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Every year, at least 16.7 million unwanted pregnancies occur worldwide. 15 million of them (that is, almost 90%!) could be prevented if women used modern contraceptive methods correctly. Surprisingly, inIn the 21st century, millions of people ignore them or use them incorrectly. As recent events have shown, women are afraid side effects, have different prejudices or simply lack information. MedNews figured out how the most popular contraceptive methods work (and whether they work).
"Barrier" contraception
Barrier contraception consists of male and female condoms, vaginal diaphragm and the uterine cap. All these devices physically block the sperm from entering the uterus. The sperm cannot meet the egg and fertilization does not occur.
Condoms
Male condom everyone knows, but female much less popular. This is a small pouch, usually made of polyurethane, which is inserted into the vagina and secured there thanks to elastic rings. The advantage of both types of condoms is that they not only prevent unwanted pregnancy, but also protect against sexually transmitted diseases.
The effectiveness of condoms is relatively high: according to WHO, with correct use male prevents unwanted pregnancy in 98% of cases, but female - only in 90%. In addition, you need to take into account that the condom may break.
Caps
Uterine cap And vaginal diaphragm - These are latex caps of different shapes that are installed on the cervix. They no longer protect partners from gonorrhea or syphilis, but they do prevent sperm from entering the uterus. Their main disadvantages are the difficulty of use (not every woman will be able to put on the cap on her own) and allergies, which can arise due to the tight and prolonged contact of the mucous membrane with latex.
"Natural" contraception
“Natural” are methods of birth control that do not require mechanical or medicinal intervention.
Coitus interruptus
One of the most popular and at the same time least reliable “natural” methods. When using it, the partner removes the penis from the woman's vagina a few moments before ejaculation. The unreliability of this method is determined by two factors. Firstly, a man may not have time to remove the penis in time (here everything depends on his ability to self-control). Secondly, during friction, a small amount of pre-seminal fluid is released, which may contain some sperm - and pathogenic agents. The effectiveness of the method, according to WHO, ranges from 73 to 96%, depending on correct use.
Calendar method
Another popular and not always effective method. A woman tracks the days of her menstrual cycle that are favorable and unfavorable for conception. Fertilization of the egg can occur only within 48 hours after ovulation, and the lifespan of the sperm in the cervix is up to a week, but often less. Therefore, several days before ovulation (sperm can remain in the woman’s genitals and wait for a mature egg) and a couple of days after ovulation are considered dangerous for conception. Adherents of the calendar method argue that it is during this period that a woman should abstain from sexual intercourse if she does not want to get pregnant. The disadvantage of the method is that it is not always possible to calculate exactly when ovulation will occur, especially in women with irregular menstrual cycles.
Temperature method
This method allows you to clarify the moment of ovulation. It is not for the lazy: every day, immediately after waking up, you need to measure your basal temperature (by inserting a thermometer into anus). Before ovulation, the basal temperature drops slightly, and immediately after ovulation it rises by 0.3-0.5 degrees and remains at this level until the end of the cycle. By tracking your temperature daily, you can quite accurately determine when ovulation occurs, and accordingly, abstain from sexual intercourse on days favorable for conception.
Cervical method
Another method that helps determine the onset of ovulation is cervical method, or Billings method. This Australian doctor noticed that shortly before ovulation, the mucus released from the vagina becomes more viscous. This way you can track “dangerous” days. However, due to fluctuations in hormones, mucus can become viscous even in the absence of ovulation, so the method is inaccurate.
Method lactational amenorrhea
The point is simple: in the first months breastfeeding ovulation does not occur, so there is no need to protect yourself. But there is a condition: a woman must breastfeed her baby very actively (at least every three hours during the day and every six hours at night), otherwise the production of the hormones prolactin and oxytocin decreases, and their “protective” effect disappears. However, frequent feeding is also not a 100% guarantee.
Spiral
Intrauterine device- a common and fairly simple method of contraception. This device, usually made of copper or silver with plastic, is inserted into the uterus by a doctor for several years. Copper or silver have a detrimental effect on sperm, and the spiral itself, if fertilization does occur, prevents the egg from attaching to the wall of the uterus (thus, the embryo does not have the opportunity to develop). The method is convenient because it requires almost no effort on the part of the woman, but it has its drawbacks - for example, it increases the risk of developing infections and inflammation.
Hormonal contraception
There are a huge variety of hormonal contraceptives, and they work in different ways. In general, they can be divided into two types: those containing the hormones estrogens (or rather, their analogues) and those that do not contain them.
