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Types of contraceptives for women. Effective contraceptives for irregular relationships

Maria Sokolova

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Most of modern methods contraception does not provide a 100% guarantee, especially since more than a third of women become pregnant using one method or another.

What methods for preventing pregnancy are considered the least reliable?

Calendar method and calculation of safe days - does it make sense?

Basis of the method– calculation of safe days. How to determine these safe days? The viability of sperm is about three days, fertilization of the egg occurs within two days after ovulation . Thus, two days should be added to the day of ovulation (in both directions): for a cycle of thirty days it will be the fifteenth day, for a cycle of twenty-eight days it will be the thirteenth. It is believed that it is on these days that there is a risk of getting pregnant, but on the rest you can “not worry.”

Flaw:

The main disadvantage is that the method good only for ideal cycle . But are there many women who can boast of this? After all, the time of ovulation is influenced by many factors:

Weather
Chronic diseases
Stress
Other factors

Not to mention the fact that there are women who become pregnant during what seems to be a safe period. Therefore, before using this method, you must at least study your cycle for a whole year . According to statistics, every fourth woman becomes pregnant after using the calendar method.

Does the temperature method of protection work?

The basis of the temperature method of contraception
A woman’s temperature (measured rectally) changes according to the stage of egg maturation: below 37 degrees – before ovulation, above 37 – after . Safe days are determined as follows: the temperature is measured every morning for six months to a year (right in bed, for at least five to ten minutes). Next, the results obtained are compared, the day of ovulation is identified, and the period dangerous for pregnancy is calculated. It usually starts 4 days before ovulation and ends four days after.

Flaw:

Just like the calendar, this method applicable only if the menstrual cycle is ideal . In addition, it is very complex in its calculations.

Coitus interruptus

Basis of the method known to everyone - interruption of sexual intercourse before ejaculation.

Disadvantage of the method:

The unreliability of this method occurs even with the man’s complete self-control. Why? A separate amount of sperm may be released from the very beginning of sexual intercourse . Moreover, it remains unnoticed by both partners.

Also, the low effectiveness of the method can be explained by the presence of sperm in the urethra, preserved from the previous ejaculation. Out of one hundred women using this method, thirty become pregnant.

Douching after intercourse

Basis of the method– douching of the vagina with potassium permanganate, your own urine, herbal decoctions and other liquids.

Disadvantage of the method:

This method is dangerous not only due to pregnancy, which you did not plan at all, but also with such consequences as:

Violation of the vaginal microflora.
Infection in the vagina.
Vaginitis.

There was no evidence of the effectiveness of the douching method, and no. It does not protect against pregnancy.

Spermicidal lubricants - how reliable is the method?

Basis of the method– use of creams, suppositories, jellies and foams with spermicides. These products have a double effect:

Filler creates mechanical boundary .
Special component eliminates sperm .

Flaw:

Of one hundred percent of women who use spermicides, one in three becomes pregnant. That is, the method is not 100% effective. The following disadvantages of the method should also be noted:

Certain types of spermicides lose effectiveness with regular use due to the habituation of the organisms of both partners to them.
Spermicides considered hazardous due to nonoxynol-9 content which causes destruction skin. And cracks in the genitals are a direct path for infection.
Violation of instructions for the use of spermicides multiplies the risk of pregnancy .

When do oral contraceptives fail?

Basis of the method– regular intake hormonal drugs (tablets). Typically, out of one hundred percent of women who practice this method of protection against pregnancy, five percent become pregnant.

Disadvantage of the method:

Poor memory often causes pregnancy: you forgot to take a pill, and the concentration in the body of a substance necessary for protection decreases. And by the way, you need to drink them constantly and for a very long time .
It is also impossible not to note the main disadvantage of such tablets. Namely - consequences for the body , even if these are fourth generation hormones. Possible consequences– metabolic disorders, weight gain, .
In parallel.
Many medicines reduce or even completely eliminate efficiency this protection against pregnancy.
This method of contraception does not protect against sexually transmitted diseases .

Our people have always been cunning in their invention, as a result of which, since ancient times, the people have had many of their own “home” methods of contraception, which, of course, are absolutely useless.

The most unreliable and dangerous contraception - traditional methods

In such a matter as protection from unwanted pregnancy, you should not trust dubious folk methods.

We do not live in ancient times, and today every woman has the opportunity go for a consultation with a specialist and choose the ideal contraception option for yourself .

Pregnancy in women after 30 years of age represents increased risks both for the baby and for the expectant mother, since fertility begins to decline at this age. To prevent unwanted pregnancy, there is currently a whole range of contraceptives or contraception for women over 30 years old.

According to one study, in 16% of cases, women of fertile age do not use any method of protection against unwanted pregnancy. The main reasons for this behavior of women during sex are inconvenience, religious beliefs and mistrust of modern methods of protection.

The same study says that about 40% of pregnancies are unplanned.

All contraceptives are divided into two large classes: those after which you can get pregnant, and those after which you cannot. The first group is divided into disposable contraceptives and long-term, reusable contraceptives. Disposable protective equipment includes the following:

female condom;
diaphragm;
birth control pill;
ring;
hormonal patch.

Methods such as various implants and hormonal injections are long-acting contraceptives.

Disposable contraceptives

These contraceptives are effective when used either once (female condom and diaphragm) or for short periods of time (pills, patch and ring). At correct use The effectiveness of these methods exceeds 90%.

