Temporary & Permanent Methods of Birth control MCQ - Practice Questions with Answers

Temporary Methods of Birth Control - Natural Methods

1. Periodic Abstinence:

• The couples avoid or abstain from coitus from day 10 to day 17 of the menstrual cycle.
• During these days, the ovulation occurs and hence, the chances of fertilization are high. 
• The following facts are taken into consideration:
• Ovulation occurs on about 14th day of menstruation
• Secondary oocyte remains alive for 1-2 days
• Sperm survives for about 3 days

Advantages of this method:

• No side effects
• No cost implied
• No effect on natural menstruation

Disadvantages of this method:
Unsuitable for females with the irregular menstrual cycle
High chances of failure

2. Lactational Amenorrhea Method:

• This method is based on the fact that menstruation does not occur during lactation following parturition.
• Hence, there will be no ovulation. 
• This method can be used if:
  • The menstrual period has not returned since delivery
  • Breastfeeding baby on demand, both day and night and not feeding other foods or liquids regularly
  • Baby is less than six months old
• Therefore, this method is effective only up to a maximum of six months after childbirth. 

3. Coitus interruptus:

• It is also known as the withdrawal method.
• Male withdraws his penis from the vagina of the female before ejaculation.
• This prevents the entry of semen in the female reproductive tract.
• However, as documented, the secretion of the bulbourethral gland which is secreted during sexual arousal to neutralize the acidity of the urethra may contain sperm.
• Alternatively, semen can be injected if there’s a delay in the act of withdrawal.
• Therefore, there are high chances of contraceptive failure in this method.

Temporary Methods of Birth Control - Barrier Methods

• The aim of the barrier methods is to prevent the live sperm from meeting the ovum. Barrier methods suitable for both men and women are available. 
• They have both contraceptive and non- contraceptive advantages.
• The main contraceptive advantage is the absence of side effects. 
• The non-contraceptive advantage is the protection from sexually transmitted diseases or STD. 
• These methods prevent sperm deposition in the vagina or prevent sperm penetration through the cervical canal. 
• These are of following types:
• Condoms
• Diaphragm, cervical cap & vault cap

Condoms:

• These are made up of this rubber or later.
• These are used to cover penis in the males or vagina or cervix in the females just before coitus so that the ejaculated semen is not released in the female reproductive tract.
• Advantages of condoms:
  • When used consistently and correctly with every act of sexual intercourse, condoms can prevent pregnancy and STDs, including HIV/ AIDS.
  • They are safe, and have no hormonal side-effects.
  • They can be stopped at any time, and fertility returns shortly after each use. 
  • They are very easy to find and use without seeing a healthcare provider first.
• Disadvantages of condoms:
  • Latex condoms may cause itching for a few people who are allergic to latex and/or lubricants.
  • There is a small possibility that a condom will slip off during sex.
  • Condoms can weaken and may break during use if stored for too long or in too much heat, sunlight or humidity.

Diaphragm:

• The diaphragm is a small dome-shaped latex cup with a flexible ring that fits over the cervix.
• The cup acts as a physical barrier against the entry of sperm into the uterus. 
• A diaphragm is usually used along with spermicide.
• Diaphragms can be inserted up to two hours before sex, because spermicide is only effective for two hours.
• The diaphragm has a relatively high failure rate, about 16% over the first year of use.
• However, it is considered a good choice by women whose health or lifestyle prevents them from using more effective hormonal contraceptives.

Cervical Caps:

• It is a miniature diaphragm that covers the cervix closely.
• It prevents sperm from reaching an ovum and holds spermicide.
• It is fairly effective and can remain

Vault Cap:

• It is dome-like rubber or plastic cap.
• It is meant for fitting over the vaginal or cervix.
   

Chemical Methods:

• Various spermicidal agents are available in the market either in the form of spermicidal cream, jelly or tablets. 
• These agents produce sperm immobilisation and kill the sperm. But these are not popular and the failure rate is quite high. 
• Also, concern about possible teratogenic effects on fetuses has been suggested. 
• There may be occasional local allergic reactions in the vagina.

Intrauterine Devices (IUDs):
The IUCD is a small device usually made of polyethylene or other polymers. It is inserted into the uterus by a doctor.

