All means of contraception. Contraception

We live in a time when it is possible to be almost 100% sure that you are protected from unwanted pregnancy. There are so many methods of contraception that women and men are often confused about which type to choose. Incorrect selection of the method threatens with an increased risk of becoming pregnant or side effects from an overdose of potent drugs.

All methods of contraception will be grouped according to their main properties. When choosing, you should start from your main goal, the time during which you would like to protect yourself, gender and personal preferences.

Read more about each method by clicking on the appropriate link.

This method is based on the effect of hormones on your endocrine system. To understand how it works, it is important to have a basic knowledge of ovulation and when pregnancy is possible.

In the middle of the cycle (approx. 15 days after the onset of menstruation), a woman ovulates (a mature egg leaves its usual place to “meet” with a spermatozoon). The hormone estrogen is responsible for this process.

Hormonal agents contain artificial hormone etrogen, but in smaller quantities. Due to an insufficient amount, ovulation does not occur, which means that pregnancy too.

Hormonal contraception is represented by several types (you can read more about each of them).

• Hormonal contraceptive coil
• Contraceptive implant

If you don't plan on having children for a few years, try putting in a helix. She is placed on for a long time and does not interfere with the natural sensations during intercourse.

That would mean rewriting the article. Almost all sections of this article are devoted to contraception for the fair sex.

Contraception for men

There are not so many types of contraceptives for men. There is one more or less reliable, one eternal and several unreliable and rare options.

Unreliable methods of contraception for men include:

• coitus interruptus (simple and free, practiced by most young men, but not everyone thinks about the threat of catching an STI)

New methods currently under testing include:

• men's birth control pills(Must be taken at least 3 months before sexual intercourse, interfere with the birth of spermatozoa). Unlike female counterparts, they contain more hormones, which may have Negative consequences for a man.
• male contraceptive implant (for the onset of its contraceptive properties, it must be inserted a few months before sexual intercourse. Also, like pills, it contains a large number of artificial hormones).

If a man has at least two children, a sufficient amount of money and a desire to be active sexual life, he can have a vasectomy (an irreversible operation to deprive him of reproductive function).

The most popular method used by 70% of men is the condom. It also protects against STIs, and has excellent reliability indicators, and is inexpensive.

Barrier Methods

Barrier methods are so called because they create a barrier between the sperm and the egg. These are the easiest contraceptives to use. They are suitable for people without permanent partners, living a spontaneous sexual life.

• all types of condoms

If sexual intercourse occurs several times a month and not even every month, the most proven way is

Family planning methods include contraception, as it helps prevent the development of unwanted pregnancies and avoid abortions. Most of the currently known methods and means of protection were developed in the second half of the last century. Each has its own advantages and disadvantages, but in one way or another performs its function.

Contraception can be biological, barrier, chemical, implantation, hormonal and surgical. To assess its effectiveness, the Pearl index is used, which reflects the number of pregnant women out of 100 using contraception. a certain kind. The indicator is displayed as a percentage.

Hormonal contraception is the most popular and effective way to prevent unplanned pregnancy.

It includes:

• Combined preparations containing estrogen and progestin (Rigevidon, Tri-Regol, Marvelon, Femoden, etc.).
• "Mini-drank" - drugs with progestin (Microlut, Exluton, etc.).

The action of these drugs is based on the following processes:

• suppression of ovulation (the egg does not mature and does not come out);
• thickening of the mucus secreted into the cervix does not allow the passage of spermatozoa;
• a change in the mucous membrane of the uterus, as a result of which the fertilized egg is not able to gain a foothold on it;
• decrease in motor activity of spermatozoa in the fallopian tubes.

Thus, various stages of the onset of pregnancy are blocked: from the maturation of the egg to its fertilization and attachment to the uterus. Due to this, the efficiency of the method reaches 99.9%.

Such a strong effect of drugs can cause a number of side effects. Nausea, vomiting, headaches, edema, vaginal discharge, irritability, depression, acne, decreased sex drive and weight gain.

Contraindications include the presence malignant neoplasms in the mammary glands and genitals, vascular diseases brain, venous thromboembolism, unrecognized acyclic vaginal bleeding, migraine, hereditary hyperlipidemia.

