Intrauterine Device (coil) Contraceptive in Kenya

IUD Contraceptive Kenya

IUD contraceptive Kenya
The contraceptive coil comes in two different types: copper-based intrauterine devices (IUD) and hormonal intrauterine devices (sometimes known as IUS – intrauterine system). Both are essentially made of plastic, then either “coated” with copper or hormones.
copper IUDs may increase menstrual bleeding and result in more painful cramps, hormonal IUDs may reduce menstrual bleeding or stop menstruation altogether. After three months there is about a 90% decrease in bleeding
IUD contraceptive Kenya

Non Hormonal IUDs
IUD contraceptive Kenya

Copper IUDs primarily work by disrupting sperm motility and damaging sperm so that they are prevented from joining with an egg. Copper acts as a spermicide within the uterus, increasing levels of copper ions, prostaglandins, and white blood cells within the uterine and tubal fluids.The increased copper ions in the cervical mucus inhibit the sperm’s motility and viability, preventing sperm from traveling through the cervical mucus, or destroying it as it passes through.
Advantages of the copper IUD include its ability to provide emergency contraception up to five days after unprotected sex. It is the most effective form of emergency contraception available

Hormonal IUDs

Hormonal IUDs work by releasing a small amount of levonorgestrel, a progestin. Each type varies in size, amount of levonorgestel released, and duration. For example, Mirena and Liletta measure 32x32mm while Skyla and Kyleena measure 28x30mm. The primary mechanism of action is making the inside of the uterus difficult to sperm.

What are the benefits of IUDs?

  • They last a long time.
  • They’re mostly hassle-free. Once you have one inserted, you don’t have to think about it, and neither does your partner.
  • It’s one cost, upfront.
  • They’re safe to use if you’re breastfeeding.

Who can IUD contraceptive ?

Most healthy women can use an IUD. They’re especially suited to women with one partner and at low risk of contracting an STD. IUDs don’t protect against STDs. You shouldn’t use one if:

  • You have an STD or had a recent pelvic infection.
  • You’re pregnant.
  • You have cancer of the cervix or uterus.
  • You have unexplained vaginal bleeding.

How is IUD inserted
IUD contraceptive Kenya IUD contraceptive Kenya

To put the IUD in, the nurse or doctor will put a speculum into your vagina and then use a special inserter to put the IUD in through the opening of your cervix and into your uterus. The process usually takes less than five minutes.

Cost of IUD insertion In Kenya
The cost depends on clinic and type of the IUD

References for IUD contraceptive Kenya
1.British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 557–559.
2.Speroff, Leon; Darney, Philip D. (2011). A Clinical Guide for Contraception. Lippincott Williams & Wilkins. p. 243
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971735/
4.Rivera R, Yacobson I, Grimes D. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. Am J Obstet Gynecol. 1999 Nov. 181(5 Pt 1 IUD contraceptive Kenya

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Erectile dysfunction in Kenya

erectile dysfunction Kenya

Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection.
Signs and symptoms

Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. It is analyzed in several ways:

Obtaining full erections at some times, such as nocturnal penile tumescence when asleep (when the mind and psychological issues, if any, are less present), tends to suggest that the physical structures are functionally working.

Causes

1.Drugs (anti-depressants (SSRIs and nicotine are most common)
2.Cavernosal disorders (Peyronie’s disease )
Neurogenic disorders
3.Psychological causes: performance anxiety, stress,
4.Surgery
5.Aging.More common in men aged above 60 years
6.Kidney failure
7.Diseases such as diabetes mellitus and multiple sclerosis (MS).
8.Lifestyle: smoking is a key cause of erectile dysfunction.smoking causes impotence due to the fact that it  promotes arterial narrowing

Treatment options for ED in Kenya:

Sexual counseling, if no organic causes can be found for the dysfunction
Oral medications:
According to (AUA) guidelines, oral phosphodiesterase type 5 (PDE5) inhibitors are first-line therapy unless contraindicated.These Agents include the following:
Sildenafil (Viagra,Kamagra,Manforce,MtM etc)
Vardenafil
Tadalafil
Avanafil

Surgery:
Selected patients with ED are candidates for surgical treatment. Procedures to be considered include the following:
Revascularization (rarely indicated)
Surgical elimination of venous outflow (rarely indicated)

Injected, implanted, or topically applied medications
Hormone replacement may beneficial to  men with severe hypogonadism and may possibly be useful as adjunctive therapy when other treatments are unsuccessful. Replacement androgens are available in oral (used rarely), injectable, gel, and transdermal preparations.Intracavernosal injection therapy may be considered its almost always effective if the vasculature within the corpora cavernosa is healthy. Agents used include the following:

External vacuum and constriction devices
The following external devices may be used:
Vacuum devices to draw blood into the penis
Constriction devices placed at the base of the penis to maintain erection

Placement of penile implant (semirigid or malleable rod implant, fully inflatable implant, or self-contained inflatable unitary implant) – this is the last option considered in current practice
Prevention
Optimal management of diabetes, heart disease, and hypertension
Lifestyle modifications to improve vascular function (eg,Cease or avoid smoking, maintaining ideal body weight, and engaging in regular exercise)

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