Contraceptives. Modern methods of contraception

Think and care about protection from unwanted pregnancy During sexual intercourse, not only the man, but also the woman should. Moreover, it is she who subsequently has to make the most important decisions - to give birth or have an artificial termination of pregnancy, to get married or remain a single mother. Therefore, it is worth knowing about all types of female contraception that are approved and recommended by official medicine.

Table of contents:

Barrier method of female contraception

The essence barrier contraception is to prevent sperm from entering the uterus. Such a barrier can be created mechanically and/or chemically.

Local chemicals

In medicine, such products are called spermicides and are available in various pharmacological forms - foaming tablets and suppositories, aerosols, pastes, balls for intravaginal use. Such products contain substances that have a detrimental effect on sperm - for example, benzalkonium chloride, nonoxynol-9. It is believed that the effectiveness of local chemicals from the category of contraceptives is 85%.

Features of local chemicals:

can be used by a woman without prior examination by a gynecologist and receiving prescriptions;
these means of protection against unwanted pregnancy contribute to the formation of additional lubrication in the vagina;
it is not contraindicated to use simultaneously with chemicals any other contraceptives will only enhance the effect;
are capable of exerting a mild anti-inflammatory effect, and according to some data they even serve as a prevention of cancer of the female reproductive system.

Please note:spermicide does not begin to act instantly - it will take 15-20 minutes, so the introduction contraceptives This particular group should be carried out just 15-20 minutes before sexual intercourse. If several sexual acts occur in a row, then before each of them you need to administer the drug.

Mechanical methods of female contraception

Such products are considered absolutely harmless and can be used by all women without any restrictions. Moreover, a woman can refuse such contraception at any time if a decision is made to conceive a child. But doctors say that a woman will need special training in how to use it. mechanical means contraception, and after childbirth or in case of sudden weight gain you will need to change/select new size. Mechanical methods of female contraception include:

. They look like a cap with a flexible rim and are made of rubber or latex. The dome of the diaphragm covers the cervix, which makes it impossible for sperm to penetrate into the abdominal organ.

How to use it correctly: the diaphragm is inserted into the vagina immediately before sexual intercourse, but it can also be done in advance - the contraceptive in question can be left in the vagina for 6 to 24 hours. The vaginal diaphragm is used together with spermicides - they are coated with them inner side diaphragm and ring.

Female condoms. They are a polyurethane bag 17 cm long and 7-8 cm in diameter with two rings at the ends. There is a thin film on one ring - it is adjacent to the cervix and prevents sperm from penetrating into the organ cavity.

How to use it correctly: the female condom is inserted simply like a regular tampon, a few hours before sexual intercourse. This product is disposable; for the next sexual intercourse you need to use a new female condom.

Cervical caps. This is a soft rubber cap that is placed directly on the cervix - negative pressure is created between the cervix and the rim of the cap, which makes it impossible for sperm to penetrate. The cervical cap is smaller in size than the vaginal diaphragm, its effectiveness is 60-80%.

How to use it correctly: the cervical cap is inserted half an hour before sexual intercourse and is not removed for 6-8 hours. Before use, the contraceptive in question is treated with spermicides - they lubricate the rim.

This type of female contraception is considered one of the most effective, but it can only be used as prescribed by a doctor, and even intrauterine device A woman cannot do it on her own. Gynecologists establish only two types of contraception in question:

copper-containing;
progestin-containing.

Intrauterine devices are made of plastic (absolutely safe), into which either copper wire or a miniature container with progestin is mounted.
Operating principle of intrauterine devices:

prevent the penetration of sperm into the uterus - progestin-containing IUDs significantly reduce this ability;
do not allow implantation (movement) of the egg into the uterine cavity;
counteract ovulation - this applies only to progestin-containing intrauterine devices;
Copper-containing products have a detrimental effect on both sperm and eggs.

The intrauterine device is installed on long time– from 2 to 5 years and usually the woman’s body reacts normally/adequately to such “intervention”. In some cases, complications may develop:

inflammatory processes of the cervix and appendages - according to statistics, the risk of developing such pathologies with an existing intrauterine device increases 2-3 times;
menstrual irregularities – the dates of monthly bleeding may shift, they become more abundant, and intermenstrual bleeding may occur;
discomfort during sexual intercourse - pain, burning.