Benefits hormonal contraception efficiency comes first. In addition, these drugs have a number positive effects: reduce the likelihood of ectopic fixation of the fetal egg, prevent the formation and spread inflammatory processes in the genitals, prevent the development of neoplasms, restore the menstrual cycle, reduce pain syndrome during menstruation.

Hormonal drugs are convenient to use, they are available and are presented in a wide range in most pharmacies. The possibility of conception is restored 2 months after the pills are discontinued.

The disadvantage of the hormonal method of contraception is the presence of contraindications, side effects. Long term use or an overdose may cause malfunctions of cardio-vascular system, to an increased risk of developing hypertension, atherosclerotic changes, blockage of blood vessels.

An effective method is only with daily pills, so constant monitoring is necessary. In addition, do not forget that hormonal drugs do not protect against infections.

condoms

Condoms are male barrier methods of contraception. The action is based on the physical obstruction of the penetration of spermatozoa into the vagina. Efficiency this method with the correct use of a condom - about 90%.

The advantages of using a condom include the absence of contraindications and side effects, protection against sexually transmitted diseases, the presence of additional lubrication, availability and "mobility" in use (does not require prior preparation, consultation with a doctor, adherence to a schedule, can be used at any time).

The downside is a decrease in sensitivity during sexual contact, the need to interrupt it to put on a condom. In addition, in rare cases, latex causes an allergic reaction.

Intrauterine device

This IUD is a T-shaped device made of copper and plastic. The action of the spiral is based on inhibition of the advancement of spermatozoa into the uterus, a decrease in the viability of the egg and the prevention of its attachment to the uterine mucosa after fertilization. The efficiency of the method is more than 95%.

The undoubted advantage of the intrauterine device is its ease of use: no additional actions are required from the woman, the gynecologist installs it in 1 appointment. The spiral begins to "work" immediately after the installation procedure. At the same time, if a woman wants to get pregnant, she will not need to wait for some time as when taking hormonal drugs. The ability to conceive resumes immediately after the removal of the IUD.

The intrauterine device is a reliable way to prevent unwanted pregnancy during breastfeeding. It does not affect the production of milk and its composition. Does not affect sexual activity, is not felt by the woman herself or her partner.

The disadvantages of the intrauterine device include:

• the presence of contraindications (blood diseases, detection of precancerous processes in the cervix, neoplasms in the genital organs, a history of trauma to the cervix during childbirth);
• installation is not recommended for nulliparous, as there is a risk of inflammation and subsequent infertility;
• after the installation procedure - uncomfortable sensations, bleeding may occur;
• pregnancy occurs in 5-10% of cases, often - ectopic;
• The IUD does not protect against infections and, when infected, increases inflammation;
• The risk of developing inflammation due to injury to the walls of the uterus with a spiral.
• This method of contraception is most suitable for those who have given birth, including lactating women, who have a permanent partner.

Coitus interruptus

With an interrupted act, the man removes the penis before the onset of ejaculation. The effectiveness of such contraception compared to the previously discussed methods is low, about 70%.

The advantages of interrupted sexual intercourse in the first place include its absolute availability and the absence of monetary and time costs. Supporters of this method of contraception emphasize the ease of use, the absence of contraindications and side effects, and the preservation of high sensitivity of the genital organs. Coitus interruptus is a way to help not get pregnant without additional protection.

The main disadvantage is high risk development of an unplanned pregnancy: every 4 women become pregnant. In addition, the method does not protect against infection and contributes to the development of impotence in men, as the blood supply to the penis deteriorates. Women, on the other hand, often do not reach orgasm, and with prolonged practice of this method of contraception, they develop frigidity.

Other methods of contraception

Hormonal contraceptives, condoms, the intrauterine device, and coitus interruptus are the most common methods of preventing unwanted pregnancies.

