About 90 out of 100 cases could be prevented. However, for some reason women do not want or cannot use contraceptives. Often patients are simply not sufficiently informed about what reliable methods of birth control are available. Today's article will tell you about them.

How to choose a contraceptive?

If your immediate plans do not include having children, then it is worth finding out what methods of birth control are available. A lot of products have now been developed for women. Some of them are based on hormonal correction, others are barrier methods. Some contraceptives may also protect against sexually transmitted infections. Some drugs are suitable only for women who have given birth, while others are preferable for those with irregular sex life.

To choose the right methods of birth control (for women), you need to consult a gynecologist. The doctor will prescribe an examination for you. After this - taking into account individual characteristics- the specialist will offer you several suitable ways. You can choose one or more of them. Next, you can learn how to protect yourself from unwanted conception.

Hormonal drugs: COCs, patches and others

What methods of birth control for women are considered the safest? Experts say that when used hormonal drugs the chance of unexpected conception is almost zero.

There are several types. Before choosing one or another remedy, you must undergo tests.

• Pills. There are different types: monophasic, biphasic, three-phase. Such drugs have many contraindications. They are not prescribed for diabetes, varicose veins, migraines, smoking and many diseases. You need to take the pills at the same time every day. Only in this case will the effect be expected.
• Plasters. Hormonal drugs of this type are used less frequently. These modern methods Pregnancy protection is considered quite expensive. One patch is used for 22 days. After this there is a week break. Then the scheme is repeated.
• Subcutaneous implants. Such contraceptives are used in cases where the use of patches or tablets is not possible. Capsules are sewn under the skin for up to several years. As a result, a woman does not have to bother with taking pills and gets rid of worries about unwanted conception.

All hormonal methods of birth control for women are based on one action. They stop the ovaries from working and prevent the release of an egg.

Barrier methods: condoms and vaginal products

The most popular barrier method is the condom. However, it is used by men, not women. A condom is placed on the penis before sexual intercourse. This method allows you to protect against all infections, including syphilis and HIV. Condoms are suitable for women who do not have a regular partner. They are also used as additional contraceptives. An alternative to such products would be

Barrier contraceptives include various spermicidal contraceptives. These are candles, creams, gels or foams. They are used 10-15 minutes before sexual intercourse and are effective for 40 minutes. The drugs can protect against certain infections and have a bactericidal effect. However, not all microbes die from these agents. In addition, long-term use of spermicides can disrupt the vaginal microflora.

Natural Methods

Most dangerous methods protection from pregnancy - calendar calculation, interrupted sexual intercourse and some others. All of them are based on the woman’s feelings and assumptions. Often, representatives of the fairer sex who prefer these options end up pregnant.

• The essence of contact) is that the man ejaculates outside female body.
• contraception is used by women with regular cycles. Representatives of the fairer sex calculate the timing of ovulation and during this period refrain from intercourse.

TO natural ways protection can be attributed to tracking basal temperature, studying cervical mucus and so on. Be that as it may, but this is a method of contraception not recommended by gynecologists.

Intrauterine devices

Reviews from experts about the use of IUDs say that this method of protection is proven and safe. But it is not recommended nulliparous women, since they require expansion during insertion of the device cervical canal. Intrauterine devices do not allow the fertilized egg to attach to the surface of the endometrium, even in the event of conception. Therefore, there is a guarantee of a contraceptive effect.

Reviews from some women about the IUD say that they managed to get pregnant even with the device installed. Such conception is considered pathological and in most cases ends in miscarriage.

Postcoital remedies

After the act? In such situations, modern post-coital methods of contraception come to the rescue. Drugs are produced in tablets: “Mifegin”, “Postinor”, ​​“Escapelle” and so on. They should be taken no later than three days after intercourse. The drugs are contraindicated in liver failure, smoking, thrombosis.

The action of the drugs is based on stopping the production of progesterone and separating the endometrium from the lining of the uterus. Such medications should be used only in emergency cases. They are not suitable for permanent birth control. Side effects of the drugs include nausea, abdominal pain, hormonal imbalances, and so on.

Emergency methods of contraception include the installation of an intrauterine device. It has already been discussed above. In this case, you need to meet the deadline of 5 days. If during this time you manage to carry out the manipulation, then the likelihood of pregnancy will be close to zero. But it is worth remembering that before such a procedure it is necessary to undergo tests. Some studies take more than five days.

Traditional methods

Our grandmothers and great-grandmothers also knew how not to get pregnant after intercourse. For this purpose various folk remedies and recipes. But modern gynecologists are against such “amateur activities”. The ineffectiveness of such methods has long been proven. But for general information, it’s worth talking about them.

