Contraception overview:Type,Uses,Side effect for doctors and Medical students

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Family planning method overview

Family planning method overview 

What is Contraception? 

Contraception definition :

Contraception means prevention of Conception, or to prevent pregnancy by which method is called contraception. 

Type of contraception :

Contraception mainly two types.  
Such as
  1. Temporary Method
  2. Permanent Method

Temporary contraception method

Temporary contraception method including following :
  1. Natural Method
  2. Condoms
  3. Ring
  4. Diaphragm 
  5. Oral pill
  6. Injection
  7. Implant
  8. Intrauterine Device  

Permanent Method:

  1. Vasectomy for male
  2. Bilaterally Tubal ligation

Top 10 Contraception Method in the world 

1. Natural Method

2. Condoms

What is condom? 

Condoms are a safe and effective method of birth control. Condoms are a very effective birth control method if used properly. Its use to prevent unwanted pregnancies and to prevent spread of sexually transmitted diseases. 

How condoms work to prevent pregnancy?
Condoms act as a barrier to enter sperm in the uterus that’s result failure to fusion between sperm and Ovum. After ejaculation, the sperm remains inside the condom. As a result, it cannot be interrupted with the ovum in uterus, which prevents fertilization of sperm and ovum.

When and what type of couple will use condoms?

Any fertile male can use condoms for birth control, and for prevents sexually transmitted diseases. The Couples who do not want to use any family planning method of birth control permanently or temporarily they can use condoms. If the baby is breastfed for the first 6 months after delivery, you can use a condom for effective contraception. For those who ejaculate early, doctors often advise them to use condoms regularly. Everyone can use condoms Without who are allergic to condoms.Symptoms of allergies include redness, swelling, and itching of the penis. Condom effectiveness, Proper, use of condoms protects against sexually transmitted diseases such as HIV / AIDS, gonorrhea, syphilis, chlamydia, typhoid fever,malaria etc. In addition, the use of condoms prevents herpes, genital warts and other sexually transmitted diseases.

Convenience of using condoms: 

  1. Safe,
  2. no hormonal side effects.
  3. Used properly, it can protect against birth control as well as HIV / AIDS and other sexually transmitted diseases.
  4. Protects women from inflammation / pain in the lower abdomen and male / female infertility by preventing sexually transmitted diseases.
  5. Suitable for all men.
  6. Can be saved from the east for sexual intercourse.
  7. Only to be used during intercourse. Available, low cost and can be used without the help of a service provider.
  8. A suitable method for newlyweds.

Difficulty using condoms :

  1. Some couples may feel less emotional about sex.
  2. Some people may be allergic to latex or the lubricant used in condoms.
  3. Many times buying, wearing, opening condoms can feel embarrassing to someone.
  4. If not worn properly, condoms can rupture and lead to pregnancy. Awareness and caution are required to discard used condoms after use. Side effects of condoms Some people may be allergic to latex or the lubricant used in condoms.

Where different types of condoms are available?

Condoms are available at the government level for field workers, and in various health centers. SMC brand condoms such as — 

  • Raja, 
  • Hero, 
  • Panther, 
  • Sensation, 
  • U&M, 
  • Extreme etc.

These are available in pharmacies.

3. Contraceptve Injection 

What is contraceptive injection? 

Contraceptive injection is a three-month temporary family planning method for women. Only progesterone-rich DMPA contraceptive injections are common in the Bangladesh, India, Nepal and Developing Countries.

Contraception method for birth control

How are Contraceptive injection work?

How to work Contraceptive injection:

  1. Contraceptive injection thickens and sticks the juice secreted in the cervix, and preventing the sperm from entering to the uterus.
  2. Inhibits ovulation. If ovulation Doesn, ‘t occur, The uterus will not allow the endometrium to be suitable for fertilization Between ovum and sperm. As the number and size of glands in the endometrium decrease, it becomes thinner due to failure of ovulation. 

What are the dosage of Contraceptive injection and rules of application?

  • First dose of injection: 150 mg injection is given intramuscularly. 
  • Next dose: After the first dose, the next dose should be given every three months. 
  • However, in special cases such as Ramadan, foreign travel, relocation, floods due dose can be the given within the previous 14 days or within the next 28 days of the expected date. 