COCs
The most common method hormonal contraception. When used correctly, it is considered one of the most reliable. The tablets contain two types of hormones: estrogens and progestins. They suppress ovulation and pregnancy becomes impossible.
It’s a paradox, but it is precisely these means that most fears are associated with. Women are afraid of side effects, for example, blood thickening: estrogens promote blood clots and increase the risk of thrombosis. In fact, this danger is much higher, say, with smoking or even pregnancy. So if a woman does not have serious contraindications (history of thrombosis and among family members, highly elevated blood pressure etc.), the use of COCs is considered safe. However, women are much more afraid of thrombosis excess weight: the belief that you can get better from pills is one of the most persistent. In reality, this has not been the case for a long time: modern oral contraceptives contain minimal doses of hormones, which, although they may slightly aggravate the feeling of hunger (and even then not for everyone), do not in themselves increase weight gain.
Vaginal ring
This is another method of hormonal contraception using estrogen. It is similar in composition and principle of action to COCs, but is radically different in the method of application. The flexible ring is inserted directly into the vagina, where required doses releases hormones that help suppress ovulation. The advantage over COCs is that the ring has almost no effect on the liver; the disadvantages are the relative inconvenience of use: it can fall out of the vagina or interfere with the woman.
Hormonal patch
The hormonal patch also contains estrogens, but is glued to the skin and delivers hormones to the body through the blood.
Mini-pill
Another group hormonal contraceptives, they do not contain estrogens, only progestogens. Due to this, they do not have side effects associated with estrogen and are considered safer, although less effective. This group includes the so-called mini-pills: these are tablets containing a minimum dose of the hormone.
The principle of their action differs from estrogen-containing contraceptives: they do not prevent ovulation, but cause thickening cervical mucus(mucus in the cervix), which prevents sperm from penetrating into the uterus itself. In addition, progestogens prevent swelling inner shell uterus, or endometrium (without the use of hormones this naturally occurs in the second half of the menstrual cycle). Because of this, the embryo cannot attach to the wall of the uterus and continue its development.
Subcutaneous implants
Particularly desperate women may decide to sew a contraceptive hormonal implant under their skin, which also does not contain estrogen. It is installed for several years and releases into the body in doses required quantity progestogen hormone. Like the mini-pill, the implant increases the viscosity of the cervical mucus and prevents the endometrium from swelling.
Hormonal intrauterine device
Its operating principle is mixed. It immobilizes sperm and mechanically prevents the embryo from attaching to the uterine wall, like a regular spiral. In addition, just like implants, it releases a minimal amount of the progestogen hormone every day, which prevents the growth of the endometrium and thus prevents the embryo from implanting.
Chemical contraception
Vaginal suppositories, creams, foams, sponges and tablets that have a spermicidal effect, that is, they destroy sperm. Typically, all these remedies should be used 10-15 minutes before sexual intercourse. Their advantage is that they also protect against sexually transmitted diseases - but not all and not completely. The disadvantage is that the efficiency is much lower than that of other methods. Therefore, they are recommended to be used in combination with other means.
Emergency (aka “morning”) contraception
If unprotected sexual intercourse has already occurred, but the woman does not plan to have a child, then all is not lost: conception can still be prevented for some time. There are a variety of methods for this - from folk to hormonal.
Traditional methods
A slice of lemon, an aspirin tablet, laundry soap and a solution of potassium permanganate - this is far from full list funds that traditional medicine ready to offer to unwary lovers. It is implied that citric acid components laundry soap, potassium permanganate and acetylsalicylic acid(aspirin) acidify the environment, and this kills sperm.
Doctors apply folk remedies is categorically not recommended for two reasons. The first is their low efficiency: sperm can penetrate the cervical canal within a few seconds after ejaculation, and before that it is unlikely to have time to insert a lemon into the vagina. And the second is side effects: aggressive acid or improperly diluted potassium permanganate can “burn” the mucous membrane and disrupt the vaginal microflora.
Hormonal pills
There are more reliable way postcoital (that is, used after sexual intercourse) contraception. Designed especially for this case hormonal pills. At the core different drugs lie different substances, but their mechanism of action is similar: they suppress ovulation, and if conception has already occurred, they prevent the fertilized egg from attaching to the wall of the uterus. The pills usually need to be taken in the first few days after unprotected intercourse (the sooner the better), but with each day of delay their effectiveness will decrease.
It is widely believed that the use of such drugs is extremely harmful, but WHO has repeatedly emphasized that they are safe. This, of course, does not mean that such products should be used regularly: they are simply not intended for this.