Please note:if a woman notes too much prolonged bleeding from the vagina, there is intense pain in the lower abdomen, weakness and pallor of the skin appear, then you should immediately seek medical attention medical care. This condition may indicate perforation (breakthrough) of the uterine wall by the intrauterine device. This happens extremely rarely - according to statistics, 1 case in 10,000, but every woman should be aware of this complication. Benefits of using an intrauterine device:

Disadvantages of using an intrauterine device:

before installation, you must undergo an examination by a gynecologist;
Only a doctor can insert and remove an IUD;
after each menstruation, you need to check the presence of the antennae of the intrauterine device - sometimes it can fall out;
In the first few months after installation of the IUD, increased menstrual bleeding may occur.

Contraindications to installation of an intrauterine device:

diagnosed oncological diseases genitals or internal genital organs;
suspicion of a completed pregnancy;
acute/chronic processes of inflammatory or infectious nature in the reproductive system (including on the external genitalia);
uterine bleeding pathological nature unknown etiology;
bicornuate uterus;
cervical stenosis.

There are also conditional contraindications to the use of an intrauterine device as a contraceptive - that is, it is undesirable to insert an IUD with them, but the final decision is made only by a gynecologist. Conditional contraindications include:

history of ectopic;
diagnosed ;
absence of childbirth;
bleeding disorders.

Hormonal contraception

We recommend reading:

Hormonal contraceptives are products that contain chemical analogues female hormones. They prevent the onset of ovulation, which makes it impossible to conceive a child. The group of hormonal contraceptives includes pills, implants, patches, and a hormonal vaginal ring. Pills are considered the most popular, but you need to select the type of hormonal contraceptive based on your needs/capabilities:

Birth control pills require excellent memory, responsibility and punctuality - they should be taken at a strictly defined time and not miss a single day;
the patches can be used for 7-9 days in a row, that is, only 3 patches will need to be changed per month;
the hormonal ring has month period operation.

Before starting to use hormonal contraceptives, you must visit a gynecologist, undergo an examination and make a choice in favor of one or another. There are also clearly defined contraindications to the use of this type of contraceptive:

you are breastfeeding and less than 6 months have passed since giving birth;
There is no breastfeeding, but less than 3 weeks have passed since birth;
there is a history of stroke, ischemic disease hearts, pulmonary hypertension, bacterial endocarditis;
thrombophlebitis was previously diagnosed;
are strong and your age is 35 years or older;
in the recent past the woman suffered (less than 3 months ago);
liver cirrhosis and other pathologies of this organ were previously diagnosed;
a history of diseases of the gallbladder and biliary tract that require constant use of medications;
breast cancer (even after complete healing);
increased blood clotting;
The doctor has prescribed and is constantly taking anticonvulsants and/or antituberculosis drugs.

Please note:If at least one of the above factors occurs, then taking hormonal contraceptives is strictly prohibited.

Female surgical contraception

We are talking about sterilization - an irreversible process that is considered the most effective for preventing unwanted pregnancy. Indications for sterilization of a woman are only the desire to stop the possibility of conception. But this issue should be approached extremely carefully - the process is irreversible, although there are expensive microsurgical operations that can “turn back time.” Often, surgical contraception is used for medical reasons - for example, a woman has severe malformations of the cardiovascular, respiratory, urinary systems, blood diseases, malignant neoplasms. Contraindications to sterilization are:

acute inflammatory diseases of the pelvic organs;
infection of generalized or focal localization;
benign tumors developing in the pelvis;
severe cachexia;
diabetes mellitus/diabetes insipidus;
adhesive disease of the pelvic organs and/or abdominal cavity;
umbilical hernia – applies only to surgical contraception using the laparoscopic method.

Please note:There are still debates about sterilization of women with diagnosed mental disorders, mental retardation– these pathologies are not a medical indicator for surgical contraception.

