Reproductive Health 1

Reproductive Health
Indian Population
• India – second most populated country
Population Explosion
Population explosion
• Our population which was approximately 350 million at the time of
our independence reached close to the billion mark by 2000 and
crossed 1 billion in May 2000.
• Increased health facilities along with better living conditions had an
explosive impact on the growth of population.
• The world population which was around 2 billion in 1900 rocketed to
about 6 billions by 2000.
• Such an alarming growth rate could lead to an absolute scarcity of
even the basic requirements, i.e., food, shelter and clothing, in spite
of significant progress made in those areas.
Reasons for high
population in India?
High Population - Reasons
High mortality and

01 Child marriage 02
higher life span
Preference for
Illiteracy 03 male kids
04
Aversion from Non-availability of

family planning 05 contraceptives 06
High Population - Problems
Scarcity
Shortage of funds
Problems of
over
population
Over consumption
Ecological Imbalance
Population
Stabilisation
Policy
Stabilisation Policies
National Program for Family Planning (1952)
• India – first to launch family planning program
• Objective: to promote small family and introduction of contraceptives
Stabilisation Policies
Hum Do Hamare Do
Stamps promoting family
planning
Reproductive and
Child Healthcare
Programmes
Stabilisation Policies - RCH
Reproductive and Child Healthcare Program (RCH) - 1997
• Objectives:
❖ Reduce infant mortality rate and maternal mortality rate
❖ Monitor overall well being of mother and child
❖ Measures to avoid unwanted pregnancies and sexually
transmitted diseases
Stabilisation Policies - Outcomes
• Access to good health care for
❖ Pregnancy, STDs, abortions, menstrual problems, infertility
• Raise of marriageable age
o Females – 18 years; males – 21 years
• Awareness
o Introduction of sex education in schools
• Educating fertile couple –

❖ Birth control options
❖ Care of pregnant mothers
❖ Postnatal care
❖ Importance of breastfeeding
• Providing information about

❖ Reproductive organs
❖ Adolescence
❖ Safe and hygienic sexual practices
❖ Sexually transmitted diseases
• Statutory ban on fetal sex determination methods
❖ Amniocentesis
❖ Ultrasound scanning to determine sex
• Research of newer , better and easier to use family
planning methods
• For example:
❖ Saheli – 1st and only non-hormonal oral
contraceptive for females
❖ Developed by Central Drug Research Institute

(CDRI) Lucknow, India
• Cheap and wide availability of contraceptives

• Contraceptives at medical shops, health centers
• Free distribution of contraceptives
Question Time
Saheli is the first
a) Hormonal oral contraceptive
b) Non-hormonal oral contraceptive
c) Hormonal implant
d) None of the above

Saheli is the first
a) Hormonal oral contraceptive
b) Non-hormonal oral contraceptive
c) Hormonal implant
d) None of the above

Reproductive
Health
Reproductive Health
Reproductive health is physical, emotional, behavioural and

social well-being in all aspects of reproduction
Birth Control/
Contraceptive
methods
Birth Control/ Contraceptive methods
Contraception
Contra Conception
against fertilisation of the

ovum by sperm
Contraception
• A method or system which allows sexual intercourse but

prevents pregnancy.
• The method is called temporary if the effect of the method
lasts till the time couple uses the method and fertility resumes
immediately after or within few months of its discontinuation.
Contraceptives
Contraceptive Methods
Temporary Methods Permanent Methods

Shouldn’t
User interfere with
friendly sexual act
Ideal Shouldn’t
Easily
Contraceptive interfere with
available
sexual drive
?
Reversible;
Effective No/Less side
effect
CONTRACEPTIVE METHODS
Natural Surgical
Chemical
Barrier Implant
Natural Methods
Avoid meeting of ovum and sperm
No need of chemicals or physical equipment
Natural Methods
1 2 3
Periodic abstinence Coitus interruptus Lactational amenorrhea

(Rhythm method) (Withdrawal method) (Absence of menstruation)
Periodic abstinence
(Rhythm method)
For both Reversible Short term

males and females
Periodic abstinence (Rhythm method)
❖ Avoid coitus from day 10-17
of menstrual cycle
❖ Ovulation may occur- chances

of fertilisation
1 2 3 4 5
6 7 Ovul8ation 9 10 11
Fertile period
12 13 14 15 16 17
18 19 20 21 22 23
24 25 26 27 28
Sperm Ovum
Survives 3 days Survives 1 day
Periodic abstinence (Rhythm method)
Efficiency
Actual time 80-87%

of ovulation cannot
be predicted
Drawbacks
Natural Methods
1 2 3

Coitus Interruptus
(Withdrawal method)
For males only Reversible Short term

Coitus interruptus (Withdrawal method)
Efficiency
Some
sperms Moderate
enter vagina 80-96%
before ejaculation
Drawbacks
Natural Methods
1 2 3

