Types of pregnancy protection for women. Modern methods of contraception for women. Contraindications to the use of an intrauterine device
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Contraceptives
Contraceptives are traditionally divided into mechanical, biological and chemical. Different products naturally have varying degrees of effectiveness. Almost none of the methods of preventing pregnancy (except sexual abstinence) can give a 100% guarantee. Quite often, in order to achieve greater safety and reliability, various contraceptives are combined. However, it is best to select a contraceptive after consulting a gynecologist.
In this article we will talk in detail about the most popular types of contraception.
CONDOMS
Condom (condom) - made of latex (polyurethane). Placed on the male penis during an erection, before engaging in sexual intercourse. After ejaculation, the condom is immediately removed and discarded. In addition to its main purpose, this contraceptive also protects partners from most sexually transmitted sexually transmitted infections (syphilis, gonorrhea, AIDS, chlamydia, herpes, hepatitis B). The percentage of effectiveness of this contraceptive is quite high - 85-95%. However, not everything is 100%, because condoms can break and are sometimes used incorrectly.
SPIRAL
An intrauterine device (also known as an IUD, or commonly referred to as a spiral) is a convenient and highly effective device that is placed in the uterus. The spiral, despite its high percentage of effectiveness (98-99%), has a number of possible complications. For this reason, the IUD is not recommended for use by women under 23 years of age who do not yet have children. This product should only be installed and removed by a gynecologist after a medical examination. The advantages of the spiral include its long-term use - up to 5 years.
CONTRACEPTIVE PATCH
The principle of operation of the patch is that it is glued to a certain area of the body, and then hormones are absorbed into the body through the skin. The effect of this contraceptive is that the development of the egg is delayed and the viscosity of the mucus in the cervical area increases. Three patches are usually used per menstrual cycle, meaning one patch is applied for seven days. Next, you need to take a week's break, and at this time menstruation begins. The disadvantages of this method include the appearance of discharge (between cycles) and headache.
VAGINAL RING
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LONG-ACTING INJECTIONS
The method of protection using injections is to stop ovulation (the process of the release of an egg from the ovary) by changing the mucus in the cervical area, changing the mucous membrane of the uterine cavity itself, as a result of which the development of pregnancy is impossible. The contraceptive effect of this method lasts 3 months. However, this method also has a number of quite serious disadvantages. Problems with bleeding may occur, as well as swelling, headaches, and a decrease in the level of sexual desire. Also, with prolonged use of this method, bone tissue is destroyed.
NORPLANT
The Norplant contraceptive system is six small capsules that contain the hormone levonorgestrel (progestin). The capsules are installed under the skin, on the inside of the shoulder, after which the hormone gradually begins to be released into the blood. The contraceptive effect begins within a day and lasts for five years. It is achieved by changes in the endometrium, which lead to disruption of the process of attachment of the egg to the walls of the uterus. When using this implant, intermenstrual discharge may appear, the menstrual cycle may also be disrupted, depression, headaches, fluid retention in the body, acne and pain in the mammary glands may appear.
MALE AND FEMALE STERILIZATION
It should be remembered that sterilization is a method of irreversible contraception, which leads to complete infertility (however, even in this case we cannot talk about 100% reliability, because there is always a possibility that even the operation will not bring the desired result). Male sterilization is a fairly simple surgical procedure that involves cutting and then ligating the vas deferens. Female sterilization takes place in a hospital setting and involves cutting and ligating the fallopian tubes. Do not forget that, as with any other surgical operation, during sterilization there is always a risk of complications - bleeding, infection, adhesions.
DIAPHRAGM
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BIOLOGICAL REMEDIES
Biological contraceptives are a way to prevent pregnancy using hormonal contraceptives. With this method of contraception, a woman must take pills daily that contain female sex hormones. After their use, the general hormonal background changes, which in turn inhibits ovulation, changes the state of the intrauterine environment, preventing the possible occurrence of pregnancy. The effectiveness of hormonal contraception is 97-99%. There are combined oral hormonal contraceptives, that is, those that contain estrogen and gestagen, and non-combined ones, that is, those that contain only gestagen. You need to select a hormonal contraceptive with the help of a gynecologist. Since there are diseases for which the use of hormonal contraceptives is contraindicated.
MINI PILL TABLETS
These are hormonal pills that do not contain estrogens. Their effect is to increase the viscosity of the cervical mucus, which in turn makes it very difficult for sperm to pass into the uterus. Also, these drugs inhibit the maturation of the endometrium, as a result of which it becomes impossible for the egg to attach to the walls of the uterus for its further development. Mini-pills are taken without interruption for the entire time required to prevent pregnancy. The main disadvantage of this method is the slightly higher frequency (compared to other oral contraceptives) of breakthrough bleeding. Mini-pills are a solution for women who are contraindicated in the use of estrogens, including nursing mothers.
