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Management of Abortion
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
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With increasing globalization and lifestyle changes, even general practitioners are getting more and more young patients willing to adopt contraceptive measures. An optimum clinical choice of contraceptive can only be done through a mutual discussion between the physician and patient taking into consideration both clinical aspects and patient's choice. This article gives a brief general summary of the methods of contraception.
Contraception is the process of taking steps to ensure about not becoming pregnant after having sex. There are different types of contraceptive measures. They all have pros and cons. Different methods will be right for different couples, or right at different times in life.
Types of contraceptives:
* percentages mentioned within brackets are failure rates
It involves the use of estrogen and progesterone to prevent fertilization; associated with a 2-3% failure rate.
Oral contraceptive pills suppress the action of fsh/lh from the pituitary gland, they also suppress the lh surge, alter the cervical mucosa to inhibit penetration by spermatozoa, and they inhibit atrophic change in the endometrium.
Complications: venous thrombosis, pulmonary embolism, cva, mi, htn, amenorrhea, cholelithiasis, hepatocellular adenoma. Risks increase with smoking.
Contraindications: dvt, pe, cvd, cva, pregnancy, cancer, abnormal lfts
Monophasic (fixed combination: take estrogen and progesterone on days 1-21 and placebo on days 22-28. Increased estrogen increases the side effects of a headache, weight gain, nausea, and edema decreased estrogen and progesterone increase the risk of breakthrough bleeding and increases the failure rate.
Multiphasic: low-dose estrogen with varying doses of progesterone on days 1-21.
Progestin-only pills: not as effective and can cause breakthrough bleeding.
Levonorgestrel: lasts up to five years.
Medroxyprogesterone: lasts three months.
Decreases the risk of ovarian and endometrial cancer and decreased the risk of ectopic pregnancy.
It involves the insertion of a small device into the uterus with the hopes of inhibiting implantation, altering tubal motility, or inflaming the endometrium.
Intrauterine contraceptive devices are associated with a relatively low failure rate (2-4% pregnancy rate) but do suffer from a higher rate of complications (e. G, four times increased the risk of ectopic pregnancy).
Intrauterine device (iud) with progestogen: it releases progesterone and must be replaced annually.
Iud with copper-t: it contains copper and can last up to 4-6 years.
Increased blood loss and duration of menses, increased dysmenorrhea
Expulsion of iud, pregnancy, perforation of the uterine wall when inserted, increased risk of tubo-ovarian abscess (esp. Among younger nulliparous females with greater than ;1 sex partner). Pid is not as common with the newer iuds but still a significant risk factor.
Indicated for: multiparous women greater than 35 years who smoke.
Concerns about pelvic infections and subsequent fertility often limit the use of iucds to women who are at low risk for sexually transmitted disease and to those less likely to desire further children, i. E, monogamous multigravid patients.
It involves the use of an artificial device to inserted into the vagina or fitted to the penis with the intent to retain the products of intercourse.
Condoms: condoms have a 2% failure rate in consistent couples and a 10% failure rate in occasional users. They are best indicated for std prevention.
Vaginal diaphragms: they have a 15-20% failure rate, but when combined with a spermicidal jelly and left in for 6-8 hours post-coitus failure rate declines to 2%. Diaphragms are associated with side effects of bladder irritation and cystitis, also colonization with s. Aureus if left in too long.
Cervical caps: they must be properly fitted and can be left in for a longer time than the diaphragm.
It has a 15- 20% failure rate and involves the use of sponges and spermicides.
Spermicides contain surfactants to disrupt cervical membranes; placed in the vagina up to 30 minutes before intercourse.
It involves the avoidance of intercourse from an onset of menses to 2-days post ovulation.
This method involves manipulation of parts of male and female anatomy such that conception is prevented by failure and gametes to combine.
Vasectomy: lesser than 1% failure and can be successfully reversed in some cases.
Tubal ligation: lesser than 1% failure rate. Increase risk of ectopic.
Emergency contraception pills - emergency contraception can be used if one had sex without using contraception; or if someone had sex but there was a mistake with contraception.
Emergency contraception options are usually very effective if started within 3-5 days of unprotected sex. The earlier you take this pill, the more effective it is. It works either by preventing or postponing ovulation or by preventing the fertilized egg from settling in the womb (uterus).
A proper patient counseling informing the success rate and complication of contraception should be an integral part of the treatment regime.
