The most reliable contraceptive. The best contraceptive candles. Hormonal methods of contraception

For right choice method of protection against unwanted pregnancy in this topic, we will tell you what methods and methods of contraception exist. After learning about methods of protection, you can choose a more convenient contraceptive for yourself and enjoy love games without fear of getting pregnant. The term contraception refers to the prevention of pregnancy. different ways: Mechanical, Chemical, etc., moreover, some methods prevent the transmission of sexual diseases.

To determine the reliability of a particular method of contraception, we will use the pearl index, which indicates how many women became pregnant out of a hundred, using one of the types of contraception during when

NATURAL TYPES AND WAYS OF CONTRACEPTION

INTERRUPTION: It consists in the fact that a man, at the moment of receiving pleasure, removes the penis from a woman. The pearl index for this type of contraception ranges from 4 to 18. In most cases, the unreliability of this method of protection lies in the lack of self-control of a man when receiving pleasure, which leads to untimely extraction of the male organ from a woman and her fertilization. Also, at the time of sexual intercourse, pre-seminal fluid is released from the male organ, which may contain live spermatozoa, and even if the man managed to extract his organ at the moment of pleasure, this does not mean that there is no pregnancy, the woman could be fertilized with pre-seminal fluid, which of course is very rarely occurs and has no basis scientific evidence. Moreover, after a man has enjoyed, a part of the ejaculate remains in the channels of his organ, which, when re-entering a woman, can lead to ejaculate exit and pregnancy, so that the remaining ejaculate does not enter the woman, the man is recommended to urinate. This type of contraception is psychologically negative for a man.

CALENDAR METHOD OF CONTRACEPTION: With this method of protection, it is necessary to calculate the days of ovulation of the egg, how to do this, read here: . The Pearl Index with this method of protection is from 9 to 40. Remember that the male ejaculate can live inside a woman from several hours to 7 days, and the average life is 2-3 days. Moreover, this type of contraception is not suitable for women whose menstrual cycles are irregular.

TEMPERATURE TYPE OF CONTRACEPTION: It consists in the fact that a woman measures her basal temperature and maintains a graph, almost the same as the calendar method, but based on temperature. The pearl index ranges from 0.8 to 3.

CHURCH TYPE OF CONTRACEPTION: A woman observes vaginal discharge with tests, something like a calendar method. The pearl index is 15.

SYMPTOTHERMAL TYPE OF CONTRACEPTION: The method of protection, which includes temperature and ecclesiastical form of contraception. Pearl index 0.3.

MEASUREMENT OF THE LEVEL OF HORMONES: For protection using this method, tests are needed that measure the hormones LH and FSH in morning urine, indicating ovulation. Pearl index from 4 to 18.

LACTATIONAL AMENORRHEA METHOD: effect protection method breastfeeding within 6 months after the birth of the child. Pearl index from 2 to 3.

MECHANICAL OR BARRIER CONTRACEPTIVES

CONDOM: A type of protection that consists of putting on male organ sheaths made of latex or thin rubber, in which, after pleasure, the male ejaculate remains. This type of contraception protects not only from unwanted pregnancy but also from sexually transmitted diseases. When using, beware of applying oily lubricants, as oils corrode the latex, and the contraceptive may break. The pearl index ranges from 2 to 12.

CONDOM FOR FEMALE: Unlike the male contraceptive, it is not put on the male organ, but is inserted inside the woman. In all other respects, the principle of operation is the same as that of the male contraceptive. The index of pearl is from 5 to 25.

FEMALE DIAPHRAGM: A type of contraception, which is a latex dome-shaped cap with a flexible rim that covers the cervix of the female uterus. Pearl index from 6 to 20.

WOMEN'S CAP: The type of contraceptive is very similar to the diaphragm, the only difference is that it is half the size of the diaphragm and is worn at the entrance to the uterus. Pearl index from 9 to 20.

HORMONAL TYPES OF CONTRACEPTION

Hormonal contraceptives have various activities protection. Some hormonal pills suppress ovulation, which is expressed in obstructing the development and release of the egg, other hormonal pills change the structure of the uterine mucosa (endometrium) and the fertilized egg cannot attach to the walls of the uterus, others can thicken the cervical mucus, which prevents the ejaculate from moving. Self-selection of hormonal contraceptives is not recommended, it would be better if a doctor prescribes it to you with a preliminary opinion based on the tests received. FAQ and general information Read more about oral contraceptives here: .

COMBINED ORAL CONTRACEPTIVES: These pills contain the hormones estrogen and progestin. Pearl index from 0.1 to 0.9.

MINI-PILS: Contain only progestin in their composition and do not have the substance estrogen, which, according to research, adversely affects a woman's health. Pearl index from 0.5 to 4.3.

HORMONAL INJECTIONS: Intramuscular injections are made every 3 months, the composition includes progestin. Pearl index from 0.3 to 1.4.

NORPLANT: Type of contraceptives inserted under the skin, containing the substance levonorgestin. Pearl index from 0.08 to 0.09.