CALENDAR METHOD
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The beginning of the fertile phase described above is determined by subtracting 18 days from the shortest cycle, and the end by subtracting 11 days from the longest cycle.
Example:
The shortest cycle lasts 28 days, and the longest cycle lasts 30 days.
The beginning of the fertile phase is 28-18 = 10th day of the cycle.
End – 30-11=19th day of the cycle.
That is, from the 10th to the 19th day of the cycle, fertilization can occur, which means that on these days you need to use barrier contraceptive methods or abstain from sex altogether. The disadvantages of this method primarily include its unreliability, since initially it assumes a regular, constant menstrual cycle, which, unfortunately, not a single woman has.
TEMPERATURE METHOD
It is based on calculating the fertile phase by measuring basal (or rectal) temperature in women. You need to start measuring your basal temperature on the first day of your cycle. After waking up in the morning, without getting out of bed, you need to place the thermometer in the rectum at a level of 1-2 cm, and hold it there for 5-6 minutes. The data obtained must be entered into a special chart of your basal temperature. It should be remembered that throughout the entire period it is necessary to use one thermometer, and measure the temperature at the same time every day.
During the first half of the cycle, the basal temperature is usually below 37°C. 12-24 hours before ovulation, body temperature decreases by 0.1-0.2°C, and after ovulation it increases by 0.2-0.5°C (usually to 37°C or higher). And this temperature remains at this level throughout the second half of the cycle until the start of menstruation. The fertile period begins six days before the preovulatory decline and lasts another three days after it (the total duration of the fertile phase is 9 days).
The advantages of the temperature method of contraception include: ease of use; absence of any side effects; the most accurate determination of days of probable conception when planning pregnancy.
Disadvantages: high risk of unwanted pregnancy (because the level of basal temperature is influenced by a very large number of factors); the need to measure basal temperature daily.
SEXUAL WITHDRAWAL
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EMERGENCY (aka post-coital, fire) CONTRACEPTION combines methods of preventing unwanted pregnancy, which are used after unprotected sexual intercourse has taken place. Most emergency contraception can be purchased in pharmacies without a prescription and used independently, but we strongly recommend that you consult a doctor so that he can select the most optimal method of emergency contraception for you, check for contraindications to the chosen method and select the required dosage.
TYPES OF EMERGENCY CONTRACEPTION:
1) Douching
Douching with various solutions even immediately after unprotected intercourse is very ineffective, because sperm penetrate into the cervix within a minute after ejaculation. Also, do not forget that a small amount of active sperm can be released directly during sexual intercourse - with lubricant.
2) Hormonal contraceptives
The first way to use hormonal contraception is to simultaneously take several types of COC tablets (combined oral contraceptives). The number of tablets required for taking is based on the dosage of the level of hormones in the drugs: Miniziston, Rigevidon, Femoden, Marvelon, Microgynon, Regulon - two times four tablets (interval between taking 12 hours), Logest, Mercilon, Novinet - two times five tablets. This method is called the Yuzpe method and it is effective for three days after unprotected sexual intercourse. The effectiveness of this method is not very high - 75-85%.
The main advantage of this method is its accessibility, since all drugs are sold in any pharmacy without prescriptions. Side effects after use - nausea, pain in the mammary glands, vomiting, dizziness, headache.
An alternative to COCs are drugs that contain only progestins and do not contain estrogens. The most effective drugs of this type are Escapelle and Postinor. Escapelle contains 1.5 mg of the hormone and is used once. Postinor contains 0.75 mg of levonorgestrel and must be used twice with an interval of 12 hours. Minor side effects that may be caused by hormonal emergency contraception usually go away within two days.
It must be remembered that after using emergency hormonal contraception methods, it is imperative to use additional methods of contraception until the next menstrual cycle: spermicides, condoms, etc.
3) Non-hormonal emergency contraception
Mifepristone (Gynepristone) is one of the most effective emergency protection drugs. A single dose of this drug within three days after unprotected sexual intercourse causes a slowdown in ovulation (this process depends on the phases of the menstrual cycle), changes in the endometrium, and also prevents the attachment of a fertilized egg.
This drug has fewer side effects - for example, the incidence of bleeding is only 15%, compared with 31% with levonorgestrel. The effectiveness of this method of emergency contraception is 98.8%. The advantages of this method include the fact that it can be used for a longer period compared to other means of emergency contraception, and also that after taking it there are practically no hormonal-dependent side effects.
4) Intrauterine devices
Another way to protect against unplanned pregnancy is to use an intrauterine device (IUD). To achieve the desired effect, copper-containing IUDs are inserted within five days after unprotected sexual intercourse.
Emergency contraception is an alternative to abortion, but it is strongly not recommended for use as permanent contraception, but only in “emergency” situations (maximum once every six months). Since frequent use of emergency contraceptive methods can lead to disruption of a woman’s reproductive functions.
