Contraceptive means. Contraception and its types.

Contraceptive means are traditionally divided into mechanical, biological and chemical. Different means naturally have a different degree of efficiency. Virtually none of the ways to prevent pregnancy( except sexual abstinence) can not give a 100% guarantee. Quite often, in order to achieve greater safety and reliability, combine various contraceptives. However, it is best to choose a contraceptive, after consulting with a gynecologist in advance.

In this article we will tell you in detail about the most popular forms of contraception.

CONDOMS

Condom( condom) - is made of latex( polyurethane).It is put on the male penis during the erection, before starting the sexual act. After ejaculation, the condom is immediately removed and discarded. This means of contraception in addition to its main purpose also protects partners from the majority of sexually transmitted infections that are sexually transmitted( 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 tear and sometimes they misuse them.


The intrauterine device( which is the IUD, and in everyday life - a spiral) is a convenient and highly effective device that is placed in the uterus. The spiral, despite the high percentage of efficiency( 98-99%), has a number of possible complications. For this reason, the spiral is not recommended for women younger than 23 years old who do not yet have children. To establish and extract this remedy should only the gynecologist after the medical examination. The advantages of the spiral include its long-term use - up to 5 years.


The principle of the patch is that it is glued to a specific area of ​​the body, and then the 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 region increases. For one menstrual cycle, usually three patches are used, that is, one patch is stuck on for seven days. Next, you need to make a one-week break, and at this time menstruation begins. The drawbacks of this method include the appearance of discharge( between cycles), headache.


This protective device is a transparent elastic ring that is made of a synthetic material and contains hormones that begin to separate only after insertion of the ring into the vagina. With the help of a complex system of membranes, only a strictly defined amount of hormones is released daily. The ring can easily be 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 interruption. Side effects: Spotlight, nausea, headaches, etc.


The method of protection by injection consists in stopping ovulation( the process of egg release from the ovary) due to changes in mucus in the cervix, changes in the mucous membrane of the uterine cavity, due to which the development of pregnancy is impossible. The contraceptive effect of this method lasts 3 months. However, this method also has a number of rather serious drawbacks. There may be problems with bleeding, as well as the possible appearance of edema, headaches, a decrease in the level of sexual desire. Also, with prolonged use of this method, bone tissue is destroyed.


The contraceptive system Norplant 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 disruption of the process of fixing the egg to the walls of the uterus. When this implant is used, intermenstrual secretions may appear, the menstrual cycle may also be disrupted, depression, headache, fluid retention in the body, acne and pain in the mammary glands.


It should be remembered that sterilization is a method of irreversible contraception, which leads to complete infertility( however, even in this case we can not talk about 100% reliability, because there is always the likelihood that even the operation will not bring the desired result).Male sterilization is a fairly simple surgical procedure, including the intersection and subsequent dressing of the vas deferens. Female sterilization is performed in a hospital and consists of cutting and ligation of the fallopian tubes. Do not forget that, as with any other surgical operation, sterilization always has the risk of complications - bleeding, infection, adhesions.


Looks like a domed cap made of latex or rubber. It is injected into the vagina no earlier than 6 hours before the onset of sexual intercourse, while closing the cervix. Also, the diaphragm serves as a reservoir for a special cream that suppresses the activity of spermatozoa. The principle of its action coincides with the principle of the condom - these barrier means do not allow a mechanical way to get the sperm into the uterus.


Biological contraceptives are a method of preventing pregnancy with the help of hormonal contraceptives. With this method of contraception, a woman should take tablets daily, which include female sex hormones. After their application, the general hormonal background changes, which in turn inhibits ovulation, changes the state of the intrauterine environment, preventing the possible onset of pregnancy. The effectiveness of hormonal contraceptives 97-99%.Oral hormonal contraceptives are combined, that is, they contain estrogen and progestogen and are not combined, that is, they contain only gestagen. To select a hormonal contraceptive is necessary with the help of a gynecologist. Since there are diseases in which the intake of hormonal contraceptives is contraindicated.


These are hormonal tablets that do not contain estrogens. Their action is to increase the viscosity of the cervical mucus, which in turn greatly complicates the spermatozoa passage into the uterus. Also, these drugs inhibit the maturation of the endometrium, which makes it impossible to attach the egg to the walls of the uterus for its further development. Mini-pills are taken without interruptions, during the entire time needed for protection from pregnancy. The main disadvantage of this method is a somewhat higher frequency( in comparison with other oral contraceptives) of breakthrough bleeding. Mini-pili - is an outlet for women, which is contraindicated in the use of estrogens, and for nursing mothers, including.




