home Analyzes Contraception: types and action. What methods of contraception are there?

Contraception: types and action. What methods of contraception are there?

About 90 out of 100 cases could be prevented. However, for some reason women do not want or cannot use contraceptives. Often patients are simply not sufficiently informed about what reliable methods of birth control are available. Today's article will tell you about them.

How to choose a contraceptive?

If your immediate plans do not include having children, then it is worth finding out what methods of birth control are available. A lot of products have now been developed for women. Some of them are based on correction hormonal levels, others relate to barrier methods. Some contraceptives may also protect against sexually transmitted infections. Some drugs are suitable only for women who have given birth, while others are preferable for those with irregular sex life.

To choose the right methods of birth control (for women), you need to consult a gynecologist. The doctor will prescribe an examination for you. After this - taking into account individual characteristics - the specialist will offer you several suitable ways. You can choose one or more of them. Next, you can learn how to protect yourself from unwanted conception.

Hormonal drugs: COCs, patches and others

What methods of birth control for women are considered the safest? Experts say that when using hormonal drugs, the chance of unexpected conception is almost zero.

There are several types. Before choosing one or another remedy, you must undergo tests.

Pills. There are different types: monophasic, biphasic, three-phase. Such drugs have many contraindications. They are not prescribed for diabetes, varicose veins, migraines, smoking and many diseases. You need to take the pills at the same time every day. Only in this case will the effect be expected.
Plasters. Hormonal drugs of this type are used less frequently. These modern methods Pregnancy protection is considered quite expensive. One patch is used for 22 days. After this there is a week break. Then the scheme is repeated.
Subcutaneous implants. Such contraceptives are used in cases where the use of patches or tablets is not possible. Capsules are sewn under the skin for up to several years. As a result, a woman does not have to bother with taking pills and gets rid of worries about unwanted conception.

All hormonal methods Pregnancy protection for women is based on one action. They stop the ovaries from working and prevent the release of an egg.

Barrier methods: condoms and vaginal products

The most popular barrier method is the condom. However, it is used by men, not women. A condom is placed on the penis before sexual intercourse. This method allows you to protect against all infections, including syphilis and HIV. Condoms are suitable for women who do not have a regular partner. They are also used as additional contraceptives. An alternative to such products would be

Barrier contraceptives include various spermicidal contraceptives. These are candles, creams, gels or foams. They are used 10-15 minutes before sexual intercourse and are effective for 40 minutes. The drugs can protect against certain infections and have a bactericidal effect. However, not all microbes die from these agents. In addition, long-term use of spermicides can disrupt the vaginal microflora.

Natural Methods

Most dangerous methods protection from pregnancy - calendar calculation, interrupted sexual intercourse and some others. All of them are based on the woman’s feelings and assumptions. Often, representatives of the fairer sex who prefer these options end up pregnant.

The essence of contact) is that the man ejaculates outside the woman's body.
contraception is used by women with regular cycle. Representatives of the fairer sex calculate the timing of ovulation and during this period refrain from intercourse.

TO natural ways protection may include tracking basal temperature, studying cervical mucus, and so on. Be that as it may, but this is a method of contraception not recommended by gynecologists.

Intrauterine devices

Reviews from experts about the use of IUDs say that this method of protection is proven and safe. But it is not recommended nulliparous women, since they require expansion during insertion of the device cervical canal. Intrauterine devices do not allow the fertilized egg to attach to the surface of the endometrium, even in the event of conception. Therefore, there is a guarantee of a contraceptive effect.

Reviews from some women about the IUD say that they managed to get pregnant even with the device installed. Such conception is considered pathological and in most cases ends in miscarriage.

Postcoital remedies

After the act? In such situations, modern post-coital methods of contraception come to the rescue. Drugs are produced in tablets: “Mifegin”, “Postinor”, “Escapelle” and so on. They should be taken no later than three days after intercourse. The drugs are contraindicated in liver failure, smoking, thrombosis.

The action of the drugs is based on stopping the production of progesterone and separating the endometrium from the lining of the uterus. These medications should only be used when in case of emergency. They are not suitable for permanent birth control. Side effects of the drugs include nausea, abdominal pain, hormonal imbalances, and so on.