On World Contraception Day, we decided to throw you an honest article about birth control. You can read it yourself, or you can give the link to your wife, girlfriend or wife's friend - depending on which of them is at risk of getting pregnant from you.
Sergey Titov · Alexander Lozovsky
First a mystery. Let's say you have a hundred women. Of these, you gave a third into sexual slavery to the editorial office of the magazine (by the way, thank you). And of this third, another third are black. Attention, question: what is the Pearl index? Right. This is an index of failures, showing how many women out of a hundred, using the chosen means of protection for a year, will eventually become pregnant. The lower it is, the better the product. For example, for condoms this index is up to 12, which is quite a lot. What does black concubines have to do with it, you ask. Yes, the image is beautiful.
We collected the data on the Pearl index in a table, and described the remaining pros and cons of all known contraceptives (both male and female) in detail.
1. Condoms
Better than anything they protect against infections. Efficiency - 85-90% (less only for mycoplasmosis and herpes).
Safe, even indifferent to health, if you are not allergic to latex.
They need to be bought, kept in your pocket and put on on time (according to the Sanders-Graham-Crosby study, 50% of women do not have this skill: they put their partner in protection after the start of the act).
There is nothing to add to what has been said. Just to get a little boring. According to science, to achieve an impressive 95% effectiveness of a condom, you need to:
● inspect the condom packaging for damage;
● do not put it on inside out...
● ...and on the erect penis, to the end (follow me, Beavis, we said “end”!);
● always leave a spout at the end to collect sperm (you will be surprised, but this actually somehow increases the effectiveness of your latex friend);
● use exclusively water-based lubricants (leave butter to the heroes of “Tango in Paris”).
2. Barrier contraception
In our editorial office, full of hypocrites, and even Old Believers, there was not a person who could, without embarrassment, write down all the words of the expert on female contraception Tatyana Kaznacheeva, Ph.D., Associate Professor of the Department of Reproductive Medicine and Surgery of the Faculty of Education and Science of Moscow State Medical University. Therefore, warn your woman: it is better to get information about suppositories and sponges not from a men's magazine or even from a women's magazine, but from a conversation with a personal gynecologist. However, we learned something. The diaphragm and the female condom, according to Tatyana, have not taken root in our country, despite the fact that “this rare condom, due to its larger surface area, is capable of protecting against STIs to a greater extent than the male condom.” Well, as for spermicidal products (creams, vaginal tablets and suppositories), their only advantage is their availability. There are at least three disadvantages.
Spermicides can cause irritation and allergies not only for her, but also for you.
They are so ineffective that young anemones are not recommended to use them at all due to frequent misfires.
Most products need to be administered 20–30 minutes before the act and renewed with each subsequent one, and this is not always convenient.
3. Vasectomy
This method, with a stretch, can also be classified as a barrier method, only the barrier to the sperm is not foam tablets and latex, but your surgically tied vas deferens. Vasectomy does not affect sperm count, which is something that lovers of sperm count will appreciate.
Contraception is always with you, it does not require you to download new firmware and generally take care of its maintenance.
A vasectomy is only suitable if you have already had some children. Because it may not work out anymore...
- ...since reconstructive surgery is a procedure several orders of magnitude more complex than basic knot tying. Its result is unpredictable. It often happens that it is completely impossible.
4. Female sterilization
Almost one hundred percent effective.
One operation for life.
It is regulated by law and even in our liberal (ha ha) country it is prohibited for nulliparous women under 35 years of age.
A real operation - with preparation, hospitalization, anesthesia.
Conditionally irreversible. Reconstructive surgery is possible, but there are a lot of reservations.
There is, however, a method of reversible sterilization, when spiral-shaped devices are inserted into the mouths of the fallopian tubes, making it impossible for the egg and sperm to rendezvous. But this method is not widespread in our country, to put it mildly.
5. COC tablets
Few side effects. With continuous use for two years or more, they reduce the likelihood of developing various female diseases. No new ones are added.
Long history of observations and quality control: tablets have been used in the civilized world for 50 years.
They require daily intake and, as a result, the presence of a certain amount of gray matter in a woman’s head. If the dosage regimen is violated, COCs lose effectiveness.
They are not subject to strict male control: it is impossible to understand by the type of pills what your woman is drinking - contraceptives or glycine, which means that deception and intrigue are likely (well, suddenly).
Bad reputation: if your woman has decided that she will not “go on hormones,” then it will be logically impossible to convince her. Moreover, side effects like weight gain and headaches do occur even with the most modern wheels. True, noticeably less often than with “classical” drugs.
If your woman is prejudiced only by the form of release of combined contraceptives, you can offer her a skin patch or vaginal ring. You don’t even have to blatantly lie that these remedies are more gentle and less hormonal. This is often true. Oh yes, there are also mini-pills! These do not contain estrogens at all, and besides, they are more harmless purely visually - due to their size.