RING NOVARING: A type of contraceptive containing estrogen and progestogen. Pearl index from 0.4 to 0.65.

EURA PATCH: A type of contraception in the form of a patch attached to a woman's skin and supplying hormones through the bloodstream to the woman's body: Pearl index from 0.4 to 0.9.

INTRAUTERINE DEVICE: A type of contraceptive, which is a plastic device with a copper spiral inserted into female uterus. It prevents the advancement of the ejaculate, the attachment of the egg to the walls of the uterus and shortens the life of the egg. The pearl index ranges from 0.1 to 0.5.

TYPE OF POSTCOITAL CONTRACEPTION: This type is used for unprotected intercourse and the ingress of ejaculate into the woman. It consists in the emergency taking of a hormonal pill after intercourse. Due to the high harmfulness of this type of contraception, it should be used only in emergency cases, no more than once every six months. Pearl index 2.

CHEMICAL TYPES OF CONTRACEPTIVES

CREAMS, AEROSOLS, CANDLES, ETC.: Entered into female vagina about 10-15 minutes before the start of sexual intercourse, see the instructions for the contraceptive for more details. Pearl index from 3 to 21.

INTRAUTERINE DEVICE: Yes, this type of contraception can be attributed not only to hormonal, but also to chemical methods of protection, since the composition of the spiral can include a metal that is detrimental to the ejaculate.

SURGICAL TYPES OF CONTRACEPTION

The type of contraception in the form of sterilization is used for people with children, since reverse recovery is almost impossible.

MALE CONTRACEPTION: This type of contraception is called a vasectomy or sterilization, which is a simple operation to block the seminal ducts. Pearl index 0.4.

FEMALE CONTRACEPTION: Sterilization of a woman, the operation is more complicated than in men and consists in tying the tubes blocking the patency of the fallopian tubes. Pearl index from 0.01 to 0.1.

Not only a man, but also a woman should think and take care of protection from unwanted pregnancy during sexual intercourse. Moreover, it is she who subsequently has to make the most important decisions - to give birth or to have an artificial termination of pregnancy, to get married or remain a single mother. Therefore, it is worth knowing about all types of female contraception that are approved and recommended by official medicine.

Table of contents:

Barrier method of female contraception

essence barrier contraception is to prevent sperm from entering the uterus. Such a barrier can be created mechanically and/or chemically.

Local chemicals

In medicine, such drugs are called spermicides and are available in various pharmacological forms - foaming tablets and suppositories, aerosols, pastes, balls for intravaginal use. The composition of such funds includes substances that have a detrimental effect on spermatozoa - for example, benzalkonium chloride, nonoxynol-9. It is believed that the effectiveness of local chemicals from the category of contraceptives is 85%.

Features of local chemicals:

can be used by a woman without preliminary survey at the gynecologist and getting appointments;
these means of protection from unwanted pregnancy contribute to the formation of additional lubrication in the vagina;
not contraindicated for use concomitantly with chemicals any other contraceptives - this will only enhance the effect;
are capable of exerting a non-intensive anti-inflammatory effect, and according to some data, they even serve as a prevention of oncological diseases of the female reproductive system.

Note:spermicide does not begin to act instantly - this will take 15-20 minutes, so the introduction of contraceptives of this particular group should be carried out just 15-20 minutes before sexual intercourse. If several sexual intercourses go in a row, then before each of them you need to enter the remedy.

Mechanical methods of female contraception

Such funds are considered absolutely harmless and can be used by all women without any restrictions. Moreover, a woman can refuse such contraception at any time if a decision is made to conceive a child. But doctors say that a woman will need special training in the use of mechanical means contraception, and after childbirth or with sudden weight gain, you will need to change / select a new size. Mechanical methods of female contraception include:

. They look like a cap with a flexible rim, made of rubber or latex. The dome of the diaphragm closes the cervix, which makes it impossible for sperm to enter the abdominal organ.

How to use it correctly: the diaphragm is inserted into the vagina immediately before intercourse, but it can also be done in advance - the contraceptive in question is allowed to be in the vagina from 6 to 24 hours. The vaginal diaphragm is used together with spermicides - they are coated with inside diaphragm and ring.

female condoms. They are a polyurethane bag 17 cm long and 7-8 cm in diameter with two rings at the ends. On one ring there is a thin film - it adjoins the cervix and prevents the penetration of spermatozoa into the organ cavity.

How to use it correctly: The female condom is inserted just like a regular tampon, a few hours before sexual intercourse. This is a one-time use, for the next sexual intercourse you need to use a new female condom.

Cervical caps. This is a cap made of soft rubber that is put directly on the cervix - negative pressure is created between the cervix and the rim of the cap, which makes it impossible for sperm to enter. The cervical cap is smaller than the vaginal diaphragm, the efficiency of application is 60-80%.