TO emergency methods contraception can also include the installation of an intrauterine device. It has already been discussed above. In this case, you need to meet the deadline of 5 days. If during this time you manage to carry out the manipulation, then the probability of pregnancy will be close to zero. But it is worth remembering that before similar procedure You definitely need to get tested. Some studies take more than five days.

Traditional methods

Our grandmothers and great-grandmothers also knew how not to get pregnant after intercourse. For this, various folk remedies and recipes were used. But modern gynecologists are against such “amateur activities.” The ineffectiveness of such methods has long been proven. But for general information they are worth talking about.

Douching. Potassium permanganate is used as the basis of the solution for insertion into the vagina, citric acid and aspirin tablets. All these components are diluted in water. It is assumed that the liquid radically changes the microflora and acidity in the vagina. This is why sperm cannot survive.
Another “grandmother’s” method of contraception is a loading dose of vitamin C. It has long been known that this method can bring menstruation closer. It is believed that after unprotected sex, vitamin C can prevent conception.
In ancient times, before sexual intercourse, women inserted a slice of lemon into the vagina. The acidic environment did not allow viable sperm to penetrate into the uterine cavity.

Finally

Modern medicine offers couples a variety of contraceptives. They are selected individually, taking into account all your characteristics and wishes. If a woman has a hormonal disorder, then certain medications can help eliminate it. Be sure to visit a gynecologist and choose the method that is right for you. By using contraceptives, you can protect yourself from abortion and its complications. Approach this issue responsibly and take care of yourself!

Constantly take oral contraceptives makes no sense if a woman is not active sex life. It is better to choose methods that have less impact on the body, which can reliably protect against unplanned pregnancy and sexually transmitted diseases. In pharmacies today you can easily find various modern contraceptives that are quite effective and convenient.

What types of single-use contraceptives are there?

For irregular relationships, one-time products are best. In each individual case they must be selected individually. For women with irregular sexual activity, it is important that the chosen contraceptive has the following properties:

reliability;
convenience and ease of use;
safety of use;
availability;
protection against unplanned pregnancy;
protection against sexually transmitted diseases.

There are 3 main methods of protection:

barrier;
chemical;
hormone.

Which ones are better to choose? It all depends on many factors: personal preferences, risk, contraindications, and the situation itself. Each of them has its own pros and cons, so we’ll try to understand it in more detail.

Barrier method

The barrier method is the oldest and, perhaps, the most widespread among the population, because it has many advantages, such as:

relative cheapness;
availability;
ease of use;
quite high reliability;
no contraindications (except for allergies to the material);
absolute safety for the body;
protection not only from pregnancy, but also from infections.

Barrier methods can be used by everyone: nursing mothers, young girls, older women. In some cases, they are even recommended for pregnant women (to protect against infection).

The essence of the method is a mechanical obstacle that prevents sperm from penetrating the cervix. Use requires some attention from partners before and during sexual intercourse. Barrier methods include not only the well-known condoms, but also some other products.

Condoms

Everyone knows about condoms - this is perhaps the most accessible and simple means of protection. Its main advantage is protection against various sexually transmitted infections, which is why the condom has been and remains the number one remedy against unprotected sex. It is the condom that is best chosen as a method of protection during a casual relationship or at the beginning of a relationship when there is no complete confidence in the partner. It is easy to purchase at any pharmacy or store. A regular condom is placed on a man's penis and removed immediately after intercourse.

However, this proven tool has its own, very significant, disadvantages:

average contraceptive reliability;
they can rub, tear, or jump off;
decreased sensitivity during intimacy;
inability to use if you are allergic to latex;
a certain lack of aesthetics when used.

Some manufacturers produce condoms with spermicidal lubricant to increase reliability.

Despite popular belief, condoms can be used not only by men - there are special female condoms that have certain advantages over classic products:

polyurethane material is suitable for people allergic to latex;
you can insert such a condom several hours before sexual intercourse;
you can even go to the toilet with it;
he doesn't jump off;
can further stimulate the female genital organs during sex.

Unfortunately, the female condom can cause local irritation and is somewhat more difficult to put on than a classic condom (this will require a little practice). The product has two flexible rings - an internal one, which expands near the cervix, fixing the product, and an external one, which remains outside.

