Modern contraceptives for women are local. Comparison of various dosage forms for local contraception. Indications for use

Unplanned pregnancies often end in abortion. This method has a negative effect on health, so it is necessary to use effective methods contraception. One of better ways prevention of pregnancy is currently recognized for use oral contraceptives, which contain synthetic analogues of female sex hormones.

The effectiveness of modern contraceptive pills reaches 100%. In many cases, thanks to them, healing effect. Oral hormonal contraceptives (OCs) have been used for over 40 years. During this time they have been constantly studied and improved. Combined OCs were created, in which the content of hormones is significantly reduced, and contraceptive efficacy saved.

How does hormonal contraception work?

Birth control pills "turn off" ovulation, while maintaining cyclical bleeding, reminiscent of menstruation. The follicle does not grow, the egg does not mature in it, it does not leave the ovaries, so pregnancy is impossible. In addition, the mucus in the cervix thickens, and the endometrium also changes, which prevents the attachment of a fertilized egg in case of pregnancy.

The beneficial effect of oral contraceptives on a woman's body is as follows:

stabilization menstrual cycle while reducing the amount of blood produced. This helps to correct iron deficiency anemia that occurs in many women;
reduction of abdominal pain during ovulation with and manifestations;
increasing the protective properties of the mucus of the cervical canal, which reduces the frequency of infections of the uterus and appendages by half;
reduction in the frequency and associated curettage;
reducing the risk of developing mastopathy when taking monophasic oral contraceptives, especially those containing progestogens with low androgenic activity;
suppression of androgen production in the ovaries, helping to treat acne, seborrhea, hirsutism and other manifestations of the viril syndrome. This is especially true of contraceptive pills containing progestogens with an antiandrogenic effect or with low androgenic activity;
increase bone density, improve calcium absorption, which prevents the development of osteoporosis.

Composition of oral contraceptives, classification and their names

Combined oral contraceptives contain an estrogen and a progestogen component. Progestogens prevent pregnancy, and estrogen causes endometrial proliferation, mimicking its normal development, while irregular uterine bleeding. In addition, it replaces the body's own estrogens, which cease to be produced in the ovaries when using oral contraception.

The active estrogen found in most birth control pills is ethinyl estradiol. The progestogenic component is represented by 19-nortestosterone derivatives: Norethisterone, Levonorgestrel, Norgestrel. Modern progestogens have been created: Dienogest, Drospirenone, Dezostrel, Norgestimate, Gestodene. They have a minimal androgenic effect, do not cause weight gain, do not affect the metabolism of fats in the body.

After childbirth with breastfeeding it is recommended to take medicines only with a progestogen component (Mini-pill), since estrogens suppress the production of milk. Pure progestin preparations are also indicated for women who need to limit the intake of estrogen (patients with hypertension, diabetes, obesity). These include Microlut, Exkluton, Charosetta (contains desogestrel).

If oral contraceptives contain less than 35 micrograms of estrogen, they are called "low-dose." In microdosed birth control pills, the concentration of estrogens is reduced to 20-30 mcg. High-dose preparations containing 50 μg ethinylestradiol are used mainly in medicinal purposes.

What is the difference between monophasic, biphasic, and triphasic medications?

Oral contraceptives are divided into monophasic, biphasic and triphasic.

In monophasic, the content of both components is the same in all tablets.
Biphasic contain constant dose estrogen and a fluctuating concentration of progestogens, which increases in the second phase of the cycle. At the same time, the total dose of estrogens is slightly higher than in monophasic preparations, and progestogens are less.
Three-phase contraceptives have a changing ratio of components that mimics the normal menstrual cycle.

List of the most common monophasic contraceptives:

low-dose: Femodene containing desogestrel - Marvelon and Regulon;
microdosed: Logest containing desogestrel - Mercilon and Novinet.

List hormonal contraceptives new generation with three-phase structure:

Tri-merci (contains desogestrel);
trialen;
Trisilest.

Contraceptive pills with an antiandrogenic effect include a progestogenic component with an antiandrogenic effect (Diana-35, Janine) or with a strong progesterone-like effect (Tri-merci, Regulon, Novinet). Preparations containing desogestrel are often used to treat hyperandrogenism in adolescents.

Drospirenone is a fourth-generation progestogenic component with significant antiestrogenic, antiandrogenic, and antigonadotropic effects. It does not cause any serious side effects. Drospirenone, in particular, is part of such a microdosed monophasic drug as Dimia. It is especially indicated for patients with unstable blood pressure. This drug is very effective in relieving signs of premenstrual syndrome.