The following options are less popular:

• Female Barrier Methods: vaginal diaphragm, cervical cap, contraceptive sponge. All of them have the same advantages and disadvantages as condoms: they are effective, affordable, protect against genital infections, but require certain manipulations before sexual intercourse. In addition, unlike condoms, female barrier methods have contraindications (mainly gynecological diseases).
• Chemical methods. Spermicides inactivate sperm and prevent it from entering the vagina. They are easy to use, provide a certain degree of protection against genital infections, and can be used alone or in combination with other methods. Disadvantages: not a high degree of protection against pregnancy (16 cases out of 100).
• biological methods(calendar, temperature, cervical, symptothermal). Based on the identification of the days of the cycle, in which the fertility of a woman is increased and abstinence during these periods from sexual intercourse. Depending on the correct application of the methods, the efficiency ranges from 60% (cervical mucus assessment) to 99% (temperature determination). The absolute advantages include the safety and availability of biological methods. They have no contraindications, side effects, do not require material costs. The disadvantage is the complexity of measurements, the need to constantly monitor the characteristics of the body, requires accuracy in the calculations with the calendar method. The biological method does not protect against sexually transmitted diseases and is not always effective.
• Sterilization(surgical method) is the most effective, but irreversible method of contraception. At proper conduct procedure efficiency is 100%. Advantages: does not require constant monitoring, material costs, refers to natural methods. Disadvantages: contraception is irreversible, may develop postoperative complications there are contraindications.

Contraception is a set of methods and means to prevent pregnancy at a certain point in time. Contraceptives are being improved every year, and it is quite difficult to choose one of them on your own, without the help of a specialist. Modern contraception affects both men and women, although contraceptives for women are most often used, it is easier to prevent the penetration of spermatozoa to the egg than to try to stop their formation. So which of the methods of contraception is the most effective, how to make the right choice?

At all times, the most reliable and trouble-free way to prevent conception was a firm female "No"! This method of contraception still works, but you should not ignore intimate life just because of the fear of pregnancy, it is enough to choose individual contraceptives and enjoy all the delights of sex.

What do you pay attention to when choosing contraceptive methods:

• contraceptive efficacy.
• Harmlessness.
• Ease of use.
• Guaranteed restoration of childbearing function after cancellation.
• Price.

Do not think that female and male contraception was invented in the 21st century, the history of the use of various methods is rooted in antiquity. Even in the treatises of Pedanius Dioscorides (1st century AD), an ancient Greek military doctor and author of De Materia Medica, there are references to the root of Dioscorea (mandrake), which was used by the Mayans, Incas and Aztecs, and which is still used by modern pharmacologists when creating range of oral hormonal contraceptives.

All methods are good in their own way.

A huge step in the creation of means to protect against unwanted pregnancy was made in the 20th century. Hormonal methods of contraception became popular after 1929, when the sex hormones estrogen and progesterone were discovered. But the very first oral contraceptive approved in practice was Enovid in 1960, containing 15 mg of norethinodrel and 0.15 mg of mestranol. The first generation drug turned out to be not to the taste of many, as it caused a lot of unwanted side effects due to high content hormones. It was this fact that gave rise to a lot of rumors about the excessive "harmfulness" of hormonal contraceptives, although the latest generation of contraceptives contain a minimal amount of hormones and have few side effects.

Unfortunately, the denseness in relation to methods of contraception persists in the 21st century not only among young people who begin sexual activity, but also among couples. In some regions of the Russian Federation, where civilization is reaching too slowly, abortion is still considered the most reliable method of not having children. You can talk about the medical and moral side of artificial termination of pregnancy for a long time, but it is better to know for sure what effective modern means exist to prevent the birth of a new life.

Table number 1. Classification traditional methods contraception

Table No. 2. Classification of modern methods of contraception

All means of contraception are diverse, so it is impossible to consider any single method as the most effective and suitable for any person. Each of the ways to prevent unwanted pregnancy is based on a lot of physiological aspects:

• Biological (physiological) methods. The features of the fertile period in women are taken into account. Such methods are available, absolutely free and simply involve the absence of sexual activity during the period when pregnancy is most likely. But these methods have a very low percentage of safety, in almost 25% of cases, conception occurs, despite compliance with all the rules.
• Modern methods of contraception. These include the latest developments in protective agents that prevent pregnancy in women. The funds are intended for both men and women, although they still prevail female contraceptives as more convenient in development, production and application.