Female condom and diaphragm

The female condom is barrier method, which is an alternative to the male condom. It is a thin case made of transparent and soft plastic that fits loosely to the walls of the vagina. In addition to its role as a physical barrier that prevents sperm from penetrating the egg, the product is best protection from sexually transmitted diseases. You can wear this condom for up to 8 hours and use it only once. General estimates indicate that this method is 79% to 90% effective against conception, depending on whether it is used correctly or not.

The advantages of this method also include the fact that it is safe for a woman’s fertility and does not lead to side effects. hormonal consequences. However, many women reject this barrier contraceptive due to its anti-aesthetic appearance (the edges of the condom protrude from the vagina). Another disadvantage is its high price.

Another method of protection against conception is the diaphragm.. It is a cover made of latex or silicone, which a woman inserts into the vagina and covers the cervix with it, thereby blocking sperm from entering the uterine cavity. Before using this method, it is necessary to consult a gynecologist, as the woman must learn how to correctly install the diaphragm. In addition, it is most effective to use this barrier method in conjunction with spermicides.

Experts say the diaphragm should be inserted 10 minutes before sex and removed only 8 hours after sex to ensure the spermicide has done its job. After the diaphragm is pulled out of the vagina, it must be thoroughly washed with water and neutral soap, dried and placed in an appropriate case. It should be stored in a dry and cool place. The diaphragm should be changed once a year.

Correct use of this method in conjunction with spermicides determines its effectiveness between 84% and 95%. Just like the female condom, the diaphragm can protect against certain diseases and does not negative impact on a woman’s health, so it can be used even during lactation. The disadvantages of the method are the high price, the feeling of discomfort in some women when the diaphragm closes the cervix, and the inability to use it during menstruation.

Oral methods

These are pills that consist of a set of hormones that must be taken once a day at the same time to increase their effectiveness. There are two types of such tablets:

Combined, consisting of two types of hormones: gestagens and estrogens. Progestogens prevent ovulation, and the additional amount of estrogens leads to a regular menstruation process. However, there are groups of women for whom estrogen use is contraindicated due to health problems, such as hypertension and obesity, and for women over 35 years of age who smoke heavily.
Mini-tablets containing only gestagens.

An analysis of research results shows that the rate of use of contraceptive pills is in second place after the frequency of use of the male condom. The effectiveness of this anti-conception drug is in the range of 90−99%.

The main advantage of the tablets is fast recovery fertility after a woman stops drinking them, as well as their low price. In addition, they help with problems with skin acne, hair loss and reduce the risk of ovarian cancer. It should be remembered that the effectiveness of tablets directly depends on their daily use at the same time.

The disadvantage of this method is that it does not protect against diseases that are transmitted during sexual intercourse.

It should be noted that there is also an emergency contraceptive pill, which is taken by a woman after sexual intercourse and only if sex was carried out without any means of protection or this means has failed. At the same time, the risk of becoming pregnant is reduced by 95%.

Bandage and ring

The patch is a tissue consisting of gestagens and estrogens, which are released gradually after the patch comes into contact with human skin. It is attached to those areas of the body that are not influenced by clothing. Its action is carried out according to the same principle as the action of the contraceptive pill. The patch needs to be changed every 21 days. Seven days after removing the patch, the woman begins to menstruate. The patch is not too expensive, and its effectiveness is 98.8−99.7%.

This method has the same disadvantages as the pill, that is, it does not protect against diseases transmitted during sexual intercourse, and is also contraindicated in smoking and women suffering from hypertension and obesity.

Another effective contraceptive is the period ring, which consists of transparent and flexible plastic, has a diameter of 5 centimeters and is inserted into the woman's vagina, like a tampon, between the 1st and 5th day of menstruation. The ring functions for 21 days, then it is removed and menstruation begins after 7 days.

Like combination pills, the ring releases the same hormones (progestins and estrogens) that are absorbed by the vaginal mucosa. The effectiveness, price, disadvantages and contraindications of using this method are similar to those for the contraceptive pill and patch.

Long-acting agents

The list of contraceptives for women over 30 years of age includes hormonal injections and an implant, as well as an intrauterine device. Their effectiveness lasts from several months to several years.

Hormonal injections

This method is not widely used, but its effectiveness is estimated to be between 97% and 99%. The method consists of an intramuscular hormonal injection between the first and fifth days of menstruation. The injection is carried out by a gynecologist, and there are three types:

monthly;
two months;
three months.

In the first case, the injection contains progestogens and estrogens, in the last two - only progestogens. The principle of operation of this method is to block the ovulation process. In addition to its main function, the product also helps reduce the risk of inflammatory diseases of the reproductive system and reduces painful sensations during menstruation.

The disadvantage of this method is the lack of protection against sexually transmitted diseases and the failure monthly cycle in a woman. It is also harmful to fertility, which only recovers several months after the injection takes effect.

Contraception with an implant

This is a 4 cm wand that is placed inside the non-dominant arm under local anesthesia. This stick releases a special hormone (etonogestrel) every day, and the implant is effective for three years. The effectiveness of this contraceptive method is above 99.5%, and a woman’s menstruation may completely disappear. This method can be used instead hormonal drugs, which contain estrogens and are contraindicated for those suffering from hypertension and obesity, as well as for women who smoke.

This method allows a woman to feel maximum sexual freedom. The disadvantage of the implant is that it does not protect against sexually transmitted diseases. In addition, some women may experience side effects from action active hormone, for example, severe headaches, acne, constant fatigue and fluid retention in the body. Another disadvantage is that the implant is placed in the body surgically, so it leaves a small scar on the arm.

