INDICE 1.- INTRODUCION . 2.- MARCO TERORICO 3.- NORMA OFICIAL MEXICANA MEXICANA DE LOS SERVICIOS SERVICIOS DE PALNIFICACION FAMILIAR. 4.- DEFINICION DE METODOS ANTICONCEPTIVOS ANTICONCEPTIVOS 5.- CLASIFICASION DE METODOS ANTICONCEPTIVOS ANTICONCEPTIVOS 6.- METODOS NATURALES 7.-RITMO O CALENDARIO 8.-TEMPERATURA CORPORAL O BASAL 9.-MOCO CERVICAL 10.-COITO INTERRUMPIDO 11.-SINTOTERMOCO 12.-LACTANCIA 12.-LACTANCIA PROLONADA 13.-METODOS DE BARRERA 14.-CONDON MASCULUNO 15.-CONDON FEMRNINO 16.-DIAFRAMA 17.-!UIMICOS" ESPERMATICIDAS ESPERMATICIDAS 18- E#$%&'( (&)*+%&+,$)*( (*&(/ 19.-C($+& +,*+(/ 20.- E#+% , /,( 21.-ANTICONCEPTIVOS MECANICOS 22.-DISPOSITIVO INTRAUTERINO 23-ANTICONCEPTIVOS ORMONALES 24.-ORMONALES ORALES 25.-OMONALES INECTABLES INECTABLES 26.-IMPLANTES SUBDERMICOS DE DEPOSITO 27.- ANILLO VAINAL 28.- PARCE CUTANEO 29.-METODOS IRREVERSIBLES O DEFINITIVOS 30.-LIADURA DE TROMPAS 31.-VASECTOMIA LOSARIO TERMINOLOIA BIBLIORAFIA
1 INTRODUCCIÓ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
#, *&*+*( ,& 1929 +%& /( $,#,&)(+*& $,#,&)(+*& ,(/*:(( ,(/*:(( $% R*+), R*+), , & (),&)*+% (),&)*+% *#$%#*)*% *#$%#*)*% *&)(),*&% >, +%&#*#)?( +%&#*#)?( ,& & /(:% /(:% */% , #,(. M(# )(,< ,& 1929< 1929< *&,#) (,, (,, (*+% (*+% & *#$%#*)* *#$%#*)*% % +%& (/,(+*& (/,(+*& , +%, = $/()( +%& (& (+,$)(+*& ,& A/,(&*( = %)%# P(?#,#. E& /( +(( , /%# 50(#< O$$,&,*, ,& I#(,/ &%)**+% ,&%# ,#/)(%# +%& ,#)%# *#$%#*)*%#. E# ,/ (% , 1970 +(&% #, *&*+*% +%& /( (*+(+*& ,/ DIU ,*+(%# % *%(+)*(%#< +%& *%&,# , +%, = $/()( $/()( % +%& %%&( %%&(#< #< *&+,,& *&+,,&)& )&%#, %#, /( ,*+(+*( ,*+(+*( (&)*+%& (&)*+%&+,$ +,$)* )*% % = ,%/+*%&&%#, /%# ,,+)%# #,+&(*%#. A/ $*&+*$*% , /( +(( , /%# 50(#< #, ,#(%//(%& /(# $*,(# $%,#),%&(# $%,#),%&(# *&=,+)(/,#< *&=,+)(/,#< $,% ,# (#)( /( +(( , /%# 60(#< +(&% #, *&*+*(& *&*+*(& /%# ,&#(=%# +/?&*+%# +%& *&,# *&,# (&)*+%&+,$)*%#< +%&%+*%# +%% /%# *&=,+)(/,# , $*,( ,&,(+*&. E#)%# *&=,+)(/,# ,#/)(%& #, (/)(,&), ,*+(+,#< $,% +%& (/&%# ,,+)%# ,,+)%# +%/(),(/,# +%/(),(/,# +%% #(&(% #(&(% ?&), ,&#)(/< ,&#)(/< A& (#?< (# , 600<000 600<000 ',,# ,& A*+( L()*&( /%# )*/*:(%& ,& /(# +((# , /%# 70(#. E & 1995< ,#$# , &( *&,#)*(+*& , +(#* 20 (%#< ($(,+, ,& M*+% & (&)*+%&+,$)*% *&=,+)(/, , #,&( ,&,(+*&" ,*+(: = , ($/*+(+*& ,&#(/< +%& ,&%# ,,+)%# #,+&(*%# = ,&%# *&+*,&+*( *&+*,&+*( , #(&(% #(&(% ?&), ,&#)(/, ,&#)(/,## (#? +%% & ,)%&% ,)%&% ),$(&% (/( ,)*/*( (/ ##$,&,#, ,/ )()(*,&)%. E& 1880< L&,& ,(/*:% ,/ $*, $%+,**,&)% , ,#),*/*:(+*& )%*+(< ,#$# , &( %$,(+*& , +,#,(. D,#, ,&)%&+,#< #, (& ,#+*)% (# , 100 )+&* )+&*+( +(## *, *,,& ,&), ),## , *&), *&), ,& ,&+* +*%& %&,# ,# >* >* * *+( +(## $(( $(( ,#), ,#),* */*/*:( :(+* +*& & ,, ,,&* &*&( &( ,*&* ,*&*)* )*(. (. U& (#$,+)% (#$,+)% = *$%) *$%)(&) (&), , $(( $(( /( ,/,++* ,/,++*& & , ,#),* ,#),*/*: /*:(+* (+*& & ,,&* ,,&*&( &( @S(/$*&%+/(#*( +%% )%% (&)*+%&+,$)*% ,# ,/ , # *,,#**/*(. L( (#,+)%?( #, *&*+*( ( $*&+*$*%# , ,#), #*/% +%& S($ ,& 1930< $,% &% ,# (#) (#)( ( 1963 1963 >, >, P%) P%), ,&, &, , , $/* $/*+( +( 2<00 2<000 0 +(#%# +(#%# , (#,+ (#,+)% )%? ?( ( %/ %/&) &)( (*( *( ,,+)((# , 1956 ( 1961< +%& ,+,/,&),# ,#/)(%#. P(( 1983 #, (?(& ,,+)(% (# , 32< 931<000 (#,+)%?(# ,& )%% ,& &%. A/ *(/ >, /( ,#),*/*:(+*& )( *+(< #, , +%&#*,( >, ,# & )%% >**+% *,,#*/,< (&>, =( ,& (/&%# $(?#,# #, ,(/*:( +%& *)% # ,,#**/*(.
3 NORMA OFICIAL MEXICANA DE LOS SERVICIOS DE PLANIFICACION FAMILIAR Aspectos rele!"tes L( #(/ ,$%+)*( ,# /( +($(+*( , /%# *&**%# = , /(# $(,'(# , *#)( &( *( #,(/ = ,$%+)*( #()*#(+)%*(< #(/(/, = #*& *,#%#< +%& /( (#%/)( /*,)( $(( ,+* , (&,( ,#$%&#(/, = *,& *&%(( #%, ,/ &,% = ,#$(+*(*,&)% , ## *'%#.
