CONTRACEPTION

Contraception is prevention occur fertilization among ovum cell and sperma cell at the wall ofuterus.

Effectiveness at method of contraception that be used dependon use of typical ( sometimes do not consistence ) and use of perfect ( follow all instruction precisely ).

There are some method be used as contraception, include :

1. Method of hormonal.

Hormone that be used to prevent conception include estrogen and progestin ( acompound like with progesteron hormone ). Method of hormonal prevent pregnancy with inhibit release of ovum cell from ovary, or coagulating serviks mucus sothat sperma cannot can passing by serviks to uterus.

a. Contraception oral.

Effectiveness at use of perfect 0,3% and use of typical 8 %. Oral contraception must be cunsumed every day, for the oral contraception combination ( containing progestin and estrogen ), a woman consume active pill every day during 3 week,then be followed consume inactive tablet during 1 week, for the oralcontraception that only contain progestin so pill be consumed every day. Sideeffects at use of the oral contraception is the increase of blood clot risk and possibility of serviks cancer.

b. Contraception implan.

Contraception that form of small bar contain progestin hormone. Contraception implan only require to be attached 1 times for the usage of during 3 year. Sideeffects at period of menstruate is not regular, during use first year. Effectiveness at use of perfect 0,05% and use of typical 0,05 %.

c. Contraception patch.

Contraception patch glued one week during 3 week successively. Patch glued atthe skin, then let during 1 week. At the fourth week so patch is not used.Effectiveness at use of perfect 0,3% and use of typical 8 %.

d. Vagina ring.

Vagina ring have shape small plastic appliance be placed in vagina during 3week. Then, ring can be released during 1 week. A woman can install and releasevagina ring alone. Vagina ring consist of one size and can be placed whereverat vagina. Usually ring is will not felt when intercourse. The new ring ofvagina is just changed per month. Effectiveness at use of perfect 0,3% and useof typical 8 %.

e. Injection medroxyprogesterone.

Injection progestin or medroxyprogesterone be done by the doctor every threemonths once. Available two type of injection is injection to muscle tissue atbackside and arm, and injection to under skin. Side effects include addition ofweight, headache, menstruating not regular until not menstruate, and and density of bone decrease the time being. Medroxy progesterone do not improve cancercous risk, including mammae cancer and endometrial cancer, reduce inflammatory of pelvis and anaemia. Effectiveness at use of perfect 0,3% anduse of typical 3 %.

2. Method of barrier.

Barrier contraception prevent sperma enter woman uterus, including :

a. Condom.

Condom is appliance of contraception as a flimsy protector close penis, madefrom latex as contraception that can protecting sexual contagion, includingbecause of bacterium ( like syphilis and gonorrhea ) and caused by virus ( like HPV / papillomavirus human and HIV / virus immunodeficiency human ). Effectiveness at use of perfect 2 % and use of typical 15 %.

b. Diaphragm.

Diaphragm is rubber in form of is hemispherical provided with cover flexible that can insert into vagina, and placed in serviks. Diaphragm as a barrier for sperma enter uterus. Contraception cream and also contraception gel which can kill sperma must be always be used if use of diaphragm, because diaphragm canshift during intercourse. Diaphragm be inserted before intercourse and may notbe moved from its place ( vagina) at least 8 hour after intercourse, but at themost 24 hour. Effectiveness at use of perfect 6 % and use of typical 16 %.

c. Spons of contraception.

Spons of contraception contain spermisida, spons can be inserted into vagina around 24 hour before intercourse and provide the the protection during thistime, without influencing how many intercourse be repeated. Spons be hushed atleast 6 hour after last intercourse, but spons may not be hushed more than 30hour/clock. Usually couple do not realize existence of spons. Side effect include reaction of allergy, vagina become dry or vagina iritasi and difficultyrelease spons. Effectiveness at use of perfect 26 % ( at woman which have ownedchild ), 9 % ( at woman which not yet owned child ), and use of typical 32 % (at woman which have owned child ), 16 % ( at woman which not yet owned child ).

d. Cover of serviks

Cover of serviks appear like diaphragm, but smaller and harder. Cover ofserviks be inserted in serviks by snugly. Contraception cream or gel must bealways used if using cover of serviks. Cover of serviks have to be inserted before intercourse and be hushed at least 8 hour after intercourse, but at themost 48 hour. Effectiveness at use of perfect 18 % ( at woman which have ownedchild ), 9 % ( at woman which not yet owned child ), and use of typical 40 % (at woman which have owned child ), 18 % ( at woman which not yet owned child ).

