Chemical methods of contraceptives. Chemical methods of contraception: action, types, efficiency. Folk remedies for contraception. Recipes

Think and care about protection from unwanted pregnancy during sexual intercourse, not only a man, but also a woman should. 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 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 even put intrauterine device A woman can't do it on her own. Gynecologists establish only two types of contraception in question:

• copper-containing;
• progestin-containing.

Intrauterine devices are 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;
• violations menstrual cycle- 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 seek medical help. 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;
• hormone ring It has month operation.

Before starting 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 is 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:

• sharp inflammatory diseases 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 on the skin there is no scar, the rehabilitation period is very short, the patients tolerate such an intervention well. Note:laparoscopic dressing cannot be ruled out fallopian tubes in 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 in 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 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%. Women's contraception - a rich choice, ample 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.

Spermicides - chemical substances that cause immobilization of spermatozoa, destruction of the membrane (shell) of spermatozoa, thickening of cervical mucus, a decrease in their mobility and ability to fertilize an egg, since they contain surfactants (nonoxynol) and inhibitors of active enzymes. Spermicides prevent the development of STDs. As the main active ingredients in modern production spermicides are used: benzonium chloride, octoxynol, menfegol. At the same time, there are contraceptives, the active component of which is nonoxynol and other drugs. Nonoxynol is able to kill gonococci, a virus herpes simplex, Trichomonas and there is evidence that can prevent infection with HIV. In previous years, there were reports of the possibility of damage to the epithelium of the vagina and rectum with prolonged and frequent use nonoxynol, in connection with which it is not recommended to use it for the prevention of STDs.

Time of contraceptive protection modern spermicides and their effectiveness lasts from 15 minutes to 1-8 hours from the start of use and depends on the form of release (tablets, cream, foam, etc.). Within 2 hours before and after sexual intercourse, an intimate toilet must be carried out without the use of ordinary soap(because of the risk of destruction active substance).

When using creams and gels, both their independent use and in combination with the vaginal diaphragm or cervical cap. In this case, the efficiency of use increases significantly. Spermicides are also used with condoms, which provides a greater contraceptive effect and protection against STDs.

Forms of release of spermicides: aerosols (foam), pastes, gels, creams, vaginal foam tablets, vaginal foam suppositories, soluble suppositories, soluble films, sponges.

Benefits of using CMC:

• prevention of STDs and lack of systemic exposure;
• the possibility of use in women of reproductive and premenopausal age;
• use for a long time;
• possibility of combination with other methods of contraception.

Disadvantages of using CMC:

• the need to adhere to a 15-minute interval before intercourse for the introduction of spermicide;
• postponement of hygiene procedures (not earlier than 6 hours after intercourse).

When using spermicides, side effects may occur in the form of irritation of the mucous membranes and allergic reactions for spermicide. The use of spermicides in the form of vaginal tablets and vaginal suppositories(benzalkonium chloride) is administered no later than 10 minutes before sexual intercourse for uniform distribution of the drug, and the duration of their action is 3-4 hours. Candles containing chinosol, tannin and boric acid, act within 1-2 hours, from the moment the candle is inserted, it is not recommended to get up or sit down. The drug should not be used if one of the partners is HIV-infected, since there is no data on its antiviral effect.

The vaginal cream is administered before sexual intercourse in the supine position with the help of a dispenser applicator, the effect of the drug lasts 10 hours. It is both a spermicide and an antiseptic, does not affect normal microflora vagina and hormonal cycle. All irrigation of the vagina or washing with soap and water is contraindicated, since soap destroys the active substance of the drug. When using creams, the external toilet of the genitals is possible only with clean water. Mandatory Introduction new pill, suppositories or portions of cream in case of repeated sexual intercourse. Women who use BMC should not leave them in the vagina for more than 24 hours. It is not allowed to use BMK during menstruation.

Features of the choice of spermicides:

• foamy vaginal tablets, capsules and suppositories are convenient to store and transport, but require a 15-minute wait after administration before sexual intercourse;
• spermicidal gels are usually only used in combination with a vaginal diaphragm;
• aerosols (foams) are effective immediately after administration; they are recommended if the spermicide is used in isolation (without another method of contraception).

Indications for the use of spermicides:

• unwillingness or contraindications for the use of hormonal methods (for example, women who smoke, over 35 years old);
• unwillingness or contraindications for the use of IUDs;
• breastfeeding with the need to use additional contraceptive methods;
  a woman's desire to be protected from STDs against the background of a partner's reluctance to use a condom;
• the need to use a temporary method for the period of selection of another contraceptive;
• the need for an additional contraceptive method;
• low frequency of sexual intercourse.