Consists of simple mathematical calculations of the estimated date of onset 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 described fertile phase 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 = the 10th day of the cycle.
The end is 30-11 = the 19th day of the cycle.

That is, from 10 to 19 day of the cycle, fertilization may occur, which means that in these days it is necessary to use barrier contraceptive methods or in general to refrain from sex. The drawbacks of this method are, first of all, its insecurity, since initially it involves a regular, constant menstrual cycle, which, unfortunately, no woman has.


Based on calculating the fertile phase by measuring basal( or rectal) temperature in women. Begin the basal temperature measurement on the first day of the cycle. After waking up in the morning, without getting out of bed, you should place the thermometer in the rectum at a level of 1-2 cm, and keep it there for 5-6 minutes. The data obtained must be recorded in a special chart of your basal temperature. It should be remembered that throughout the entire time 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 rises by 0.2-0.5 ° C( usually up to 37 ° C or higher).And this temperature keeps at this level throughout the second half of the cycle until the onset of menstruation. The fertile period begins six days before the predovulatory recession and lasts three more days after it( the total duration of the fertile phase is 9 days).

Advantages of the temperature method of contraception include: ease of use;absence of any side effects;the most accurate definition of days of probable conception when planning pregnancy.
To disadvantages: a high risk of unwanted pregnancy( because the level of basal temperature is affected by a very large number of factors);the need for a daily measurement of basal temperature.


This method consists in the complete removal of the male penis from the woman's vagina until the moment of the beginning of ejaculation. Interruption of intercourse is one of the least effective methods of contraception. According to statistics, out of a hundred couples who use this method, approximately 20-25% face an unplanned pregnancy. First, during the onset of sexual intercourse, a number of active spermatozoa are released together with natural lubrication. Secondly, not every man can control himself during orgasm. And also, when you have sex again, you should use another method of contraception to avoid getting sperm into the vagina. The advantages of this method include accessibility and simplicity, to disadvantages is the incomplete satisfaction of the partners process.

EMERGENCY( also postcoital, fire) CONTRACEPTION combines the methods of preventing unwanted pregnancies, which are used after an unprotected sexual intercourse. Most emergency contraceptive products can be purchased from pharmacies without a prescription and can be used on their own, but we strongly recommend that you consult a doctor to choose the most appropriate emergency contraceptive method for you, check for contraindications to the chosen method, and choose the appropriate dosage.


1) Douching
Douching with a variety of solutions even immediately after unprotected intercourse is very ineffective, because spermatozoa penetrate the cervix just within a minute of ejaculation. Also do not forget that a small number of active sperm can also stand out directly during the sexual intercourse - with lubrication.

2) Hormonal contraceptives
The first way to use hormonal contraception is the simultaneous administration of several kinds of KOC tablets( combined oral contraceptives).The number of tablets required for the administration comes from the dosage of the hormone level in the preparations: Miniziston, Rigevidone, Femoden, Marvelon, Microgonon, Regulon - twice four tablets( interval between admission 12 hours), Logest, Mersilon, Novinet - twice five tablets. This method is called the Yuzpe method and it is effective within three days after the commission of an unprotected sexual intercourse. The effectiveness of this method is not very high - 75-85%.

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

Alternatives to COCs are preparations that contain only progestins and do not contain estrogens. The most effective drugs of this type are Escapel and Postinor. The escapel contains 1.5 mg of the hormone and it is used once. Postinor also contains 0.75 mg of levonorgestrel and should be applied twice at 12-hour intervals. Minor side effects, which can be caused by hormonal methods of emergency contraception, usually for two days pass.

It should be remembered that after applying the methods of emergency hormonal contraception, it is mandatory to apply additional methods of contraception before the next menstrual cycle: spermicides, condoms, etc.

3) Non-hormonal emergency contraception
Mifepristone( Ginepristone) is one of the most effective emergency drugs. A single dose of a small dose of this drug for three days after unprotected intercourse has caused 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 less side effects - for example, the frequency of bleeding is 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 for a longer period in comparison with other emergency contraceptive methods, and that after its administration, there are practically no hormonal-dependent side effects.

4) Intrauterine devices
Another way to protect against unplanned pregnancy is using intrauterine devices( IUDs).To achieve the desired effect, copper-containing IUDs are administered within five days after unprotected intercourse.

Emergency contraception is an alternative to abortion, but it is strongly discouraged from being used as a permanent contraceptive, but only in "emergency" situations( maximum once every six months).Since frequent use of emergency methods of contraception can lead to a violation of the reproductive functions of women.