How to use it correctly: the cervical cap is inserted half an hour before sexual intercourse and is not removed for 6-8 hours. Before use, the contraceptive in question is treated with spermicides - they lubricate the rim.

This type of female contraception is considered one of the most effective, but it can only be used as prescribed by a doctor, and a woman will not be able to put an intrauterine device on her own. Gynecologists establish only two types of contraception in question:

copper-containing;
progestin-containing.

Are made intrauterine devices made of plastic (absolutely safe), in which either a copper wire or a miniature container with progestin is mounted.
The principle of operation of intrauterine devices:

prevent the penetration of spermatozoa into the uterus - progestin-containing IUDs significantly reduce this ability;
do not allow implantation (movement) of the egg into the uterine cavity;
counteract ovulation - this applies only to progestin-containing intrauterine devices;
copper-containing agents have a detrimental effect on both spermatozoa and eggs.

The intrauterine device is placed on long time- from 2 to 5 years, and usually the woman's body responds normally / adequately to such an “intervention”. In some cases, complications may develop:

inflammatory processes of the cervix and appendages - according to statistics, the risk of developing similar pathologies with an existing intrauterine device, it increases by 2-3 times;
menstrual irregularities - the dates of monthly bleeding may “shift”, they become more abundant, intermenstrual bleeding may occur;
discomfort during intercourse - pain, burning.

Note:if a woman notes too long bleeding from the vagina, there are intense pains in the lower abdomen, weakness and pallor of the skin appear, then you should immediately seek medical care. This condition may indicate perforation (breakthrough) of the uterine wall with an intrauterine device. This happens extremely rarely - according to statistics, 1 case per 10,000, but every woman should be aware of such a complication. Benefits of using an intrauterine device:

Disadvantages of using an intrauterine device:

before installation, it is necessary to undergo an examination by a gynecologist;
Only a doctor can insert and remove an IUD;
after each menstruation, you need to check for the presence of antennae of the intrauterine device - sometimes it can fall out;
in the first few months after the installation of the IUD, menstrual bleeding may increase.

Contraindications to the installation of an intrauterine device:

diagnosed oncological diseases genitals or internal genital organs;
suspicion of an accomplished pregnancy;
acute/chronic processes of inflammation or infectious nature in the reproductive system (including the external genitalia);
uterine bleeding pathological unknown etiology;
bicornuate uterus;
cervical stenosis.

There are also conditional contraindications to the use of an intrauterine device as a contraceptive - that is, with them it is undesirable to put an IUD, but only the gynecologist makes the final decision. Conditional contraindications include:

ectopic in history;
diagnosed;
lack of childbirth;
blood clotting disorders.

Hormonal contraception

We recommend reading:

Hormonal contraceptives are drugs that contain chemical analogues in their composition. female hormones. They prevent the onset of ovulation, which makes it impossible to conceive a child. To the group hormonal contraceptives includes pills, implants, patches, hormonal vaginal ring. Pills are considered the most popular, but you need to select the type of hormonal contraceptive based on your needs / capabilities:

birth control pills require excellent memory, responsibility and punctuality - they should be taken in strict certain time and not miss a single day;
patches can be used for 7-9 days in a row, that is, only 3 patches will need to be changed per month;
hormone ring It has month operation.

Before you start using hormonal contraceptives, you need to visit a gynecologist, undergo an examination and make a choice in favor of one or another remedy. There are well-defined contraindications to the use of this type of contraceptive:

you are in the period of breastfeeding, and less than 6 months have passed since the birth;
no breastfeeding, but less than 3 weeks after delivery;
have a history of stroke ischemic disease hearts, pulmonary hypertension, bacterial endocarditis;
thrombophlebitis was previously diagnosed;
strong are noted, and your age is 35 years and older;
in the recent past, the woman suffered (less than 3 months ago);
cirrhosis of the liver and other pathologies of this organ were previously diagnosed;
a history of diseases of the gallbladder and biliary tract, which require permanent reception medicines;
breast cancer (even after complete healing);
increased blood clotting;
the doctor has prescribed and constantly takes anticonvulsant and / or anti-tuberculosis drugs.

Note:if at least one of the above factors takes place, then taking hormonal contraceptives is strictly prohibited.

Female surgical contraception

We are talking about sterilization - an irreversible process, which is considered the most effective for preventing unwanted pregnancy. Indications for sterilization of a woman are only the desire to stop the likelihood of conception. But this issue should be approached very carefully - the process is irreversible, although there are expensive microsurgical operations that can "turn back the clock." Often surgical contraception used for medical reasons - for example, a woman has severe malformations of the cardiovascular, respiratory, urinary systems, blood diseases, malignant neoplasms. Contraindications to sterilization are:

acute inflammatory diseases of the pelvic organs;
infection of generalized or focal localization;
benign tumors that develop in the pelvis;
cachexia of a pronounced nature;
diabetes/diabetes insipidus;
adhesive disease of the pelvic organs and / or abdominal cavity;
umbilical hernia - applies only to surgical contraception by the laparoscopic method.

