ABSTRACT
This chapter presents advantages, adverse effects, risks and contraindications of combined oral contraceptive pills usage. Advantages are avoidance of artificial contraception with its attendant risks, and regular personal monitoring of reproductive function. The chapter provides a brief account of the available Intrauterine devices (IUD), their advantages, disadvantages, adverse effects, precautions and contraindications. Contraindications for any intra-uterine device include pregnancy, severe anaemia, untreated sexually transmitted diseases; small or distorted uterus undiagnosed or unexplained uterine bleeding and malignancy of the genitourinary tract. Progestogen-based IUDs thicken cervical mucus to hinder penetration of spermatozoa and create an endometrium hostile to implantation of a fertilised ovum. Copper-based IUDs induce a sterile anti-inflammatory reaction in the uterus, which changes uterine and fallopian tube fluid composition, which in turn destroys the viability of both the ovum and the spermatozoa. The progestogen- based IUD probably acts through a combination of both hormonal- and inflammation-based reactions.