• Douching. Potassium permanganate, citric acid and aspirin tablets are used as the basis of the solution for insertion into the vagina. All these components are diluted in water. It is assumed that the liquid radically changes the microflora and acidity in the vagina. This is why sperm cannot survive.
• Another “grandmother’s” method of contraception is a loading dose of vitamin C. It has long been known that this method can bring menstruation closer. It is believed that after unprotected sex, vitamin C can prevent conception.
• In ancient times, before sexual intercourse, women inserted a slice of lemon into the vagina. Acidic environment did not allow capable sperm to penetrate into the uterine cavity.

In conclusion

Modern medicine offers couples a variety of contraceptives. They are selected individually, taking into account all your characteristics and wishes. If a woman has hormonal disease, then some medications can help eliminate it. Be sure to visit a gynecologist and choose the method that is right for you. By using contraceptives, you can protect yourself from abortion and its complications. Approach this issue responsibly and take care of yourself!

Application chemicals contraception, or spermicide, is quite widespread. Spermicides are chemicals that inactivate sperm in the vagina and prevent it from passing into the uterus. Like any other means of contraception, spermicides have their positive and negative aspects.

Chemical methods of contraception - advantages and disadvantages

Disadvantages of chemical methods of contraception

• Low effectiveness compared to the effectiveness of hormonal and intrauterine contraceptives. Pregnancy occurs in 21% of women who regularly use this method of contraception during the first year due to errors in use. With constant and correct use spermicides, pregnancy occurs only in 6% of cases;
• chemical contraceptives may have a local irritant effect;
• Some spermicides, especially foaming ones, create discomfort during sexual intercourse.

Benefits of chemical contraceptive methods

• Spermicides are easy to use;
• their effect is short-lived;
• spermicides do not cause serious side effects;
• they can be used during the period of withdrawal of hormonal and intrauterine contraceptives;
• some of them have protective properties- create a chemical barrier to intravaginal infections.

Spermicides provide some protection against many sexually transmitted diseases (such as gonorrhea, trichomoniasis, chlamydia) and reduce the risk of developing inflammatory processes in the pelvic organs.

Frequent or chronic use of spermicides can irritate and damage the vaginal lining, which can facilitate the transmission of HIV infection. If irritation or allergic reaction In women, it is recommended to stop using spermicides, especially if there is a risk of HIV transmission.

Features of the impact of chemical methods of contraception

Each chemical contraceptive consists of an active principle (chemical substance) and a base, or filler, i.e. the substance on which the drug is prepared. To prepare the bases of chemical contraceptives, glycerin, cocoa, gelatin, polyethylene oxide, cellulose derivatives, etc. are used.

The mechanism of operation of chemical methods of contraception

A variety of substances are used as the active principles of chemical contraceptives, since spermatozoa are very sensitive to changes external environment and to many chemical agents. So, for example, if the vaginal environment is changed from slightly acidic to strongly acidic or alkaline, then the sperm will quickly die. This is the basis for the use of acids and alkalis for contraceptive purposes. In addition, antiseptic substances (alcohols, etc.), quinine, various salts (sodium chloride, copper sulfate, potassium permanganate, sodium salicylic, etc.) are used as active principles. Most famous chemicals components of spermicides are nonoxynol-9, octoxynol-9, menfegol and benzalkonium chloride.

Spermicides are available in the form of creams, gels, soluble or foaming tablets, aerosol foam, films, and as condom lubricants.

Suppositories and tablets are produced in sealed packages, other spermicides are produced in special tubes. Different drugs have different physical properties. The duration of the contraceptive effect, as well as the length of time required for the formation of a barrier and distribution of spermicide in the vagina, depend on the characteristics of the spermicidal filler. There is a certain period of time during which spermicides are effective after they are administered. If sexual intercourse occurs outside the established period of validity, then an additional dose of spermicide must be injected into the vagina.

Spermicides can be used with condoms, diaphragms, caps, or alone. Spermicides are injected into the upper part of the vagina 10-15 minutes before sexual intercourse. For one sexual act, a single use of the drug is sufficient. With each subsequent sexual intercourse, additional administration of spermicide is necessary.

The failure rate of isolated spermicide use ranges from 3 to 5 pregnancies per 100 women per year when correct use of this method. On average, it is about 16 pregnancies per 100 women per year.

Contraceptives

Contraceptives are traditionally divided into mechanical, biological and chemical. Various means naturally have varying degrees efficiency. Almost none of the methods of preventing pregnancy (except sexual abstinence) can give a 100% guarantee. Quite often, in order to achieve greater safety and reliability, various contraceptives are combined. However, it is best to select a contraceptive after consulting a gynecologist.

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

CONDOMS

Condom (condom) - made of latex (polyurethane). Placed on the male penis during an erection, before engaging in sexual intercourse. After ejaculation, the condom is immediately removed and discarded. In addition to its main purpose, this contraceptive also protects partners from most sexually transmitted sexually transmitted infections (syphilis, gonorrhea, AIDS, chlamydia, herpes, hepatitis B). The percentage of effectiveness of this contraceptive is quite high - 85-95%. However, not everything is 100%, because condoms can break and are sometimes used incorrectly.