Combined contraceptive male educational program
Gynecologist, Ph.D., Medical Adviser, MSDPharmaceuticals LLC
COOK
Pills containing the female hormones estrogen and progesterone should be taken daily for three weeks, then take a week's break during which menstruation occurs. The main mechanism of action is suppression of egg maturation. There are pills that do not contain estrogen, they contain analogues of progesterone (one of the female hormones) and are just as reliable as combination pills. Such drugs may be recommended for breastfeeding women or those for whom estrogens are contraindicated. The tablets are often packaged in a blister with a picture of flowers, but this is not necessary. They look like any other small tablets.
Patch
It also contains analogues of two female sex hormones. The patch, measuring 4.5 by 4.5 cm, is self-adhered by the woman to a clean, dry butt. That is, sorry, skin. The mechanism of action is the suppression of ovulation. The color is beige and does not peel off by itself.
Flexible vaginal ring
Designed on the principle of a multilayer membrane. Continuously releases minimal (due to localization they should not be large) doses of estrogen and progestogen, which are absorbed into the blood through the mucous membrane of you know what. It couldn’t be simpler: a flexible ring with a diameter of 5.4 cm is inserted by the woman herself, you know where (following the example of a tampon). The location of the ring does not affect its effectiveness. The ring remains inside for three weeks, and, like a cat’s litter box, it’s best not to forget to change it. There is a one-week break between the removal of the old and the introduction of the new. The ring effectively suppresses the release of the egg. By the way, as private surveys show, some people really like it when their partner knows where (in none of our articles has this bashful euphemism been repeated such a terrifying number of times. - Editor's note) there is such a nice ring. This supposedly improves the sensation.
6. Injections and implants
The merciless need to take pills every day often leads to truly Zen riddles like “I forgot to take them for three days. Can I take three pills at once now?” In order not to answer endless questions from endless forum visitors, doctors came up with long-lasting solutions.
Long-term effect: 3 months for injections and up to 5 years for implants.
They do not require feats of self-discipline. Injections need to be done quite rarely, which the organizer or secretary will always remind you of - after all, she is also interested in this.
All procedures are invasive and require a visit to the doctor. You can theoretically cope with an intramuscular injection, but not with subcutaneous implantation.
No matter how few side effects modern drugs cause, in this case they are irreversible: if the injection is given and something goes wrong, then the entire duration of the drug will expire.
7. Intrauterine devices
The effectiveness of some “spiral” solutions is up to 99%.
It’s very convenient to use: set it and forget it. Moreover, not for myself, but for her. And you have nothing to do with it at all. Although no, you will have to periodically monitor the position, forgive the details, of the “antennae” of the intrauterine device and monitor the service life. However, this mission is also unlikely to be entrusted to you.
Can be used as early as six weeks after birth. You're so paranoid.
There are no draconian restrictions on age and smoking, characteristic of COCs.
Any foreign object in the body reduces local resistance to infection and gladly aggravates and aggravates its course, if it has already appeared. This also applies to the spiral.
Your partner can no longer catch an STI. That is, both you and all her other men are now required to use condoms. So give them all this magazine - let them know that this is not a joke, and generally photocopy the article.
Conventional copper intrauterine devices can, especially at first, cause discomfort, pain and all sorts of bleeding. Expensive hormonal systems like Mirena are almost devoid of such effects; their main disadvantage is the price, that is, the only parameter of the IUD that, for once, concerns you.
There is one more important point to remember. This hellish remedy is famous for one unpleasant fact: pregnancy is still possible when using it. The sperm unites with the egg - life actually begins, but things do not go further than that. The resulting zygote cannot adhere to the wall of the uterus due to the local effects created by the spiral, so in some cases it does not care about the health of the mother and nests wherever it wants. It's called an ectopic pregnancy, and it's no laughing matter. Go to the hospital immediately!
8. Natural methods
They are always with you, you don’t need to buy them at the pharmacy. That is, you only pay with them for sex!
Most so-called natural contraceptive methods do not work at all and are based on myths. Even for interrupted coitus, the Pearl index is very high, and for other tricks and subterfuges it is even higher.
Again, there are studies showing the harm of interrupted intercourse for prostate health. They are not supported by the proper apparatus of evidence, but they are still somehow alarming.
“I have safe days”, “She is breastfeeding. I read somewhere that it is possible”, “I went to the sauna, and sperm remain alive only at temperatures below 36 degrees” - what phrases do not resonate with joy in the hearts of irresponsible partners! Some even still believe in a lemon stuck in you know where (that’s it, this phrase will not be used again), and that you can’t get pregnant in the cowgirl position. Ha! I wouldn't believe it! Cash costs - zero. Zero hassle. Guarantees - well, let's say, not zero, but they are rather absent, if the word “guarantee” is correctly understood.