Lactational amenorrhea
(Absence of menstruation)
For females only Reversible Short term

Lactational amenorrhea (Absence of
menstruation)
Hypothalamus
Lactation
▪ No menstruation
▪ No ovulation
Pituitary gland
Lactational amenorrhea (Absence of
menstruation)
Efficiency
Effective
only upto
98%
6 months
from parturition
Drawbacks
Question Time!!
For effective use of the rhythm method, coitus
should be avoided from day to
A 10;17
B 13;15
C 10;14
D 1;7
For effective use of the rhythm method, coitus
should be avoided from day to
A 10;17
B 13;15
C 10;14
D 1;7
Barrier Methods
Avoid meeting of ovum and

sperm prevent fertilisation
Barrier Methods
1 2
Condoms Diaphragms, Cervical Caps

and Vaults
Condoms - Merits
For both Reversible Short term

males and females
Condoms
Male Condom Female Condom
❖ Thin rubber/ latex sheath
❖ Used just before and during coitus

Condoms
❖ Prevents release of semen into female reproductive tract

❖ Prevents fertilisation
Condoms
Female
Male condoms
condoms/Femidoms
Unrolled
Rolled
Advantages of Condoms
Advantages of Condoms
1 2 3
Protects user Easy to access Can be
from STDs and and dispose self inserted;
AIDS gives privacy to
user
Barrier Methods
1 2
Condoms Diaphragms, Cervical Caps

and Vaults
Diaphragms, Cervical Caps and Vaults
For females only Reversible Short term

Diaphragms, Cervical Caps and Vaults
Diaphragm Cervical Cap Vault Cap
❖ Exclusively for women

❖ Made of rubber
❖ Holds spermicide
Spermicidal Agents
❖ These are available in the form of
○ Creams
○ Jellies
○ Foams
○ Vaginal tablets
❖ These are usually used along with barrier methods

to increase their contraceptive efficiency.
❖ These contain chemicals which kill the sperm like

boric acid, zinc sulphate, nonoxynol-9.
Spermicide vs Sperm
Spermicide vs Sperm
Question Time!!
What are the advantages of using condoms?
A Protection from STDs
B Prevention from conception
C Can be self inserted
D All of the above

What are the advantages of using condoms?
A Protection from STDs
B Prevention from conception
C Can be self inserted
D All of the above

Methods of contraception
Natural Barrier Chemical Implants Surgical
Diaphragms, Cervical
Condoms
Caps and Vaults
Male Female
Methods of contraception
Natural Barrier Chemical Implants Surgical

Chemical
Contraceptives
Contraceptives in which
chemical constituents
are used to prevent
fertilisation or avoid
implantation.
Steroidal Hormones
O HO
OH
H H H
H H H H H H
HO O
O
Estrogen Progesterone Testosterone
Hormonal Chemical Contraceptives
How to use?
Hormonal Chemical
Skin
Pills Injections Implants Vaginal Rings
Patches
How to use?
Hormonal Chemical
Skin
Patches
Hormonal Chemical Contraceptives - Oral Contraceptive Pills
What is it?
Oral administration of small doses of
progestogen or combination of progestogen-
estrogen.
They are used by females in the form of
tablets and hence are popularly called the
pills.
There are many different formulations or
brands, but the average pack is designed to
be taken over a 28-day cycle.
Hormonal Chemical Contraceptives - Oral Contraceptive Pills
How does it work?