Emergency installation of a spiral
The same copper or silver spiral, which was already mentioned above, can be installed urgently - within five days after unprotected sexual intercourse. The principle of its operation is the same: copper or silver has a detrimental effect on sperm and eggs, and the spiral itself prevents the attachment of the embryo to the wall of the uterus. After emergency installation, the IUD can be left as a permanent means of contraception.
Karina Nazaretyan
Knowing how to protect yourself from unwanted pregnancy eliminates the risks associated with childbirth for women's health, reduces the rate of child mortality and the spread of STIs.
This number shows the number of women out of one hundred who became pregnant during the year using a specific contraceptive method. The lower the indicator, the higher the effectiveness of contraception.
It is important to distinguish between “method effectiveness” (proper, consistent use of one type of contraceptive) and “method effectiveness” (inappropriate use of contraception, using different contraceptives throughout the year). Because of these two indicators, the upper and lower limit Pearl index can vary significantly.
The principle of PPA is to prevent semen from entering the partner's genital tract: the penis is removed from the vagina before ejaculation occurs.
Pearl index: 4-17.
The calendar method is based on determining fertile days from the menstrual cycle and the use of contraception/abstinence during this period. The method is only suitable for women with a stable cycle.
Pearl index: 4-17
An IUD is a device placed into the uterus of healthy and previously given birth women using a special applicator and mechanically preventing the development of pregnancy.
Pearl index: 5.
The most popular contraceptive in this category is produced under the name Mirena. This is a T-shaped contraceptive coil containing 52 mg of levonorgestrel. Can be used for lactating women, as well as medicinal purposes. The principle of operation of the device is to suppress ovulation, thicken mucus in cervical canal and thinning of the endometrium.
Pearl index: 0.2.
"Jaydes" is an IUD with a lower content of levonorgestrel (13.5 mg). The principle of action is a predominantly local effect on the uterus.
Pearl index: less than 1.
They are also combined oral contraceptives. The very name of the group of drugs indicates that there are several active ingredients. Modern pills contain estrogen and progestin. The principle of action of COCs is to prevent ovulation.
Pearl index: with proper use - 1, with normal use - 8.
This is the name given to pills that contain only progestin. The principle of operation of these contraceptives is to prevent fertilization by thickening the mucus in the cervix, as well as preventing ovulation.
Pearl index: with proper use - 1, with normal use - 3-10.
This small size capsules or elastic rods inserted under local anesthesia under the skin of the shoulder. Implants contain one type of hormone, the period of protection against unwanted pregnancy is up to 3-5 years.
Pearl index: 1-3.
IR are long-acting progestogens. They are presented on the domestic market under the names “Depo-provera” (depo-medroxyprogesterone acetate 150 mg) and “NET-EN” (northisterone enanthate 200 mg).
Pearl index: 0.5 - 1.5.
Contraceptive patches - modern contraception containing progestin and estrogen. In domestic pharmacies, the patch is presented under the name “Evra”.
Pearl index: 0.9.
The vaginal ring for pregnancy protection is a special elastic membrane that releases the hormones estrogen and progestogen in low concentrations. In the CIS countries it is produced under the name “NovaRing”.
Pearl index: 0.7.
To the means chemical contraception spermicides are substances that have a detrimental effect on sperm. There are creams, tablets, jellies, foams, soluble films, suppositories for preventing pregnancy. The most popular representatives of spermicides are benzalkonium chloride (Erotex, Pharmatex), non-oxylon-9 (Conceptrol, Dolphin).
Pearl index: 18-24.
Barrier contraception includes male and female condoms, diaphragms and caps. For unmarried people, the question of which contraceptive to choose should not arise. Condoms are the only method of protection that protects not only from pregnancy, but also from STDs.
A condom is a sheath that is placed on the erect penis before sexual intercourse. Often made from latex, but condoms are also available from polymer materials: AT-10 resin, polyurethane, polyisoprene.
When using the method correctly, the Pearl index is 2-4, in other cases - 15-25.
The female condom is a blind-ended tube with elastic rings on both ends. Made from polyurethane or latex. The standard length of the femidom is 18 cm, diameter is 8 cm.
The blind end of the contraceptive is inserted deep into the vagina, the larger ring remains outside.
The Pearl index for polyurethane femidoms, as well as for condoms, is 5-25.
The diaphragm is a dome-shaped cap with an elastic rim, placed on the cervix shortly before intercourse. The device should be removed 6-24 hours after the end of sexual intercourse.
Pearl index: 6-20.
Vasectomy - uncomplicated surgery which involves cutting the vas deferens. Does not affect the ability to have intercourse and sensations during it.
