Means and methods of contraception. All types of contraceptives for women and men. Chemical types of contraceptives

Contraceptives

Contraceptives are traditionally divided into mechanical, biological and chemical. Various means naturally have varying degrees efficiency. Virtually none of the methods of preventing pregnancy (except for sexual abstinence) can not give a 100% guarantee. Quite often, in order to achieve greater safety and reliability, various contraceptives are combined. However, it is best to choose a contraceptive, after consulting with a gynecologist.

In this article, we will talk in detail about the most popular types of contraception.

CONDOMS

SPIRAL

CONTRACEPTIVE PATCH

VAGINA RING

LONG-LASTING INJECTIONS

NORPLANT

MALE AND FEMALE STERILIZATION

DIAPHRAGM

BIOLOGICAL PROTECTION

MINI-PILI TABLETS

CALENDAR METHOD

Example:
Most short cycle lasts 28 days, and the longest is 30 days.
The beginning of the fertile phase is 28-18 = 10th day of the cycle.
End - 30-11 = 19th day of the cycle.

That is, from the 10th to the 19th day of the cycle, fertilization can occur, which means that these days you need to use barrier contraceptive methods or refrain from sex altogether. The disadvantages of this method include, first of all, its unreliability, since initially it assumes a regular, constant menstrual cycle, which, unfortunately, no woman has.

TEMPERATURE METHOD

During the first half of the cycle, the basal body temperature is usually below 37°C. 12-24 hours before ovulation, body temperature drops by 0.1-0.2°C, and after ovulation it rises by 0.2-0.5°C (usually up to 37°C or higher). And this temperature is kept at this level throughout the second half of the cycle until the onset of menstruation. The fertile period begins six days before the preovulatory recession and lasts three more days after it ( total duration fertile phase - 9 days).

The advantages of the temperature method of contraception include: ease of use; absence of any side effects; most precise definition days of probable conception when planning a pregnancy.
Cons: high risk unwanted pregnancy(because the level of basal temperature is affected very a large number of factors); the need for daily measurement of basal temperature.

COMMISSIONING

EMERGENCY (aka postcoital, fire) CONTRACEPTION combines methods of preventing unwanted pregnancy, which are used after unprotected intercourse has taken place. Most funds emergency contraception can be purchased at pharmacies without a prescription and used on your own, but we strongly recommend that you consult a doctor so that he selects the most optimal method of emergency contraception for you, checks for contraindications to the chosen method and selects the required dosage.

TYPES OF EMERGENCY CONTRACEPTION:

2) Hormonal contraceptives
The first way to use hormonal contraception is simultaneous reception several types of COC tablets (combined oral contraceptives). The number of tablets required for taking is based on the dosage of the hormone level in the preparations: Miniziston, Rigevidon, Femoden, Marvelon, Microgynon, Regulon - two times four tablets (the interval between taking is 12 hours), Logest, Mercilon, Novinet - two times five tablets. This method called the Yuzpe method and it is effective for three days after unprotected intercourse. The efficiency of this method is not very high - 75-85%.

The main advantage of this method is its availability, since all drugs are sold in any pharmacy without prescriptions. Side effects after application - nausea, pain in the mammary glands, vomiting, dizziness, headache.

An alternative to COCs is preparations that contain only progestins and do not contain estrogens. The most effective drugs of this type are Escapel and Postinor. Escapelle contains 1.5 mg of the hormone and is used once. Postinor also contains 0.75 mg of levonorgestrel and it must be applied twice with an interval of 12 hours. Minor side effects, which can be called hormonal methods emergency contraception, usually within two days pass.

It must be remembered that after using methods of emergency hormonal contraception, it is necessary to without fail use additional methods of contraception until the next menstrual cycle: spermicides, condoms, etc.

3) Non-hormonal emergency contraception
Mifepristone (Ginepristone) is one of the most effective drugs emergency protection. Single dose small dose this drug in for three days after the unprotected incident happened intercourse causes a slowdown in ovulation (this process depends on the phases of the menstrual cycle), a change in the endometrium, and also prevents the attachment of a fertilized egg.

