Contraception during a nursing mother. Suitable methods of contraception for a nursing mother. Injectable hormonal contraceptives

Many women who are breastfeeding their baby are interested in - how to protect yourself breastfeeding . After all, the onset of another pregnancy is not always desirable at a time when a recently born child is very small.

The peculiarity of contraception during lactation is that properly carried out breastfeeding is already a method that helps protect against unwanted pregnancy and bearing the name "method of lactational amenorrhea". Rest contraceptive methods(barrier, intrauterine, progestin, etc.) are used to enhance the contraceptive effect even when the method of lactational amenorrhea is no longer effective enough. This article will help you understand what is possible contraception while breastfeeding However, only the attending physician can choose the most appropriate method.

Lactational amenorrhea method (LAM)

Amenorrhea is the absence of menstruation, so the method of lactational amenorrhea is based on the fact that a nursing mother has no periods for some time after the birth of a child. This happens because the hormone prolactin, which is synthesized in the body of a nursing woman, suppresses ovulation. In order for the LAM to work properly, all of the following factors must be met:

1. The child who is on breastfeeding is not yet 6 months old.
2. The woman has not yet resumed menstruation after giving birth.
3. The baby is exclusively on breastfeeding without taking any other food or liquid, and:

• The first time the baby took the breast for an hour after birth.
• There is frequent attachment to the baby's breast during the day (about 10 times).
• Night feedings are a must.

The advantages of LAM are obvious: it is free, does not require medical intervention and has no side effects. The disadvantages include a short time of use (only the first six months after childbirth) and the lack of protection against STDs.

With properly established breastfeeding, without the use of nipples and bottles, such contraception during lactation 98% effective.

natural methods

Usage efficiency natural methods contraception (such as: the calendar method, the method of monitoring cervical mucus, the method of determining, the symptomatic method) during lactation is very small - only 50%. This is due to the changes taking place in the body of a woman who has recently given birth.

Barrier Methods

The use of barrier methods (condoms, caps, diaphragms) during lactation is acceptable, because this way protection does not affect breast milk and is safe for the baby.

Depending on the quality of the condom and the presence or absence of spermicidal preparations in it, the effectiveness of its use is 85-98%.

You can use a cervical cap or diaphragm after 6 weeks from the date of birth. Together with the doctor, you should choose right size cap or diaphragm, as the pre-delivery size may not be appropriate. Their first introduction should also be made by a doctor.

The efficiency of using the cap is 73-92%, and the diaphragm is 82-86%.

Intrauterine device (IUD)

Intrauterine devices (ring, coil, or T-shaped) do not interfere with lactation and can be used during breastfeeding. However, if the spiral was introduced immediately after the birth of the child, then there is high risk its loss, therefore it is recommended to use the IUD 1.5 months after childbirth.

Modern intrauterine hormonal systems (for example, the Mirena coil) contain a container with a synthetic hormone levonorgestrel, which is released in small doses and is an additional contraceptive protection.

The use of intrauterine devices is quite reliable breastfeeding protection, since the efficiency of this method reaches 99% when using hormonal spiral and 97-98% when using a conventional spiral.

Chemicals (spermicides)

During lactation, it is permissible to use various spermicides in the form of suppositories (candles), foam, jelly, creams, etc. The spermicide coats the cervix and vagina, and chemical substances the drug destroys spermatozoa. Moreover, such contraception while breastfeeding solves the problem of vaginal dryness, which often occurs in women after childbirth. Depending on the correct use of the method, the effectiveness of the method varies from 64 to 98%.

Hormonal contraceptives

Combined hormonal birth control pills for lactation cannot be used (regardless of whether they are monophasic, biphasic or triphasic), since they affect not only the amount of breast milk, but also its quality, which can unpredictably affect the health of the child.

During breastfeeding, you can use purely progestin tablets, the so-called "mini-pill", since they contain only microdoses of progestin. According to experts, these birth control pills while breastfeeding are quite safe and do not affect the milk and the baby. The efficiency of use is quite high - up to 99%, but only if the exact schedule for taking the pills is observed.