Now this is the most popular method of surgical contraception - the method has many advantages. For example, after such surgical intervention no scar remains on the skin, the rehabilitation period is very short, patients tolerate such an intervention well. Please note:laparoscopic ligation cannot be excluded fallopian tubes V outpatient setting– the woman is given local anesthesia, and 2 hours after completion of the procedure and in the absence of any visible changes in well-being for the worse, the patient can go home.

A miniature incision is made in the anterior abdominal wall - the size does not exceed 6 cm. The advantages of this method of surgical contraception are that there is no need to use expensive equipment and quick rehabilitation.

The rectal uterine space is opened with scissors and the fallopian tube is removed into the resulting wound until its fimbria appears. The suture is placed in the middle of the fallopian tube, but somewhat closer to the fimbria. Then they tie the tube with a thread and pull it closer to the surgeon, then the tube is crushed and ligated. The same algorithm of actions is used for the second fallopian tube. Please note:the ends of all suture threads are cut only after the surgeon has finished working on the two fallopian tubes. The incision is closed with a mattress suture. Advantages of sterilization with colpotomy access:

can be performed in any gynecological hospital;
there are no cosmetic defects on the anterior abdominal wall;
there is no need to use expensive equipment and specific tools;
the pursued goal (sterilization) is achieved immediately after surgery.

Very often, sterilization surgery is performed during caesarean section– there is no additional stress on the body, the woman’s well-being does not change, the periods of lactation and recovery after childbirth pass without changes, hormonal background doesn't change. Timing for surgical contraception:

in the second phase of the menstrual cycle - delayed sterilization;
6 weeks after birth naturally;
immediately after an artificial termination of pregnancy, but only if the abortion was without complications.

It is strictly contraindicated to carry out sterilization after childbirth if acute infectious disease during childbirth or even during pregnancy, if the anhydrous period of labor exceeded 24 hours. Possible complications in the postoperative period:

bleeding;
intestinal damage;
postoperative infection.

These complications relate to rare events, but a woman who agreed to surgical contraception should know about them. Please note:Doctors warn that in the first 10 years after sterilization surgery, the probability of pregnancy remains within 2%. Female contraception– rich choice, wide possibilities. It is necessary not only to independently decide on the choice of means of protection against unwanted pregnancy, but also to obtain competent advice from a gynecologist.

Maria Sokolova

Reading time: 12 minutes

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Most modern methods contraception does not provide a 100% guarantee, especially since more than a third of women become pregnant using one method or another.

What methods for preventing pregnancy are considered the least reliable?

Calendar method and calculation of safe days - does it make sense?

Basis of the method– calculation of safe days. How to determine these safe days? The viability of sperm is about three days, fertilization of the egg occurs within two days after ovulation . Thus, two days should be added to the day of ovulation (in both directions): for a cycle of thirty days it will be the fifteenth day, for a cycle of twenty-eight days it will be the thirteenth. It is believed that it is on these days that there is a risk of getting pregnant, but on the rest you can “not worry.”

Flaw:

The main disadvantage is that the method good only for ideal cycle . But are there many women who can boast of this? After all, the time of ovulation is influenced by many factors:

Weather
Chronic diseases
Stress
Other factors

Not to mention the fact that there are women who become pregnant during what seems to be a safe period. Therefore, before using this method, you must at least study your cycle for a whole year . According to statistics, every fourth woman becomes pregnant after using the calendar method.

Does the temperature method of protection work?

The basis of the temperature method of contraception
A woman’s temperature (measured rectally) changes according to the stage of egg maturation: below 37 degrees – before ovulation, above 37 – after . Safe days are determined as follows: temperature is measured every morning for six months to a year (right in bed, for at least five to ten minutes). Next, the results obtained are compared, the day of ovulation is identified, and the period dangerous for pregnancy is calculated. It usually starts 4 days before ovulation and ends four days after.

Flaw:

Just like the calendar method, this method applicable only if the menstrual cycle is ideal . In addition, it is very complex in its calculations.

Coitus interruptus

Basis of the method known to everyone - interruption of sexual intercourse before ejaculation.

Disadvantage of the method:

Unreliability this method occurs even with complete self-control of a man. Why? A separate amount of sperm may be released from the very beginning of sexual intercourse . Moreover, it remains unnoticed by both partners.