SPIRAL

An intrauterine device (also known as an IUD, or commonly referred to as a spiral) is a convenient and highly effective device that is placed in the uterus. The spiral, despite the high percentage of efficiency (98-99%), has a number of possible complications. For this reason, the IUD is not recommended for use by women under 23 years of age who do not yet have children. Only a gynecologist should install and remove this product after medical examination. The advantages of the spiral include its long-term use - up to 5 years.

CONTRACEPTIVE PATCH

The principle of operation of the patch is that it is glued to a certain area of ​​the body, and then hormones are absorbed into the body through skin. The effect of this contraceptive is that the development of the egg is delayed and the viscosity of the mucus in the cervical area increases. Three patches are usually used per menstrual cycle, meaning one patch is applied for seven days. Next, you need to take a week's break, and at this time menstruation begins. The disadvantages of this method include the appearance of discharge (between cycles) and headache.

VAGINAL RING

This means of protection is a transparent elastic ring, which is made of synthetic material and contains hormones that begin to be released only after the ring is inserted into the vagina. With the help of a complex membrane system, only a strictly defined amount of hormones is released daily. The ring can be easily inserted and removed by the woman herself. It is used for contraception for one menstrual cycle, which includes 21 days of use and seven days off. Side effects: spotting, nausea, headaches, etc.

LONG-ACTING INJECTIONS

The method of protection using injections is to stop ovulation (the process of the release of an egg from the ovary) by changing the mucus in the cervix, changing the mucous membrane of the uterine cavity itself, as a result of which the development of pregnancy is impossible. The contraceptive effect of this method lasts 3 months. However, this method also has a number of quite serious disadvantages. Problems with bleeding may occur, as well as swelling, headaches, and a decrease in the level of sexual desire. Also when long-term use this method is destroyed bone tissue.

NORPLANT

The Norplant contraceptive system is six small capsules that contain the hormone levonorgestrel (progestin). The capsules are installed under the skin, on the inside of the shoulder, after which the hormone gradually begins to be released into the blood. The contraceptive effect begins within a day and lasts for five years. It is achieved by changes in the endometrium, which lead to disruption of the process of attachment of the egg to the walls of the uterus. When using this implant, intermenstrual discharge may appear, the menstrual cycle may also be disrupted, depression, headaches, fluid retention in the body, acne and pain in the mammary glands may appear.

MALE AND FEMALE STERILIZATION

It should be remembered that sterilization is a method of irreversible contraception that leads to complete infertility (however, even in this case we cannot talk about 100% reliability, because there is always a chance that even the operation will not bring desired result). Male sterilization is a fairly simple surgical procedure that involves cutting and then ligating the vas deferens. Female sterilization takes place in a hospital setting and involves cutting and dressing fallopian tubes. Do not forget that, as with any other surgery, during sterilization there is always a risk of complications - bleeding, infection, adhesions.

DIAPHRAGM

It looks like a dome-shaped cap made of latex or rubber. It is inserted into the vagina no earlier than 6 hours before sexual intercourse, while closing the cervix. The diaphragm also serves as a container for a special cream that suppresses sperm activity. The principle of its action coincides with the principle of action of a condom - these barrier agents don't allow mechanically get sperm into the uterus.

BIOLOGICAL REMEDIES

Biological contraceptives are a way to prevent pregnancy using hormonal contraceptives. With this method of contraception, a woman must take pills daily that contain female sex hormones. After their use, the overall hormonal background, which in turn inhibits ovulation, changes the state of the intrauterine environment, preventing the possible occurrence of pregnancy. The effectiveness of hormonal contraception is 97-99%. There are combined oral hormonal contraceptives, that is, those that contain estrogen and gestagen, and non-combined ones, that is, those that contain only gestagen. You need to select a hormonal contraceptive with the help of a gynecologist. Since there are diseases for which the use of hormonal contraceptives is contraindicated.

MINI PILL TABLETS

This hormonal pills, which do not contain estrogens. Their effect is to increase the viscosity of the cervical mucus, which in turn makes it very difficult for sperm to pass into the uterus. Also, these drugs inhibit the maturation of the endometrium, as a result of which it becomes impossible for the egg to attach to the walls of the uterus for its further development. Mini-pills are taken without interruption for the entire time required to prevent pregnancy. The main disadvantage of this method is the slightly higher frequency (compared to other oral contraceptives) of breakthrough bleeding. Mini-pills are a solution for women who are contraindicated in the use of estrogens, including nursing mothers.

CALENDAR METHOD

It consists of calculating the estimated date of ovulation using simple mathematical operations and abstaining from sexual intercourse during the fertile phase (the ovulation phase during which a woman can become pregnant).
The beginning of the fertile phase described above is determined by subtracting 18 days from the shortest cycle, and the end by subtracting 11 days from the longest cycle.

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

That is, from the 10th to the 19th day of the cycle, fertilization can occur, which means that on these days you need to use barrier contraceptive methods or abstain from sex altogether. The disadvantages of this method primarily include its unreliability, since initially it assumes a regular, constant menstrual cycle, which, unfortunately, not a single woman has.