Postcoital (emergency) contraception. Postinor while breastfeeding

Emergency contraception is used in very rare cases after sexual intercourse, when normal contraceptive methods did not help (for example, the condom broke). The question is whether it is possible to use such hormonal pills, how Postinor while breastfeeding expert opinions differ. Some believe that it is definitely impossible, some that it is possible, but with caution. This is explained by the fact that the effect of the drug on lactation and the child is not well understood. If a woman nevertheless took an “emergency” pill, then you can feed the baby only after 36 hours. The effectiveness of postcoital contraception is about 97%.

Sterilization

Female (tubal occlusion) or male (vasectomy) sterilization is very radical ways contraception. This method, of course, is almost 100% effective, but it is absolutely irreversible, so its application is possible after long and careful consideration: the decision not to have more children should not be made under the influence of stress or any circumstances.

The list of contraceptives that can be used during lactation is quite large, so each couple can choose the best one for themselves. the best option. However, one should once again pay attention to the fact that combined hormonal contraceptives while breastfeeding cannot be used. When using combined oral contraceptives there is a risk various kinds unscheduled bleeding: from spotting blood to copious breakthrough bleeding when you can't wait to see a doctor. The hormones contained in contraceptives, of course, pass into breast milk, and, accordingly, into the body of the child. This can lead to a violation of the hormonal background of the baby and adversely affect his health: for example, there are cases when girls reached precocious puberty at the age of 5-7 years, instead of the usual 12-13 years.

The content of progestin in the "minimal pills" - from 300 to 500 micrograms. AT combined means contains synthetic substitutes for progesterone and estrogen, the dosages of which are higher. Progestin preparations are inferior in their effectiveness to combined ones, however, they also act on the woman's body much softer, which makes it possible to use them for those women who have contraindications to COCs.

When are progestin contraceptives the drug of choice?

• during lactation ( do not affect the quality and taste of milk).
• When smoking in older women ( nicotine in combination with COCs contributes to thrombosis due to a violation of blood clotting).
• With cardiac pathologies.

Names of drugs included in the group

• Charosetta,
• Ovret,
• Exluton,
• Primoliut-Nor,
• Micronor,
• Continuin.

Mechanism of action

In addition, the peristalsis of the fallopian tubes slows down ( The ovum travels through the tubes into the uterine cavity).

The effectiveness of progestin drugs - 95%; combined oral contraceptives - 99%.

Instructions for use

When breastfeeding in lactating women, ovulation is suppressed and physiological infertility develops - the so-called lactational amenorrhea. This is because when ovulation is suppressed, the egg does not mature and does not come out of the ovary. But even in this period, before the onset of menstruation, the follicle can mature and then ovulation will occur. In this case, pregnancy occurs without the start of the menstrual cycle after childbirth. That is why it is very important to use contraceptives during lactation.

Mini-drinks are allowed to be taken by lactating women. However, after the cessation of feeding and the appearance of menstruation, it is better to switch to combined oral contraceptives. However, if desired, a woman can continue to use progestin drugs if she is satisfied with the schedule for taking the pills.

For best choice contraceptives, you need a consultation with a gynecologist, who will prescribe a diagnosis and, in accordance with its results, recommend the most suitable for a woman a drug. Before prescribing progestin drugs, gynecological examination, swabs are taken from the cervix and vagina ( to exclude oncology and determine the microflora); ultrasound of the pelvic organs ( to absolutely exclude pregnancy and confirm the fact of lactational amenorrhea).

When should you start taking?

• On the first day of menstruation.
• Right after the abortion.
• Six weeks after giving birth.

Advantages

• Soft effect on the female body.
• Unlike the estrogen found in combination oral products, minipills do not reduce lactation or impair the taste of breast milk.
• Render quick effect- in 4 hours the contraceptive effect reaches a maximum.
• Do not cause headache or nausea even at the beginning of application.
• Reception is not directly related to sexual intercourse.
• No risk of thrombosis.
• Does not increase the pressure in those who suffer from hypertension.
• They do not affect emotionality, unlike COCs.
• Do not affect libido.
• Approved for use during preparation for surgical procedures ( COCs, on the contrary, are not recommended for use in such situations.).
• Reduce pain during menstruation.
• The ability to conceive is restored quickly - within a month after the abolition of the mini-pill.

Flaws

• The regularity of the use of tablets - this requires a high organization from a woman.
• Lower efficiency than COC.
• Small changes in a woman's weight ( plus or minus a few kilos).
• Lack of protection against genital infections.
• The contraceptive effect decreases with simultaneous reception Phenytoin and Phenobarbital ( anticonvulsants), Rifampicin ( anti-tuberculosis agent).

