It happens that during sexual intercourse the condom breaks, so seminal fluid penetrates inside female body. Also, unwanted penetration of sperm can occur during rape. What should a woman do to avoid a deeply unwanted conception, should she really resort to such an unsafe method as abortion. There is a way out, and it’s not so dangerous. There are emergency contraceptive pills that are designed to prevent unnecessary conception and prevent the consequences of unprotected sex. But these drugs can only be taken in real in case of emergency, since frequent use is fraught dangerous complications for a woman.
During intimacy, anything can happen - the condom came off, the COC was missed, or the partners simply forgot about protection. What should a woman do in such a situation to still avoid pregnancy?
Any means and categories of such contraception cannot be called completely safe and useful for the female body, and therefore they are resorted to only in extreme situations, when coitus has already occurred, or the woman has been raped, etc. In general, every emergency contraceptive is intended more for women living intimate life quite rare, and also indispensable in unforeseen situations when sex occurred without protection.
Such medications are called post-coital, since they are used after the fact that sperm enters the vaginal environment. If sexual intercourse occurred before the onset of the ovulatory period, then a high dose of hormonal substances will prevent its onset and the woman’s given cycle will be anovulatory. If fertilization occurs, then emergency contraception will prevent the embryo from consolidating. Such medications contain a very high dose of hormonal substances, so such high-dose hormonal drugs should be taken as rarely as possible.
The medicinal effect of emergency contraception comes down to such effects as suppressing the maturation of the female cell, preventing the cell from meeting the sperm and preventing its implantation into the uterine wall. Therefore, after taking the drug, a thickening of the cervical secretion occurs in the female body, which does not allow sperm to enter the uterus. Also, at the same time, high dosages of hormonal components prevent ovulation, so the cell does not come out and the sperm die safely.
If sperm nevertheless penetrated the uterus, reached the cell and fertilized it, then under the influence of the hormonal components of the drug, hypotrophy of the endometrial layer occurs, which does not allow the zygote to gain a foothold on it, therefore further development pregnancy does not occur, and the embryo leaves the uterus during the next menstruation along with bloody discharge. The effectiveness of emergency contraceptives reaches quite high performance, amounting to about 97-99%. But there are also pitfalls here. A high contraceptive effect is achieved due to the high content of hormonal substances, which do not have the best effect on the female body.
Experts distinguish several categories of emergency contraceptives.
To get the proper effect from taking emergency contraception, you need to follow the rules for its use. When taking medications with levonorgestrel as an active ingredient (Postinor, etc.), you need to take into account that they should be taken no later than 72 hours after unprotected intimacy. The first pill must be taken immediately, and the sooner, the higher the contraceptive effect. The second pill is taken after 12-16 hours. If a woman vomits, then she needs to take another Postinor tablet. If we talk about other drugs with levonorgestrel, for example, Eskinor F or Escapel, then they are taken once, one pill, also within a 72-hour period. Efficiency similar means depends on how quickly the drug was taken after sex. Taking a day or less provides a contraceptive effect by 95%, after 25-48 hours - by 85%, and after 2-3 days - by only 58%.
Preparations with gestagen and estrogen are taken according to the Yuspe regimen. This technique involves taking COCs, but in higher dosages. For the first time, take 2-4 pills no later than the third day after intimacy. The second dose of the same number of tablets is taken after 12 hours. Typically, combined oral agents such as Ovidon or Rigevidon, Silesta and Non-ovlon are used as fire contraception. The effectiveness of this method reaches 75-85 percent.
Mifepristone pills like Mifolian and Agesta, Ginepristone or Zhenale are recommended to be taken during the first 3 days. Take just one pill. An important condition is an empty stomach, so you can’t eat a couple of hours before and after taking the pill.
Emergency contraception due to large dose causes a lot of hormonal substances side effects, which include nausea and vomiting reactions and intermenstrual bleeding, breast tenderness and migraine symptoms. If the patient already has varicose veins, then taking fire contraception can provoke blood clots. Also, adverse reactions often include menstrual irregularities and dizziness. Taking high-dose hormonal drugs often leads to menstrual disorders, when the patient’s periods begin to last longer or become more abundant.
Also, in response to taking fire contraception, they may develop allergic reactions, painful sensations in the area of the uterus and genital tract. But adverse reactions occur only in a fifth of patients; the rest of the women tolerate the effects of this category of drugs more easily. If the instructions are followed, emergency contraception will help avoid unwanted motherhood.