In general, natural methods are among the most unreliable. Indeed, overheating of the scrotum sometimes prevents conception. And during the period of breastfeeding or severe stress, some women experience confusion and even complete loss of the ovulation mechanism. However, you should not rely on these vagaries of nature. Cunning spermatozoa are contained not only in sperm, but also in lubricant; they live in the communication routes, sometimes for ten days in a row (that is, they can hold out and greet the dawn of a “dangerous” day with a whoop). Do not consider all these dances with tambourines as serious methods of contraception and turn your attention, for example, to the most reliable method, according to experts. We saved it for last, of course.
Conclusion
Just so you know, our consultants tried not to use the word “contraception” at all. Allegedly, there is a connotation of undesirability in it, and it should say “family planning.” Because the thing here is this: today you don’t plan it, but tomorrow amniotic fluid may well hit your head.
Therefore, in most cases, especially with unfamiliar partners with whom you don’t even plan to have breakfast yet, doctors recommend using the “double Dutch method.” This is when a woman drinks COCs and a man uses a condom. Even in the case of the most chaotic lifestyle, such a tandem brings to zero not only the likelihood of pregnancy, but also the risk of contracting an STI.
Well, if you both realized that children are exactly the reason you need to take out another consumer loan from the bank, you can always abandon the Dutch method.
Contraceptives are divided into several types:
- barrier,
- chemical,
- hormonal (including mechanical hormone releasers),
- intrauterine devices,
- sterilization.
Reliability of contraception- this is the probability of not getting pregnant within a year if you constantly (and correctly) use this contraceptive. This Not the likelihood of becoming pregnant after one sexual intercourse.
For example, 98% reliability for male condoms means that if 100 women protect themselves using (correctly worn) male condoms at every sexual intercourse for a year, then no more than 2 of them will have a chance of getting pregnant in that year, of which -for various failures. Of course, all such reliability calculations are only approximate.
All contraceptive methods except sterilization have limited reliability, since each method has failures. How to achieve greater security? Firstly, when using two methods of contraception at the same time, reliability increases dramatically, because it is extremely unlikely that two methods at the same time will fail. Secondly, if there is an obvious contraceptive failure such as a broken condom, you can use emergency contraception, otherwise called post-coital pills.
Barrier contraceptives
Barrier contraceptives prevent live sperm from entering the uterus. They do not have long-term effects on the body of a woman or man. These include:
- male and female condoms,
- vaginal diaphragms and
- cervical (cervical) caps.
The condom is the most important means of contraception at the moment, because when used correctly, it reliably prevents not only pregnancy, but also the transmission of infections, including HIV and hepatitis.
Disadvantages: requires a stable erection; may tear.
The use of a condom is under the control of the man, while the negative consequences of improper use - unwanted pregnancy - mainly fall on the woman. Both partners are at risk of contracting sexually transmitted diseases (STDs).
Many men refuse to use condoms, believing that they reduce the intensity of sensations, obviously without comparing them with the intensity of sensations a woman experiences during an abortion. In fact, there are condoms with special surfaces that improve the sensation of both partners, which are recommended even for men who have difficulty achieving orgasm.
Condoms are also used to protect against the transmission of infections during oral and anal sex.
Reliability: 98%
Female condom – a polyurethane tube with a diameter of 8 cm and a length of 15 cm. Placed in the vagina and protects the mucous membranes of partners from direct contact.
Like the male condom, it prevents pregnancy and the transmission of infections. Can be used for weak erections. May remain in the vagina for several hours.
Disadvantages: currently not sold in Russia.
Reliability: 95%
Vaginal diaphragms and cervical caps.
Caps and softer elastic diaphragms made of various materials (silicone, latex) are used in conjunction with spermicidal ointments. They are placed in the vagina so as to prevent sperm from entering the uterus, and are removed no earlier than 6 hours after the last ejaculation. Reduce the risk of transmission of certain infections. Does not prevent HIV infection. Can be used repeatedly (usually for 1-2 years). To choose the appropriate cap or diaphragm size, you need to consult a gynecologist.
Disadvantages of caps: Less effective for women who have given birth. You need to re-size after giving birth. May cause inconvenience to partners.
Disadvantages of diaphragms: You need to reselect the size after childbirth and with a significant (from 5 kg) change in weight. May increase the risk of certain infections and inflammation of the cervix.
Reliability: 85-95%.
Chemical contraceptives
These include vaginal creams, suppositories, tampons.
One of the easiest to use means, which also have not only contraceptive properties, but also protect against bacteria and viruses, in particular against chlamydia, staphylococci, herpes type 2. However, this type of contraception is more suitable for people who have irregular sex life , since the antiseptic not only destroys sperm and kills some viruses, but also disrupts the microflora, which can cause vaginal dysbiosis. It is best to use these products in combination with a condom, because their duration of action is short (with the exception of tampons) and repeated intercourse requires reintroduction of the contraceptive. It is also important to remember that upon contact with soap (with any alkaline medium), the active substance of the drugs is destroyed, so all washing before and after sexual intercourse is possible only with clean water.