For the first 21 days of the cycle, users take a daily pill that contains hormones
(estrogen and progestogen).
The last 7 days of the cycle are hormone free days.
Some packets only contain 21 pills and users are then advised to take no pills for
the following week.
How to use?
Hormonal Chemical
Skin
Patches
Hormonal Chemical Contraceptives - Injections
What is it?
Injections of progestogen alone or in
combination with estrogen.
E.g., DEPO-PROVERA
How to use?
Once in three months.
Mode of action?
Similar to that of pills
Efficiency
94 - 99%
How to use?
Hormonal Chemical
Skin
Patches
Hormonal Chemical Contraceptives - Implants
What is it?
Matchstick sized rod of plastic or other inert material containing a form of the
hormone progesterone called etonogestrel.
Norplant has six small capsules containing hormone and these are inserted under
skin of left upper arm.
Hormonal Chemical Contraceptives - Implants
How to use?
Doctor or trained nurse
insert the plastic rod
implant under the skin
of the inner arm above Subdermal
the elbow. implant Implant is
placed
underneath
skin of arm
Efficiency
99%
How to use?
Hormonal Chemical
Skin
Patches
Hormonal Chemical Contraceptives - Skin Patches
What is it?
Transdermal patch applied to the skin.
Contains estrogen - progestogen combination.
Hormonal Chemical Contraceptives - Skin Patches
How to use?
Skin patch is adhesive patch worn on
Upper torso Buttock Upper outer Abdomen

(excluding breasts) arm
Replace patch after 28 days
Efficiency
99%
How to use?
Hormonal Chemical
Skin
Patches
Hormonal Chemical Contraceptives - Vaginal Rings
What is it?
Small, flexible, soft plastic ring which releases continuous dose of
estrogen - progestogen combination
Common drawbacks
• Irregular periods
• Mood changes
• Depression
• Weight gain
• Sore breast
• Vaginal irritation or inflammation
• No protection against Sexually
Transmitted Infections (STI)
• Low sexual drive
• Migraine and Nausea
Chemical Contraceptive - Types
Chemical
Contraceptives
Hormonal Non-hormonal
Saheli
Non - Steroidal Pill- Saheli
What is it?
World’s first and only oral non-steroidal contraceptive pill.
Developed at Central Drug Research Institute (CDRI), India.
What is it?
It is a ‘once a week’ pill with very few side effects and high contraceptive value.
It is taken twice weekly for the first three months and then once a week.
How to use?
Initial 3 months After 3 months
S M T W T F S S M T W T F S
Efficiency
99%
Drawbacks
Very few side effect like
• Weight gain
• Nausea and vomiting
Spermicidal
Formulation
Non-Hormonal Contraceptives - Spermicidal Formulations
What is it?
Non - Steroidal chemical formulation for topical application
• Cream
• Jelly
• Foam
How does it work ?

Contains chemicals which prevent pregnancy by
• Killing the sperm
• Blocking cervix and entry to the uterus
• Slowing down the sperm’s movement
How to use?
• Spermicides creams are applied deep in the vagina and cervix just
10-60 minutes before sex
• Not to be washed immediately after sex
• Must stay inside till 5-6 hours after sex, so reapply after 3-4 hours
Drawbacks
• No protection against STIs
• Effective for a limited time only and should be reapplied
after three hours
• Vaginal irritation and infections
CONTRACEPTIVE METHODS
Natural Surgical
Chemical
Intra
Barrier Uterine
Intrauterine
Devices
(IUDs)
Intrauterine Devices or IUDs
• Small birth-control devices placed in the uterus to prevent

pregnancy
• Long-acting reversible contraception
Types of
IUDs
Intrauterine Devices or IUDs - Types
IUDs
Non-medicated Hormone
Copper
releasing
IUDs releasing IUDs
IUDs
Mechanism of action:
● IUDs increase phagocytosis of sperms within the uterus.
● Cu ions released suppress sperm motility and the
fertilising capacity of sperms.
● Cu ions make uterine endometrium unfavourable for
implantation.
Mechanism of action:
● Hormone releasing IUDs, in addition, make the uterus
unsuitable for implantation and the cervix hostile to the
sperms.
● IUDs are ideal contraceptives for females who want to
delay pregnancy and/or space children.
● It is one of most widely accepted methods of
contraception in India.
IUDs
Copper
releasing
IUDs releasing IUDs
IUDs
Non-medicated IUDs - Lippes Loop
What is it?
Double S shaped inert flexible plastic
loop.
Overall trapezoid shape.
How does it work?

Foreign material inserted into the uterus
provokes an increase in the immune
cells in the uterus
• Killing (phagocytosing) the sperm
• Preventing implantation of the embryo

IUDs
Copper
releasing
IUDs releasing IUDs
IUDs
Cu Releasing IUDs - CuT, Cu7 & Multiload 375
What is it?
Plastic frame wrapped with fine copper wire
CuT Cu7 Multiload 375

Cu Releasing IUDs - CuT
What is it?
● It is a T-shaped device
● The main frame of copper-T is made up of
polyethylene coated with barium sulfate to
make it radio opaque so that its presence
can be detected by X-ray.
CuT
How does it work?

