home Endocrinology What kind of contraception is there? Types of emergency contraception. Video: Hormonal contraception

What kind of contraception is there? Types of emergency contraception. Video: Hormonal contraception

Today, every couple can control their sex life and consciously plan their pregnancy. The existence of such freedom in life is a huge merit of scientists and pharmacists, who regularly invent more and more advanced methods of contraception. Of course, even the most reliable method sometimes fails. In addition, there are many myths that make it difficult to understand the true reliability of a particular method.

Let's try to figure out which methods of contraception are the most reliable.

Sterilization - 99.9%

The most effective method of contraception is sterilization. In men it is a vasectomy, in women it is tubal ligation. These procedures require surgery and exclude the possibility of having a child in the future, so, naturally, they are not particularly popular among young men and women. In terms of reliability, sterilization is surpassed only by complete abstinence.

Features: Recommended only for women who already have several children and in case of medical contraindications to pregnancy, because the ability to become pregnant is not restored. There is also a risk of ectopic pregnancy.

Oral contraceptives - 99.7%

Hormonal pills are one of the most reliable methods of contraception.

Their main feature consists in the mechanism of action on the woman’s body. They have a complex effect on the female reproductive system: ovulation is suppressed, mucus thickens cervical canal, the endometrial layer in the uterus becomes thinner. While taking the pills, the woman’s ovaries “rest”, and the required dose of the hormone is provided by the drug. Thickening of cervical mucus in the cervix prevents not only sperm from entering the uterus, but also bacteria, thereby reducing the risk infectious diseases. However, it should be understood that oral contraceptives do not protect against sexually transmitted infections. Also, when using this method of contraception, a woman’s blood loss during menstruation is reduced by reducing the inner layer of the uterus. This effect has positive influence on health in general, especially for women suffering from iron deficiency anemia.

Features: Combined oral contraceptives are qualitatively different from other hormonal contraceptives, since different tablets contain different dosages and combinations of hormones. This allows for an individual approach and the choice of exactly those pills that can solve the problems of a particular woman. Naturally, a gynecologist should select them. Hormonal pills latest generation, in addition to the contraceptive effect, have a pronounced non-contraceptive effect: they have a positive effect on the condition of the skin and hair, eliminate PMS, shorten the duration of menstruation and reduce pain during this period. Of the many oral contraceptives available in pharmacies, we can highlight tablets with innovative dosage regimens 24+4 and 26+2. They shorten the non-hormonal period, which allows minimizing negative symptoms. Also Special attention It is worth paying attention to the latest generation of oral contraceptives, which contain the active form of folic acid. This component allows a woman to take care not only of her health, but also of the future generation. Once a woman decides that she is ready to have a baby, she can stop taking the pill, confident that her body is already prepared for pregnancy.

Intrauterine contraception - 99.2-99.8%

This type of contraception includes an intrauterine device and an intrauterine hormonal system. Both in terms of reliability and mechanism of action, they differ from each other. The spiral is installed in the uterine cavity and prevents the implantation (attachment) of a fertilized egg.

The intrauterine hormonal system is administered in the same way, but acts differently - it regularly releases a certain amount of hormone, which, acting locally, has several effects: it increases the viscosity of mucus in the cervical canal, suppresses sperm motility, and thins the inner layer of the uterine cavity (endometrium).

Features: The intrauterine hormonal system is suitable for women who do not intend to become pregnant for a long time, as well as for nursing mothers. It is installed for 5 years, however, if necessary, it is possible to remove it earlier. Unlike the IUD, the hormonal system is not an abortive method of contraception.

Hormonal implants and injections - 90-99%

These methods of contraception work on the principle of hormonal pills, only the hormone is introduced into the body in other ways: intramuscular injection carried out every three months (or monthly), hormonal implant is inserted into the upper arm and provides contraception for 5 years.

Features: It is difficult to choose individually, based on the woman’s health status and her individual needs. There are a number side effects: Irregular bleeding, discharge, headache, weight gain and acne.

Hormonal patch and ring - 92%

The same level of reliability for these two methods does not at all indicate the similarity of their use: the hormonal patch is glued to the skin, and the hormonal ring must be inserted into the vagina independently.

Features: The hormonal patch must be applied every 7 days, starting from the first day of the cycle. The use of a hormonal ring is designed for one cycle. It needs to be installed from the 1st to the 5th day of the cycle, and after three weeks (on the 22nd day) removed. On the 8th day of the break, a new one is introduced. It is the adherence to clear patterns that allows these methods to be effective, so they are only suitable for very organized women.

Barrier methods: condom, diaphragm, cap, sponge - 84-85%

The condom is the only one among all the above contraceptives that protects not only from pregnancy, but also from any infections and bacteria. But its low reliability means that this product often fails (simply breaks).

The diaphragm, cap and sponge are also barrier methods of contraception; these devices are installed in the vagina immediately before sexual intercourse.

Features: These methods of contraception require preparation for sexual intercourse - and, therefore, can significantly reduce sexual desire, cause discomfort and reduce sensitivity.

Calendar method - 80%

Involves mathematical calculations of the days on which fertilization can occur, according to a woman’s menstrual cycle. Thus, during the “dangerous” period, you need to either abstain from sexual contact or use other methods of contraception.

Features: Suitable only for women with a regular menstrual cycle who are not embarrassed by “love on a schedule.”

Coitus interruptus 73%

The bottom line is that a man must have time to remove the penis from the vagina before ejaculation. This is one of the most ancient methods of birth control, but far from the most reliable. Keep in mind that a small amount of seminal fluid may be released during sexual intercourse.

Features: When resorting to PPA, a man is forced to deliberately control ejaculation, and this not only distracts from the process itself, depriving him of the opportunity to experience the full range of sensations for which, in fact, sexual contact occurs, but is also incorrect from a medical point of view. Thus, a volitional obstacle to reflex ejaculation leads to problems with potency and ejaculation (for example, among men with prostatitis, half regularly practiced coitus interruptus).

The lack of reliability of the PAP also negatively affects a woman’s sex life. She also experiences psychological stress, which does not allow her to relax and receive maximum satisfaction during sexual intercourse. According to statistics, among women who have never experienced an orgasm, 50% used PAPs.

Spermicides 71%

Spermicides are called chemical contraception: vaginal suppositories, creams, tablets, capsules. They mainly contain “nonoxynol” or “benzalkonium chloride”, which have a destructive effect on sperm. A woman should use chemical contraceptives every time before sexual intercourse.

Features: If pregnancy occurs with this method of contraception, this can have a bad effect on the fetus; most often, doctors recommend an abortion. In addition, chemical contraceptives often cause irritation and inflammation of the vaginal mucosa and vaginal candidiasis.

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The modern rhythm of life dictates its own rules to us. It gives people many possibilities and restrictions. He gives us, perhaps, the most important thing - the right to choose. Modern couples, in each individual case, decide for themselves the important issue of their offspring, and when choosing contraception, couples are often lost in the multifaceted abundance of contraceptive methods offered. In this article we will tell you which type of contraception is preferable and in what situations, reviews of contraception and some secrets.

Contraception from novolat. contraceptio - literally - contraception.

Natural method of contraception

Natural methods of contraception differ from others in that when they are used, no other methods of contraception, such as barrier methods, are used during sexual intercourse.

Calendar method of contraception

This method is based on the fact that, ideally, if a woman’s cycle is 28 days, then ovulation usually occurs on the 14th day. Considering the viability of sperm and eggs, a woman should avoid unwanted pregnancy, you should not have unprotected sex two days before ovulation and two days after it.

How to use the calendar method of contraception correctly

For the most accurate use of the calendar method, a woman needs to keep a menstrual calendar, noting the duration of each menstrual cycle for at least 8 months;
A woman should identify her shortest and longest menstrual cycles;
Using the method for calculating the interval of possibility of conception, it is necessary to find the first “fertile day” (the day when pregnancy is possible) according to the shortest menstrual cycle, and the last “fertile day” according to the longest menstrual cycle;
Considering the duration of the current menstrual cycle, determine the interval of opportunity to become pregnant;
During this period, you can either completely abstain from sexual activity, or use barrier methods and spermicides.

Temperature method of contraception

The temperature method of contraception is based on determining the time of rise in basal temperature by measuring it daily. The period from the beginning of the menstrual cycle until her basal temperature is increased for three consecutive days is considered favorable for conception.

How to use the temperature method of contraception correctly

The most important rule for using the temperature method of contraception is to measure your basal temperature at the same time in the morning, without getting out of bed;
In the evening, prepare everything you need to measure your basal temperature and place it in close proximity to your bed.

Cervical method of contraception

This method is based on observations of change vaginal discharge during the menstrual cycle. Known as the method of natural family planning (Billing method). After menstruation and in the period before ovulation, cervical mucus is absent or observed in small quantities with a white or yellowish tint. In the days immediately before ovulation, the mucus becomes more abundant, light and elastic, the stretching of the mucus between the thumb and forefinger reaches 8-10 cm. Ovulation is observed a day after the disappearance of the characteristic mucus (in this case, the fertile period will continue for an additional 4 days after the disappearance of light, elastic secretions).

Symptothermal method of contraception

The symptothermal method of contraception is a method that combines elements of the calendar, cervical and temperature, taking into account such signs as the appearance of pain in the lower abdomen and scanty bleeding during ovulation.

Coitus interruptus as a method of contraception

The principle of the coitus interruptus method is that the man removes the penis from the vagina before he ejaculates. In this method, the most important thing is the man’s control and reaction J

Lactational amenorrhea method (LAM) as a type of contraception

Contraceptive effect breastfeeding within 6 months after the birth of the child. You can count on its effectiveness only if all feeding conditions are met. Its effectiveness is gradually decreasing.

Barrier methods of contraception

Today, one of the most popular types of contraception is the barrier method of contraception. Barrier methods are traditional and the most ancient. In the first half of our century various shapes barrier methods were the only contraceptives. The advent of more effective methods of contraception over the past 20 years has significantly reduced the popularity of barrier methods. However, complications that may arise when using more modern methods contraception, contraindications to use, as well as the significant prevalence of sexually transmitted diseases, force the improvement of barrier methods of contraception.

Barrier methods of contraception are divided into:

Women's: non-medicinal barrier and medicinal agents;
Men's barrier products.