Classification of oral contraceptives depending on the composition and phase of action:

Fixed combinations of estrogens and progestogens:

Norgestrel + estrogen (cyclo-progynova)
Levonorgestrel + estrogen (microgynon, minisiston 20 fem, oralcon, rigevidon)
Desogestrel + estrogen (Marvelon, Mercilon, Novinet, Regulon)
Gestodene + estrogen (gestarella, lindinet, logest, femoden)
Norgestimate + estrogen (silest)
Drospirenone + estrogen (Vidora, Dailla, Jess, Dimia, Midiana, Modell Pro, Modell Trend, Yarina)
Nomegestrol + estrogen (zoel)
Dienogest + ethinylestradiol (diecyclene, janine, silhouette)

Progestogens and estrogens in combinations for sequential administration:

Levonorgestrel + estrogen (tri-regol, trigestrel, triquilar)
Desogestrel + estrogen (tri-merci)

Progestogens:

Linestrenol (exluton)
Levonorgestrel (postinor, escapel, eskinor-f)
Desogestrel (lactinet, modell mam, charozetta)

Preparations for emergency contraception- levonorgestrel.

Which of the following is the best choice for permanent reception? It is impossible to answer this question unambiguously. AT different situations different drugs will be more effective.

Selection of hormonal oral contraceptives

The appointment of hormonal contraceptives is carried out by a gynecologist after examination and taking into account many factors: the age of the patient, the type of contraceptive, the dosage and type of the progestogen component, the dose of estrogens.

The best birth control pills new generation contain in their composition such progestogens as gestodene, desogestrel, norgestimate, drospirenone.

How to choose birth control pills according to age:

For women under the age of 35, low-dose or microdose monophasic contraceptives, as well as triphasic contraceptives, including those containing desogestrel or drospirenone, are preferable.
Women after 35-40 years of age are more suitable for monophasic drugs with desogestrel or drospirenone, pure progestins or microdose agents.

The names of birth control pills should be checked with a doctor, because the prescription will most likely only list the active ingredients. The doctor now has no right to write the specific name of the drug in the prescription.

How to take birth control pills

For many years, doctors have used the 21 + 7 scheme for constant intake. Now the “24 + 4” mode is becoming more widespread, that is, 24 days of admission, a break in admission of 4 days.

During the break, bleeding usually occurs, resembling menstruation. It can begin 2-3 days after stopping the intake and continue during the first days of taking a new package.

There are regimens that allow you to shift the onset of this bleeding or reduce the number of such cycles during the year. These modes can be used for short periods of time, such as when driving sport competitions or on vacation, before surgical operation and so on. Modes for long-term use can be prescribed during treatment, anemia, as well as with the peculiarities of a woman's life, including sports and professional activity. In this case, the woman does not have menstruation for many weeks.

Long-term use of oral contraceptives without interruption is used for diseases of the genital organs, for example,. In addition, it increases the reliability of contraception and does not harm health.

Schemes of taking hormonal contraceptives

Tablets are taken orally, once a day, at the same time, with a small amount of water. For convenience, many modern contraceptives are available in special packages that make it easier to count days. If you miss taking the drug, you need to follow clear rules specified in the instructions. Most often it is recommended to take as soon as possible next pill and use barrier methods of contraception during this cycle.

Pregnancy after discontinuation may occur in different dates- from a month to a year. It depends on the state of health of the woman, her hormonal levels, ovarian function. Taking oral contraceptives in cycles preceding pregnancy is safe for the unborn child. If pregnancy is suspected, oral contraceptives should be stopped immediately. However, their use on early stages also will not harm the fetus.

In some cases, short-term use of contraceptives for 3 months is used to stimulate ovulation after they are stopped, which increases the chance of becoming pregnant. This property of hormonal contraceptives is used to treat infertility.

How long can birth control pills be taken?

With regular monitoring by a gynecologist, good tolerance and effectiveness, such drugs have been used for several years. If necessary, the medicine can be changed, but the method of hormonal contraception itself has proven itself very well for the treatment and prevention of female diseases.

emergency contraception

Cases of its use are not uncommon, especially if a woman uses primitive methods of protection (coitus interruptus). It happens that a condom breaks or violence occurs. Every woman should know the names of emergency contraceptive pills. Most often, such means as Postinor, Escapel, Eskinor-F are used.

They must be taken within the first 72 hours after intercourse. It is not recommended to reuse the same drugs in the current menstrual cycle. Barrier methods of contraception should be used to prevent pregnancy. In the case of repeated unprotected intercourse during the cycle, only emergency hormonal contraception using the drug Danazol. Its effectiveness is much lower than levonorgestrel.