Intrauterine device (IUD) or IUD

An IUD is a small plastic device shaped like a “T” that a gynecologist places inside a woman’s cervix. Usually the plastic spiral is coated with copper. This metal is toxic to sperm and prevents them from fertilizing an egg. The spiral is effective for 5 years, and its effectiveness in preventing unwanted pregnancy is 99%.

Due to the size of the device and some of the effects it can cause, it can only be used by women who have already given birth. There are also cases where IUD changes the menstrual cycle and makes its symptoms more painful.

In this regard, recently there have been models of devices that use hormonal drugs instead of copper. Such devices are smaller in size and can be used even by nulliparous girls. The effect of IUD with hormones lasts for 3 years, and its effectiveness is approximately the same as that of IUD with copper.

Another advantage of the IUD is that a woman’s fertility is restored immediately as soon as the device is removed from the cervix.

The only disadvantage of this method is that it does not protect against sexually transmitted diseases.

When choosing one or another means of protection against unwanted pregnancy, it is necessary to take into account several basic factors, for example, for contraception after childbirth it is better to use disposable methods. Right choice a woman can do if she has sufficient information about existing means contraception. In this case, she must consult a gynecologist, since not all remedies can be used in certain cases. The gynecologist will provide the woman with all necessary information and will offer her the most effective method contraception in its specific circumstances.

Attention, TODAY only!

Today there are many ways to prevent unwanted pregnancy. A wide selection allows you to choose the most suitable contraceptives for each woman. At irregular relationships It is also important to take care of protection. How to decide on a contraceptive method and what to look for when choosing? Let's try to understand this issue in more detail.

Why is contraception needed?

Every woman sooner or later thinks about how to avoid an unwanted pregnancy. At the same time, it is absolutely not necessary to exclude love pleasures from life, which, by the way, negatively affects the psycho-emotional state. Modern medicine currently offering a large number of a variety of methods of contraception.

The use of contraceptives allows you to maintain women Health and reproductive function. Selection optimal method should be handled by a gynecologist, since the patient’s age, medical history and regularity of sexual activity are taken into account.

What contraceptives are there?

To protect against unwanted pregnancy, there are many types of contraception, each of which is suitable in a specific situation. They are usually divided into traditional and modern. The first includes interrupted sexual intercourse, barrier methods (condoms, diaphragm), spermicides, non-hormonal agents and a biological (calendar) method of protection.

Modern types of preventing egg fertilization are the most popular, as they provide an almost 100% guarantee. These include hormonal IUDs (intrauterine devices), injections, and vaginal rings. Each method has its own indications, side effects and contraindications. Therefore, without consulting a specialist, it is unlikely that you will be able to select effective contraceptives.

Hormonal methods of contraception

The most common and reliable are based on female hormones(synthetic analogues) - estrogen and progesterone. Some may be single-component and contain only progesterone, in which case they are called mini-pills. They are the most gentle for the body. Combined contraceptive drugs may contain different doses of the main active ingredient.

The action of hormonal drugs to protect against unwanted pregnancy is to block the maturation of the egg and the onset of ovulation. Mini-pills only affect the uterine mucosa, making it looser, and the secreted secretion becomes viscous. This prevents the sperm from fertilizing the egg. Planning for pregnancy can begin 2-3 months after stopping taking birth control pills, when reproductive function is completely restored.

Benefits of hormonal drugs

Past generation hormonal pills had a number of side effects, which forced many women to abandon their use. The newest contraceptives are well tolerated by the body and are practically devoid of unpleasant consequences use. They are produced in patches, injections, vaginal rings and hormonal implants.

Oral contraceptives, containing one type of hormone (mini-pill) are allowed to be taken during lactation. The components of the medicine do not affect the baby’s body. To normalize the menstrual cycle or have a medical abortion, women are recommended to take combination medications. They allow not only to further prevent the fertilization of the egg, but also to protect against inflammatory diseases.

The benefits of hormonal medications also include eliminating skin problems. Sex hormones are known to influence sebum production. If a violation occurs, male hormones begin to be developed in more than women, and, as a result, acne appears on the skin.

Quite often, women are prescribed to treat polycystic ovary syndrome and eliminate severe pain syndrome during menstruation. It has been scientifically proven that such products have preventive action and significantly reduce the risk of developing cancer of the mammary glands, uterus, ovaries, and also prevent mastopathy, endometriosis and fibroids.

Contraindications

You should carefully study the list of contraindications for use to prevent pregnancy. The main factors prohibiting the use of oral contraceptives are:

Cardiovascular diseases ( ischemic disease, hypertension, stroke, heart attack), venous pathologies.
Kidney diseases.
Oncology.
The last stages of obesity.
Autoimmune diseases.
Benign neoplasms.
Venereal diseases.
Vaginal bleeding during the intermenstrual period of unknown etiology.
Pregnancy.
Diabetes.

Each drug has its own list of contraindications, and therefore you should seek help from a specialist who will help you choose the right hormonal contraceptives. In case of irregular relationships, such drugs can also be avoided. Non-hormonal contraceptives are the most suitable method of protection against unwanted pregnancy if sexual intercourse occurs less than once a week.

Mechanism of action of non-hormonal contraceptives

Non-hormonal methods are very relevant during lactation, with irregular sexual relations, or if taking hormonal drugs is prohibited. The action of such drugs is based on the destruction or damage of sperm. Non-hormonal contraceptives have a wide variety of reviews. For some women, this is the best and safest way to plan a family, while for others it is completely untrustworthy.