The advantage of taking contraceptive injections: 

  1. Highly effective and safe birth control method. 
  2. Privacy can be protected. 
  3. One injection prevents pregnancy for up to three months. 
  4. Temporary methods, so other methods can be used or conceived without the method. 
  5. Does not affect the quantity and quality of breast milk. As a result, it can be used only after 6 weeks of childbirth. 
  6. Reduces the risk of miscarriage outside the uterus. 
  7. Many times it stops menstruation and reduces anemia. 
  8. Helps prevent cancer in the lining of the uterus (endometrium). Helps to prevent tumors / cysts in the uterus. 
  9. Lack of estrogen does not cause blood clots or heart attacks. 

Difficulty taking contraceptive injections: 

  1. Irregularities in the menstrual cycle, such as Spotting, dripping or irregular bleeding, prolonged or excessive bleeding, menopause. 
  2. Some people’s menstrual periods may stop for a long time after 1 year of continuous use. 
  3. May gain weight. 
  4. It usually takes 6-12 months to re-conceive after stopping the contraceptive injection. 
  5. Prolonged use may reduce volatile concentrations. 
  6. You have to go to the service center after 3 months to get the injection. 
  7. Some recipients feel dizzy, their heads tingle, their breasts feel heavy and painful, they feel depressed, their mood is irritable, and their desire for sexual intercourse decreases. 
  8. Does not prevent sexually transmitted diseases or infections of the reproductive system. 

Appropriate time for contraceptive injections:

  1. Within the first 5 days of menstruation. 
  2. If you are sure that you are not pregnant, you can start at any time during menstruation, such as if you have not had sexual intercourse after the last menstrual period, if any other effective birth control method is used properly, etc. 
  3. During breastfeeding: If the baby is breastfed. You can start from 6 weeks after delivery. If the baby is breastfed immediately after delivery. Within 7 days of MR or abortion.
  4. As Soon after stopping regular use of other modern birth control methods. 

Side-effects of contraceptive injections:

Minor problems such as weight gain, heaviness in the lower abdomen, feeling pain, headache, mental anxiety, etc. can occur. Amenorrhea may be stopped for some time. Bleeding or spotting or break-through bleeding may occur between the two menstrual periods. May cause excessive bleeding (menorrhea). Infection can occur at the injection site. May cause yellowing of eyes and skin or anyone (in case of jaundice) Frequent severe headaches and blurred vision. Severe pain in the back of the foot and can last for several days. Even after stopping the injection, you may not be able to get pregnant. Any other difficulty. Such as- Diarrhea 

Where contraceptive injections services are available?

 In our country, injection services are available at every health and family welfare center, upazila health complex, maternal and child welfare center, district headquarters hospital, medical college hospital and recognized NGO / private clinic at the union level. Moreover, if there are adequate facilities, it is also possible to provide this service to the satellite clinic. 

What are the Contraceptive injections of different brands?

 At the government level, only progesterone-rich DMPA contraceptive injection Depot-Provera is available at a free community clinics, FWC, FWA. SMC brand progesterone-rich contraceptive injections are available at any pharmacy 
called Somaject and Saina Press

4. Oral Contraceptive pills

The pills are used to prevent pregnancy is called Oral Contraceptive pills.

Type of Oral Contracetive pills

1. Progesteron only pill
2. Combined pill
3. Emergency contraceptive pill

Birth control pills are safe, and effective birth control methods. Oral contraceptive pills are the most used method in the world. The most common combination of pills today is the hormone estrogen and progesterone. Basically the type of Oral contraceptive pill is determined based on the amount of estrogen hormone. Additionally, only progesterone-rich minipill is used as an effective contraceptive pill.

How Oral contraceptive pills work to prevent pregnancy?

Condensing the secretions of the cervix prevents the sperm from entering the uterus. Inhibits ovulation.Ovulation occurs as a result of a sudden increase in luteinizing hormone in the middle of the normal menstrual cycle.Oral Contraceptive pills prevent the sudden increase in luteinizing hormone(LH) and prevent ovulation. It slows down the normal movement of the fallopian tubes, which in turn reduces the speed of the sperm. The sperm weaken or die because it takes longer than usual to reach the ovum. Prevents the growth of the lining of the uterus, so that the fertilized ovum cannot be embedded in the uterus without having an environment in which it can be fertilized.

