What are the most reliable ways to prevent pregnancy? Intrauterine Therapeutic System

Contraceptives

Contraceptives are traditionally divided into mechanical, biological and chemical. Different agents naturally have varying degrees of effectiveness. Almost none of the ways to prevent pregnancy (except for 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 choose a contraceptive, after consulting with a gynecologist.

In this article we will talk in detail about the most popular types of contraception.

Condoms

Condom (condom) - made of latex (polyurethane). It is put on the male penis during an erection before starting sexual intercourse. After ejaculation, the condom is immediately removed and discarded. This contraceptive, in addition to its main purpose, 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 all 100%, because condoms can break and sometimes they are used incorrectly.

SPIRAL

An intrauterine device (it is also an IUD, and in everyday life - a spiral) is a convenient and highly effective device that fits into the uterus. The spiral, despite a high percentage of efficiency (98-99%), has a number of possible complications. For this reason, the spiral is not recommended for women under 23 years of age who do not yet have children. Install and remove this tool should only be a gynecologist after a medical examination. The advantages of the spiral include its long-term use - up to 5 years.

CONTRACEPTIVE ADHESIVE

The principle of the patch is that it is glued to a specific area of \u200b\u200bthe body, and then hormones are absorbed into the body through the skin. The effect of this contraceptive is that there is a delay in the development of the egg and increases the viscosity of the mucus in the cervical region. Three plasters are usually used for one menstrual cycle, that is, one patch is glued for seven days. Next, you need to take a week break, and at this time, menstruation begins. The disadvantages of this method include the appearance of secretions (between cycles), headache.

VAGINAL RING

This remedy is a transparent elastic ring, which is made of synthetic material and contains hormones that begin to secrete only after the ring is inserted into the vagina. With the help of a complex membrane system, only a strictly defined amount of hormones is released daily. The ring can be easily inserted and removed by the woman herself. It is used for contraception during one menstrual cycle, which includes 21 days of use and seven days of a break. Side effects: spotting, nausea, headaches, etc.

LONG-TERM INJECTIONS

The method of protection by injection is to stop ovulation (the process of the ovum leaving the ovary) by changing the mucus in the cervix, changing the mucous membrane of the uterine cavity itself, which makes pregnancy impossible. The contraceptive effect of this method lasts 3 months. However, this method also has a number of rather serious drawbacks. Problems with bleeding may occur, as well as the appearance of edema, 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). Capsules are placed 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 in a day and lasts for five years. It is achieved by changes in the endometrium, which lead to a violation 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 disturbed, depression, headache, 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 the possibility that even the operation will not bring the desired result). Male sterilization is a fairly simple surgical procedure, including the intersection and subsequent ligation of the vas deferens. Female sterilization takes place in a hospital and consists in transection and ligation of the fallopian tubes. Do not forget that, as with any other surgical operation, there is always a risk of complications during sterilization - bleeding, infection, adhesions.

DIAPHRAGM

It looks like a domed cap made of latex or rubber. It is inserted into the vagina no earlier than 6 hours before the onset of sexual intercourse, while closing the cervix. Also, the diaphragm serves as a container for a special cream that suppresses sperm activity. The principle of its action coincides with the principle of the condom - these barrier agents do not allow sperm to enter the uterus mechanically.

BIOLOGICAL PROTECTION

Biological contraceptives - a way to prevent pregnancy with hormonal contraceptives. With this method of contraception, a woman should take pills daily, which include female sex hormones. After their use, the general hormonal background changes, which in turn inhibits ovulation, changes the state of the intrauterine device, preventing the possible onset of pregnancy. The effectiveness of hormonal contraceptives is 97-99%. Oral hormonal contraceptives exist combined, that is, those that contain estrogen and progestogen and non-combined, that is, those that contain only progestogen. Select a hormonal contraceptive with the help of a gynecologist. Since there are diseases in which the use of hormonal contraceptives is contraindicated.

MINI PILL TABLETS

These are hormonal tablets, which do not include estrogens. Their action is to increase the viscosity of cervical mucus, which in turn greatly complicates the passage of sperm into the uterus. Also, these drugs inhibit the maturation of the endometrium, as a result of which it becomes impossible to attach the egg to the walls of the uterus for its further development. Mini-drinks are taken without interruption, throughout the entire time necessary to protect against pregnancy. The main disadvantage of this method is a slightly higher frequency (in comparison with other oral contraceptives) of breakthrough bleeding. Mini-drank is a way out for women who are contraindicated in the use of estrogen, and for nursing mothers as well.

CALENDAR METHOD

It consists in calculating with the help of simple mathematical operations the estimated date of the beginning of ovulation and abstinence from sexual intercourse during the fertile phase (the phase of ovulation during which a woman can become pregnant).
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 - 30 days.
The beginning of the fertile phase is 28-18 \u003d 10th day of the cycle.
End - 30-11 \u003d 19th day of the cycle.

That is, from 10 to 19 days of the cycle, fertilization can occur, which means that these days you need to use barrier contraceptive methods or generally refrain from sex. The disadvantages of this method are primarily its unreliability, since initially it involves a regular constant menstrual cycle, which, unfortunately, does not have a single woman.