Releases Cu ions that
• Decrease sperm motility
• Decrease fertilising ability of sperms
• Kill sperm
• Disrupt implantation of embryo
Drawbacks
• Expulsion from the uterus
• Perforation into the uterus wall
• Pelvic inflammation
• Cramping
• Heavier periods
Cu Releasing IUDs - Multiload 375
● It has about 375 mm2 of copper wire wound around its

stem.
● The flexible arms are designed to minimize expulsions.
● The multiload 375 and T Cu-380 A are similar in their
efficacy and performance.
IUDs
Non- Copper
Hormonal
medicated releasing
IUDs
IUDs IUDs
Hormonal IUDs - Progestasert, LNG-20
What is it?
T-shaped piece of plastic with a reservoir containing the hormone.
Progestasert LNG-20
Hormonal IUDs - Progestasert, LNG-20
How does it work?

Hormone in the reservoir is continuously released into the uterus as
regulated by the membrane enclosing it
Hormone reservoir
Hormone reservoir
Progestasert LNG-20
Hormonal IUDs - Progestasert
How does it work?

Releases progesterone that
inhibits the ovulation.
Does not increase the serum
levels of the hormone Reservoir with
Progesterone
Lasts only for 1 year
Progestasert
Efficiency
>99%
Hormonal IUDs - LNG-20
How does it work?

Releases levonorgestrel, a
progestin (synthetic hormone
similar to progesterone) Reservoir with
Levonorgestrel
• Thickens cervical mucus -
prevents entry of sperm
• Prevents ovulation (same
mechanism as progesterone)
Lasts about 5 years
LNG-20
Efficiency
>99%
How to use?
A doctor or a trained nurse
inserts the IUD into the uterus.
The T arms sit between the Reservoir with
Levonorgestrel
folds of the uterus.
LNG-20
Drawbacks
Same as other IUDs
• Weight gain
Reservoir with
• Ovarian cysts Levonorgestrel
• Negatively affects mental

health
• Nausea
• Headache & migraine
LNG-20
• Lower sexual drive
and many more ...
Emergency Contraceptive
Methods
Emergency contraception refers
to methods of contraception that
can be used to prevent
pregnancy after sexual
intercourse.
Emergency Contraception
● Administration of progestogens or progestogen-estrogen
combinations within 72 hours of coitus have been found to be
very effective as emergency contraceptives (morning after
pills).
● These could be used to avoid possible pregnancy due to rape,
missed pills or casual unprotected intercourse.
Emergency Contraceptive Pills
What is it?
Medical formulation containing levonorgestrel
How does it work?

Levonorgestrel has a few effects
• Delay or prevent ovulation
• Thickening of the cervical mucus to
prevent sperm entry into the uterus
• Prevent implantation of the embryo
How to use?
Pill should be taken within 5 days of
sexual intercourse.
More effective when taken as early as
possible especially within 3 days or
3 x 24 = 72 hours
Best used after unprotected sex or rape
Efficiency
~95%
Contraceptive
methods
Intrauterine
Natural Barrier Chemical Surgical
Devices (IUDs)
Surgical Contraceptives
Terminal method of birth control to prevent
any more pregnancies
Surgical Contraceptives- Types
Chemical
SurgCicoanl tCraocnetrpatciveepstives
Vasectomy Tubectomy
Done in
Done in males
females
Vasectomy
Vasectomy
What is it?
• Surgical method of male sterilisation
• Prevents sperm transport
How does it work?
• Small part of vas deferens removed/tied up
Vas ectomy
Vas deferens Surgical removal

Vasectomy
Vas deferens
Vasectomy
Vasectomy
Efficiency
99%
Drawbacks
• Cannot be easily reversed
• Reversal is usually not successful
Tubectomy
Tubectomy
What is it?
• Surgical method of female sterilisation
• Prevents ovum transport
How does it work?
• Small part of fallopian tube removed/tied up
• Also called tubal ligation
Tub ectomy
Fallopian tube Surgical removal