The Pearl index, provided that a spermogram was performed a quarter after the operation, is less than 1. Without sperm analysis, the indicator is 2-3.
The so-called “tubal ligation” is a voluntary, most often laparoscopic operation, as a result of which the patency is impaired fallopian tubes.
Pearl index: less than 1.
During breastfeeding, a woman's body produces the hormone prolactin, which suppresses ovulation.
Pearl index: 1-2.
Suitable for women with a cycle from 26 to 32 days. Women are watching dangerous days» using special beads or rosaries, stringing beads on them different colors. For example: red - menstruation, white - “dangerous days” (usually from 8 to 19 days), green - all other days.
Pearl index: 5-12.
Basal temperature is measured daily at the same time immediately after waking up. Until the measurement is completed, you cannot get out of bed or even lower your feet to the floor. To measure, a thermometer is inserted into the rectum for 5-10 minutes to a depth of approximately 5 cm. It is not advisable to use an electronic thermometer. Promotion basal temperature more than 0.5 degrees over three days indicates ovulation. On the fourth day and until the next menstruation, contraception may not be used.
The Pearl index ranges from 1 to 25.
Based on daily examination of mucus from the cervix. During the fertile period, the discharge is more abundant and resembles in color and consistency egg white. Open sexual intercourse can be resumed after 2 days with scanty discharge uncharacteristic of ovulation.
Pearl index: 4-16.
The symptothermal method is the best way to protect yourself when choosing natural contraception. The method combines the calendar method, the BBT measurement method and the two-day method.
Pearl index: 2.
Emergency contraception is a means of preventing pregnancy that is taken by a woman after unprotected intercourse or when contraception does not work.
Postcoital contraceptive drugs:
Contraceptives are drugs used to prevent pregnancy. The purpose of contraception is family planning, preserving the health of a woman, and partly her sexual partner, and realizing a woman’s right to free choice: to become pregnant or to refuse it.
Why are all types of contraception necessary:
The effectiveness of contraceptives is assessed using the Pearl index. It shows how many women out of a hundred who used the method during the year became pregnant. The smaller it is, the higher the effectiveness of protection. Modern methods contraception has a Pearl index close to 0.2-0.5, that is, pregnancy occurs in 2-5 women out of 1000.
Classification of contraceptive methods:
Let's consider the listed types of contraception, the principle of their action, effectiveness, indications and contraindications.
Foreign objects placed in the uterine cavity are used. Intrauterine contraception is widespread in China, Russia, and Scandinavian countries.
The method was proposed at the beginning of the twentieth century, when it was proposed to insert a ring made of different materials into the uterine cavity to prevent pregnancy. In 1935, intrauterine contraception was banned due to large number infectious complications.
In 1962, Lipps proposed the famous device made of curved plastic with an attached nylon thread for removing contraceptives - the Lipps loop. Since then, intrauterine contraception has been constantly evolving.
Intrauterine devices are divided into inert and medicinal. Inert ones are not currently used. Only medicated contraceptives containing metal supplements or hormones are recommended, including:
The intrauterine contraceptive has the following effects:
The abortive mechanism includes:
The Pearl index for coils containing copper is 1-2, for the Mirena system it is 0.2-0.5. So this hormonal system – best way intrauterine contraception.
An intrauterine device is installed after an abortion or removal of a used one, 1.5-2 months after the birth of a child or six months after caesarean section. Before this, the patient is examined, paying attention to signs of infection.
After 7 days, the woman visits the gynecologist. If everything went well, she should visit the doctor at least once every 6 months.
The contraceptive is removed at the request of the patient, if complications develop or at the end of the period of use, by pulling the “antennae”. If the antennae are torn off, removal is carried out in a hospital. It happens that the spiral grows into the thickness of the myometrium. If a woman has no complaints, it is not removed, and the woman is recommended to use other methods of contraception.
Possible complications:
When severe pain in the abdomen, cramping sensations with bleeding, heavy menstruation, fever, heavy discharge If the IUD “falls out,” you should immediately consult a doctor.
The insertion of the IUD is absolutely contraindicated during pregnancy, infection or tumors of the genital organs. It is better not to use it if it is broken menstrual cycle, there is endometrial hyperplasia, anatomical features of the genital organs, blood diseases, large ones, allergies to metals, severe concomitant conditions. For nulliparous women, use intrauterine contraception it is possible, but the risk of future pregnancy pathologies is higher.
Pros this method contraception - possible use during lactation, no side effects caused by estrogens, less impact on body systems. Disadvantages: less effectiveness and likelihood of metrorrhagia.