TEMPERATURE METHOD

Based on calculating the fertile phase by measuring basal (or rectal) temperature in women. You need to start measuring basal temperature on the first day of the cycle. After waking up in the morning, without getting out of bed, you need to place the thermometer in the rectum to a level of 1-2 cm, and hold it there for 5-6 minutes. The obtained data must be entered in a special schedule of your basal temperature. It should be remembered that throughout the whole time it is necessary to use one thermometer, and to measure the temperature at the same time every day.

During the first half of the cycle, basal temperature is usually below 37 ° C. 12-24 hours before ovulation, body temperature decreases by 0.1-0.2 ° C, and after ovulation increases by 0.2-0.5 ° C (usually up to 37 ° C or higher). And this temperature keeps at this level all the second half of the cycle until the onset of menstruation. The fertile period begins six days before the pre-ovulatory decline and lasts three more 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; the absence of any side effects; the most accurate determination of the days of probable conception when planning pregnancy.
Disadvantages: high risk of unwanted pregnancy (because a very large number of factors affect the level of basal temperature); the need for daily measurement of basal temperature.

INTERRUPTING A SEX

This method consists in the complete removal of the male penis from the woman’s vagina before ejaculation begins. Interruption of sexual intercourse is one of the least effective methods of contraception. According to statistics, of the one hundred couples who use this method, approximately 20-25% experience an unplanned pregnancy. Firstly, during the onset of sexual intercourse, a certain amount of active sperm is excreted along with natural lubrication. Secondly, not every man can control himself during an orgasm. And also, when re-engaging in sex, another method of contraception should be used to prevent sperm from entering the vagina. The advantages of this method include accessibility and simplicity, while the disadvantages are incomplete satisfaction with the process of partners.

EMERGENCY (aka postcoital, fire) CONTRACEPTION combines the methods of preventing an unwanted pregnancy, which are used after an unprotected sexual intercourse has taken place. Most emergency contraceptives can be purchased in pharmacies without a prescription and used on their own, but we strongly recommend that you consult a doctor so that he chooses the most suitable method for emergency contraception for you, checks for contraindications to the chosen method and selects the required dosage.

TYPES OF MEANS OF EMERGENCY CONTRACEPTION:

1) Douching
Douching with a variety of solutions, even immediately after unprotected intercourse, is very ineffective, because spermatozoa penetrate the cervical region within a minute after ejaculation. Also, do not forget that a small amount of active sperm can be released directly during sexual intercourse - with lubrication.

2) Hormonal contraceptives
The first way to use hormonal contraception is to take several types of COC tablets (combined oral contraceptives) at the same time. The number of tablets necessary for taking comes from the dosage of the hormone level in the preparations: Minisiston, Rigevidon, Femoden, Marvelon, Mikroginon, Regulon - two times four tablets (interval between doses 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 intercourse. The effectiveness of this method is not very high - 75-85%.

The main advantage of this method is its availability, since all drugs are sold in any pharmacy without prescriptions. Side effects after application are nausea, pain in the mammary glands, vomiting, dizziness, headache.

An alternative to COCs is drugs that contain only progestins and do not contain estrogens. The most effective drugs of this type are Escapel and Postinor. Escapel contains 1.5 mg of the hormone and is used once. Postinor also contains 0.75 mg of levonorgestrel and it must be used twice with an interval of 12 hours. Minor side effects that can be caused by hormonal methods of emergency contraception usually disappear within two days.

It must be remembered that after applying the methods of emergency hormonal contraception, it is imperative that additional contraceptive methods be used before the next menstrual cycle: spermicides, condoms, etc.

3) Non-hormonal emergency contraception
Mifepristone (Ginepriston) is one of the most effective emergency protection drugs. A single dose of a small dose of this drug within three days after an unprotected intercourse occurs slows down 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 less side effects - for example, a bleeding rate of only 15%, compared with 31% when taking 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 over a longer period compared to other means of emergency contraception, as well as the fact that after its administration there are practically no hormone-dependent side effects.

4) Intrauterine devices
Another way to prevent an unplanned pregnancy is to use an intrauterine device (IUD). To achieve the desired effect, copper-containing IUDs are injected within five days after unprotected intercourse.

Emergency contraception is an alternative to abortion, but it is not recommended to use it as a permanent contraception, but only in "emergency" situations (maximum once every six months). Since the frequent use of emergency methods of contraception can lead to a violation of the reproductive functions of women.

2 Sterilization

Female sterilization is also called tubal occlusion or "tubal ligation." As a result of the operation, an artificial obstruction of the fallopian tubes is created: the female egg is isolated from spermatozoa and fertilization becomes impossible. In Russia, such a method of contraception is legally permitted only to women after 35 years of age with at least one child.

BEHIND   Almost 100% protection against unwanted pregnancy; the operation does not entail changes in health, in the hormonal background, does not affect sexual desire, and sometimes even increases it; the risk of ovarian cancer is reduced.