Side effects

• Short-term changes in the menstrual cycle: the appearance of unplanned bleeding, increased duration of bleeding or their absence. Cancellation of the drug is not required.
• Development of ovarian cysts after the abolition of the mini-pill, the cysts resolve spontaneously after 1-2 months).
• Exacerbation of thrush chronic course diseases.
• Nausea and weakness in diabetes mellitus are short-term effects that do not require discontinuation of the drug.
• Change in oily skin temporarily).
• Increasing sensitivity mammary glands (no cancellation required).
• Sensitivity to ultraviolet rays ( it is undesirable to sunbathe).
• Increased body hair growth rarely).
• Swelling of the legs.

Contraindications

• Bleeding from the genitals of unknown etiology.
• Severe lesions of the vessels of the heart and brain.
• malignant tumor breast.
• Tumor-like diseases of the liver, cirrhosis.
• Serious pathologies kidneys.
• Hepatitis in the active phase.
• Simultaneous use of anticonvulsants.

Who can use?

• Women of all ages: reproductive period and postmenopausal.
• Lactating women.
• Parents but not breastfeeding.
• Smokers.
• Women after an abortion.
• Women who have contraindications to taking combined oral contraceptives.

If a woman wants to switch from COCs to progestin drugs, then the mini-pill tablet can be taken immediately after taking the last COC tablet. Two weeks later, a full contraceptive effect occurs.

If a woman wants to switch to barrier methods of contraception, it is advisable to take another additional package of progestin preparation in combination with the barrier method to be sure.

What to do if you forget to take a pill?

When do you need an urgent consultation with a gynecologist?

• Profuse and prolonged bleeding.
• Delayed menstruation in the absence of pregnancy.
• Pain in the pelvic region it could be a sign of an ectopic pregnancy).

drug interaction

Storage method

Where to buy and what is the price?

Becoming a mother, a woman does not cease to be a wife. And for some time after giving birth, she begins to be interested in issues related to contraception. Is it possible to take birth control pills with HB? What drugs are there? Or when feeding is better to use barrier methods? Or maybe during lactation there is no need to protect yourself at all? In the article we will try to answer all these questions and even look at the situation a little wider.

Why is a second pregnancy in a row undesirable?

Some mothers who have given birth to their first child and have not encountered serious difficulties during pregnancy and childbirth do not pay special attention protection. Pregnancy will come - good. I still want another child. And so “I’ll shoot early” and I’ll be free.

Such an approach, of course, is possible, but a woman must understand that too little interval between births can have a bad effect on both the mother herself and both children: the eldest and the youngest. What problems can arise (of course, everything is individual, and such problems may not arise, but every woman needs to know about this)?

1. A woman fully recovers after pregnancy, childbirth and breastfeeding only after 2.5-3 years. Exhaustion of the body can lead to miscarriage or premature birth.

1. Having experienced serious stress during pregnancy and lactation, a woman is psychologically not ready for their repetition.

1. If a new pregnancy occurs earlier than 2 years after the previous birth, then the woman in the body often does not have time to restore iron reserves, especially if the child has been on breastfeeding for a long time. And with the second pregnancy comes Iron-deficiency anemia. This condition often leads to late toxicosis and premature birth. The baby may develop poorly in utero and be born with insufficient body weight. Serious problems can be expected even if not too heavy bleeding in childbirth.

1. Caring for two very young children is very difficult, especially if the mother has no one to help.

1. The older child is too soon deprived of the attention of the mother. Often you have to turn off the GW ahead of time. Strong stress for the baby, there may be a situation when the mother goes to the hospital. If the mother has to lie on conservation for a long time, then the child may receive psychological trauma which will influence him for the rest of his life.

1. Especially dangerous is the onset too early repeated pregnancy after caesarean section. A seam that has not yet fully formed can simply disperse.

Easier to carry medical abortion. But, firstly, it needs to be done on time, and a woman caring for a baby rarely listens to her own condition and may well miss early signs pregnancy. Secondly, mothers who have recently given birth to a baby are psychologically very difficult to endure even medical abortion for early dates. In addition, medical abortion usually means giving up breastfeeding.