Non-hormonal preparations contain special substances - spermicides, which contribute to damage to the sperm membrane, which provokes their death. The active component may be nonoxynol, benzalkonium chloride. The substances form a thin film on the vaginal mucosa, which performs protective function, as well as contributing to the thickening of mucous secretions. Non-hormonal contraceptive drugs are administered directly into the vagina, where they begin to act within 10-15 minutes. That is why they are classified as barrier methods of contraception.

Are non-hormonal remedies effective?

Non-hormonal contraceptives cope with the task only in 80% of cases. For active women sex life, this method is not reliable. Local protection is suitable for irregular contacts, the impossibility of using oral contraceptives and intrauterine hormonal IUD, some diseases of the female genital organs, endocrine pathologies, during breastfeeding.

Main advantage non-hormonal agents protection - absolute safety for health and absence of serious side effects (in in rare cases itching is possible). A woman may not worry that she did not take the pill, as is the case with hormonal drugs, because the drugs are used immediately before sexual intercourse.

Disadvantages of non-hormonal drugs

The disadvantages of non-hormonal contraceptives include:

Administration before coitus - it is necessary to precisely control the process and administer the drug no later than 10 minutes before contact.
It is forbidden to take a shower immediately: soap neutralizes the acidic environment in the vagina created by the product. In the annotation to the drugs you can find information that hygiene procedures allowed only 2-3 hours after unprotected contact.
Short-term effect of the drug - the protection created by the product lasts for 3-4 hours, that is, before the next contact it is recommended to administer new pill, because reliable protection the first one will no longer provide.
Itching - some women note that after introducing the product into the vagina, itching appears (an allergic reaction).
Intolerance to the components included in the drug - in this case, do not use a contraceptive.

Types of non-hormonal contraception

Non-hormonal contraceptives have recently become increasingly popular due to their safety. They are classified according to the form of release (tablets, suppositories, creams, tampons, vaginal balls, aerosols) and the main active ingredient. Despite some differences, the main effect of the drugs will be the same. A wide selection of drugs allows a woman to choose the most suitable and easy-to-use contraception. It is recommended that you first read the instructions, which will indicate the method of administration and the duration of the effect.

Non-hormonal birth control pills

Girls and women who have contraindications for use hormonal contraceptives and who do not want to influence hormonal background, you can use local birth control pills or suppositories. These are the most convenient spermicide-based protection products to use.

Non-hormonal birth control pills in case of irregular relationships, this is an ideal option for women to protect against unwanted pregnancy and sexually transmitted diseases. Quite often they are used by girls who are afraid of the side effects of oral contraceptives or, due to health conditions, cannot use other methods. You can choose vaginal tablets yourself or with the help of a gynecologist. Manufacturers recommend combining some of them with other methods of protection, such as a diaphragm.

The following non-hormonal contraceptives (for women) are most effective:

"Benatex";
"Pharmatex";
"Patentex Oval";
"Traceptin";
"Conceptrol".

Some of the listed remedies are based on the substance nonoxynol, which can somewhat prolong love pleasures by reducing sensitivity, others are based on benzalkonium chloride. The drugs do not differ in effectiveness and mechanism of action. You should prefer a product whose components a woman will not have allergic reaction in the form of burning and itching.

"Pharmatex"

Currently, Pharmatex is the most popular among non-hormonal methods of contraception. As active component benzalkonium chloride acts as medicinal antiseptic, which has antifungal and contraceptive effects. At the local level, the drug destroys sperm and increases the secretion of viscous secretions, like other non-hormonal contraceptives.

For irregular relationships, Pharmatex suppositories will be the most convenient option for protection. The drug is also available in the form of cream, vaginal tablets and capsules, and tampons. Suppositories are effective for 4 hours, tablets - no more than 3. The manufacturer recommends introducing a new suppository (tablet, capsule) with each subsequent sexual intercourse.

According to studies, Pharmatex can protect against gonococcus, chlamydia, trichomonas, and type 2 herpes virus. At the same time, the remedy does not provide harmful influence on the vaginal microflora and does not change normal level acidity.

"Patentex Oval"

When safe contraception is necessary, non-hormonal and at the same time effective contraceptives are selected. In irregular relationships, many women use a product based on nonoxynol - Patentex Oval. Its effectiveness ranges from 80 to 90%. The drug is produced in the form of vaginal foaming suppositories, which must be administered before sexual intercourse. In addition to protecting against unwanted pregnancy, suppositories provide antifungal and antiviral effect, that is, they protect a woman from many diseases transmitted through unprotected sexual contact.

Contraception after exposure

Emergency contraception is used if sexual intercourse was completely unprotected. In order to definitely protect yourself from unwanted pregnancy, it is recommended to take a contraceptive. No more than three days should pass after the act.

One-time contraception is based on blocking the release of a mature egg from the ovary and preventing attachment to the wall of the uterus in the event of fertilization. Doctors advise resorting to this method only in the most extreme situations. Popular products from this category include “Postinor”, “Escapelle”, “Zhenale”.

Prevention of abortion is key point in preserving the reproductive health of a girl. According to experts, artificial termination of pregnancy quite often leads to infertility. Today, approximately every fifth pregnant woman resorts to abortion. Despite high efficiency contraceptives, many young ladies unreasonably neglect this opportunity. We should not forget that the main objectives of contraception are not only to prevent medical abortions, but also to prevent infection with sexually transmitted diseases.

Types of contraception

There are different methods of contraception. However, regardless of the type of contraception, female contraceptives must be highly effective, safe for health, easy to use and available for purchase.