The principles of action of barrier contraceptives are to block the penetration of sperm into the cervical mucus.

Advantages of barrier methods of contraception:

are applied and act only locally, without causing systemic changes;
have a small number of side effects;
significantly protect against sexually transmitted diseases;
have virtually no contraindications for use;
do not require consultation with qualified medical personnel.

The use of barrier methods of contraception is better in the following cases:

contraindications to the use of oral contraceptives and IUDs ( intrauterine device);
during lactation, since they do not affect either the quantity or quality of milk;
in the first cycle of taking oral contraceptives from the 5th day of the cycle, when the own activity of the ovaries is not yet completely suppressed;
if necessary, take medications that are not compatible with OK or reduce their effectiveness;
after spontaneous abortion until a period favorable for a new pregnancy occurs;
as a temporary remedy before sterilization of a man or woman.

Disadvantages of barrier methods:

are less effective compared to most oral contraceptives and intrauterine devices;
in some patients, use is not possible due to an allergy to rubber, latex or polyurethane;
their successful application requires constant attention;
use requires certain manipulations on the genitals;
Most barrier contraceptives should be used during or immediately before sexual intercourse.

Barrier contraception for women

Vaginal diaphragm (vaginal pessary)

The vaginal diaphragm is used for contraception alone or in combination with spermicides. The vaginal diaphragm prevents sperm from entering the uterus. It is a dome-shaped rubber cap with a flexible rim, which is inserted into the vagina before sexual intercourse so that the posterior rim is in the posterior vaginal fornix, the anterior one touches the pubic bone, and the dome covers the cervix. Diaphragms come in different sizes: from 50 to 150 mm. A vaginal diaphragm measuring 60-65 mm is usually suitable for nulliparous women, and a vaginal diaphragm measuring 70-75 mm is usually suitable for women who have given birth. After childbirth or loss of weight, the size must be selected again.

How to use a vaginal diaphragm

A woman who chooses a diaphragm as a method of contraception should be instructed by a doctor. The doctor introduces her to the anatomy of the pelvis and genital organs so that the woman can imagine the location of the diaphragm in relation to the cervix and the uterus itself.

Procedure for installing a vaginal diaphragm:

The gynecologist examines the woman and selects the diaphragm according to size and type.
Insertion of the diaphragm: with two fingers of the right hand, a woman, squatting or lying on her back, inserts the diaphragm into the vagina (with her left hand, the woman spreads the labia) in a compressed form from above and moves it along the posterior wall of the vagina until she reaches the posterior vaginal fornix. Then the part of the edge that passed last is pushed upward until it contacts the lower edge of the pubic bone.
After insertion of the diaphragm, the woman should check the position of the diaphragm covering the cervix.
The health care provider rechecks to determine whether the woman inserted the diaphragm correctly.
Removal of the vaginal diaphragm should be done with the index finger by pulling down the front edge. If difficulties arise, the woman should push. After removing the diaphragm, it should be washed hot water with soap, wipe and place for 20 minutes in a 50-70% alcohol solution.

Benefits of the vaginal diaphragm:

ease of use;
reusability;
harmless and largely protect against sexually transmitted infections.

Contraindications to the use of a vaginal diaphragm:

endocervicitis;
colpitis;
cervical erosion;
allergy to rubber and spermicides;
abnormalities of genital development;
prolapse of the walls of the vagina and uterus.

Side effects of vaginal diaphragm:

possible infection urinary tract due to pressure of the diaphragm on the urethra;
Inflammatory processes may occur at the points of contact of the diaphragm with the walls of the vagina.

Cervical caps

A latex or silicone cap that covers the cervix; more reliable when used simultaneously with spermicides. There are currently three types of cervical caps made from latex rubber.

Prentif's cervical cap is deep, soft, rubber, with a hard rim and a recess to enhance suction. With its rim it fits tightly near the junction of the cervix and vaginal vaults. Prentif cap dimensions: 22, 25, 28, 31 mm (outer rim diameter).

The Vimulus cap is bell-shaped, with the open end wider than the body. It is installed directly above the cervix, but its open end also covers part of the vaginal vault. The cap is made in three sizes - with a diameter of 42, 48 and 52 mm.

The Dumas cap, or vaulted cap, has a flat dome configuration and resembles a diaphragm, with the only difference being that it is made of a denser material and there is no spring in its rim. The cap is available in sizes from 50 to 75 mm.

When placed, the cap covers the cervix, fornix, and upper part of the vagina and is held in place by the vaginal walls rather than by adhesion to the cervix.

Instructions for use of the uterine cap

The appropriate type and size of cervical cap is determined during an examination by a gynecologist based on the shape and size of the cervix. Insertion through the vaginal opening is facilitated by compressing the edges, and placement over the cervix is facilitated by tilting the cap into the vagina. Before inserting the cap, place it on inner surface you need to apply a spermicidal drug. After medical worker installed a cap on a woman, he must explain to her how to check whether the product is installed correctly and whether it covers the cervix. The woman then removes the cap and reinserts it, while the health care provider checks that she is doing it correctly. It is not recommended to leave the cap in the vagina for more than 4 hours.

Female condom

The female condom is a tube made of polyurethane or latex inserted into the vagina.

Barrier contraception methods for men

Condom

The condom is the only contraceptive used by men. The condom is a sac-shaped formation made of thick elastic rubber, about 1 mm thick, which makes it possible to increase the condom depending on the size of the penis. Condom length 10 cm, width 2.5 cm.

How to use a condom

A rolled condom is placed on the erect penis when the head is not covered by the foreskin.

Disadvantages and side effects of a condom (both male and female):

there may be a decrease in sexual sensation in one or both partners;
the need to use a condom at a certain stage of sexual intercourse;
you may be allergic to latex rubber or the lubricant used in the condom;
The condom may break.

Advantages of a condom (both male and female):

the condom is easy to use;
a condom is used immediately before sexual intercourse;
A condom protects against sexually transmitted diseases and HIV infection.

At the moment, the condom and femid (female condom) are the only means of contraception that protect against sexually transmitted diseases, including HIV infection, so they can also be used in addition to others (hormonal, chemical) contraceptive methods(“safe sex”). At the same time, along with protection against infections, the contraceptive effect increases.

Chemical contraceptives (spermicides)

The mechanism of action of spermicides is to inactivate sperm and prevent its penetration into the uterus. The main requirement for spermicides is the ability to destroy sperm in a few seconds.

Spermicides are available in various forms, namely:

cream;
jelly;
foam aerosols;
melting candles;
foaming suppositories and tablets.

Some women use douching after sexual intercourse for contraception with solutions that have a spermicidal effect, acetic, boric or lactic acid, lemon juice. Considering the data that 90 seconds after sexual intercourse, sperm are detected in the fallopian tubes, douching with a spermicidal drug cannot be considered a reliable method of contraception.

Modern spermicides consist of a sperm-killing substance and a carrier. Both components play an equally important role in providing the contraceptive effect. The carrier distributes the chemical into the vagina, enveloping the cervix and supporting it so that no sperm can escape contact with the spermicidal ingredient.

How to use spermicides

Spermicides can be used with condoms, diaphragms, caps, or alone. Spermicides are injected into the upper part of the vagina 10-15 minutes before sexual intercourse. For one sexual act, a single use of the drug is sufficient. With each subsequent sexual intercourse, additional administration of spermicide is necessary.

Benefits of spermicides:

ease of use;
providing a certain degree of protection against certain sexually transmitted diseases;
they are simple backup agents in the first cycle of oral contraceptives.

Disadvantages of spermicides:

limited period of effectiveness and the need for some manipulation of the genitals.

Hormonal types of contraception

Hormonal drugs act differently, depending on their composition.

Combined oral contraceptives (COCs)

These drugs are the most common form of hormonal contraception in the world. Contains estrogen and progestin.

Depending on the dose of estrogen and the type of progestogen components, OCs may have a predominantly estrogenic, androgenic or anabolic effect.

Mechanism of action of oral contraceptives

The mechanism of action of OK is based on the blockade of ovulation, implantation, changes in gamete transport and the function of the corpus luteum.

Blocking ovulation with COCs

The primary mechanism for blocking ovulation is suppression of the secretion of gonadotropin-releasing hormone (GTR) by the hypothalamus. The secretion of pituitary gonadotropic hormones (FSH and L) is inhibited. An indicator of hormonal suppression of ovulation is the absence of an estrogen peak in the middle of the menstrual cycle and inhibition of the normal postovulatory increase in serum progesterone. Throughout the menstrual cycle, estrogen production in the ovaries remains at a low level corresponding to the early follicular phase.

Effect of COCs on cervical mucus

Thickening and thickening of cervical mucus becomes apparent 48 hours after the start of progestin administration. The motility and ability of sperm to penetrate the cervical mucus is impaired due to its compaction and thickening; cervical mucus becomes a mesh-like structure and is characterized by reduced crystallization.

The effect of COCs on implantation

Implantation of a developing pregnancy occurs approximately 6 days after fertilization of the egg. To ensure successful implantation and development of pregnancy, sufficient maturity of the superficial endometrial glands with adequate secretory function and appropriate endometrial structure for invasion is necessary. Changes in levels and disturbances in the ratio of estrogen and progesterone lead to disruption of the functional and morphological properties of the endometrium. All this disrupts the implantation process. The transport of the fertilized egg changes under the influence of hormones on the secretion and peristalsis of the fallopian tubes. These changes disrupt the transport of sperm, eggs or developing embryos.

Efficacy and acceptability of COCs

OCs are the only means of preventing pregnancy with 100% effectiveness. It is customary to distinguish between theoretical effectiveness, which involves the use of a method without errors and missed pills, and clinical effectiveness, which is calculated based on the number of pregnancies in real conditions, taking into account the errors made by women.

Thus, COCs meet all the requirements for modern contraceptives:

highly effective in preventing pregnancy;
ease of use (coitus-independent);
reversibility of the impact.