1. Intrauterine devices. They affect the mobility of the egg and sperm, prevent the implantation of the fetal egg. IUDs are highly efficient and long term actions, but the disadvantages include the fact that their independent use is excluded - the introduction and removal of the IUD is carried out only by a gynecologist.
2. Hormonal agents. Acting on endocrine glands, suppress ovulation, are highly effective. The disadvantages of hormonal contraceptives include the fact that the means of strictly individual purposes are selected by a gynecologist. Provide for daily use according to the scheme, have contraindications and a number of side effects that occur with an overdose of drugs.
3. Surgical means (sterilization). It is an irreversible method, it is used in both women and men. During surgical intervention the vas deferens or fallopian tubes are blocked, which automatically makes it impossible for the sperm and egg to meet. Of all the contraceptives, this one is the most reliable, with 100% effectiveness.
4. Male contraception. AT last years began to gain popularity, although the point here is not only the complexity of developing special tools, but also psychological aspect. Men have a strong, indestructible conviction - using contraceptives, they automatically become incapable of intimate life. Where such an unshakable confidence in “acquired impotence” came from is unknown, experts completely deny this fact. The new tool is a male "spiral" that resembles a mini-umbrella, which is inserted through the urethra into the scrotum. The tip of the "umbrella" contains a gel that kills spermatozoa and makes it impossible to conceive a child. This method does not bring any physical and physiological inconvenience, the man remains fully "capable" in intimate terms.

Of course, short review all known to science modern methods of contraception will not give complete confidence and a sense of protection, it is important not only to study each one on your own, but also to understand which means will be the most acceptable. Apart from physiological characteristics there are life aspects of the body, stable relationships may include other types of contraception, while in casual sexual relationships, each person is responsible for his own safety.

Expert opinions

What are the modern methods of contraception, how to use them and how each of them works? Only a doctor can answer all these questions in detail, he will also help assess the risks of using a particular method. It is important to remember that this also takes into account the time elapsed from an accidental (without protection) sexual intercourse, the presence of diseases not only in the genital area, and much more. You should not consider contraceptives as something unimportant, optional, applied from time to time.

All methods of contraception are divided into:

• Barrier.

Most traditional means popular in the last century. But over the past 30 years, more modern and safer methods have taken their place, and their use has declined. Although, according to many experts, this happened undeservedly, since more modern means carry many complications and have a lot of contraindications. In this regard, it is necessary to improve barrier methods and return them "to service".

The principle of their action is based on preventing spermatozoa from entering the cervical mucus; when analyzing the impact on the body, the following points can be noted:

1. Local effects do not contribute to systemic changes in the body.
2. Minimum side effects.
3. A small percentage of protection against STDs.
4. Does not require the participation of highly qualified medical personnel.

Barrier methods also have a number of disadvantages that should not be ignored when assigning:

1. Less effective when compared to IUDs or oral contraceptives.
2. Successful application requires constant attention to them.
3. Possible allergic reactions on latex, rubber, polyurethane.
4. Requires some knowledge of the application.
5. It is mainly used during intercourse or immediately before it, which introduces a certain psychological inconvenience.

• Chemical.

The basis of the action of spermicides is the inactivation of seminal fluid and sperm and the setting of a "block" on their way to the uterus. Each of the spermicides must have one very important property- the ability to destroy spermatozoa in a few seconds. Chemical contraceptives (spermicides) are available in the form of jelly, cream, foam, suppositories and tablets. Modern chemical contraceptives necessarily contain a carrier and a sperm-killing component (strong surfactants), both of them complement each other and fulfill their role - providing contraceptive effect(Dolphin, Contracentrol, Coromex, Neosampuun, Pharmatex, Ortoginal). All these drugs are used both with concomitant contraceptives (diaphragm, condom), and independently, using 10–15 minutes before sexual intercourse, and if there are several coitions, then a dose of spermicide must be added before each of them, which in some way is not very convenient .

Douching with solutions containing acid (lactic, boric, acetic, lemon juice), but given that already 80–90 seconds after ejaculation, sperm enter the fallopian tubes, this method of contraception is not considered reliable.

• Biological.