TEMPERATURE METHOD

It is based on calculating the fertile phase by measuring basal (or rectal) temperature in women. You need to start measuring your basal temperature on the first day of your cycle. After waking up in the morning, without getting out of bed, you need to place the thermometer in the rectum at a level of 1-2 cm, and hold it there for 5-6 minutes. The data obtained must be entered into a special chart of your basal temperature. It should be remembered that throughout the entire period it is necessary to use one thermometer, and measure the temperature at the same time every day.

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

The advantages of the temperature method of contraception include: ease of use; absence of any side effects; the most accurate determination of days of probable conception when planning pregnancy.
Disadvantages: high risk unwanted pregnancy(because the level of basal temperature is greatly influenced by large number factors); the need to measure basal temperature daily.

SEXUAL WITHDRAWAL

This method consists of complete elimination the male penis from the woman's vagina before ejaculation begins. Coitus interruptus is one of the least effective methods contraception. According to statistics, out of a hundred couples who use this method, approximately 20-25% experience an unplanned pregnancy. Firstly, during the initiation of sexual intercourse, a certain amount of active sperm is released along with natural lubrication. Secondly, not every man can control himself during orgasm. And also, when having sex again, you should use another method of contraception to avoid sperm getting into the vagina. The advantages of this method include accessibility and simplicity, while the disadvantages include incomplete satisfaction of partners with the process.

EMERGENCY (aka post-coital, fire) CONTRACEPTION combines methods of preventing unwanted pregnancy, which are used after unprotected sexual intercourse has taken place. Most emergency contraception can be purchased in pharmacies without a prescription and used independently, but we strongly recommend that you consult a doctor so that he can select the most optimal method of emergency contraception for you, check for contraindications to the chosen method and select the required dosage.

TYPES OF EMERGENCY CONTRACEPTION:

1) Douching
Douching with various solutions even immediately after unprotected intercourse is very ineffective, because sperm penetrate into the cervix within a minute after ejaculation. Also, do not forget that a small amount of active sperm can be released directly during sexual intercourse - with lubricant.

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

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

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

It must be remembered that after using emergency hormonal contraception methods, it is necessary to mandatory apply until the next menstrual cycle additional ways contraception: spermicides, condoms, etc.

3) Non-hormonal emergency contraception
Mifepristone (Gynepristone) is one of the most effective drugs emergency protection. One-time dose low dose this drug in within three days after the unprotected incident occurred sexual intercourse causes a slowdown in ovulation (this process depends on the phases of the menstrual cycle), changes in the endometrium, and also prevents the attachment of a fertilized egg.

This drug has fewer side effects - for example, the incidence of bleeding is only 15%, compared with 31% with levonorgestrel. The effectiveness of this method of emergency contraception is 98.8%. The advantages of this method include the fact that it can be used for a longer period compared to other means of emergency contraception, and also that after taking it there are practically no hormonal-dependent side effects.

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

Emergency contraception is an alternative to abortion, but it is strongly not recommended for use as permanent contraception, but only in “emergency” situations (maximum once every six months). Since frequent use emergency methods contraception may lead to disruption reproductive functions women.

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

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

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

Hormonal methods of contraception

Hormonal methods of contraception are based on taking pills containing synthetic female sex hormones, which suppress ovulation and make pregnancy impossible. Hormonal contraceptives can be oral, injectable, implantable, or transdermal. Oral hormonal contraceptives- these are tablets, injectable - these are injections, and implantation or transdermal - these are patches or implants.

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

Oral contraceptives for each woman must be selected individually, taking into account existing diseases, type of menstrual cycle, hormonal levels, etc. Hormonal pills prevent the development of ovulation and also change the state of the endometrium, preventing the fertilized egg from implanting in the uterus. Thanks to this action, hormonal pills reliably protect against unwanted pregnancy. Oral contraceptives also reduce the duration and volume of blood lost during menstruation, eliminate pain syndrome and minimizes the risk of developing inflammatory pathologies.

The modern oral contraceptive drug Delsia contains the most studied combination of active ingredients, ethinyl estradiol and drospirenone. This combination restores hormonal balance, helps normalize the cycle, maintain stable body weight, eliminate oily skin and hair, reduce anxiety and improve mood. The optimal regimen is one tablet for 21 days with a physiological break of 7 days.

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

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

Injectable contraceptives are injections containing synthetic hormones that provide protection against pregnancy. long term up to several months.

Implantable contraceptives are implants containing synthetic hormones that are inserted under the skin, providing gradual release. active substance and long lasting action.