Principles of using oral contraceptives

Although modern contraceptives contain low doses of sex hormones and are well tolerated, they are still medications, the use of which has various restrictions. The basic therapeutic principle is to prescribe to each woman the smallest dose of steroids that can provide optimal contraceptive reliability. For continuous use in healthy women, OCs containing no more than 35 mcg of ethinyl estradiol and 150 mcg of levonorgestrel or 1.5 mg of norethisterone are recommended. The most important task The doctor's goal is to identify women for whom hormonal contraception is contraindicated, which makes it necessary to carefully collect anamnesis and carefully examine each patient.

Absolute contraindications to the use of COCs are the following diseases that the patient currently has or has a history of:

cardiovascular diseases;
history of thromboembolism;
varicose veins with a history of thrombophlebitis;
cerebrovascular diseases;
malignant tumors of the genital organs and mammary glands;
liver diseases;
sickle cell anemia;
history of severe forms of gestosis;
diabetes;
blood pressure above 160/95 mm Hg;
gallbladder diseases;
smoking;
trophic ulcer of the leg;
long-term plaster cast;
prediabetes;
severe headaches;
significant headaches;
significant excess weight;
age 40 years and above;
epilepsy;
hypercholesterolemia;
kidney diseases.

Systemic changes when taking OK

Taking OCs may have adverse effects on cardiovascular disease; metabolic and biochemical processes; liver diseases; some forms of cancer. It should be emphasized that all of the above complications relate to taking tablets containing 50 mcg estrogen and a high content of 1st and 2nd generation gestagens. Specified negative impact does not appear when using OCs with lower doses of estrogens and 3rd generation gestagens. In addition, there are a number of risk factors that cause complications when taking OCs: smoking; obesity; age over 35 years; history of severe toxicosis.

To the most serious complications thromboembolism occurs when taking OCs. Estrogens increase most blood clotting parameters, while the anticoagulant factor, antithrombin III, decreases. Platelet aggregation tendencies increase. The result may be blood clots. Oral contraceptives containing more than 50 mcg of estrogen increase the incidence of fatal embolism by 4-8 times. The use of the latest generation of OCs containing small doses of estrogens - 20-35 mcg, only slightly increases mortality from embolism compared to the population not using OCs.

The risk of thromboembolism increases in women who smoke. Smoking increases mortality from thromboembolism in women taking OCs over the age of 35 years by 5 times and over 40 years by 9 times. It should be noted that the mortality rate from thromboembolism in women who smoke is 2 times higher than in women taking OCs. The combination of several risk factors in women taking OCs increases the likelihood of developing thromboembolism by 5-10 times. When prescribing OCs, you should always remember that the risk of thromboembolism associated with taking OCs is 5-10 times less than the risk associated with normal pregnancy and childbirth.

It should be noted that the increase in the incidence of diabetes in the group of women using OCs compared with the control changes in carbohydrate metabolism in the body healthy woman has a transient nature and disappears after discontinuation of the OC. In addition, these disorders of carbohydrate metabolism are observed only when taking drugs containing high doses steroids. Women with previously established glucose tolerance should be considered a risk group and be under constant medical supervision. Oral contraceptives may be prescribed to young women with established diabetes in the absence of other risk factors. Monopreparations containing only a progestogen component affect carbohydrate metabolism to a much lesser extent than combined ones. They are the drugs of choice for hormonal contraception in patients with diabetes.

Oral contraceptives and fertility

After stopping taking OCs, ovulation quickly recovers and more than 90% of women are able to become pregnant within two years. The term "Post-pill" amenorrhea is used to describe cases of secondary amenorrhea for more than 6 months after stopping OC use. Amenorrhea for more than 6 months occurs in approximately 2% of women and is especially characteristic of the early and late reproductive periods of fertility.

Oral contraceptives and pregnancy

Women who used OCs did not experience an increased incidence of spontaneous miscarriage, ectopic pregnancy, or fetal abnormalities. In those in rare cases When a woman accidentally took OCs during early pregnancy, their damaging effect on the fetus was also not revealed.

Oral contraceptives and age

An important issue is the age at which a woman can start taking OCs to prevent unplanned pregnancy. Previously, there was prejudice against the prescription of oral contraception to teenage girls. Currently, such ideas are rejected. In any case, taking birth control pills is the best alternative to pregnancy and especially abortion in adolescence. OCs have been shown to have no effect on body growth and do not increase the risk of amenorrhea.

The need for effective contraception is also evident in the period preceding menopause. In cases where other methods of contraception are unacceptable for a woman and her partner, when risk factors for cardiovascular and metabolic complications, such as hypertension, diabetes mellitus, obesity, hyperlipidemia, are excluded, it is possible to take OCs before menopause. A woman's age is not so important in the absence of risk factors. The creation of modern OCs with low doses of hormones allows their use by women up to 45 years of age and older. The drug of choice at this age may be drugs containing only gestagens.

Oral contraceptives during lactation

Combined contraceptives have an undesirable effect on the quantity and quality of milk and can shorten the duration of lactation, so they should not be prescribed until breastfeeding is stopped. If a woman wishes to use OCs during lactation, then only progestogen contraceptives should be used.

Duration of COC use

With constant medical supervision and the absence of contraindications, women can continue taking OCs for many years. There are no sufficiently justifiable reasons for periodic abstinence from taking oral contraceptives.

Interaction of OK with drugs

If OC is prescribed, it is necessary to take into account the possibility of their drug interactions with a number of drugs, manifested in a weakening of the contraceptive effect, in case of their simultaneous use.

A weakening of the contraceptive effect is possible if a woman takes:

Adverse reactions and complications when taking OK

Adverse reactions and complications when taking OCs are mainly associated with disturbances in the estrogen-progesterone balance. They are most often observed in the first 2 months of taking OCs (10-40%), and then are observed only in 5-10% of women.

Adverse reactions when taking OCs due to excess content of the estrogen or progestogen component.

Possible adverse reactions when taking OK:

Mini - drank

Mini pills contain only progestin and do not have estrogen side effects. Mini-pills are taken continuously, starting from the 1st day of the cycle, daily, for 6-12 months. As a rule, at the beginning of using the mini-pill, intermenstrual bloody issues, the frequency of which gradually decreases and completely stops by the 3rd month of use. If intermenstrual bleeding appears while taking the mini-pill, then we can recommend prescribing 1 tablet of OK for 3-5 days, which gives a quick hemostatic effect. Since minipills do not produce other side effects, their use in clinical practice has broad prospects.

How mini-pills work:

Changes in the quantity and quality of cervical mucus, increasing its viscosity;
Reduced penetration ability of sperm;
Changes in the endometrium that exclude implantation;
Inhibition of fallopian tube mobility.

Mini-pills do not affect the blood coagulation system and do not change glucose tolerance. Unlike combined OCs, mini-pills do not cause changes in the concentrations of key indicators of lipid metabolism. Changes in the liver when taking the mini-pill are extremely minor. Based on the characteristics of the mini-pill, they can be recommended as a method of contraception for women with extragenital diseases (liver diseases, hypertension, thrombophlebitic conditions, obesity).

women who complain of frequent headaches or increased blood pressure when using combined OCs;
during lactation 6-8 weeks after birth;
for diabetes;
at varicose veins veins;
for liver diseases;
women over 35 years old.

Hormonal injections

Intramuscular injections every 3 months; contain progestin. A sterile aqueous suspension of medroxyprogesterone acetate is administered intramuscularly once every 3 months. Thus, contraception for a whole year is provided with only four injections. This type of contraception is especially indicated for women during lactation from the 6th week after birth, at the age of the late reproductive period in the absence of the opportunity to resort to surgical sterilization, women for whom other methods of contraception are contraindicated, women with sickle cell anemia, in which OCs are contraindicated, for the treatment of estrogen-dependent diseases.

Hormonal implants

Implants inserted under the skin; contain levonorgestrel. Presents 6 cylindrical capsules, which under local anesthesia injected subcutaneously into the forearm of the left hand. The contraceptive effect is provided for 5 years. The implant can be inserted in the first days of the menstrual cycle, immediately after an induced abortion, 6-8 weeks after birth. Random spotting occurs in 2 out of 3 women during the first year of use.

Hormonal ring

Flexible contraceptive ring; contains small doses of estrogen and progestogen. It is inserted by the gynecologist at the beginning of the cycle and removed at the end, attached to the cervix.

Hormonal patch

The thin patch delivers hormones into the body through the bloodstream.

Intrauterine contraception

The history of intrauterine contraception begins in 1909, when the German gynecologist Richter proposed introducing 2-3 silk threads twisted into a ring into the uterine cavity for the purpose of contraception. In 1929, another German gynecologist, Graofenberg, modified this ring by inserting a silver or copper wire into it. However, the design was rigid, caused difficulties during administration, or the Mini-pill does not affect the blood coagulation system and does not change glucose tolerance. Unlike combined OCs, mini-pills do not cause changes in the concentrations of key indicators of lipid metabolism. Changes in the liver when taking the mini-pill are extremely minor. Based on the characteristics of the mini-pill, they can be recommended as a method of contraception for women with extragenital diseases (liver diseases, hypertension, thrombophlebitic conditions, obesity).p extraction, caused pain in the lower abdomen, bleeding and, as a result, did not find widespread use. And only in 1960, when, thanks to the use of inert and flexible plastic in medical practice, polyethylene IUDs of the Lipps loop type were created, intrauterine contraception began to be used quite widely (IUD - intrauterine device).

Theory of the mechanism of action of the IUD

Today, there are several theories about the mechanism of the contraceptive action of the IUD.

The theory of the abortifacient action of the IUD

Under the influence of the IUD, the endometrium is traumatized, prostaglandins are released, and the tone of the uterine muscles increases, which leads to the expulsion of the embryo in the early stages of implantation.

Theory of accelerated peristalsis

The IUD increases contractions of the fallopian tubes and uterus, so the fertilized egg enters the uterus prematurely. The trophoblast is still defective, the endometrium is not prepared to receive a fertilized egg, as a result of which implantation is impossible.

Theory of aseptic inflammation

The IUD, as a foreign body, causes leukocyte infiltration of the endometrium. The resulting inflammatory changes in the endometrium prevent implantation and further development of blastocysts.

Theory of sperm toxicity

Leukocyte infiltration is accompanied by an increase in the number of macrophages that carry out phagocytosis of sperm. Adding copper and silver to the IUD enhances the spermotoxic effect.