Modern methods of contraception:

Physiological.
Barrier or mechanical.
Chemical.
Hormone.

Female contraceptives can be bought in pharmacy chains without a prescription.

Physiological

Peculiarity physiological method contraception is that the girl in certain period her menstrual cycle should abstain from intimacy or actively use other contraceptives. As a rule, if the menstrual cycle lasts 28 days, then it is necessary to abstain from vaginal sex in the period from the 11th to the 18th day, when ovulation occurs. The physiological method is based on alternating periods of high and low fertility (ability to bear children). Scientists have found that the egg remains viable for 1–3 days, and the sperm for about 5 days. What methods can be used to clarify the time of ovulation:

Calendar. It is necessary to calculate the fertile period, taking into account individual duration menstrual cycle.
Temperature. To determine the fertile period, measurements are taken rectal temperature. They should be held at the same time in the morning. While lying down, the woman inserts a special thermometer into the rectum for 5–6 minutes. Ovulation is recognized by analyzing the temperature curve. The defining moment is a temperature drop of 0.2–0.3 °C and a subsequent rise of 0.7–1.0 °C. Such changes are observed only 1–2 days after the completion of the ovulatory phase. Having determined the day of ovulation, the “dangerous period” is calculated.
Cervical. By the nature of the changes cervical mucus Due to estrogen during the menstrual cycle, it will be possible to judge what phase the woman is in.
Multicomponent. Judging by the name, it is not difficult to guess that this method involves measuring basal temperature, recording changes in the properties of cervical mucus, calendar calculations and some subjective signs (in particular, the appearance of pain in the lower abdomen, discharge, etc.).

The main advantage of the physiological method is considered to be ease of use and absolute safety for the female body, since no consequences or adverse reactions can be expected. However, it is worth noting that this method of contraception is suitable for women with normal menstrual cycles. But for teenagers and young girls, the physiological method is inappropriate to use for several reasons:

Irregular ovulatory cycle.
Young girls quite often experience random or extraordinary ovulation.
Late ovulation is more common.
Low efficiency.
Girls find it difficult to make correct calculations and perform basic methods of physiological contraception.
This method is not able to protect against sexually transmitted diseases.

Not all types of contraception can provide 100% protection against unwanted pregnancy.

Barrier or mechanical

Usage special means, preventing sperm from moving into the uterine cavity is called a barrier or mechanical contraceptive method. It is known that barrier contraceptives are provided for both women and men. The most common types of barrier protection against unplanned pregnancy:

Condoms (female and male).
Vaginal diaphragm.
Cervical caps.

Condoms

Today, the main material for making condoms is latex. It helps not only protect against unplanned pregnancy, but also prevents infection with sexually transmitted diseases. The main disadvantage of the method is the frequent rupture of condoms made of thin elastic rubber. According to statistics, this happens approximately once every 50-300 times we have sex.

If a condom ruptures, it is recommended to inject a spermicidal substance into the vagina and/or use an oral contraceptive for emergency post-coital prevention of unwanted pregnancy. In addition, quite often when using a condom, both sexual partners note a decrease in sexual pleasure. Clinical studies show that many boys and men neglect this method of contraception.

Therefore, a condom for women was invented, which is effective both as a contraceptive and in preventing infection with sexually transmitted diseases. It must be put on a few hours before intimacy and removed after sex. Repeated use is strictly prohibited.

Vaginal diaphragm

To explain in a nutshell, the vaginal diaphragm is a fairly good barrier contraceptive, shaped like a hemisphere and consisting of a rubber cap connected to a ring. To prevent the passage of sperm, it should be inserted into the vagina in such a way as to close the cervical canal. To increase contraceptive effectiveness, the vaginal diaphragm is used together with spermicidal agents, which can be purchased in the form of creams, foams, gels, etc.

Various models and sizes are available, so individual selection is recommended. As a rule, the insertion of the vaginal diaphragm is carried out immediately before intimacy, using a spermicide on both sides. Its removal is carried out 7–10 hours after completion of sexual intercourse. I would like to note that this barrier method of contraception does not help protect against diseases transmitted during sex, although it can protect the internal genital organs from certain types of infections.

Cervical cap

The mechanism of action and contraceptive effectiveness of cervical caps are almost the same as that of vaginal diaphragms. In shape they resemble a hemisphere with thickened edges. The negative pressure created helps the cap not to slip off the cervix. It should be administered 30–10 minutes before sexual intercourse. It can remain in the vagina for 6–9 hours (maximum period – 1.5 days). Unlike a condom, the vaginal diaphragm and cervical cap can be used more than once. Before using any method of barrier or mechanical contraception, it is recommended that you carefully read the instructions.

Modern contraceptives for women (contraceptives) must be available with a prescription.

Chemical (spermicidal)

The chemical or spermicidal method of contraception is based on the use of special agents that can inactivate sperm. This effect is realized due to the active component, which destroys the cell membrane of male germ cells in a few seconds. Spermicides are available in the form of gel, cream, suppositories, foam, tablets, etc. The effectiveness of the chemical method of contraception directly depends on its correct use. Features of application:

Spermicidal preparations are administered no later than 30–60 days before sexual intercourse.
Spermicides must come into contact with the cervix.
If you don't know how to use it correctly chemical method contraception, consult your gynecologist.

The active substances included in spermicides can not only destroy sperm, but also have a bactericidal and virusicidal effect. For example, the active component nonoxynol or benzalkonium chloride inhibits the growth and reproduction of such pathogenic microorganisms, such as chlamydia, mycoplasma, trichomonas, ureaplasma, etc. To increase contraceptive effectiveness, many experts advise combining the use of chemical and barrier contraceptive methods.

