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Non Hormonal Contraception Part 1-Basics of Cancer Cytogenetic-Lecture Handout, Exercises of Cancer Cytogenetics

This lecture handout was designed and distributed by Prof. Akhilesh Kulkarni at Sree Chitra Thirunal Institute of Medical Sciences and Technology. This is part of Cancer Cytogenetic course. It includes: Contraception, Papyrus, Stiliborn, Transmitted, Smear, Polyurethance, Impregnated, Nonoxynol, Diaphragm, Impregnated

Typology: Exercises

2011/2012

Uploaded on 08/01/2012

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I
N SUMMARY
N
ON
-H
ORMONAL CONTRACEPTION
N
ON
-H
ORMONAL CONTRACEPTION
H
ISTORY
o E
bers Papyrus (1550 BC)
o P
liny the Elder (23
-7
9 AD)
o D
ioscorides (58
-6
4 AD)
o S
oranus (100 AD)
o A
l
-R
azi (923 AD)
o A
li ibn Abbas (994 AD)
o A
vicenna (1037 AD)
L
actational Cont rol of Fertilit
y
o D
arwin (1809
-1
882)
o K
oran (2:223)
o
Mothers shall give suck to their offspring for two whole years if they desire to complete
t
he term”
o S
tillborn
pregnancy interval reduced
o H
igher fertility rates among users of “wet nurse”
o P
atterns changed around 1750’ w
h
en breast feeding started to decline
R
easonable at Time
o W
iping out the vagina
o ?
Reasonable bu t ineffective
o H
oney, alum, lactic acid, pepper as pessar
o T
otally unreasonab le and ineffective
o H
olding breath at time of ejaculation
o J
umping backw
a
rds 7 times after coitus
C
ontraception
o (
Population control ???)
o I
nfanticide
ies and barriers
o O
piates, gin, too little food, smothering (common in 18
t
h century)
o A
bandonment
o F
oundling Hospital (Coram 1741)
o 1
0,204/14934 infants admitted then died
o M
ajority were illegitimate
c
hildren
o 5
0% of all legitimate births admitted were of mothers wi
I
UD History
o 1
909 Richter used silkworm gut
o 1
909 Graefenberg used silkworm gut and silver wire
o 1
960 Lippes Loop, Margulies Spiral, Saf
-T-C
oil
o 1
960’s Zipper used copper d
e
vices
o T
ail
-l
ess steel ring used in China by 45 million
o A
bout 10% of contraceptors in USA
o P
rogesterone impregnated
o C
opper coated (various shapes)
o 1
0 year use
th 6 or more children
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NON-HORMONAL CONTRACEPTION

NON-HORMONAL CONTRACEPTION

HISTORY

o Ebers Papyrus (1550 BC) o Pliny the Elder (23-79 AD) o Dioscorides (58-64 AD) o Soranus (100 AD) o Al-Razi (923 AD) o Ali ibn Abbas (994 AD) o Avicenna (1037 AD) Lactational Control of Fertility o Darwin (1809-1882) o Koran (2:223) o “Mothers shall give suck to their offspring for two whole years if they desire to complete the term” o Stillborn  pregnancy interval reduced o Higher fertility rates among users of “wet nurse” o Patterns changed around 1750’ when breast feeding started to decline Reasonable at Time o Wiping out the vagina o? Reasonable but ineffective o Honey, alum, lactic acid, pepper as pessar o Totally unreasonable and ineffective o Holding breath at time of ejaculation o Jumping backwards 7 times after coitus Contraception o (Population control ???) o Infanticide ies and barriers o Opiates, gin, too little food, smothering (common in 18th^ century) o Abandonment o Foundling Hospital (Coram 1741) o 10,204/14934 infants admitted then died o Majority were illegitimate children o 50% of all legitimate births admitted were of mothers wi IUD History o 1 909 Richter used silkworm gut o 1909 Graefenberg used silkworm gut and silver wire o 1960 Lippes Loop, Margulies Spiral, Saf-T-Coil o 1960’s Zipper used copper devices o Tail-less steel ring used in China by 45 million o About 10% of contraceptors in USA o Progesterone impregnated o Copper coated (various shapes) o 10 year use th 6 or more children