AGAINST   Sterilization is almost irreversible, the operation to restore fertility is very expensive and there is no guarantee of a successful outcome; the operation is performed under general anesthesia, and these are associated risks; does not protect against sexually transmitted diseases and HIV infection.

PERLYA INDEX   0, 15 (in an extremely small percentage of women, pregnancy occurred in the first year after surgery).

3 Vasectomy

Type of male sterilization. During the operation, a part of the vas deferens is ligated or removed in the man and thus the sperm do not enter the ejaculate.

BEHIND   Relatively simple operation; local anesthesia; libido, erection, ejaculation, sexual desire, orgasm do not undergo changes.

AGAINST You need to carefully consider your decision, since the reconstructive operation is much more complex, expensive and success is not guaranteed. Does not protect against genital infections.

PERLYA INDEX   0.4 pregnancies per 100 women.

4 Intrauterine device

The spiral is a fairly common method of contraception in women 25-30 years old. This is a small device that is inserted into the uterine cavity to prevent conception. Today, there are about 50 types of spirals: round, spiral, T-shaped, made of copper or silver, hormonal, etc. The IUD prevents the implantation of an egg into the uterine wall, has a detrimental effect on spermatozoa (copper spirals), affects their ability to pass through the cervix (hormonal). The average period of use is 2-5 years.

BEHIND   High protection against unwanted pregnancy. Using the Navy, you can forget about other methods of protection for several years. The spiral does not affect lactation, is easily removed by a doctor and is inexpensive.

AGAINST   In some women, it can provoke heavy menstruation. A long stay of a foreign body in the body reduces immunity, and can also cause inflammatory processes. The spiral is not recommended for nulliparous girls.

PERLYA INDEX   1 pregnancy per 100 women.

Hormonal contraception

5 Hormonal implants and capsules

This type of contraception is a small plastic stick (the size of a match) or a thin capsule filled with hormonal drugs and usually injected subcutaneously into the inner side of the left forearm. After installation, the implants regularly release a hormone that interferes, and also alters the mucous membrane of the cervix, making it difficult for sperm to travel. In 2018, a new progressive product is expected in the US market - a hormonal chip contraceptive, which will be implanted into the patient under the skin and controlled using a smartphone and a special application.

BEHIND   There is no need for frequent implant replacement. The effect lasts about 5 years. The operation is quite simple and painless.

AGAINST   Side effects: nausea, headaches and possible allergic reactions. Implants are not widely represented on the Russian market, hence the high cost. In addition, gynecologists do not recommend installing implants for girls who have not yet given birth.

PERLYA INDEX   0.3 pregnancies per year per 100 women.

6 Combined oral contraceptives

AGAINST There is a risk of thrombosis, if there is a predisposition. Need discipline and regularity of use. In addition, COCs can reduce libido, cause allergies, nausea, breast tenderness, pigmentation and mood swings.

PERLYA INDEX   About 0.5 pregnancies per year per 100 women for combined oral medications.

7 Hormonal injections

BEHIND   Accessibility and ease of use, wide selection. Condoms best protect against sexually transmitted diseases.

AGAINST   Protection against pregnancy is only 82% in male and 79% in female condoms. Many women complain about the absurdity of female condoms and that they may make inappropriate sounds during sex. A contraindication is latex allergy.

PERLYA INDEX   From 5 to 12 pregnancies per 100 women.

11 Birth control caps, vaginal diaphragms and sponges

The contraceptive cap is a reusable contraceptive, which is a silicone cup with a loop that is worn on the cervix. Caps are recommended for use with spermicides. A contraceptive is administered immediately before sexual intercourse and can be worn for about 48 hours.

The vaginal diaphragm has the shape of a cup with a metal spring along the edge, it is inserted before sexual intercourse so that the rim is in the walls of the vagina and the dome covers the cervix. The spring presses slightly on the walls of the vagina and urethra. The selection of the diaphragm in size is done by a gynecologist, you can wear a contraceptive for no more than 24 hours.

A sponge soaked with spermicidal solution looks like a small donut with a recess that should fit snugly against the cervix. The sponge combines both mechanical and chemical protection. The size of the sponge is universal, and in the USA you can buy it in a regular supermarket.

BEHIND   Caps and Co are reusable, they do not change the hormonal background, are suitable for breast-feeding and for those who are contraindicated with hormonal drugs.

AGAINST   In case of improper administration, the effect is extremely weak. They do not protect against infections, and the quality of sex is sometimes reduced. In addition, there are a number of contraindications.

PERLYA INDEX   From 6 to 20 pregnancies per 100 women.

12 Spermicides

Spermicides are chemicals that destroy sperm in a short period of time (up to 1 minute). They contain special creams, jellies, suppositories, vaginal tablets, foams and films - all this is sold freely in the pharmacy. Spermicides themselves have a low contraceptive effect, so gynecologists advise combining them with barrier methods of protection.

BEHINDEase of use, protection against certain infections.

AGAINSTLow contraceptive effect. Spermicides can adversely affect the vaginal flora. And one more thing: make sure that you are no longer pregnant, because in this case there is a great risk to the fetus.

PERLYA INDEX25-30 pregnancies per 100 women per year.