Also low efficiency method may be explained by the presence of sperm in the urethra, preserved from the previous ejaculation. Out of one hundred women using this method, thirty become pregnant.

Douching after intercourse

Basis of the method– douching of the vagina with potassium permanganate, your own urine, herbal decoctions and other liquids.

Disadvantage of the method:

This method is dangerous not only due to pregnancy, which you did not plan at all, but also with such consequences as:

Violation of the vaginal microflora.
Infection in the vagina.
Vaginitis.

There was no evidence of the effectiveness of the douching method, and no. It does not protect against pregnancy.

Spermicidal lubricants - how reliable is the method?

Basis of the method– use of creams, suppositories, jellies and foams with spermicides. These products have a double effect:

Filler creates mechanical boundary .
Special component eliminates sperm .

Flaw:

Of one hundred percent of women who use spermicides, one in three becomes pregnant. That is, the method is not 100% effective. The following disadvantages of the method should also be noted:

Certain types of spermicides lose effectiveness with regular use due to the habituation of the organisms of both partners to them.
Spermicides considered hazardous due to nonoxynol-9 content which causes destruction skin. And cracks in the genitals are a direct path for infection.
Violation of instructions for the use of spermicides multiplies the risk of pregnancy .

When do oral contraceptives fail?

Basis of the method– regular intake hormonal drugs (tablets). Typically, out of one hundred percent of women who practice this method of protection against pregnancy, five percent become pregnant.

Disadvantage of the method:

Poor memory often causes pregnancy: you forgot to take a pill, and the concentration in the body of a substance necessary for protection decreases. And by the way, you need to drink them constantly and for a very long time .
It should also be noted main drawback such tablets. Namely - consequences for the body , even if it’s hormones fourth generation. Possible consequences– metabolic disorders, weight gain, .
In parallel.
Many medicines reduce or even completely eliminate efficiency this protection against pregnancy.
This method of contraception does not protect against venereal diseases .

Our people have always been cunning in their invention, as a result of which, since ancient times, the people have had many of their own “home” methods of contraception, which, of course, are absolutely useless.

The most unreliable and dangerous contraception - traditional methods

A tampon in the vagina during sexual intercourse. Ineffective and dangerous: disruption of the vaginal microflora, risk of injury, and there is no question of dubious pleasure for both partners. As for the effect, a tampon will not protect against pregnancy.
Breastfeeding. It is believed that it is impossible to get pregnant during this period. Of course, considering that menstrual cycle after childbirth, it does not improve immediately, the risk of becoming pregnant is reduced, but it is certainly not excluded. And guess if yours has already woken up reproductive system- impossible. Many nursing mothers, naively believing that they were “protected by lactation,” became pregnant within a couple of months after giving birth. Therefore, hoping that you will be “carried away” is, at a minimum, imprudent.
Gynecological diseases. This is another mythical “protection” against pregnancy. In fact, there is only one female disease eliminates the risk of getting pregnant - this.
Vaginal douche. Another fairy tale that the strong pressure of water, which is used to wash the vagina after sexual intercourse, can “wash away” sperm. Don't believe it. While you were running from the bed to the bathroom, the sperm could already have “jumped” to the treasured egg.
Lemon inside. The myth that creation in the vagina acidic environment ensures the death of sperm. What naive women don’t use: lemon peels, powdered citric acid, and boric acid, and even ascorbic acid! The only effect of this procedure is an internal burn of the mucous membrane due to an overdose of acid.
Herbal decoctions.“And my grandmother (friend...) advised me...” This folk method is not even worth commenting on. Can you imagine how much you need to drink this (any) decoction, and what concentration it must be in order to “drown” all the sperm in it? This also includes the infusion bay leaf after sex and beet juice- gastronomic, but useless.
Soap laundry soap inserted into the vagina. Likewise. No effect other than disruption of microflora, bacterial vaginosis and other “joys”.
Douching. As a rule, young inventors use this method, using protective agent– Pepsi-Cola, urine, potassium permanganate, etc. Using Pepsi-Cola (which, by the way, can descale a kettle) leads to vaginal diseases. This is quite strong chemical substance, which does not prevent pregnancy. Urine also has no contraceptive properties. But there is a possibility of introducing an infection along with urine. As for potassium permanganate - it contraceptive effect so small that such douching will not help against pregnancy. A strong concentration of potassium permanganate will cause a very serious burn to the mucous membrane.
An aspirin tablet inserted into the vagina after sex. Extremely low efficiency of the method. Equivalent to the method with potassium permanganate.
Jumping after sex. You might as well drink a cup of coffee and smoke after sex. Spermatozoa are not dice, they cannot be shaken out of the vagina. And their speed of movement, by the way, is three millimeters per minute.
Steam the legs in mustard. An absolutely pointless procedure. And it’s hard to imagine how a girl, after an act of love, rushes for a basin to soak her feet.
Rubbing the head of the penis with cologne before sexual intercourse. Ineffective. In addition, you should remember about those “unforgettable” sensations that await a man after this procedure.
“You can’t get pregnant on your period!” Absolutely untrue. No, for many women, menstruation is indeed a period during which it is impossible to get pregnant. But there are so many exceptions that it is at least unreasonable to consider menstruation a protection. Moreover, taking into account the fact that the survival rate of sperm in the uterine mucosa is up to three days. These “tailed ones” are very, very tenacious.