Side effects and contraindications

One of the biggest myths about birth control pills is that they can cause cancer. Modern oral contraceptives do not cause cancer. On the contrary, in women using this method of contraception for 3 years, the frequency of endometrial cancer is reduced by half, the frequency of ovarian or intestinal cancer by a third.

Side effects are most often mild. At the beginning of the reception, they occur in a third of patients, then these phenomena are observed in every tenth woman.

Side effects of oral contraceptives:

1. Clinical:

A) general;
B) disturbing cycle.

2. Dependent on the action of hormones.

Common side effects include headache and dizziness, depression, feeling of tension in the mammary glands, weight gain, irritability, stomach pain, thrombophlebitis, decreased glucose tolerance, skin rash and other symptoms. An allergy to the components of the drug is not excluded. Hair loss when taking such drugs is rare, it is associated with insufficient antiandrogenic activity of the drug and requires changing the drug to a more effective one.

Menstrual disorders include intermenstrual spotting when taking hormonal contraceptives, as well as the absence of menstruation. If the side effects do not go away within 3 months, you need to replace the drug with another one.

Amenorrhea after taking hormonal contraceptives occurs due to atrophy of the endometrium, goes away on its own or is treated with estrogens.

Severe consequences after taking contraceptives are rare. These include thrombosis and thromboembolism, including deep veins or pulmonary artery. The risk of these complications is lower than during pregnancy. However, oral contraceptives are relatively contraindicated if there is at least one risk factor for thrombosis: smoking, obesity, arterial hypertension.

Application is contraindicated in the following cases:

arterial and venous thromboses;
transferred transient ischemic attack;
ischemic disease hearts;
diabetes mellitus with vascular complications;
migraine with focal neurological symptoms;
a combination of risk factors for thrombosis;
severe diseases of the liver and pancreas;
tumors of the liver, genital organs, mammary glands;
uterine bleeding of unknown cause;
pregnancy;
for combined drugs - lactation.

If you avoid the use of birth control pills with such contraindications, then probable harm from hormonal contraceptives is much less than their real benefit.

If a woman does not want or cannot take hormonal OCs, she can use new generation non-hormonal contraceptive pills to prevent pregnancy. It must be clearly understood that they are understood as spermicidal agents for local application i.e. vaginal tablets. They must be inserted into the vagina before intercourse. These drugs not only kill sperm, but also have an anti-inflammatory effect. Unfortunately, the contraceptive effectiveness of such drugs is less, the chance of getting pregnant when using them is 20-25%. Of this group, the most commonly used vaginal tablets are Pharmatex, Benatex, Gynecotex.

AT modern gynecology hormonal contraception is considered the "gold standard" for contraception unwanted pregnancy. Modern means effective, well tolerated, not only contraceptive, but also therapeutic effect. Self-selection of birth control pills is difficult. To discuss issues of contraception, you should consult a doctor.

Today, prevention of unwanted pregnancy is one of the most topical issues that worries women. Everyone understands that abortion is very harmful and dangerous for female body. But gynecologists are very concerned about the fact that despite the existence of a new generation of contraceptives, cases of unplanned pregnancies ending in abortions are increasing every year.

On the dangers and harms of abortions done by women because of neglect modern methods contraception has been and is being said a lot. Therefore, this article will talk about the existence of topical contraceptives and their classification.

Local contraceptives for women

Today, contraceptive methods represent a fairly wide choice for women. If, say, a woman does not want to take birth control pills for any reason, a local contraceptive may be her choice. The principle of operation of this method of protection is that chemicals are introduced into the vagina. When spermatozoa get there, spermicide chemicals quickly destroy them. Moreover, spermicides create a thin protective film on the vaginal mucosa, and then the cervical secretions thicken. That is, it is an additional barrier to the penetration of spermatozoa.

There are two chemicals, which are used in topical contraceptives: these are benzalkonium chloride and nonoxynol. Based on them, some contraceptives, for example, Pharmatex. An important plus local remedy contraception is that it can be used during breastfeeding, since the active substances do not enter the milk, and this guarantees complete safety for the baby.

Local contraceptives also include barrier or mechanical means. They are able to create a barrier between the sperm and the egg, thereby preventing fertilization. Diaphragms, condoms and caps are used as mechanical means. Diaphragms and caps must be inserted into the vagina immediately before intercourse, this closes access to the uterus. Usually only a doctor can choose the size, and they must be used together with spermicides, since without the latter there will be little effect from them. Local contraceptives have a great advantage: they do not contain hormones, and therefore they can be used during breastfeeding.

