Natural methods of sterilisation. OBG.pptx

Natural methods of sterilisation

1. Natural methods of sterilisation

2. Natural methods are methods where no medications or contraceptive devices are used. Since conception requires the sperm to reach the ovum, methods of naturally avoiding the sperm from reaching the ovum work as contraception.

3. Coitus interruptus Coitus interruptus involves withdrawing the entire penis from the vagina prior to ejaculation .This prevents contact between the sperm and the ovum.. Efficacy: Coitus interruptus fails mainly because of the-man’s inability to judge the timing of ejaculation and failure to withdraw prior to ejaculation. The failure rate is estimated to be approximately 20%during the first year of use.

4. Lactational amenorrhea After delivery, when a woman is actively breast-feeding, ovulation is suppressed due to • Elevated prolactin levels • Reduction of gonadotropin-releasing hormone from the hypothalamus • Decreased levels of LH • Lack of follicular maturation Anovulation from lactational amenorrhea varies in duration. There can be breakthrough ovulation. Once the first menses has resumed following childbirth, this method is no longer safe and another contraceptive method must be adopted. Efficacy : The failure rate within the first 6 months in a woman who is exclusively breastfeeding and is amenorrheic is 2%.

5. Advantages • The woman has complete control. • There is no requirement for exogenous contra- ceptive methods. Disadvantages • Return to fertility is uncertain. • Pregnancy may occur during the period of amenorrhea.• This method cannot be used if the mother has human immunodeficiency virus (HIV) infection.

6. Natural methods based on fertile days

7. Natural methods of pregnancy prevention based on fertile days are some of the most commonly used methods of fertility regulation. They involve identifying the woman's fertile days during the menstrual cycle and then avoiding unprotected sexual intercourse on those days. Techniques to determine the fertile period include the following: • The calendar method • Cervical mucus method • The sympto-thermal method

8. Rhythm method or calendar method The rhythm method or calendar method is based on the following assumptions: • The ovum can be fertilized only 12-24 hours after release. • The sperm is viable for only 3-5 days in the cervical mucus and the upper genital tract. • Ovulation occurs 12-16 days prior to the next menses. Intercourse is avoided on the days calculated to be the ovulation time.

9. The standard days method : Women with regular cycles of 26-32 days are asked to avoid unprotected intercourse from days-8 through 19. The user abstains completely or uses a barrier method on those 12 days. Two Day method : Women using the Two Day method are counseled to avoid unprotected intercourse on days when they note cervical secretions and on the first day after a day with cervical secretions . The advantage of the Two Day method is that it can be used by women with short, long, or irregular cycles. With this method most women will abstain or use a barrier method for approximately 13 days in a cycle.

10. Cervical mucus method Under the influence of estrogen, the mucus increases in quantity and becomes progressively more copious, clear, and stretchy until it peaks for 3-4 days immediately before, during and immediately after ovulation. The woman is taught to test her cervical mucus several times each day and avoid intercourse on the days where the secretions suggest ovulation.

11. The sympto-thermal method The sympto-thermal method combines the temperature method, the cervical mucus method and the calendar method. The first day of the fertile period is calculated by either the calendar method or the first day the mucus is detected.The end of the fertile period is predicted by a slight rise (0.2°C - 0.5°C), in the basal body temperature (BBT). A special thermometer is required to measure the BBT. Intercourse can resume 3 days after the rise in temperature. Efficacy The failure rate for the natural methods is high and is approximately 25%. The 1-year Pearl Index is 20 per 100 women-years of use.

12. Disadvantages of natural methods • Most suitable for women with regular and predictable cycles • Require complete abstinence during the fertile period unless backup contraception is used • Require discipline • Relatively high failure rate • Do not protect against STDs

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