over the cervix; must be used with spermicide to be effective.

• Chemical Methods:

  • Spermicide: A substance that kills sperm (unreliable if used alone).

• Intrauterine Device (Copper IUD): Also known as the "copper coil." It does not use hormones but kills sperm in the uterus.

• Surgical Methods (Sterilization):

  • Females: Cutting or tying the fallopian tubes to prevent eggs from reaching the uterus.

  • Males: Cutting or tying the sperm ducts.

• Natural Methods: Includes abstinence (100% effective) or "rhythm" methods (tracking the menstrual cycle), though the latter is highly unreliable.

Summary Table: Comparing Contraceptive Methods