But condoms may also be less effective, because their reliability depends entirely on correct use. Their advantage is that they are used not only as a local contraceptive, but also as protection against sexually transmitted infections. Condoms are available and can also be used during lactation.

Here are some local contraceptives widely known in our pharmacies:

"Contraceptin" - is in the group of "chemical contraceptives". It disinfects, kills spermatozoa and produces an antibacterial effect. It remains the best remedy for those women whose sexual life is irregular. The drug is enough to enter into the vagina once before sexual intercourse.
"Nonoxynol" - also belongs to this group. It has a strong spermicidal effect, and is a consequence of the immobilization and death of spermatozoa. In addition to all this, the drug has antiviral, antifungal and antibacterial action, and this serves as a reliable protection against sexually transmitted diseases.

These are possessed by such means as "Patentex", "Sterilin" which are produced in the form of candles.

Gramicidin paste is also popular among contraceptives. In her active substance is an antibiotic such as gramicidin. It should be used by those women who suffer from diseases of the vagina or cervix.

But local contraception also has its drawbacks. These include:

possibility of loss of spontaneous intercourse
there is a risk of latex allergy
constant need use before intercourse
due to such agents, sensitivity may decrease

Used drugs:

All local contraceptives can be divided into two groups: barrier and chemical. Barrier contraceptives are, first of all, condoms known to all. Less popular diaphragms and cervical caps for women, most likely, the absence of their adherents is due to the inconvenience of their use. In addition, condoms not only protect against pregnancy, but also reliably protect against sexually transmitted diseases. But condoms also have their drawbacks - they tear and slip off, and, in addition, a decrease in sensitivity also does not add any advantages to this method. That's probably why everyone more men prefer not to use condoms. Then there is the issue of female contraception.
Spermicidal intravaginal suppositories are designed to neutralize spermatozoa. Such local contraceptives first act on the membrane of the flagella, and then on the spermatozoon itself. Treated in this way, "gum" can no longer fertilize the egg.

Candles of the first generations have a number of significant drawbacks: they foam and have a specific smell. The new spermicidal suppositories dissolve surprisingly quickly in the vagina, literally within five minutes. At the same time, they form a film inside, which serves as a kind of barrier against spermatozoa. A woman can safely breastfeed her baby without fear of getting the active substance from the suppositories into the milk through the blood, as it is not able to penetrate the walls of the vagina.

Modern spermicidal suppositories do not leak from the vagina and have no smell at all. It is also very convenient that such a candle is valid for 4 hours. This gives the couple the opportunity to "manoeuvre". For example, if a child woke up and needs to be fed, or you need to urgently answer phone call, you can always be distracted, and then continue to make love. During this period, candles still reliably fulfill their protective function without causing any discomfort. In addition, spermicidal suppositories create a very good lubricant inside the vagina, thereby enhancing the thrill of intimacy with a loved one.

Local contraceptives can be used not only by nursing mothers, but also by women who missed taking a hormonal contraceptive pill. Spermicidal suppositories are convenient to carry in handbag in case of completely unplanned sexual intimacy (which only happens in life!): they will protect against unwanted pregnancy with a 99 percent guarantee. In addition to the main effect, such candles kill pathogenic infections into the vagina without disturbing its beneficial microflora.

There comes a time in every woman's life when she thinks about protection against unwanted pregnancy. Currently on the pharmacy shelves is presented a wide range of hormonal pills having high efficiency. However, in the minds of Russian women, the memory of their side effects associated with the recruitment is still alive. excess weight.

In this regard, many representatives of the beautiful half of humanity prefer to use contraceptives that do not contain hormones, despite their low effectiveness. What non-hormonal contraceptive pills do pharmacists offer women, and what new generation hormonal contraceptives do not have? side effects on the female body?

Women are currently reproductive age are increasingly resorting to chemical protection from pregnancy provided by non-hormonal pills. However, they justify their name only by the form, although they are not tablets as such. These drugs are not taken orally, like traditional hormonal contraceptives, but are inserted into the vagina.

The composition of such drugs includes spermicides - substances that destroy spermatozoa for a short period of time, preventing their penetration to fallopian tube. Their active substance is benzalkonium chloride or nonoxynol.

How exactly do non-hormonal contraceptives work?

Coming into contact with the spermatozoon, spermicides destroy the flagellum, preventing its further movement.
When interacting with the head of the sperm, the membrane is damaged, which leads to its death.
Causes thickening of mucus cervical canal the cervix, which becomes a reliable obstacle to the advancement of weakened spermatozoa.