Note:there is still debate about the sterilization of women with diagnosed mental disorders, mental retardation These pathologies are not medical indicator to surgical contraception.

Now it is the most popular method of surgical contraception - the method has many advantages. For example, after such surgical intervention on the skin there is no scar, the rehabilitation period is very short, the patients tolerate such an intervention well. Note:laparoscopic tubal ligation cannot be ruled out outpatient settings- the woman is given local anesthesia, and 2 hours after the completion of the procedure and in the absence of any visible changes in her state of health for the worse, the patient can go home.

A miniature incision is made in the anterior abdominal wall- the size does not exceed 6 cm. The advantages of this method of surgical contraception are that there is no need to use expensive equipment, quick rehabilitation.

The recto-uterine space is opened with scissors and the fallopian tube is removed into the resulting wound - until its fringe appears. The suture is placed in the middle of the fallopian tube, but somewhat closer to the fringes. Then the tube is tied with a thread and pulled closer to the surgeon, then the tube is crushed and bandaged. The same algorithm of actions is used for the second fallopian tube. Note:the ends of all suture threads are cut only after the surgeon has completed work on two fallopian tubes. The incision is closed with a mattress suture. Advantages of sterilization with colpotomy access:

can be performed in any gynecological hospital;
cosmetic defects on the anterior abdominal wall are absent;
there is no need to use expensive equipment and specific tools;
the goal pursued (sterilization) is achieved immediately after surgery.

Very often, the sterilization operation is performed during a caesarean section - no additional loads does not appear on the body, the woman's well-being does not change, periods of lactation and recovery after childbirth pass without changes, hormonal background does not change. Timing of surgical contraception:

in the second phase of the menstrual cycle - delayed sterilization;
6 weeks after giving birth naturally;
immediately after artificial termination of pregnancy, but only if the abortion was without complications.

It is strictly contraindicated to carry out sterilization after childbirth if acute infection during childbirth or even during pregnancy, if the anhydrous period of childbirth exceeded 24 hours. Possible complications in the postoperative period:

bleeding;
intestinal damage;
postoperative infection.

These complications are related to rare events, but a woman who agreed to surgical contraception should know about them. Note:doctors warn that in the first 10 years after the sterilization operation, the probability of pregnancy remains within 2%. Female contraception - a rich choice, wide opportunities. It is necessary not only to independently decide on the choice of means of protection against unwanted pregnancy, but also to get competent advice from a gynecologist.

Abortion prevention is key point in preserving the reproductive health of the girl. According to experts, artificial termination of pregnancy quite often leads to infertility. Today, approximately one in five pregnant women resort to abortion. Despite the high effectiveness of contraceptives, many young ladies unreasonably neglect this opportunity. Do not forget that the main tasks of contraception are not only to ensure the prevention of medical abortions, but also to prevent infection with sexually transmitted diseases.

Varieties of contraception

Methods of contraception are different. However, regardless of the type of contraceptive, female contraceptives should be highly effective, safe for health, convenient to use and affordable.

Modern methods contraception:

Physiological.
Barrier or mechanical.
Chemical.
Hormone.

You can buy female contraceptives at pharmacy chains without recipe.

Physiological

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

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

The main advantage of the physiological method is considered to be ease of use and absolute safety for the female body, since neither consequences nor adverse reactions not to be expected. However, it is worth noting that this method of contraception is suitable for women who have normal menstrual cycles. But for teenagers and young girls physiological method inappropriate for several reasons:

Irregular ovulatory cycle.
In young girls, accidental or extraordinary ovulation is quite common.
Late ovulation is more common.
Not high efficiency.
Girls are hard to come by correct calculations and the implementation of basic methods of physiological contraception.
This method is not able to protect against sexually transmitted diseases.

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

Barrier or mechanical

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

Condoms (female and male).
vaginal diaphragm.
Neck caps.

condoms

Latex is the main condom material today. It helps not only protect against unplanned pregnancy, but also prevents infection with sexually transmitted diseases. Main disadvantage method - frequent breaks of condoms made of thin elastic rubber. According to statistics, this happens about once in 50-300 sex sessions.

If a condom break occurs, it is recommended to introduce a spermicidal substance into the vagina and / or use an oral contraceptive for emergency postcoital prevention of unwanted pregnancy. In addition, quite often, when using a condom, both sexual partners note a decrease in sexual pleasure. As clinical studies show, many boys and men neglect this method of contraception.

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

Vaginal diaphragm

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

Available various models and dimensions, so it is recommended to select individually. As a rule, the introduction of the vaginal diaphragm is carried out immediately before intimacy, reversed with a spermicidal agent on both sides. Her extraction is carried out 7-10 hours after the completion of sexual intercourse. I would like to note that this barrier method of contraception does not help protect against diseases transmitted during sex, although it can protect the internal genital organs from certain types of infections.

cervical cap

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

Modern contraceptives for women (contraceptives) must be dispensed by prescription.

