Non-Hormonal Contraception

“Contraceptive techniques including IUDs, Barrier Methods, and Sterilisation”

Copper Intrauterine Devices (IUD)

• T-shaped coil contains copper
  • Toxic to sperm and ova preventing fertilisation
  • Inflammatory endometrial reaction preventing implantation
  • Cu ions reduce cervical mucous permeability to sperm
• 5-10yrs. No fertility delay, hormonal side effects. Very effective >99%
• Complications include perforation 2/1000, expulsion 1/20, relative increase in ectopic pregnancy, pelvic infection, bleeding when first administered
• Can be used as emergency contraception

Barrier Methods

• Female and male condoms
  • Prevent HIV and STI transmission
  • 98% effective if perfect use
• Diaphragms
  • 92-96% effective used with spermicide
  • Inserted prior to sex. Leave in place >6hrs to ensure sperm in the lower reproductive tract is unlikely to be alive
• Cervical caps and dams

Sterilisation

• Tubal occlusion. Laparoscopic. Filshie clips. Failure in 1/200
• Vasectomy. Occlude vas deferens. Failure 1/2000. Post-vasectomy semen analysis

Others

• Natural family planning e.g. using apps to track menstrual cycle and basal body temperature
  • Typical use 7 in 100 women pregnant in 1 yr
  • Cervix changes around fertile time. Mucous changes. BBT rises 0.2-0.4 degrees after ovulation
  • Withdrawal method