Intrauterine contraception

Intrauterine contraception has been known since ancient times. The essence of this method is the introduction into the uterus foreign body, which prevents the fertilized egg from attaching to the endometrium. Even the ancient Egyptians inserted stones into the uterus of camels to prevent the animals from becoming pregnant. The most common method of intrauterine contraception is the IUD. The IUD can be simple or hormonal. Hormonal intrauterine devices contain small doses of hormones that are gradually released and further prevent the fertilization of the egg. IUDs are placed for 1,2 or 5 years, during which they protect women from unwanted pregnancy.

Barrier methods of contraception

Barrier methods of contraception include mechanical and chemical structures, preventing sperm from penetrating the fallopian tubes and fertilizing the egg. Barrier methods of contraception include condoms, vaginal diaphragms, cervical caps and spermicidal gels, suppositories, tablets and sprays. A condom prevents sperm from entering a woman's genital tract, and caps and diaphragms prevent them from entering the uterine cavity. Spermicides contain substances that kill sperm. Barrier methods of contraception are highly effective if used correctly.

Surgical method of contraception

Surgical contraception involves sterilizing a man or woman. This method provides absolute reliability, since it creates artificial infertility. However surgical sterilization does not affect sexual function. Sterilization of women is carried out by ligating or cutting the fallopian tubes, and for men by pulling the vas deferens. After sterilization, it is impossible to restore the ability to bear children.

Postcoital contraception

Postcoital contraception is also called emergency contraception. The essence of this method is that within three days after unprotected sexual intercourse it is necessary to take hormonal pills that will prevent pregnancy, even if fertilization of the egg has occurred. Emergency contraception should only be used when necessary, for example, if a woman has been raped or a condom has broken, etc. Postcoital contraception cannot be used as a primary contraceptive.

Postcoital contraceptives include the drugs Escapelle, Postinor, Danazol or Mifepristone. The use of any drug for emergency contraception will seriously imbalance functional state reproductive system women. The disturbance can be so severe that it can lead to ovarian dysfunction.

Biological methods of contraception

Biological methods of contraception are based on physiological characteristics the female body, as well as the essence of sexual intercourse. TO biological methods include temperature and calendar methods, as well as interrupted sexual intercourse. Temperature and calendar methods are based on identifying dangerous days on which pregnancy may occur. Having calculated these days, the woman needs to exclude sexual intercourse during this period. On the remaining days of the menstrual cycle, you can have sexual intercourse, since the likelihood of pregnancy is minimal. These methods can only be used by absolutely healthy women with a regular menstrual cycle.

When using the calendar method, women calculate dangerous days according to the length of your own menstrual cycle. And the use of the temperature method requires daily measurement of basal temperature (in the rectum). When the temperature rises by 0.4 - 0.5 degrees, it means ovulation has occurred. 4 - 5 days before its onset are the days on which pregnancy is most likely to occur. It is necessary to measure the temperature over several menstrual cycles and calculate, based on the chart, dangerous days on which you cannot have sexual intercourse, since the likelihood of pregnancy is maximum.

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

Before use, you should consult a specialist.

Prevention of abortion is key point in preserving reproductive health girls. According to experts, artificial termination of pregnancy quite often leads to infertility. Today, approximately every fifth pregnant woman resorts to abortion. Despite the high effectiveness of contraceptives, many young ladies unreasonably neglect this opportunity. We should not forget that the main objectives of contraception are not only to ensure the prevention of medical abortions, but also to prevent infection with sexually transmitted diseases.

Types of contraception

There are different methods of contraception. However, regardless of the type of contraceptives, female contraceptives must be highly effective, safe for health, easy to use and available for purchase.

Modern methods of contraception:

• Physiological.
• Barrier or mechanical.
• Chemical.
• Hormone.

Female contraceptives can be bought in pharmacy chains without a prescription.

Physiological

Peculiarity physiological method contraception is that a girl during a certain period of her menstrual cycle must abstain from intimacy or actively use other contraceptives. As a rule, if the menstrual cycle lasts 28 days, then it is necessary to abstain from vaginal sex in the period from the 11th to the 18th day, when ovulation occurs. The physiological method is based on alternating periods of high and low fertility (ability to bear children). Scientists have found that the egg remains viable for 1–3 days, and the sperm for about 5 days. What methods can be used to clarify the time of ovulation:

1. Calendar. It is necessary to calculate the fertile period, taking into account the individual duration of the menstrual cycle.
2. Temperature. To determine the fertile period, measurements are taken rectal temperature. They should be held at the same time in the morning. While lying down, the woman inserts a special thermometer into the rectum for 5–6 minutes. Ovulation is recognized by analyzing the temperature curve. The defining moment is a temperature drop of 0.2–0.3 °C and a subsequent rise of 0.7–1.0 °C. Such changes are observed only 1–2 days after the completion of the ovulatory phase. Having determined the day of ovulation, the “dangerous period” is calculated.
3. Cervical. By the nature of changes in cervical mucus due to estrogen during the menstrual cycle, it will be possible to judge what phase the woman is in.
4. Multicomponent. Judging by the name, it is not difficult to guess that this method includes measuring basal temperature, recording changes in the properties of cervical mucus, calendar calculations and some subjective signs (in particular, the appearance of pain in the lower abdomen, discharge, etc.).