Theory of enzyme disorders in the endometrium

This theory is based on the fact that IUDs cause changes in the content of enzymes in the endometrium, which has an adverse effect on the implantation process.

Types of intrauterine devices

Currently, more than 50 types of IUDs made of plastic and metal have been created, which differ from each other in rigidity, shape and size.

There are three generations of intrauterine devices:

Contraindications to the use of an intrauterine device

Absolute contraindications for the intrauterine device:

acute and subacute inflammatory processes of the genitals;
confirmed or suspected pregnancy;
confirmed or malignant process of the genitals.

Relative contraindications for the intrauterine device:

abnormalities in the development of the reproductive system;
uterine fibroids;
hyperplastic processes of the endometrium;
hyperpolymenorrhea;
anemia and other blood diseases.

Insertion of an intrauterine device

The intrauterine device is usually inserted on the 4th-6th day of the menstrual cycle. During this period, the cervical canal is slightly open, which makes the procedure easier. In addition, at this time a woman can be sure that there is no pregnancy. If necessary, the IUD can be inserted in other phases of the cycle. An IUD can be inserted immediately after an abortion, as well as in the postpartum period. The main disadvantage of inserting an IUD at this time is the relatively high frequency of expulsions during the first few weeks. Therefore, it is better to insert the IUD after 6 weeks. after childbirth.

How is an intrauterine device inserted?

Under aseptic conditions, the cervix is exposed with mirrors, treated with a disinfectant solution and the anterior lip is grabbed with bullet forceps.
The length of the uterine cavity is measured using a uterine probe.
Using a guide, the IUD is inserted into the uterine cavity.
A control examination is done with a uterine probe, making sure that correct position Navy.
Trim the IUD threads to a length of 2-3 cm.
Remove the bullet forceps and treat the cervix with a disinfectant solution.

How to remove an intrauterine device:

The cervix is exposed in the speculum. An IUD that has threads is usually removed with a forceps. If there are no threads, you can use a queen hook with great care.

Observation after insertion of the intrauterine device.

The first medical examination is carried out 3-5 days after administration, after which it is allowed sex life without using any other contraceptive. It is advisable to carry out repeated examinations every 3 months.

Relevance of the intrauterine device

Intrauterine contraceptives are an excellent reversible method of contraception.

The intrauterine device has the following advantages:

the use of an IUD is not associated with interference in a woman’s normal life;
After insertion of an IUD, only minimal medical care and monitoring are usually needed;
IUDs are possible view contraception for older women and especially in cases where OCs are contraindicated;
IUDs can be used during breastfeeding;
possibility of long-term use (from 5 to 10 years);
Economic factor: In general, the annual costs associated with IUD use are relatively small for both women and family planning programs.

If pregnancy occurs while using an IUD and the woman desires to continue the pregnancy if the threads are present, the IUD should be removed. If there are no threads, extremely careful monitoring of the course of pregnancy is required. It should be noted that in the literature there is no indication of an increase in the incidence of malformations or any damage to the fetus if the pregnancy is carried to term with an IUD. In women using IUDs, the generative function is not impaired. Pregnancy occurs after removal of the IUD within a year in 90%.

Possible complications when using an intrauterine device:

discomfort in lower sections belly;
lower back pain;
cramping pain in the lower abdomen;
bloody issues.

The pain, as a rule, goes away after taking analgesics; bleeding can last up to 2-3 weeks.

Bleeding when using an intrauterine device

Violation of the nature of uterine bleeding is the most common complication when using an IUD.

There are three types of changes in the nature of bleeding:

increased volume of menstrual blood;
longer period of menstruation;
intermenstrual bleeding. Menstrual blood loss can be reduced by prescribing prostaglandin synthetase inhibitors.

Inflammatory diseases when using an intrauterine device

The question of the relationship between IUDs and inflammatory diseases of the pelvic organs is important. Large-scale studies in recent years indicate a low incidence of pelvic inflammatory diseases when using IUDs. The risk increases slightly in the first 20 days after administration. In the subsequent period (up to 8 years), the incidence rate remains at a consistently low level. The risk of disease is higher in women under 24 years of age and is closely correlated with sexual behavior. An active and promiscuous sex life significantly increases the risk of these diseases.

Uterine perforation is one of the rarest (1:5000), but serious complications of intrauterine contraception. There are three degrees of uterine perforation:

1st degree- The IUD is partially located in the muscle of the uterus

2nd degree- The IUD is completely located in the uterine muscle

3rd degree- partial or complete release of the IUD into the abdominal cavity.

With the 1st degree of perforation, it is possible to remove the IUD vaginally. For grades 2 and 3 of perforation, the abdominal route of removal is indicated.

In conclusion, it should be emphasized once again that the IUD is the optimal means of contraception for healthy women who have given birth, have a permanent partner and do not suffer from any inflammatory diseases of the genitals.

Postcoital contraception

Contraceptive measures are carried out after unprotected sexual intercourse. Do not confuse this with medical abortion!

The concept of postcoital contraception combines various types of contraception, the use of which in the first 24 hours after coitus prevents unwanted pregnancy. Postcoital contraception cannot be recommended for continuous use, since each method is an emergency intervention functional state reproductive system with subsequent formation of ovarian dysfunction.

Contraceptive effectiveness

The effectiveness of contraception is determined by the Pearl index. Pearl index (Pearl index), failure rate - an index showing the effectiveness of the chosen method of contraception. The lower this indicator, the more reliable the contraceptive method. A small example: 3 women out of a hundred who have been protected for 12 months with the same method of contraception become pregnant, despite the protection. In this case, the Perl index is 3.

Method of contraception	Pearl index
Calendar	14,0 - 50,0
Temperature	0,3 - 6,6
Cervical	6,0 - 39,7
Symtothermal	15,0 - 30,0
Spermicides	20,0 - 25,0
Diaphragm	4,0 - 19,0
Cervical cap	17,4 - 19,7
Sponge	18,9 - 24,5
Coitus interruptus	5,0 - 20,0
Condoms	12,5 - 20,0
Intrauterine contraception	1,0 - 3,0
*Hormonal contraceptives*
Mini-pill	0,3 - 9,6
Injectable	0,5 - 1,5
COOK	0 - 0,9
Subcutaneous implants	0,5 - 1,5
Method of contraception	Pearl index

Every representative of the fair sex strives to avoid unwanted pregnancy. Therefore, contraceptives must meet all health safety requirements. The goal of all gynecologists in the world is to combat abortion, which causes significant harm to female reproductive abilities. Nowadays, medicine and the pharmaceutical industry have achieved significant results to offer people the most modern contraceptives.

The main requirement for them is reliability, safety and efficiency. There is a large selection of such products on sale. Therefore, before choosing any of them, it is advisable for both the wife and husband to consult a specialist.

Hormonal contraceptives

These methods of birth control are used in great demand. Their particular convenience lies in the fact that they can be used at any time and can be stopped as soon as the woman wants to become a mother. Therefore, this type of contraception has long been popular.

The most significant advantages hormonal contraceptives are:

absolute reliability;
clear regulation;
significant relief of well-being during menstruation;
complete disappearance of acne on the face and body;
stabilization of ovarian function;
prevention of diseases of the female genital organs;
exclusion of ectopic pregnancy.

Hormonal contraceptives affect the entire body, regulating the content of various substances in the blood and creating impossible conditions. In addition, they help stabilize the menstrual cycle and provide relief during menstruation. Therefore they are very effective method protection.

Birth control pills

Such pharmacological agents are based on interfering with a woman’s menstrual cycle. They are absolutely safe and do not affect the functioning of organs and systems.

They give you the opportunity to get pregnant at any time after they are discontinued. If the lady then decides to take a break between births or abandons the desire to become a mother again, their reception can be resumed. These drugs have had great success. They are very convenient to use and quite reliable.

There are such contraceptive pills as:

combined (containing estrogen and progesterone);
mini-pills (include only progesterone).

The second type of these drugs has an advantage, since it interferes less radically with the functioning of the endocrine organs.

Vaginal ring

This type of contraceptive, which also contains estrogens, is a very effective means of protection.

An elastic ring is inserted into the woman's vagina and, over time, gradually releases hormones into the blood. Their increased content allows you to stop the ovulation process, which is most suitable for fertilization of the egg.

In addition, such a contraceptive prevents sperm from passing through the cervix, further protecting against unwanted pregnancy.

The huge advantage of this method of protection is its safety for operation. internal organs. However, when administered it requires special measures precautions against spontaneous release.

Contraceptive patch

This type of contraceptive is also based on the use of estrogens. It is glued to a convenient place and released into the bloodstream as needed. This method does not reduce a woman's sex drive or her ability to experience orgasm.

You can apply it to the skin at any time, as well as remove it. Its great advantage is that it can be used even for a short time, if certain period It is not desirable for a woman to become pregnant, although she wants to become a mother in the future.

Injection

Progesterone injections also have a great impact on the course of the menstrual cycle, suppressing the ovulation phase. The validity period of such a contraceptive is ninety days.

The big advantages of injections are:

reliability;
Possibility of use during breastfeeding after forty-five days after birth;
dosed infusion of hormones into the bloodstream;
their rapid removal from the body;
availability of the method;
improvement of a woman’s general well-being;
minimum contraindications.

Contraceptive implant

This means of preventing unwanted pregnancy is based on the drug Norplant, which contains six silastic capsules with the progestogen levonorgestrel. Using a special technique, they are placed in the subcutaneous tissue for a period of five years. Gradually, the substance from them enters the bloodstream and prevents conception.

It dissolves itself in the body and does not require subsequent extraction. This is a very reliable and convenient method of contraception. During its use, it facilitates the functioning of the uterus and ovaries. In addition, the constant presence of female sex hormones perfectly regulates the course of the menstrual cycle and helps make the period preceding the onset of menstruation less noticeable.

Intrauterine contraception - spiral

This type of contraceptive is a ring made of elastic material that includes a copper spiral. The ions coming out of it directly affect the egg, making fertilization impossible. This happens due to change chemical environment in the cervical canal, which allows you to simultaneously influence the condition of the ejaculate and the composition of the mucous contents of the vagina.

It reliably protects against the penetration of sperm into the cervical area, and the action of copper prevents the egg from being reliably fixed. The effectiveness of this contraceptive is close to one hundred percent.