COMPONENTES DE LA SALUD REPRODUCTIVA
P/(&**+(+*& (*/*(
S(/ $,*&()(/
S(/ , /( ',
L( $/(&**+(+*& (*/*( ,& # &,% +%&),)% $%&, (/ (/+(&+, , )%( /( $%/(+*& *&%(+*& ,(: = %$%)&(< (#? +%% &( *,#*( , )%%# = ,#)(),*(# (&)*+%&+,$)*(# >, ,#$%&(& ( /(# &,+,#*(,# , +(( *&**% = , +(( $(,'(< , (+,% ( /(# *,,&),# ,)($(# , # +*+/% ,$%+)*%. P%,, /( +%,#$%&#(*/*( = $()*+*$(+*& (+)*( ,/ %, ,& /( )%( , ,+*#*%&,# ,$%+)*(#. F%,&)( (+)*),# = +%&+)(# ,#$%&#(/,# ,& /( $%/(+*& (%/,+,&),< A)*,&, /(# &,+,#*(,# , $%# *&%*)(*%# +%& (#%/)% ,#$,)% ( # *,#*( +/)(/ = )&*+(. F#"$!%e"to &#r'$(co E/ &(,&)% '?*+% , /( $/(&**+(+*& (*/*(< , /( ,>*( ,&), /%# &,%# = ,/ ,,+% ( /( #(/ ,#)( *&#+*)% ,& /( C%&#)*)+*& P%/?)*+(< /( L,= ,&,(/ , S(/ = L( L,= ,&,(/ , P%/(+*&. HE/ (& = /( ', #%& *(/,# (&), /( /,= T%( $,#%&( )*,&, ,,+% ( ,+** , (&,( /*,< ,#$%&#(/, , *&%((< #%, ,/ &,% = ,/ ,#$(+*(*,&)% , ## *'%#< T%( $,#%&( )*,&, ,,+% ( /( $%),++*& , /( #(/J. C%&#)*)+*& P%/?)*+( , /%# E#)(%# U&*%# M,*+(&%#. A)*+/% 4K
HL( $/(&**+(+*& (*/*( )*,&, +(+), $*%*)(*%. E& ## (+)**(,# #, ,, *&+/* /( *&%(+*& = %*,&)(+*& ,+()*( $(( /%# (%/,#+,&),# = ',&,#J. L,= ,&,(/ , S(/. A)*+/% 67.
HL( *&%(+*& = /%# #,*+*%# , #(/< ,+(+*& = /%# , # ,/()*%# ( /%# $%((# , $/(&**+(+*& (*/*( #,& ()*)%# +(&% #,(& $,#)(%# $% ,$,&,&+*(# = %(&*#%# ,/ #,+)% #(/J. R,/(,&)% , /( L,= ,&,(/ , P%/(+*&< A)*+/% 17.
E/ ,/(,&)% *&),&% , /( S,+,)(*( , S(/< ,&,&(% ,& 1997 *&+%$%( ( /( $/(&**+(+*& (*/*( +%% & +%$%&,&), ,/ $%(( , #(/ ,$%+)*( (+%, +%& /( R,%( ,/ S,+)% S(/.
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D(spos(c(o"es ) pr("c(p(os $e los ser(c(os $e pl!"(*(c!c(+" *!%(l(!r NOM. E/ ,,+% , )%( /( $%/(+*& ( ,+** *&%(+*& ,(: = %$%)&( #%, (&)*+%&+,$+*& = $/(&**+(+*& (*/*(. E/ (++,#% &*,#(/ ( /%# #,*+*%# , $/(&**+(+*& (*/*(< ,& %( ()*)( ,& /(# *&#)*)+*%&,# ,/ #,+)% $/*+%. E/ (++,#% ( *,,&),# %$+*%&,#< )%%# = ,#)(),*(# (&)*+%&+,$)*(#< +%& (#%/)% ,#$,)% ( /( *&*( , /%# *&**%# = , /(# $(,'(#< = ,/ ,,+% ( # /*, ,+*#*&. -D*#$%&**/*( , )%%# (&)*+%&+,$)*%# ,,+)*%#< #,%# = (+,$)(/,# $(( #()*#(+, /(# &,+,#*(,# = $*%*(,# , /( $%/(+*& #(*(< , (+,% ( /(# *,,&),# ,)($(# , # +*+/% ,$%+)*%. -P%*#*& , )%%# (&)*+%&+,$)*%# ),$%(/,#< >, ,*),& ,((:%# &% $/(&,(%# = $,*)(& ,/ ,#$(+*(*,&)% ?&), ,&#*+% (,+(%. -P%$%+*%&( *&%(+*& #%, /%# ,&,*+*%#< ,+(&*#% , (++*&< %% , ,$/,% = $%#*/,# ,,+)%# #,+&(*%# , /%# )%%# (&)*+%&+,$)*%# ),$%(/,#< $(( %),&, ,/ +%&#,&)**,&)% *&%(%. -A#,( ,/ (++,#% ( )%%# $,(&,&),#< $(( ,/ %, = /( ',< +(&% (=(& +%$/,)(% ## ,$,+)()*(# ,$%+)*(# %)%(&% %*,&)(+*&+%&#,',*( >, (#,, ,/ +%&#,&)**,&)% *&%(%< (#? +%% /( *( % *$,#*& (+)*/( , /( ,/ #(*%< ,& /%# %()%# ,#$,+?*+%#. -((&)*:( ,/ ,,+% , /%# = /(# #(*(# , )%%# (&)*+%&+,$)*%# ( ,(/*:( +(*%# % *&),$* ,/ #% , /%# *#%#< , (+,% ( ## &,+,#*(,#.
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l aborto inducido no constituye bajo ninguna circunstancia, un método de planificación familiar.
Co%#"(c!c(+" ("terperso"!l. E/ $,#%&(/ , #(/ )*/*:(( (),*(/,# *+)*+%#< $%%+*%&(/,#< (*%*#(/,# = *+%#< +%& +(+), , ,&),),&**,&)% ,+()*%< >, (+*/*),& (/( $%/(+*& #(*( /( +%$,&#*& , /%# ,&#(',#. Orientación-Consejeria
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$(), , /( % ,/ #(*%. E/ $,#%&(/ , #(/ *&( %*,&)(+*&-+%&#,',*( $(( (#,( /( ,+*#*& (# +%&,&*,&),. Constancia del expediente clínico .
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6 METODOS NATURALES
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M',,# +%& +*+/%# ,&#)(/,# *,/(,#. I&(*/*( , /( ', $(( *,&)**+( ,/ *&*+*% = ,/ *&(/ , # $,*%% )*/ ,#$# , /( +($(+*)(+*&. C%&*+*%&,# >, *$*, *#$%&**/*( , /( $(,'( $(( //,( (+(% $,*%%# , (#)*&,&+*( (&), ,/ $,*%% )*/.
EFECTOS SECUNDARIOS N% #, ,#+*,& ,,+)%# #,+&(*%# ( ,#), )%%< =( >, #* /( $,#%&( +,&)( +%& %)(# $(,'(# #,(/,# $,,& +%&)(, ,&,,(,# , )(&#*#*& #,(/ % *,& ,/ VISIDA.
RITMO O CALENDARIO E/ )%% ,/ +(/,&(*%< +%&%+*% (&),*%,&), +%% ,/ )%% ,/ *)%< $,*), ,),*&( ,/ %,&)% , /( %/(+*& ,& ',,# +%& +*+/%# ,&#)(/,# ,/(,#. E#), #, (#( ,& /( $%#**/*( , >, /( %/(+*& %+( ,& /%# ?(# 12 ( 16 ?(# ,/ +*+/%< +%&#*,(&% >, ,#), #,( ,/ 20 (/ 30 ?(# = )%(&% +%% *&*+*% ,/ +*+/% ,&#)(/ ,/ $*, ?( , #(&(% +%& +((+),?#)*+(# &%(/,# ,& +(&)*( = ,+,&+*( )()(&% , ,$,#( +(/,# #%& /%# ?(# )*/,#. P(( >, ,#)%# #,(& , (#)*&,&+*(# % $%),++*& ,)(. Formula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
N% ,# ($/*+(/, ( ',,# +%& +*+/%# *,/(,# % ,& (>,//(# +=% +*+/% /(% ,+,, 10 ?(# (/ +%)%. R,>*,, +%&%+**,&)% , (&()%?( = *#*%/%?( A,*)( , *#+*$/*&( ,& (/)% (% &% #%/% , /( ', #*&% , # $(,'(< /% +(/ ,# *?+*/ , /%( ,& (/)%# = # (& ,& (%/,#+,&),# $% /(# +((+),?#)*+(# $#*+%/*+(# $%$*(# , /( ,(.