The main advantage of the physiological method is considered to be ease of use and absolute safety for the female body, since no consequences or adverse reactions can be expected. However, it is worth noting that this method of contraception is suitable for women with normal menstrual cycles. But for teenagers and young girls physiological method inappropriate to use for several reasons:

• Irregular ovulatory cycle.
• Young girls quite often experience random or extraordinary ovulation.
• Late ovulation is more common.
• Low efficiency.
• Girls find it difficult to make correct calculations and perform basic methods of physiological contraception.
• This method is not able to protect against sexually transmitted diseases.

Not all types of contraception can provide 100% protection against unwanted pregnancy.

Barrier or mechanical

Usage special means preventing sperm from moving into the uterine cavity is called barrier or mechanical contraceptive method. It is known that barrier contraceptives are provided for both women and men. The most common types of barrier protection against unplanned pregnancy:

• Condoms (female and male).
• Vaginal diaphragm.
• Cervical caps.

Condoms

Today, the main material for making condoms is latex. It helps not only protect against unplanned pregnancy, but also prevents infection with sexually transmitted diseases. Main disadvantage method - frequent ruptures of condoms made of thin elastic rubber. According to statistics, this happens approximately once every 50-300 times we have sex.

If a condom ruptures, it is recommended to inject a spermicidal substance into the vagina and/or use an oral contraceptive for emergency post-coital prevention of unwanted pregnancy. In addition, quite often when using a condom, both sexual partners note a decrease in sexual pleasure. Clinical studies show that many boys and men neglect this method of contraception.

Therefore, a condom for women was invented, which is effective both as a contraceptive and in preventing infection with sexually transmitted diseases. It must be put on a few hours before intimacy and removed after sex. Repeated use is strictly prohibited.

Vaginal diaphragm

To explain in a nutshell, the vaginal diaphragm is a fairly good barrier contraceptive, shaped like a hemisphere and consisting of a rubber cap connected to a ring. To prevent the passage of sperm, it should be inserted into the vagina in such a way as to close the cervical canal. To increase contraceptive effectiveness, the vaginal diaphragm is used together with spermicidal agents, which can be purchased in the form of creams, foam, gels, etc.

Available various models and sizes, so it is recommended to select individually. As a rule, the insertion of the vaginal diaphragm is carried out immediately before intimacy, using a spermicide on both sides. Its removal is carried out 7–10 hours after completion of sexual intercourse. I would like to note that this barrier method of contraception does not help protect against diseases transmitted during sex, although it can protect the internal genital organs from certain types of infections.

Cervical cap

The mechanism of action and contraceptive effectiveness of cervical caps are almost the same as that of vaginal diaphragms. In shape they resemble a hemisphere with thickened edges. The negative pressure created helps the cap not to slip off the cervix. It should be administered 30–10 minutes before sexual intercourse. Can remain in the vagina for 6–9 hours ( maximum term– 1.5 days). Unlike a condom, the vaginal diaphragm and cervical cap can be used more than once. Before using any method of barrier or mechanical contraception, it is recommended that you carefully read the instructions.

Modern contraceptives for women (contraceptives) must be available with a prescription.

Chemical (spermicidal)

The chemical or spermicidal method of contraception is based on the use of special agents that can inactivate sperm. This effect is realized due to active component which destroys cell membrane male reproductive cells in a few seconds. Spermicides are available in the form of gel, cream, suppositories, foam, tablets, etc. The effectiveness of the chemical method of contraception directly depends on its correct use. Features of application:

1. Spermicidal preparations are administered no later than 30–60 days before sexual intercourse.
2. Spermicides must come into contact with the cervix.
3. If you do not know how to use chemical contraception correctly, consult your gynecologist.

The active substances included in spermicides can not only destroy sperm, but also have a bactericidal and virusicidal effect. For example, the active component nonoxynol or benzalkonium chloride inhibits the growth and reproduction of pathogenic microorganisms such as chlamydia, mycoplasma, trichomonas, ureaplasma, etc. To increase contraceptive effectiveness, many experts advise combining the use of chemical and barrier contraceptive methods.

Pharmatex

One of the most popular spermicidal agents for chemical contraception is Pharmatex. For complete destruction For sperm, 20 seconds of male germ cells being in an environment with Pharmatex is enough. Repeated sexual intercourse requires a new administration of the drug. In addition, it has antimicrobial activity against a number of sexually transmitted diseases (for example, gonorrhea, chlamydia, trichomoniasis, etc.). At the same time, Pharmatex does not affect normal microflora vagina and does not lead to menstrual irregularities.

It can be combined with intrauterine devices (IUD), condoms, vaginal diaphragm, cervical caps. Pharmatex is available in following forms for vaginal use:

• Pills.
• Pills.
• Candles.
• Tampons.
• Cream.

