Reproductive Health and Contraception

Reproductive Health and Contraception

Reproductive health means a total well-being in all aspects of reproduction, including physical, emotional, behavioural and social well-being. It is not merely the absence of reproductive diseases.

एक व्यक्ति की reproductive health अच्छी तब मानी जाती है जब उसे reproduction से जुड़ी सही जानकारी, healthy reproductive organs, safe reproductive behaviour और आवश्यक medical facilities उपलब्ध हों।

1. Importance of Reproductive Health

Reproductive health is important for both individuals and society. Proper knowledge and healthcare help people make responsible decisions regarding reproduction.

• Provides correct knowledge about reproductive organs and their functions.
• Creates awareness about puberty and reproductive changes.
• Promotes menstrual hygiene and health.
• Helps in preventing unwanted pregnancies.
• Helps prevent sexually transmitted infections.
• Provides awareness about infertility and its treatment.
• Promotes responsible parenthood.
• Helps reduce maternal and infant health problems.

2. Reproductive Health Programmes

Government and non-government organisations conduct programmes to create awareness about reproductive health.

In India, reproductive health programmes focus on areas such as:

• Sex education and awareness
• Maternal and child health
• Family planning
• Contraceptive awareness
• Prevention and treatment of STIs
• Prevention of unwanted pregnancies
• Infertility management

Contraception

Contraception refers to the deliberate prevention of pregnancy by using suitable methods.

Contraceptive methods prevent pregnancy mainly by preventing ovulation, fertilisation or implantation.

सही contraceptive method का चयन व्यक्ति की age, health, reproductive needs और medical advice के अनुसार किया जाना चाहिए।

3. Ideal Contraceptive

An ideal contraceptive should have the following characteristics:

• Highly effective
• Reversible
• Easy to use
• Affordable
• Readily available
• Should have minimal or no side effects
• Should not interfere permanently with reproductive function

4. Types of Contraceptive Methods

Contraceptive methods can broadly be classified as:

Natural or Traditional Methods

5. Periodic Abstinence

Periodic abstinence is a method in which couples avoid sexual intercourse during the fertile period of the menstrual cycle.

In a typical 28-day cycle, the period from approximately day 10 to day 17 is considered the fertile period. Couples avoid intercourse during this period to prevent the meeting of sperm and ovum.

6. Withdrawal Method

The withdrawal method, also called coitus interruptus, involves withdrawal of the penis from the vagina before ejaculation.

The aim is to prevent semen from entering the female reproductive tract.

7. Lactational Amenorrhea

Lactational amenorrhea refers to the temporary absence of menstruation during intense breastfeeding after childbirth.

During the first few months after childbirth, frequent breastfeeding can suppress ovulation and therefore reduce the probability of pregnancy.

Barrier Methods

8. Condoms

Condoms are thin rubber or latex sheaths used to cover the penis during sexual intercourse. Female condoms are also available.

They prevent sperm from entering the female reproductive tract and therefore help prevent fertilisation.

Condoms are disposable and should be used correctly during every act of intercourse when relying on them for contraception and STI risk reduction.

9. Diaphragms, Cervical Caps and Vaults

Diaphragms, cervical caps and vaults are barrier methods used by females.

They cover the cervix and prevent sperm from entering the uterus. They are often used with spermicidal substances to increase effectiveness.

Spermicides are chemical substances that immobilise or destroy sperm.

Intrauterine Devices (IUDs)

10. What are IUDs?

Intrauterine Devices (IUDs) are contraceptive devices inserted into the uterus by a trained healthcare professional.

They are suitable for many women and provide long-term contraception depending on the type of device.

11. Types of IUDs

Hormonal Methods

12. Oral Contraceptive Pills

Oral contraceptive pills contain hormones that prevent pregnancy primarily by suppressing ovulation and producing changes in the female reproductive tract that make fertilisation less likely.

Combined oral pills generally contain synthetic forms of estrogen and progesterone/progestin.

They are generally taken regularly according to the prescribed schedule.

13. Saheli

Saheli is a non-steroidal oral contraceptive pill developed at the Central Drug Research Institute (CDRI), Lucknow.

It contains centchroman, also known as ormeloxifene.

14. Injectable and Implant Contraceptives

Hormonal contraceptives may also be administered through injections or implants.

These methods release hormones that suppress ovulation and/or produce changes in the reproductive tract that prevent pregnancy.

Surgical Methods

15. Vasectomy

Vasectomy is a surgical method of contraception in males.

In vasectomy, a small portion of each vas deferens is cut or blocked and the ends are sealed or tied.

This prevents sperm from entering the semen during ejaculation.

16. Tubectomy

Tubectomy is a surgical method of contraception in females.

In this method, a small portion of each fallopian tube is cut and tied or otherwise blocked.

This prevents the sperm from reaching the ovum and therefore prevents fertilisation.

Medical Termination of Pregnancy (MTP)

17. What is MTP?

Medical Termination of Pregnancy (MTP) refers to the intentional termination of pregnancy before full term under appropriate medical and legal conditions.