Spermicide-based preparations are also available in other substances, which include the following forms:

vaginal suppositories;
vaginal creams and gels;
tampons;
diaphragms in the form of soft dome-shaped caps covering the cervix.

Regardless of the form of release, the use of non-hormonal contraceptives allows you to create a reliable protective barrier against fungi and other diseases transmitted during unprotected intercourse. This is facilitated by the substances that are part of the preparations, which have a bactericidal and antimicrobial effect.

Distinctive feature non-hormonal methods contraception lies in the fact that they must be used immediately before intimacy. At the same time, they retain their effectiveness for several hours.

Degree of reliability

Evaluation of the effectiveness of certain contraceptive drugs is made on the Pearl scale. The study is conducted among 100 women using this particular method of contraception. This indicator is based on information about how many women among the subjects managed to become pregnant despite protection. And the lower the indicator, the higher the effectiveness of the evaluated group of drugs.

AT this case this indicator is 8-36. And this means that from 8 to 36 women out of 100 become pregnant even with protection from unwanted pregnancy.

When is the use of non-hormonal drugs indicated?

Despite the rather low efficiency, non-hormonal contraceptive pills have a number of advantages compared to hormonal methods contraception.

They can be used for various gynecological diseases, for example, uterine myoma, as well as in the presence of hormone-dependent tumors.
These drugs do not enter the stomach and are not absorbed into the blood, and therefore are not able to affect the liver, blood vessels and other body systems.
They can be used for rare sexual contact.
They have a bactericidal and antimicrobial effect, which hormonal agents are deprived of.

Non-hormonal contraception will be a reliable protection for women who are breastfeeding babies. They are used if women are contraindicated in the use of COCs or other types of contraceptives.

These drugs will help prevent pregnancy in women of Balzac age (40-45 years). In that age period the menstrual cycle is already irregular. However, the possibility of pregnancy is not excluded yet.

Disadvantages and contraindications

Similar drugs inserted into the vagina. Moreover, this must be done at least 10 minutes before the intended sexual contact. This means the absence of any unpredictability in sex and the need to discuss with the partner the time of each intercourse. When using these drugs, it is not recommended to take a shower immediately before and after sexual intercourse. The time to wait is specified in the instructions for each drug.

As part of non-hormonal drugs, there is an acid that can irritate the mucous membrane, causing itching and burning in the vagina. At the same time, these funds are not recommended for regular use, since they long-term use can lead to a violation of the microflora in the vagina, causing the development of dysbacteriosis. There are no contraindications for the use of these contraceptives. The only exception is the individual intolerance of their components.

Overview of popular contraceptives

All non-hormonal pills are divided into groups based on which of the active substances is included in their composition.

Names of contraceptives based on benzalkonium chloride:

Pharmatex is the most popular because of its low cost, combined with high efficiency. It is available as vaginal tablets, and in the form of cream, suppositories and even tampons. Regardless of the dosage form, the drug begins to act 10 minutes after ingestion, without losing its properties for 3-4 hours.
Ginotex are ring-shaped tablets. It is recommended to enter them no later than 5 minutes before contact. The action of the tablet lasts for 4 hours.
Genoteks are tablets, the action of which is identical to the previous drugs.
Erotex - non-hormonal contraceptive suppositories, the action of which begins after 10 minutes, and ends after 3 hours.
Contratex are candles that begin to perform their functions after 10 minutes and finish after 4 hours.

Names of contraceptives based on nonoxenol:

Patentex Oval - highly effective suppositories that are inserted into the vagina 10 minutes before the intended intimacy. They keep their action up to 10 hours.
Nonoxenol is a contraceptive suppository that has the same characteristics as the previous drug.

It should be remembered that before each subsequent sexual intercourse, non-hormonal contraceptives must be reintroduced.

Features of choice

How to determine which non-hormonal birth control pills are best? Given their low cost, when choosing the price is not a decisive factor. However, as the experience of women who have already experienced everything existing forms non-hormonal contraceptives, candles are suitable for ladies suffering from vaginal dryness. When using them, there is no need to use lubricants.

There are also unpleasant phenomena associated with the fact that when the tablet dissolves, a characteristic hiss is heard, and foam is released from the vagina. In addition, even using the most good drugs, it is not excluded the occurrence of irritation, itching and burning not only in women, but also in their partners. Every woman's body reacts differently to certain substances. Therefore, it will be necessary to determine which of the non-hormonal contraceptives is better through trial and error.