But, in order to install an IUD, you need to make sure that there is no allergic reactions. Therefore, before using it, you must undergo a medical examination.

Barrier method of protection against pregnancy

Such methods do not allow sperm to penetrate into the cervical space.

They are divided into:

mechanical, which include cervical caps;
chemical, involving the use of spermicides;
combined.

In addition, the barrier method of protection is intended for both women (spermicides and cervical caps) and men (condoms). It aims to prevent the sperm and egg from meeting. This method of contraception has a dual function: it prevents conception and protects both partners from sexually transmitted diseases.

It has virtually no side effects or contraindications.

Condoms

This is the only way male contraception. The product for it is like a cover made of dense flexible material. The width of the wall is about one millimeter, the length reaches ten centimeters, and the diameter is about three centimeters.

This method is one of the oldest and most popular. The action of the condom is very simple. It prevents ejaculate from entering the uterine space. The only thing that is required from partners is to monitor its integrity and high quality manufacturing.

Cervical cap

This convenient device has the shape of a hemisphere, compacted at the edges. It creates negative pressure and thereby prevents sperm from entering the uterine cavity. It is usually administered half an hour before the intended intimate act.

There are three main forms of cervical caps.

Cervical (Prentifa) is designed for deep planting. Made of soft rubber with a tight rim and indentation for a secure fit. Inserted into the space between the cervix and vagina.
Vimulya is similar in structure to a bell. It is fixed above the cervix, the other end covers the vagina.
The dumasa is shaped like a dome and is made of thick rubber without a spring base.

The cervical cap can stay inside for up to nine hours, the maximum allowed period is forty-five hours. This reliable product can be used for quite a long time until its expiration date expires.

Spermicides

Such chemical medications are designed to completely neutralize the effect of ejaculate. This happens because the mechanism of action of this remedy is based on instant destruction cell membrane sperm in contact with the active substance.

The pharmaceutical industry produces spermicides in the form of:

The biggest advantage of spermicides is their high efficiency of action. Before using them, you must carefully read the attached instructions for use. Particular attention should be paid to the fact that these products should be used no later than forty-five minutes before an intimate meeting. They need to be applied so deeply that they reach the surface of the cervix.

It is advisable to first consult with a gynecologist, who will show you how to behave and tell you about precautions.

Surgical method

Voluntary sterilization is the most effective way to avoid unwanted pregnancy once and for all. This operation is performed for both men and women. It is a painless, safe and highly reliable method of contraception.

Nowadays, gentle technologies have been developed that allow surgical intervention very quickly and in the most minimally traumatic way.

repeated caesarean section;
cicatricial changes in the uterus;
transferred oncological diseases;
cardiopathology;
significant metabolic disorders;
profound mental changes;
severe diseases of the central nervous system;
pathologies of smooth and striated muscles;
unfavorable genetics, etc.

Calendar method

Can be used by any woman, even those who suffer from allergies or have contraindications to many pharmacological drugs.

To use it, you need to record the days from the first day of your last menstruation to the start of a new one. The ovulation phase is gradually revealed, when an egg is born and the process of fertilization becomes possible. It usually takes several days and occurs approximately on the twelfth day from the date of the appearance of menstruation. For those who want to avoid unwanted pregnancy, this is the most dangerous period; on other days, conception practically does not occur.

It is necessary to monitor the dates on the calendar very carefully, since any mistake can lead to sperm penetrating into the uterine cavity by the time the egg matures.

Coitus interruptus

This method of birth control was probably used back in cave times. Its essence is extremely simple. During intimate intercourse, the partner removes his penis from the woman’s vagina as soon as he feels orgasm approaching. He leaves the sperm outside her body.

Indicated in cases where the partner is unable to use hormonal or other chemical contraceptives due to contraindications.

It is an indispensable method of protection if she has:

In such cases, it is undesirable to introduce any medicinal substances into the body. Coitus interruptus will help you maintain regular sexual activity without the risk of unwanted pregnancy.

Emergency contraception

Every woman has the right to choose the right time to become a mother. However, a completely unexpected situation may arise when urgent protection against possible fertilization is necessary. To avoid abortions, which could permanently prevent her from having children, it is better to use methods that help quickly avoid the impact of sperm on the egg.

Provides for the use of several methods of protection against unwanted pregnancy.

They include:

combination of gestagens and estrogens (Yuzpe method);
prompt installation of an IUD containing copper;
use of gestagen;
taking progesterone antagonists.

Emergency contraception, contrary to some prejudices, does not pose any threat to a woman’s health. It is especially indicated in cases where sexual contact was unplanned and, even more so, unwanted.

These means are indispensable when the condom was damaged during intimate intercourse, the cervical cap spontaneously came out, the woman forgot about the next use of the contraceptive, the spermicidal substances were administered incorrectly, or the lady got confused in the calculations on the calendar.

Thus, the choice of ways to protect against unwanted pregnancy is truly great. Nowadays, modern pharmacology, gynecology and surgery provide the widest possibilities for safe, reliable and convenient methods of contraception for both women and men. Their diversity is so great that it covers all groups of the population, very different ages, health conditions and regularity of sexual activity.

The products are mainly intended for women, but in some cases, her partner also comes into contact with her partner's contraceptive substances. Therefore, you should make sure that they are safe and convenient for both spouses.

In order to experience the fullness of love and joy from a fulfilling sex life, consultation with a specialist is necessary. In addition, you need to carefully study the instructions for use of each product in order to avoid mistakes or the development of side effects.

In many developing countries, which, unfortunately, includes ours, abortion still continues to be one of the most widespread ways to prevent unwanted pregnancy. But why does this happen? Either this is a lack of basic sex education, or an absolutely disregard for one’s health, or echoes of old Soviet statements like “there is no sex in our country,” which prevent parents from telling their children correctly and without shame about the rules of safe sexual behavior. But still, most likely there is an influence of all the above factors in combination.

According to statistics, abortion leads to infertility in every fifth woman. Even if you do not take into account the enormous number of other complications that arise after and during an abortion, the risk of infertility should be quite enough to make you wonder if the gamble is “worth the candle.”

Modern medicine offers a huge arsenal of ways to protect against unwanted pregnancy. In order not to regret what you did in the future (we mean abortion), you just need to decide on the method of contraception that is suitable for you personally.

Let's start with the reliability of existing methods.

Reliability of contraceptive methods:

Method of contraception	Degree of reliability
Interrupted sexual intercourse	80% - 85%
Calendar method (safe days method) *	80% - 90%
Basal temperature measurement method *	80% - 90%
Vaginal douching	10% - 15%
Condom	90% - 95%
Diaphragm (vaginal cap)	90% - 95%
Intrauterine devices (spirals)	90% - 92%
Hormonal intrauterine devices (spirals)	90% - 97%
Chemical contraception (creams, suppositories, tampons)	79% - 90%
Hormonal pills ( oral contraception)	96,5% - 97%
Hormonal injections	96,5% - 97%
Hormonal implants	99% - 99,8%
Hormonal ring NuvaRing	99%
Hormonal contraceptive patch Evra	99,4%
Medical sterilization	99,8% - 99,9%
Emergency postcoital contraception	-

* this degree of reliability is only possible with a regular menstrual cycle.

Coitus interruptus

The correct technique for using this method is as follows: the man must remove the penis from the woman's vagina immediately before ejaculation (ejaculation). Ejaculation itself can occur anywhere, but not in a woman’s vagina.

The popularity of this method of preventing unwanted pregnancy is understandable. It does not require material costs and does not reduce the sensitivity of the partners’ genitals during intercourse. However, it has much more negative sides than positive ones. Firstly, the method is very unreliable. This is explained by the fact that the “lubricating” (pre-seminal) fluid that is released from a man during sexual intercourse contains from 10 to 20 million sperm, which is more than enough to fertilize an egg. And even if you are sure that your partner has excellent control over the process of ejaculation, then no man can control the release of “lubricating” fluid (except perhaps a few yogis in distant India, and even then it’s unlikely). Secondly, long-term use of this method of protection has a negative impact on psychological state partners, since interruption of sexual intercourse is not physiological. Many studies have proven that regular absence natural satisfaction can lead to sexual coldness in women, impotence in men and a sharp decrease in sexual desire in both partners. Thirdly, interrupted sexual intercourse will never protect you from sexually transmitted diseases, as well as AIDS and viral hepatitis. Therefore, it is unacceptable to use this method for casual sex.

Calendar method ("safe days" method)

The calendar method belongs to the group of natural methods for preventing unwanted pregnancy. The essence of the method is that a woman is capable of conceiving only for several days after the release of the egg from the ovary (ovulation) - that is, during the life of the egg. Theoretically, ovulation occurs in the middle monthly cycle- approximately on his 11-15th day. It is this period of time that is considered favorable for conception, and the rest of the time a woman is not capable of conceiving. But this is only theoretical. A regular 28-day menstrual cycle with ovulation in the middle occurs in only 30% of women. And this is the exception rather than the rule. It is also necessary to take into account that sperm in a woman’s vagina can remain viable for up to 9 days. And if ovulation occurs during this period, then rest assured that they will not miss their goal. The calendar method is very “labor-intensive”, since in order to correctly count safe days, a woman must be aware of any changes in her menstrual cycle, that is, regularly keep records for at least the last year. Agree, not every woman is capable of such a feat.

But let's not talk about sad things, since nothing is impossible in our life. And if you really want to use this method of contraception, then use it. Its effectiveness directly depends on your organization and the presence of basic mathematical skills.

How do you still calculate “safe” days?

Firstly, it is necessary to clearly understand that the first day of the menstrual cycle is considered the day the menstruation (discharge) begins. The last day is the first day of the next and nothing else.

For clarity and ease of counting the days you are interested in, create a table. In the first column, indicate the month, in the second, the start date of the menstrual cycle, and in the third, its duration.

Month	Date of the first day of the cycle	Cycle duration
January	10	-
February	7	28
March	5	26
April	1	27
May	1	30
June	29	28
July	27	29
August	27	30
September	24	28
October	21	28
November	18	27
December	13	29

In this case, the table data shows that the shortest cycle is twenty-six days (March), and the longest is thirty days (August). That is, there is no clear regularity in the duration of the menstrual cycle.