In such a matter as protection against unwanted pregnancy, trust dubious traditional methods not worth it.

We do not live in ancient times, and today every woman has the opportunity go for a consultation with a specialist and choose for yourself ideal option contraception .

Contraception is a way to prevent unwanted pregnancy. Throughout the history of mankind, many of these methods have been invented: from the usual “depending on your luck” to the idea of protecting yourself with the droppings of domestic animals. Fortunately, contraceptive methods have now been developed, the description of which does not make you want to faint.

How to choose contraception

Before choosing a method of contraception, you need to remember that safe sex is not one that does not lead to pregnancy, but one that prevents you from catching sexually transmitted infections, including HIV and hepatitis.

If you do not have a regular partner, if you both do not know your HIV status (that is, there is no certificate), if you have a new partner, then you can only protect yourself with condoms.

For those who have been in a relationship for a long time and do not forget to get tested or are interested in donating, the choice of contraception is much wider, and the choice must be based on the effectiveness of the method.

Theoretical effectiveness shows how many women out of a hundred who used this method became pregnant within a year. Moreover, they used this method perfectly: according to the instructions.
Practical effectiveness shows how many women became pregnant in real world, where even contraception cannot be used ideally. For example, partners don’t put on a condom on time, women miss pills or forget to go to the doctor to replace the contraceptive on time.

We will only show data that is close to reality. How less number in the “effectiveness” paragraph in the description of each method, the better: this means that fewer women got pregnant while using this remedy. Since the figures differ slightly from one source to another, we indicate maximum quantity pregnancy - just in case.

And don’t forget to consult your doctor which method is right for you.

Hormonal methods

Many people know about hormonal contraception, but usually they only mean pills. But hormones can be delivered to the body in different ways.

Pills

Efficiency: 9.

It's worth nothing.

Flaws

You always have to worry about whether you can stop sex for real. interesting place, and then worry whether it happened this time or not.

Sterilization

Sterilization is a surgical procedure after which it is impossible to have children naturally at all. Since there are no absolute numbers in medicine, a ghostly chance remains, but it is just that, ghostly (in the event of an error in a procedure, for example).

In Russia there is a restriction on sterilization: it can only be done by people over 35 years old with two children.

Women's

Efficiency: 0.5.

How it works

During surgery, the fallopian tubes are ligated or removed so that the egg from the ovary does not enter either the tube or the uterus.

Advantages

Highly effective, contraception for life.

Flaws

Surgical intervention; conceiving a child after the procedure is possible only with the help of IVF.

Men's

Efficiency: 0.15.

How it works

During the operation, the surgeon ties or partially removes the vas deferens, so sperm do not enter the ejaculate.

Advantages

Highly effective, no side effects or contraindications, and does not require attention for the rest of your life.

Flaws

Surgery, you cannot change your mind and conceive a child.