Chemical contraceptives: Pharmatex (vaginal suppositories, cream, tampons); "Patentex-Oval" (candles); "Nonoxynol" or "Conceptrol"; "Sterilin" (candles).
Reliability: 75-80%
Hormonal contraceptives
Currently, only female hormonal birth control medications are widely available. Male hormonal contraceptives exist, but are still in the research stage and are not widely used.
The principle of action of female hormonal contraceptives is that they prevent ovulation.
Modern hormonal contraceptives come in many forms: pills (combined containing two hormones, progesterone and estrogen, as well as purely progestogenic, or mini-pill), implants(there are none in Russia) and injectable drugs. Different products contain different doses of hormones. To choose the most suitable hormonal contraceptive, you need to contact a gynecologist and do a blood test for hormones.
Hormonal contraceptives have some contraindications and side effects. But if first-generation contraceptives could cause serious complications, then correctly selected modern means are completely harmless. Contrary to popular belief, not all hormonal contraceptives cause weight gain.
Combined oral contraceptives taken every day for 21 days of the menstrual cycle; mini-pill– every day throughout the entire cycle, and it is important to take them at the same time of day.
Injections hormonal contraceptives are taken every 2-3 months. They are indicated only for women over 35 who have given birth, as they can disrupt the menstrual cycle. Injections do not protect against STDs.
Drugs: Depo-Provera, Net-En (Noristerat).
Reliability: 96.5-97%
Hormonal means of preventing unwanted pregnancy include: postcoital pills , or emergency contraception. They are taken after unprotected sexual intercourse and prevent the egg from maturing (and then it cannot be fertilized), or, if it is already mature and fertilized, they prevent it from attaching to the wall of the uterus. Emergency contraception is effective in the first five days after intercourse, and it is best to take it the next day. In any case, you should carefully read the instructions before using.
There are often misconceptions about the mechanism of action of postcoital pills. For example, people sometimes believe that they are "scraping out the lining of the uterus." To be frank, this is complete nonsense.
In Russia, the most widely known of these drugs is Postinor. It quite strongly destabilizes hormonal levels, so its frequent use can cause very serious complications. There are newer and safer drugs (for example, Ginepristone), in which the dose of the hormone is much lower. However, it is important to remember that all postcoital medications are emergency contraception and should not be used regularly. At the same time, emergency contraception is much more gentle on the body than even the safest medical abortion. Therefore, you should not use emergency contraception as the only method of protection, but if for some reason unprotected sexual intercourse occurs, and the pregnancy, if it happens, will still be terminated, then it is much better to use emergency contraception.
Reliability: 97%
Mechanical contraceptives that release hormones
These are the NuvaRing vaginal ring and the Evra contraceptive patch.
NuvaRing ring It is made of elastic material and, when inserted into the vagina, adapts to the contours of the woman’s body. The ring does not reduce the sensitivity of partners, does not prevent a woman from playing sports, does not affect blood clotting (varicose veins of the lower extremities, which to one degree or another happens from birth control pills), but it does not protect against STDs.
One ring is designed for one cycle; on the 22nd day it is removed, and a week later a new one is inserted.
Reliability: 99%
"Evra" patch Small in size, it can be glued to almost any part of the body. The patch is changed every week and is not used during the fourth week of the cycle.
Disadvantages: Contraindicated for women who smoke 10 or more cigarettes per day. Safe and effective only for women between 18 and 45 years of age. Does not protect against STDs.
Reliability: 99.4%
Intrauterine devices (IUD)
Spirals can be like hormonal, so non-hormonal. But both are inserted into the uterine cavity for a maximum of 5 years, after which the IUD must be removed and a new one inserted during the next menstruation. Only a gynecologist can install the IUD.
Regular IUD prevents the fertilized egg from attaching to the wall of the uterus and, therefore, developing into an embryo; it reduces the vital activity of sperm and eggs.
Hormonal IUD
Constantly releases the hormone levonorgestrel (a synthetic analogue of progestogen), which even more reliably protects against unwanted pregnancy.
Despite its popularity and ease of use, this type of contraception is quite dangerous due to the risk of ectopic pregnancy. It has a long list of contraindications and does not protect against STDs.
Reliability: 75-80%
Sterilization – one of the methods of contraception (not to be confused with castration). Sterilization involves creating an artificial obstruction of the fallopian tubes in women and the vas deferens in men. In this case, neither the ovaries nor the testicles are removed, continuing to function fully. Sterilization does not have a negative impact on a person's sex life.
In Russia, sterilization surgery is permitted only upon written application from citizens who are at least 35 years old or have two or more children.
