Vaginal Contraceptives
VAGINAL CONTRACEPTIVES
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Introduction
· Vaginal
contraceptives are a form of birth control used to prevent pregnancy.
· These contraceptives
are inserted into the vagina and work through various mechanisms to inhibit
sperm from fertilizing an egg.
Definition
· Vaginal
contraceptives refer to methods of contraception that are administered via the
vaginal route.
· These include
hormonal and non-hormonal methods designed to prevent pregnancy.
Classification
1.
Hormonal Vaginal Contraceptives:
o
Vaginal Rings:
§ Example: NuvaRing
(etonogestrel/ethinyl estradiol)
o
Hormonal Gels:
§ Example: Phexxi (lactic
acid, citric acid, and potassium bitartrate)
2.
Non-Hormonal Vaginal Contraceptives:
o
Spermicides:
§ Example: Nonoxynol-9
o
Barrier Methods:
§ Example: Diaphragms and
Cervical Caps (e.g., FemCap)
Pharmacokinetics
Hormonal Vaginal Contraceptives:
·
Absorption: Hormones are absorbed through the
vaginal mucosa.
·
Distribution: Hormones are distributed throughout
the bloodstream.
·
Metabolism: Metabolized primarily in the liver.
·
Excretion: Metabolites are excreted via urine
and feces.
Non-Hormonal Vaginal Contraceptives:
·
Absorption: Minimal systemic absorption; act
locally.
·
Excretion: Residual compounds are washed out of
the vagina naturally or during intercourse.
Mechanism of Action
Hormonal Vaginal Contraceptives:
·
Inhibit Ovulation: Prevent the release of an egg from
the ovaries.
·
Thicken Cervical Mucus: Makes it difficult
for sperm to enter the uterus.
·
Thin Endometrial Lining: Reduces the
likelihood of implantation.
Non-Hormonal Vaginal Contraceptives:
·
Spermicides: Immobilize or kill sperm.
·
Barrier Methods: Physically block sperm from entering
the uterus.
Uses
·
Contraception: Primary use to prevent pregnancy.
·
Regulation of Menstrual Cycles: Hormonal methods
can help in regulating menstrual cycles.
·
Management of Menstrual Symptoms: Reduce symptoms
such as heavy bleeding and menstrual pain.
Adverse Effects
Hormonal Vaginal Contraceptives:
·
Common: Vaginal irritation, discharge, and
discomfort.
·
Serious: Increased risk of blood clots,
stroke, and cardiovascular events.
Non-Hormonal Vaginal Contraceptives:
·
Common: Vaginal irritation and allergic
reactions.
·
Serious: Increased risk of urinary tract
infections (UTIs) and toxic shock syndrome (with diaphragms and cervical caps).
Contraindications
Hormonal Vaginal Contraceptives:
·
History of thromboembolic disorders.
·
Hormone-sensitive cancers (e.g., breast cancer).
·
Uncontrolled hypertension.
·
Liver disease.
Non-Hormonal Vaginal Contraceptives:
·
Allergy to components.
·
Abnormal vaginal anatomy that prevents proper placement.
Role of Nurse
·
Education: Educate patients on the proper use
and insertion techniques of vaginal contraceptives.
·
Assessment: Assess patient suitability for
vaginal contraceptives, considering medical history and contraindications.
·
Monitoring: Monitor for adverse effects and
provide guidance on managing any complications.
·
Counseling: Counsel patients on various
contraceptive options, helping them make informed decisions.
·
Support: Provide emotional support and address
concerns or misconceptions about vaginal contraceptives.
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