Hormonal birth control

All yearly more women prefer the use of hormonal oral contraceptives, due to their high efficiency. They not only reliably protect against unwanted pregnancy, but also provide beneficial effect for women's reproductive system. Among other contraceptives, a new generation of contraceptives took pride of place on the pedestal.

All modern hormonal preparations for oral administration are divided into four types, based on the amount of hormones they contain.

Microdose contraceptives contain minimal amount hormones, which practically deprives them of side effects. The active substance in such preparations is a synthetic analogue of estradiol. Because of this, they are used to treat acne and painful menstruation due to hormonal imbalance. Such drugs can be used by both very young nulliparous girls and mature women who have never taken hormonal contraceptives.
Low-dose contraceptives also contain synthetic in combination with. Such drugs will ideal remedy protection against unwanted pregnancy for young women who have already given birth. Except contraceptive action, data medicines help to eliminate the manifestations caused by excessive content in the body of male sex hormones. These include hair growth in inappropriate places, acne and male pattern baldness.

Medium-dose contraceptives contain synthetic analogues of estradiol with progesterone. They are intended for mature women who have given birth. Like the previous version, these drugs are designed to normalize hormonal levels. However, they should not be used during breastfeeding.
High-dose contraceptives contain high doses of estradiol and progesterone. Such drugs are most often used for medicinal purposes to restore hormonal levels. To protect against unwanted pregnancy, birth control pills of a new generation are recommended for women who have given birth after 35 years of age.

emergency contraception

These funds are used in emergency situations, and allow you to prevent pregnancy after unprotected intercourse. They are recommended for use in the following cases:

in case of violent actions, or if the condom is damaged;
with infrequent sexual intercourse.

Contraindications to their use include a violation of blood clotting, diseases of the heart and blood vessels, hepatic and kidney failure, malignant tumors and smoking.

Features of taking pills

How long can oral contraceptives be taken, and do they need to be changed? They must be taken daily and preferably at the same time. And it is recommended to start taking them on the first day of menstruation. These drugs are intended for long-term use. However, women taking hormonal contraceptives need to visit a gynecologist every year. In the absence of any contraindications, contraception can be continued.

At long-term use COC menstruation may stop altogether, and this is not a pathology. However, if a woman forgets to take her birth control pill and last day menstruation has been left behind for a long time, this may be a sign of pregnancy. After the abolition of contraceptives, the menstrual cycle is fully restored within 1-2 months. In this case, pregnancy can occur immediately or after short span time. You can drink birth control pills for several years. If they do not cause any side effects in a woman, they should not be changed. Otherwise, the body will experience stress.

Natural ways of protection

Methods of protection against unwanted pregnancy without hormones have been used since ancient times. In spite of wide range modern contraceptives offered by pharmacists, they still do not lose their relevance today.

One of them is based on counting the days of ovulation. The average menstrual cycle is 28 to 30 days long. In its first half, the follicle matures. And ovulation occurs in the second half of the cycle. The ability to fertilize a mature egg remains for 2-3 days. In this case, spermatozoa can take a wait-and-see position for 4 days. Therefore, special care must be taken only about a week in the middle of the cycle.

In some cases, the measurement of ovulation allows you to determine the days of ovulation. basal body temperature, which is the most dangerous days rises. However, the reliability of calculations and measurements of temperature in the rectum cannot guarantee full protection.

Some couples practice coitus interruptus. However, in this case, the onset of pregnancy is not excluded, since a large number of sperm may be contained in the lubricant secreted by the partner's penis. In this case, the likelihood of pregnancy increases depending on how many sexual acts were performed.

Bibliography

Venereal diseases. Directory. Ed. N. 3. Yagovdika. - Minsk: "Belarusian science", 1998. - 342 p.
Emergency conditions in obstetrics. Sukhikh V.N., G.T. Sukhikh, I.I. Baranov et al., Publisher: Geotar-Media, 2011.
Pregnancy and childbirth with extragenital diseases. UMO vulture medical education, Apresyan S.V., Radzinsky V.E. 2009 Publisher: Geotar-Media.
Rakovskaya I.V., Vulfovich Yu.V. Mycoplasma infections of the urogenital tract. - M.: Medicine, 1995.
Diseases of the cervix, vagina and vulva / Ed. V.N. Prilep-

Graduated from the Kirov State medical academy in 2006. In 2007 she worked at the Tikhvin Central district hospital on the basis of the therapeutic department. From 2007 to 2008 - an employee of the hospital of a mining company in the Republic of Guinea ( West Africa). From 2009 to the present, he has been working in the field of information marketing. medical services. We work with many popular portals, such as Sterilno.net, Med.ru, website

Today, there are many ways to prevent unwanted pregnancy. A wide selection allows you to choose the most suitable contraceptive for each woman. At irregular relationships it is also important to take care of protection. How to decide on the method of contraception and what to look for when choosing? Let's try to understand this issue in more detail.