EFECTOS SECUNDARIOS S, (& ,#+*)% /( $%#**/*( ,/ &(+**,&)% , &*%# (&%(/,# +(&% (//( ,/ )%% $% /( &*& ,/ /% % ,#$,()%:%*, ,#$# , (*%# ?(# , (, #*% $%+*% $% /% >, ,/ &,% #, #, %( ( $()* , /(# +//(# *,'(#. S, *&%( ,$,+#*%&,# $#*+%/*+(# >, *&+*,& ,& /( ,/(+*& , $(,'( E& ,&,(/ &% #, ,+%*,&( ,& (%/,#+,&),# $% >, (( ,: ,*#), /( %)*(+*& = )%(# /(# +((+),?#)*+(# >, #, &,+,#*)(& $(( >, #, /%, >, #,( ,,+)*% = ,/ , (+(#%# ,# = (/)% (& ,& $(,'(# ,&),&((#
TEMPERATURA CORPORAL 0ASAL E# /( ),$,()( ,/ +,$% ,& ,$%#%. M,*(&), ,/ ,*#)% , /(# ,(/(+*%&,# = ,#+,&#%# *(*%# , /( ),$,()( +%$%(/< &( ', $,, ,),*&( +%& (#)(&), $,+*#*& ,/ %,&)% ,& >, #, ( ( $%+* /( %/(+*&. E / (#+,&#% %#+*/( ,&), 0.2 ( 0.5 (%# = ,# ,*% ( /( /*,(+*& , $%,#),%&(. E# , ,#)(+( >, 12 ( 24 %(# , /( %/(+*& /( ),$,()( +%$%(/ $,, ('( /,,,&),. INDICACIONES T%(# /(# ((&(# (&),# , /,(&)(#, = ,(/*:( +(/>*, (+)**(< /( ', ,, )%(#, /( ),$,()( = /( ,*#)( ,& &( (*+( % +(,&% ,#$,+*(/< =( >, ,, #, ( /( *#( %( = (=&(#. @#*& (, $%(% &*&& (/*,&)% % ,*(#
L( ', ,, ,#)( +($(+*)(( $(( (+, /(# /,+)(# = +%% (&,'( ,/ ),,)% S, ,, )%( /( ),$,()( %(/< ,+)(/ % (*&(/< $,% #*,$, ,& ,/ *#% /(. E/ )*,$% , )%( ,, #, &% ,&% ( 3 *&)%#. U&( ,: #+,*% ,/ (#+,&#% , /( ),$,()( ,>*,, , ),# ?( , (#)*&,&+*( #,(/. 72 %(# ,#$# ,/ (#+,&#% $,,& ),&, ,/(+*%&,# (#)( ,/ *&*+*% ,/ $,*%% ,&#)(/.
CONTRAINDICACIONES E*#),& (*(# (:%&,# $% /(# >, $,, ,#/)( *?+*/ ,#), )%%< =( >, $, ,*#)* ,/,(+*& , ),$,()( $% $%+,#%# &% ,/(+*%&(%# +%& /(# (*(/,# , /%# &*,/,# %%&(/,# $% ,',$/%" ,&,,(,# *&&*:(+*%&,#< = ,/ #% , (/&%# (+%# >, $,,& ,/,( /( ),$,()(. L( *,, $,, +%&&* /( ($/*+(*/*( , ,#), )%% D,,& (#),&,#, , #( ,#), )%% #* #, ,&+,&)(& ,& ,#)(# +*+&#)(&+*(#" $,*%%# , ,#)#< *&,#)*& , ,*(# (/+%/*+(#< )%( , ,*+(,&)%#< *(',#. E# *$%)(&), #,(/( >, #, $%?, ),&, ,/(+*%&,# #,(/,#< +(&% /( ),$,()( (*&(/ (,&)( ,& +(#* & (% +,&)?(%. EFECTOS SECUNDARIOS P,, (, >, (=( *&#()*#(++*& #,(/ $% /( %/*(( (#)*&,&+*( #,(/ (&), ,),*&(%# $,*%%#
MOCO VERVICAL
E#), )%% #, (#( ,& /( *,&)**+(+*& , %+% +,*+(/ ,& ,/ $,*%% %/()%*%. D,#$# , /( %/(+*& = (/,,% ,/ %,&)% , /( ,&#)(+*&< /( +(&)*( ,/ %+% +,*+(/ ,# = ,#+(#( $% /% ,&,(/ ,# ,#$,#%< )*% = +(*( , +%/%< , /(&+% ( ((*//,&)%. A ,*( >, #, (+,+( /( %/(+*&< ,/ %+% +,*+(/ ,$,*,&)( (/&%# +(*%# >, (+,& (# (+%,%(# /(# ?(# ,/ #*#),( ,$%+)% , /( ', $(( /%# ,#$,()%:%*,#. L( +(&)*( , %+% #, ,/, (# *&%< )(&#$(,&), = ,/#)*+%. INDICACIONES
M,*(&), /( %#,(+*& , /%# +(*%# ,/ %+% +,*+(/< &( ', $,, $,+*#( /%# %,&)%# , *( % ?&*( ,+&*(. E/ %+% %/()%*% ,# +*#)(/*&%< ,/#)*+%< ,#(/%#%< (&(&),< /*+(&),< ($(*,&+*( #**/( (/( H+/(( , ,%J.
CONTAINDICACIONES
#, ,, ,#)*&* /(# ,/(+*%&,# #,(/,# ,&), 2 ?(# = 4 ,#$# , /( ($(*+*& ,/ %+% %/()%*% E/ $,*%% , , (#)*&,&+*( $,, #, /(%# #* /%# +(*%# ,/ %+% #, ,(/*:(& ,& %( /,&)( E*)( ,/(+*%&,# (&), /( ,&#)(+*& +(&% /%# +*+/%# #%& = +%)%#< =( >, /( %/(+*& $%?( (#, (&),# , ),*&( ,/ #(&(%. C(&% ,/ %+% #, (+, = *#+%#% = +(, ,&), /( #,$((+*& ,/ $*, = #,&% ,% (=% ( 3+.
EFECTOS SECUNDARIOS L%# /'%# (*&(/,# **+/)(& ,/ ,+%&%+**,&)% ,/ %+% +,*+(/ ,& /( (#, %/()%*(. E*#),& (*%# (+)%,# &% %%&(/,# = $%+,#%# >, $,,& (/),( /( +%&#*#),&+*( ,/ %+% +,*+(/. D+(#< E#$,()*+*(#< /*+(&),#< , *&,++*%&,# $% %&%# $,,& (+, >, ,#/), *?+*/ (/%( +%& ,(+)*) /(# #,+,+*%&,# +,*+(/,# T*,&, & (/)% $%+,&)(', , (+(#% 12<7 ( 37.2 $% 100 ',,# , #%.
14 COITO INTERRUMPIDO Coitus interruptus E/ Coitus interruptus #, ,*,, ( /( ,)*(( $,+%: ,/ $,&, , /( ('*&(< (&),# , >, #, $%:+( /( ,=(+/(+*%&< ,*)(&% ,/ ,$#*)% , ,#), ,&)% , /( *#(. E/ C%*)# *&),$)# ,# &( $(+)*+( ,+,&), $%>, #, )()( , & )%% #,&+*//%< (()%< >, &% ,*, /( (>*#*+*& , &*&& *#$%#*)*%. INDICACIONES P,,& $,#,&)(#, ,#$,()%:%*,# *(/,# ,& ,/ /?>*% #,*&(/ >, #(/, (&),# , /( ,=(+/(+*%&< +(&% #, (& ),&*% ,=(+/(+*%&,# $,*(# (#)( 3 ?(# (&),#. P% ,//% # (+)**( #,(/ #, ,*, +(( +()% ?(. CONTAINDICACIONES N% #, ,+%*,&( (%/,#+,&),< &* ,=(+/(%,# $,+%+,#. D(% >, ,/ /*>*% $,,=(+/()%*% $,, +%&),&, ,#$,()%:%*,# +($(+,# , ,+&( ,/ /%< ,*#),& +(# $%#**/*(,# , >, #, $%:+( &( ,+&(+*& (&), ,/ C%*)# *&),$)# EFECTOS SECUNDARIOS E#), $,, $,#,&)( & ,#+($, , #,,& (&),# , /( ,=(+/(+*%&. S,/, #+,, &( +(?( , #,,& ,& /%# ,&*)(/,# ,),&%# , /( ',. N% ,# ,+%,&(/, $(( (>,//%# %,# >, &% )*,&,& & (,+(% ()%+%&)%/. N% (%,+, /( #()*#(++*& #,(/. P,, %+(#*%&( $%/,(# $#*+%/*+%# ,*(%# , /( ),&#*& (&), ,/ (+)% #,(/ >, $,, %**&( *#&+*%&,# #,(/,# +%% (&%(#*(< *$%),&+*( (#+/*&( = %)%#.