This drug has less pronounced side effects - for example, the frequency of bleeding is only 15%, compared with 31% when taking levonorgestrel. The effectiveness of this method of emergency contraception is 98.8%. The advantages of this method include the fact that it can be used for a longer period compared to other means of emergency contraception, as well as the fact that after its administration there are practically no hormonally dependent side effects.

4) Intrauterine devices
Another way to prevent an unplanned pregnancy is to use an intrauterine device (IUD). To achieve the desired effect, copper-containing IUDs are inserted within five days after unprotected intercourse.

Emergency contraception is an alternative to abortion, but it is strongly discouraged from being used as permanent contraception, but only in "emergency" situations (maximum once every six months). Since the frequent use of emergency contraceptive methods can lead to a violation reproductive functions women.

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 take major decisions- give birth or make an artificial termination of pregnancy, 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.

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:

1. . 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.

1. 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.

1. Cervical caps. This is a cap made of soft rubber that is put directly on the cervix - a 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 prolonged bleeding from the vagina, there are intense pains in the lower abdomen, weakness and pallor of the skin appear, you should immediately apply for 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 of the 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

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. The group of 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;
• the hormonal ring has a monthly life.

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 heart, 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 a medical indication for surgical contraception.

Now it is the most popular method of surgical contraception - the method has many advantages. For example, after such surgical intervention no scar remains on the skin, the rehabilitation period is very short, patients similar interference tolerate well. Note:laparoscopic tubal ligation cannot be ruled out outpatient settings- done to a woman local anesthesia, and 2 hours after the completion of the procedure and in the absence of any visible changes well-being in the worst side 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 off only after the surgeon has finished working 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 carried out during caesarean section- there are no additional loads on the body, the woman's well-being does not change, periods of lactation and recovery after childbirth pass without changes, the 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 rare, but a woman who agrees to surgical contraception should be aware of them. Note:doctors warn that in the first 10 years after the sterilization operation, the probability of pregnancy remains within 2%. Female contraception- rich selection 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.

Photo from wusf.usf.edu

At least 16.7 million unwanted pregnancies occur worldwide each year. 15 million of them (that is, almost 90%!) could be prevented if women used modern methods of contraception correctly. Surprisingly, inIn the 21st century, millions of people ignore them or misuse them. As shown recently, women are afraid of side effects, have different prejudices, or they simply do not have enough information. MedNews figured out how (and whether) the most popular methods of contraception work.

"Barrier" contraception

Barrier contraception is a male and female condom, a vaginal diaphragm and a uterine cap. All of these devices physically block the way for sperm to enter the uterus. The sperm cannot meet the egg and fertilization does not occur.

condoms

male condom known to all, but female much less popular. This is a small pouch, usually made of polyurethane, that is inserted into the vagina and held in place by elastic rings. The advantage of both types of condoms is that they not only prevent unwanted pregnancy, but also protect against sexually transmitted diseases.

The effectiveness of condoms is relatively high: according to WHO, with correct use male prevents unwanted pregnancy in 98% of cases, but female - only 90%. In addition, you need to take into account that the condom can break.

caps

Uterine cap and vaginal diaphragm are latex caps different shapes that are placed on the cervix. They will no longer protect partners from gonorrhea or syphilis, but they do not allow sperm into the uterus. Their main disadvantages are the complexity of use (not every woman will be able to put on the cap on her own) and allergies, which can occur due to the tight and prolonged contact of the mucosa with latex.

"Natural" contraception

"Natural" refers to methods of protection that do not require mechanical or medical intervention.

Coitus interruptus

One of the most popular and at the same time the least reliable "natural" methods. When used, the partner removes the penis from the woman's vagina moments before ejaculation. The unreliability of this method is determined by two factors. Firstly, a man may not have time to remove the penis in time (it all depends on his ability to self-control). Secondly, during frictions, a small amount of pre-seminal fluid is released, which may contain a certain amount of sperm - and disease-causing agents. The effectiveness of the method, according to WHO, ranges from 73 to 96%, depending on the correct use.