After sex, the condom is twisted to prevent sperm from leaking out, removed and discarded, just like a male condom. It is unacceptable to use male and female condoms at the same time - there is a high probability that they will break due to friction.

Vaginal diaphragm and cervical cap

The diaphragm is a dome-shaped rubber product that is inserted deep into the vaginal canal before sexual intercourse so that it covers the cervix. A latex product that is placed directly on the cervix is called a cervical (that is, cervical) cap. The cap is slightly different in shape from the diaphragm, but operates on the same principle.

The diaphragm or cap may cause irritation where it comes into contact with the mucosa. They cannot be used for protection inflammatory processes, cervical erosion, prolapse of the vaginal walls.

To increase reliability, it is recommended to additionally use spermicides. After use, the product is carefully removed, washed and placed in disinfectant solution- it is reusable and with proper care can last up to a year. It is imperative to remove the cap immediately after sexual intercourse, otherwise you can cause a strong inflammatory reaction and even the development of toxic shock syndrome.

Before purchasing, it is better to consult a specialist to determine right size, and also learn how to properly insert a contraceptive.

Other means

There are also less common products that are nevertheless quite often used in some countries. One of them is the vaginal sponge. It is a concave hemisphere made of porous material, having a loop for extraction and impregnated with a spermicidal substance. The sponge is inserted into the vagina at the cervix about a day before sexual intercourse and removed no later than 30 hours after that. Thus, it combines barrier and chemical methods of protection.

Chemical method

The chemical method means the introduction of substances that are harmful to sperm - spermicides. The main spermicides, on the basis of which a lot of modern drugs have been developed, are nonoxynol and benzalkonium chloride, which reduce the activity and even completely destroy sperm, making fertilization impossible.

There are now many tools available various forms, which are inserted into the vagina a certain time before sexual intercourse. Active substances begin to act in advance by doing cervical mucus thicker so that it is difficult for sperm to penetrate. In addition, they create a protective film on the mucous membrane, protecting against the development of infection.

If it was not possible to resort to contraception in time, non-hormonal birth control pills can also be used after unprotected sex - this will significantly reduce the likelihood of pregnancy and infectious diseases(however, only a condom can prevent the transmission of sexually transmitted infections).

Spermicides act exclusively locally - this is the safety of their use even during breastfeeding. In addition, they moisturize the vaginal mucosa, acting as a lubricant. The disadvantages are:

low reliability;
inconvenient to use (it is necessary to calculate the exact time before sexual intercourse);
sometimes a burning sensation in the woman and her partner;
cannot be used frequently (the composition of the vaginal microflora is disrupted);
After sex, you should not take a shower or bath for a certain time (this will reduce spermicidal properties).

Due to its relatively low effectiveness, this method of contraception is best chosen as additional protection or when ovarian activity decreases (during lactation, at the beginning of menopause).

It is optimal to use it in conjunction with condoms: spermicides will enhance protection against infections, protect against damage to the condom, and also act as a lubricant.

Facilities chemical contraception usually presented in the following forms:

Which one to choose depends on the situation and type of drug:

most famous drug- Pharmatex, it is available in various options, the most long-term action(up to 24 hours) tampons have;
Patentex Oval and Conceptrol in the form of suppositories are administered 10 minutes before intimacy;
Gynekotex - vaginal tablets, which have an antibacterial effect and are effective for 4 hours after administration;
Benatex gel will help relieve inflammation of the vaginal mucosa.

Thus, it can be used in various situations different drugs: Genikotex is optimal in case of unprotected sex with a new partner, Benatex - for colpitis, if everything is in order and the woman is more or less confident in her partner, then Pharmatex, Patentex Oval or Coceptrol are suitable. Whatever medications are chosen, it is important to follow the instructions exactly and not hygiene procedures certain time after intimacy.

By the way, it is precisely on creating an unfavorable environment for sperm that most folk remedies. Many recipes advise women to introduce an acidic solution into the vagina by douching. It is better to ignore such advice - commercial spermicides are much more reliable and safer.

Hormonal agents

Conventional oral contraceptives should not be used if you have irregular sex life. What hormonal pills are rarely used? There are so-called emergency or post-coital remedies that are created specifically in case of unprotected sexual intercourse.

