Contraceptive llicacy wief % of individuals who become cel pregnant within 12 months of *reported as the contraceptive failive rate inialing a contraceptive method •failwe nale with typical ure = includes all individuals using that method regardless of whether it is used correctly flor consistently failme rate with perfect correctely consistently use (Peaul's Index) 1= only those who use the method • mainly used in cinical studies Imandant Nole 85% of females curently using a contraceptive method would become pregnant within 1 year if contraception were stopped Indrauterne Devices copper is most effective for emergencies, Bus neve evidence suggests that levonorgestel tups one nar-inferior to coppie for amegencies Basics * used for both regular emergency ontracedian * lasts 3-12 years * mainly works by fertilisation, but also likelihood of implantation y additional berehts= list of cervical endometrial conc I menstural pain ½ bleeding Types of 1005 Copper Intrauterine Device upto 5-10 years Basics No Hormones res copper * longest lasting vevesible method of contracephan * copper wraped asound the stem Mechanism of Action Cut embryonic loss post Peshlisation localised inflammation sperm viability f(x) moblity → modifies lining of utens traps spem in the cervical mucus after produchon endometrium no linger suitable for implantation → Peshlisahon Ambryonic loss post feshilisahan Yglucose-6-phosphate production ATP synthesis Failure rates ~0.6% Hormonal Intrauterine Device Basics levonogestrel-releasing 3-8 years after insertion →Mirena Liletla Sz. mg of levonorgestrel upto & years Kylema 19.5 mg of Levonorgested 5 yeus Skyla Bs my of levonorgestrol 3 yeas Mechanism of Adian pagesths a mlike systemic progestins, IDU progestins don't onulation cervical producion sperm fic charging of the endomemal lining less suitable for implantution muus viscosity viability spelm reaching cocyle hus can't be sed bprevent wasian agits Failure Raes 01-0.4% typical poftect failure rates and the same Initiation Guidelines of JUDS to assess the uterus size position of look for signs of injection xensure no copper or hormal 100 contradications Perform a bimanuel exam to speculum-assisted visualisation of the ceux * Exclusion of pregnancy pregnant women with 10U's have a higher risk of spontaneous abortion, septic abortion, preterm birth intrauterine infechon Adverse Effects #All IUDs = temporary cramping discomfort * Hormonal IDU = abdormal ulerine bleeding (eg. sporing, isregular menses), amenorrhea * Copner 1UD = heavy menstural bleeding ½ dysmenorihea Complications * Expulsion *ulerine perforation * if pregnancy ocess there is a high risk of it being ectopic, but the absolule nsk of an ecopic pregrancy is very love Hormonal Contraceptions Basics *protection against pregnancy *non-contraceptive benehts of CHC regulation of menstural cycle cel an be induced by continous CHC Imerstural bleeding, including amenorrhea. ↓ painful mensturation ↓ risk of endometrial & ovarion conces