Pharmatex

One of the most popular spermicidal agents for chemical contraception is Pharmatex. To completely destroy sperm, 20 seconds of male germ cells being in an environment with Pharmatex is enough. Repeated sexual intercourse requires a new administration of the drug. In addition, it has antimicrobial activity against a number of sexually transmitted diseases (for example, gonorrhea, chlamydia, trichomoniasis, etc.). At the same time, Pharmatex does not affect the normal microflora of the vagina and does not lead to menstrual irregularities.

It can be combined with intrauterine devices (IUD), condoms, vaginal diaphragm, cervical caps. Pharmatex is available in the following forms for vaginal use:

Pills.
Pills.
Candles.
Tampons.
Cream.

Each form has its own characteristics of use, which can be found by reading the official instructions for the drug. It should be remembered that Pharmatex is contraindicated in case of hypersensitivity to its active components and inflammatory diseases genitals. To avoid a decrease in spermicidal effect, simultaneous vaginal use of several drugs is not recommended.

Contraceptive sponge

A product that combines mechanical and chemical protection against unwanted pregnancy is called a contraceptive sponge. It acts as a barrier, preventing the movement of male germ cells in the cervical canal, and also secretes a spermicidal component that helps destroy sperm. The shape is a round pad with a small depression on one side, which should be adjacent to the cervix. However, due to its low contraceptive effectiveness, it is usually not recommended for use by adolescents and young girls. More experienced and older women are quite capable of installing this type of contraceptives and do not have special problems using.

The best method of contraception is the combined use of contraceptives (for example, hormonal drugs and a condom).

Hormone

Statistics show that almost 150 million girls and women around the world take oral contraceptives every day. At the same time, at present, the newest hormonal drugs are taken either orally or can be introduced into the body in other ways (injection, transdermal, intravaginal, etc.). Mechanism hormonal contraception is as follows:

Slow down the production of gonadotropic hormones.
Suppress the ovulation process.
Increase the viscosity and density of cervical mucus, which is produced by the cervix.
By changing the properties of cervical mucus, the motility of sperm in the direction of the uterine cavity is inhibited.

Taking oral contraception stops ovulation and prevents the fertilization of the egg. Also, due to the effect on the endometrium, there is a prevention of egg implantation in the uterine cavity.

Oral contraceptives

There are many types of hormonal contraceptives. Let's focus on the most clinically significant ones. Depending on the composition, oral contraception is divided into the following main groups:

Combined hormonal drugs containing progestogen and estrogen (Mersilon, Ovidon, Regulon, Rigevidon, Silest, Triziston, Triquilar, Belara).
Hormonal drugs whose active component is progestogen (Exluton, Ovret, Microlut, Charozetta). They are also called Mini-pills.

The ethinyl estradiol content plays a significant role when choosing the optimal combined oral contraceptive. Considering the amount of estrogens, hormonal drugs are divided into three large groups: high-, low- and micro-dose. Popular representatives of each of these groups:

The first is Anteovin, Silest, Non-ovlon. They contain more than 35 mcg of ethinyl estradiol.
The second is Regulon, Belara, Microgynon, Femoden (30 mcg each).
Third - Mercilon, Mirrel, Miniziston (20 mcg each).

Main advantages and disadvantages

Among all hormonal oral contraceptives, priority is given to monophasic drugs containing a stable amount of both female hormones (for example, Mercilon). Two- and three-phase drugs have different amounts of estrogens and gestagens, which helps them act on different periods menstrual cycle. The main advantages of monophasic oral contraceptives:

They are more effective than other types of non-invasive contraceptives.
Available for most girls and women.
They do not provide severe consequences for the body.
After stopping use, fertility is restored fairly quickly.
It is considered a highly safe method.
Long-term use possible.

A distinctive feature of most new combined oral contraceptives is their high efficiency and safety. In addition, according to clinical studies, the contraceptive effect is not their only property. What else is typical for contraceptive hormonal drugs:

Able to regulate the menstrual cycle, especially in young girls.
Helps get rid of algodismenorrhea (painful menstruation).
If you choose the right contraceptive, you don't have to worry about weight gain.
They do not affect the main types of exchange.
Eliminate deficiency of female hormones.
Reduce the likelihood of a number of gynecological and somatic diseases.

The appearance of side effects is possible in the first 3 months of taking combined hormonal drugs. In most cases, they gradually disappear over time. Long-term use usually does not provoke such adverse reactions as headache, dyspeptic disorders, swelling of the mammary glands, painful menstruation, etc.

Unlike combined oral contraceptives, Mini-pills containing only progestogens have less pronounced contraceptive effectiveness. However, they do not apply serious harm young body. In addition, they are recommended for girls and women who have contraindications to the use of other oral contraceptives.

Use latest methods Contraception for women is recommended after consultation with a specialist.

Contraindications

Hormonal contraceptives can boast quite long list various kinds of contraindications. Most attention those that have a high lethal risk deserve it. Diseases related to absolute contraindications on the use of hormonal oral contraceptives:

Heart and vascular diseases (uncontrolled high blood pressure, myocardial infarction, atherosclerotic lesion bloodstream).
Severe pathologies of the blood coagulation system and other diseases that provoke the formation of blood clots ( venous thrombosis, thromboembolism).
Tumors reproductive system and mammary glands.
Severe pathology of the liver and kidneys with the development of functional failure.