11 SINTOTERMICO P,*), ( /(# $(,'(# $,,+* /( %/(+*& +%& (=% *(*/*( )*/*:(&% &( +%*&(+*& , )+&*+(#; #,**,&)% ,/ +*+/% ,&#)(/< ,),*&(+*& , /(# +((+),?#)*+(# ,/ %+% +,*+(/< ,*#)% ,/ ,, %/% (%*&(/ ,&#(/ >, $,, ,,#, ( /( %/(+*& @*)),/#+,:. U&( ,: >, /( $(,'( ( ,),*&(% +(&% #, $%+* /( %/(+*&< $,,& (/),( # +%$%)(*,&)% #,(/ $(( (,&)( % *#*&* /(# $%#**/*(,# , ,+&(+*&. INDICACIONES E# /( +%*&(+*& , /%# )%%# %&, ,*#), &( *&*+(+*& , /( (+, %/()%*(. I&),(&% ,/ )%% ,/ *)%< %+% +,*+(/ = ),$,()( (#(/.
CONTRAINDICACIONES P% /% ,&,(/ &% #, ,+%*,&( ( (%/,#+,&),# $% >, (( ,: ,*#), /( %)*(+*& = )%(# /(# +((+),?#)*+(# >, #, &,+,#*)(& $(( >, #, /%, >, #,( ,,+)*% = ,/ , (+(#% ,# = (/)% (& ,& $(,'(# ,&),&((#. EFECTOS SECUNDARIOS S, )*,&,& >, (( /(%# $,*%%# , (#)*&,&+*( E/ $%+,&)(', , (+(#% ,# #**/( (/ #,(/(% $% ,/ )%% ,/ %+% +,*+(/. S, *&%( ,$,+#*%&,# $#*+%/*+(# >, *&+*,& ,& /( ,/(+*& , /( $(,'( S, ( ,#+*)% /( $%#**/*( ,/ &(+**,&)% , &*%# (&%(/,# +(&% (//( ,/ )%% $% /( &*& , & /% % ,#$,()%:%*, ,#$# , (*%# ?(# , (, #*% $%+*% $% /% >, ,/ &,% #, #, %( ( $()* , +//(# *,'(#.
12 LACTANCIA PROLON5ADA E# & )%% ,& %&, /%# &*,/, (/)%# , $%/(+)*&( @%%&( >, (+*/*)( /( /(+)(&+*(< *&*, /( %/(+*&. E# ,+%,&(/, ,+** %*,&)(+*& $% # ,*+% ,& /( +%&#/)( $%#$()% ( ,(/*:(#, 30 % 40 ?(# , &(+**,&)%. A/ *& , +%$/,,&)(#, ( & )%% >, &% *&),*,( +%& /( /(+)(&+*( (),&(. ( >, ,#), )%% &% ,# = ,*+(: ,& )%(# /(# ',,#. INDICACIONES S, ,>*,, , /( /(+)(&+*( (/ ,+*& &(+*% +%& &( $,*%+*( ?&*% , ),# %(#. S* (= &( /(+)(&+*( ,+/#*(< $,(&,&), = #*& ,&#)(+*&< $,, (, &( $%),++*& ,/ 98 ,& /%# $*,%# #,*# ,#,# $%#$()%. CONTRAINDICACIONES E#), )%% ,#)( ,+%,&(% &(( (# $(( ',,# >, ,#)& /(+)(&%. EFECTOS SECUNDARIOS
N% $%#,, ,+( ,*&*( , $%),++*&< (& +(&% ,*#)( ,+,&+*( = )*,$% (,+(% , /( /(+)(&+*(. L( %/(+*& $,, $,#,&)(#, (&),# , /( $*,( ,&#)(+*& $%#$()%< (+*&%/( $%+% +%&*(/,.
13 METODOS DE BARRERA
E#)%# (&)*+%&+,$)*%# #%& /%# >, )*/*:(& &( (,( ?#*+( $(( *$,* /( //,(( ,/ ,#$,()%:%*, (/ /%. O #,( >, +%,#$%&,& ( (>,//%# )%%# >, , (&,( ,+&*+( %#)=,& ,/ $(#% , /%# ,#$,()%:%*,# % , (&,( >?*+( (,+)(& /( %*/*( % *)(/*( ,#$,)*+( ,*)(&% /( ,+&(+*&. U&( , ## ,&)('(# ,# >, )*,&, /( +($(+*( (#%+*(( , $,,&* ,/ +%&)(*% , /(# ,&,,(,# #,(/,&), )(&#*#*/,# +%% #%&" ,/ ,$,#< VI< %&%+%+%< C/(*=(< ,)+.
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16 DIAFRA5MA
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ESCUDO DE LEA,
El Escu"o "e Lea es un aparato "e silicona en -orma "e c.pula con un anillo para su e/tracci0n ue se a2usta "entro "e la aina "e la mu2er 4 cu5re el cuello uterino) Se usa con un espermici"a) El Escu"o "e Lea se proporciona en un solo tamao 4 reuiere receta m7"ica) La 8lula "e una 9a ue contiene crea una succi0n ue a4u"a a ue se a2uste 5ien so5re el cuello uterino) La 8lula permite el -lu2o :acia a-uera "e secreciones sin permitir ue entren espermato;oi"es) El Escu"o "e Lea "e5e intro"ucirse antes "e ca"a acto se/ual) De5er8 permanecer intro"uci"o por lo menos < :oras "espu7s "el mismo= pero no "urante m8s "e >< :oras en total) Es posi5le oler a usarlo 4 es necesario laarlo con aua 4 2a50n entre ca"a uso) Tam5i7n "e5e reempla;arse cuan"o muestre in"icios "e "esaste o "e5ili"a") El Escu"o "e Lea no protee contra las enfermedades venéreas.