Chemical (spermicidal)

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

Spermicidal preparations are administered no later than 30-60 before sexual intercourse.
Spermicides must be in contact with the cervix.
If you do not know how to use the chemical method of contraception correctly, consult a gynecologist.

The active substances that make up spermicidal agents can not only destroy spermatozoa, but also have a bactericidal and virocidal effect. For example, the active ingredient nonoxynol or benzalkonium chloride inhibits the growth and reproduction of such pathogenic microorganisms, like chlamydia, mycoplasma, trichomonas, ureaplasma, etc. To increase contraceptive effectiveness, many experts advise combining the use of chemical and barrier contraceptive methods.

Pharmatex

One of the most popular spermicides for chemical contraception is Pharmatex. For the complete destruction of spermatozoa, 20 seconds of the presence of male germ cells in the medium with Pharmatex is enough. With repeated sexual intercourse, a new administration of the drug is required. In addition, it has antimicrobial activity against a number of sexually transmitted diseases (for example, gonorrhea, chlamydia, trichomoniasis, etc.). At the same time, Pharmatex does not affect normal microflora vagina and does not lead to menstrual irregularities.

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

Tablets.
Tablets.
Candles.
Tampons.
Cream.

Each of the forms has its own application features, which can be found by reading official instructions to the drug. It should be remembered that Pharmatex is contraindicated in hypersensitivity to its active ingredients and inflammatory diseases sexual organs. In order to avoid a decrease in the spermicidal effect, the simultaneous vaginal use of several drugs is not recommended.

contraceptive sponge

A tool that combines mechanical and chemical protection from an unwanted pregnancy is called a contraceptive sponge. It acts as a barrier, preventing the advancement of male germ cells in the cervical canal, and also releases a spermicidal component that helps destroy spermatozoa. The shape is a rounded pillow with a small depression on one side, which should be adjacent to the cervix. However, due to the low contraceptive effectiveness, it is usually not recommended for use by adolescents and young girls. More experienced and adult women are quite able to install this type of contraceptive and do not have special problems using.

The best method of contraception is the combined use of contraceptives (such as hormonal drugs and a condom).

Hormone

Statistics show that almost 150 million girls and women around the world take oral contraceptives daily. At the same time, at present, the latest hormonal preparations are taken both orally and can be introduced into the body in other ways (by injection, transdermally, intravaginally, etc.). Mechanism hormonal contraception is as follows:

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

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

Oral contraceptives

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

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

When choosing the optimal combined oral contraceptive, the content of ethinyl estradiol plays a significant role. Given the amount of estrogen, hormonal drugs are divided into three large groups: high, low and microdosed. Popular representatives of each of these groups:

The first is Anteovin, Silest, Non-ovlon. They contain more than 35 micrograms of ethinylestradiol.
The second - Regulon, Belara, Microgynon, Femoden (30 mcg each).
The third is Mercilon, Mirrel, Minisiston (20 mcg each).

Main advantages and disadvantages

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

They have the most pronounced effectiveness than other types of non-invasive contraceptives.
Available for most girls and women.
Not rendered severe consequences for the body.
After stopping the intake, fertility is quickly restored.
It is considered a highly secure method.
Long-term use is possible.

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

Able to regulate the menstrual cycle, especially in young girls.
Helps to get rid of algomenorrhea ( painful menstruation).
If you choose the right contraceptive, you can not worry about weight gain.
Do not affect the main types of exchange.
Eliminate insufficiency from female hormones.
Reduce the likelihood of a number of gynecological and somatic diseases.

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

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

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

Contraindications

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

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

How to take oral contraceptives?

To reduce the development of side effects and increase contraceptive properties, new schemes for the use of hormonal contraceptives. One of the latest innovations has been the introduction of clinical practice prolonged use of combined oral contraceptives. It was proposed to take the drug continuously for 3-5 menstrual cycles, after which a 7-day break was made and the use was resumed.

Successfully passed clinical trial mode called "63 + 7". Its essence lies in the fact that the contraceptive is taken for 63 days, then a pause is made in taking exactly one week. In certain cases, the prolonged mode can be extended up to 126 + 7. With prolonged use of oral contraceptives with a minimum interruption, a decrease in the occurrence of "withdrawal symptoms" is observed. The prolonged regimen made it possible for girls and women to experience less headaches, menstrual irregularities different nature, breast pathology and other side effects.

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

It is allowed to start taking combined oral contraceptives at absolutely any period of the menstrual cycle.
Lack of significant negative impact on pregnancy and fetal development from the latest contraceptive drugs allowed scientists to come to such conclusions.
In the case when pregnancy is diagnosed against the background of the use of oral contraception, then the drug should be stopped. It has been established that short-term use of hormonal contraceptives during the period of childbearing does not affect the threat of abortion.

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

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

emergency contraception

Despite the extensive range of contraceptives, the problem of unplanned pregnancy remains very relevant for millions of girls and women. As a rule, the risk of unwanted pregnancy is associated with having sex without using contraception or its ineffectiveness. Oddly enough, but many women believe that in such situations, the only thing left for them is to wait for the next period to go or not.