How to take oral contraceptives?

To reduce the development of side effects and increase contraceptive properties, new regimens for the use of hormonal contraceptives have been developed. One of the latest innovations was the introduction into clinical practice prolonged use of combined oral contraceptives. Continuous use of the drug was proposed for 3–5 menstrual cycles, after which a 7-day break was taken and use was resumed.

Passed successfully clinical trial mode called “63+7”. Its essence is that the contraceptive is taken for 63 days, then there is a pause in taking it for exactly a week. In certain cases, the prolonged regimen can be extended to 126+7. With prolonged use of oral contraceptives with minimal interruption, a decrease in the occurrence of “withdrawal symptoms” is observed. The prolonged dosage regimen made it possible for girls and women to experience fewer headaches, menstrual irregularities of various types, breast pathologies and other side effects.

In addition, another innovative approach to taking hormonal contraceptives, called quick start, is being actively developed. What are its features:

It is allowed to start taking combined oral contraceptives at absolutely any period of the menstrual cycle.
The absence of a significant negative impact on pregnancy and fetal development from the latest contraceptive drugs allowed scientists to come to such conclusions.
If pregnancy is diagnosed while using oral contraception, the medication must be stopped. It has been established that short-term use of hormonal contraceptives during pregnancy does not affect the risk of miscarriage.

The combined method is the most reliable way protection against unwanted pregnancy, involving the simultaneous use of several types of contraceptives.

Modern contraceptives for women may have contraindications and side effects, which should be familiarized with before using them.

Emergency contraception

Despite the wide range of contraceptives, the problem of unplanned pregnancy remains very relevant for millions of girls and women. As a rule, the risk of unwanted pregnancy is associated with having sex without using contraception or its ineffectiveness. Oddly enough, many women believe that in such situations the only thing they can do is wait to see whether the next period will come or not.

However, by using emergency contraception methods, you can significantly reduce the likelihood of unexpected conception. It is worth noting that this approach is practically unknown to many girls and women. At the same time, popularizing the basic principles of emergency contraception among the masses would significantly reduce the number of abortions.

When is emergency contraception indicated?

It's no secret that the chance of conceiving a child varies throughout the menstrual cycle. According to some data, the probability of pregnancy after unprotected intercourse is approximately 20%, regardless of the day of the menstrual cycle. At the same time, if sex without contraception occurred during the periovulatory period, then the chances of getting pregnant increase to 30%.

A British study showed that unprotected intercourse during ovulation can result in conception in 50% of cases, even during the first menstrual cycle. It has long been proven that sperm in a woman’s genitals remain viable for 3–7 days, and an unfertilized egg remains viable for 12–24 hours. According to most experts, it is advisable to carry out emergency contraception in the first 1–3 days after intimacy. In what cases is it indicated:

Any unprotected sexual intercourse. Simply put, vaginal sex occurred without the use of contraceptives (condom, vaginal diaphragm, combined oral contraceptives, etc.).
During intimacy, the condom broke or fell off.
Premature removal of the vaginal diaphragm or cervical cap.
Skipping a dose of oral contraceptives or taking the drug more than 12 hours late.
A girl or woman was forced to have sex without her consent.

As shown clinical experience, modern contraceptives for women, regardless of the type, method and route of administration, are highly effective in preventing unplanned pregnancy.

Emergency contraception methods

Use of combined oral contraceptives (Yuzpe method).
Specially developed drugs for emergency protection.
Use of intrauterine contraception.

Combined hormonal oral medications It is used quite often as emergency contraception. This method was named after the Canadian scientist Albert Yuzpe, who first used it and widely promoted it. Its essence was reduced to 2 times the use of a large dosage of estrogens and progestogens for 3 days from the moment of completion of sexual intercourse. The break between doses should have been at least 12 hours.

The effectiveness of the method was more than 95% and depended on two factors:

The duration of the interval between intimacy and the prescription of emergency contraception. The earlier contraceptives are taken, the higher the expected effect.
The day of the menstrual cycle when there was sex.

Despite the high effectiveness of the Yuzpe method, it requires the use high doses oral contraceptives and is associated with a high risk of adverse reactions. It has been recorded that in 30% of cases quite pronounced side effects are observed, including nausea, vomiting, migraine attacks, pain in the mammary glands, etc.

In addition, specially developed drugs based on levonorgesterel are also successfully used for emergency contraception. They are characterized by a pronounced gestagenic effect and the absence of estrogenic action. Among the female population, the two most popular drugs that contain levonorgesterel are Postinor and Escalep. According to the results of world clinical trials, the effectiveness of these contraceptives is slightly higher than that of the Yuzpe method. Also, the tolerability of Postinor and Escalep is much better.

Properly selected female contraception will help maintain reproductive health.

Non-hormonal drugs for emergency contraception

Most non-hormonal drugs for emergency protection against unplanned pregnancy contain the active component mifepristone, which is a synthetic antiprogestin. It is quite often used as a means for artificial termination of pregnancy in the early stages ( medical abortion). However, it can also be used for emergency contraception, especially when the patient cannot be prescribed hormonal contraceptive methods. Taking into account the phase of the cycle, the drug realizes its contraceptive effect due to:

Interfering with the release of luteinizing hormone.
Blocking or delaying ovulation.
Disruption of natural changes in the endometrium.

During some scientific research mifepristone was found to be more effective and better tolerated than levonorgesterel. One of the main advantages of mifepristone over other methods of emergency contraception for women was that there was no decrease in effectiveness when the interval between sex and use of the contraceptive was increased (up to 120 hours).