*1 MECAN(COS
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22 DISPOSITIVO INTRAUTERINO S%& $,>,%# ,/,,&)%# , $/#)*+% /,*/, +%& (/,++*%&,# , +%, %%&(# >, #, +%/%+(& ,&)% ,/ ),% % ()*:. E/ DIU ,*+(% +%& +%, ,# & $,>,% (),(+)% , $%/*,)*/,&% $/#)*+%< /,*/, ,& %( , T< +%& ,#$*(/,# , +%, =% (/(, , +%, (,*% (/ (+%. E*#),& (*%# *#,%# , DIU /%# +(/,# )*,&,& */(,&)%# % */%# , ?(< +%)%# % /(%#< $(( # /%+(/*:(+*& % ,)(++*&< ,/ (# ,+%,&(% ,# ,/ DIU ,*+(%# +%& +%, >, *&(& &( $%),++*& ,/ 98 (/ 99< +%% /( T-380 A = ,/ M/)*/%( 375< #%& (# ,,+)*%# >, /%# >, )*,&,& ,&% +%&),&*% , +%,. P% ## +((+),?#)*+(# %# DIUS $,,& +/(#**+(#, ,&" D*#$%#*)*%# *&,),< ,# ,+*< (>,//%# >, +$/,& # &+*& $% #* *#%< #*& ,*( ##)(&+*( (/&(. D*#$%#*)*%# /*,(%,# , *%&,#< >, (/( (++*& , (),*(/ $/#)*+% &,& /( , /%# *%&,# >, /*,(& #,& # +%$%#*+*&. D*#$%#*)*%# /*,(%(# , %%&(#< >, (,# , /( (++*& ,/ $%$*% *#$%#*)*%< $,#,&)(& /( , /( %%&( >, /*,( ,/ *#$%#*)*% = (+)(/,&), /% /)*% ,& DIU ,# ,/ ,&%#,$)*%. E/ DIU $,, +%&#,( # ,*+(+*( (#)( (&), 6 (%#< /% >, $,*), ( /( ', = # $(,'( $()*+*$( ,& &( (+)**( #,(/ ,#$%&)&,(. L( *$%)(&+*( ,/ DIU ,# >, *$*, >, /%# ,#$,()%:%*,# ,+&,& ,/ /% (/),(&% /( +($(+*)(+*& ,#$,)*+(< (/),( /( ,#)+)( ,/ ,&%,)*% $% /( *&/((+*&< )(*& (/),( /( ,#)+)( ,/ %+% %/*&%/% *&(,+(% $(( /( $%,#*& ,#$,)*+(. INDICACIONES E/ DIU #, ,, +%/%+( $,,*/,,&), ,& ,/ #,&% ?( , /( ,#)(+*%& % 40 ?(# $%#)$()%. S* #, +%/%+( $%#) (%)% ,, ,**+(#, >, &% $,#,&), *&,++*& $,*(. P% /% ,&,(/< /%# *#$%#*)*%# *&)(),*&%# #, *&)%+,& ,& & +,&)% , (),&+*& #(&*)(*( (&), &( ,$/%(+*& $/*+( = $(( # ,)*% )(*& #, &,+,#*)( , & $,#)(% , /( (),&+*& #(&*)(*(. A&),# , *&)%+* ,/ DIU< ,/ ,*+%< /( ,&,,( ()%&( % /( ,&,,( ,&,(/< ,),*&(( #* /( ', ,# &( +(&*()( *,(/ $(( ,/ *#$%#*)*%. L(# *&*+(+*%&,# $(( # ,)(++*& ,# >, $,, ,)*(#, ( #%/*+*) , /( #(*(< $,,*/,,&), +%& /( ,&#)(+*&. E/ DIU ,#)( *&*+(% $(( ',,# #*& % +%& ('% *,#% , (>** ,&,,(,# #,(/,&), )(&#*#*/,# = ,& #(*(# ,& >*,&,# ,/ #% , )%%# %%&(/,# ,#)( +%&)(*&*+(%. C(&% ,*#), %/% $/*+% % +/*+%# *&),&#%#< #(&(% ,&#)(/ ,+,#*%< ,&,,( $/*+( *&/(()%*(< ,#$/(:(*,&)% ,/ *#$%#*)*% ,& /( +(*(
),*&(< ,((:%< ,&%$(#*( @,#)% ,# ,*% ( >, # (++*& =( &% ,# &,+,#(*(. L( %,#*(< ,&,,( +(*%(#+/( % )((>*#%< &% +%&#)*)=,& ,#)*++*%&,# $(( ,/ #% , ,#), )%%. L%# DIU ,*+(%# ,#)& *&*+(%# $(( ',,# ,& ,( )*/ +%& *( #,(/ (+)*(< &/*,#)(#< &/?$(( % /)?$((#< *&+/=,&% (%/,#+,&),#. L%# DIUS ,*+(%# &% *&),*,,& +%& /( /(+)(&+*( (),&(< $% /% >, ,#)& *&*+(%# ,& ,/ $%#)$()% = ,& /( )(&#$%#)+,#(,(.
CONTRAINDICACIONES E/ DIU ,#)( +%&)(*&*+(% ,& /%# #**,&),# +(#%#" A&%(/*(,# (&()*+(# *&+%$()*/,# +%& /( *&#,+*& ,/ DIU. L(# ',,# +%& *,#% , ,#(%//( ,&,,( *&/(()%*( $/*+( @$% ,',$/% (>,//(# +%& (*(# $(,'(# #,(/,# = (>,//(# >, (& $,#,&)(% $%/,(# (&),*%,&), +%& ,/ DIU< &% #%& ,&(# +(&*()(# $(( /( +%/%+(+*& ,/ DIU. C&+, +,*+%),*&%< , ,&%,)*% % , %(*%. I&,++*& ),*&( $%#),,&)% %#))*+%. S(&(% (*&(/ , ,)*%/%?( &% ,),*&((. N% #, ,, +%/%+( #* ,*#),& /%# #**,&),# +(#%" ,((:% #%#$,+(% % +%&%+*%< #(&(% (*&(/ &% *(&%#)*+(%< $%+,#% (/*&% *&,+%/*+%< *&,++*& $/*+(< (&%(/?(# +%&&*)(# ,/ ),%< ,&%,)*)*#< ,#),&%#*# +,*+(/ #,,(< )(#)%&%# ,%*+%# % , +%(/(+*&< (&),+,,&), , ,((: ,+)%$*+% = ,& ',,# $%*#+(#. T,+/%#*# $/*+( E&,,( )%%/(#)*+( ,#)(+*%&(/ @+%*%+(+*&%( EFECTOS SECUNDARIOS D(&), /( *&)%++*&< /( ', $,, ,$,*,&)( +(/(,# = %/%,# % $*&+(:%#. E#)% #, /, (/**( (*&*#)&%/, & (&(/#*+% %(/ #(, % & ,/('(&), #+/(. A ,+,# ,/ DIU #, $,, %, = #, ,$/#(%< ,#$,+*(/,&), (&), /%# %# % ),# $*,%# +*+/%# ,&#)(/,# ,#$# , # +%/%+(+*&. A/&%# , ## *&+%&,&*,&),# ,# >, #%& # (#%+*(+*& ( &( (=% *&+*,&+*( , ,&,,(,# *&/(()%*(# $/*+( @EIP< (/ *,#% , %)( ),*&(< ( *#,&%,( @,&#)(+*& %/%%#(< ,%(*( = ,((:% ,+)%$*+% @*&((+*& ,/ /% ,+&(% ,& /( )%$( , F(/%$*%. A& +(&% ,/ DIU ,# & )%% = ,,+)*% $(( /( $,,&+*& ,/ ,((:%< ,/ $,#)(% ,/ #,*+*% ,, $%&, ,#$,+*(/ (),&+*& +(&% %+( &( (//( ,/ )%% = /( #(*( #, ,((+,. T(& $%&)% +%% #, +%&*, ,/ ,((:%< ,/ DIU ,, #, ,%*% #* ,#)% ,# $%#*/,. S* /( ,%+*& &% #, $*,( ,(/*:(< /( (),&+*& $,&()(/ ,, #, ,#$,+*(/,&), +*(%#( $(( ,*)(
+(/>*, *,#% , *&,++*& % )(('% , $()% $,()%. E# = (% >, ,/ )%% (//, #* ,#)% #+,*,( %+*?( & ,((:% ,+)%$*+%. M(=% (+*& ,/ #(&(% ,&#)(/ ,& (/&%# +(#%# %/% $/*+%.
