Contraception- Classification, barrier methods, IUDs, Hormonal pills

 

NEET PG High-Yield: Contraception

1. Classification

  • Barrier: Male/Female condoms, diaphragms.
  • Intrauterine: Cu-T, LNG-IUS.
  • Hormonal: OCPs, injectables (DMPA), implants.
  • Permanent: Tubectomy, Vasectomy.
  • Natural: Calendar method, Basal body temp, LAM.

2. Barrier Methods

  • Condoms: The only method that provides dual protection (prevents pregnancy + STIs/HIV).
  • Diaphragms: Must be used with a spermicide for efficacy; require fitting by a trained provider.

3. Intrauterine Devices (IUDs)

Type Mechanism
Cu-T 380A Copper ions cause spermicidal effect; alters endometrial environment.
LNG-IUS Thickens cervical mucus; atrophies endometrium.

4. Hormonal Pills (OCPs)

  • Mechanism: Primary action is the inhibition of ovulation by suppressing FSH and LH.
  • Contraindications: H/o DVT/PE, migraine with aura, uncontrolled hypertension, smoking (>35 yrs).
High-Yield NEET PG Pearls:

  • Pearl Index: Lower index = Higher efficacy (Implants > IUDs > OCPs > Barrier).
  • Cu-T Emergency Use: Most effective form of emergency contraception (up to 5 days).
  • OCP Benefits: Reduces risk of Ovarian and Endometrial cancer.
  • LAM Criteria: < 6 months post-partum, exclusive breastfeeding, no menses.