Reliability: 100%(for men it reaches 100% one and a half years after surgery).
Disadvantages: performed in a hospital; the probability of restoration of fertility is not one hundred percent and is low in women; Women who regain fertility are at risk of ectopic pregnancy.
Male sterilization
called a vasectomy.
A vasectomy is performed only with the voluntary, informed consent of the man. The wife's consent is not required. The operation is always carried out for a fee.
Currently practiced in the Russian Federation surgical And no-scalpel vasectomy methods.
The surgery is performed under local anesthesia. If there are no complications, the man remains in the hospital for one day. After three to five days he can resume sexual activity. After a vasectomy, men need to use other methods of contraception for about three months, since during this time the semen may contain active sperm. Within 17 months after surgery, the patency of the vas deferens may spontaneously recover, so it is necessary to do a semen analysis for the presence of live sperm.
Currently, microsurgery methods make it possible, with a reasonable degree of probability, to restore reproductive function in men by restoring the vas deferens.
Scientists are also developing a method of ultrasonic vasectomy, which leads to temporary sterilization (for several months).
Female sterilization called tubal occlusion. It is carried out in a hospital and can be carried out in three ways.
Laparotomy- abdominal surgery, the abdominal incision reaches 20 cm. This method has many complications and leads to the formation of scars and scars. For medical reasons it is carried out free of charge.
Minilaparotomy It is performed through a 2-5 cm long incision under local anesthesia.
Laparoscopy– an operation during which the surgeon makes 3-4 incisions 1 cm long and carries out all the necessary procedures using special equipment and a video camera. In the absence of complications after laparotomy, women are discharged from the hospital on days 7-10, after laparoscopy - on days 2-3. The rehabilitation period ranges from a week to a month.
Minilaparotomy and laparoscopy are included in the list of paid services. Tubal occlusion is performed only with the voluntary informed consent of the patient. Spousal consent is not required.
Restoring fertility (the ability to bear children) is possible using microsurgery methods, but the success rate of these operations is still low. When artificially restoring fertility in women, there is a risk of ectopic pregnancy.
Contraception is the prevention of pregnancy using contraceptives. Modern medicine allows you to choose the best protection option from hormonal or non-hormonal drugs.
Non-hormonal drugs - mechanism of action
More and more women are choosing to take non-hormonal pills as protection against pregnancy. This type of contraceptive is inserted into the vagina, and is not drunk like hormonal medications.
The product consists of special substances that destroy sperm. Their main components are nonoxynol or benzalkonium.
Mechanism of action of non-hormonal drugs:
- when touching a sperm, the product does not allow it to move further, destroying its flagellum;
- damage to the membrane upon contact with the head of the sperm;
- Thick mucus appears in the uterine cervical canal, preventing the movement of already weakened sperm.
In addition to the tablet form, such spermytite-based products are manufactured in the following forms:
- tampons;
- vaginal suppositories;
- diaphragms;
- gels, creams.
Regardless of the type of non-hormonal drugs, they protect against fungal and other diseases transmitted during unprotected intercourse. This is due to the fact that the components of contraceptives have antimicrobial and antiseptic effects.
The main difference between these methods of protection lies in their use before intimacy. Effectiveness lasts for a couple of hours.
Degree of reliability
The Pearl scale allows you to evaluate the effectiveness of any contraceptive medication. The study involves 100 women who use a specific method of contraception. The fewer pregnancies developed during its use, the greater the reliability value of the drug.
The level of protection of a non-hormonal agent is 8-36. This suggests that so many women have a high risk of becoming pregnant when using this type of protection.
When is the use of non-hormonal drugs indicated?
Non-hormonal protective agents have low effectiveness, but they also have advantages over hormonal contraception. List of the main advantages of such drugs:
- not contraindicated in the presence of gynecological diseases or hormone-dependent neoplasms;
- can be used for short periods of intercourse;
- I do not affect other systems and organs, because it does not penetrate the digestive tract and does not enter the bloodstream;
- have antimicrobial and bactericidal properties.
Non-hormonal contraceptives are allowed for women who are breastfeeding. They are prescribed when the use of COCs and other contraceptives is contraindicated. This type of protection will help avoid pregnancy in women over 40 years old, when the cycle gets confused and becomes irregular.
Disadvantages and contraindications
Non-hormonal drugs are administered orally at least a quarter of an hour before copulation. This helps to avoid talking to your partner before each intercourse and pregnancy. When using the medication, it is not recommended to take a shower or bath before and after sex. The instructions indicate the time that must be waited.
Non-hormonal drugs contain acid, which causes itching, burning and irritation of the vaginal mucosa. Gynecologists do not advise frequently resorting to this type of protection. Long-term use of non-hormonal drugs leads to disruption of the internal microflora, resulting in the development of dysbacteriosis.
There are practically no contraindications to this contraception. Such products are not used only in case of hypersensitivity or intolerance to the components.