Doctors identify several popular fire contraception drugs that are most often used to prevent unwanted conception:
But such high-dose hormonal contraception has a number of specific contraindications, which include long experience nicotine addiction And mature age after 35, the presence of a hereditary tendency to thromboembolism. In addition, patients suffering from severe migraine pain, a predisposition to uterine bleeding, or advanced liver and biliary pathologies will have to abandon the use of emergency contraceptives. Also, the use of such contraception is not recommended for young girls (under 16), pregnant women, and lactating patients.
If completely unformed girls of puberty take such contraceptives, they will experience serious cycle disturbances, and in some cases, irreversible infertility may develop. Also, fire contraception is not recommended for lactose intolerance, Crohn's disease, unstable and irregular menstrual cycle, and hormonal-dependent reproductive problems. tumor processes, as well as women who have had cases in the past ectopic pregnancy.
Emergency contraception is a fairly serious category of drugs that are unsafe to take on your own, therefore a gynecological prescription and strict adherence to the rules of administration are necessary, then unwanted conception and further abortion can be avoided.
Emergency contraception is a necessary measure to prevent unwanted fertilization in the first three days after unprotected sexual intercourse. Usually used for emergency contraception hormonal agents(tablets) or intrauterine drugs.
It is important to remember: emergency contraception is a one-day drug and cannot be taken continuously!
Postcoital contraception is designed for women specifically in cases where conception is very undesirable for them. There may be several such options: a random intimate meeting, violence, health status, age, etc. Even prosperous married couples sometimes resort to EC means when the PAP was performed incorrectly or when product No. 2 is torn.
If a woman uses emergency contraception methods, you need to remember about the moments that necessarily happen when taking hormonal drugs:
If after 21 days from the moment when emergency contraceptives were used, menstruation has not begun, a visit to the doctor should be mandatory.
It is important to remember that EC tablets with frequent and regular use can cause serious pathology in the body, so emergency contraception (like birth control) is not constantly used. Otherwise, emergency contraception is much preferable to later abortion.
What is the effect of the “second day pill” based on? These drugs contain a loading dose of hormones or dietary supplements, which are designed to block pregnancy.
Contraceptive emergency pills are divided into two groups:
In both the first and second cases, the mechanism of action is the same: the drugs block ovulation, making pregnancy impossible or preventing the attachment of a fertilized egg. Hormonal (emergency) pills, if used correctly and in concentration, are quite effective.
Ginepristone is the best among emergency contraceptive drugs.Benefits of Gynepristone:
Emergency contraception also has two popular options: intrauterine methods and birth control pills. They are taken from 1 to 7 days, after which they will not be effective:
Agest is practically harmless to the female body and is effective in the first 72 hours.
Many women use old-fashioned methods, one of which is douching. Absolutely useless, the speed of sperm is much higher, they penetrate the uterus within 60-70 seconds after ejaculation.
The fact is that the harm from emergency contraception is much lower than from any type of abortion. Hormonal imbalances after taking the pills are predictable and completely correctable with the correct assistance from a gynecologist.
Contraindications:
Unfortunately, emergency contraception is not widely available, especially in remote areas of the country. Many women and men know nothing about it, some believe all sorts of rumors or use “emergency” drugs incorrectly. In the territory of the former USSR, misconceptions are even more widespread than in Western countries. The reason is that many women still consider it shameful to discuss intimate problems with a gynecologist.
It is important to remember that taking emergency contraception is a measure of last resort, as it has a number of serious contraindications.Even if everyday methods of contraception are very effective, it is necessary to have a “Plan B” on hand, since circumstances vary.
What are the most common misconceptions?
This is fundamentally wrong, since most drugs prevent pregnancy. This should not be confused with medical abortion, when under the influence medicines the embryo is expelled.
Another misconception. Many women go to extremes: they either avoid emergency contraception or use it too often. However, any gynecologist will say that the use of emergency means should be the exception rather than the rule. But in unfavorable circumstances, EC should undoubtedly be used.
Unfortunately, most women prefer to constantly take contraceptives different types post-coital remedies, although in practice it should be the other way around. There is no doubt that EC is better than abortion, but still worse than daily contraception. What do gynecologists advise women who, due to certain circumstances, have to take EC? The most important thing is to form a clear understanding of the situation with possible pregnancy and have the most appropriate personal contraception available.