Traditional methods

Numerous remedies such as douching with lemon or any other juice may have a slight spermicidal effect, but their effectiveness tends to zero. But unpleasant consequences in the form of inflammation, allergic reactions and discomfort are guaranteed to you.

Contraceptives are drugs used to prevent pregnancy. The purpose of contraception is family planning, preserving the health of a woman, and partly her sexual partner, and realizing a woman’s right to free choice: to become pregnant or to refuse it.

Why are all types of contraception necessary:

any methods of contraception reduce the number of abortions - the causes of gynecological diseases, premature birth, maternal and infant mortality;
contraception helps plan the birth of a child depending on living conditions family, parental health and many other factors;
some effective methods contraception also helps fight gynecological diseases, osteoporosis, infertility.

The effectiveness of contraceptives is assessed using the Pearl index. It shows how many women out of a hundred who used the method during the year became pregnant. The smaller it is, the higher the effectiveness of protection. Modern methods contraception has a Pearl index close to 0.2-0.5, that is, pregnancy occurs in 2-5 women out of 1000.

Classification of contraceptive methods:

intrauterine;
hormonal;
barrier;
physiological (natural);
surgical sterilization

Let's consider the listed types of contraception, the principle of their action, effectiveness, indications and contraindications.

Intrauterine methods

Use foreign objects placed in the uterine cavity. Intrauterine contraception is widespread in China, Russia, and Scandinavian countries.

The method was proposed at the beginning of the twentieth century, when it was proposed to insert a ring made of different materials into the uterine cavity to prevent pregnancy. In 1935 intrauterine contraception was banned due to the large number of infectious complications.

In 1962, Lipps proposed the famous device made of curved plastic with an attached nylon thread for removing contraceptives - the Lipps loop. Since then, intrauterine contraception has been constantly evolving.

Intrauterine devices are divided into inert and medicinal. Inert ones are not currently used. Only medicated contraceptives containing metal supplements or hormones are recommended, including:

MultiloadCu-375 - an F-shaped spiral, coated with copper and designed for 5 years;
Nova-T - a T-shaped device covered with copper winding;
CooperT 380 A – T-shaped coil, designed for 6 years;
- the most popular device today, which gradually releases levonorgestrel, a progesterone derivative, into the uterine cavity, which has a contraceptive and therapeutic effect.

Mechanism of action

The intrauterine contraceptive has the following effects:

death of sperm that have penetrated the uterus due to toxic effect metal;
increasing the viscosity of cervical mucus due to the hormone, which prevents sperm;
endometrial atrophy under the influence of levonorgestrel; ovulation and the effect of estrogen on female body at the same time, it persists, and menstruation becomes shorter, less frequent or completely disappears;
abortive action.

The abortive mechanism includes:

active movement of the tubes and entry of an immature egg into the uterine cavity;
local inflammatory process in the endometrium, preventing the attachment of the embryo;
activation of uterine contractions that release the egg from the genital tract.

The Pearl index for coils containing copper is 1-2, for the Mirena system it is 0.2-0.5. So this hormonal system – best way intrauterine contraception.

Introduction of a contraceptive

An intrauterine device is installed after an abortion or removal of a used device, 1.5-2 months after the birth of a child, or six months after a cesarean section. Before this, the patient is examined, paying attention to signs of infection.

After 7 days, the woman visits the gynecologist. If everything went well, she should visit the doctor at least once every 6 months.

The contraceptive is removed at the request of the patient, if complications develop or at the end of the period of use, by pulling the “antennae”. If the antennae are torn off, removal is carried out in a hospital. It happens that the spiral grows into the thickness of the myometrium. If a woman has no complaints, it is not removed, and the woman is recommended to use other methods of contraception.

Complications and contraindications

Possible complications:

myometrial perforation (1 case per 5000 injections);
pain syndrome;
bloody discharge;
infectious diseases.

When severe pain in the abdomen, cramping sensations with bleeding, heavy menstruation, fever, heavy discharge If the IUD “falls out,” you should immediately consult a doctor.