This method is used for long-term protection against unwanted pregnancy. The drug Depo-Provera, containing only a progestogen component, is used; it is injected into the muscle once a quarter. Pearl index 1.2.
Advantages of injection contraception:
Disadvantages of the method: the ability to conceive is restored only 6 months - 2 years after the last injection; development trend uterine bleeding, and subsequently – to their complete cessation.
This method is recommended for women who need long-term contraception (which, however, is reversible), during breastfeeding, with contraindications to estrogen drugs, as well as for patients who do not want to take tablet forms every day.
For the same indications, you can install the implantable drug Norplant, which consists of 6 small capsules. They are sutured under the skin of the forearm under local anesthesia, the effect develops during the first day and lasts up to 5 years. The Pearl index is 0.2-1.6.
One of the advantages barrier methods is protection from venereal diseases. Therefore they are widespread. They are divided into chemical and mechanical methods of contraception.
Spermicides are substances that kill sperm. Their Pearl index is 6-20. Such drugs are produced in the form of vaginal tablets, suppositories, creams, foam. Solid forms(suppositories, films, vaginal tablets) are inserted into the vagina 20 minutes before sexual intercourse so that they have time to dissolve. Foam, gel, cream act immediately after application. If coitus occurs again, spermicides must be administered again.
The most common products are Pharmatex and Patentex Oval. Spermicides somewhat increase protection against sexually transmitted diseases, since they have bactericidal effect. However, they increase the permeability of the vaginal walls, which increases the likelihood of contracting HIV infection.
The advantages of chemical methods of contraception are their short duration of action and the absence system effects, good tolerance, protection against sexually transmitted diseases. Disadvantages that significantly limit the use of such products include low efficiency, the risk of allergies (burning, itching in the vagina), as well as the direct connection of use with coitus.
Such methods retain sperm, creating a mechanical obstacle to their path to the uterus.
The most common are condoms. They are available for men and women. Men's should be worn during an erection. Female condoms consist of two rings connected by a latex film, forming a cylinder closed at one end. One ring is put on the neck, and the other is brought out.
The Pearl Index for condoms ranges from 4 to 20. To increase their effectiveness, it is necessary to use these accessories correctly: do not use oil-based lubricants, do not reuse the condom, avoid prolonged intense acts during which the latex can tear, and also pay attention to expiration date and storage conditions of the contraceptive.
Condoms protect quite well from sexually transmitted diseases, but do not completely protect against infection with syphilis and some viral diseases transmitted by skin contact.
This type of contraception is most indicated for women with infrequent or promiscuous sexual intercourse.
Which method of contraception should I choose for the most complete protection against pregnancy and sexually transmitted diseases? In this case it is recommended combined method– taking hormonal contraceptives and using a condom.
Vaginal diaphragms and caps are not widely used. These devices are placed on the cervix before sexual intercourse and removed 6 hours after it. They are usually used together with spermicides. They are washed, dried, stored in a dry place and reused if necessary. The use of these tools requires training. They are not used for deformation of the cervix, vagina, inflammatory diseases genitals. The undoubted advantage of such devices is their reusable use and low cost.
Mechanical methods of contraception have the following advantages: safety, protection against sexually transmitted diseases (for condoms). The disadvantages are related to the lack of effect and the connection between use and coitus.
Natural methods involve abstaining from sexual intercourse in the days close to ovulation. The Pearl index reaches 40. To determine the fertile (“dangerous” period), the following methods are used:
Used only in women with regular cycle. It is believed that ovulation occurs on days 12-16 of the cycle with a duration of 28 days, the sperm lives 4 days, the egg lives 1 day. Therefore, the “dangerous” period lasts from 8 to 17 days. These days you need to use other methods of protection.
First a mystery. Let's say you have a hundred women. Of these, you gave a third into sexual slavery to the editorial office of the magazine (by the way, thank you). And of this third, another third are black. Attention, question: what is the Pearl index? Right. This is an index of failures, showing how many women out of a hundred, using the chosen means of protection for a year, will eventually become pregnant. The lower it is, the better remedy. For example, for condoms this index is up to 12, which is quite a lot. What does black concubines have to do with it, you ask. Yes, the image is beautiful.
We collected the data on the Pearl index in a table, and described the remaining pros and cons of all known contraceptives (both male and female) in detail.
1. Condoms
Better than anything they protect against infections. Efficiency - 85-90% (less only for mycoplasmosis and herpes).
Safe, even indifferent to health, if you are not allergic to latex.
They need to be bought, kept in your pocket and put on on time (according to the Sanders-Graham-Crosby study, 50% of women do not have this skill: they put their partner in protection after the start of the act).