NON-HORMONAL CONTRACEPTION

CONDOMS

Condom History o Used for centuries o Pregnancy protection o Infection protection o Stimulation o Decoration o 1350 BC Egyptians wore decorative covers for penis o 1564 Fallopius described linen sheaths o 1700’s animal intestines: o Given name “Condom”: Protection from venereal disease and numerous bastard offspring o 1798 Casanova (from his memoirs) Barrier Methods Dr. Condom - English physician Charles II had many children 1800 in brothels all over Europe English Cape French letters 1844 Vulcanization of rubber 1850 rubber condoms in USA 1880 Diaphragm in Germany Sponge Real sponges used for centuries June 1983 “TODAY” (Two Day) 2 inches long by 1.25 inches thick Polyurethane - 1 gram nonoxynol- 9 125 - 150 ug per 24 hours (10-15%) Rare toxic shock Bacteriocidal/virocidal/spermicidal Not carcinogenic Remove 6 hours after the last coitus

FUNDAMENTAL QUESTIONS

1. What are condoms made of?

2. Which sexually transmitted disease do the various types of condoms protect

against and why?

3. What is a contraceptive sponge made of? How effective is it?

4. How does the IUD work?

5. What are the different types of IUD available?

6. What are life spans of the various types of IUD’s in current use?

7. What non-contraceptive benefits does the MIRENA have?

8. What is the causative organism of “toxic shock syndrome”? What are the

clinical manifestations of this syndrome?

9. Discuss the history of the IUD.

NON-HORMONAL CONTRACEPTION

FUNDAMENTAL QUESTIONS

1. What is a cervical cap?

2. What is the contraceptive efficacy?

3. What is the mechanism of action of the cap?

4. What are cervical caps made of and why?

5. What is a contraceptive sponge?

6. What spermicide is used in the sponge?

7. Are there any risks in using the sponge?

NON-HORMONAL CONTRACEPTION

FEMALE CONDOMS

ADVANTAGES

  • Effective immediately
  • Do not affect breastfeeding
  • Do not interfere with intercourse (may be inserted up to 8 hours before)
  • Can be used as backup to other methods
  • No method-related health risks
  • No systemic side effects
  • No prescription or medical assessment necessary
  • Controlled by the woman
  • May provide protection against STDs
  • May help prevent cervical cancer DISADVANTAGES
  • Expensive (at this time)
  • Moderately effective (5-21 pregnancies per 100 women during the first year1)
  • Effectiveness as contraceptives depends on willingness to follow instructions
  • User-dependent (require continued motivation and use with each act of intercourse)
  • Disposal of used condoms may be a problem
  • Adequate storage must be available at the client’s home
  • Supplies must be readily available before intercourse begins
  • Resupply must be available FOR THESE Women
  • Who prefer not to use hormonal methods or cannot use them (e.g., smokers over 35 years of age)
  • Who prefer not to use IUDs
  • Who are breastfeeding and need contraception
  • Who want protection from STDs and whose partners will not use condoms Couples:
  • Who need contraception immediately
  • Who need a temporary method while awaiting another method (e.g., implants, IUD or voluntary sterilization)
  • Who need a backup method
  • Who have intercourse infrequently
  • In which either partner has more than one sexual partner (at high risk for STDs, including HBV and HIV/AIDS), even if using another method PROBLEMS
  • Diminished sexual pleasure:
  • Condom breaks or breakage suspected (before intercourse):
  • Condom breaks or slips off during intercourse

FUNDAMENTAL QUESTIONS

1. Of what are female condoms made?

2. What is the efficacy of the female condom?

3. Do female condoms protect against STD’s?

4. Who might be a good candidate for the female condom?