*3 %ORMONALES L%# (&)*+%&+,$)*%# %%&(/,# #%& ##)(&+*(# #*&))*+(#< +%& ,,+)%# #**/(,# ( /(# %%&(# #,(/,# ,,&*&(# &()(/,# >, $%+, ,& /( #(*( &( (/),(+*& ,/ ,+(&*#% , ,)*/*:(+*&. E#)%# (&)*+%&+,$)*%# %%&(/,#< #, $,,& (*&*#)( $% ?( %(/< ,& *&=,++*%&,# *&)(#+/(,# % ,*(&), *$/(&)(+*%&,# ,& ,/ (:%< (+)(&% , &( (&,( %)( #,& # +%$%#*+*&. E#)& +%$,#)%# $% %# %%&(# /%# ,#),&%# = /%# $%,#)(,&%#. L%# (&)*+%&+,$)*%# %%&(/,# #, $,#,&)(& , /( #**,&), %(" 1.- %%&(/,# %(/,# +%*&(%#< 2.- %%&(/,# %(/,# , $%,#)*&( 3.- %%&(/,# *&=,+)(/,# >, #%/% )*,&, $%,#)*&( 4.- %%&(/,# *&=,+)(/,# +%*&(%#
2, ANTICONCEPTIVOS 9ORMONALES ORALES E#), )*$% , (&)*+%&+,$)*% ,# &( %$+*& ,,+)*( = #,( $(( /(# ',,# >, ,#,(& ,/( # ,+&*( ,& %( ),$%(/ = >, ,#)& *#$,#)(# ( /( )%( *(*( ,/ (&)*+%&+,$)*%. E#)%# ,#)& +%$,#)%# $% %# %%&(# /%# ,#),&%# = /%# $%,#)(,&%# L%# ,#),&%# (& *#*&*% # +%&+,&)(+*& , (&,( #*&**+()*( #+(&% /( ?&*( %#*# , ,,+)**(. %= ,& ?( )*,&, &( +%&+,&)(+*& >, +%,#$%&, (/
40 , /( +%&+,&)(+*& )*/*:(( ,& /%# (%# 60. /% +(/ *$/*+( = $%+%# ,,+)%# +%/(),(/,#. E& ,/ +(#% , /%# $%,#)(,&%# #, (& #,/,++*%&(% (>,//%# (# #,/,+)*%# = ,&%# &%+*%# $(( ,/ %(&*#%. C%,+)(,&), )*/*:(%# )*,&,& &( ,*+(+*( ,/ 99. S,& # +%*&(+*& %%&(/ #, $,,& +/(#**+( ,&" M%&%(#*+%# @*(/ +%&+,&)(+*& , /%# ,#),&%# = $%,#)(,&%# ,& )%(# /(# $(#)*//(#. B*#*+%# @11 $(#)*//(# +%&)*,&,& &( +%&+,&)(+*& *,,&), ( /(# 10 ,#)(&),#. T*#*+%# @#, ,#)=, /( +%&+,&)(+*& ,&), ,)($(# E*#),& %# $,#,&)(+*%&,# , 21 = 28 $(#)*//(#. E#)(# ,#)& &,((# % (+((# +%& /%# ?(# , /( #,(&(. L(# $*,(# +%&)*,&,& 21 $(#)*//(# ,>**,&% , 7 ?(# , ,#)% $(( *&*+*( ,/ &,% #%,. L( #,&( )*,&, 21 $(#)*//(# , & +%/% >, +%,#$%&, ( /(# >, +%&)*,&,& %%&(# = 7 , %)% +%/% #%& $/(+,%< ,# ,+* &% $%#,,& ,*+(+*&. E#)% *$/*+( >, &( ,: ),*&(% ,/ #%, #, *&*+*( ,/ #**,&), $,#,&)(% ,/ #(&(% ,&#)(/ (&), /( )%( , /(# $(#)*//(# $/(+,%< $,),&*,&% >, /( #(*( &% $*,( /( +%#), , /( )%( *(*( S, ,, ,+%( >, /(# #*,), $(#)*//(# , %)% +%/% ,& /(# $,#,&)(+*%&,# , 28< &% #%& (&)*+%&+,$)*%#< #%& $/(+,%#. -%ormonales orales combinados< $,*,&, ,/ ,((:% &% ,#,(%< &(,&)(/,&), ( )(# , *&** /( %/(+*&. S ,+(&*#% , (++*& ,# , *&+* +(*%# ,& /( +%&#*#),&+*( ,/ %+% +,*+(/< %(&% &( (,( >, *$*, ,/ $(#% , /%# ,#$,()%:%*,#. E& ,/ $*, +*+/% , )()(*,&)%< ,, *&*+*(#, ,&)% , /%# $*,%# +*&+% ?(# ,/ +*+/% ,&#)(/. E/ &,% , )(/,)(# ( )%( ,$,&, , /( $,$((+*& (&)*+%&+,$)*( ,$/,((. E& /(# $,#,&)(+*%&,# , 28 )(/,)(# % (,(#< #, *&*,, &( *(*(,&), (&), 28 ?(# +%&#,+)*%#. L%# +*+/%# ##,+,&),# ,,& *&*+*(#, (/ +%&+/* ,/ +*+/% $,*%< *&,$,&*,&),,&), , +(&% #, $,#,&), ,/ #(&(% ,&#)(/. E& /( $,#,&)6(+*%&,# , 21 )(/,)(# % (,(#< #, *&*,, &( *(*(,&), (&), 21 ?(# +%&#,+)*%#< #,*%# , #*,), ?(# , ,#+(&#%< #*& ,*+(+*&. L%# +*+/%# ##,+,&),# ,,& *&*+*(#, (/ +%&+/* /%# 7 ?(# , ,#+(&#% ,/ +*+/% $,*%< *&,$,&*,&),,&), , +(&% #, $,#,&), ,/ #(&(% ,&#)(/. INDICACIONES L( *&*+(+*%&,# , /%# %%&(/,# %(/,# +%*&(%# #%&" M',,# +%& ,( )*/ +%& *( #,(/ (+)*(< &/*,#)(#< &/?$(( % /)?$((#< ,#, /( ,&(>*( (#)( /%# 39 (%# , ,(< >, ,#,(& $%),++*& (&)*+%&+,$)*( ),$%(/. M',,# ,& ,/ P%#)(%)% M',,# ,& ,/ $#)(%)% % $%#+,#(,(< &*+(,&), +(&% &% ,#)& /(+)(&% L( %,#*( &% ,# &( ,#)*++*& $(( ,/ #% , ,#), )%%.
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ormonales orales de progestina . S%/% ,#)%# &% *&*,& /( %/(+*& = # ,,+)%
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
M',,# /(+)(&% ,& ,/ $%#)$()% % $%#)+,#(,( >, ,#,(& & )%% (&)*+%&+,$)*% ),$%(/ = >, &% (=(& (+,$)(% ,/ #% ,/ DIU ,*+(% +%& +%,; ,& ,#), +(#% /( (*&*#)(+*& #, ,& /( #,)( #,(&( $%#),*% (/ ,,&)% %#))*+%. A/ ##$,&, /( /(+)(&+*( #, $,, ,+%,&( %)% )%% (&)*+%&+,$)*%. M', ,& ,/ $%#)$()% /( (*&*#)(+*& #, $,, *&*+*( , *&,*()%.
CONTRAINDICACIONES E((:%< #%#$,+( , ,((:%. *$,),&#*& (),*(/ #,,( @(=% 160100 . +%& % #*& ,&,,( +(*%(#+/(. C(*%$()?( *#>,*+( C&+, , ((. S(&(% (*&(/ , ,)*%/%?( &% ,),*&((. EFECTOS SECUNDARIOS A/&(# ',,# $,,& $,#,&)( *,/(*(,# ,&#)(/,# +%%" ,%(*(< (&+(% $,#*#),&), % (,&%,(. P,*( , $,#% % (,&)% ,& (/&%# +(#%#. D,$,#*&< +(?( , +(,//%< +(&#(&+*%< %/% ((*%< (=% ($,)*)%< ,&% *$/#% #,(/. C,(/,( % (#)(/*(. @&% )%%# ,#)%# #*&%# = #?&)%(# $,,& ()*?#,/%# (/ )%%. P% /%# >, ,# +%&,&*,&), ,+** &( %*,&)(+*& , # ,*+%.
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L%# (&)*+%&+,$)*%# %%&(/ *&=,+)(/, ,$,#,&)( &( %$+*& ,,+)*( = #,( $(( (>,//(# ',,# >, ,>*,,& $%),++*& ),$%(/< = )*,&,& (& (+,$)(*/*(
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a formulación combinada 'ue contiene progestina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
EFECTOS SECUNDARIOS E& (/&(# ',,# $,, $%%+( *,/(*(,# ,& ,/ #(&(% ,&#)(/ = (,&%,(. T(*& $,,& #* & *&+,,&)% , $,#%< +,(/,(< **)(*/*(< &(#,(#< (,% % (#)(/*(. -(ormulaciones 'ue contienen progestina< >, *&(& $%),++*& (&)*+%&+,$)*(
(&), %# ,#,#; /( %/(+*& (# )*/*:(( +%&)*,&, ,&(&)()% , &%,#)*#),%&(. L( (*&*#)(+*& , ,&(&()()% , &%,)*#),%&( #, ,(/*:( $% ?( *&)(#+/( $%&( ,& /( ,*& /),(. L( $*,( *&=,++*& ,, ($/*+(#, ,& +(/>*,( , /%# $*,%#7 ?(# ,/ +*+/% ,&#)(/ = /( $%),++*& (&)*+%&+,$)*( ,# *&,*()(. L( *&=,++*%&,# ##,+,&),# ,,& , ($/*+(#, +(( %# ,#,#< (# % ,&%# &( #,(&(< *&,$,&*,&),,&), , +(&% #, $,#,&), ,/ #(&(% ,&#)(/< E& ,/ $%#)$()% % $%#)+,#(,( /( ($/*+(+*& , NET-EN #, ,, *&*+*( ,& /( 6K #,(&( ,#$# ,/ ,,&)% %#))*+%< *,&)(# >, ,/ P%#)(%)% $,, ($/*+(#, *&,*()(,&),. INDICACIONES E& ',,# ,& ,( )*/< +%& *( #,(/ (+)*(< &/*,#)(#< &/?$((< /)?$((# *&+/=,&% (%/,#+,&),#< >, ,#,(& &( $%),++*& (,+((. E& ,/ $%#)$()% % $%#)+,#(,( >, $% (/&(# +*+&#)(&+*(# &% (=(& ( ( /(+)(&+*( (),&(< % >, (& /(+)(&+*( (),&( = >, &% (+,$)(%& ,/ #% ,/ DIU ,*+(% +%% & )%% ),$%(/; ,& ,#), +(#%< /( (*&*#)(+*& *&=,+)(/, #, *&*+*( ,& /( 6K #,(&( $%#),*% (/ ,,&)% %#))*+%< /( %,#*( &% +%&#)*)=, &( ,#)*++*& $(( ,/ #% , ,#), )%%.. P%#)(%)%. M',,# ,& >*,&,# ,#)( +%&)(*&*+(% ,/ #% , ,#),&%#< +%% ,& ,/ +(#% , *%>*#)*+( , (( < +&+, , ,&%,)*% % , %(*%. E&,,( )%% ,%/*+( % *$,),&#*& (),*(/ /,, % %,(( @14015090-99 .. CONTRAINDICACIONES C&+, , ((. E((:% #%#$,+( , ,((:% % ,#,% , ,((:% ,& /%# $*%# 6 ,#,#. *$,),&#*& (),*(/ #,,( +%& % #*& ,&,,( +(*%(#+/(. C(*%$()?( *#>,*+(. S(&(% (*&(/ , ,)*%/%?( &% ,),*&((. EFECTOS SECUNDARIOS E& ,/ $*, (% , #% #, $,, $,#,&)(" #(&(%# ,&#)(/,# *,/(,# = (,&%,(. @/%# +(/,# &% $,#,&)(& *,#%# *$%)(&),# $(( /( #(/.