Natural methods of contraception

13 Interrupted intercourse and others

Interrupted sexual intercourse, a calendar method, a method that involves monitoring the basal temperature, monitoring the consistency of secretions and other methods inherited from our grandmothers and mothers are all natural methods of contraception. Even modern methods of protection do not give a 100% guarantee, and the reliability of “folk” methods is all the more out of the question: out of 100 women who use interrupted sexual intercourse, an average of 19-20 become pregnant within a year. In addition, none of the natural methods protects against sexually transmitted infections.

In conclusion, an important disclaimer: before choosing a method of protection, be sure to consult your gynecologist.

Text: Julia Oleinikova.

Today, there is a huge selection of contraceptive methods for women that will help prevent unwanted pregnancies and maintain women's health for the possibility of having healthy children.

According to statistics, about half of the girls lose their virginity before they reach the age of twenty. However, in most cases, the girls are not married. Two-thirds artificially terminate the first pregnancy before the age of seventeen. Statistics, of course, depressing. You can blame everything on the freedom of morals, introduce all kinds of prohibitions, etc. However, nothing can be more effective than basic knowledge about the methods of contraception that every girl must have. Only knowledge will help reduce the number of abortions in girls and young women who have not yet experienced the joys of motherhood, who have various gynecological diseases, infertility and subsequent inability to bear pregnancy. According to research by American experts in the field of cancer, it is the first abortion that provokes the development of cancer of the mammary glands and uterus.

The issue of contraception should be in the first place for sexually active young girls and women who are at least a little worried about their future. So what you need to know about contraception, and what methods exist?

Contraception means preventing the onset of an unplanned pregnancy during casual relationships or regular sexual intercourse. Each woman can choose for herself the most optimal method. At the same time, some nuances should be taken into account, among which the absence of pathological effects on the body, the high contraceptive reliability and safety of the method, the reversibility of the process (that is, at the end of their action there are no obstacles to pregnancy), be accessible and easy to use. The effectiveness of any contraceptive is expressed by the Pearl index, which is determined by the number of pregnancies in 100 women who have used this method of contraception during the year.

Methods of contraception for women are divided into groups:
Group 1 - provides for complete abstinence from sexual activity. This method has absolute effectiveness.

Group 2 - includes contraceptive methods with low efficiency, but without any beneficial or harmful effects on the female body (rhythmic method (abstinence from sexual intercourse during ovulation or the use of additional contraceptives during this period), intermittent sex, lactational method amenorrhea, temperature method, calendar method).

Group 3 - contraceptive methods with low efficiency, not having a harmful effect, but at the same time showing some protective properties for a woman's body (condom, vaginal diaphragm). Their advantage is that they prevent the possibility of infection with sexually transmitted diseases, STDs, AIDS.

Group 4 - highly effective methods of contraception (hormonal contraceptives).

Group 5 - highly effective methods of contraception, but with a risk of a number of complications (intrauterine contraception, surgical sterilization of women or men).

Contraceptive methods are divided into:

• hormonal;
• intrauterine;
• barrier;
• surgical;
• postcoital.

Hormonal method of contraception.
This method includes: combined (estrogen-progestogen) oral contraceptives (COCs), which are divided into monophasic oral agents with a constant dose of estrogen and gestagen, two-phase (the first 10 tablets contain estrogen, and the remaining eleven are combined), three-phase (include three type of pills, their administration recreates the secretion of estrogen and gestagen during the menstrual cycle), vaginal rings and transdermal contraceptive system (contraceptive patch Evra), gestagen oral proti ozachatochnye means (mile-pill), long-acting injectable contraceptives, contraceptive implant (hormonal implant).

Oral contraceptives are today the most common and popular methods of contraception. This group of contraceptives is selected for each woman individually, taking into account her characteristics of the physiological properties, the state of the hormonal background, as well as existing diseases. Third-generation birth control pills recreate a woman’s normal menstrual cycle and have virtually no side effects. Their action is aimed at inhibiting the production of hormones that promote ovulation. Under their influence, there are some changes in the endometrium, due to which a fertilized egg is not able to implant. In addition, this group of contraceptives reduces the duration of menstruation, the amount of blood loss during the same period, reduces pain, and also reduces the risk of inflammatory diseases.

Combined oral contraceptives have their drawbacks. Basically, when they are taken, nausea, dizziness, headaches, irritability and mood swings can occur.

The main advantages of this method of contraception include high efficiency, a positive effect on the woman’s body, including the reproductive function, ease of use, process reversibility. It is proved that among women who regularly take this method of contraception for two years, the incidence of cancer of the reproductive system and mastopathy is reduced.

COC has some contraindications, including thrombophlebitis, pregnancy, vascular hypertension, strokes, liver disease or impaired function, hormone-dependent tumors, obesity, oncology, and bleeding of an unknown etiology. In addition, COCs should not be used by women smokers over 35 years old.

Progestogenic oral contraceptives contain only progestins. These contraceptives are best used by women of mature age. As a rule, their administration is prescribed for women with heavy and painful menstruation, mastalgia, PMS (premenstrual syndrome). Contraceptives of this group can be used even during breastfeeding, while they in no way affect the quality and quantity of milk.