Having taken pills after unprotected sex, a woman can practically not worry about the onset of unwanted pregnancy, however large doses hormones often have an adverse effect on the body: one tablet can cause painful menstruation and on long months disrupt the normal menstrual cycle. That is why such contraception is called emergency - it is created for use in exceptional, extremely rare cases, it is better not to resort to it more than twice a year.

Hormonal pills single use most often contain levonorgestrel, a synthetic analogue of progesterone. It has the following effects on the reproductive system:

delayed ovulation;
thickening of cervical mucus;
thinning of the uterine endometrium.

If the drug is taken on time, then pregnancy is practically excluded - even if ovulation has occurred and fertilization has occurred, the egg will not be able to attach.

The drug should be taken as quickly as possible after unprotected sexual intercourse: no later than three days later, the first tablet is taken, then after 12 hours - the second. Taking two tablets at once just to be on the safe side can be life-threatening - high doses of hormones can cause thrombosis and other terrible consequences.

Emergency hormonal contraception most often causes a number of unpleasant symptoms, such as:

nausea and vomiting;
diarrhea;
abdominal pain;
pain and engorgement of the mammary glands;
menstrual irregularities;
headache;
feeling tired.

It must be taken into account that the contraceptive effect of the pill may decrease after vomiting and severe diarrhea. You need to carefully study the instructions for contraindications, possible interactions with other medications and side effects.

Another common group is tablets based on mifepristone, a progestogen antagonist. This means that this substance blocks the action of the hormone progesterone, as a result of which the fertilized egg cannot attach to the endometrium, and in large dosages, contractions of the uterus occur, expelling it. Mifepristone and medicines based on it (Gynepristone) are taken within 72 hours after unprotected contact to protect against unwanted pregnancy, and even to terminate pregnancy (in very high doses, no later than 42 days of delay, strictly under the supervision of a doctor)

is a very reliable remedy, but it greatly affects a woman’s health, despite the fact that it cannot be considered a hormonal agent (in fact, this substance is only a hormone blocker), so its use unless absolutely necessary is unacceptable. In case of heavy bleeding and pain, it is better to consult a specialist. Strong post-coital medications should never be used as regular contraception.

Whatever remedy you choose, the main thing is to take care of your health in a timely manner. It would be optimal to combine barrier and chemical methods contraception, since they can perfectly complement each other, protecting against pregnancy and infections. Moreover, these funds local application and do not have a negative effect on the body.

If you experience discomfort after unprotected sexual intercourse, or if you suspect pregnancy, it is better to consult a doctor without delay.

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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(method " safe days») *	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 reliability is only possible with 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 contraception negatively affects the psychological state of 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 natural methods 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 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 possible conception in each cycle of the specified duration is 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: efficient use 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 refers to natural methods of planning pregnancy. 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 the next level high temperatures, which 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 influence the sperm already present in the woman’s vagina with various chemicals, capable of killing 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. Wherein reproductive system women inhabit microorganisms that normally are either very small or should not exist at all (for example, Candida fungi).

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, it is completely ineffective to use this tool 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 its 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.

The negative aspect of this method of contraception, in addition to its inability to protect against infections, is also the need correct installation cap into 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 local aseptic (without the participation 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 use additional methods 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:

Availability foreign body in the uterine cavity - this is always an open entrance gate 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 of using this method of contraception is the increased risk of developing ectopic pregnancy after removing the spiral. 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 hormonal IUD Compared to using a regular one, no. The only thing a woman needs to know is that the ability to conceive after removal of the hormonal IUD can be restored more quickly. long time. 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 only has local action and does not enter the bloodstream, and, accordingly, into breast milk.

Negative consequence frequent use chemical contraception (the same as with douching) is a violation of the normal composition vaginal microflora with the formation of dysbacteriosis.

Hormonal pills

This method of contraception was discovered not so long ago, but its appearance opened up new era in solving the problem of protection from unwanted pregnancy. The essence 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 treatments for 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).

The effectiveness of the contraceptive effect of hormonal drugs directly depends on the correct use of them. 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 to do if observed 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 occurs during a week-long break from taking it hormonal contraceptives hasn't started?