( >, (= &( (/),(+*& ,& # ,&#)(+*&< (/&(# ',,# ,'(& , ,&#)( $% & )*,$% @,)(#% ,&#)(/ A,&)% , $,#% +%$%(/. C,(/,(< **)(*/*(< (#)(/*(< (,%#< ()*( % (+&,. P,, +(#( ,%(# (/ )()( , ,((:(#, ,#$# , ##$,&, /(# *&=,++*%&,#. L%# ,,+)%# #,+&(*%# &% $,,& ,,)*#, (#)( >, /( ,*+(+*& *&=,+)(( ,#), +%$/,)(,&), +%&#*( @(#)( /(# %+, #,(&(#
26 IMPLANTES SU0DERMICOS DE DEPÓSITO E#)& +%$,#)%# #%/% $% $%,#)(,&%# *#$,#)%# $(( &( (+*& , 5 (%#. S, ($/*+( +%& /( ,&#)(+*& % *% 7 ?(# ,#$#. P%#)$()% # ($/*+(+*& ,# ($()I , /(# 6 #,(&(#. S (++*& (&%/()%*( *&*+*( ( /(# 24 %(# , *$/(&)(%. S, *$/(&)( #,*+(,&), ,& /( $(), *&),&( ,/ (:%. INDICACIONES E# &,+,#(*% &( +%&#,',*( (&),# , ($/*+(/% CONTRAINDICACIONES T%% ,*+(,&)% >, #, L,%&%,#),/ *#*&=, /( ,,+)**( ," (*)*+%#< ,&*)%*&(#< ,&*/)(:%&(< *#%&*(+*( = *($*+*&(. EFECTOS SECUNDARIOS
A/),( /%# $()%&,# &%(/,# , /( ,&#)(+*& @,#$,+*(/,&), (&), ,/ $*, (% A,&)% , $,#% A+&, % (,&)% , ,//% (+*(/. C/%(#(< ,$,#*& = %/% , +(,:(
$or 9a intraainal 4 trans"7rmica, A"(llo !:("!l ) el P!rc;e 2 ANILLO VA5INAL El !"(llo !"t(co"cept(o !:("!l ,# & &%,%#% )%% (&)*+%&+,$)*% = #,&+*//% , )*/*:( = #(,&), ,,+)*%< ,#) ,/(%(% ,& & (),*(/ )(&#$(,&), = /,*/, $(( $%, #, *&#,)(% #*& $%/,(# ,& ,/ *&),*% , /( (*&(. L( &+*& >, +$/, ,# /*,( $os(s $e estr+:e"o ) pro:estero"! (/ %(&*#%< /(# +(/,# *&*,& /( %/(+*& = %**+(& /( +%#( ,/ +,//% ),*&% $(( >, **+/), ,/ $(#% , /%# ,#$,()%:%*,#. E/ (&*//% (*&(/ #, #( $% tres se%!"!s co"sec#t(!s< #*& ,)*(/% #*&% (#)( /( +()( #,(&(< #, ,'( & /($#% , 7 ?(# $(( #,*(,&), *&#,)( & &,% (&*//%. E#), )%% (&)*+%&+,$)*% ((&)*:( & 92 (/ 99.7 , ,,+)**( = +(( (&*//% $%,, & ,# , ,,+)% (&)*+%&+,$)*%.
Mo$o $e #so $el !"(llo !:("!lS, *&#,)( ,& (&*//% (&), /%# $*,%# 5 ?(# , /( ,/( % *,& /%# $*,%# 5 ?(# ,#$# , & (%)%. L(# ',,# >, /% #(& $% $*,( ,: ,# +%&,&*,&), >, (&), /( $*,( #,(&( , +%/%+(%< ),&(& ,/(+*%&,# #,(/,# +%& +%&&. L( coloc!c(+" ,/ (&*//% ,# #,&+*//(< =( >, &% #, )()( , & )%% , (,(. P(( $%, *&#,)(/% +%(,&), /% ,+%,&(/, ,# (+%#)(#, %+( (*( +%& /(# %*//(# (*,)(#< ,& ++/*//(# % *,& $((#, = ,/,( &( $*,&(. S, ,, , )%( /%# ,),%# ,/ (&*//% %(&% & %(/% = ,$'(/% #(,,&), ,&)% , /( (*&(< (#)( >, =( &% #, #*,&)( # $,#,&+*(. P(( ,)*(/% #%/% (#)( +%& ,&(&+(/% +%& ,/ ,% = '(/(/% (+*( (,(. E& +(#% , >, ,/ (&*//% #, :(, , /( (*&(< #*$/,,&), (= >, /((/% +%& (( )**( % ?( , *&)%+*/% &,(,&),< = #* #, ( $,*%< (= >, *&#,)( &% &,% /% (&),# $%#*/,< $,% ),&*,&% ,& +,&)( >, #* $(#(& # , ),# %(#< ,/ $%, +%&)(+,$)*% ,( = (= $%#**/*(,# , ,((:%.
2 PARC9E CUT=NEA E/ $(+, +)&,% +%&#*#), ,& & $(+, (,#*% $,>,% @1.75 $/((# +(((# >, #, +%/%+( ,& /( $*,/ $(( ,*)( >, %+( & ,((:%. C%& ,/ $(+,< ,/ ,#),&% = /( $%,#)*&( #, (#%,& ( )(# , /( $*,/ (#)( $,&,)( ,/ /'% #(&?&,%. E/ $(+, $,, %,+, +%# , /%# *#%# ,&,*+*%# = +%&//,( /%# *#%# *,#%# , /(# $?/%(# (&)*+%&+,$)*(# +%*&((#. U&( ,: >, &( ', %)*,&, &( ,+,)( $(( ,/ $(+,< &% )*,&, >, (+* (/ *+% $(( ($/*+(/% &* ,)(,/%. E/ $(+, $,, +%/%+(#, ,& /(# &(/(#< ,/ $,+% @,+,$)% ,& /%# #,&%#< /( $(), #$,*% , /( ,#$(/( % ,/ (:%< % ,& ,/ (%,&. D,, +%/%+(#, ,& & /( &,% +(( #,(&( $(( ,*)( **)(+*%&,#. E# &,+,#(*% #( & $(+, &,% +(( #,(&( $(( & )%)(/ , 3 #,(&(# +%&#,+)*(#. D(&), /( +()( #,(&(< #, ##$,&, ,/ #% ,/ $(+, = %+, ,/ $,?%% ,&#)(/. A/ +(% , /( +()( #,(&(< #, +%/%+( & $(+, &,% = ,/ +*+/% #, ,$*),. A&>, ,/ $(+, +%*,&:( ( (+)( *&,*()(,&),< #, ,, #( & )%% (&)*+%&+,$)*% , ,#$(/%< +%% & +%&&< (&), /( $*,( #,(&( ,/ $*, +*+/%. E/ $(+, $%?( #, ,&%# ,*+(: ,& /(# ',,# >, $,#(& # , 198 /*(#.