In a short (26-day) cycle, ovulation occurs approximately fourteen days before the start of menstruation - on the 12th day of the cycle. Considering possible deviations the onset of ovulation within 3 days in one direction or another, we can conclude that the period of possible conception in each cycle of the specified duration ranges from the 9th to the 15th day.

In a long (30-day) cycle, ovulation also occurs 14 days before menstruation, that is, on the 16th day. Possible three-day deviations are not going away and they also need to be taken into account. In this case, the period of probable conception ranges from the 13th to the 19th day of the menstrual cycle.

Even with such slight variability in the menstrual cycle (the difference between the duration of the longest and shortest cycles is only 4 days), it becomes impossible to predict the duration of the next one. Therefore, the woman in the example we described should assume that ovulation can occur between days 9 and 19 of the cycle. And if we additionally take into account the viability of sperm and possible re-ovulation during active sexual life, then there will be practically no “safe” days left.

Therefore, we repeat: effective use of this method of contraception is possible only with a regular menstrual cycle with a predictable time of ovulation.

Basal temperature measurement method

This method also applies to natural ways pregnancy planning. Its essence is as follows. Before ovulation, the basal temperature is kept at a lower level due to the action of estrogen; after ovulation, progesterone raises the temperature by more high level. A rise in basal temperature means that ovulation has already occurred. When measuring basal temperature, you must adhere to several rules:

It is necessary to measure the temperature at the same time every morning, without getting out of bed
Temperature should be measured throughout the entire cycle, including during menstruation
the duration of the measurement should be the same each time (for example, when using a regular glass thermometer - 5 minutes)
Throughout the entire cycle you need to use the same thermometer.

Standard temperature rise type clearly shows the level low temperatures, then a sharp rise of at least two tenths of a degree and a subsequent level of high temperatures that remains until the end of the current cycle. Difference between average temperature the second and first phases of the menstrual cycle should be at least 0.4-0.5 degrees.

The effectiveness of this method increases when used in combination with the calendar method described above.

Disadvantage All of the above methods of natural protection from unwanted pregnancy, in addition to their low effectiveness, also have a high risk of contracting sexually transmitted diseases, AIDS and viral hepatitis.

Vaginal douching

The essence of this method is to expose the sperm already present in the woman’s vagina to various chemicals that can kill them. Various antiseptics are often used, for example, miramistin, chlorhexidine and others. In fact, these substances are not able to protect you from unwanted pregnancy due to the fact that, one: sperm are extremely mobile, two: there are unusually many of them, three: they know how to hide in the mucus of the cervical canal, which makes them inaccessible to disinfectants.

It is the above reasons that determine the low efficiency of this method.

It is also necessary to remember that frequent exposure of the vaginal mucosa to drugs aggressive against microorganisms leads to disruption normal composition microflora and the subsequent development of a condition called dysbiosis. At the same time, the woman’s reproductive system is populated by microorganisms that are normally either very small or should not exist at all (for example, fungi of the genus Candida).

Condom

The mechanism of action of a condom as a means of contraception is to create a mechanical barrier for the penetration of sperm into the vagina. Therefore, the complete ineffectiveness of using this means of protection is observed only when it is damaged. It should be borne in mind that the resulting defect can be quite small and is often almost impossible to notice.

To reduce the risk of damage to the condom during use, you must follow certain rules. Firstly, you should not roll out the condom before putting it on the penis; secondly, do not try to check its integrity in any way (for example, by inflating or filling with water), as this significantly increases the risk of damage; thirdly, you should not simultaneously with condoms, use additional oil-based lubricants, as they can reduce the strength of latex - it is permissible to use only water-based lubricants; fourthly, you must strictly follow the instructions for using the condom.

remember, that correct use A condom will not only protect you from unwanted pregnancy in 90% - 95% of cases, but will also reduce the risk of contracting sexually transmitted diseases by 90%.

Diaphragm (vaginal cap)

The diaphragm is the female version of the condom. It also consists of the finest latex. Before use vaginal cap consultation with a gynecologist is necessary, since the effectiveness of using a diaphragm directly depends on the correct choice of its size, which must clearly correspond to the size of the vagina and cervix. The vaginal cap, like a condom, creates a mechanical obstacle to the path of sperm, but, unlike the latter, does not protect against sexually transmitted diseases.

A negative aspect of this method of contraception, in addition to its inability to protect against infections, is also the need to correctly install the cap in the vagina. Agree that not every woman will be able to do this correctly the first time.

Intrauterine devices (spirals)

The contraceptive effect of the IUD is due to the following. The leg of the intrauterine device consists of copper, which, when released into the uterine cavity, creates an environment that is impossible for sperm and eggs to exist. Copper also provokes the development of a local aseptic (without the participation of pathogens) inflammatory reaction, which, in turn, does not allow sperm and eggs to function fully. The effectiveness of this method of contraception is on average 80%.

Like any method of preventing unwanted pregnancy, the use of an IUD has positive and negative sides.

Let's start with positive sides:

The IUD begins to act immediately after insertion and does not require the use of additional methods of contraception;
Installation of an IUD implies a long-term contraceptive effect (up to 6 years) and the IUD is often removed not because its expiration date, but more often because of the woman’s desire to become pregnant;
The ability to conceive is restored immediately after the IUD is removed from the uterine cavity.

TO negative The aspects of using an IUD include the following:

The presence of a foreign body in the uterine cavity is always an open entrance for infection;
When using this method of contraception, regular (at least once every six months) examination by a gynecologist is necessary;
The presence of an IUD may cause increased profuseness menstrual flow, as well as provoke their pain;
IUDs do not protect against sexually transmitted diseases;
The use of an IUD is not recommended for nulliparous women.

Also, before using the IUD, it is necessary to consult a gynecologist who will determine the presence of contraindications to inserting the IUD (for example, the IUD cannot be installed if a woman has any genital infection).

One of the most unpleasant consequences Using this method of contraception increases the risk of developing an ectopic pregnancy after removal of the IUD. Many studies have proven that the risk of ectopic pregnancy in women who used IUDs is 4 times higher.

Hormonal intrauterine devices (spirals)

Hormonal intrauterine devices differ from regular ones in that, in addition to the copper component, they also contain the hormone levonorgestrel, which prevents pregnancy. That is, the effect of the hormone is added to the effect of local inflammation, which causes more high efficiency method compared to using conventional spirals.

Fundamental differences in contraindications, positive and negative effects There is no hormonal IUD compared to using a regular one. The only thing a woman needs to know is that the ability to conceive after removal of the hormonal IUD can take a longer time to recover. So, 6 months after its removal, pregnancy occurs in 50% of women, and after a year, almost all women are already capable of conceiving (98%).

Chemical contraception (creams, suppositories, tampons)

Chemical contraception combines several effects: contraceptive, antimicrobial and antiviral. These drugs contain antiseptic substances that actively affect both sperm and pathogens of infectious diseases, including viruses. But, unfortunately, using this method in mono mode (without the parallel use of other means) is not always effective.

When using them, it is necessary to remember that the acid, which is what chemical contraceptives are, is neutralized when interacting with alkali, which causes a decrease in the effect until it disappears completely. That is why you should not use soap before and after sexual intercourse using chemical contraception (soap has an alkaline reaction).

Again, it is known from practice that the duration of action of candles and creams is much shorter than the manufacturer claims on the packaging. Therefore, before the next sexual intercourse (even if it occurs a short period of time after the previous one), it is recommended to introduce a new suppository or portion of cream. This nuance does not apply to contraceptive tampons. Their action lasts from 12 to 16 hours.

This method is convenient for women who are breastfeeding, since the substance contained in the contraceptive has only a local effect and does not enter the bloodstream, and, accordingly, into breast milk.

A negative consequence of frequent use of chemical contraception (as well as with douching) is a disruption of the normal composition of the vaginal microflora with the formation of dysbacteriosis.

Hormonal pills

This method of contraception was discovered not so long ago, but its appearance opened a new era in solving the problem of protection from unwanted pregnancy. The essence of hormonal contraception is to prevent ovulation - the release of a mature egg from the ovary. And if the egg does not appear in the field of vision of the sperm, then they sit idle, unable to fertilize it.

The effectiveness of hormonal contraception when used correctly is close to 100%, but it must be remembered that the use of hormonal pills does not protect you from sexually transmitted diseases.

Rules for choosing a hormonal contraceptive

The most correct method of choosing an oral contraceptive is a visit to a gynecologist. He will be able to comprehensively assess your health, take into account all possible contraindications and then recommend a hormonal contraceptive that will best suit you.

Today there are the following groups of oral contraceptives:

Combined oral contraceptives (COCs)– these drugs contain both gestagens and estrogens. Depending on the dose of hormones, drugs are divided into groups:
- Microdosed COCs. Contain lowest dose hormones and is therefore indicated for young nulliparous women who have regular sex life.
- Low-dose COCs. The dose of hormones is slightly higher than in the drugs of the previous group. Indicated to the same group of women in case of ineffectiveness (ovulation still occurred) of microdose COCs
- Medium-dose COCs. This group of drugs contains average dose hormones. Indicated for women who have given birth and who have regular sex life.
- High-dose COCs. These drugs are used not so much as contraceptives, but as means for the treatment of hormonal diseases. Their use in order to prevent unwanted pregnancy is recommended for women who have given birth in case of ineffectiveness of all groups of drugs listed above.
Progestin oral contraceptives
These contraceptives can be used by women after childbirth during breastfeeding, as well as in case of contraindications to taking COCs. This group of drugs is also successfully used to treat gynecological diseases (uterine fibroids, endometriosis).

Efficiency of the contraceptive effect hormonal drugs directly depends on the correctness of their application. The tablets should be taken strictly according to the schedule indicated in the instructions, at the same time of the day.

It must be remembered that in the first month of taking the drug, the contraceptive effect is incomplete, since at this time the body “gets used” to new operating conditions. Accordingly, in the first month it is recommended to additionally use some other means of protection.

Some drugs (painkillers, antibiotics, etc.) can reduce the effectiveness of hormonal contraception, so in this case it is also necessary to use additional protection.