calendar method

Another popular and not always effective method. A woman keeps track of favorable and unfavorable days for conception of her menstrual cycle. Fertilization of the egg can occur only within 48 hours after ovulation, and the life expectancy of the sperm in the cervix is ​​up to a week, but often less. Therefore, a few days before ovulation are considered dangerous for conception (the sperm can remain in the woman's genitals and wait for the mature egg) and a couple of days after ovulation. Adepts calendar method argue that it is during this period that a woman should refrain from sexual intercourse if she does not want to become pregnant. The disadvantage of the method is that it is not always possible to accurately calculate exactly when ovulation occurs, especially in women with irregular menstrual cycles.

temperature method

This method just allows you to specify the moment of ovulation. It is not for the lazy: every day, immediately after waking up, you need to measure the basal temperature (by inserting a thermometer into the anus). Before ovulation, the basal temperature drops slightly, and immediately after ovulation it rises by 0.3-0.5 degrees and stays at this level until the end of the cycle. By monitoring the temperature daily, you can determine quite accurately when ovulation occurs, and in accordance with this, refrain from sexual intercourse on fertile days.

cervical method

Another method to help determine the onset of ovulation is cervical method, or the Billings method. This Australian doctor noticed that shortly before ovulation, the mucus secreted from the vagina becomes more viscous. In this way, "dangerous" days can be tracked. True, due to fluctuations in hormones, mucus can become viscous even in the absence of ovulation, so the method is inaccurate.

Lactational amenorrhea method

The bottom line is simple: in the first months breastfeeding ovulation does not occur, so you can not use protection. But there is a condition: a woman must breastfeed her baby very actively (at least every three hours during the day and every six hours at night), otherwise the production of prolactin and oxytocin hormones decreases, and their “protective” effect disappears. However, frequent feeding is also not a 100% guarantee.

Spiral

The intrauterine device is a common and fairly simple method of contraception. This device, usually made of copper or silver with plastic, is placed in the uterus by a doctor for several years. Copper or silver has a detrimental effect on spermatozoa, and the spiral itself, if fertilization does occur, prevents the egg from attaching to the wall of the uterus (the embryo is thus unable to develop). The method is convenient in that it requires almost no effort on the part of the woman, but has its drawbacks - for example, it increases the risk of developing infections and inflammations.

Hormonal contraception

There are a huge variety of hormonal contraceptives, and they work in different ways. In general, they can be divided into two types: containing estrogen hormones (or rather, their analogues) and not containing them.

COCs

The most common method of hormonal contraception. When used correctly, it is considered one of the most reliable. Pills contain two types of hormones: estrogens and progestins. They suppress ovulation, and pregnancy becomes impossible.

It is a paradox, but it is with these means that the most fears are associated. Women are afraid of side effects, for example, blood clots: estrogens contribute to thrombosis and increase the risk of thrombosis. In fact, this danger is much higher, say, with smoking or even pregnancy. So if a woman does not have serious contraindications (a history of thrombosis and among family members, severely elevated blood pressure, etc.), the use of COCs is considered safe. However, women are much more afraid of thrombosis excess weight: the belief that you can get better from pills is one of the most persistent. In fact, this has not been the case for a long time: modern oral contraceptives contain minimal doses of hormones, which, although they can slightly exacerbate the feeling of hunger (and even then not for everyone), do not in themselves increase weight gain.

vaginal ring

This is another method of hormonal contraception using estrogens. It is similar in composition and principle of action to COCs, but radically differs in the method of application. A flexible ring is inserted directly into the vagina, where it releases hormones in the right doses that help suppress ovulation. The advantage over COCs is that the ring has almost no effect on the liver, the disadvantages are the relative inconvenience of use: it can fall out of the vagina or interfere with the woman.

Hormonal patch

The hormonal patch also contains estrogens, but is glued to the skin and delivers hormones to the body through the blood.

mini pili

Another group of hormonal contraceptives, they do not contain estrogens, only progestogens. Because of this, they do not have estrogen-related side effects and are considered safer, although less effective. This group includes the so-called mini-pills: these are tablets containing the minimum dose of the hormone.

The principle of their action differs from estrogen-containing contraceptives: they do not prevent ovulation, but cause thickening cervical mucus(mucus in the cervix), which prevents sperm from entering the uterus itself. In addition, progestogens do not allow the inner lining of the uterus, or the endometrium, to swell (without the use of hormones, this naturally occurs in the second half of the menstrual cycle). Because of this, the embryo cannot attach to the wall of the uterus and continue its development.