The method of periodic abstinence consists in calculating the "stray" days and those in which fertilization is definitely impossible. Despite some difficulties, these techniques have not lost their relevance to this day:

1. Rhythmic (calendar) method. It is ineffective if the woman's menstrual cycle is irregular, according to WHO, with correct application in 15% of cases, pregnancy does occur.
2. Temperature. Requires daily measurement of the temperature in the vagina to determine fertile days. The method is not widespread, although its effectiveness is relatively high.
3. Cervical. Or the Billing method, based on the observation of natural vaginal discharge. With the onset of preovulatory days, there is a lot of cervical mucus, it is light and elastic. Ovulation is possible up to 5 days after the disappearance (reduction) of heavy discharge. The efficiency is not too high.
4. Symptothermal. Combines all three of the above methods and requires careful observation and record keeping. According to statistics, the possibility of pregnancy is reduced if sexual intercourse occurs only after the end of the ovulation period. If intimate acts are carried out before and after the ovulatory period, the possibility of conception increases by 5-6 times.

Each of their methods has its advantages and disadvantages, however, it requires certain inconveniences or risks from sexual partners. Despite this, they continue to be used everywhere, but experts still advise paying attention to more modern and reliable methods that have a higher degree of protection against unwanted conception.

• Intrauterine (IUD) contraception.

They first heard about it at the beginning of the 20th century, but then the Navy was completely different from modern ones and poorly protected women. And only after the 60s of the last century, the Navy firmly entered life and became very popular. Currently, there are over 50 varieties of intrauterine devices, which differ in the mass of parameters. They are considered an excellent method of contraception, but in some cases their use is strictly contraindicated. An undoubted advantage is the possibility long-term use– 5–10 years, and the efficiency is estimated as 91–98%.

• Hormonal contraceptives.

They are considered the best based on efficiency (100%), but subject to all the rules of application and the absence of omissions in the reception of OK. In addition, before the appointment, it is important to find out if, for health reasons and age (after 40, it is impossible), taking hormonal drugs is allowed. Self-appointment, as well as the use of OK from time to time is unacceptable, this can lead to a serious failure in the hormonal system.

• Postcoital contraception.

Not recommended for use as permanent method, as it is regarded as a means of "ambulance" in non-standard situations. Loading doses of hormones cause serious malfunctions in the functioning of the reproductive system in women (the development of ovarian dysfunction). The most famous postcoital drugs are Postinor, Danazol, Mifepriston (Antiprogestin Ru-486).

• Sterilization

The method is completely voluntary, based on surgical intervention(DSH) in men and women. In addition to 100% protection results, it is economical and safe. However irreversible, restore reproductive function after sterilization is not possible. The standard conditions for holding are the presence of at least 2 children in the family and the age of 35 years. For DSH, the patient signs the application with his own hand.

Used "female" methods:

1. Mr. Pomeroy.
2. Mr. Pritchard.
3. fibrioectomy.
4. Clamp Filshi.
5. Electrocoagulation.
6. Excision of the fallopian tube.

The choice of method is carried out by the doctor according to the anamnesis and taking into account all tests and concomitant diseases. When sterilizing, one should also take into account the possibility of long-term complications - ectopic pregnancy, although the rates of "contraceptive failure" are estimated at 0-0.8%.

For men, the DSH procedure is somewhat different. Vasectomy involves blocking the passage of sperm through the vas deferens. This is the simplest, cheapest and most reliable method. male contraception. Most men are afraid that vasectomy affects potency, experts in this regard reassure: the ability to have sex is not lost, only the fertile function of the sperm itself is disturbed.

Implants and injections

Separate modern methods can be considered Depo-Provera or an injectable progestogen contraceptive. This is a long-acting drug a high degree effectiveness, which occurs a day after the injection. The mechanism of action of Depo-Provera is similar to traditional progestogen OK, but experts highlight the exceptional advantages of injectable contraceptives:

1. High percentage of the effectiveness of the method.
2. There are no estrogen-dependent complications.
3. The method is easy to apply.
4. Injections are allowed during breastfeeding.

In addition, most women note the presence of pleasant pluses: menstruation becomes less abundant and less painful, there is no PMS and iron deficiency anemia, the risk of developing endometrial cancer is reduced, etc.