Tubectomy
Fallopian tube
Tubectomy
Tubectomy
Tubectomy
Tubectomy
Efficiency
99%
Drawbacks
• Cannot be easily reversed
• Reversal is usually not successful
What if a female is pregnant due to…
Contraception failures Rape Unprotected sex

Or she finds out..
Continuation of pregnancy
harmful for her or foetus
Medical Termination of
Pregnancy (MTP)
Medical Termination of Pregnancy
• Intentional or voluntary termination of pregnancy
• Also called induced abortion

Are you aware of
birth defects?
Birth defects
Is there a method to
detect these diseases?
Amniocentesis
Recall! Gastrulation
Amniotic cavity
Epiblast
Hypoblast
Amniotic fluid
Amniotic
Placenta sac
Umbilical Amniotic
cord fluid
Growing
fetus
Amniocentesis
• It is a prenatal test
• Determination test based on the genetic
makeup in the cells from the amniotic fluid.
o Sex determination test
o Fetal disorder test
Amniocentesis
• Performed between 15th - 20th weeks of pregnancy
• Amniotic fluid sample is taken and tested
Not recommended
Safe
Safe
Not
recommended
0
12 24 36
Weeks of pregnancy
Amniocentesis
Ultrasound
When is amniocentesis
advised?
Female foeticide- Reasons
Above 35 years
Previous history of pregnancy with

genetic abnormality in the child
Amniocentesis
advised
Abnormality found by ultrasound
Family history of genetic disease

Infertility
Inability to conceive or produce
children even after 2 years of
unprotected sexual cohabitation
Disease Congenital
Psychological
Physical
Immunological Drugs
So, what happens when couples
are diagnosed infertile?
Assisted Reproductive Technologies
A set of medical procedures aimed at
treating infertility
● Various techniques which are used to help infertile

couples to conceive when natural conception is not
possible.
Types of ART
In vitro fertilisation In vivo fertilisation

Surrogacy
It is an arrangement, often supported by a legal agreement,
whereby a woman (the surrogate mother) agrees to bear a child
for a couple
Unconventional Parenthood
Adoption
It is a legal process which fully transfers

parental responsibility from
a child's biological parents to their adoptive
parents
Reproductive Health
Sexually Transmitted
Infections (STIs)
Sexually Transmitted Infections
Sexually Transmitted Infections (STIs) are the diseases which can
transmit through sexual intercourse or body fluid interaction
They are also called
• Sexually transmitted diseases (STDs)
• Venereal disease (VD)
• Reproductive tract infections (RTIs)
Genital
Syphilis AIDS
warts
STIs 1 2 3 4 5 6
Genital
Gonorrhoea Hepatitis B
herpes
Gonorrhoea
Gonorrhoea
Causative organism Type
Neisseria gonorrhoeae Bacteria

Gonorrhoea
Symptoms
Burning sensation Penile/Vaginal Testicular Bleeding

during urination discharge swelling between
periods
Gonorrhoea
Transmission
Sex Mother to baby
Vaginal Oral Anal

Antibiotics
• Antibiotics are the medicines which are used to kill bacteria and
prevent them from growing, multiplying and causing diseases
• Examples - Penicillin, tetracycline, amoxicillin, etc.

Genital
Syphilis AIDS
warts
STIs 1 2 3 4 5 6
Genital
herpes
Syphilis
Syphilis
Treponema pallidum Bacteria

Syphilis
Symptoms
Infectious painless genital sores

Syphilis
Symptoms
Swollen lymph Sore throat Hair loss Body rash

nodes
Syphilis
Transmission
Unprotected sex Direct contact

with sores
Vaginal Oral Anal

Syphilis
Treatment
Antibiotics
Genital
Syphilis AIDS
warts
STIs 1 2 3 4 5 6
Genital
herpes
Genital Herpes
Genital Herpes

Herpes Simplex Virus Type 2
Virus
(HSV-2)
Genital Herpes
Symptoms
Infectious sores in
Penis Mouth Anus Vagina

Genital Herpes
Symptoms
Itchiness Body pain Fever

Genital Herpes
Transmission

with sores
Vaginal Oral Anal

Genital Herpes
Treatment
▪ Cured by the immune system of the body
Antiviral drugs Petroleum jelly

Antivirals
Antivirals are the medicines which are used to minimize
symptoms and infectivity of the viruses.
Examples - Acyclovir, retroviral, etc

Genital
Syphilis AIDS
warts
STIs 1 2 3 4 5 6
Genital
herpes
Genital Warts
Genital Warts
Human Papilloma Virus (HPV) Virus