Subdermal implants

Particularly desperate women may decide to sew a contraceptive hormonal implant under their skin, which also does not contain estrogen. It is installed for several years and dosed releases the required amount of the hormone progestogen into the body. Like mini-pills, the implant increases the viscosity of the cervical mucus and does not allow the endometrium to swell.

Hormonal intrauterine device

Her principle of operation is mixed. It immobilizes spermatozoa and mechanically prevents the embryo from attaching to the wall of the uterus, like a conventional spiral. In addition, just like implants, she secretes daily minimal amount the hormone progestogen, which prevents the growth of the endometrium and thus prevents the embryo from gaining a foothold.

Chemical contraception

Vaginal suppositories, creams, foams, sponges and tablets that have a spermicidal effect, that is, destroy spermatozoa. Usually, all these funds should be used 10-15 minutes before sexual intercourse. Their advantage is that they also protect against sexually transmitted diseases - but not from all and not completely. The disadvantage is much lower efficiency than other methods. Therefore, they are recommended to be used in combination with other means.

Emergency (aka "morning") contraception

If unprotected intercourse has already occurred, but the woman is not planning a child, then not everything is lost: for some time, conception can still be prevented. There are a variety of methods for this - from folk to hormonal.

Folk methods

A slice of lemon, an aspirin tablet, laundry soap and a solution of potassium permanganate - this is far from full list funds that ethnoscience ready to offer careless lovers. It is implied that lemon acid, Components laundry soap, potassium permanganate and acetylsalicylic acid(aspirin) acidify the environment, and this kills spermatozoa.

Doctors apply folk remedies strongly discouraged for two reasons. The first is their low efficiency: spermatozoa can penetrate the cervical canal within a few seconds after ejaculation, and before that it is hardly possible to introduce a lemon into the vagina. And the second is side effects: aggressive acid or improperly diluted potassium permanganate can “burn out” the mucous membrane and disrupt the vaginal microflora.

Hormonal pills

There are more reliable way postcoital (that is, used after sexual intercourse) contraception. Especially for this case, hormonal pills have been developed. At the core different drugs lie different substances, but their mechanism of action is similar: they suppress ovulation, and if conception has already occurred, they prevent the fertilized egg from attaching to the wall of the uterus. Tablets usually need to be taken in the first few days after unprotected intercourse (the sooner the better), but with each day of delay, their effectiveness will decrease.

It is widely believed that the use of such drugs is extremely harmful, but WHO has repeatedly emphasized that they are safe. This, of course, does not mean that such remedies should be used regularly: they are simply not designed for this.

Emergency coil installation

The same copper or silver coil, which has already been mentioned above, can also be installed urgently - within five days after unprotected intercourse. The principle of its operation is the same: copper or silver has a detrimental effect on spermatozoa and the egg, and the spiral itself prevents the embryo from attaching to the wall of the uterus. After emergency insertion, the coil can be left as a permanent contraceptive.

Karina Nazaretyan

Modern means of contraception: barrier, chemical, biological, hormonal, intrauterine contraception, surgical - there are a lot of them, but often a woman cannot decide what to choose. And in the end, unexpectedly, she becomes pregnant. We will briefly describe the different contraceptives for women, their advantages and disadvantages.

Intrauterine systems

These are those that are installed in the uterine cavity for a long time. Usually recommended exclusively for women who have given birth due to possible side effects. But we'll start with the benefits.

1. You can not worry about unwanted pregnancy for several years, it has a positive effect on sexual relations.

2. High reliability. Slightly less than 100%.

3. Availability. The most inexpensive intrauterine device costs about 200-300 rubles. Purchased once.

And these are shortcomings.

1. Unpleasant sensations when installing. Some women require local anesthesia.

2. The possibility of falling out and displacement of the spiral, which provokes a decrease or termination of its contraceptive action.

3. Inflammatory diseases. The installation of the system can provoke the penetration of pathogens into the uterine cavity, which sometimes causes endometritis, the occurrence of adhesions in the intestines, fallopian tubes. Accordingly, the risk of infertility in the future increases. Therefore, spirals are usually recommended for women who have given birth.