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 status and identify concomitant diseases and determining contraindications to the use of the method.

Hormonal implants

Implantation 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 surface thighs 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 sun rays. 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 contraception, it is also necessary to first visit a gynecologist to assess the presence of possible contraindications.

Medical sterilization

This radical method contraception, which 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 the intersection of both fallopian tubes. This makes it impossible for the egg and sperm to meet.

Restoring natural reproductive function after medical sterilization is impossible.

Medical sterilization is possible in several ways:

conventional 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 control optical instruments. Less traumatic surgery recovery period short, scars at puncture sites are almost invisible
culdoscopic method. The operation is performed through a puncture back wall vagina. This is the most progressive method, since the number of complications is minimal, and no scars remain 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 outpatient.

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, if three or more tablets of combined oral contraceptives are missed, if the intrauterine device falls out and in other similar circumstances accompanied by increased risk development of 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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In the clinic " New life"You can get advice from highly qualified gynecologists-endocrinologists on the most suitable method of contraception for you.

Many women are interested in the question: which method of contraception should they prefer? To make a choice, many listen to the advice of friends or simply use “folk” methods familiar to them. But no one can choose the right contraceptive for you the way a competent specialist can.

Pros and cons of different contraceptive methods

The female body was created by nature in order to reproduce and feed offspring. But today, few women are ready to give birth from the moment of puberty until old age, practically without interruptions. Therefore, the issue of contraception is quite acute.

Today there are many different methods contraception. All of them can be divided into two groups: reliable and unreliable. The first group includes only four methods: application birth control pills, use of intrauterine contraceptives, surgical sterilization and refusal of sexual activity. Other methods are unreliable.

Naturally, the woman herself must decide which method to choose; the doctor can only give advice and choose for you the optimal method of protection against unwanted pregnancy.

Modern contraception

. Hormonal pills

These are oral contraceptives, which come in two types: combined estrogen-progestogen drugs and mini-pills containing only progestogen. We will touch on the latter later. But the advantage of combined drugs is their almost 100% effectiveness.

Hormonal pills are the most reliable contraceptives that exist today, with the only exception being voluntary surgical sterilization. Hormonal pills provide a contraceptive guarantee if you start taking them from the first day of your cycle. They are easy to use, and the only thing you need to do is not miss taking them and try to take them at the same time. In addition, many drugs have a cosmetic effect - they can improve the condition of the skin.

It should be noted that such drugs differ greatly from each other in composition, clinical properties and dose of hormones. Therefore, the question of choosing a drug should definitely be entrusted to a doctor.

. Mini-pill

These pills contain only microdoses of progestogens, approximately 15-30% of what is contained in combination pills. The contraceptive effect of the mini-pill is significantly lower than that of the tablets. But due to their lesser impact on the blood coagulation system, they can be used smoking women over 35 years of age, as well as those who suffer diabetes mellitus and other diseases for which the use of combined oral contraceptives is prohibited.

. Intrauterine device

Method intrauterine contraception is based on the introduction into the uterus of a device that prevents pregnancy - a spiral. It is only suitable for women who have given birth. The procedure for inserting an intrauterine device is carried out by a doctor in the clinic quite quickly and almost painlessly.

Despite the reliability of such a contraceptive, recently many patients have refused to use it, since the spiral can cause an increase in the amount of menstrual flow and painful menstruation.

Our clinic specialists will be able to select for you best view intrauterine contraception and correctly install the device, which is very important for its effective functioning and your comfort.

. Hormonal ring NuvaRing

NuvaRing is a flexible ring made of hypoallergenic EVA material used for the manufacture of implants. It is inserted into the vagina for 21 days and releases hormones, thereby ensuring high contraceptive effectiveness. The convenience of the ring is that it needs to be inserted once a month, whereas tablets need to be taken daily. It allows you to conduct active image life, but some patients note that the ring interfered with them during sex.

. Barrier contraceptives

. Hormonal implant

A special capsule with hormones, which is administered through surgical manipulation on the inner side forearms for a period of 5 years. A good solution for women who are contraindicated in taking hormonal pills.

. Hormonal injections

Hormone injections are high effective method contraception. After injection into the buttock, the contraceptive effect lasts 3 months.