There is nothing to add to what has been said. Just to get a little boring. According to science, to achieve an impressive 95% effectiveness of a condom, you need to:
● inspect the condom packaging for damage;
● do not put it on inside out...
● ...and on the erect penis, to the end (follow me, Beavis, we said “end”!);
● always leave a spout at the end to collect sperm (you will be surprised, but this actually somehow increases the effectiveness of your latex friend);
● use only water-based lubricants ( butter leave it to the heroes of “Tango in Paris”).
2. Barrier contraception
In our editorial office, full of hypocrites, and even Old Believers, there was not a person who could, without embarrassment, write down all the words of an expert on female contraception Tatyana Kaznacheeva, Ph.D., Associate Professor of the Department reproductive medicine and surgery FPDO MGMSU. Therefore, warn your woman: it is better to get information about suppositories and sponges not from a men's magazine or even from a women's magazine, but from a conversation with a personal gynecologist. However, we learned something. The diaphragm and the female condom, according to Tatyana, have not taken root in our country, despite the fact that “this rare condom, due to its larger surface area, is capable of protecting against STIs to a greater extent than the male condom.” Well, as for spermicidal agents (creams, vaginal tablets and candles), their only advantage is their availability. There are at least three disadvantages.
Spermicides can cause irritation and allergies not only for her, but also for you.
They are so ineffective that young anemones are not recommended to use them at all due to frequent misfires.
Most products need to be administered 20–30 minutes before the act and renewed with each subsequent one, and this is not always convenient.
3. Vasectomy
This method, with a stretch, can also be classified as a barrier method, only the barrier to the sperm is not foam tablets and latex, but your bandaged ( surgically) vas deferens. Vasectomy does not affect sperm count, which is something that lovers of sperm count will appreciate.
Contraception is always with you, it does not require you to download new firmware and generally take care of its maintenance.
A vasectomy is only suitable if you have already had some children. Because it may not work out anymore...
- ...since reconstructive surgery is a procedure several orders of magnitude more complex than basic knot tying. Its result is unpredictable. It often happens that it is completely impossible.
4. Female sterilization
Almost one hundred percent effective.
One operation for life.
Regulated by law and even prohibited in our liberal (ha ha) country nulliparous women up to 35 years old.
A real operation - with preparation, hospitalization, anesthesia.
Conditionally irreversible. Reconstructive surgery is possible, but there are a lot of reservations.
There is, however, a method of reversible sterilization, when spiral-shaped devices are inserted into the mouths of the fallopian tubes, making it impossible for the egg and sperm to rendezvous. But this method is not widespread in our country, to put it mildly.
5. COC tablets
Few side effects. With continuous use for two years or more, they reduce the likelihood of developing various female diseases. No new ones are added.
Long history of observations and quality control: tablets have been used in the civilized world for 50 years.
Require daily intake and, as a result, the presence of a certain amount gray matter in a woman's head. If the dosage regimen is violated, COCs lose effectiveness.
They are not subject to strict male control: it is impossible to understand by the type of pills what your woman is drinking - contraceptives or glycine, which means that deception and intrigue are likely (well, suddenly).
Bad reputation: if your woman has decided that she will not “go on hormones,” then it will be logically impossible to convince her. Moreover, side effects like weight gain and headaches do occur even with the most modern wheels. True, noticeably less often than with “classical” drugs.
If your woman's prejudice only applies to the release form combined contraceptives, you can offer her a skin patch or vaginal ring. You don’t even have to blatantly lie that these remedies are more gentle and less hormonal. This is often true. Oh yes, there are also mini-pills! These do not contain estrogens at all, and besides, they are more harmless purely visually - due to their size.
Gynecologist, Ph.D., Medical Adviser, MSD Pharmaceuticals LLC
COOK
Pills containing the female hormones estrogen and progesterone must be taken daily for three weeks, then take a week's break during which menstruation occurs. The main mechanism of action is suppression of egg maturation. There are tablets that do not contain estrogen; they contain analogues of progesterone (one of female hormones) and are as reliable as combination tablets. Such drugs may be recommended for breastfeeding women or those for whom estrogens are contraindicated. The tablets are often packaged in a blister with a picture of flowers, but this is not necessary. They look like any other small tablets.
Patch
It also contains analogues of two female sex hormones. The patch, measuring 4.5 by 4.5 cm, is self-adhered by the woman to a clean, dry butt. That is, sorry, skin. The mechanism of action is the suppression of ovulation. The color is beige and does not peel off by itself.