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

When is emergency contraception indicated?

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

A British study has shown that unprotected intercourse during ovulation can result in conception in 50% of cases, even during the first menstrual cycle. It has long been proven that spermatozoa located in the genitals of a woman retain their viability for 3–7 days, and an unfertilized egg for 12–24 hours. According to most experts, it is advisable to carry out emergency contraception in the first 1-3 days after intimacy. When is it shown:

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

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

Emergency contraceptive methods

The use of combined oral contraceptives (Yuzpe method).
Specially designed preparations for emergency protection.
Use of intrauterine contraception.

Combined hormonal oral preparations are used quite often as emergency contraception. This method was named after the Canadian scientist Albert Yuzpe, who first used it and widely promoted it. Its essence was reduced to 2-fold application large dosage estrogens and progestogens for 3 days from the moment of completion of sexual intercourse. The break between doses should be at least 12 hours.

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

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

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

In addition, specially designed drugs based on levonorgesterel are also successfully used for emergency contraception. They are characterized by a pronounced gestagenic effect and the absence of estrogenic action. Among the female population, two drugs that contain levonorgesterel are most popular - Postinor and Escalep. In accordance with the results of world clinical studies, the effectiveness of the use of these contraceptives is slightly higher than that of the Yuzpe method. Also, the portability of Postinor and Escalep is an order of magnitude better.

Properly selected female contraception will help maintain reproductive health.

Non-hormonal drugs for emergency contraception

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

Inhibition of the release of luteinizing hormone.
Blocking or delaying ovulation.
Violation of natural changes in the endometrium.

During some scientific research mifepristone was found to be more effective and better tolerated than levonorgesterel. One of the main advantages of mifepristone over other methods of emergency contraception for women was the absence of a decrease in effectiveness with an increase in the interval between sex and the use of a contraceptive (up to 120 hours).

On the post-Soviet space Ginepristone is widely used for emergency contraception. Its distinctive feature is that it is well tolerated and has a low dosage of the active ingredient, compared with other existing non-hormonal drugs that are used for "quick" protection against unwanted pregnancy. Ginepristone must be taken once for 3 days after intimacy without taking into account the period of the menstrual cycle. If after taking the drug there were repeated coitus, you should use additional contraceptive methods(for example, a condom). Since the contraceptive effect of Ginepristone is somewhat reduced during subsequent sexual intercourse.

Benefits of emergency contraception

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

The ability to take contraceptives occasionally. Especially this method will be of interest to girls and women who have an irregular sex life.
In most cases, there is a high contraceptive effect.
There are no pronounced adverse reactions.
Availability for many patients.

It should be remembered that emergency contraception drugs do not affect the implanted egg. Most of the recommended methods are safe for the fetus and the course of pregnancy. Therefore, even if conception occurred against the background of the use of the above drugs, the pregnancy can be saved. In addition, do not forget that contraceptive drugs used in emergency situations do not protect against diseases that are sexually transmitted. If infection is suspected venereal infection after intimacy, you should immediately contact a specialist.

The diaphragm is a domed rubber cap. It is selected for each woman in size: from 50 to 150 mm. nulliparous women a vaginal diaphragm of 60-65 mm is usually suitable, and women who have given birth use a vaginal diaphragm of 70-75 mm. After childbirth or weight loss, the size should be adjusted again. The advantages of the cap are ease of use, reusability, harmlessness, and largely protection against sexually transmitted infections. But he has contraindications: endocervicitis, colpitis, cervical erosion, allergies to rubber and spermicides, anomalies in the development of the genitals, prolapse of the walls of the vagina and uterus.

Condom

Condom - . But this method is considered the most effective against sexually transmitted diseases. Doctors remind that a postcoital contraceptive or termination of pregnancy will still save you from an unwanted pregnancy. Venereal diseases are for a long time, and in the worst case, forever. Our article "" describes one of the diseases that can be avoided by using a condom.

female condoms- such condoms will help out a woman if the thought of sex with a condom makes her partner nervous tick("After all, this reduces all sensations!").

latex-free condoms- they do not contain dyes and flavors, which means they cannot cause allergic reaction during intercourse.

These include special spermicidal preparations

in year

menstrual calendar ovulation programs, which help to keep this kind of "accounting". Set the shortest and longest menstrual cycles, find the first "fertile day" (according to the shortest menstrual cycle) and the last "fertile day" (according to the longest menstrual cycle). Then, given the length of the current menstrual cycle, determine the fertility interval. During this period, you can either completely refrain from sexual activity, or apply barrier methods and spermicides.

temperature method

basal body temperature 0.3-6.6 per 100 female-years.

special thermometer

Symptothermal method

intrauterine contraception

The contraceptive effectiveness of the plastic “spiral” (Lipps loop) averages 91 percent, or 5.3 pregnancies per 100 women per year. Many modern intrauterine devices contain copper - the contraceptive properties of this metal have been proven for a long time. Their efficiency increases to 98 percent - 0.4-0.5/100 female-years.