A number of disadvantages are still inherent in long-acting injectables, so self-administration of Depo-Prover is excluded.

Progestogen implant for PC administration. The method is based on the use of the Norplant contraceptive, which consists of 6 silastic capsules that contain the progestogen levonorgestrel. Capsules are injected under the skin and provide a long-term contraceptive effect for up to 5 years. Currently, new types of implantable contraceptives are being developed, including those with a resorption effect (biodegradable capsules), which will not need to be removed after the allotted time.

What are the most effective contraceptives? What will give a woman confidence in 100% protection against pregnancy? The choice of method is carried out independently, but with mandatory consultation with a specialist. It is impossible to say unequivocally which of the methods of contraception is the best, each of them is unique in its own way, but in order for it to work for sure, you need to choose your method, then you can be sure that intimate life will not bring unexpected surprises.

Content

Prevention of unwanted pregnancy refers to critical issue maintenance of women's reproductive health. It's no secret that the consequences of an abortion cause more harm body than rationally selected hormonal methods of contraception. Today, every patient is able to find best way prevention of pregnancy, if necessary, supported by a therapeutic effect.

Modern contraceptive methods for women

To date, there are a huge number of ways to prevent conception. Each method individually has its own advantages and disadvantages. When choosing the safest contraceptive to prevent unwanted pregnancy, the patient should receive the following information:

• the effectiveness of the method, the likelihood of pregnancy;
• rules for the use of contraception;
• mechanism of action, adverse reactions;
• possible health risks;
• degree of protection of the method against STIs;
• symptoms requiring medical attention;
• restoration of fertility if desired.

Despite many myths, modern contraception includes hormonal methods in various variations of the delivery of the main substance. Hormonal pills latest generations, in addition to the main effect of preventing unwanted pregnancy, they simultaneously have a number of affirmative action: improve the skin, reduce the amount of discharge and pain during menstruation, eliminate PMS. Some contraceptives additionally include folic acid as a preparation of the patient's body for future gestation.

Rules for choosing a contraceptive method

On the consultative appointment after a thorough examination and additional examination, the gynecologist selects the most appropriate method of contraception on an individual basis. Properly selected contraceptive for women provides the desired result with the least amount of unwanted effects, while the patient must be ready to use the selected method for a long time.

There are no special rules for choosing a contraceptive method. During the examination, the woman is informed about all possible protection options, advised to choose the most reliable modern products.

Some patients are indignant that the doctor did not prescribe hormonal examination before prescribing COCs. WHO recommendations and studies confirm that a healthy young woman does not need to be tested for sex steroids to successfully select a hormonal contraceptive method.

Attention! In routine practice, contraceptives for women under 30 are selected by careful questioning, examination and measurement of pressure in the absence of data on serious diseases.

Types of contraception

There are biological, barrier, hormonal and surgical methods contraception. The first two are considered relatively outdated, ineffective. The degree of protection of the method depends on the rules of use and subjective feelings, which does not always guarantee a high result. The advantage of these tools is security. The rest of the methods are modern, effective ways regulation of conception. The disadvantages of such contraception are the existence of contraindications, the development adverse reactions. In order to avoid serious harm to health, a medical consultation is always carried out to clarify all possible risks.

Important! Only a condom (male and female) can protect a woman from STIs.

Hormonal contraceptives

The most common method of preventing pregnancy in the world is hormonal. The classification of contraceptives divides hormonal preparations into combined and containing only progestin. Combined funds contain estrogen and progesterone components. Depending on the concentration of substances in the drug, it differs: monophasic, two- and three-phase contraception.

Taking hormonal contraceptives provides reliable protection from conception. Hormones can enter a woman's body in different ways:

• orally;
• injection;
• to be implanted under the skin;
• applied as a patch to the surface of the body;
• inserted with a spiral into the uterus.

Most women use the oral route active substance. However, this technique of contraception requires patients to be systematic. Tablets should be used daily, preferably at the same time of day. Distortion, violation of the regimen, vomiting or diarrhea lead to a decrease in the protective effect.