There is no doubt that EC is better than abortion, but still worse than daily contraception.Eat known opinions about situations where sexual intercourse can be safe, but they are a myth, and this is what every woman and man should learn:
Despite the fact that this is the 21st century, many couples use rather Old Testament methods to avoid pregnancy. Gynecologists can recall in their practice a lot of examples when they had to listen to “innovative” methods of contraception that were absolutely ridiculous from a medical point of view:
When entering into intimate relationships and neglecting basic means of protection, both men and women must remember that the speed of sperm movement through the female genitals is large and irreversible; already 1.5 minutes after ejaculation they end up in the uterine cavity, and “shake them out” It's impossible from there. It is also important to remember that emergency (“firefighter”) contraception can be compared to calling an ambulance; it cannot be used constantly, but rather in the most exceptional cases. At other times, on the advice of a gynecologist, you can choose the optimal protection option and enjoy intimacy without fear of unwanted pregnancy.
In a fit of passion, many couples forget about contraception, deliberately do not use them, or use them incorrectly. Nevertheless, such “playing with fire” often leads to unwanted pregnancy. Emergency contraception may help in this case. However, women's parts often suffer from such assistance.
First of all, there is no need to panic. This will only make the situation worse. In addition, you should not immediately run to the bathroom and do douching. This practice will be useless in 99% of cases, since the part that gets into the vagina almost instantly ends up in the cervix. And even one lost cell already increases the risk of pregnancy.
You should not resort to others folk methods contraception. Using lemon, potassium permanganate and boric acid It will only harm your sexual health and will not protect you from pregnancy.
As a rule, used in tablets within 72 hours after unprotected intercourse. After this time, the effectiveness of such protection decreases, and its further use is simply pointless. If you take the drug within the first 12 hours after sex, it will significantly reduce your chance of getting pregnant. Moreover, after some time, taking the drug is often repeated to consolidate the contraceptive effect.
Means emergency contraception mostly suppress hormone production, responsible for ovulation and a woman’s ability to conceive. By the way, conception itself occurs in the first 72 hours after sexual intercourse. That is why it is important to take the pill before the end of this period, before pregnancy occurs.
Not every sexual intercourse ends in conception, even with complete abandonment of contraceptives. The fact is that the birth of a new life occurs only during the period ovulation– during the release of the egg from the ovary into the fallopian tubes. This process is relatively rare and very short: the egg does this only 1 time per month and is located in fallopian tubes Oh about 24 hours. After this time, the egg simply dies.
Since the egg lives only for a day, a woman is actually unable to get pregnant on other days menstrual cycle. However, in practice pregnancy can occur when having sex on any day of the cycle, even during menstruation. But the probability of conception will be significantly lower than during the period of ovulation.
As a rule, in women with an even menstrual cycle, pregnancy does not occur if sexual intercourse occurs during the non-fertile phase (in safe days). Typically this period lasts from 1st to 7th, and also from 20th to 28th day(provided that the cycle is constant and its duration is 28 days). In this case, you can refuse funds at your own peril and risk emergency contraception. However, the likelihood of pregnancy will be much higher.
Typically, oral hormone-containing medications are used to prevent pregnancy. Emergency contraception- these are funds based levonorgestrel (Postinor, Escapel, etc.) And mifepristone (Agesta, Zhenale). In addition to them, drugs with ulipristal acetate, which also prevent conception. The mechanisms of action of the listed contraceptives are somewhat different. However, despite this, they are all effective in preventing pregnancy.
In addition to emergency medications, they are used to prevent pregnancy. combined oral contraceptives (COOK). As a rule, COCs are used on an ongoing basis as contraception. But in emergency cases, if the woman has not previously taken them, these drugs can be used to prevent conception.
Note that emergency contraception includes not only pills, but also intrauterine device with a contraceptive effect. However, to get the latter, you need to install it within 5 days after intercourse, since then its effectiveness will decrease significantly. However, it is not recommended to install a spiral nulliparous women. In addition, this method of contraception requires the intervention of a doctor.
Emergency contraception dangerous for women's health, especially if drugs of this group are used more than 2 times a year. First of all, taking such drugs is a serious blow to hormonal system. By interfering with the balance of hormones, emergency contraceptives can lead to a temporary cessation of ovulation, and then completely infertility.
Moreover, the imbalance female hormones when using emergency contraception leads to decreased bone density and early menopause . Because of frequent use these drugs reduce the level of and responsible for mineralization bone tissue. A decrease in these two hormones in a woman’s body promotes development, which significantly increases the risk.