. Coitus interruptus

A very common method that has many disadvantages. First of all, sperm can be released before complete ejaculation, in addition, some men find it very difficult to stop, and finally, this method is harmful for men, as it is fraught with the development

Unwanted pregnancy is often a big problem for a woman. To avoid it, it is necessary to use contraception. Today there are a lot of options: from natural methods to hormonal remedies. A doctor’s recommendation, as well as knowledge of the operating principle of each of them, will help you make the right choice.

Combined oral contraceptives. These are tablets containing 2 types of hormones: progestogen and estrogen. Their effect is to suppress ovulation, as a result of which pregnancy is not possible. Modern drugs are safe, and there is no need to worry about side effects, such as excess weight.
Vaginal ring. It is made of elastic material and is inserted into the vagina. The ring contains estrogens, which prevent ovulation. It is safe to use, but it can give a woman discomfort or fall out completely.
Hormonal implants. They are implanted under a woman’s skin for several years. During this time, the hormone progestogen enters the body, which increases the viscosity of endometrial mucus, preventing the attachment of the egg.
Hormonal patch. It sticks to the skin and releases the hormone estrogen, which enters the body through the blood and blocks ovulatory function.
Hormonal intrauterine device. It has 2 types of action: it blocks the movement of sperm, and the progestogen that it secretes prevents the embryo from attaching to the wall of the uterus.
Mini-drinks. These are oral contraceptives containing small amounts of progestogen. The principle of action is to influence the mucus in the cervix, thereby preventing sperm from entering the uterus.

Chemical contraception

These are vaginal contraceptives: suppositories, tampons, creams that have a spermicidal effect, that is, when sperm enter the woman’s genital tract, they are immediately destroyed. Since the validity period is not long, it is recommended to use them immediately before sexual intercourse. The advantage of this type of contraception is that they also protects against some infections.

Natural contraception

Interrupted sexual intercourse. A popular but not very effective method. During sexual intercourse, the partner must have time to remove the penis before ejaculation.
Calendar method. The bottom line is that a woman tracks the days in which the probability of conceiving a child tends to zero, namely a few days before and a few days after ovulation. This method of contraception is low in effectiveness, since it is extremely difficult to accurately determine “safe” days.
Temperature method. This is a measurement of basal temperature to determine the day of ovulation: a couple of days before its onset, the temperature drops, and immediately after it rises.
Lactation method. The essence is the active production of prolactin and oxytocin when the baby is frequently attached to the breast. These noises provide a protective effect.

Barrier contraceptives for women

Female condom. This is a polyurethane tube that is inserted into the vagina and secured there with elastic rings. The condom mechanically prevents the penetration of sperm and also protects against infections.
Uterine caps and vaginal diaphragm. Devices made of silicone or latex, installed inside the genitals and preventing sperm from entering the uterus.
Spiral. A device made of metal and plastic. It is installed by a gynecologist into a woman’s uterus. The bottom line is the destructive effect of silver or copper (the material of the spiral) on the egg. The period of continuous validity is several years.

In which cases which contraceptives are better?

It is best to select female contraceptives together with a gynecologist. It is important to choose a convenient and highly effective remedy. You also need to consider contraindications and the likelihood adverse reactions that an individual woman may have. In general The method of contraception is usually determined based on age.

16-20 years old

The best option is considered hormonal contraceptives. It is important to remember that their use is advisable with regular sexual activity and the absence of diseases of cardio-vascular system. Preference should be given combination drugs, not providing negative influence on the processes of the female body.

20-35 years

In this case, any methods are good. However, they fit perfectly intrauterine contraceptives And hormonal drugs low in progestogen and estrogen. The first option is optimal based on the fact that there is no need for constant monitoring. The second method is good due to the fact that hormonal drugs prevent the development of sexual diseases.

35-45 years

Hormonal drugs are optimal. However, choosing pills can be extremely difficult due to health problems that exist at this age. And here Hormonal implants or patches are ideal.

After 45 years

At this age, both against unwanted pregnancy and for the prevention and treatment of diseases, combined hormonal contraceptives.

Video about types of contraception

In the next video fragment, a specialist will talk about the types of contraception, their action and how to choose the right one.