Mechanism of action of hormonal contraceptives

Basic principle of data protection medicines from conception - prevention of ovulation. The absence of a monthly egg release makes fertilization an impossible phenomenon, which ensures reliable contraception. In addition to blocking ovulation, the method contributes to a change in the properties of cervical mucus, which leads to death, prevents the advancement of spermatozoa into the vagina. The drugs reduce the contractility of the fallopian tubes and prevent the thickening of the endometrium before the proposed implantation.

The regular intake of COC hormones maintains contraception at the proper level, a decrease in the concentration of substances leads to a loss of effectiveness. Therefore, when choosing this method of contraception, it is important to take pills daily.

The appointment of hormonal contraceptives is carried out only by a specialist, which is associated with a wide variety of drugs with different auxiliary effects:

• regulation of the duration of the cycle, the ability to delay the onset of menstruation;
• decrease in blood loss;
• elimination of PMS;
• renders therapeutic effect with endometriosis, androgenital syndrome.

Such drugs can simultaneously provide therapeutic effect and prevent conception, which is why COCs are the number one contraceptive method worldwide.

Side effects of hormonal contraceptives

When using contraceptives, the following adverse reactions may develop, which often develop in the first months of using drugs due to the restructuring of endocrine regulation:

• headache;
• intermenstrual bleeding;
• mood swings, apathy;
• violation of well-being and performance;
• soreness of the mammary glands;
• puffiness;
• increase in blood pressure.

Important! Hormonal contraception is contraindicated in venous thrombosis, arterial hypertension severe degree, after 40 years with a long smoking history, with migraine with aura, stage 3-4 obesity, cancer.

New generation hormonal contraceptives

Thanks to long-term research and advances in molecular chemistry, it was possible to minimize the doses of hormones in drugs while maintaining the contraceptive effect. Today, low-dose contraceptives with a minimum amount of adverse reactions. One tablet of this remedy contains up to 35 mcg of the estrogen component.

Gestagens, in turn, are divided into 3 generations. New progestins have no negative effect on carbohydrate, fat metabolism and blood coagulation processes. As a result, modern methods of hormonal contraception are much safer than their predecessors.

List of hormonal contraceptives

Young women concerned about weight control prefer contraception with:

• Lindinet 20;
• Logest;
• Novinet;
• Mercilon.

• Diana -35;
• Jeanine;
• Modell Pro;
• Rigevidon;
• Yarina;
• Qlaira;
• Jess;
• Femodene;
• Silhouette.

During lactation, young mothers use following methods protection:

• Charosetta;
• Lactinet;
• Microlute.

Barrier contraception

The barrier method of preventing conception is considered preferable for non-permanent sexual contracts, insecurity in a partner. condom feel the only way contraception that protects against most STIs. Other women's contraceptives lack this property. Barrier methods are still one of the main means used by adolescents.

Important! Necessary correct use condom from the beginning to the end of sexual intercourse. The use of the drug only before ejaculation significantly reduces the contraceptive effect.

Chemical contraceptives

Spermicides are available in different forms: cream, candles, gels, aerosol, sponges, tablets for local application. Thanks to the special composition of the contraceptive, spermatozoa are inactivated. The effectiveness of the method is highly dependent on compliance with the rules for using the drug. If instructions are not followed contraceptive effect contraception can be completely leveled. Plus, a significant drawback is that such contraception is felt by both partners, sometimes causing a burning sensation.

Mechanical contraception

Cervical caps, diaphragms, condoms for women serve as a mechanical obstacle to fertilization. The effectiveness of the methods depends on the accuracy and correct installation of the protective formation.

Local contraceptives for women

The intrauterine device is considered a fairly simple and reliable modern method of contraception. On average, the device provides protection against unwanted pregnancy for 5 years, and you do not need to worry about taking the drug or the reliability of the condom every time. The method of contraception is acceptable when breastfeeding, and is recommended for use by all women who have given birth.

Single contraceptives

As an emergency method of protection against pregnancy are applicable emergency contraceptives for girls. This concept involves the use of special methods after sexual contact to reduce the likelihood of conception. This method of contraception is allowed to be taken during forced sexual intercourse, in case of violation of the integrity of barrier contraceptives. The method is not intended for permanent use. The greatest effectiveness of postcoital contraception is shown when taking pills in the first 72 hours after intercourse.