4. Probability of occurrence ectopic pregnancy. A fertilized egg cannot be fixed in the uterine cavity due to the spiral and can return back to the fallopian tube and implant there.

5. Increasing Probability heavy menstruation. Therefore, non-hormonal intrauterine systems it is not advised to put women who have severe cyclic and acyclic uterine bleeding.

condoms

Barrier contraceptives have a number of advantages and can be used without consulting a doctor. Always welcome.

1. Reliability. Almost 100% protection not only from unwanted pregnancy, but also from sexually transmitted infections.

2. Ease of use and availability. Can be purchased at any pharmacy, supermarket. The abundance of models allows any couple to choose the right contraceptive for themselves.

3. Absence of contraindications. Only sometimes they appear allergic reactions. More often than not, it's the lubricant, dye, or flavor that's coated on the condom. In this case, you need to try another, ordinary, without "bells and whistles".

But there are downsides too. They are usually especially frightening for couples who have previously used other types of contraception.

1. Negative influence erection, sensitivity. Usually in this case, a condom with ultra-thin walls helps.

2. Falling off the condom during intercourse. Again, due to poor erection. It happens when a condom is put on with insufficient sexual arousal.

3. Damage to the condom. Often happens if you try to apply on it various substances in the form of a lubricant that is not intended for this. But damage can also be the result of a defective product. If the condom breaks, emergency contraception is used to prevent pregnancy.

Incidentally, as emergency contraception you can use an intrauterine device. It should be installed a maximum of 5 days after unprotected intercourse. Naturally, this method is suitable for those women who already thought about installing an intrauterine system.

Spermicides

They have no contraindications and can be used, if necessary, by women who are breastfeeding. chemical method contraception also has pros and cons.

Some benefits.

1. Availability. ten vaginal tablets(or candles), for 10 sexual acts, cost about 300 rubles. Sold in all pharmacies.

2. They do not affect the body, like hormonal contraceptives, that is, they have only a local effect.

3. Have some antimicrobial and antibacterial action.

4. Have no contraindications and can be used in cases where no other contraception is suitable.

And these are the cons.

1. Often cause irritation of the vaginal mucosa and glans penis.

2. With regular use, 2-3 times a week or more, the vaginal microflora is disturbed.

3. Efficiency is significantly lower than stated if sexual intercourse is started earlier than the time specified in the instructions. After the introduction of the drug into the vagina, you need to wait a bit for it to start working.

Hormonal remedies

They are considered one of the most reliable and convenient, but at the same time having many contraindications and side effects. We will talk about oral contraceptives. First about the good.

1. When correct reception birth control pills are almost 100% effective.

2. Make the menstrual cycle regular.

3. It is possible sometimes to postpone menstruation, to delay its onset, if necessary. To do this, a break that is taken in taking pills for 7 days every month is transferred.

4. Have a positive effect on the endometrium. Also, hormonal contraception is the prevention of the formation of certain types of ovarian cysts.

5. Can be taken indefinitely, with interruptions only for pregnancy. Reception ends with the onset of menopause.

And cons.

1. Sometimes they provoke the development of varicose veins.

2. Should be taken without gaps, and preferably at the same time, so that the effectiveness does not decrease.

3. In parallel with oral contraceptives, you can not take some medicines, for example, antibiotics, as protection against pregnancy is reduced because of this.

4. Diarrhea and diarrhea are also undesirable effects, especially in the first three hours of taking the pill.

5. Sometimes taking hormonal contraception provokes weight gain.

6. Spotting discharge outside of menstruation. A common side effect in the first three cycles of taking the drug. If they persist longer, you need to think about taking a drug with a higher dosage of the hormone estrogen.

7. Decreased libido, vaginal dryness. We'll fix it. A longer prelude and the use of water-based lubricants will solve this problem. In some cases, women switch to triphasic drugs or no estrogen at all. It can also help in the return of sexual desire.

And that's not all. Full list side effects can be found in the instructions for the drug. But, of course, it is not at all a fact that any of them will affect you or be pronounced.