Contraindications for the use of spermicides:

• the woman's age, number of births, or health problems that make pregnancy extremely risky (should help choose a high effective method);
• difficulties in application;
• allergy to spermicides;
• genital anomalies;
• a woman's desire to use a highly effective method of contraception;
• the reluctance of the couple to use the method according to the instructions during each sexual intercourse.

Contraceptive effect: 82% with proper and regular use.

Literature: Modern methods of pregnancy planning / G.I. Reznichenko, A.B. Gordeychuk, N.Yu., Reznichenko. - Kyiv: RVH Ferz, 2012.

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 are combined estrogen-progestin and pure progestogen. Combined preparations contain two types of female sex hormones - estrogen and progestogen. 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 ways pregnancy prevention.

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 and minimize the risk of developing inflammatory pathologies.

The 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 refer 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- These are injections containing synthetic hormones that provide protection from pregnancy for a long time up to several months.

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

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 women. 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 maximum probability pregnancy occurs. It is necessary to measure the temperature for several menstrual cycles 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.

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 them correctly modern methods contraception. 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 feminine 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, 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. Adherents of the 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 (inserting the thermometer into 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 that helps determine the onset of ovulation is the 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, a greatly increased blood pressure etc.), the use of COCs is considered safe. However, women are much more afraid of being overweight than thrombosis: 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 into the body required amount progestogen hormone. 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, it releases a minimal amount of the hormone progestogen daily, which prevents the growth of the endometrium and thus prevents the embryo from being fixed.

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 categorically do not recommend using folk remedies 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

For every family, the appearance of a child is happiness, but not everyone can give him good conditions and proper education. To avoid unwanted pregnancy, there are means, methods and methods of contraception that enable a woman and a man to maintain a safe sex life, these are oral and hormonal contraceptives. The following describes the types of contraception and their percentage of safety.

What is contraception

This is to prevent unwanted pregnancy. Means are divided into mechanical, chemical and other preparations for safe sexual intercourse. Modern contraceptives divided into women's and men's. Using this technique, not only prevent pregnancy, but protect against:

• different sexually transmitted diseases(syphilis, herpes, chlamydia or gonorrhea);
• human immunodeficiency virus.

Contraceptives for women

There are many options for contraception for women. safe sex, they all have different index Pearl. it special study, which determines annually what percentage of women who used one or another method of protection became pregnant. Means of protection (contraceptives) are divided into:

• physiological;
• barrier;
• spermicidal;
• hormonal;
• non-hormonal;
• means of emergency protection;
• folk methods.

Male contraceptives

For men, there is no such range of contraceptives, but scientists are actively developing methods of contraception for the male. Basically, a man can use a condom or sterilization - these methods are not always comfortable, so there are little-known protection options: these are subcutaneous implants, birth control pills for men and men's spiral. In order to use one of these methods of contraception, a man needs to discuss them with his doctor.

Modern means of contraception

If a earlier people simply abstained from sex to avoid the birth of a child, then today there are many ways to protect against various diseases or pregnancy. For example, modern oral contraceptives for women have become popular now. They are convenient, and if the couple decides to have a baby, the pills can be stopped, and the pregnancy rate increases.

Why do we need

Such funds are needed in order to avoid abortion (termination of pregnancy for early dates), which can lead to problems and diseases of the reproductive system, infertility and other complications. funds help to avoid early pregnancy: at this age, a girl can not always bear a child. Contraceptive methods can be used by women over 40 years of age. Pregnancy at this age can cause the birth of a child with chromosomal abnormalities.

Percentage of contraceptive effectiveness

In total, there are 3 groups of contraceptives: barrier, chemical, mechanical. A wide range of contraceptives allows women and men to choose the methods of protection that are convenient for them. For selection the best option contraception, it is recommended to contact the attending gynecologist. Next, we consider the groups and types of contraceptives, determine their effectiveness, advantages and disadvantages.

barrier methods of contraception

The most common and simple methods of contraception today are barrier contraceptives. These include:

• male condoms;
• female condoms;
• vaginal diaphragms.

The mechanism of action of this group is that the products block the penetration of spermatozoa into the cervical mucus. The male condom comes in the form of a thin, oblong latex sheath. The product for women is a tube made of polyurethane (dimensions: diameter - 8 cm; length - 15 cm). Vaginal diaphragms or cervical caps are available in latex or silicone. Pearl index (efficiency):

• male / female contraceptives - from 7 to 14%;
• cervical caps - 5%;
• vaginal diaphragms - from 6 to 20%.

The principle of operation of the male condom: put on the penis during an erection. Its advantages: protects the mucous membranes of partners during direct contact; prevents the occurrence of infections, hepatitis, HIV, pregnancy; It has different sizes and surfaces. Cons: may break; requires a stable erection. The principle of operation of the female condom: inserted into the vagina. Pros: a contraceptive is used with a weak erection; can be left in the vagina for several hours. Cons: these funds are not sold in the CIS countries.

