During 5 first years of using its contraceptive efficiency is similar to IUD use, but after five years, its contraceptive efficiency is similar to Tubal ligation. QS does not cause any higher risk of female cancer.
Birth control is an effective method for preventing maternal death. Modern contraceptives have the same following targets
1. High contraceptive effect
2. Easy to use and to recover reproductive potential after stopping use.
3. Fewer side effects.
4. Easy to approach and not too expensive. They now are used widely and extensively studied.
Mechanism of their action is to make an interruption of one or more sites on the axe of hypothalamus – hypophyse – ovary and endometrial. The following schema explains that clearly. It is a feedback mechanism.
Estrogen component in the contraceptive makes a normal development of the endometrial which maintains menses and the women keep their menstrual bleeding. Estrogen inhibits FSH production, therefore not any follicle can be developed to a dominant one for ovulation.
Progesterone component inhibits LH production, creating no LH peak, resulting in anovulation. At the same time cervical mucus become dense, which does not allow spermatozoid to pass through.
Oral Contraceptive has several health benefits:
Reduction of abortioneeds.
1. Reduction of tubal sterilization and IUD use.
2. Less of endometrial cancer.
3. Less of ovarian cancer.
4. Less of benign tumor of the breast
5. Less of ectopic pregnancies.
6. More regular menses (no massive bleeding, less painful, less anemic…)
7. Less of adnexites (tubal)
8. Reduction of arthritis
9. Increase bone density
There are 4 potentially better:
- Less of endometrioses
- Less of arterioscleroses
- Less of myofibrome
- Less of ovarian cyst
Saving is better in women using hormonal contraceptive they should not pay for other possible illness.
Several female diseases can be treated with hormonal contraceptive are:
- Acnea and hirsutism
- Amenorrhea due to hypophysal failure
- Bleeding irregular
- Premenstrual syndrome
Progestine is used in long-term hormonal contraceptive such as Norplant (5 years), implanon (3 years), Depo Provera (3 months), Norethindrone enanthrate (2 months) and IUD coated progestine.
Female sterilization by tubal ligation, clamping and male sterilization by vasectomy are being used widely in Asia, Europe and Americas… but unfortunately they do not receive a welcome in Vietnam because Vietnamese couples are afraid of being operated or cut or remove something from their bodies.
Non surgical quinacrine female sterilization by the insertion quinacrine pellet (7 pellets x 35mg) into the uterine fundus to make an occlusion of the two tubes was introduced in Vietnam during 1998 – 1993. It was widely accepted in 24 big provinces by more than 50.000 users and most welcomed in the Red River Delta. The procedure is realized by midwives chiefly.
There was a rumor that Quinacrine sterilization can cause higher risk of female cancer and it can be abused because it is too cheap and easy to apply.
The MoH temporarily stopped it in December, 1993 to reevaluation.
Family Health International (FHI) assisted MOH technically to carry out two big studies from 1994 to 2005. These studies’ results showed that Quinacrine sterilization does not violate women rights in choosing FP method and does not cause any higher risk of cancer for women.
Prof.Dr. Do Trong Hieu
Former Director of the RH Department of the MOH