Flexible vaginal ring
Designed on the principle of a multilayer membrane. Continuously releases minimal (due to localization they should not be large) doses of estrogen and progestogen, which are absorbed into the blood through the mucous membrane of you know what. It couldn’t be simpler: a flexible ring with a diameter of 5.4 cm is inserted by the woman herself, you know where (following the example of a tampon). The location of the ring does not affect its effectiveness. The ring remains inside for three weeks, and, like a cat’s litter box, it’s best not to forget to change it. There is a one-week break between the removal of the old and the introduction of the new. The ring effectively suppresses the release of the egg. By the way, as private surveys show, some people really like it when their partner knows where (not in any of our articles has this bashful euphemism been repeated such a terrifying number of times. - Ed.) there is such a nice ring. This supposedly improves the sensation.
6. Injections and implants
The merciless need to take pills every day often leads to truly Zen riddles like “I forgot to take them for three days. Can I take three pills at once now?” In order not to answer endless questions from endless forum visitors, doctors came up with long-lasting solutions.
Long-term effect: 3 months for injections and up to 5 years for implants.
They do not require feats of self-discipline. Injections need to be done quite rarely, which the organizer or secretary will always remind you of - after all, she is also interested in this.
All procedures are invasive and require a visit to the doctor. You can theoretically cope with intramuscular injection, but not with subcutaneous implantation.
No matter how few side effects they cause modern drugs, V in this case they are irreversible: if the injection is given and something goes wrong, the entire duration of the drug will expire.
7. Intrauterine devices
The effectiveness of some “spiral” solutions is up to 99%.
It’s very convenient to use: set it and forget it. Moreover, not for myself, but for her. And you have nothing to do with it at all. Although no, you will have to periodically monitor the position, forgive the details, of the “antennae” of the intrauterine device and monitor the service life. However, this mission is also unlikely to be entrusted to you.
Can be used as early as six weeks after birth. You're so paranoid.
There are no draconian restrictions on age and smoking, characteristic of COCs.
Any foreign object in the body it reduces local resistance to infection and gladly aggravates and aggravates its course, if it has already appeared. This also applies to the spiral.
Your partner can no longer catch an STI. That is, both you and all her other men are now required to use condoms. So give them all this magazine - let them know that this is not a joke, and generally photocopy the article.
Conventional copper intrauterine devices can, especially at first, cause discomfort, pain and all sorts of bleeding. Expensive hormonal systems like Mirena are almost devoid of such effects; their main disadvantage is the price, that is, the only parameter of the IUD that, for once, concerns you.
One more thing to remember important point. This hellish remedy is famous for one unpleasant fact: pregnancy is still possible when using it. The sperm unites with the egg - life actually begins, but things do not go further than that. The resulting zygote cannot adhere to the wall of the uterus due to the local effects created by the spiral, so in some cases it does not care about the health of the mother and nests wherever it wants. It's called an ectopic pregnancy, and it's no laughing matter. Go to the hospital immediately!
8. Natural methods
They are always with you, you don’t need to buy them at the pharmacy. That is, you only pay with them for sex!
Most so-called natural contraceptive methods do not work at all and are based on myths. Even for interrupted coitus, the Pearl index is very high, and for other tricks and subterfuges it is even higher.
Again, there are studies showing the harm of interrupted intercourse for prostate health. They are not supported by the proper apparatus of evidence, but they are still somehow alarming.
"I have safe days", "She is breastfeeding. I read somewhere that it is possible”, “I went to the sauna, and sperm remain alive only at temperatures below 36 degrees” - what phrases do not resonate with joy in the hearts of irresponsible partners! Some even still believe in a lemon stuck in you know where (that’s it, this phrase will not be used again), and that you can’t get pregnant in the cowgirl position. Ha! I wouldn't believe it! Cash costs - zero. Zero hassle. Guarantees - well, let's say, not zero, but they are rather absent, if the word “guarantee” is correctly understood.
All in all, natural methods- one of the most unreliable. Indeed, overheating of the scrotum sometimes prevents conception. And during the period of breastfeeding or severe stress, some women experience confusion and even complete loss of the ovulation mechanism. However, you should not rely on these vagaries of nature. Cunning spermatozoa are contained not only in sperm, but also in lubricant; they live in the communication routes, sometimes for ten days in a row (that is, they can hold out and greet the dawn of a “dangerous” day with a whoop). Do not consider all these dances with tambourines as serious methods of contraception and turn your attention, for example, to the most reliable method, according to experts. We saved it for last, of course.