The insertion of the IUD is absolutely contraindicated during pregnancy, infection or tumors of the genital organs. It is better not to use it if the menstrual cycle is disrupted, there is endometrial hyperplasia, anatomical features genital organs, blood diseases, large, allergies to metals, severe associated conditions. For nulliparous women It is possible to use intrauterine contraception, but the risk of future pregnancy pathology is higher.

The advantages of this method of contraception are the possibility of use during lactation, the absence of side effects caused by estrogens, and less impact on the body's systems. Disadvantages: less effectiveness and likelihood of metrorrhagia.

Injectable contraceptives and implants

This method is used for long-term protection against unwanted pregnancy. The drug Depo-Provera, containing only a progestogen component, is used; it is injected into the muscle once a quarter. Pearl index 1.2.

Advantages of injection contraception:

quite high efficiency;
duration of action;
good tolerance;
no need to take daily pills;
You can take the drug for uterine fibroids and other contraindications for products with an estrogen component.

Disadvantages of the method: the ability to conceive is restored only 6 months - 2 years after the last injection; development trend uterine bleeding, and subsequently – to their complete cessation.

This method is recommended for women who require long-term contraception (which is, however, reversible), during breastfeeding, with contraindications to estrogen drugs, as well as for patients who do not want to take tablet forms daily.

For the same indications, you can install the implantable drug Norplant, which consists of 6 small capsules. them under local anesthesia sewn under the skin of the forearm, the effect develops during the first day and lasts up to 5 years. The Pearl index is 0.2-1.6.

Barrier methods of contraception

One of the advantages of barrier methods is protection against sexually transmitted diseases. Therefore they are widespread. They are divided into chemical and mechanical methods contraception.

Chemical methods

Spermicides are substances that kill sperm. Their Pearl index is 6-20. Such drugs are produced in the form of vaginal tablets, suppositories, creams, foam. Solid forms(suppositories, films, vaginal tablets) are inserted into the vagina 20 minutes before sexual intercourse so that they have time to dissolve. Foam, gel, cream act immediately after application. If coitus occurs again, spermicides must be administered again.

The most common products are Pharmatex and Patentex Oval. Spermicides somewhat increase protection from sexually transmitted diseases because they have a bactericidal effect. However, they increase the permeability of the vaginal walls, which increases the likelihood of contracting HIV infection.

The advantages of chemical methods of contraception are their short duration of action and the absence of systemic effects, good tolerability, and protection against sexually transmitted diseases. Disadvantages that significantly limit the use of such products include low efficiency, the risk of allergies (burning, itching in the vagina), as well as the direct connection of use with coitus.

Mechanical methods of contraception

Such methods retain sperm, creating a mechanical obstacle to their path to the uterus.

The most common are condoms. They are available for men and women. Men's should be worn during an erection. Female condoms consist of two rings connected by a latex film, forming a cylinder closed at one end. One ring is put on the neck, and the other is brought out.

The Pearl index for condoms ranges from 4 to 20. To increase their effectiveness, it is necessary to use these accessories correctly: do not use lubricants on oil based, do not reuse the condom, avoid prolonged intense acts during which the latex may break, and also pay attention to the expiration date and storage conditions of the contraceptive.

Condoms protect quite well from sexually transmitted diseases, but do not completely protect against infection with syphilis and some viral diseases transmitted by skin contact.

This type of contraception is most indicated for women with infrequent or promiscuous sexual intercourse.

Which method of contraception should I choose for the most complete protection against pregnancy and sexually transmitted diseases? In this case it is recommended combined method– taking hormonal contraceptives and using a condom.

Vaginal diaphragms and caps are not widely used. These devices are placed on the cervix before sexual intercourse and removed 6 hours after it. They are usually used together with spermicides. They are washed, dried, stored in a dry place and reused if necessary. The use of these tools requires training. They are not used for deformation of the cervix, vagina, or inflammatory diseases of the genital organs. The undoubted advantage of such devices is their reusable use and low cost.

Mechanical methods of contraception have the following advantages: safety, protection against sexually transmitted diseases (for condoms). The disadvantages are related to the lack of effect and the connection between use and coitus.

Natural ways

Natural methods involve abstaining from sexual intercourse in the days close to ovulation. The Pearl index reaches 40. To determine the fertile (“dangerous” period), the following methods are used:

calendar;
measuring temperature in the rectum;
examination of cervical mucus;
symptothermal.

