lacctational amenorrhoeah
- exclusive breastfeeding day and night
- woman is amenorrhoeic
- infant is under 6 months old
fertility awareness (3)
- Rhythm: mid-cycle ovulation
- Temperature: body temperature drops 12-24h before ovulation
Cx Mucus: recognition of fertile days by appearance and sensation of mucus at vulva: wed, slippery mucus indicates fertility
Barrier methods
Male condoms: traps semen, highly efficient
Female condoms: prevents passage in to genital tract, efficiency unknown
Female diaphram: dome covering Cx
IUD
IUD: stimulates chane in endometrium and unterine tubal fluid, thickens Cx mucus. coper and progesterone.
alters bleeding
highly effective
COC pill
supression of FSH and LH
Estrogen: supresses FSH > follicle maturation > reduces LH via negative feedback to GnRH
Pogesterone: inhibits LH, thickens Cx mucus and thins endometrium
COC pill complications
Thromboembolism: estrogen increases blood clotting factors
Hypertension
Lactation: estrogen suppresses prolactin action at breasts
Other: weight gain, headaches/migraines, increase risk of Cx and breast cancers, alter liver function
POP
- Thickens Cx mucus
- Strict compliance req’d
Progesterone
- injection: 3 monthly
- Implants: 3 yearly
- Patch: dermal release. change weekly
- contraceptive ring: remove after 3 weeks, change 4 weekly
Sterilisation
Tubal ligation: removal of part of fallopian tube and closer of ends by clips or ring
Vasectomy: removal of portion of vas deferens and closer of open ends or application of clip.
Reversals performed with varying success