So let's take it as an axiom that it is necessary for a nursing woman to protect herself.

When is the right time to start protecting yourself?

In the first weeks after childbirth, gynecologists usually do not recommend that women have sex, even if there were no incisions and tears during childbirth, and no stitches were applied. The reason for this is that during childbirth, almost everyone develops microcracks, into which infection easily enters, which can lead to serious inflammation. Inner surface The uterus is a continuous wound, which can also easily get an infection.

Before this, it is advisable to see a doctor to make sure that the recovery after childbirth went well. At the same time, you can discuss with your doctor what contraception for nursing is.

lactational amenorrhea

It is believed that pregnancy is impossible while breastfeeding. Is it so? Yes, not so. Indeed, the phenomenon of lactational amenorrhea exists. But, firstly, not everyone. And secondly, it is necessary that the mother feeds the child on demand, including at night, does not feed or supplement anything. And even in this case, it is not worth hoping that she will not ovulate even after 6 months after giving birth.

The fact is that ovulation occurs earlier than menstruation, therefore, when feeding, a woman can become pregnant, even if she has never had a period after giving birth. So it’s better not to rely on the lactational amenorrhea method, but to use other methods during the period of breastfeeding.

Hormonal contraceptives

One of the most reliable methods of contraception, the effectiveness of which is 98-99% depending on the drug, is hormonal. Previously, oral contraceptives were not considered suitable for nursing. But science has stepped forward a long time ago, and doctors may well recommend birth control pills for nursing mothers.

It is unacceptable to take pills containing both estrogen and progesterone.

Such drugs pass into milk. And they are absolutely useless to a child.

Besides, similar drugs reduce the secretion of breast milk. And this is another reason why combined ok when breastfeeding should not be taken.

Popular in recent times The NuvaRing vaginal ring also contains estrogen, so NovaRing should not be used during lactation.

When breastfeeding, you can drink the following OK:

• tablets containing only progesterone;
• mini-pills, progestogen-based pills.

These drugs do not affect the baby and do not reduce the amount of milk. But both tablets and mini-drinks must be taken daily at exactly the same time. A pill missed in the hassle can cause the baby to have a brother or sister.

What hormonal drugs can be an alternative to oral contraceptives:

• contraceptive injections;
• capsules injected under the skin.

Both injections and capsules contain the hormone progestogen. Their efficiency approaches 99%. They do not need to be taken every day like tablets every day. After all, injections are made once every 8-12 weeks, and the capsules are enough for as much as 5 years.

Cons of all hormonal contraceptives:

• the possibility of intermenstrual bleeding;
• too much heavy discharge during menstruation;
• do not protect against sexually transmitted infections;
• after discontinuation of the drug, conception is not possible immediately.

Intrauterine device

it good method for nursing mothers. It has high efficiency. An intrauterine device is installed for several years, does not affect the baby in any way, does not affect lactation. But it does not protect against infections and can lead to painful periods. Not applicable after caesarean section.

You can insert an intrauterine device as early as 6 weeks after birth. Until that time, there is usually no need for contraception. But if a woman starts intimate relationship earlier, then she should use barrier methods just in case.

barrier methods of contraception

Barrier methods of protection include the use of:

• condoms
• caps and diaphragms;
• spermicides.

All of these methods are easy to use and can be used during lactation. But they are less efficient than hormonal means. But condoms protect against various infections which is very important after childbirth.

To increase efficiency, you need to use high-quality condoms. Choose a new size of caps and diaphragms due to changes in the size of the cervix and vagina.

Spermicides: suppositories, creams, gels are best used in conjunction with other methods, since these agents are not very effective. The names of some drugs: "Pharmateks", "Zhinofilm", "Sterymin".

calendar method

Suitable only for women regular cycle. But since after childbirth it takes time to recover, the calendar method is not recommended during this period.

During breastfeeding, almost all protective equipment is acceptable for use. And birth control pills for nursing mothers are easy to pick up. Only combinations are prohibited. hormonal preparations. But still, it is desirable that a woman selects a method of contraception together with her gynecologist, since their experience allows us to determine best contraceptives for nursing mothers.

Birth control pills while breastfeeding are considered the most common method of contraception. They help prevent pregnancy. Furthermore, hormonal background is not broken, and the weight does not begin to increase. For this reason, even nursing mothers choose for themselves just such a protection option. So that it does not affect the health of the baby, you should carefully study the types of pills and the features of their intake.