The rule of starting combined contraceptive pills 

first Almost all combined oral pills in Bangladesh contain 21 white birth control pills and 8 brown pills (iron pills). Packets that contain 21 or 22 pills have to wait for menstruation when they are all over. When menstruation starts, you have to start taking new packets of pills again from the first day of menstruation. If it is not menstrual and the recipient is sure there is nothing wrong with taking any pill, then start taking the pill from the new leaf 7 days after taking the last pill. Also- It should be started from the first day of menstruation to prevent ovulation properly. If the woman is sure that she is not pregnant, she can start from any day if necessary.

Minipill eating rules

 Minipill The only contraceptive pill or pill that is made with progesterone is Minipill. Minipill is 97-98 percent effective.
You have to take one pill at the same time, every day. Once all the pills in a packet has been consumed, you have to start from another new leaf the next day. There can be no break between the two packets. When the minipill first started Within 5 days of the start of menstruation. Those who are breastfeeding their baby can start from 6 weeks after the baby is born. People who are not breastfeeding can start at any time, menstruating or not. If she starts eating 4 weeks after the baby is born. She needs to make the sure she is not pregnant.

What to do if you forget to take Oral contraceptive pills?

If you forget to take a pill one day, take one pill whenever you remember and take the pill on time. If you forget to take pills for two days in a row, take two pills as soon as you remember. Take the rest of the leafs pills once a day at regular intervals and use a condom or abstain from sexual intercourse until the next menstrual period. If you forget to take the pill for three days in a row, do not take the pill from that leaf anymore and use a condom until the next menstrual period or abstain from sexual intercourse. If you forget to take brown pills (28 packets of pills), do not take brown pills from that leaf anymore and start taking one white pill every day from the new leaf. If the husband is not at home temporarily for any reason, taking pills cannot be omitted. 

Advantages of oral contraceptive pills

  • It is very effective and safe when played properly. 
  • Reproductive women of all ages can use birth control pills. 
  • This is a temporary method, another method can be used to leave the pill at any time, or get pregnant. 
  • It can also be used as an emergency contraceptive. 
  • Other health benefits of oral contraceptive pills reduces the risk of pregnancy outside the uterus. 
  • Reduces uterine contractions during menstruation. 
  • Reduces the duration and amount of menstruation and helps to eliminate anemia. 
  • Regulates the menstrual cycle. 
  • Reduces the risk of ovarian cysts and cancer of female. 
  • Reduces the chances of breast disease and Cancer. 
  • Reduces gonorrhea-causing PID levels. 
  • Reduces acne, unwanted hair growth. 
  • Reduces premenstrual symptoms.

Disadvantage taking if oral contraceptive pills

  • Is eaten every day.
  • Does not prevent sexually transmitted diseases like Condoms.
  • Menstruation may be off.
  • Vaginal lubrication may be reduced.
  • Breast milk may be reduced. Depression can occur.

Side effects of oral contraceptive pills

Minor side effects may occur early (3 to 4 months) after taking the pill. , E.g. 

  • High blood pressure can occur Feeling of heaviness in the breasts and pain when touching the breasts Bleeding droplets between the two menstrual periods. 
  • Depression can occur. 
  • Nausea Headache
  • Acne in the face 
  • Weight gain Women who are at risk for myocardial infarction, stroke, etc., have an increased risk. 
  • There may be a change in the color of the facial skin. 
  • The risk of blood clots in the veins increases. 

So those who have had this problem in the past or present, they cannot take estrogen-rich mixed diet pills.

Where to find oral contraceptive pills?

In our country, food pills are available at government level field workers, community clinics, satellite clinics, union level health and family welfare centers, upazila health complexes, maternal and child welfare centers, district headquarters hospitals, medical college hospitals and recognized NGOs / private clinics, pharmacies. Birth control pills of different brands Government pills are available from happy free field workers, community clinics, satellite clinics, health and family welfare centers at the union level. SMC brand pills are available at any pharmacy called Noret-28, Femicon, Famipil, Mypil, Ovacon Gold, and the only progesterone-rich Minipil Minicon etc.

5. Implnt

Implants are only temporary long-term contraceptive methods rich in the hormone progesterone, which are placed under the skin in the arms of women. The duration of the effectiveness of this procedure for a period of 3-5 years depends on the number of rods and the type of hormone. A device with one or more capsules made of implant With plastic or silicone rubber, containing the synthetic progesterone hormone. After being placed under the skin, a certain amount of hormone is secreted through the numerous microscopic pores of the capsule.

Different types of implants


This is a 3 year term implant with single rod. The implant contains a polymer capsule containing 68 mg of ethnogestrel ethylene-vinyl acetate. It is pre-loaded on a one-time sterile applicator.