MTP may be performed for medical reasons and in certain circumstances permitted by law. It should always be carried out by qualified healthcare professionals in an appropriate medical setting.

18. Why is MTP Performed?

MTP may be advised or legally permitted in circumstances such as:

• Risk to the life or health of the pregnant woman.
• Serious abnormalities in the developing foetus.
• Pregnancy resulting from rape.
• Failure of a contraceptive method in certain legally recognised circumstances.
• Other circumstances permitted under applicable law.

Sexually Transmitted Infections (STIs)

19. What are STIs?

Sexually Transmitted Infections (STIs) are infections that can be transmitted mainly through sexual contact.

They may be caused by bacteria, viruses or other microorganisms.

20. Examples of STIs

21. Symptoms of STIs

Common symptoms may include:

• Abnormal discharge from genital organs
• Itching or irritation
• Pain during urination
• Genital sores or lesions
• Pain in the lower abdomen
• Swelling or discomfort in reproductive organs

However, many STIs may remain asymptomatic, especially in the early stages. इसलिए केवल symptoms की absence को infection की absence नहीं माना जा सकता।

22. Prevention of STIs

• Avoid sexual contact with infected individuals.
• Maintain mutual faithfulness with an uninfected partner.
• Use condoms correctly and consistently.
• Avoid sharing contaminated needles.
• Use screened blood when transfusion is required.
• Seek medical testing and treatment when exposure or symptoms are suspected.

Infertility

23. What is Infertility?

Infertility refers to the inability of a couple to conceive a child despite regular unprotected sexual intercourse over an appropriate period.

Infertility may be associated with problems in either the male or female partner, or sometimes no specific cause is identified.

24. Causes of Infertility

Infertility can result from:

• Physical problems
• Congenital abnormalities
• Hormonal disorders
• Infections
• Problems with sperm production or transport
• Problems with ovulation or reproductive organs
• Psychological factors in some cases
• Age-related factors

Assisted Reproductive Technologies (ART)

When natural conception is difficult, certain medical techniques called Assisted Reproductive Technologies (ART) may be used.

25. IVF-ET

IVF stands for In Vitro Fertilisation. In this technique, fertilisation occurs outside the body under laboratory conditions.

The resulting embryo is then transferred into the female reproductive tract. This is commonly referred to as IVF-ET (In Vitro Fertilisation and Embryo Transfer).

सरल रूप में: egg और sperm को laboratory में fertilisation के लिए मिलाया जाता है और बनने वाले embryo को appropriate stage पर female reproductive tract में transfer किया जाता है।

26. ZIFT

ZIFT stands for Zygote Intra-Fallopian Transfer.

In this technique, a zygote or early embryo is transferred into the fallopian tube.

27. IUT

IUT stands for Intra-Uterine Transfer.

In this technique, an embryo with more than 8 blastomeres is transferred into the uterus.

28. GIFT

GIFT stands for Gamete Intra-Fallopian Transfer.

In this technique, gametes are transferred into the fallopian tube so that fertilisation can occur inside the female reproductive tract.

29. ICSI

ICSI stands for Intracytoplasmic Sperm Injection.

In ICSI, a single sperm is directly injected into the cytoplasm of an ovum to facilitate fertilisation.

30. AI and IUI

Artificial Insemination (AI) involves introducing semen from the husband or a donor into the female reproductive tract.

Intra-Uterine Insemination (IUI) is a form of artificial insemination in which processed semen is introduced directly into the uterus.

Contraception vs MTP

Important Terms

Board-Focused Important Questions

Very Short Answer Questions

1. What is reproductive health?
2. What is contraception?
3. Name two natural methods of contraception.
4. What is periodic abstinence?
5. What is coitus interruptus?
6. What is lactational amenorrhea?
7. Name two barrier methods.
8. What is an IUD?
9. Name two copper-releasing IUDs.
10. Which contraceptive method is called vasectomy?
11. What is tubectomy?
12. What is Saheli?
13. What is MTP?
14. Name two sexually transmitted infections.
15. What is infertility?
16. What is IVF?
17. What is ICSI?
18. What is GIFT?

Short Answer Questions

1. Explain the importance of reproductive health.
2. Describe the natural methods of contraception.
3. Explain the role of condoms in contraception and prevention of STIs.
4. Describe the different types of IUDs.
5. Explain the mechanism of action of copper-releasing IUDs.
6. Explain the role of oral contraceptive pills.
7. Differentiate between vasectomy and tubectomy.
8. What are STIs? Give examples and methods of prevention.
9. What is infertility? Mention its major causes.
10. Explain IVF-ET, ZIFT and GIFT.

Long Answer Questions

1. Describe the different methods of contraception with their advantages and limitations.
2. Explain the various methods of contraception used in humans.
3. Describe sexually transmitted infections, their symptoms and preventive measures.
4. Explain infertility and discuss the major assisted reproductive technologies used for its management.
5. Explain the different assisted reproductive techniques such as IVF, ZIFT, GIFT and ICSI.