Hormonal contraception

with 100% efficiency. It is customary to distinguish:

The latest contraceptives

“Sadists” gynecologists call all this the most cruel term: woman-year. Often this indicator is translated into percentages for clarity and persuasiveness. Is the contraceptive you have chosen effective enough?”

If your plans do not include pregnancy and you will not read our article with 100% certainty, check out the list of all contraceptives officially available to mankind.

Vaginal diaphragm, or "cap"

The diaphragm is a domed rubber cap. It is selected for each woman in size: from 50 to 150 mm. For nulliparous women, a 60-65 mm vaginal diaphragm is usually suitable, and women who have given birth use a 70-75 mm vaginal diaphragm. After childbirth or weight loss, the size should be adjusted again. The advantages of the "cap" are ease of use, reusability, harmlessness, and a significant degree of protection against sexually transmitted infections. But he has contraindications: endocervicitis, colpitis, cervical erosion, allergies to rubber and spermicides, anomalies in the development of the genitals, prolapse of the walls of the vagina and uterus.

The pregnancy rate when using a diaphragm in combination with spermicides is 2 pregnancies per year per 100 women per year. At misuse"cap" the chance of getting pregnant increases up to 10 women-years.

Condom

Condom - the only contraceptive used by men. This contraceptive is quite common, and is used in 20-30 percent of cases. At the same time, the clinical effectiveness of the condom is quite low: 15-20 pregnancies per 100 woman-years. But this method is considered the most effective against sexually transmitted diseases. Doctors remind that a postcoital contraceptive or termination of pregnancy will still save you from an unwanted pregnancy. Venereal diseases are for a long time, and in the worst case, forever. Our article "" describes one of the diseases that can be avoided by using a condom.

By the way, recently appeared female condoms- such condoms will help a woman out if the thought of sex with a condom causes her partner to have a nervous tic ("because it reduces all sensations!").

With increased sensitivity of the genital organs in both men and women, you can safely use hypoallergenic latex-free condoms- they do not contain dyes and flavors, which means they will not be able to cause an allergic reaction during intercourse.

Chemical means of contraception

These include special spermicidal preparations(tablets, suppositories (candles), gels, ointments, creams, foams). For most modern spermicides active ingredients are potent surfactants that destroy the cell membrane of spermatozoa. These are nonoxynol-9, menfegol, octoxynol and benzalkonium chloride.

Contraceptive gels are popular as they are excellent and effective method protection without the use of hormones (which means you can not worry about side effects). For example, the advantage of Options Gynol II spermicidal gel is that it is safe and approved for use even during breastfeeding.

The failure rate for isolated use of spermicides ranges from 3 to 5 pregnancies per 100 womenin year. But this is only when applied correctly. this method. Apparently, most couples are still used to being protected at random: the actual effectiveness of spermicides is about 16 pregnancies per 100 woman-years.

Calendar (rhythmic) method

The method is based on the fact that ovulation develops 14 days before the onset of menstruation (with a 28-day menstrual cycle), as well as the duration of the viability of spermatozoa in the woman's body (approximately 8 days) and the egg after ovulation (usually 24 hours). It is important to accurately calculate your individual fertility period (or "fertility"). Lead within 8 months menstrual calendar, marking the length of each menstrual cycle. Today on the Internet you can buy special convenient ovulation programs, which help to keep this kind of "account". Set the shortest and longest menstrual cycles, find the first "fertile day" (according to the shortest menstrual cycle) and the last "fertile day" (according to the longest menstrual cycle). Then, given the length of the current menstrual cycle, determine the fertility interval. During this period, you can either completely refrain from sexual activity, or use barrier methods and spermicides.

The calendar method of contraception is ineffective for irregular menstrual cycles. The efficiency of the calendar method is 14.4-47 pregnancies per 100 woman-years.

temperature method

Based on rise time basal body temperature corpus luteum by daily measurement. Fertile is considered the period from the beginning of the menstrual cycle until the basal body temperature is increased for three consecutive days. Although the need for daily temperature measurement and the period prolonged abstinence limit the prevalence of the method, its effectiveness is 0.3-6.6 per 100 female-years.

In order to freely use the temperature method of contraception, every woman in the medicine cabinet should have special thermometer, which can be used to take measurements in the mouth, in the vagina or rectally to measure basal temperature (the so-called body temperature at rest or sleep).