Just so you know, our consultants tried not to use the word “contraception” at all. Allegedly, there is a connotation of undesirability in it, and it should say “family planning.” Because the thing here is this: today you don’t plan it, but tomorrow amniotic fluid may well hit your head.
Therefore, in most cases, especially with unfamiliar partners with whom you don’t even plan to have breakfast yet, doctors recommend using the “double Dutch method.” This is when a woman drinks COCs and a man uses a condom. Even in the case of the most chaotic lifestyle, such a tandem brings to zero not only the likelihood of pregnancy, but also the risk of contracting an STI.
Well, if you both realized that children are exactly the reason you need to take out another consumer loan from the bank, you can always abandon the Dutch method.
“Conscious pregnancy” is a popular term today, which denotes the right of every couple to consciously choose the time for such important step like the birth of a baby. There are many methods of contraception: to suit everyone’s taste and budget - monophasic contraceptives, implants, condoms, rings, IUDs and much more. But any method of preventing unwanted pregnancy has both advantages and disadvantages. Let's figure out how to choose from this variety suitable look contraception and how to avoid misfires.
This is the most effective method of contraception with 99.9% reliability. Women are sterilized by tubal ligation, men by vasectomy.
BUT! The main disadvantage of sterilization is its radical nature. Conclusion: if after a certain number of years you want to leave behind offspring, you will not succeed.
Leader non-invasive methods contraception - combined oral contraceptives (COCs) in tablets. Their reliability is estimated at up to 99.7%. Complexly influencing the female reproductive system With the help of hormones, oral contraceptives suppress ovulation, thicken mucus in the cervical canal and provoke thinning of the endometrial layer in the uterus. This triple action provides temporary “rest” for the ovaries, reducing the risk infectious diseases through the barrier function of mucus (however, they do not completely protect against sexually transmitted infections) and reduces the amount of blood loss of a woman during menstruation.
Combined oral contraceptives compare favorably with others hormonal drugs contraception in that different pills contain different dosages and combinations of hormones. In European countries, this method is the most popular among women. different ages And different styles life. Indeed, in a wide range of these products, including those presented on the Ukrainian market, there are even tablets with innovative dosage regimens 24+4 and 26+2. They shorten the non-hormonal period, which allows you to minimize negative symptoms, and, importantly, simplifies the regimen for taking such tablets.
Additional non-contraceptive actions: COCs latest generation, also already available to Ukrainian women, contain, in addition to hormones, an additional substance - calcium levomefolate (active form folic acid). Thanks to this substance, modern contraceptives have a pronounced additional non-contraceptive effect: they eliminate negative manifestations PMS, improve the condition of skin and hair, fight acne, prevent photoaging ( negative influence sun on the skin), and even have an antidepressant effect. In addition, folate-containing contraceptives significantly reduce the risk of developing defects nervous system child during future pregnancy.
BUT! Oral contraceptives have some contraindications, are selected and prescribed exclusively by a gynecologist individually for each woman, and also require the woman to be organized and attentive when taking it.
We are talking about an intrauterine device and an intrauterine hormonal system, which differ both in reliability and mechanism of action. The spiral performs a barrier function and prevents the implantation of a fertilized egg into the uterine cavity. The intrauterine hormonal system secretes a certain amount of hormone, which increases the viscosity of mucus in the cervical canal, thins the endometrial layer and suppresses sperm motility. The reliability of intrauterine contraception ranges from 99.2 to 99.8%.
BUT! The intrauterine device increases the risk of inflammation of various nature, often causes heavy, long, painful periods and poses a risk ectopic pregnancy. And the hormonal system is usually placed on long time- 5 years. Therefore, it is not suitable for women who do not plan to delay conception for so long. In addition, this method of contraception sometimes causes intermenstrual bleeding and pain.
This one ancient way contraception consists of the partner removing the penis from the vagina before ejaculation.
BUT! A small amount of seminal fluid is also released during sexual intercourse, so the reliability of the method does not exceed 80%. In addition, the method is very inconvenient for a man, who is not only forced to closely monitor the process, but also risks problems with potency, ejaculation, and even prostatitis. In addition, when using this method, the woman also experiences greater psychological discomfort.
This chemicals in the form vaginal suppositories, creams, tablets and capsules that are inserted into the vagina and have a destructive effect on sperm. Their effectiveness is no more than 70%.
BUT! Chemical contraceptives require constant administration before sexual intercourse and often cause irritation and inflammation of the vaginal mucosa, as well as vaginal candidiasis.
There are also drugs emergency contraception containing levonorgestrel, which affects ovulation and reduces the risk of fertilization of a woman’s egg in the preovulation period. These drugs include escapelle and others.