3. Other method.

a. Intrauterine Devices ( IUD ).

IUD is small size made from elastic plastical be inserted into uterus during 5 until 10 year. There are some type of IUD such as type release copper and typeof release progestin. IUD prevent pregnancy by killing and imobilisasi sperma,and preventing fertilization. Effectiveness at use of perfect 0,1 - 0,8 % anduse of typical 0,1 - 0,8 %.

b. Natural contraception.

Natural contraception method with way not doing intercourse when woman in a period of fertility. Effectiveness at use of perfect 1 - 9 % and use of typical25 %.

Some natural contraception method include :

Method of calendar.

This Method is not effective for the woman of have cycle menstruate is not regular. To calculate time couple may not be done intercourse, a woman can doing addition 18 day from short cycle and 11 day from longest cycle from 12cycle menstruate forwards.

Method of temperature.

Temperature of woman body at the time rest ( temperature of basal ) increase little by little around 0.9° F ( 0.5° C), after ovum cell experience ovulation. To know temperature of basal, a woman have to measure its body temperature every morning before awaking up from bed. Woman may not doing intercourse start from early period menstruate until at least 72 hour after occur the increase at temperature of basal.

Method of vagina mucus.

A woman can determine period of fertility by mucus secretory from vagina that be started from day after menstruating to end, there is mucus jell and not clear. Momentary before happened ovulasi, released mucus will more and more,becoming more watery, elastic and more clear appear like water. Intercourse can be done if there is no vagina mucus which emerge but intercourse may not bedone besides that day. If vagina mucus emerge, intercourse must be avoided during 3-4 day after change at vagina mucus as a indication the happening of ovulasi. Intercourse can be done without there is prohibition order until period menstruate come next.

Method of simptotermal.

This Method is combination between inspection method of body temperature,inspection of vagina mucus and also calendar system. Woman have to pay attention if there are increase of vagina mucus, becoming is thicker, elasticand also more clear appear like water ( like at inspection of vagina mucus )and the increase of body temperature. This moment woman may not doing intercourse start from first day tear away from intercourse according to calendar system until at least 72 hour after occur the increse of body temperature ( inspection of body temperature ) and change of vagina mucus ( inspection system of vagina mucus ).

c. Coitus interuptus.

To prevent sperma step into vagina, man can draw its penis from vagina, before sperma go out at the time of orgasm. Effectiveness at use of perfect 4 % anduse of typical 27 %.

Emergency contraception, which is ordinary be called as a morning after pill contain drug or hormone which can influence hormone. This pill be used at longest 72 hour after happened intercourse without use of contraception method or contraception fail, for example happened leakage of condom. Emergency contraception can lessen pregnant possibility after happened once intercourse without protector, including when the intercourse be done near moment of ovulation. Faster emergency contraception be used will progressively effective.

Available two choice in emergency contraception :

1. Levonorgestrel

Levonorgestrel or progestin in lower dose at most used in emergencycontraception. Generally, one dose be consumed, followed with other dose 12hour then. If consumed by first dose 72 hour after intercourse, possibility the happening of pregnancy decrease until almost 90%. If consumed first dose during24 hour after intercourse, pregnancy opportunity decrease until around 95 %.

2. Combination contraception

Emergency contraception using combination oral contraception pill. 2 tablet of combination contraception pill be consumed at the same time within 72 hour after happened intercourse without protector. Hereinafter, 2 tablet of combination contraception pill be consumed 12 hour then. Medicinize antiemetik can be used to prevent queasy and vomit.

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