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*# METODOS (RRRE'ERS(BLES O DEF(N(T('OS
S%& (>,//%# >, (/ ,(/*:(#, *,& #,( /( (#,+)%?( @%, % /*(( , )%$(# @', ,*)(& $,(&,&),,&), = ,*&*)*(,&), /( ,+&(+*&. R,>*,, , &( *&),,&+*& >**+( , +(+), (/()%*%.
34 LI5ADURA DE TROMPAS S, ,(/*:( ,& /(# ',,# , (&,( %/&)(*(< =( >, $(( ,(/*:( ,#)( *&),,&+*& >**+( ,>*,, , &( ()%*:(+*& $% ,#+*)% $% /( $(+*,&), = /,(/,&), &% ,# &,+,#(*( /( ()%*:(+*& , # $(,'( = +%&#*#), ,& /*( = +%)( /(# )%$(# ),*&(#. L% +(/ *$*, >, ,/ /% #,( ,+&(%< &% *&/=, ,& # #,(/*(< $% ,/ +%&)(*% $%?( #, ,'% =( >, #, ,# +%&#*,&), , &% >,( ,((:((. INDICACIONES P(*( #()*#,+( R*,#% ,$%+)*% @,*,, ( (>,//(# ,&,,(,# >, $%&(& ,& $,/*% /( *( , /( (, +%& & ,((:% E((:% CONTRAINDICACIONES N% (= +%&)(*&*+(+*&< ,+,$)% +(&% ,*#), *&,++*& (+)*( (&), ,/ $%+,**,&)%. E& )(/ +(#% #,*( *,*/,. E&,,( *&/(()%*( $/*+( (+)*(.
EFECTOS SECUNDARIOS O+(#*%&(/,&), $,,& $,#,&)( *&,++*& % ,%(*( $%#)>**+(. D,#$%',# ,/ $%+,**,&)% /( #(*( ,, ,#)( ,& %#,(+*& $% & $,*%% , 2 ( 6 %(#.
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
L,#*%&,# ,#+%)(/,# $,,*#),&),# T,#)?+/% &% ,#+,&*% C(&% #, )*,&, $%/,(# $#*+%/*+%#" *$%+%&?(+%#< *$%),&+*( % %%#,(/*#%.
EFECTOS SECUNDARIOS E#)(# #%& $%$*(# , /( +*?(< $,,&*/,# ,& (& $%+,&)(',. C%$,&, /%# ,()%(#< *&,++*%&,#< ,$****)%# = /%# (&/%(#. S*& ,(% #, ,#)& ,(/*:(&% )+&*+(# %,&(# #*& ,/ ,>,**,&)% , #)(# *#*&=,&% #*&**+()*(,&), /(# +%$/*+(+*%&,#. P%/,(# $#*+%/*+%# ,/(+*%&(%# +%& ,/ +%$%)(*,&)% #,(/ $,,& #, (((%#.
5LOSARIO A"t(co"cept(o- E# +(/>*, (++*&< *&#),&)% % ,*+(+*& ***% ( ,*)( /( +%&+,$+*& % ,/ ,((:% *(/,. Co(to ("terr#%p($o- )+&*+( (&)*+%&+,$)*( ,& /( +(/ ,/ %, ,)*( ,/ $,&, , /( ('*&( (&),# , /( ,=(+/(+*&. E#)( )+&*+( &% ,# #,( +%% )%% (&)*+%&+,$)*%. Co"cepc(+"- ,+&(+*& , & /% $% & ,#$,()%:%*,< #,*( , /( *$/(&)(+*& ,/ /(#)%+*#)% ,#/)(&), ,& /( +%#( ,/ ),%. Co"$+"- )%% (&)*+%&+,$)*% ),$%(/ = , (,( >, )*/*:(& /%# %,#; )*,&, /( %( , &( *&( (*&( , %( % , $/#)*+% @#, +%/%+( ,&+*( ,/ $,&, +(&% ,#) ,,+)% = (&),# ,/ +%*)%; #, )*/*:( & +%&& $(( +(( ,/(+*&. D(spos(t(o ("tr!#ter("o >DIU?- *#$%#*)*% ,+&*+% >, #, *&)%+, ,& ,/ ),% $(( *$,* ,/ ,((:%. Erecc(+"- ,&,+**,&)%< *&+(:& = ,/,(+*& ,/ $,&,< %)*(% ,&,(/,&), $% ,#,% #,(/ % ,#)*/(+*& ?#*+(. T(*& #, $,, $%+* (&), ,/ #,% = #*& %)*% ,*,&), ,& +%# ',&,#.
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Testostero"!- %%&( #,(/ (#+/*&( # *$%)(&),. E#)*/( ,/ +,+**,&)% #,% = #+/( = ,/ ,#(%//% #,(/. E# $%+*( $% /%# ),#)?+/%#. Tr(co%o"(!s(s- *&,++*& , /( ('*&(< ( ,&% )(&#*)*( #,(/,&),< ,*( (/ $%)%:%% @%(&*#% , &( #%/( +//(. A,# , )(&#*)*#, (&), ,/ (+)% #,(/< ( ,+,# #, +%&)(, $% &( ,#$%&'(< )%(//(< % /( ', #, /% +%&)(*( ( # *'% ,& ,/ $()%. Tro%p!s $e F!lop(o- )% >, #, ,)*,&, ,#, ,/ ),% (/ %(*%. L( )%$( , F(/%$*% )(&#$%)( /%# /%# = ,#$,()%:%*,# = ,# ,/ /( %&, #, $%+, /( ,+&(+*&. tero- (&% #+/( ,+% ,/ ($(()% ,$%+)% ,,&*&%< ,& ,/ +(/ ,/ /% ,+&(% @,% #, *&+#)( ,& +%&*+*%&,# &%(/,# = ,& ,/ >, ,/ ,*& = ,/ ,)% ,& ,#(%//% #, &),& = +,+,&. E/ ),% ,#) #*)(% ,& /( +(*( $/*+(< ,)# , /( ,'*( = ,/(&), ,/ *&),#)*&%. V!&("!- +%&+)% #+/( >, %( $(), ,/ ($(()% ,$%+)% ,,&*&% = >, +%&*+( ,/ +* @+,//% ,/ ),% +%& /%# ,&*)(/,# ,),&%#. L( ('*&( )*,&, &( /%&*) , 7 ( 10 +,&)?,)%# = # $(, $%#),*% ,# /*,(,&), # /(( >, /( (&),*%. V!secto%'!- %$,(+*& $(( +%&#,* /( ,#),*/*:(+*& (#+/*&(. L( (#,+)%?( ,# &( *&),,&+*& , +*?( ,&%< >, +%&#*#), ,& +%)( (%# +%&+)%# ,,,&),#< /%# +(/,# )(&#$%)(& /%# ,#$,()%:%*,# , /%# ),#)?+/%# ( /(# ,#?+/(# #,*&(/,#.
0I0LIO5RAFIA LI0ROS
C%% %*,&)( ,& /( $/(&**+(+*& (*/*(. C(/,# (. E*)%*(/ P( M*+%. M*+% 13. $$. 50130.
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E&+*+/%$,*( , /( ,&,,?(. E*)%*(/ %+(&%< %/,& 4 (),&% *&(&)*/-1. $$. 622-644. E&,,?( M(),&(/. N. A. D*%&(< M. . M(G#< R. . E*+*& M+RAILL INTERAMERICANA EDITORES< S.A. , C.V.< A% 1998. $$. 39-60. F%(+*& C?*+( = Q)*+(. /%*( %/( C(#)%< %# L+*% V:>,: R,=&(< R*,( M((/,&( T*+(# R?%#. P$. 106-129.