Nexaplanon one

A new brand of implant used in Britain, Minilap. It also contains progesterone hormone called etonorgestrol like implanon. Because of the presence of barium in it, X-rays can be used to identify its location.


Jadel is a 5 year term implant with two rods. Each of Jadel’s two rods contains a total of 150 mg of levonorgestrel, 75 mg each. It is also known as Norplant- (II) Jadel contains two silicone capsules (sylastic tubes) and a trucker in a sterile packet.

Sino Implant-II

This is a 4 year term implant with two rods. It has two rods contain 75 mg levonorgestrel per rod, and a total of 150 mg of levonorgestrel, which is inside the silicone elastomeric coating. In 2010, NTC approved the trial of acceptance of Sino Implant-II in Bangladesh and this trial has been going on since June 2011.

How to do the implant works? 

Prevents ovulation. Implanon completely prevents ovulation for the whole 3/5 years.
Increases the secretion of mucus or the concentration of mucus.
Reduces the thickness of the endometrium.

Who is the implant suitable for?

  1. Newlyweds.
  2. Those who want a birth break for a long time.
  3. Those who breastfeed the baby.
  4. Those who cannot use estrogen-rich methods.
  5. Implant benefits
  6. Very effective.
  7. Long term
  8. The ability to conceive returns almost immediately after removal.
  9. Newlyweds can also use.
  10. Does not interfere with sexual desire or sexual intercourse.
  11. Postnatal mothers who are breastfeeding can use it from 6 weeks of age.
  12. It is a suitable method for those who cannot use estrogen rich method.

Disadvantages of implants

Changes the type of menstrual discharge.
Women who are sensitive to the hormone progesterone cannot use it.
Sometimes understood from the outside.
If you want to wear and open it, you have to go to the service center.

Appropriate time to take /use the implant:

  • Within 1-7 days of menstruation.
  • In case of recipient of Combined Contraceptive pills –
  • The most appropriate time is the day after taking the last meal pill (White Pills).
  • Also the next day after finishing all the pills (including iron).
  • In case of any other progesterone hormone user –
  • Minipill drop day.
  • The day of opening the implant.
  • While the expiration date of the injectables is effective.
  • Postpartum–After 6 weeks of breastfeeding.
  • If the mother does not breastfeed immediately after delivery.
  • Immediately in case of miscarriage.
  • At any time if you are sure that there is no pregnancy.

Where to get implant services

The help of an experienced doctor or caregiver should be sought for implant placement. Implant services are available at every Health and Family Welfare Center, Upazila Health Complex, Maternal and Child Welfare Center, District Sadar Hospital, Medical College Hospital and recognized NGO / Private Clinic in our country.

Follow-up after implant placement:

A total of 3 visits to the clinic within a year of receiving implants for regular follow-up-
1st follow-up: 1 month after installation (+ 7 days).
2nd follow-up: 6 months after installation (+ 1 month).
3rd follow-up: 12 months after installation ( + 1 month).
★It is also advisable to visit the clinic at any time in case of emergency.

What are the Reasons to contact the service center?

  1. When menstruation stops.
  2. In case of infection at the place of implant rod placement.
  3. If there is severe pain in the lower abdomen.
  4. In fact any rod of the implant comes out.
  5. If there is excessive bleeding.
  6. Severe headache or blurred vision.
  7. Implant side effects and do’s and don’ts
  8. Bleeding may occur between the two menstrual periods.
  9. Bleeding or excessive bleeding for a long time. The rate of this problem is very low and it gets better after the first few months.
  10. May be off menstruation (some women find this an advantage)
  11. May cause headache, nausea, weight gain or loss, etc.
  12. Fatigue may occur.
  13. There may be pain or heaviness in the breast.
  14. There may be pain in the lower abdomen (may or may not be related to the procedure).

★Go to the hospital or health center as soon as any of the possible complications mentioned.

Contraceptive implants of different brands:

One-rod Etonorgestril Ethylene-Vinyl Enriched 3 year Implan which is given free of cost at MCWC and Upazila Health Complex at the Government level in Bangladesh. 
Levonorgestrel-rich 5-year SMC brand iplants with two rods were delivered to the experienced doctor’s chambers.

6. Intra Uterine Device

7. Diaphragm

8. Ring


9. Vasectomy 

10. Tubal Ligation 

Intrauterine Device  
Tubal Ligation 
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