Even if you chose the right one yourself contraceptive drug and you do not experience any health problems or side effects, a visit to the gynecologist still cannot be avoided, since it is necessary to determine how effectively the drug you have chosen blocks ovulation. And only a specialist can evaluate this by conducting an ultrasound examination on days 11-13 of the menstrual cycle.

Most frequently asked questions

How to behave if you miss taking another pill from the package?

The tablet must be taken as quickly as possible. If less than 12 hours have passed since the proper dosing time, then just take another pill and don't worry about anything else. In this case, the contraceptive effect of the drug is not reduced. Take your next tablet when possible (the sooner the better). If more than 12, or even more so 24, hours have passed, then it is necessary to use additional protective equipment before starting a new package, since the risk of pregnancy is increased.

What should you do if you experience side effects and their intensity greatly affects your well-being?

If you experience pronounced side effects while taking the drug (intense headache, increased blood pressure, depressed mood, sudden weight gain), then most likely the drug is not suitable for you and you need to change it to another, lower dose.

What to do if spotting appears between periods?

This also means that the drug is not suitable for you and you need to change it to another, higher dose.

What to do if menstruation does not start during a week-long break from taking hormonal contraceptives?

This means that the dose of hormones contained in the selected drug is too high for you. It is necessary to change the contraceptive to a drug containing a lower dose of hormones.

How long can you take hormonal pills?

Since hormonal contraception to some extent still disrupts the activity of the ovaries, it is recommended to take the drugs without interruption for no more than 2-3 years. After this, you need to take a break for at least six months. During this time, the ovaries completely restore their function.

Once again, a reminder: only a gynecologist can select the most correct drug. But if you decide to do it yourself, then read the instructions for use very carefully. Only strict adherence to it will ensure a reliable contraceptive effect and minimize the risk of developing side effects. If you feel unwell while taking the drug, consult your doctor immediately.

Hormonal injections

The essence of the method is as follows. The drugs used for this type of contraception contain the hormone levonorgestrel, which after administration is gradually released, as a result of which its constant concentration in the blood is maintained for 2-3 months. This is a method of long-term contraception.

Just as when taking pills, for 20-30 days after the first injection the contraceptive effect is incomplete and during this period it is recommended to use additional funds protection.

The negative effect of this method of preventing unwanted pregnancy is the effect of “inhibition” of ovarian function. It is because of this that hormonal injections can only be used by women who have given birth. As with choosing hormonal pills, you must first visit a gynecologist to assess your health, identify concomitant diseases and determine contraindications to using the method.

Hormonal implants

Implantation of hormonal capsules refers to long-term methods contraception. The mechanism of action is the same as hormonal injections: gradual release of hormones while maintaining their constant concentration in the blood. The peculiarity of this method is that it provides a complete contraceptive effect for 5 years.

Implants can only be used by women who have given birth, since the “inhibition” of ovarian function when using this method is quite intense, and in nulliparous young girls there is a high risk of non-restoration of reproductive function after the drug wears off. The capsule is injected subcutaneously into the shoulder, forearm, inner thigh or lower abdomen (optional).

Hormonal ring NovaRing

A hormonal ring is a contraceptive that is inserted into a woman's vagina. The action of NuvaRing is the daily release of microdoses of hormones that prevent the onset of ovulation. Unlike hormonal pills, shots, and implants, the hormones released from the ring act primarily locally. This reduces the risk of side effects that can occur when hormones are systemically exposed to the body. In addition, the concentration of hormones released from the ring is much less than in the lowest-dose COCs.

NuvaRing is inserted into a woman’s vagina from the 1st to the 5th day of the menstrual cycle. Due to its elasticity, it takes up the most comfortable position, adapting to the individual characteristics of a woman’s vagina. The contraceptive effect of the ring lasts 21 days, that is, a new ring must be inserted in the next menstrual cycle.

The disadvantage of this method is that the ring does not protect against sexually transmitted diseases.

Contraceptive hormonal patch Evra (Evra)

The Evra contraceptive patch is a method of long-term hormonal contraception. The patch is applied to the skin once a week; after this period it must be changed. The action of the patch, like other methods of long-term contraception, is the gradual release into the blood of hormones that prevent ovulation.

One of the main positive effects of the Evra patch is its convenience. It is firmly attached to the skin, does not come off when exposed to water, and does not lose its properties when exposed to sunlight. The patch is applied to your choice of buttocks, abdomen, shoulder blade or shoulder.

The side effects of the Evra patch are the same as those of microdosed COCs. If you have chosen this method of contraception, you must also first visit a gynecologist to assess the presence of possible contraindications.

Medical sterilization

This is a radical method of contraception that can only be used by those women who are 100% sure that they will never want to get pregnant again. The essence of the method is to intersect both fallopian tubes. This makes it impossible for the egg and sperm to meet.

Restoration of natural reproductive function after medical sterilization impossible.

Medical sterilization is possible in several ways:

regular surgery with an abdominal incision. It is rarely used for the purpose of sterilization due to the long recovery period and the subsequent presence of a scar at the incision site
laparoscopic method. The operation is performed not through an incision, but through a puncture of the anterior abdominal wall under the control of optical instruments. Less traumatic operation, short recovery period, scars at puncture sites are almost invisible
culdoscopic method. The operation is performed through a puncture in the back wall of the vagina. This is the most progressive method, since the number of complications is minimal and there are no scars left at all.

Men can also use the method of medical sterilization. To achieve a contraceptive effect, the vas deferens is simply ligated, as a result of which sperm cannot exit the testicles. The operation is performed under local anesthesia on an outpatient basis.

Emergency contraception (after sexual intercourse)

Emergency (postcoital, emergency contraception), unlike planned, is used immediately after sexual intercourse or during the first 1-3 days after it. The essence of this method of contraception is to prevent the processes of egg fertilization and/or implantation ovum due to inhibition of ovulation, disruption of egg transport and/or changes in the structure of the endometrium (uterine mucosa).

The most reliable and popular method nowadays emergency contraception is a one-time (or divided into two doses) dose of a drug containing 1.5 mg of levonorgestrel. This method of contraception can be used after unprotected sexual intercourse (including after rape), if the integrity of the condom is broken, three or more tablets of combined oral contraceptives are missed, the intrauterine device falls out and in other similar circumstances accompanied by an increased risk of developing an unwanted pregnancy.

Greatest efficiency emergency contraceptives noted when taken within the first 24 hours after unprotected intercourse, the effectiveness remains acceptable up to 72 hours after intercourse and sharply decreases in a later period. It is important to understand that levonorgestrel-based emergency contraceptives are not abortifacients and can only act until the egg is implanted into the wall of the uterine cavity. Therefore, the use of emergency contraception in women with confirmed pregnancy is pointless.

Levonorgestrel, which is part of emergency contraceptives, does not pose a danger to the embryo that has passed the implantation stage, so there is no need to terminate a pregnancy that occurs while taking an emergency contraceptive for fear of developing defects in the fetus.

Emergency contraceptives are intended only for use in an “emergency” situation and are not suitable for regular use as planned contraception, since, firstly, their effectiveness with continuous use is much lower than the effectiveness of modern planned contraceptives, and secondly, regular use of emergency contraceptives can cause menstrual irregularities.

Conclusion

Childbearing is an exclusive feature female body, and in no case should it be treated negligently. To ensure that your pregnancy is desired and timely, choose a contraceptive method that is right for you. It is not recommended to use methods whose effectiveness is below 50-60%
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Contraceptive methods for women are considered. The names of the most common contraceptives sold in pharmacies are presented.

Contraceptives are means that protect a woman from unwanted pregnancy. There are a lot of myths around hormonal pills. Many people believe that taking them is accompanied by weight gain and the inability to become pregnant in the future. We will try to dispel or confirm dubious information regarding female contraceptives.

Why should women use contraceptives?

If you ask about the most popular contraceptive, most will answer that these are condoms. But this method inconvenient and quite expensive if you have a regular sexual partner whom you trust.

Accordingly, contraceptives are used by women to protect against pregnancy and to obtain more vivid sensations during sex. Oral contraceptives are used for medicinal purposes and help get rid of skin problems and female ailments.

What types of contraceptives are there for women?

Types of female contraceptives:

Spermicides– ointments or gels containing substances that slow down the movement of sperm. These drugs thicken cervical mucus and prevent male cells from entering the uterus.
Spiral– a small plastic or metal product. Placed by a doctor inside the uterus
Oral contraceptives– tablets based female hormones. They may block ovulation or thicken cervical mucus
Patch- hormonal contraceptive. Hormones enter the body through the skin
Vaginal ring– a silicone or plastic ring that contains a small dose of hormones. Set for 21 days. You can do this yourself without the help of a doctor.
The natural way – calendar method. Used based on calculating periods of pregnancylessness and fertility
Method of interrupting sexual intercourse– before ejaculation, the partner removes the penis from the vagina

Barrier contraceptives for women. Pros and cons

Barrier contraception is a method of preventing pregnancy by using mechanical barriers to prevent sperm from entering the uterine cavity. Barrier contraception includes local chemicals, inhibiting sperm activity. Barrier contraceptives include: sponge, diaphragm, cap, female condom, suppositories, ointments, gels.

Advantages:

Can be used immediately before sexual intercourse
Protects against most sexually transmitted diseases (spermicides)
High reliability
Can be used by parous and nulliparous women
Low price
Rapid restoration of reproductive function

Flaws:

Less reliable compared to hormonal contraceptives
Often cause allergies and itching
Reduce sensitivity

Chemical contraceptives for women

This is a barrier contraception based on reducing sperm activity using chemicals. Often cause allergies and burning. High degree of protection and low price. Below is a list of popular spermicides.

Non-hormonal contraceptives for women, list

These substances are barrier contraceptives. Their effectiveness is due to a decrease in sperm activity. Some of the products actually kill sperm.

List of chemical non-hormonal contraceptives:

Pharmatex– a drug produced in the form of suppositories, sponges, cream and gel. This is a regular spermicide that contains benzalkonium chloride, an antiseptic. Accordingly, the drug can be used when having sex with casual partners. Effective period: 3 hours after insertion into the vagina
Benatex– Available in the form of vaginal tablets and gel. Contains spermicide and antiseptic. The drug contains no hormones, so the substance does not affect the menstrual cycle
Pantex Oval- spermicide based on nonoxynol. Has antimicrobial and antiviral properties. Inserted into the vagina 15 minutes before sexual intercourse
Conceptrol– available in the form of suppositories and contains nonoxynol
Gynekotex– spermicide based on benzalkonium chloride. This is a combined substance that kills viruses and bacteria, and also reduces the motor activity of sperm.