Why is contraception necessary?

Every woman sooner or later thinks about how to avoid unwanted pregnancy. At the same time, it is absolutely not necessary to exclude love joys from life, which, by the way, negatively affects psycho-emotional state. modern medicine currently offers a large number of the most different ways contraception.

The use of contraceptives can save women Health and reproductive function. selection best method a gynecologist should be involved, since the age, anamnesis and regularity of the patient's sexual life are taken into account.

What are the contraceptives?

To protect against unwanted pregnancy, there are many types of contraception, each of which is suitable in a particular situation. They are usually divided into traditional and modern. The former include coitus interruptus, barrier methods (condoms, diaphragm), spermicides, non-hormonal agents and a biological (calendar) method of protection.

Modern types of prevention of egg fertilization are the most popular, as they give an almost 100% guarantee. These include hormonal IUDs (intrauterine devices), injections, vaginal rings. Each method has its own indications, side effects and contraindications. Therefore, without consulting a specialist, it is unlikely that it will be possible to choose effective contraceptives.

Hormonal methods of contraception

The most common and reliable are based on female hormones(synthetic analogues) - estrogen and progesterone. Some may be single-component and contain only progesterone, in which case they are called mini-pills. They are the most gentle for the body. Combination contraceptives may contain various doses the main active ingredient.

The action of hormonal agents to protect against unwanted pregnancy is to block the maturation of the egg and the onset of ovulation. Mini-pills affect only the uterine mucosa, making it looser, and the excreted secret becomes viscous. This prevents the sperm from fertilizing the egg. Pregnancy planning can be started as early as 2-3 months after the end of taking birth control pills, when the reproductive function is fully restored.

Benefits of hormonal drugs

The past generation of hormonal pills had a number side effects, which caused many women to abandon their use. The newest contraceptives are well tolerated by the body and are practically devoid of unpleasant consequences use. They are produced in patches, injections, vaginal rings and hormonal implants.

Oral contraceptives containing one type of hormone (mini-pill) are allowed to be taken during lactation. The components of the medicine do not affect the baby's body. To normalize the menstrual cycle or medical abortion, women are advised to take combined preparations. They allow not only to further prevent the fertilization of the egg, but also to protect against inflammatory diseases.

The benefits of hormonal drugs include the elimination of skin problems. Sex hormones are known to affect sebum production. If a violation occurs, male hormones begin to develop in more than women's, and, as a result, acne appears on the skin.

Quite often, women are prescribed to treat polycystic ovaries and eliminate strong pain syndrome during the period of menstruation. It has been scientifically proven that such drugs have a preventive effect and significantly reduce the risk of developing oncology of the mammary glands, uterus, ovaries, and also prevent mastopathy, endometriosis and fibromyoma.

Contraindications

You should carefully study the list of contraindications for taking to prevent pregnancy. The main factors prohibiting the use of oral contraceptives are:

Cardiovascular diseases (ischemic disease, hypertension, stroke, heart attack), venous pathologies.
Kidney diseases.
Oncology.
The last stages of obesity.
Autoimmune diseases.
Benign neoplasms.
Venereal diseases.
Vaginal bleeding in the intermenstrual period of unknown etiology.
Pregnancy.
Diabetes.

Each drug has its own list of contraindications, and therefore you should seek the help of a specialist who will help you choose the right hormonal contraceptives. With an irregular relationship, such drugs can also be abandoned. Non-hormonal contraceptives are the most suitable method protection against unwanted pregnancy sexual contact occur less than once a week.

The mechanism of action of non-hormonal contraceptives

Non-hormonal methods are very relevant during lactation, with irregular sexual relations, or if hormonal drugs are not allowed to be taken. The action of such funds is based on the destruction or damage of spermatozoa. Non-hormonal contraceptives reviews are very diverse. For some women, this is the best and safe way family planning, while others are completely untrustworthy.

As part of non-hormonal drugs contain special substances - spermicides, which contribute to damage to the membrane of spermatozoa, which provokes their death. The active ingredient can be nonoxynol, benzalkonium chloride. Substances form a thin film on the mucous surface of the vagina, which performs a protective function, and also contributes to the thickening of mucous secretions. Non-hormonal ones are injected directly into the vagina, where they begin to act within 10-15 minutes. That is why they are referred to barrier methods contraception.

Are non-hormonal remedies effective?