• Types of IUDs:
  • Inert or non-medicated: These devices are made of plastic or stainless steel only. Lippes loop made of plastic (polyethylene) impregnated with barium sulphate is still used in many parts of the world.
  • Copper IUDs: Copper wire or copper sleeves are put on the plastic frame (polyethylene frame). Examples include Copper T, CuT380A, Multiload 375 etc.
  • Hormone-Releasing IUDs:
    • Progestasert - It is a T shaped IUD made of ethylene and vinyl acetate copolymer containing titanium dioxide. It contains a reservoir of progesterone together with barium sulfate dispersed in silicone fluid. 
    • LNG - 20 (Mirena) - This T shape & device has a collar attached to a vertical arm containing levonorgestrel dispersed in poly dimethyl siloxane. 
• Mode of Action:
  • IUD mainly works by changing the intrauterine environment and making it spermicidal. 
  • Non-medicated IUD causes a sterile inflammatory response by producing a tissue injury of minor degree but sufficient enough to be spermicidal.
  • Copper containing IUD, in addition, release free copper and copper salts that have both a biochemical and morphological impact on the endometrium and also produce alteration in cervical mucus and endometrial secretions.
  • Hormone releasing IUD adds progesterone effect on endometrium to the foreign body reaction. The endometrium becomes decidualized with atrophy of glands.
  • The progesterone IUD mainly acts by inhibition of implantation, sperm-capacitation and survival. 
• The advantages of IUD are –
  • simplicity in insertion; 
  • insertion takes only a few minutes; 
  • inexpensive; 
  • virtually free of metabolic side effects associated with hormonal pills; 
  • reversibility to fertility is immediate soon after removal
• The disadvantages are:
  • heavy and irregular menstruation and pelvic inflammatory diseases. Pelvic inflammatory disease (PID) is a collective term that includes acute and chronic conditions of the ovaries, ducts, uterus and it occurs as a result of infection. Women with PID suffer from vagina discharge, pelvic pain, tenderness, abnormal bleeding, chills and fever. Some women suffer uterine perforations leading to inflammatory responses in the abdomen.
     

Temporary Methods of Birth Control - Oral Contraceptive Pills

• These are medicines taken by mouth to help prevent pregnancy.
• Pills have to be taken daily for 21 days starting within the first five days of the menstrual cycle.
• After a gap of 7 days (during which menstruation occurs) it has to be repeated.
• These pills act in four ways:
  • Inhibition of ovulation
  • Inhibition of motility and secretory activity of fallopian tubes
  • Changes in cervical mucus impairing its ability to allow passage and transport of sperm.
  • Alteration in uterine endometrium to make it unsuitable for implantation

Types of Contraceptive Pills:

• Mini Pills: 
  • They contain progesterone only.
  • Saheli is a non-steroidal pill developed at Central Drug Research Institute (CDRI).
  • It contains centchroman which is taken once a week after an initial intake of twice a week dose for 3 months.
  • These pills primarily act on cervical mucus by making it inhospitable to sperm.
  • These also hinder implantation.
• Combined Pills:
  • These are most commonly used oral contraceptive pills.
  • They contain both progesterone and estrogen to check ovulation. 
  • Pill Mala D and Mala N are commonly used. They are taken daily without break.
• Morning After Pills:
  • These are also called the emergency contraceptives.
  • These pills can prevent pregnancy if taken within 72 hours of coitus.
  • They can either suppress ovulation or prevent fertilization.
  • They are most effective in the first 24 hours.
     

Termination or Permanent Methods of Birth Control

• Permanent contraception is a surgical method whereby the reproductive function of an individual male or female is permanently stopped. 
• Surgical method is also known as sterilisation. 
• The surgery done on males is vasectomy and on females is tubectomy.

Vasectomy:

• It is the method of male sterilisation.
• It is a permanent sterilisation done in males where a segment of the vas deferens on both sides is cut and the cut ends are ligated. 
• The technique is simple and can be performed even in primary health centres by trained doctors under local anesthesia. 
• The failure rate is minimal and it is a very reliable method of contraception but it is an irreversible operation.

Tubectomy:

• Blockage or closing of the fallopian tubes is the underlying principle to achieve female sterilisation.
• In tubectomy, a small part of the fallopian tube is removed or tied up through a small cut in the abdomen or through vagina.