Sufficiently long-term protection against unwanted pregnancy is given by injectable contraceptives or implants implanted subcutaneously. These funds are constantly dosed constantly special hormones that prevent pregnancy. When using this group of contraceptives, the same side effects exist as when using oral contraceptives.

Intrauterine contraception (IUD).
Among the means of intrauterine contraception, the most common is the spiral. Made of plastic or copper, the spiral quickly and painlessly penetrates the woman’s uterus for two years or 5 years. Modern intrauterine devices release doses of hormones that impede the fertilization of the egg. Its action is aimed at reducing the viability of sperm, enhancing the spermicidal properties of the endometrium, reducing the viability of the egg, and also creates obstruction of the fallopian tubes and strengthens the contractile function of the uterus, due to which pregnancy does not occur even after fertilization.

This method of contraception also has its contraindications. The main ones are pregnancy, oncology of the uterus or its neck, uterine bleeding, infections of the reproductive system.

Barrier methods of contraception and spermicides.
They include: male condoms, vaginal diaphragms, cervical caps and spermicides.

This method of contraception mechanically creates obstacles in the way of sperm into the vagina (condom), cervix (caps, diaphragms), and also block sperm activity (spermicides). The effectiveness of this method of contraception directly depends on the correct application.

Surgical method of contraception.
This method of contraception is widespread throughout the world. Its effectiveness is absolute, since fertilization does not occur. Surgical contraception or sterilization is resorted to if the couple decided that they should no longer have children. This method does not affect sexual function. Female sterilization is carried out by means of occlusion of the fallopian tubes with the help of laparoscopic surgery, male - through ligation of the vas deferens. After sterilization, it is impossible to regain the ability to bear children.

Postcoital contraception or emergency contraception.
Emergency contraception is a collective concept that combines various methods of contraception, the reception of which in the first 1-3 days after unprotected intercourse prevents the onset of an unplanned pregnancy. Emergency contraception is used in cases where sexual intercourse, not protected by other means, has taken place, as well as in cases where pregnancy can pose a threat to the life of the expectant mother. Emergency or postcoital contraception is recommended for women who have been raped, if the condom is broken, if an intrauterine contraceptive has been lost completely or completely, has interrupted intercourse, when ejaculation was performed earlier, and women with irregular sex life. This type of contraception is not intended for continuous use, it can not be considered as a contraceptive.

This type of contraception includes: high-dose gestagen drug Postinor. It is taken immediately after sexual intercourse and after 12 hours, 2 tablets, oral contraceptives, which contain 50 μg of estrogen (2 tablets 2 times with an interval of 12 hours) - Danazole 400 mg 3 times at intervals of 12 hours, Mifepristone 600 mg once or 200 mg per day for 5 days in the 2nd phase of the menstrual cycle.

Each of these methods of contraception carries with it a serious interference with the functional state of the woman’s reproductive system, a violation of which can cause further development of ovarian dysfunction.

Temperature and calendar methods of contraception.
Temperature and calendar methods can only be used by healthy women with a regular menstrual cycle. Moreover, these methods are not effective and inferior to modern means. Most often, when using these very methods, women are mistaken in the calculations.

The temperature method is based on the identification of a period in which, for physiological reasons, conception is impossible. During the menstrual cycle, a woman daily in the morning immediately after awakening measures the basal temperature by introducing a thermometer into the rectum. With an increase in temperature by 0.4-0.5 degrees, ovulation occurs. After 2-3 days, unfavorable days for conception follow. The possibility of fertilization occurs 4-5 days before the next ovulation.

The calendar method of contraception provides a monthly record of the start date of menstruation and its end in order to identify adverse days for conception.

Interrupted intercourse.
The most popular, but not reliable, method of contraception is interrupted sexual intercourse, in which a man removes the penis from the vagina before ejaculation occurs. In the process of intercourse, a man must constantly control himself, which is difficult psychologically. In addition, in the process of intercourse in men, droplets of semen are secreted, which is completely impossible to control. This drop is enough for fertilization to take place.

The choice of a contraceptive method must be carried out in conjunction with a gynecologist, who, taking into account the physiological characteristics and health status, will tell you the best option for you.

An unplanned pregnancy is a matter that worries most modern women. After all, if it has come, then a completely reasonable question arises: to leave the child or not? When a woman decides to have an abortion, she exposes herself to tremendous psychological and physical stress. Although, a nervous shock does not overtake all women, but this procedure is still harmful for the body. Deciding on an abortion for the first time, young girls expose themselves to possible infertility.

Contraceptives for women will help to avoid all of the above problems. There are a huge number of them. In order to choose the one that is right for you, you need to study all their types and features. Despite the age of information technology, many do not know how to use it properly and what types of contraception are. Almost 90% of unwanted pregnancies could have been avoided if the women had been sufficiently informed.

