Methods of Contraception

Contraception refers to methods to prevent pregnancy which range from devices to medications to procedures and can be either temporary or permanent.

Temporary contraception methods include barrier and hormonal methods.Barrier methods can be mechanical, like devices such as male and female condoms and diaphragms; or chemical, like spermicides.Now, male condoms are a thin stretchable sheath, commonly made of latex, that’s applied over the penis.Female condoms are a small pouch made of synthetic rubber with flexible rings at both ends; the closed end is inserted into the vagina and secured around the cervix, and the open end covers the labia.

Both male and female condoms are single use and applied immediately prior to intercourse.Diaphragms are dome-shaped silicone devices that cover the cervix and are usually used with a spermicide.

They can be inserted six hours before intercourse and should remain in place for at least six hours following intercourse, but no longer than 24 hours.

If they’re left in place longer than 24 hours or if they’re used during menses, there’s a risk of toxic shock syndrome.Next, spermicides are chemical-based formulations that destroy sperm cell membranes and reduce sperm motility, reducing their ability to reach the cervix, and are available as foams, tablets, suppositories, vaginal films, creams or gels.Spermicides should be inserted deep into the vagina about 15 minutes before intercourse and must be reapplied before repeat intercourse since they're only effective for about an hour.

When used together with a mechanical barrier like a diaphragm, the contraceptive effectiveness is improved.Now, with all barrier methods, there are some common advantages and disadvantages.

The advantages are that they’re inexpensive, relatively easy to use, and effective when applied properly. Condoms and spermicides are readily available without a prescription, whereas diaphragms require a prescription and fitting by a health care provider to ensure they're large enough to fit snugly without causing pressure on the vagina.In terms of protection against sexually transmitted infections, or STIs, condoms offer effective protection, diaphragms offer some protection, and spermicides offer no STI protection.

Other disadvantages of barrier methods include interference with sexual spontaneity because they need to be applied before intercourse.

Additionally, spermicides may cause irritation to the urethra and vagina.Hormonal methods of contraception include oral pills, devices, or injections that contain a combination of estrogen and progestin, or progestin only.

Oral contraceptives work by inhibiting ovulation, thickening cervical mucus to prevent sperm motility, and making the endometrium unfavorable for implantation.

Depending on the brand, combination oral contraceptives are taken daily with some days containing either inactive pills or no pills.In contrast, progestin-only pills are taken daily with no hormone-free days.

For emergency contraception, effective when taken within 72 hours of unprotected intercourse or failure of birth control, a high dose progestin-only pill can be taken.Progestin-only devices include intrauterine devices, or IUDs, and contraceptive implants.

An IUD is a small T-shaped device inserted by a health care provider through the cervix into the uterine cavity, with strings that hang outside the cervix.IUDs prevent fertilization by releasing progestin, which creates an environment to decrease sperm motility, making them less likely to penetrate the egg.

Next, there’s a contraceptive implant which is a flexible rod that’s inserted subdermally in the upper inner arm by a health care provider.

It continuously releases progestin to provide up to three years of contraception.Lastly, injectable progestins are administered either intramuscularly or subcutaneously and prevent pregnancy by inhibiting ovulation.

Effectiveness lasts for 15 weeks, and injections are typically repeated every 3 months.Now, advantages of hormonal methods are that they allow for sexual spontaneity.

Also, most methods provide convenient long-term pregnancy prevention. Oral contraceptives, contraceptive implants, and most IUDs also allow for return of fertility immediately after removal, whereas injectable progestins may delay fertility up to 10 months after the last injection.

Oral contraceptives also provide health benefits, like reducing the risk of ovarian and uterine cancer and improved premenstrual symptoms.However, they may also increase the risk of venous thromboembolism, myocardial infarction, stroke, migraines, hypertension, and gallbladder disease.

Potential disadvantages of IUDs are that they can cause complications like uterine perforation, as well as ectopic pregnancy or spontaneous abortion, if pregnancy does occur.

Other disadvantages are that they can cause unwanted side effects like irregular menstrual bleeding and weight gain. Finally, hormonal methods do not offer STI protection.So, when caring for your patient using contraception, provide privacy, by closing the door or curtain and limiting distractions.

Also be sure to include your patient’s sexual partner, if they wish. Now, if your patient reports problems that interfere with use of their contraceptive, offer suggestions, like setting reminders so they remember to take their oral contraceptive at the same time each day.Also, instruct them on solutions for potential issues that may arise, like if they’re using the progestin implant and experiencing irregular bleeding, or what to do if their partner’s condom breaks during intercourse.

If their preferred contraception doesn’t protect against STIs, remind them to use a condom in addition to their regular contraceptive.

Finally, advise them on signs and symptoms of pregnancy and to contact their health care provider right away if pregnancy is suspected.Alright, as a quick recap…Contraception refers to methods to prevent pregnancy and can be either temporary or permanent.

Temporary contraception methods include barrier methods like condoms, diaphragms, and spermicides; and hormonal methods include oral contraceptives, IUDs, implants, and injections.

Nursing care for patients using contraception includes providing support and education for effective contraceptive use.