And now let's dwell on this in more detail.

Types of birth control pills

Such drugs are divided into combined oral contraceptives (abbreviated as COCs) and mini-pills. COCs contain synthetic analogues of hormones, namely estrogen.

This type of drugs is mono- and three-phase. In the first case, the level of hormones in tablets is always the same, and in the second case, it gradually decreases during the intake.

The mini-pill contains a synthetic progestogen. Such contraceptives are intended for nursing mothers while breastfeeding.

There is another classification of hormonal contraceptives, which are also used during breastfeeding. According to it, tablets are divided into 4 groups depending on the amount of hormones:

• Microdosed. These include Mercilon, and. They are suitable for nulliparous young girls who are actively leading sexual life. Also, such drugs are prescribed to women who have not previously taken hormonal contraceptives.
• Low dose. This is Charosetta, and Sileste. The preparations are intended for giving birth and older women.
• Medium dosed. It's about about, Triquilar and Tri-regola. They are suitable for both women who have given birth and women of reproductive age.
• Highly dosed. This category includes Ovidon and Non-ovlon. Most often they are appointed in the presence of hormonal diseases. In some cases, these drugs can be taken by women who have given birth.

What contraceptives can breastfeeding mothers take?

Many mothers do not even know whether it is possible to drink and how to take birth control pills while feeding.

According to many foreign studies, mini-pills do not have negative impact on lactation and child health.

List of birth control pills for nursing mothers:

• Charosetta. These pills are suitable for women for whom their own safety and a small dose of hormones are very important. The drug is not prescribed for various diseases liver, uterine bleeding, the presence of tumors and intolerance to some components. The effectiveness of Charosetta is comparable to most COCs.
• exoluton. It contains linestrenol. With the help of the drug it is possible to establish menstrual cycle and avoid unwanted pregnancies. Contraindications include uterine bleeding and liver disease.
• Microlute. The main thing active substance is a gestagen. Its amount is minimal, so the drug is well tolerated. Contraindications are diseases of the biliary tract and liver, as well as uterine bleeding.

Mini-drank - perfect option for nursing mothers. These pills have virtually no side effects. Also, the drugs do not affect the production of milk. Moreover, they minimize the likelihood of thrombosis, do not affect libido and mood.

Mini-pills are the best option for breastfeeding moms!

Mini-pills are often prescribed for painful periods, and . When the remedy is canceled, the ability to conceive is restored in a short time.

Before you start taking it, you need to study the list of contraindications to the mini-pill. This includes various tumors, impaired functioning of the kidneys, uterine and vaginal bleeding of an unclear nature, epilepsy, exacerbation of hepatitis and damage to the vessels of the heart and brain.

Benefits of the mini-pill:

• rarely cause any unwanted effects upon admission,
• do not affect the quality and quantity of breast milk,
• do not reduce the duration of breastfeeding,
• their appointment is practiced in the treatment inflammatory diseases organs of the female small pelvis, as well as painful menstrual bleeding,
• they reduce the risk of thrombosis.

The effect of contraceptives on the baby

When choosing contraceptives, it must be remembered that the composition of tablets intended for nursing should not contain estrogen. This hormone negatively affects lactation, and also slows down the development of the child. COCs can be taken only after the final completion of breastfeeding.

Breastfeeding birth control should not contain estrogen!

Nursing mothers should choose only mini-pills. According to studies and observations, these drugs are absolutely safe. During their intake, the quality and quantity of milk remains the same, and the development of the child occurs without delay.

Rules and application features

Tablets, which are presented, should be taken no earlier than 6-7 weeks after childbirth. In this case hormonal changes organism will pass naturally. Tablets with gestagen can be used after a month.

The drug should be taken in certain time . It is best to do this in the evenings. In order not to forget about the tablet, you can install on mobile phone reminder. If the next appointment was later by 3 hours, the effectiveness of the contraceptive is reduced.

After 12 hours, the likelihood of pregnancy increases significantly. Today, progestin tablets have appeared on sale. When taking them, the “lateness” can be a maximum of 12 hours. This will not affect the effectiveness of the tool.