According to the main signs, contraceptives for women are divided into the following types:

1. Barrier
2. Chemical;
3. Natural;
4. Hormonal;
5. Emergency;
6. Surgical

Barrier contraception

The barrier method is a method in which a contraceptive blocks the access of sperm to the uterus physically. Fertilization does not occur due to the fact that sperm does not bind to the egg. Such contraception can include:

Chemical contraception

The chemical method is an easier contraceptive for women to use, including various vaginal suppositories, ointments, tampons. It also protects against certain viruses and bacteria. This method is not suitable for girls who live a regular sex life. The substances contained in the preparations not only kill bacteria, sperm and viruses, but also destroy the sensitive microflora of the vagina. This can lead to unpleasant consequences such as dysbiosis, itching and dryness.

The chemical method is best combined with other methods, since it has a limited duration of action. With each new sexual intercourse, you need to re-enter the drug. It is worth washing without soap, since alkali destroys all the protective properties of a contraceptive. The reliability of this method of protection is relatively small and is 75-80%.

Natural contraception

Natural methods to prevent unwanted pregnancy include:

• Interruption of sexual intercourse is the least effective way, during which the penis is removed from the vagina a few seconds before ejaculation. Insecurity is due to the fact that during the act itself, even before ejaculation, a pre-seed fluid is released in a man. It contains a small amount of sperm. Another factor determining the degree of reliability of the interruption of an act is the different reaction of a man. Some young people simply do not have time to remove the penis in time;
• The temperature method allows you to quite accurately determine ovulation. Every day after sleep, you need to check the basal temperature. For this, a thermometer is inserted into the anus. Before ovulation, the temperature is slightly reduced, and during - increased by 0.3-0.5 degrees.
• The calendar method consists in the fact that a woman, depending on the menstrual cycle, calculates the days favorable and unfavorable for conception. After ovulation, the egg can fertilize in the next 2 days. Therefore, you should not have sex a few days before ovulation and a couple of days after, because the life of the seminal fluid is about a week. During this time, it can be in the body of a woman and wait for the egg to mature. This method is not reliable, especially for women with an irregular cycle.
• The Billings method allows you to determine ovulation by the consistency of vaginal discharge. During the "dangerous" days they are more viscous and viscous. This method is not accurate, since this mucus can also be on any other days due to hormonal fluctuations.
• The method of lactational amenorrhea also does not give a one hundred percent guarantee. The bottom line is that at first, a nursing mother cannot become pregnant. This occurs due to the lack of ovulation.

Hormonal contraception

There are a lot of ways of hormonal contraception. They are done in two groups:

1. Drugs containing an analogue of the hormone estrogen;
2. Drugs that do not contain the estrogen hormone analogue.

  The most common hormonal contraceptives for women:

• COCs are the most reliable contraceptive. Pregnancy becomes impossible due to the suppression of ovulation. The most famous myth associated with the use of COCs was the story of excess weight. Fortunately, drugs of this category have not affected weight for a long time. Some girls have increased appetite, however, this is rare. Many people think that the risk of thrombosis is increasing. This is also not true if you do not have hereditary diseases associated with high blood pressure and thrombosis;
• The vaginal ring acts in the same way as COCs. The method of application is different. The ring is inserted into the vagina. Further, it releases the right amount of hormones that suppress ovulation. This method is not very convenient, since the ring can cause discomfort to the girl or even fall out;
• The hormone patch is very convenient to use. You just need to stick it on your skin. Hormones enter the body through the blood;

The above methods belonged to the group of contraceptives containing estrogen.

• Mini-drinks are tablets that do not stop ovulation, but thicken cervical fluid. Thanks to this, it becomes difficult for sperm to get into the uterus. Mini-drinks are a safer contraceptive, but less effective than estrogenic methods;
• Subcutaneous implants act in the same way as mini-saws. The implant is sutured under the skin and it secretes the right dose of the hormone progestogen (progesterone) for more than one year;
• The intrauterine device immobilizes sperm. In addition to the fact that it mechanically prevents the embryo from attaching to the wall of the uterus, it also secretes dosed hormones. The spiral is a common and reliable contraceptive. It is put for several years. A gynecologist should be visited once a year. The ability to bear children is restored immediately after withdrawal. The disadvantage is the possibility of a spiral falling out during menstruation. Menstrual pain may intensify at first.

Emergency contraceptives

Emergency contraceptives for women are different in that they are used after sexual intercourse. Such contraceptives are often called “morning contraceptives”. These include:

• Folk ways. They are very unreliable. They are not advised to use doctors, as it is dangerous to health. Often women use laundry soap, lemon juice, manganese solution. These substances are very aggressive and can disrupt the vaginal microflora. Also, they simply may not have time to kill sperm, as some of the semen in the first few seconds after ejaculation enters the cervix.
• Hormone pills are taken on the first day after unprotected sex. They act like all hormonal contraceptives, and interfere with the attachment of the embryo to the uterine wall. This method can not be used regularly, it is simply not intended for this.
• Emergency installation of the spiral is performed within five days after sexual intercourse. The spiral is introduced ordinary and can remain in the uterus for a long time.

Surgical contraception

Surgical methods include:

• Tubal ligation method. This method is painless and quick. The patient is given local anesthesia and sent home a couple of hours after the procedure;
• During sterilization with colpotomy access, scissors open the rectum. The fallopian tube is removed into the wound and a suture is applied. Next, the pipe is bandaged and the same thing is done with the second.