Each form has its own application features, which you can familiarize yourself with by reading official instructions to the drug. It should be remembered that Pharmatex is contraindicated in hypersensitivity to its active components and inflammatory diseases genitals. To avoid a decrease in spermicidal effect, simultaneous vaginal use of several drugs is not recommended.

Contraceptive sponge

A product that combines mechanical and chemical protection against unwanted pregnancy is called a contraceptive sponge. It acts as a barrier, preventing the movement of male germ cells in the cervical canal, and also secretes a spermicidal component that helps destroy sperm. The shape is a round pad with a small depression on one side, which should be adjacent to the cervix. However, due to its low contraceptive effectiveness, it is usually not recommended for use by adolescents and young girls. More experienced and older women are quite capable of installing this type of contraceptives and do not have any special problems with use.

The best method of contraception is the combined use of contraceptives (for example, hormonal drugs and a condom).

Hormone

Statistics show that almost 150 million girls and women around the world take oral contraceptives every day. At the same time, at present, the newest hormonal drugs are taken either orally or can be introduced into the body in other ways (injection, transdermal, intravaginal, etc.). The mechanism of hormonal contraception is as follows:

• Slow down the production of gonadotropic hormones.
• Suppress the ovulation process.
• Increase the viscosity and density of cervical mucus, which is produced by the cervix.
• By changing the properties of cervical mucus, sperm motility in the direction of the uterine cavity is inhibited.

Reception oral contraception stops ovulation and prevents fertilization of the egg. Also, due to the effect on the endometrium, there is a prevention of egg implantation in the uterine cavity.

Oral contraceptives

There are many types of hormonal contraceptives. Let's focus on the most clinically significant ones. Depending on the composition, oral contraception is divided into the following main groups:

1. Combined hormonal drugs containing progestogen and estrogen (Mersilon, Ovidon, Regulon, Rigevidon, Silest, Triziston, Triquilar, Belara).
2. Hormonal drugs whose active component is progestogen (Exluton, Ovret, Microlut, Charozetta). They are also called Mini-pills.

The ethinyl estradiol content plays a significant role when choosing the optimal combined oral contraceptive. Considering the amount of estrogens, hormonal drugs are divided into three large groups: high-, low- and micro-dose. Popular representatives of each of these groups:

• The first is Anteovin, Silest, Non-ovlon. They contain more than 35 mcg of ethinyl estradiol.
• The second is Regulon, Belara, Microgynon, Femoden (30 mcg each).
• Third - Mercilon, Mirrel, Miniziston (20 mcg each).

Main advantages and disadvantages

Among all hormonal oral contraceptives, priority is given to monophasic drugs containing a stable amount of both female hormones(for example, Mercilon). Two-and triphasic drugs have various quantities estrogens and gestagens, which helps them act on different periods menstrual cycle. The main advantages of monophasic oral contraceptives:

• They are more effective than other types of non-invasive contraceptives.
• Available for most girls and women.
• They do not provide severe consequences for the body.
• After stopping use, fertility is restored fairly quickly.
• It is considered a highly safe method.
• Long-term use possible.

A distinctive feature of most new combined oral contraceptives is their high efficiency and safety. Moreover, according to clinical studies, contraceptive effect– this is not their only property. What else is typical for contraceptive hormonal drugs:

• Able to regulate the menstrual cycle, especially in young girls.
• Helps get rid of algodismenorrhea ( painful menstruation).
• If you choose the right contraceptive, you don't have to worry about weight gain.
• They do not affect the main types of exchange.
• Eliminate deficiency of female hormones.
• Reduce the likelihood of a number of gynecological and somatic diseases.

The appearance of side effects is possible in the first 3 months of taking combined hormonal drugs. In most cases, they gradually disappear over time. Long-term use usually does not provoke such adverse reactions as headache, dyspeptic disorders, swelling of the mammary glands, painful menstruation, etc.

Unlike combined oral contraceptives, Mini-pills containing only progestogens have less pronounced contraceptive effectiveness. However, they do not apply serious harm young body. In addition, they are recommended for girls and women who have contraindications to the use of other oral contraceptives.

Use latest methods Contraception for women is recommended after consultation with a specialist.

Contraindications

Hormonal contraceptives can boast a fairly long list of various contraindications. Those that have a high lethal risk deserve the most attention. Diseases related to absolute contraindications on the use of hormonal oral contraceptives:

• Heart and vascular diseases (uncontrolled high blood pressure, myocardial infarction, atherosclerotic lesions of the bloodstream).
• Severe pathologies of the blood coagulation system and other diseases that provoke the formation of blood clots (venous thrombosis, thromboembolism).
• Tumors of the reproductive system and mammary glands.
• Severe pathology of the liver and kidneys with the development of functional failure.

How to take oral contraceptives?

To reduce the development of side effects and increase contraceptive properties, new regimens for the use of hormonal contraceptives have been developed. One of the latest innovations was the introduction into clinical practice prolonged use of combined oral contraceptives. Continuous use of the drug was proposed for 3–5 menstrual cycles, after which a 7-day break was taken and use was resumed.