Multiple Choice Questions

1. The deliberate prevention of pregnancy is called:

   • A. Fertilisation
   • B. Contraception
   • C. Implantation
   • D. Ovulation

   Answer: B. Contraception

2. Which of the following is a natural method of contraception?

   • A. Copper-T
   • B. Vasectomy
   • C. Periodic abstinence
   • D. Oral pill

   Answer: C. Periodic abstinence

3. Coitus interruptus is also called:

   • A. Withdrawal method
   • B. Lactational method
   • C. Barrier method
   • D. Surgical method

   Answer: A. Withdrawal method

4. Which method also helps reduce the risk of many STIs?

   • A. Condom
   • B. Tubectomy
   • C. Copper-T
   • D. Oral pill

   Answer: A. Condom

5. Which of the following is a copper-releasing IUD?

   • A. CuT
   • B. Saheli
   • C. Progestasert
   • D. Lippes Loop

   Answer: A. CuT

6. Saheli is a:

   • A. Copper IUD
   • B. Non-steroidal oral contraceptive
   • C. Barrier method
   • D. Surgical method

   Answer: B. Non-steroidal oral contraceptive

7. Vasectomy involves the:

   • A. Cutting of fallopian tubes
   • B. Blocking of vas deferens
   • C. Removal of testes
   • D. Blocking of urethra

   Answer: B. Blocking of vas deferens

8. Tubectomy involves the:

   • A. Blocking of vas deferens
   • B. Blocking of fallopian tubes
   • C. Removal of ovaries
   • D. Removal of uterus

   Answer: B. Blocking of fallopian tubes

9. Which of the following is a bacterial STI?

   • A. HIV infection
   • B. Genital herpes
   • C. Gonorrhoea
   • D. Genital warts

   Answer: C. Gonorrhoea

10. HIV causes:

    • A. AIDS
    • B. Syphilis
    • C. Gonorrhoea
    • D. Chlamydiasis

    Answer: A. AIDS

11. ICSI involves:

    • A. Transfer of gametes into uterus
    • B. Injection of a sperm into the ovum
    • C. Blocking of vas deferens
    • D. Transfer of embryo into fallopian tube only

    Answer: B. Injection of a sperm into the ovum

12. GIFT stands for:

    • A. Gamete Intra-Fallopian Transfer
    • B. Gamete Internal Fertilisation Technique
    • C. Genetic Intra-Fallopian Technique
    • D. Gamete Implantation Fertility Transfer

    Answer: A. Gamete Intra-Fallopian Transfer

13. In ZIFT, the zygote is transferred into the:

    • A. Uterus
    • B. Vagina
    • C. Fallopian tube
    • D. Ovary

    Answer: C. Fallopian tube

14. IVF refers to:

    • A. Fertilisation inside the uterus
    • B. Fertilisation outside the body
    • C. Surgical sterilisation
    • D. Natural fertilisation

    Answer: B. Fertilisation outside the body

15. MTP means:

    • A. Medical Treatment Procedure
    • B. Medical Termination of Pregnancy
    • C. Maternal Treatment Programme
    • D. Medical Transfer of Placenta

    Answer: B. Medical Termination of Pregnancy

Fill in the Blanks

1. The deliberate prevention of pregnancy is called __________.
2. __________ is a natural method based on avoiding intercourse during the fertile period.
3. Coitus interruptus is also known as the __________ method.
4. __________ is the temporary absence of menstruation associated with breastfeeding after childbirth.
5. CuT is a __________-releasing IUD.
6. Vasectomy involves the __________ of vas deferens.
7. Tubectomy involves the __________ of fallopian tubes.
8. Saheli is a __________ oral contraceptive.
9. __________ is a bacterial STI caused by Neisseria gonorrhoeae.
10. ICSI stands for __________.

Answers: Contraception, Periodic abstinence, Withdrawal, Lactational amenorrhea, Copper, Blocking/cutting and sealing, Blocking/cutting and sealing, Non-steroidal, Gonorrhoea, Intracytoplasmic Sperm Injection.

Match the Following

Answers: 1-b, 2-c, 3-a, 4-d, 5-e

Quick Revision

• Reproductive health = Total well-being related to reproduction.
• Contraception = Deliberate prevention of pregnancy.
• Periodic abstinence = Avoid intercourse during fertile period.
• Withdrawal method = Withdrawal of penis before ejaculation.
• Lactational amenorrhea = Temporary suppression of ovulation/menstruation associated with intense breastfeeding after childbirth.
• Condom = Barrier method that also helps reduce transmission of many STIs.
• CuT = Copper-releasing IUD.
• Saheli = Non-steroidal oral contraceptive.
• Vasectomy = Male surgical contraception involving vas deferens.
• Tubectomy = Female surgical contraception involving fallopian tubes.
• MTP = Medical Termination of Pregnancy.
• STIs = Infections transmitted mainly through sexual contact.
• IVF = Fertilisation outside the body.
• ZIFT = Zygote/early embryo transferred to fallopian tube.
• GIFT = Gametes transferred to fallopian tube.
• ICSI = Single sperm injected directly into ovum.
• IUI = Processed semen introduced into uterus.