Ineffective and unreliable methods of contraception

Sex to conceive children is a much rarer thing than intercourse for pleasure. That is why not every sexual intercourse should end in pregnancy. It has always been so, but modern contraceptives have appeared relatively recently. That is why in ancient times people tried with all their might to come up with at least some reliable way to deal with unwanted conception.

Undoubtedly, some folk contraceptives worked, but most of them were real obscurantism. Unfortunately, despite modern development contraception, some people still try to use the old methods. And this is bad, because an unplanned pregnancy is a big stress for both partners, and let alone the dangers of abortion for women's health and there is nothing to say. reliable contraception we discussed, and now let's talk about the most stupid methods of folk contraception, in order to completely get rid of stupid delusions and not use them as a means of contraception after childbirth and in other situations.

1. Sex while standing. There is a myth that standing sex does not allow the male seed to reach the egg, as it simply spills out of the vagina. In fact, this is not at all the case. Spermatozoa are quite able to achieve their goal. Thus, trying to protect yourself from an unplanned pregnancy due to a standing position, and any other one too, is impossible.

2. Coitus interruptus. The most popular method of folk contraception is interrupted intercourse. However, popularity is not the key to success. The fact is that during arousal, a certain amount of lubricant containing sperm can be released from the male genital organ. Therefore, conception can occur even at the very beginning of intercourse.

3. Lemon. There is such a very unusual recipe chemical contraceptive. A slice of lemon is inserted into the vagina and remains there until the very end of sexual intercourse. It is believed that lemon juice will easily kill all spermatozoa and conception will not occur. There is still some truth in this myth: citric acid can destroy spermatozoa. But first, not all. And secondly, the impact lemon juice can cause severe burns of the vaginal mucosa, head of the penis, etc.

4. Free week or calendar method of contraception. It is believed that after menstruation, a girl has from three days to a week during which she can make love without fear of pregnancy. Purely theoretically, the way it is, because ovulation usually occurs no earlier than the 12th day of the cycle. In practice, things are not so clear cut. Indeed, in so many women, the menstrual cycle does not follow a clear schedule, and in such cases, this method of contraception is completely pointless.

Sexual intercourse during menstruation is more reliable in this regard, but only if the woman's bleeding is not prolonged. After all, it happens that menstruation continues for 7-8 days. Well, spermatozoa can safely be in active state in the female genital tract for 3 days. That is, if ovulation occurs on day 11, then the egg may well meet a sperm cell on its way.

But after ovulation, already after 3 days (the egg lives a maximum of 2 days), really “barren days” begin, this convenient period lasts until menstruation, on average 7-10 days. That's just not every woman can accurately determine the day of ovulation.

5. Urination after intercourse. This method is suitable more for men, moreover, in order to "expel" the infection from urethra, which he could receive as a result of sexual intercourse. How is the female urethra connected to the vagina? Science does not know this. The method is absolutely hopeless.

6. Vaginal douching. Often, women choose antiseptics for these purposes, such as chlorhexidine or miramistin. But it's useless. These substances can only protect against infections, and even then not always. Well, they are not terrible for spermatozoa. Within 1-2 minutes after sexual intercourse, many hustlers will enter cervical canal. And you can't get them from there.
Well, the most unpleasant thing is that douching violates the microflora of the vagina and leads to the reproduction of pathogenic and conditionally pathogenic microorganisms i.e. inflammation.

Nevertheless, many women continue to argue that medically approved methods of protection against unwanted pregnancy are by no means 100% effective. There remains only surgical contraception - tubal ligation, which can be done in some cases. However, doctors consider this approach to be wrong, folk contraception in any case, it loses to the officially recognized one in terms of effectiveness. And yet - often seriously injurious to health. Is it worth the risk?