Following surgery, the following complications are possible:

• Infection;
• Bleeding;
• Bowel damage.

These complications are very rare.

Surgical methods are often used during caesarean section. This procedure does not worsen the condition of the woman in labor and is not noticeable. The recovery processes and lactation are not affected in any way. It is worth remembering that surgical contraception is an irreversible process. Therefore, before resorting to it, you need to carefully consider everything.

In any case, before deciding on a particular method of contraception, a woman must undergo a full examination and consultation with a gynecologist. Then the chosen method will help to avoid unpleasant consequences and unplanned pregnancy.

Photo from wusf.usf.edu

Every year, at least 16.7 million unwanted pregnancies occur in the world. 15 million of them (that is, almost 90%!) Could have been prevented if women had correctly used modern methods of contraception. Amazing but inIn the 21st century, millions of people ignore them or misuse them. As shown recently, women are afraid of side effects, have different biases, or they simply lack information. MedNews figured out how the most popular methods of contraception work (and whether they work).

"Barrier" contraception

Barrier contraception is male and female condoms, the vaginal diaphragm and the uterine cap. All these devices physically block sperm from entering the uterus. The sperm cannot meet the egg and fertilization does not occur.

Condoms

Male condom   known to everyone, but female   much less popular. This is a small bag, usually made of polyurethane, which is inserted into the vagina and fixed in it thanks to the elastic rings. The advantage of both types of condoms is that they not only prevent unwanted pregnancy, but also protect against sexually transmitted diseases.

The effectiveness of condoms is relatively high: according to the WHO, when used correctly, the male prevents unwanted pregnancy in 98% of cases, but the female - only in 90%. In addition, you must take into account that the condom can break.

Caps

Fallopian cap and vaginal diaphragm   - These are latex caps of various shapes, which are installed on the cervix. They will not protect partners from gonorrhea or syphilis, but they will not allow sperm into the uterus. Their main disadvantages are the difficulty of use (not every woman can put on a cap on her own) and allergies, which can occur due to dense and prolonged contact of the mucosa with latex.

"Natural" contraception

“Natural” refers to protection methods that do not require mechanical or medical intervention.

Interrupted sexual intercourse

One of the most popular and at the same time the least reliable "natural" methods. When using it, the partner removes the penis from the woman's vagina a few moments before ejaculation. The unreliability of this method is determined by two factors. Firstly, a man may not have time to remove the penis on time (here it all depends on his ability to self-control). Secondly, during frictions, a small amount of pre-seeded liquid is released, which may contain a certain amount of sperm - and pathogenic agents. The effectiveness of the method, according to WHO, ranges from 73 to 96%, depending on the correct use.

Calendar method

Another popular and not always effective method. A woman monitors the favorable and unfavorable for conception days of her menstrual cycle. Ovum fertilization can occur only within 48 hours after ovulation, and the life span of the sperm in the cervix can last up to a week, but more often less. Therefore, it is considered dangerous for conception several days before ovulation (the sperm can remain in the genitals of a woman and wait for a mature egg) and a couple of days after ovulation. Adherents of the calendar method claim that it is during this period that a woman should refrain from sexual intercourse if she does not want to become pregnant. The disadvantage of this method is that it is not always possible to accurately calculate exactly when ovulation will occur, especially in women with an irregular menstrual cycle.

Temperature method

This method just allows you to clarify the time of onset of ovulation. It is not for the lazy: every day immediately after waking up, you need to measure the basal temperature (inserting a thermometer into the anus). Before ovulation, the basal temperature drops slightly, and immediately after ovulation increases by 0.3-0.5 degrees and remains at this level until the end of the cycle. By monitoring the temperature daily, you can fairly accurately determine when ovulation occurs, and in accordance with this, refrain from sexual intercourse on days favorable for conception.

Cervical method

Another method that helps determine the onset of ovulation is the cervical method, or the Billings method. This Australian doctor noticed that shortly before ovulation, the mucus secreted from the vagina becomes more viscous. Thus, you can track the "dangerous" days. However, due to fluctuations in hormones, mucus can become viscous even in the absence of ovulation, so the method is inaccurate.

Lactational amenorrhea method

The bottom line is simple: in the first months of breastfeeding, ovulation does not occur, so you can not protect yourself. But there is a condition: a woman must breastfeed her baby very actively (at least every three hours in the afternoon and every six hours at night), otherwise the production of the hormones prolactin and oxytocin decreases, and their “protective” effect disappears. However, frequent feeding is also not an absolute guarantee.

Spiral

An intrauterine device is a common and fairly simple method of contraception. This device, usually made of copper or silver with plastic, is installed by the doctor in the uterus for several years. Copper or silver has a detrimental effect on spermatozoa, and the spiral itself, if fertilization does occur, prevents the egg from attaching to the uterine wall (the fetus, therefore, does not have the ability to develop). The method is convenient in that it requires almost no effort from a woman, but has its drawbacks - for example, it increases the risk of infections and inflammations.