It must be remembered that oral contraceptives are not able to protect against vaginal infections. Also, birth control pills should not be used with antibiotics, which are usually prescribed after a caesarean section.

Other methods of protection

If for some reason a nursing mother cannot take oral contraceptives, then she should choose one of the following ways protection.

Contraceptive candles

Along with the advantages, there are also disadvantages of using a chemical method of contraception. Long-term use contraceptive suppositories can disrupt the microflora of the vagina, which will certainly cause discomfort.

Sexual intercourse is tied to a certain time when the candle will work, not all couples fit such a framework. The same applies to hygiene procedures: When using contraceptive suppositories, you must wait a certain time before you can go to the shower.

But, despite all the seemingly negative aspects of using this method of contraception, contraceptive candles during breastfeeding are very convenient and this makes them so popular.

Barrier Methods

The use of condoms and diaphragms is good because they do not affect lactation and the development of the baby. The size of the cap or diaphragm must be clarified, because due to childbirth, the vagina is stretched.

Barrier methods should be applied no earlier than 2 months after childbirth.

Intrauterine device

Doctors often recommend the IUD because of its effectiveness.

If the birth went without complications and the nursing mother has no contraindications, then the introduction of the spiral in the postpartum period is allowed.

If you install the IUD 6-8 weeks after birth, the risk of prolapse is significantly reduced.

If an infection is suspected, the introduction of a spiral is possible after the diagnosis is refuted or cured.

natural methods

This is about calendar method, measurement , and research cervical mucus. These methods can be used when the menstrual cycle is fully restored.

It is pointless to measure during breastfeeding, because in the morning it rises due to night feedings. In general, all the mentioned methods are considered ineffective.

Information about . Save your child from colic and allergies.

Find out how to treat a runny nose for a nursing mother. All about the treatment of colds while breastfeeding.

Male and female sterilization

This method is very effective, but irreversible. For this reason, it is worth carefully weighing the pros and cons.

Such decisions cannot be made under the influence of stress or certain circumstances. If there is any doubt, then it is worth refusing to sterilize.

Some couples choose to abstain while breastfeeding. In fact, this method is often difficult to bear, so abstinence should not be practiced for a long time.

Nursing mothers often opt for birth control pills. So that they do not affect the health of the baby, you must carefully choose the drug using an experienced doctor. You also need to follow the instructions, otherwise the oral contraceptive will be ineffective.

Modern medicine creates all the conditions for a woman during the decree to be not only a good mother to her baby. The desire to remain a wife and mistress to her spouse makes women look for reliable birth control pills while breastfeeding. What contraceptives can be used during this crucial period?

Contraceptive methods while breastfeeding

Trends modern society are such that most women give birth to one, maximum two children. At the same time, few young mothers decide to have a second baby in the first year after the last birth. The weather demands a lot of strength and resources from a woman, so many families put off planning another child for a while.

A month and a half after the birth of the first child, the question arises about reliable contraception. If the baby is on artificial feeding usually no questions arise. by the most effective tool Combined oral contraceptives are recognized for protection against unwanted pregnancy. These drugs contain estrogen and progesterone in their composition in the lowest possible doses. Daily intake of oral contraceptives reliably protects a woman from the birth of an unplanned child.

During lactation, the situation becomes somewhat more complicated. If a woman is breastfeeding her baby breast milk, she cannot take combined oral contraceptives. Estrogen, which is part of their composition, reduces the amount of milk. What about a nursing mother who does not want to refrain from intimacy with her beloved man? What are the methods of contraception for women during lactation?

All contraceptives approved for use in nursing mothers can be divided into the following groups:

• hormonal agents;
• intrauterine contraceptives;
• barrier methods;
• chemicals;
• natural methods of conception planning.

All these funds can be used during lactation 6 weeks after the birth of the baby. Let's take a closer look at each of the contraceptives.

Hormonal contraception

During lactation, to protect against unwanted pregnancy, you can use the following hormonal drugs:

• progestogen contraceptives (mini-drank);
• intrauterine device "Mirena";
• subcutaneous implants.

Contraindicated during breastfeeding:

• combined oral contraceptives;
• vaginal ring "NovaRing".

Gestagen contraceptives

Representatives of this group include Laktinet and Charozetta. These products contain only progesterone. Unlike combined oral contraceptives, mini-pills suppress ovulation weakly. Only in 30% of women taking "Laktinet" or "Charosetta", the egg does not mature in due time. Most nursing mothers ovulate, and the contraceptive effect is achieved through other mechanisms.