They are divided into several groups:
1. Abstinence from sexual intercourse. This method of contraception is 100% effective;
2. A group of methods based on physiological patterns and not very reliable. These methods do not affect the body in any way, have no side effects and contraindications, and therefore can be used by all people without exception. To such physiological methods pregnancy warnings include calendar, rhythmic, temperature methods, lactational amenorrhea and coitus interruptus;
3. A group of methods based on the application of a physical barrier to the penetration of spermatozoa into the uterine cavity. These methods have a fairly high efficiency and prevent infection with sexually transmitted diseases. This group of methods includes the use of condoms, vaginal diaphragms and caps;
4. A group of methods based on the use of chemical barriers for the penetration of spermatozoa into the uterine cavity. These methods are highly efficient and do not systemic action on the human body. Currently, this group of methods includes spermicidal suppositories, gels, lubricants, sprays, tablets, etc.;
5. Hormonal contraception with high efficiency;
6. Other methods of contraception with high level efficiency, such as an intrauterine device or sterilization.

According to the mechanism and type of action, all methods of contraception are divided into the following varieties:

• Hormonal methods;
• Intrauterine;
• barrier;
• Surgical;
• Postcoital;
• Biological.

Hormonal methods of contraception

Oral contraceptives There are combined estrogen-gestagenic and purely progestogen. Combined drugs contain two types of female sex hormones - estrogen and gestagen. And gestagenic, respectively, contain only one hormone from the progesterone group. Gestagen contraceptives are also called mini-pills. Currently, oral contraceptives are the most common among other hormonal methods of preventing pregnancy.

Oral contraceptives for each woman must be selected individually, taking into account the existing diseases, type of menstrual cycle, hormonal levels, etc. Hormonal pills do not allow the development of ovulation, and also change the state of the endometrium, preventing the fertilized egg from implanting in the uterus. Thanks to this action, hormonal pills reliably protect against unwanted pregnancy. Oral contraceptives also reduce the duration and volume of blood lost during menstruation, eliminate pain syndrome and minimizes the risk of developing inflammatory pathologies.

modern oral contraceptive drug Delsia contains the most studied combination of active ingredients, ethinyl estradiol and drospirenone. This combination restores hormonal balance, contributes to the normalization of the cycle, maintaining a stable body weight, eliminating oily skin and hair, reducing anxiety and improving mood. The optimal mode of administration is one tablet for 21 days with a physiological break of 7 days.

Oral contraceptives have advantages and disadvantages over other methods. Yes, to undeniable advantages high efficiency, ease of use and positive action on the female reproductive system. Disadvantages include side effects such as headache, nausea, irritability, mood swings, etc. In addition, combined contraceptives should not be taken by women suffering from vascular diseases (thrombophlebitis, hypertension, strokes in the past, etc.), liver, obesity, malignant tumors and bleeding. Combined contraceptives should not be taken by women over 35 who smoke. Unlike combined contraceptives, progestogen mini-pills are suitable for women over 35 years of age. Mini-pills can be used during breastfeeding.

Transdermal contraceptives are a patch containing hormones that are gradually released and enter the bloodstream. Such prolonged action with gradual release of hormones is also characteristic of vaginal rings.

Injectable contraceptives are injections containing synthetic hormones that provide protection against pregnancy for a long period of up to several months.

Implantable contraceptives are implants containing synthetic hormones that are inserted under the skin, providing a gradual release active ingredient and long-term action.

intrauterine contraception

barrier methods of contraception

Surgical method of contraception

Postcoital contraception

Postcoital contraceptives include Escapel, Postinor, Danazol or Mifepristone. The use of any drug for emergency contraception will seriously unbalance functional state reproductive system of a woman. The disruption can be so severe that it can lead to ovarian dysfunction.

Biological methods of contraception

When using the calendar method, women calculate dangerous days along the length of your own menstrual cycle. And the application of the temperature method requires daily measurement of basal temperature (in the rectum). When the temperature rises by 0.4 - 0.5 degrees, it means that ovulation has occurred. 4 - 5 days before its onset - these are the days on which pregnancy occurs with the maximum probability. Required within a few menstrual cycles measure the temperature and calculate, based on the schedule, dangerous days on which you cannot have sexual intercourse, since the likelihood of pregnancy is maximum.

Coitus interruptus is not a very reliable method of contraception, since it is based on the fact that a man, when approaching orgasm, must remove the penis from the vagina in order to prevent sperm from entering the woman's genital tract. This method requires intense attention from the man. Often men do not have time to pull out the penis, and ejaculation is carried out in the vagina. In addition, during sexual intercourse, small drops of sperm are released, which are quite enough for pregnancy to occur.