Review of popular contraceptives
All non-hormonal medications are divided into categories according to the main active component. Preparations based on benzalkonium chloride:
Pharmatex.
It is characterized by increased efficiency and affordable cost.
Release form: tampons, suppositories, cream, capsules.
The effect of the product is observed 10 minutes after use and lasts up to 4 hours.
Erotex.
Contraceptive suppositories are effective for up to 3 hours; sexual intercourse should occur no earlier than 15 minutes after their use.
Gynekotex.
The tablets are taken 5-10 minutes before copulation and last for approximately 4 hours.
Contratex.
Suppositories taken 10 minutes before intercourse.
The contraceptive effect lasts 3 hours.
Benatex.
Tablets that last up to 4 hours.
Non-hormonal medications based on nonoxynol are sold in the form of suppositories. This Nonoxynol And Patentex Oval. They are inserted 10 minutes before copulation and last up to 9 hours.
It is worth knowing that contraception is used before each intimacy and is reintroduced.
Features of choice
Many representatives of the fairer sex do not know what criteria are used to determine effective non-hormonal contraceptives for women. The cost of the drug does not always indicate quality, so this is not the criterion by which a protective agent is selected. Numerous studies have shown that suppositories are recommended for women who complain of vaginal dryness. The use of this type of contraception does not require additional purchase of lubricant.
Unpleasant manifestations from using contraception are also possible. For example, when the capsule dissolves, a foam-like substance is released and a hissing sound is heard. The use of even the best drugs does not guarantee the absence of burning, irritation and itching. Negative effects can occur in both the woman and her man.
Every body is individual, so the selection of non-hormonal contraceptives is carried out by a doctor.
Hormonal contraceptives
More and more representatives of the fair sex prefer taking hormone-containing drugs due to their high effectiveness. In addition to protecting against pregnancy, this type of protection has a positive effect on the woman’s reproductive system. The most popular contraceptives of the new generation:
- Zoely;
- Claira;
- Jess;
- Jess Plus;
- Dimia;
- Miniziston 20;
- Lindinet 20;
- Logest;
- Novinet;
- Mercilon.
All hormonal capsules for internal use are divided into 4 categories based on hormone concentration.
1. Microdosed. A small amount of hormones in the medication almost eliminates their negative effects. The main component is ethinyl estradiol, which helps fight pain during menstruation, acne and rashes. Prescribed at any age.
2. Low dosage. Contraceptives consist of ethinyl estradiol and progesterone. Recommended for young girls who have given birth. Allows you to remove unpleasant signs of increased testosterone, which leads to baldness, acne, and male-pattern hair growth.
3. Medium dose. The drugs contain progesterone, a synthetic substitute for estradiol. Designed for adult women who have given birth. Prohibited during lactation. Normalize hormonal levels.
4. Highly dosed. They are distinguished by a high concentration of progesterone and ethinyl estradiol. Medicines are usually prescribed for treatment. They are used by women over 35 years of age who have given birth as protection against unplanned pregnancy.
Emergency contraception
- infrequent intimacy;
- damage to the condom.
Such contraception is contraindicated in case of cardiovascular diseases, smoking, kidney and liver failure, problems with blood clotting, and malignant tumors.
Features of taking pills
Oral contraceptives for women are taken every day at approximately the same time.
The first capsule is taken on the first day of the cycle. Such medications are intended for continuous use and require regular annual visits to the gynecologist.
You can continue taking hormonal medications if there are no contraindications or negative effects.
Long-term use of COCs sometimes causes menstruation to stop, but this is not considered an abnormality. If a woman forgot to take the pill, and her period does not come, then this may indicate pregnancy. After stopping taking contraceptives, the cycle normalizes after 1-2 months. Fertilization of the egg occurs immediately or in the near future, if other methods of protection are not used.
Hormones can be taken for several years. In the absence of negative manifestations, it is better not to change the pills so that the body does not experience stress and the cycle does not go astray.
Natural methods of contraception
Even before the advent of hormonal and non-hormonal drugs to protect against pregnancy, people practiced other methods of birth control. Many of them remain in demand to this day.
Ovulation
The average duration of a female cycle is from 28 to 30 days. The first part is characterized by the maturation of the follicle, and the second – by ovulation. A mature egg is ready for conception in another 2-3 days. Although sperm can wait for 4 days. Maximum care is observed in the middle of the menstrual cycle for about 7 days.
Interrupted intimacy
Many couples practice this method of protection. If intercourse is interrupted, the development of pregnancy cannot be ruled out, because a small part of the sperm is in the pre-ejaculate, that is, male lubricant. The probability of fertilization increases based on the number of copulations performed.
It is better to use hormonal and non-hormonal drugs as protection. But before using them, you need to consult a gynecologist. Only a specialist can choose the best method of contraception, based on contraindications and the woman’s condition.
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