Important! Single-acting drugs use high concentrations of hormones. For permanent application partners should choose another reliable way to prevent pregnancy.

Surgical methods of contraception

Apart from sexual abstinence, sterilization is considered the most effective contraceptive. The effectiveness of the contraceptive method is close to 100%, but even in this case there is a small risk of conception. The disadvantage of this contraception is irreversibility. In most cases, sterilization is used by women who are categorically contraindicated in bearing. Another option for the use of surgical tubal ligation is when a woman has already given birth to the desired number of children (usually more than 3) and no longer needs offspring or has acquired diseases that worsen during gestation.

Important! If a married couple various reasons decided to have children after sterilization, then independent pregnancy is impossible. For conception, you will need to resort to assisted reproductive technologies.

How to protect yourself without pills and spirals

In addition to the main methods of preventing unwanted pregnancy, there are methods that protect more than 30% of the female population. These include the so-called methods of fertility control. To physiological methods contraception includes the use of coitus interruptus, counting dangerous days and determining the day of ovulation.

Unfortunately, these methods of contraception are considered the least reliable. There is no complete confidence in the correctness of using the method: the sexual partner cannot always restrain himself at the right time, there is a small amount of spermatozoa in the lubricant. calendar method contraception is based on the measurement basal body temperature, control of sensations and determination of the time of release of the egg, which is not always correct. As a result, the calculation is violated, the effectiveness of the contraceptive method decreases.

Important! When determining the period of ovulation, 9-19 days are considered potentially dangerous with a 28-day cycle. During this period, a woman must protect herself from conception in another way or not have sex.

What are the best contraceptives

The safest contraceptive is abstinence. In reproductive age, the most reliable method to prevent conception is the use of hormonal contraception. Contraceptive pills are among the most effective means. It is acceptable to use COCs in young people, in patients 6 months after childbirth while breastfeeding, in the absence of contraindications. Mini-pills (pure gestagens) are used in cases where the estrogen component is contraindicated.

However, due to the extensive list of contraindications, not every patient can use oral hormonal contraceptives. In such cases, the introduction of contraception in a different way is considered: a spiral, a ring, a patch, an injection.

Important! Intrauterine devices are preferably installed after childbirth to lengthen the periods between pregnancies.

The most reliable contraceptives

If we take into account the number of pregnancies that occurred while taking a certain method of pregnancy management (Pearl index), the list is from the most effective to the least effective methods contraception looks like this:

1. Sterilization.
2. IUD (intrauterine device).
3. COCs (combined oral contraceptives).
4. Hormonal patches and injections.
5. Mini-drank.
6. Emergency pills.
7. Mechanical methods (condoms, diaphragm).
8. Interrupted intercourse.
9. Calendar method for determining ovulation.
10. Spermicides.

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 are divided into female and male. Using this technique, not only prevent pregnancy, but protect against:

• various 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 a different Pearl index. 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;
• funds 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: subcutaneous implants, birth control pills for men and a male 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 earlier people simply abstained from sex in order to avoid the birth of a child, 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. To select the optimal contraceptive option, 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 in 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, chemical contraceptives are popular. These are: 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

The 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:

• hormone 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 advantages: changed 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

There are the following 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:

• the risk of exacerbation of inflammatory processes in the uterus and appendages increases;
• 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 on its own (it depends on the hormonal background and other points).

Natural methods of contraception

natural biological methods Contraception is a way to prevent an 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 during 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 such days it is better to use additional means of 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. The last resort is often used: there are few side effects, and more benefits 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 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 of 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 tool can be used during lactation and various diseases in which other hormonal contraceptives are strictly prohibited.

Postcoital contraception

Emergency contraception is 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 a woman is artificially blocked in the fallopian tubes, and in men, the vas deferens are tied up, while the testicles and ovaries are not removed, there is no negative impact on the couple's sexual life.

Methods of contraception after childbirth

Immediately after childbirth, it is recommended to abstain from sex for 1-2 months to avoid infection on the vaginal sutures. After the period has passed, 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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