Vaginal diaphragms and cervical caps: placed in the vagina with special spermicidal creams. Pros:

• reduce the risk of transmission of infections;
• can be used repeatedly;
• prevent pregnancy.

Cons of cervical caps: You can get HIV; not always effective for women giving birth; can cause discomfort during sex; sizes with recommendations can be obtained from a gynecologist. Cons of the diaphragm: after childbirth, you need to select a different size, as when changing the weight of a woman from 5 kg; the risk of inflammation of the cervix increases; infection is possible.

Chemical methods of protection

In addition to barrier, popular chemical contraceptives. It: vaginal creams, suppositories (candles), tampons. Means have contraceptive properties, protect against viruses, bacteria (staphylococcus, herpes, chlamydia, candidiasis). Candles, vaginal tablets and films are inserted into the girl's vagina 25 minutes before sex: during this time they have time to dissolve. Popular means are Patentex Oval and Pharmatex. Pearl Index chemical methods protection - from 6 to 20%. Means are used 15 minutes before sex. Foam, gel and cream start working after use.

Spermicides (contraceptives) have the following advantages: increase protection against herpes, chlamydia and other sexually transmitted diseases; have a bactericidal effect. Cons: increase the permeability of the walls of the vagina (there is a possibility of HIV infection); breaks down on contact with soap active action; short action (except for tampons); needs to be replaced at the next intercourse.

There are the following hormonal contraceptives: combined oral contraceptives, injections, mini-pills, emergency contraceptives. They help protect against unwanted pregnancy by "replacing" the work of the ovaries. According to the principle of action, there are multi-phase, two-phase or three-phase, according to the form of release - tablets, implants, injectables. Efficiency:

• combined contraceptives (oral) - from 0.15 to 5%;
• mini-pill - from 0.6 to 4%;
• injections - from 0.3 to 1.4%;
• implants - up to 1.5%.

Combined oral contraceptives are used daily for 21 days, at the same time, starting from the first day of menstruation. Mini-pills are used immediately before sexual intercourse for half an hour. Injections are administered 2-3 times a month. Benefits: improves the condition of the skin of the face; the menstrual cycle is normalized; reduces the risk of ovarian cancer; the breast increases, becomes elastic; protect against unwanted pregnancy; application is possible in the absence of various diseases. Flaws:

• no protection against sexually transmitted diseases;
• with long-term use, the risk of developing candidiasis, heart attack, breast, liver and cervical cancer increases;
• there are many contraindications; during a break between doses, the risk of becoming pregnant increases;
• side effects may occur.

Mechanical contraception

most popular mechanical contraceptives are the vaginal ring (NovaRing), the contraceptive patch (Evra). Their main purpose is to prevent the conception of a child. The ring is made of elastic material, the patch is made of thin soft polyurethane. Efficiency:

• hormonal ring - from 0.4 to 0.65%,
• hormonal patch– from 0.4 to 0.9%.

The ring is inserted into the vagina, adjusting to the contours of the girl's body; the patch is glued to different parts of the body (under the shoulder blade, from the bottom of the abdomen, on the buttock or on the forearm). Benefits: does not reduce the sensitivity of partners during sex; does not prevent the girl from playing sports; does not affect blood clotting; calculated for 1 cycle (21 days). Cons: Does not protect against STDs and HIV.

The contraceptive patch has the following benefits: changes every week; can be glued to any part of the body, convenient for travel, natural conditions where it is not possible to use another method of contraception. Its disadvantages: contraindicated smoking girls(10 or more cigarettes per day); does not protect against STDs, effective for women from 18 to 45 years old.

Intrauterine contraceptives

The following are the most popular intrauterine contraceptives:

• Navy Mirena;
• hormonal IUD Levonova;
• hormonal Nova-T;
• CooperT 380A;
• MultiloadCu-375.

Mechanism of action: a fertilized egg does not attach to the wall of the uterus when using this type of contraceptive. The installation is carried out only by a gynecologist. Contraception for women of this type is installed in the uterine cavity. IUD or coil is considered a reliable method of protection, but there are possible complications and contraindications:

• inflammatory processes in the pelvic organs;
• latent chronic or acute infections;
• the presence of tumors of the organs of the reproductive system;
• cervical dysplasia;
• anemia;
• uterine bleeding;
• diseases of the endocrine glands.

Complications:

• increased risk of exacerbation inflammatory processes in the uterus and appendages;
• during menstruation, menstrual blood loss increases, and menstruation lasts longer than usual;
• increases the likelihood ectopic pregnancy;
• appear smeared vaginal discharge;
• perforation of the uterus.

Advantages: a spiral is installed for 5 years; it is possible to extract it if necessary; contraceptives are suitable for nursing mothers. Disadvantages: increased risk of infection and the development of inflammation and infections. All questions regarding the installation should be discussed with the doctor, such a decision is not made independently (depends on hormonal background and other points).