In addition, in half of the cases of taking “emergency” contraceptives, uterine bleeding , similar to menstruation. However, women may experience severe pain lower abdomen, vomiting, nausea, headaches, and pain in the mammary glands.
Special danger presents during breastfeeding. Use of hormonal drugs during this period may harm the baby's health, since part of the drug enters the child’s body with mother’s milk.
The intrauterine device also has a lot of disadvantages. Its long-term use increases the risk gynecological diseases. In this case, the IUD itself can grow into the uterus and cause many complications. In addition, its installation is not suitable for every woman. And the procedure itself requires careful preparation with tests and diagnosis of the pelvic organs.
To avoid harming yourself when using emergency contraception, you must adhere to the following recommendations.
After taking contraceptive medications, young mothers should stop breastfeeding for 36 hours so as not to worsen the child’s health.
USEFUL TO KNOW:
ABOUT JOINT DISEASES
Concept postcoital contraception unites various types contraception, the use of which in the first 24 hours after sexual intercourse prevents unwanted pregnancy. This method of protection in the literature is also called emergency contraception (emergency contraception, immediate, urgent, extreme, fire, “morning after”). Emergency contraception should be used when emergency situations: women who have been raped, or when there is doubt about the integrity of the used condom, in cases where the protective diaphragm is displaced during sexual intercourse, or when planned methods of contraception cannot be used.
| Postcoital contraception cannot be recommended for continuous use , since each of the methods is an emergency intervention in functional state reproductive system women with subsequent development of ovarian dysfunction. When taking combined or pure progestin pills daily oral contraceptives The body receives low doses of a hormonal drug, designed for the entire menstrual cycle and without disturbing its duration and cyclicity, thereby improving ovarian function and eliminating existing hormonal imbalances. And when taking these same pills for the purpose of emergency contraception, the body simultaneously receives enormous doses of the drug, regardless of the phase of the menstrual cycle. For example, POCs take 40 tablets, POSTINOR, belonging to the same group of drugs, contains the same amount in 2 tablets active substance, as at 40. This leads to a sharp hormonal disruption and ovarian dysfunction. As a result of repeated use of hormonal drugs for the purpose of emergency contraception, women develop menstrual cycle disorders with its shortening or lengthening, the cycles become anovulatory (an egg is not formed), which is the cause of infertility. Ovarian dysfunction leads to the development of the syndrome metabolic disorders(increase blood pressure, increased blood sugar, excess weight). |
The main mechanism of postcoital contraception is desynchronization of the physiology of the menstrual cycle – suppression of ovulation, disruption of the fertilization process, disruption of egg transport and implantation (attachment) of the embryo in the uterus. When taking large doses COOK or PSC in the first phase of the menstrual cycle, the maturation process of the follicle is disrupted and atresia (reverse development) occurs. In addition, a single dose of these hormonal contraceptives(in any phase of the menstrual cycle) disrupts the formation of the endometrium (the mucous membrane of the uterine cavity) with its rejection. The action of COCs and POCs in large doses is aimed at hormonal disruption of the ovaries. Mechanism of action MIFEPRISTONE based on blocking the action of progesterone and increasing uterine contractility. As a result, the endometrium (the mucous membrane of the uterine cavity) is rejected. Navy, introduced into the uterine cavity, being a foreign substance, causes:
The above-mentioned regimens for taking oral contraceptives as a means of postcoital contraception differ mainly in side effects, called by them. Approximately 46% of women using to prevent pregnancy COOK or ChPOK, Nausea occurs, and 22% experience vomiting. In addition, you may experience dizziness, a feeling of fatigue, pain in the mammary glands and headaches. When using Mifipristone a feeling of discomfort in the lower abdomen, weakness, nausea, vomiting, dizziness, and increased body temperature may occur. When inserted Navy during the first two days there may be cramping pain in the lower abdomen, the duration increases menstrual flow and their number, the risk of ectopic pregnancy increases due to disruption of the wave-like contraction of the fallopian tubes and the movement of the egg through them. Sometimes spontaneous expulsion (fallout) of the IUD is possible. In very rare cases, perforation (damage) of the uterus may occur during insertion of the IUD. Follow-up with a gynecologist is not required if the patient is not delaying her next menstrual period (a delay may mean pregnancy), if the woman does not express concern about her health and does not want to start using contraception. If the patient expresses such a desire, she should be warned that after taking COCs or POCs as a means of postcoital contraception, it is necessary to use a condom, diaphragm or spermicides (substances that are harmful to sperm) for the entire time until the next menstruation. From the start of your next menstrual cycle, you can regularly take hormonal contraception or use natural family planning. At the same time, you can start using the IUD if the IUD has not already been inserted after sexual intercourse as a method of emergency contraception and the patient agrees to use it for the entire recommended period.
