Contraception methods: comparison, efficacy and NEET-PG high-yield points
RezzyContraception is a massive topic for NEET-PG, and they love asking about efficacy (Pearl Index) and specific contraindications. It's basically the "bread and butter" of family planning questions.
Let's start by looking at how these methods stack up against each other. I've put together a comparison table for you that covers the most common methods you'll see in the exam.
| Method | Type | Pearl Index (Typical Use) | Key High-Yield Point |
|---|---|---|---|
| OCPs | Hormonal | 9 | Most common cause of failure is missing a pill |
| Cu-T 380A | IUCD | 0.8 | Effective for 10 years; causes increased menstrual flow |
| LNG-IUS | Hormonal IUCD | 0.2 | Best for DUB; causes amenorrhea |
| DMPA | Injectable | 4 | Can cause delayed return of fertility (up to 1 year) |
| Male Condom | Barrier | 18 | Only method that protects against STIs/HIV |
| Vasectomy | Permanent | 0.15 | Not immediate; needs 3 months/20 ejaculations for sterility |
| Tubectomy | Permanent | 0.5 | Most common method used in India |
| Lactational Amenorrhea | Natural | 2 | Only effective for first 6 months & if fully breastfeeding |
The Pearl Index is a classic exam favorite—remember, the lower the number, the higher the efficacy.
==NEET-PG High-Yield Nuggets==
- Ideal Contraceptive for:
- Newly married couple: Combined Oral Contraceptive Pills (COCPs).
- Spacing between two children: IUCD (specifically Cu-T 380A).
- Lactating mother: Progestogen-Only Pills (POPs) or Centchroman (Chhaya). Avoid COCPs as estrogen decreases milk production.
- Emergency Contraception: Levonorgestrel 1.5mg (within 72 hours) or Cu-T (most effective, within 5 days).
- Centchroman (Chhaya): This is a SERM (Selective Estrogen Receptor Modulator). It's non-hormonal and non-steroidal. Dosage: Twice a week for first 3 months, then once a week.
- Medical Eligibility Criteria (MEC):
- MEC 4 (Absolute Contraindication) for COCPs: Breast cancer, smokers >35 years (>15 cigarettes/day), history of DVT/PE, and migraine with aura.
Since IUCDs are so frequently tested, let me pull up a diagram showing the different types and their placements to help you visualize them.
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