Symptothermal method

This method combines elements of the calendar, cervical and temperature (taking into account such signs as the appearance of pain in the lower abdomen and scanty spotting during ovulation). A study of the effectiveness of the symptothermal method showed the following: with sexual intercourse only after ovulation, the pregnancy rate is 2 per 100 woman-years, while with sexual intercourse before and after ovulation, the pregnancy rate increases to 12 pregnancies per 100 woman-years.

intrauterine contraception

The various wires and "coils" that the doctor places inside you for a long time differ in materials, active substances and validity period. Their effectiveness is quite high, but it should be remembered: in all "spirals" the action is based on injury to the tissues of the uterus. Complications when using spirals are very different: from pain and bleeding to perforation of the uterus. Even if you do not feel any discomfort, think about whether your precious health will be happy with this method along with the childbearing function.

If pregnancy occurs while using the IUD and the woman wishes to continue the pregnancy in the presence of threads, the IUD should be removed. In the absence of threads, extremely careful monitoring of the course of pregnancy is required. It should be noted that there is no indication in the literature about an increase in the incidence of malformations or any damage to the fetus if the pregnancy takes place against the background of an IUD. In women using the IUD, the generative function is not impaired. Pregnancy occurs after the removal of the IUD within a year in 90 percent.

Hormonal contraception

Hormonal contraception is based on the use of synthetic analogues of natural ovarian hormones and is a highly effective means of preventing pregnancy.

Oral contraceptives are the only way to prevent pregnancy with 100% efficiency. It is customary to distinguish:

theoretical efficiency, which involves the use of a method without errors and skipping pills,
clinical efficacy, which is calculated on the basis of the number of pregnancies that have occurred in real conditions, taking into account the errors made by women.

The advantages of oral contraceptives also include ease of use (independence from sexual intercourse), as well as reversibility of exposure (do not affect the ability to become pregnant in the future). But hormonal pills There is a huge list of contraindications, among which - cardiovascular diseases, diabetes, smoking, overweight, age over 40 years. Also oral contraceptives do not combine well with many drugs, including antibiotics, analgesics and sleeping pills.

The latest contraceptives

The latest wonders of medicine are "long-lasting" contraceptives in the form of injections and implants. Their efficiency ranges from 0.0 to 1.5 pregnancies per 100 woman-years. To the category newest contraceptives should include such types of contraceptives as prolonged injectables and implants.

Voluntary surgical contraception (sterilization)

At first glance, this irreversible method of protection is considered the most reliable. However, there are exceptions to its use. I don’t want to scare anyone, but the indicator of contraceptive failure in this case can be 0.8 percent for women and 0.5 percent for men.

Contraception is the protection against unwanted pregnancy. Modern methods of contraception are very diverse. Initially, contraceptive methods are divided into male, that is, intended for men, and female. There are much more methods of female contraception, and which method is preferable is decided by the woman herself together with the doctor, taking into account contraindications and side effects.

Physiological methods of contraception

Lactational amenorrhea method
This method is based on the fact that while a woman is breastfeeding, she releases prolactin in large quantities, which suppresses the synthesis of her own hormones by the ovaries, and, accordingly, ovulation. effective enough only in the first six months after childbirth, subject to the implementation of all the rules.

calendar method
This method is based on the calculation of dangerous and safe days. Not enough reliable way, as it is suitable for women with regular menstrual cycle, especially the life span of spermatozoa in female body is up to 7 days (even if sex was on a safe day, there is no certainty that the sperm will not die before ovulation).

Mechanical methods of contraception

It is a rubber cap that is inserted into the vagina before coitus and covers not only the cervix, but also the vaginal vaults.

cervical cap
This device is made of latex or silicone, just like the diaphragm, it is inserted before intercourse, but only covers the cervical canal.

long-acting contraceptives

These include injectable hormones (Depo-Provera), administered once every 3 months, hormonal implants (Norplant) are administered subcutaneously 6 capsules for up to 5 years, hormonal patches (Euro), are attached weekly for 3 weeks followed by a seven-day break and hormonal a ring that is inserted intravaginally for a period of 3 weeks, followed by removal for 7 days.

By cons hormonal type contraception can be attributed to the presence a large number contraindications, pronounced side effects with the wrong selection hormonal method contraception, require discipline and regular intake of hormonal pills, do not protect against sexual infections.

The positive aspects of this method of contraception are high efficiency, if necessary, can be used for "fire" contraception (as special tablets for emergency contraception, for example, and COCs), with the right selection, are well tolerated, and also normalize the cycle.

Chemical contraception

This method includes preparations - spermicides, which act locally and are available in the form of creams, gels, sponges and aerosol foams. Spermicides cause the death of sperm even in the vagina or, if the activity of the latter is preserved, prevent their penetration into the uterine cavity.

The advantages of the chemical method of contraception for women are considered to be a certain protection against genital infections and ease of use. Negative sides spermicides are the need to use immediately before sexual intercourse and a limited period of effectiveness. Efficiency chemical methods contraception is 75 - 80%.

female sterilization

This method involves occlusion of the fallopian tubes (ligation and/or crossing of the tubes). The advantage of this method is its absolute reliability (100%), although, as a matter of fact, it is rare, but there is a restoration of tubal patency and subsequent pregnancy. And the disadvantages include the impossibility of restoring fertility, that is, the irreversibility of the method.