On post-Soviet space The drug Ginepristone, used for emergency contraception, has become widespread. Its distinctive feature is that it is well tolerated and has a low dosage of the active component, compared to other existing non-hormonal drugs that are used for “quick” protection against unwanted pregnancy. Ginepristone must be taken once for 3 days after intimacy, excluding the period of the menstrual cycle. If after taking the drug there were repeated coitus, you should use additional contraceptive methods(for example, a condom). Since the contraceptive effect of Ginepristone during subsequent sexual intercourse is somewhat reduced.

Benefits of emergency contraception

I would like to clarify that hormonal and non-hormonal drugs for “urgent” contraception are intended exclusively for emergency cases and are not used on a regular basis. The main advantages of postcoital protection against unplanned pregnancy:

Ability to take contraceptives occasionally. This method will be especially interesting for girls and women who have an irregular sex life.
In most cases, there is a high contraceptive effect.
There are no significant adverse reactions.
Accessibility for many patients.

It should be remembered that emergency contraception drugs do not affect the implanted egg. Most of the recommended methods are safe for the fetus and the course of pregnancy. Therefore, even if conception occurred while using the above drugs, the pregnancy can be maintained. In addition, do not forget that contraceptives used in emergency situations, do not protect against sexually transmitted diseases. In case of suspected infection venereal infection After intimacy, you should immediately consult a specialist.

“Conscious pregnancy” is a popular term today, which denotes the right of every couple to consciously choose the time for such an important step as the birth of a baby. There are many methods of contraception: to suit everyone’s taste and budget - monophasic contraceptives, implants, condoms, rings, IUDs and much more. But any method of preventing unwanted pregnancy has both advantages and disadvantages. Let's figure out how to choose from this variety suitable look contraception and how to avoid misfires.

1. Sterilization

This is the most effective method contraception with 99.9% reliability. Women are sterilized by tubal ligation, men by vasectomy.

BUT! The main disadvantage of sterilization is its radicality. Conclusion: if after a certain number of years you want to leave behind offspring, you will not succeed.

2. Oral contraceptives

The leader in non-invasive methods of contraception is combined oral contraceptives (COCs) in tablets. Their reliability is estimated at up to 99.7%. Complexly influencing the female reproductive system With the help of hormones, oral contraceptives suppress ovulation, thicken mucus in the cervical canal and provoke thinning of the endometrial layer in the uterus. This triple action provides temporary “rest” for the ovaries, reducing the risk infectious diseases through the barrier function of mucus (however, they do not completely protect against sexually transmitted infections) and reduces the amount of blood loss of a woman during menstruation.

Combined oral contraceptives differ favorably from other hormonal contraceptives in that different tablets contain different dosages and combinations of hormones. In European countries, this method is the most popular among women. different ages and different lifestyles. Indeed, in a wide range of these products, including those presented on the Ukrainian market, there are even tablets with innovative dosage regimens 24+4 and 26+2. They shorten the non-hormonal period, which allows you to minimize negative symptoms, and, importantly, simplifies the regimen for taking such pills.

Additional non-contraceptive actions: COCs latest generation, also already available to Ukrainian women, contain in addition to hormones also additional substance- calcium levomefolate ( active form folic acid). Thanks to this substance, modern contraceptives have a pronounced additional non-contraceptive effect: they eliminate negative manifestations PMS, improve the condition of skin and hair, fight acne, prevent photoaging ( negative influence sun on the skin), and even have an antidepressant effect. In addition, folate-containing contraceptives significantly reduce the risk of developing defects nervous system child during future pregnancy.

BUT! Oral contraceptives have some contraindications, are selected and prescribed exclusively by a gynecologist individually for each woman, and also require the woman to be organized and attentive when taking it.

3. Intrauterine contraception

We are talking about an intrauterine device and an intrauterine hormonal system, which differ both in reliability and mechanism of action. The spiral performs a barrier function and prevents the implantation of a fertilized egg into the uterine cavity. Intrauterine hormonal system releases a certain amount of a hormone that increases the viscosity of mucus in the cervical canal, thins the endometrial layer and suppresses sperm motility. The reliability of intrauterine contraception ranges from 99.2 to 99.8%.

BUT! Intrauterine device increases the risk of developing inflammation of various types, often causes heavy, long, painful menstruation and creates a risk ectopic pregnancy. And the hormonal system is usually placed on long time- 5 years. Therefore, it is not suitable for women who do not plan to delay conception for so long. In addition, this method of contraception sometimes causes intermenstrual bleeding and pain.

4. Hormonal implants and injections

8. Coitus interruptus

This oldest method of contraception involves the partner removing the penis from the vagina before ejaculation.

BUT! A small amount of seminal fluid is also released during sexual intercourse, so the reliability of the method does not exceed 80%. In addition, the method is very inconvenient for a man, who is not only forced to closely monitor the process, but also risks problems with potency, ejaculation, and even prostatitis. In addition, when using this method, the woman also experiences greater psychological discomfort.

9. Spermicides

This chemical substances as vaginal suppositories, creams, tablets and capsules that are inserted into the vagina and have a destructive effect on sperm. Their effectiveness is no more than 70%.

BUT! Chemical contraceptives require constant administration before sexual intercourse and often cause irritation and inflammation of the vaginal mucosa, as well as vaginal candidiasis.

There are also emergency contraceptive medications containing levonorgestrel, which affects ovulation and reduces the risk of a woman's egg being fertilized during the preovulation period. These drugs include escapelle and others.