Natural methods of contraception

Natural biological methods of contraception are ways to prevent unplanned pregnancy. They are used only by those women who have a regular and stable menstrual cycle. Girls keep records of dangerous and safe days for unprotected intercourse. These methods are divided into calendar, temperature, cervical methods and coitus interruptus.

Calendar

The calendar method is the calculation of the day of ovulation. Suitable for girls and women with regular menstruation. Ovulation falls in the middle of the menstrual cycle, from this day the girl can calculate the period when she can become pregnant (2-4 days and 2-4 days after). Unfortunately, the method is not always effective, because ovulation can occur on other days of menstruation.

Temperature

The temperature method consists in plotting a graph of basal body temperature, that is, when a woman is at rest. It can be measured with a rectal thermometer. In the 1st phase of menstruation, the woman's temperature is slightly lower, and during ovulation it rises and remains so until the next one. By compiling this schedule, you can understand when ovulation occurs in order to avoid sex on these dangerous days.

cervical method

The essence of this method is that during the day the girl should observe the vaginal mucus after the end of menstruation. If the endometrium does not contain mucus, then you can continue to have sex without restrictions. It becomes viscous during the maturation of the egg. On days like this, it's best to use additional funds protection.

Coitus interruptus

Coitus interruptus is the cessation of sexual intercourse before ejaculation, outside the girl's vagina. it safe method contraception, because, for example, hormonal contraceptives can cause side effects. However, there is always a chance of getting pregnant: during sex, pre-seminal fluid is released (it contains up to 20 million spermatozoa).

Hormonal methods of contraception

There is a classification of hormonal methods of contraception: gestagenic and combined. The first group includes monophasic, multiphasic oral contraceptives, as well as injections, patches and a vaginal ring. Combined include implants, IUDs and vaginal rings with progestogen. Next, consider the means of contraception, and which of them belong to one of the two groups.

oral contraceptive pills

Gestagen oral contraceptive pills are divided into monophasic, biphasic and triphasic:

• Monophasic drugs include such drugs as: Gestodene, Desogestrel, Regividon, Microgynon, Minisiston.
• The biphasic ones are the following drugs: Femoston; Binovum, Neo-Eunomin, Adepal and Bifasil.
• Three-phase drugs include the following drugs: Trimersi, Triziston, Tri-Regol.

Vaginal rings and patches

The group belongs to the combined hormonal methods of contraception. On the this moment Evra is considered the most popular patch, and Nova-Ring is distinguished among the vaginal rings. Last resort is used frequently: there are few side effects, and the benefits are greater than in oral contraceptives. The Evra contraceptive patch is more convenient to use: you don’t need to insert anything into the vagina, which can damage its walls, you also don’t have to swallow, like pills, which can lead to problems with the liver.

mini pili

Small pills are a contraceptive for women and are recommended during lactation, when smoking in older women and in heart conditions. Mini-pills are gestagenic hormonal drugs contraception. This includes drugs such as: Charozetta, Continuin, Exluton, Primolut-Nor, Micronor, Ovret. For consultation on the choice, it is recommended to contact the attending gynecologist.

Hormonal injections

Injections or hormonal injections belong to the group combined drugs. The advantage of protection is that the woman does not need to take daily pills or insert new vaginal rings. For injections, drugs such as Net-en and Depo-Provera are used. The disadvantage of these contraceptives is that a condom must be used for the first 20 days.

Capsules for implantation

Special capsules for implantation belong to the group of progestogen hormonal contraceptives. These capsules are implanted under the skin. Such an implant is called Norplant. When using it, you can not use contraceptives for 3-5 years. The product can be used during lactation and various diseases, in which other hormonal contraceptives are strictly prohibited.

Postcoital contraception

emergency contraception used in case of unprotected intercourse. Such tablets can be used within 1-3 days from the end of sexual intercourse. They can help you avoid unwanted pregnancies. Contraceptives are used in cases:

• rape;
• incorrectly produced interrupted sexual intercourse;
• unprotected sex;
• if the condom breaks.

Sterilization

Complete sterilization is a method of contraception for both women and men. Male sterilization is a vasectomy, while female sterilization is a tubal occlusion. In the process surgical operation artificial obstruction of the fallopian tubes is created for a woman, and for men, the vas deferens are tied up, while the testicles and ovaries are not removed, no negative impact on the couple's sex life.

Methods of contraception after childbirth

Immediately after childbirth, it is recommended to abstain from sex for 1-2 months to avoid getting infection on the sutures of the vagina. Already after deadline will pass, it is recommended to go to the gynecologist and buy the contraceptives you need. Gynecologists recommend using as a means of contraception:

• intrauterine device;
• barrier, hormonal contraceptives;
• sterilization.

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