Local contraceptives for women

These are chemical and mechanical means that either reduce sperm motility or simply prevent them from penetrating into the uterus.

Mechanical local contraceptives:

Female condom- analogue of the male one, inserted into the vagina. One edge is fixed on the cervix, and the second will remain outside. Accordingly, it protects not only from pregnancy, but also from contracting diseases transmitted during sex
Diaphragm- This is a dome-shaped cap made of latex or rubber. It is placed on the cervix and simply prevents sperm from entering the uterus. Can be used several times. The doctor selects this method of contraception, since the sizes of the diaphragm are different. After childbirth or due to weight gain, it is necessary to purchase a larger diaphragm
Cervical cap- a product made of soft rubber. It is placed on the cervix using a suction cup principle. Negative pressure is created due to the compression of the cap, and it is securely fixed. Low degree of protection due to the possibility of the cap being skewed during sexual intercourse.

Hormonal contraceptives for women

Preparations containing the hormones estrogen and progestin. They change the composition and viscosity of cervical mucus, which makes it impossible for sperm to penetrate the vagina. Some combined contraceptives inhibit ovulation. Accordingly, the egg does not mature, so pregnancy is impossible
Mechanical products with low progestin content: patch, injections and subdermal implants. The most convenient can be considered a patch - this is relatively new contraceptive. It contains ethinyl estradiol and norelgestromin - synthetic analogues of female hormones. Hormones enter the bloodstream through the skin. Small amounts of hormones are released every day. The action of the patch is based on reducing the thickness of the uterine mucosa, to which the embryo cannot attach. In addition, the patch inhibits the functioning of the ovaries and prevents the dominant follicle containing the egg from growing

Contraceptive injections for women. Pros and cons

In our country, this method of contraception is unpopular. This is due to the high price of the drug and the mistrust of women. The injection is given intramuscularly once every 3 months. It is necessary that the injection be administered on the 5th day of the menstrual cycle.

The essence of using the drug is that it contains progesterone, which thickens the uterine mucosa and thickens cervical mucus.

In addition, ovulation is suppressed. The injections can be used by women who have given birth and those who have not given birth. There have not been any cases of infertility reported in the world after discontinuation of the drug. Although reproductive function is restored within 6-12 months.

Advantages:

Efficiency is 99%
There is no need to constantly calculate the days of the menstrual cycle
Suitable for women who smoke
It has medicinal properties and promotes the disappearance of endometriosis, endometrial hyperplasia

Oral contraceptives for women, video

Oral contraceptives - well known to everyone birth control pills with a combined hormonal composition. In the video you can watch a speech by a gynecologist regarding COCs.

Video: Oral contraceptives

Contraception for women after childbirth

Please note that combined contraceptives cannot be taken during breastfeeding. They affect the amount of breast milk.

Mini-pill
Hormonal injections
Intrauterine device
Remember, after giving birth you can’t have sex for a month, so after the discharge stops you can resume sexual activity
If you have a regular sexual partner, then it makes sense to get an IUD or take hormonal contraceptives based on gestagens. These are synthetic hormones similar in their effect to progesterone. It does not suppress lactation and does not harm the baby’s health, since a very small amount of the drug penetrates into the milk.
Previously, it was believed that it was possible to protect yourself after the birth of a child using a natural method. That is, due to the development of lactational amenorrhea, when there is no menstruation, it is safe to have sex. But now many doctors note the ineffectiveness of the method. Some women experience spontaneous ovulation, which will lead to an unplanned pregnancy

Contraception for nulliparous women

Many young girls are wary of taking hormonal oral contraceptives. they believe that they will gain a lot of weight and become unattractive. This is not true, since most women experience no weight gain at all or a slight weight gain of 2-3 kg.

There are rumors about numerous cases of infertility after stopping COCs. This is also a myth, since reproductive function is restored after 3-8 months. Some girls managed to conceive a child in the first month after stopping contraceptives.

But if you decide to take COCs, then seek help from a doctor, he will prescribe a drug with minimal doses of progestins and estrogens. Most often, young girls are prescribed Novinet, Jazz, Yarina.

They improve the condition of the skin and make periods less painful. COCs are not used for cystic changes in the ovaries and endometriosis.

The following methods are ideal for nulliparous women who have a regular sexual partner:

Barrier contraceptives
Condoms

Intrauterine device nulliparous girls not installed due to development possibilities pain syndrome and uterine bleeding after removing the IUD.

Emergency contraception is used in the following cases:

Rape
Skipping a COC dose
Damage to the condom
Unprotected sexual intercourse

These are drugs that cause detachment of the endometrium from the uterus. Thus, menstruation begins and sperm is simply carried away from the uterus along with the blood. It is recommended to take no later than 24-72 hours after sexual intercourse. Here are the names of some emergency contraceptives: Postinor, Escapel, Mifegin, Miropriston.

The best contraceptives for women over 30 years old. Video

Typically, by the age of 30, a woman already has a child and a regular sexual partner. In this case, an intrauterine device is considered the ideal option.
An IUD containing progesterone is often prescribed. Such contraceptives are indicated for women with endometriosis and other estrogen-dependent diseases. The most popular hormonal IUD is Mirena. Its cost is high, but its validity is 3-5 years
For women over 30 who have given birth, medium-dose combined oral contraceptives are used. They contain more hormones, this is due to the physiological characteristics of the body at this age. Among such drugs are Diana, Chloe, Dimulen

VIDEO: Contraceptives for women

Contraceptives for women after 45 years. Which ones to choose?

At this age, many women have chronic illnesses and are overweight. This is why classic COCs are not prescribed
For such women, three-phase drugs have been developed with minimal androgenic effect. Often before menopause, mini-pills - progestin contraceptives - are prescribed. Since many women who have given birth experience endometrial hyperplasia and endometriosis
It is best to put it after 45 years hormonal IUD Mirena. It will help not only prevent pregnancy, but also restore the uterine mucosa. This device significantly reduces the risk of developing uterine cancer.
After the birth of her second or third child, a woman can undergo sterilization. This is a tubal ligation operation. Now this operation is performed without the use of scalpels, using laparoscopy.

Contraceptives for nursing women. Features of the choice of contraceptives for breastfeeding women

The ideal option is mini-pills or Depo-Provera (progestin) injections. They do not affect lactation and do not affect the baby’s health in any way. But in most cases, women do not want to take any medications during lactation, so they use barrier methods of contraception
Absence of menstruation during lactation should not be used for contraception. This method only works if you have never missed a feeding, that is, the break between feedings was no more than 3 hours

Female contraceptive pills. Which ones to choose?

Low dose drugs. Prescribed to nulliparous girls, they contain a minimum of hormones (Jazz, Novinet)
Medium dosed drugs prescribed to women over 30 years of age (Diana)
Progestin drugs should be taken if you have endometriosis, endometrial hyperplasia (Norkolut, Mini-pill)

Do not buy birth control pills on your own based on a recommendation from a friend or pharmacist.

The doctor must assess your health condition and only then prescribe a specific drug. What suits your friend may not suit you. If you have endometrial hyperplasia and adenomyosis, you should not take medications with a high content of estrogen. This makes the mucous membrane thicken and the problem worsens.

Folk means of contraception. Recipes

Douching with a slightly acidic solution. Usually a tablespoon of acetic acid or lemon juice is added to a glass of water.
Calendar method. The periods of pregnancylessness before and after menstruation are calculated. 5 days before and after menstruation are considered safe
Rowan flower remedy. To prepare the substance, pour 200 ml of boiling water over a tablespoon of flowers. Leave for an hour and strain. Take 100 ml before each meal.
Coitus interruptus method
Douching with a weak solution of potassium permanganate

Traditional medicine offers many methods of emergency contraception that cause rejection of the fertilized egg during pregnancy. Almost after using each of these remedies, a woman is taken away by ambulance for uterine bleeding. Cleaning is carried out in the hospital. There are known cases of death due to blood poisoning due to rotting of the fetus inside the uterus.

The importance of contraceptives in preserving a woman’s reproductive health

Combined oral contraceptives for correct use and prescribed by a doctor prolong a woman’s youth. Oddly enough, after stopping the drugs, even women aged 45-55 years can become pregnant. This is due to the fact that at birth, every girl’s ovaries contain the rudiments of future dominant follicles.

When taking COCs, there is no ovulation, which means that this potential dominant follicle remains until the next time. In medicine, this phenomenon is called Anti-Mullerian hormone. If its content is high, a woman can become pregnant. With a very low concentration of this hormone, a woman will not be able to get pregnant even with IVF, since the supply of eggs has been exhausted.

The effect of contraceptives on a woman’s body

If you take the medications correctly and as prescribed by the doctor, the effect of the medications will be positive. Many of the COCs are created to treat ailments of the reproductive function of women. Try to change your contraceptive once a year, as the body often gets used to it and spontaneous pregnancy may occur.

How to protect yourself without pills and IUDs?

Despite their ineffectiveness, the following methods are still popular:

Calendar
Coitus interruptus method
Douching with potassium permanganate or vinegar solution after sex
To be sure, use barrier methods of contraception
The easiest way is to use a condom
With a regular sexual partner you can use spermicidal gels and suppositories

You can find a lot of positive and negative reviews about hormonal contraceptives. In most cases, negative experiences are associated with the use of a drug that was not prescribed by a doctor, but was recommended by a friend or pharmacist.

Often, after miscarriages, low-dose COCs are prescribed to restore the menstrual cycle. After their abolition, many women managed to get pregnant
In young girls who have not given birth, their skin condition improves, acne disappears, and menstruation becomes less painful
In general, taking hormonal contraceptives has a positive effect on a woman’s health. It's much safer than recovering from an abortion or miscarriage

The final decision on the use of contraceptives is made by the woman. Remember, no amount of persuasion from your partner and the pleasure of sexual intercourse without a condom or contraceptives is worth your health. Therefore, always use protection and consult good gynecologists. Good health to you.