See the article “In harmony with hormones. Combined oral contraceptives", No. 5, 2006.
See article " Hormonal contraception. Pure proestin oral products", No. 6, 2006.
See article " Modern methods contraception. Intrauterine devices", No. 4, 2006.
See the article “No Trespassing! Barrier methods of contraception", No. 3, 2006.
See article " Natural contraception. How to avoid pregnancy without contraception", No. 2, 2006.
Main operating principle emergency contraception(it is also called postcoital) - in disruption of the process of ovulation, fertilization or movement of the egg, as well as its implantation and further development of the embryo. This can be achieved in different ways, both quite effective and not very effective. Moreover, we should not forget that the more effective a method of postcoital contraception can be, the more it can harm health.
The simplest, cheapest, practically harmless and ineffective way is douching, for example spermicide, boiled water with the addition lemon juice or a very weak vinegar solution. Yes, in acidic environment sperm must die. But since some of them only need one and a half minutes to get to the cervix and fallopian tubes, the effectiveness of this “folk” method of contraception is questionable. According to statistics, in approximately 60% of cases, such “emergency contraception” ends in pregnancy.
Intrauterine device (IUD) Usually administered within 5 days of unprotected sex, this method is quite effective (about 99%), but is not suitable for everyone. And it’s difficult to call this method of preventing pregnancy “emergency” contraception. It is advisable to place the IUD at the beginning of the menstrual cycle, when the cervix is soft and there is the least risk of injury. An ultrasound and tests are required first; the IUD is also not recommended for those who have not given birth or those who have large number sexual intercourse, infection or inflammatory processes pelvic organs.
The method is effective, popular and far from being as safe for women’s health as some people think. Action progestin-only oral contraceptives(they are also gestagens, ChPOK, ChPK), containing a very large amount levonorgestrel (postinor, escapelle) based on the so-called blockade of ovulation (slowing down or preventing the release of the egg) in the first phase of the cycle and blocking fertilization or implantation of the egg in the second, as well as preventing the penetration of sperm into the uterine cavity (due to the fact that hormones cause thickening of the mucus in cervical canal). The earlier the pills are taken, the better. It is recommended to take such contraceptives in the first 24-72 hours after sexual intercourse. It is believed that in the first day the effectiveness of such emergency contraception is up to 95-97%. A larger dose has a similar effect. progestin COCs (mini-pills).
The main danger of such post-coital contraception is that it greatly affects hormonal background. It is no coincidence that it is considered undesirable to resort to this method more than once or twice a year. And, even more so, POCs cannot replace planned contraception.
gynecologist, Central Clinical Hospital No. 13, Moscow, doctor highest category, Ph.D.
Such pills do not provide a 100% guarantee against pregnancy. Such drugs contain a large dose of hormones, which, roughly speaking, are aimed at causing premature menstruation. They often cause severe bleeding and cycle disorders, ovarian dysfunction, normal operation which then takes a very long time to recover.
Yuzpe method, proposed more than 30 years ago by a Canadian doctor Albert Yuzpe based on loading dose combined estrogen-progestogen drugs (COCs), approximately 3-6 times greater than the amount of hormones that enters the body during routine contraception. You should also take the pills no later than 72 hours after unprotected sex. In addition to its strong influence on the menstrual cycle, global single dose hormones often causes side effects such as nausea, vomiting, headache, dizziness. Doctors estimate the effectiveness of emergency contraception using the Yuzpe method at 75-90%, and even less on days close to ovulation.
Pills are again used as emergency contraception, but only based on a steroid mifepristone– an antagonist of the pregnancy hormone progesterone. This is the same active substance, by the way, is also the basis of drugs for medicinal abortion ( medical abortion). The effectiveness of similar emergency contraceptives (eg gynepristone) is assessed by doctors as quite high, according to some data up to 97-98%. However, contraindications and side effects(including disruption of the ovaries and menstrual cycle) they also have quite a lot.