The Pearl Index (contraceptive effect) for progestin preparations is 0.3-0.9. Mini-pills increase the viscosity of cervical mucus and reduce activity fallopian tubes, thereby complicating the movement of spermatozoa. In addition, progestin contraceptives change the structure of the endometrium (the inner lining of the uterus). Even if fertilization occurs, the embryo simply will not be able to attach to the uterine wall. At long-term use mini-pills cause reversible atrophy of the endometrium (reduction in its size).

Preparations "Laktinet" and "Charozetta" are analogues. Each of them contains 75 micrograms of desogestrel. The package contains 28 tablets, which should be taken once a day, daily. A break in taking the drug is not done.

Take the mini-pill at exactly the same time every day!

Progestin preparations can be started 6 weeks after birth. "Laktinet" does not affect the composition and volume of breast milk. This tool is considered completely safe for the baby, so the entire period of breastfeeding can be used.

"Laktinet" causes the following side effects:

• heavy and prolonged menstruation;
• spotting between periods;
• decreased mood;
• decrease in sexual desire;
• soreness of the mammary glands;
• body weight gain.

"Laktinet" has some advantages over combined contraceptives. It can be used by nursing mothers suffering from varicose disease and many heart diseases. Mini-pills are much less likely to cause blood clots and other serious complications.

Of the minuses of "Laktinet" it should be noted an increase in the risk ectopic pregnancy and the occurrence of ovarian cysts. This drug also causes frequent appearance acyclic bleeding outside of menstruation. These side effects do not make Lactinet too popular among nursing mothers, forcing them to look for other methods of contraception.

Intrauterine hormonal system "Mirena"

Mirena is an intrauterine device containing levonorgestrel. This drug belongs to the group of gestagens and is approved for use during breastfeeding. Mirena inhibits the development of the endometrium, leading to its temporary atrophy. Like mini-pills, the intrauterine device increases the viscosity of the cervical mucus and reduces the activity of the fallopian tubes.

Mirena is recommended for women who have given birth and have one sexual partner. Of the advantages, it should be noted the high efficiency and convenience of the method. The spiral is installed in the uterine cavity for 5-7 years. A woman no longer needs to think about taking a pill every day or constantly buying new packs of condoms. Installation and removal intrauterine device is a gynecologist.

Do not delay your visit to the doctor after the expiration of Mirena!

The intrauterine device, like Laktinet, has a number of negative side effects:

• mood changes, depression (first 3 months after installation);
• uterine bleeding;
• menstrual irregularities;
• lack of menstruation (amenorrhea).

Barrier and chemical methods of contraception

Not all women are ready to take mini-pills or put a spiral during lactation. What other methods of contraception are allowed while breastfeeding?

Many breastfeeding mothers prefer condoms and diaphragms. These funds are completely safe for the baby and do not affect the composition and amount of breast milk. Of the minuses, it is worth noting the decrease in sensitivity during intercourse, as well as the need to keep condoms at hand all the time. In rare cases, it is possible to develop an allergy to latex. Contraceptive effect from 85 to 97%.

Chemicals (spermicides) are also allowed during lactation. Their efficiency ranges from 75 to 90%. Spermicides are recommended to be used together with barrier methods of contraception to increase their reliability. Contraceptive effect after application chemicals lasts from 1 to 6 hours.

Natural methods of contraception

During lactation, you can use not only hormonal and barrier contraceptives. The well-known method of lactational amenorrhea is very popular with nursing mothers. The contraceptive effect persists for 6 months when fed exclusively with breast milk. Supplementation with mixture and supplementation with water is not allowed. Even with all the recommendations, this method often fails young mothers. Pregnancy against the background of lactation can occur even before the arrival of the first menstruation. It is quite difficult to predict this moment, so many women, when using the lactational amenorrhea method, become mothers for the second time.

The natural fertility recognition method also applies to natural ways contraception. Its essence lies in calculating the moment of ovulation and calculating safe days for marital intimacy. This method should be used under the supervision of a recognition specialist. Otherwise, the risk of incorrect self-interpretation of the results and the occurrence of an unplanned pregnancy is too great.