Non-hormonal contraceptives cope with the task in only 80% of cases. For women who are active sexual life, this method is not reliable. Local protection is suitable for irregular contacts, the impossibility of using oral contraceptives and intrauterine hormonal spiral some diseases of the female genital organs, endocrine pathologies, during breastfeeding.

Main advantage non-hormonal drugs protection - absolute safety for health and the absence of serious side effects (in rare cases possible itching). A woman may not worry that she did not take a pill, as is the case with hormonal drugs, because the funds are used immediately before sexual contact.

Disadvantages of non-hormonal drugs

The disadvantages of non-hormonal contraceptives include:

Introduction before coitus - it is necessary to accurately control the process and inject the drug no later than 10 minutes before contact.
It is forbidden to take a shower immediately: soap neutralizes the acidic environment in the vagina created by the product. In the annotation to the preparations you can find information that hygiene procedures allowed only 2-3 hours after unprotected contact.
Short-term effect of the drug - the protection created by the drug lasts for 3-4 hours, that is, before the next contact, it is recommended to enter a new pill, because reliable protection the first will not provide.
The appearance of itching - some women note that after the introduction of the drug into the vagina, itching appears (an allergic reaction).
Intolerance to the components that make up the drug - in this case, do not use contraceptive.

Types of non-hormonal contraceptives

Non-hormonal contraceptives in recent times are becoming more and more popular due to their security. They are classified according to the form of release (tablets, suppositories, creams, tampons, vaginal balls, aerosols) and the main active ingredient. Despite some differences, the main effect of the drugs will be the same. A wide selection of drugs allows a woman to choose the most suitable and easy-to-use contraception. It is recommended that you first read the annotation, which will indicate the method of administration of the drug and the duration of the effect.

Non-hormonal contraceptive pills

Girls and women who have contraindications to the use of hormonal contraceptives and who do not want to influence hormonal background, you can use local birth control pills or suppositories. These are the most easy-to-use spermicide-based protection products.

Non-hormonal birth control pills for irregular relationships are perfect option protection against unwanted pregnancy and sexually transmitted diseases for women. Quite often, they are used by girls who are afraid of side effects of oral contraceptives or, due to health reasons, cannot use other methods. Vaginal tablets can be selected independently or with the help of a gynecologist. Some manufacturers recommend combining them with other protection methods, such as a diaphragm.

The following non-hormonal contraceptives (for women) are most effective:

"Benatex";
"Pharmatex";
"Patentex Oval";
"Traceptin";
"Conceptor".

Some of the listed drugs are based on the substance nonoxynol, which can somewhat prolong love joys by reducing sensitivity, others are benzalkonium chloride. In terms of effectiveness and mechanism of action, the drugs do not differ. A remedy should be preferred, for the components of which a woman will not have allergic reaction in the form of burning and itching.

Pharmatex

Currently, the drug "Pharmatex" is the most popular among non-hormonal methods of contraception. As active component benzalkonium chloride is a medicinal antiseptic with antifungal and contraceptive effects. At the local level, the drug destroys spermatozoa and enhances the secretion of a viscous secret, like other non-hormonal contraceptives.

With an irregular relationship, Farmateks candles will be the most convenient option for guard. Also, the drug is available in the form of a cream, vaginal tablets and capsules, tampons. Candles are valid for 4 hours, tablets - no more than 3. The manufacturer recommends introducing a new candle (tablet, capsule) with each subsequent sexual intercourse.

According to studies, "Pharmatex" can protect against gonococcus, chlamydia, Trichomonas, herpes virus type 2. However, the tool does not provide pernicious influence on the microflora of the vagina and does not change normal level acidity.

"Patentex Oval"

When needed safe contraception, non-hormonal and at the same time effective contraceptives are selected. With irregular relationships, many women use a nonoxynol-based remedy - Patentex Oval. Its efficiency is from 80 to 90%. The drug is released in the form of vaginal foaming suppositories, which must be administered before sexual intercourse. In addition to protecting against unwanted pregnancy, suppositories provide antifungal and antiviral action, that is, they protect a woman from many diseases transmitted through unprotected sexual contact.

Contraceptives after contact

The method of emergency contraception is resorted to if sexual intercourse was completely unprotected. In order to definitely protect yourself from an unwanted pregnancy, it is recommended to take a contraceptive. After the act, no more than three days should pass.

One-time contraception is based on blocking the release of a mature egg from the ovary and preventing attachment to the uterine wall in case of fertilization. Doctors advise resorting to this method only in the most extreme situations. Popular remedies from this category include Postinor, Escapelle, Zhenale.