Hormonal contraception

There are many hormonal contraceptives, and they act in different ways. In general, they can be divided into two types: hormones containing estrogens (or rather, their analogues) and not containing them.

COCs

The most common method of hormonal contraception. When used correctly, it is considered one of the most reliable. Tablets contain two types of hormones: estrogens and progestins. They suppress ovulation, and pregnancy becomes impossible.

Paradoxically, it is with these funds that most fears are associated. Women are afraid of side effects, such as blood clotting: estrogens contribute to thrombosis and increase the risk of thrombosis. In fact, this danger is much higher, say, with smoking or even pregnancy. So if a woman has no serious contraindications (history of thrombosis and among family members, severely high blood pressure, etc.), the use of COCs is considered safe. However, women are much more afraid of thrombosis than being overweight: the belief that you can get better from pills is one of the most persistent. In fact, this has not been so for a long time: modern oral contraceptives contain minimal doses of hormones, which, although they can slightly aggravate the feeling of hunger (and even then not all), do not by themselves increase weight gain.

Vaginal ring

This is another method of hormonal contraception using estrogen. In terms of composition and principle of action, it is similar to COCs, but it differs radically in the method of application. A flexible ring is inserted directly into the vagina, where it releases hormones in the right doses, which help suppress ovulation. The advantage over COCs is that the ring has almost no effect on the liver, the disadvantages are the relative inconvenience of use: it can fall out of the vagina or interfere with a woman.

Hormone patch

The hormone patch also contains estrogens, but sticks to the skin and delivers hormones into the body through the blood.

Mini drank

Another group of hormonal contraceptives, they do not have estrogens, only progestogens. Due to this, they do not have side effects associated with estrogen and are considered safer, although less effective. This group includes the so-called mini-drinks: these are tablets containing the minimum dose of the hormone.

The principle of their action is different from estrogen-containing contraceptives: they do not prevent ovulation, but cause thickening of cervical mucus (mucus in the cervix), which prevents sperm from entering the uterus itself. In addition, progestogens do not allow the inner lining of the uterus to swell, or the endometrium (without the use of hormones, this naturally occurs in the second half of the menstrual cycle). Because of this, the embryo cannot attach to the wall of the uterus and continue its development.

Subcutaneous implants

Especially desperate women may decide to sew a contraceptive hormonal implant under their skin, which also does not contain estrogen. It is established for several years and dosedly releases the necessary amount of the hormone progestogen into the body. Like mini-drank, the implant increases the viscosity of cervical mucus and does not allow swelling of the endometrium.

Hormonal intrauterine device

Her operating principle is mixed. It immobilizes sperm and mechanically prevents the embryo from attaching to the wall of the uterus, like an ordinary spiral. In addition, like implants, it daily releases a minimal amount of the hormone progestogen, which inhibits the growth of the endometrium and, thus, prevents the embryo from gaining a foothold.

Chemical contraception

Vaginal suppositories, creams, foams, sponges and tablets that have a spermicidal effect, that is, destroy sperm. Usually, all these funds should be used 10-15 minutes before sexual intercourse. Their advantage is that they also protect against sexually transmitted diseases - but not from all and not completely. The disadvantage is much lower efficiency than other methods. Therefore, they are recommended to be used in combination with other means.

Emergency (aka “morning”) contraception

If unprotected sexual intercourse has already occurred, but the woman is not planning a child, then not everything is lost: for some time, conception can still be prevented. There are a variety of methods for this - from folk to hormonal.

Folk methods

A slice of lemon, an aspirin tablet, laundry soap and a solution of potassium permanganate - this is not a complete list of the means that traditional medicine is ready to offer careless lovers. It is understood that citric acid, components of laundry soap, potassium permanganate and acetylsalicylic acid (aspirin) acidify the environment, and sperm are killed by this.

Doctors categorically do not recommend using folk remedies for two reasons. The first is their low efficiency: sperm can penetrate the cervical canal within a few seconds after ejaculation, and before that it is hardly possible to have time to introduce lemon into the vagina. And the second - side effects: aggressive acid or improperly diluted potassium permanganate can "burn" the mucous membrane and disrupt the vaginal microflora.

Hormone pills

There is also a more reliable method of postcoital (that is, used after sexual intercourse) contraception. Especially for this case, developed hormone pills. Different drugs are based on different substances, but their mechanism of action is similar: they suppress ovulation, and if conception has already occurred, they do not allow the fertilized egg to attach to the uterine wall. Tablets usually need to be taken in the first few days after unprotected intercourse (the faster the better), but with each day of delay their effectiveness will decrease.

It is widely believed that the use of such drugs is extremely harmful, but WHO has repeatedly emphasized that they are safe. This, of course, does not mean that such funds should be used regularly: they simply are not intended for this.

Emergency Spiral Installation

The same copper or silver spiral, which was mentioned above, can be installed urgently - within five days after unprotected intercourse. The principle of its action is the same: copper or silver has a detrimental effect on sperm and the egg, and the spiral itself prevents the attachment of the embryo to the uterine wall. After emergency installation, the spiral can be left as a permanent contraceptive.

Karina Nazaretyan