Hello. My period was supposed to come on date 13/2/2018 but the period did not come yet. I have regular period between 28 to 30 days. I did the pregnancy test on 18/2/2018 date but test went to negative. How many chances to pregnant?
We are planning baby and I got my semen test done. It says I have 50 millions/ml as sperm count but motile are 30%. Is this normal? Should I trust this or should I get the report done again? If this is not normal, how should I improve this motile %? How long it can take to improve?
What will happen if I take mtp kit tablet without being pregnant? I missed my periods But my pregnancy test is negative But still I didn't get it Its 18 days late So shall I take mtp kit!
I am not having my periods from last 2 months and i am not pregnant what i should do to continue my periods?
Dear Doctor. I had a protected sex with a masseuse in a spa on 12th of May and I used condom for the whole duration and it did not break. I did hiv combo test (hiv1/2+p24 antigen test) on 18th, 24th and 29th day from Dr. lal path labs. All were non reactive with values 0.04, 0.05, 0.07 respectively. I can see the value is increasing every time. Is it ok? I have also heard that the combo test is conclusive after 28 days so I want to ask are my tests relevant or l need more tests. Thanks in advance.
Both men and women can suffer from sexual dysfunction which in common man’s speak is a problem that prevents you from experiencing sexual satisfaction. If you are experiencing sexual dysfunction in any part of the sexual response cycle which traditionally includes excitement, plateau, orgasm, and resolution, you are not alone. Research suggests that 43 percent of women and 31 percent of men report some degree of sexual dysfunction or difficulty.
It also remains a topic that many people are hesitant to discuss and resolve worldwide. Read on to know more on sexual dysfunction so that you can understand it and seek treatment for it because treatment options are available and extremely helpful.
Types of sexual dysfunction
Sexual dysfunction is classified into four categories:
- Desire disorders: This is a generalized lack of sexual desire or interest in sex
- Arousal disorders: Inability to become physically aroused during sexual activity
- Orgasm disorders: A delay or absence of orgasm
- Pain disorders: Pain during intercourse
Symptoms of sexual dysfunction
- Erectile dysfunction - An inability to achieve or maintain an erection for penetrative sexual intercourse
- Retarded ejaculation - An absent or delayed ejaculation despite sexual stimulation
- Early or premature ejaculation - Inability to control ejaculation
- Inadequate vaginal lubrication before or during sex
- Inability to relax the vaginal muscles for sexual intercourse to happen
- Lack of interest in or desire for sex, an inability to become aroused or pain during intercourse are also classified as sexual dysfunction.
Causes of sexual dysfunction
- Physical causes - A number of medical conditions can cause problems with sexual function like diabetes, heart and neurological problems , hormonal imbalances, kidney or liver failure, and alcoholism and drug abuse. Anti depressant use can also affect sexual function.
- Psychological causes - Stress and anxiety, sexual performance anxiety, relationship problems, depression etc. are some of the psychological causes responsible for sexual disorders. Feelings of not being good enough and the effects of a past sexual trauma also come into play.
Diagnosis of sexual dysfunction
The doctor will begin with a history of your symptoms, followed by a physical exam to rule out medical problems.
A major part of diagnosis is psychological. The doctor will evaluate your attitude about sex, as well as other contributing factors like fear, anxiety, past sexual abuse, relationship problems, medications, alcohol or drug abuse, etc. to understand the underlying cause of the problem.
Most types of sexual dysfunction can be treated by addressing the underlying physical or psychological problems. Other common ways to treat sexual dysfunction are:
- By changing a medication which may be casing sexual dysfunction - If you have a sexual dysfunction due to hormone deficiencies, you may benefit from hormone shots, pills, or creams. Men can use Viagra or Cialis for erectile dysfunction by increasing blood flow to the penis.
- Mechanical aids - Penile implants or vacuum devices can be used in men to maintain an erection. Vacuum devices are used in women too and so are dilators to help women who have an extremely narrow vaginal opening.
- Sex therapy - Marriage counselors and therapists help couples resolve their relationship issues that may be causing sexual dysfunction.
- Behavioral therapy - This helps you to seek insight into your behaviour which may be causing sexual dysfunction and address it.
- Psychotherapy - This type of therapy can help you resolve prior sexual trauma, feelings of inadequacy, anxiety, fear, or guilt, and poor body image. In case you have a concern or query you can always consult an expert & get answers to your questions!