Genital Warts
Symptoms
Painful warts on genitals Itching

Genital Warts
Transmission

with warts
Vaginal Oral Anal

Genital Warts
Treatment
Antiviral Disinfectant
Cryotherapy Surgery gel
Injections
Genital
Syphilis AIDS
warts
STIs 1 2 3 4 5 6
Genital
herpes
Hepatitis B
Hepatitis B
Hepatitis B Virus (HBV) Virus

Hepatitis B
Symptoms
Fever Jaundice Vomiting
Headache Weakness Abdominal pain

Hepatitis B
Transmission
Organ Infected Blood Mother

transplant needle transfusion to baby
Hepatitis B
Treatment
Hepatitis B
Acute Chronic
▪ Short term disease ▪ Long term disease

▪ Cured by plenty of rest ▪ Antiviral drugs to control
and fluid diet viral spread
Did You Know?
Did You Know?
Around 5 to 9 lakhs people lose their lives annually all over

the world because of AIDS
Genital
Syphilis AIDS
warts
STIs 1 2 3 4 5 6
Genital
Gonorrhoea Hep
AaIDtiStis B
herpes
AIDS

Human Immunodeficiency
Virus
Virus (HIV)
AIDS
Symptoms
Fever Body pain Body rash Itchiness
Weakness Chills Sore throat

AIDS
Transmission
Unprotected Infected Blood Mother

sex needle transfusion to baby
AIDS
Treatment
❖ No complete cure as of now

❖ Drugs (antiretrovirals) are used to prolong
the life of the patients
Two more STIs...
Trichomoniasis
Trichomonas vaginalis Protozoa

Trichomoniasis
Symptoms
Burning sensation Vaginal discharge Genital irritation

during urination
Trichomoniasis
Transmission
Sex Unprotected sex
Vaginal Oral Anal

Trichomoniasis
Treatment
Drugs
Chlamydiasis
Chlamydia trachomatis Bacteria

Chlamydiasis
Symptoms
Vaginal discharge Testicular Bleeding Fever

pain
Chlamydiasis
Transmission
Sex Unprotected sex
Vaginal Oral Anal

Chlamydiasis
Treatment
Antibiotics
Keep
Learning
FOR COMPLETE PPT
SLIDES AT OFFEER
PRICE CONTACT
9163681973

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Reproductive Health

High mortality and

Aversion from Non-availability of

• Educating fertile couple –

• Providing information about

❖ Developed by Central Drug Research Institute

• Cheap and wide availability of contraceptives

a) Hormonal oral contraceptive

b) Non-hormonal oral contraceptive

d) None of the above

a) Hormonal oral contraceptive

b) Non-hormonal oral contraceptive

d) None of the above

Reproductive health is physical, emotional, behavioural and

against fertilisation of the

• A method or system which allows sexual intercourse but

Temporary Methods Permanent Methods

Periodic abstinence Coitus interruptus Lactational amenorrhea

For both Reversible Short term

❖ Ovulation may occur- chances

Actual time 80-87%

Periodic abstinence Coitus interruptus Lactational amenorrhea

For males only Reversible Short term

Periodic abstinence Coitus interruptus Lactational amenorrhea

For females only Reversible Short term

Avoid meeting of ovum and

Condoms Diaphragms, Cervical Caps

For both Reversible Short term

Male Condom Female Condom

❖ Thin rubber/ latex sheath

❖ Used just before and during coitus

❖ Prevents release of semen into female reproductive tract

Condoms Diaphragms, Cervical Caps

For females only Reversible Short term

Diaphragm Cervical Cap Vault Cap

❖ Exclusively for women

❖ These are usually used along with barrier methods

❖ These contain chemicals which kill the sperm like

A Protection from STDs

B Prevention from conception

C Can be self inserted

D All of the above

A Protection from STDs

B Prevention from conception

C Can be self inserted

D All of the above

Natural Barrier Chemical Implants Surgical

Natural Barrier Chemical Implants Surgical

How does it work?

Upper torso Buttock Upper outer Abdomen

Initial 3 months After 3 months

How does it work ?

• Small birth-control devices placed in the uterus to prevent

How does it work?

• Killing (phagocytosing) the sperm

• Preventing implantation of the embryo

CuT Cu7 Multiload 375

How does it work?

● It has about 375 mm2 of copper wire wound around its

How does it work?