Question
List any four major categories into which contraception methods could be broadly classified. Explain briefly each category giving one example of each.

Answer

  1. Barrier Methods: These methods prevent sperms and ovum from physically meeting in order to prevent fertilisation. These methods are available for both males and females.
These are as follows:
  1. Condoms: These are made of thin rubber or latex sheath and are used to cover the penis in males and vagina and cervix in females. These are used during coitus, so that ejaculated semen would not enter female reproductive tract. Use of condoms has increased in recent years due to its additional benefit of providing protection against $\text{STDs}$ and $\text{AIDS}$. Moreover, condoms do not interfere with the coital act, are disposable and can be self$-$inserted. Nirodh is a popular condom used by males. Female condoms are known as femidoms.
  2. Cervical caps, diaphragms and vaults: These are also made of rubber and are inserted into the female reproductive tract to cover the cervix during intercourse. They prevent conception by blocking entry of sperms through cervix. These are reusable.
  3. Spermicidal creams, jellies and foams(chemica methods): These are usually used along with the above stated barrier methods to increase their contraceptive efficiency. These are applied at the surface of vagina before intercourse.
  1. Intra Uterine Devices $\text{(IUDs):}$ These devices contain either copper or progesterone and are inserted by doctors in the uterus through vagina.
These are categorised as long term contraceptive methods and further divided into:
  1. Copper releasing $\text{IUDs}$, e.g. $\text{Cu-T, Cu-7,}$ Multiload $375$ and Paragard are some of the $\text{Cu-}$releasing $\text{IUDs.}$
  2. Hormone releasing $\text{IUDs,}$ e.g. Progestasert, $\text{LNG-20,}$ Mirena are some of the well known hormone releasing $\text{IUDs.}$
  3. Non$-$medicated $\text{IUDs,}$ e.g. Lippes loop.
IUDs prevent contraception in the following ways:
  1. By increasing phagocytosis of sperms within the uterus.
  2. By suppressing the sperm motility and fertilizing ability of sperms by releasing $\text{Cu}$ ions.
  3. The hormone releasing $\text{IUDs}$ make the uterus unsuitable for implantation and the cervix hostile to sperms. $\text{IUDs}$ are ideal contraceptives for females who want to maintain space among children and/ or delay pregnancy. It is one of most widely accepted methods of contraception in India.
  1. Oral Contraceptives: These are the preparations of hormones either progestogens or progestogen$-$oestrogen combinations in the form of pills $($tablets$)$, used by the females. They alter or inhibit ovulation and fertilisation and also modify the quality of cervical mucus to prevent or retard the entry of sperms. Oral pills are generally taken daily for a period of $21$ days starting within the first five days of menstrual cycle. After a gap of $7$ days $($during which menstruation occurs$)$, it has to be repeated in the same pattern till female desires to prevent conception. These are well$-$accepted as they are very effective with lesser side effects. They are very popular among urban women. Most common examples are $\text{‘Mala-D'}$ and 'Saheli'. Saheli is a new oral contraceptive for females that contains a non$-$steroidal preparation called centchroman. It is once a week pill with few side effects and high contraceptive value. It was developed by $\text{CDRI} ($Central Drug Research Institute$),$ Lucknow.
  2. Injectables and Implants:
  1. Hormone injections $($Depo$-$Provera$)$ are progesterone$-$derivative or progestogen$-$oestrogen combination injections, given every three months as injections or as implants under skin. They release the hormone slowly and prevent ovulation.
  2. Implant $($Norplant$)$ as a contraception method refers to sub$-$cutaneous implantation of synthetic progesterone. Though, these act similarly to oral contraceptives by blocking ovulation and thickening the cervical mucus, to prevent sperm transport, their effective periods are longer. One implant is effective for about five years.
  1. Emergency Contraceptives (Morning After Pills): Most common form is a kit consisting high dose of birth control pills. These, if taken within $72$ hours of coitus have been very effective as emergency contraceptives as they could avoid possible pregnancy due to rape or casual unprotected intercourse. Their side effects are menstrual irregulation, vomiting, etc., e.g. $i-$pill, pill $72$, unwanted $72.$

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