Calendar method of contraception

Used only in women with regular cycle. It is believed that ovulation occurs on days 12-16 of the cycle with a duration of 28 days, the sperm lives 4 days, the egg lives 1 day. Therefore, the “dangerous” period lasts from 8 to 17 days. These days you need to use other methods of protection.

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

Intrauterine systems

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

1. You don’t have to worry about an unwanted pregnancy for several years; it has a positive effect on sexual relationships.

2. High reliability. Just under 100%.

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

And these are disadvantages.

1. Unpleasant sensations during installation. Some women require local anesthesia.

2. The possibility of the IUD falling out and dislodging, which provokes a decrease or cessation of its contraceptive effect.

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

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

5. Increased likelihood of heavy menstruation. Therefore, non-hormonal intrauterine systems are not recommended for use in women who experience severe cyclic and acyclic uterine bleeding.

Condoms

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

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

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

3. No contraindications. Only sometimes allergic reactions occur to them. More often it is a matter of lubricant, dye or flavoring that is used to cover the condom. In this case, you need to try another, regular one, without any bells and whistles.

But there are also disadvantages. They tend to be especially scary for couples who have previously used other forms of contraception.

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

2. The condom falls off during intercourse. Again due to poor erection. It happens when a condom is worn when there is insufficient sexual arousal.

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

By the way, an intrauterine device can be used as emergency contraception. It should be installed a maximum of 5 days after unprotected sexual intercourse. Naturally, this method suitable for those women who were already thinking about installing an intrauterine system.

Spermicides

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

Some advantages.

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

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

3. They have some antimicrobial and antibacterial effects.

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

And these are the disadvantages.

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

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

3. Efficiency is significantly lower than declared if sexual intercourse begins before the time specified in the instructions. After introducing the drug into the vagina, you need to wait a little for it to start working.

Hormonal agents

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

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

2. Make the menstrual cycle regular.

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

4. Provide positive influence to the endometrium. Also, hormonal contraception is the prevention of the formation of certain types of ovarian cysts.

5. Can be taken for an unlimited period, with breaks only for pregnancy. Treatment ends with the onset of menopause.

And the downsides.

1. Sometimes they provoke the development of varicose veins.

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

3. In parallel with oral contraceptives, you cannot take certain medications, for example, antibiotics, since this reduces protection against pregnancy.

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

5. Sometimes reception hormonal contraception provokes excess weight gain.

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

7. Decreased libido, vaginal dryness. This can be fixed. Longer foreplay and the use of water-based lubricants will solve the problem. this problem. In some cases, women switch to three-phase drugs or no estrogen at all. It can also help in returning sexual desire.

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

Non-working and unreliable methods of contraception

Sex for conceiving children is a much rarer thing than intercourse for pleasure. That is why not every sexual intercourse should result in pregnancy. It's always been like this, but modern means contraception appeared relatively recently. That is why in ancient times people tried with all their might to come up with at least some reliable way combating unwanted conception.

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

1. Sex while standing. There is a myth that standing sex prevents the man's semen from reaching the egg, as it simply spills out of the vagina. In fact, this is not at all the case. Sperm are quite capable of achieving their goal. Thus, trying to protect yourself from an unplanned pregnancy by standing, or any other pose, is impossible.

2. Interrupted sexual intercourse. The most popular method of folk contraception is interrupted coitus. However, popularity is not a guarantee of success. The fact is that during arousal, a certain amount of lubricant containing sperm may be released from the male genital organ. Consequently, conception can occur even at the very beginning of intercourse.

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

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

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

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

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

6. Vaginal douching. Often women choose antiseptics for these purposes, such as chlorhexidine or miramistin. But it's no use. These substances can only protect against infections, and not always. Well, they are not scary for sperm. Within 1-2 minutes after intercourse, many nimble guys will enter cervical canal. And you can’t get them from there anymore.
Well, the most unpleasant thing is that douching disrupts the microflora of the vagina and leads to the proliferation of pathogenic and opportunistic microorganisms there, that is, to inflammation.

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