Passed successfully clinical trial mode called “63+7”. Its essence is that the contraceptive is taken for 63 days, then there is a pause in taking it for exactly a week. In certain cases, the prolonged regimen can be extended to 126+7. With prolonged use of oral contraceptives with minimal interruption, a decrease in the occurrence of “withdrawal symptoms” is observed. The prolonged dosage regimen made it possible for girls and women to experience fewer headaches and menstrual irregularities of various nature, breast pathology and other side effects.

In addition, another one is actively being developed innovative approach to taking hormonal contraceptives, which is called fast start. What are its features:

1. It is allowed to start taking combined oral contraceptives at absolutely any period of the menstrual cycle.
2. Lack of significant negative influence on pregnancy and fetal development from the newest contraceptive drugs allowed scientists to come to such conclusions.
3. If pregnancy is diagnosed while using oral contraception, the medication must be stopped. It has been established that short-term use of hormonal contraceptives during pregnancy does not affect the risk of miscarriage.

The combined method is the most reliable way to protect against unwanted pregnancy, involving the simultaneous use of several types of contraceptives.

Modern contraceptives for women may have contraindications and side effects, which should be familiarized with before using them.

Emergency contraception

Despite the wide range of contraceptives, the problem of unplanned pregnancy remains very relevant for millions of girls and women. As a rule, the risk of unwanted pregnancy is associated with having sex without using contraception or its ineffectiveness. Oddly enough, many women believe that in similar situations the only thing they can do is wait to see whether the next period will come or not.

However, by using emergency contraception methods, you can significantly reduce the likelihood of unexpected conception. It is worth noting that this approach is practically unknown to many girls and women. At the same time, popularizing the basic principles of emergency contraception among the masses would significantly reduce the number of abortions.

When is emergency contraception indicated?

It's no secret that the chance of conceiving a child varies throughout the menstrual cycle. According to some data, the probability of pregnancy after unprotected intercourse is approximately 20%, regardless of the day of the menstrual cycle. At the same time, if sex without contraception occurred during the periovulatory period, then the chances of getting pregnant increase to 30%.

A British study showed that unprotected intercourse during ovulation can result in conception in 50% of cases, even during the first menstrual cycle. It has long been proven that sperm in a woman’s genitals remain viable for 3–7 days, and an unfertilized egg remains viable for 12–24 hours. According to most experts, it is advisable to carry out emergency contraception in the first 1–3 days after intimacy. In what cases is it indicated:

• Any unprotected sexual intercourse. Simply put, vaginal sex occurred without the use of contraceptives (condom, vaginal diaphragm, combined oral contraceptives, etc.).
• During intimacy, the condom broke or fell off.
• Premature removal of the vaginal diaphragm or cervical cap.
• Skipping a dose of oral contraceptives or taking the drug more than 12 hours late.
• A girl or woman was forced to have sex without her consent.

As shown clinical experience, modern contraceptives for women, regardless of the type, method and route of administration, are highly effective in preventing unplanned pregnancy.

Emergency contraception methods

1. Use of combined oral contraceptives (Yuzpe method).
2. Specially developed drugs for emergency protection.
3. Use of intrauterine contraception.

Combined hormonal oral medications are used quite often as emergency contraception. This method was named after the Canadian scientist Albert Yuzpe, who first used it and widely promoted it. Its essence was reduced to 2 times the use of a large dosage of estrogens and progestogens for 3 days from the moment of completion of sexual intercourse. The break between doses should have been at least 12 hours.

The effectiveness of the method was more than 95% and depended on two factors:

• The duration of the interval between intimacy and the prescription of emergency contraception. The earlier contraceptives are taken, the higher the expected effect.
• The day of the menstrual cycle when there was sex.

Despite the high effectiveness of the Yuzpe method, it requires the use high doses oral contraceptives and is associated with high risk development of adverse reactions. It has been recorded that in 30% of cases quite pronounced side effects are observed, including nausea, vomiting, migraine attacks, pain in the mammary glands, etc.

In addition, specially developed drugs based on levonorgesterel are also successfully used for emergency contraception. They are characterized by a pronounced gestagenic effect and the absence of estrogenic effects. Among the female population, the two most popular drugs that contain levonorgesterel are Postinor and Escalep. According to the results of world clinical trials, the effectiveness of these contraceptives is slightly higher than that of the Yuzpe method. Also, the tolerability of Postinor and Escalep is much better.

Correctly selected female contraception will help maintain reproductive health.

Non-hormonal drugs for emergency contraception

Most non-hormonal drugs for emergency protection against unplanned pregnancy contain the active component mifepristone, which is a synthetic antiprogestin. It is quite often used as a means for artificial termination of pregnancy. early stages (medical abortion). However, it can also be used for emergency contraception, especially when the patient cannot be prescribed hormonal contraceptive methods. Taking into account the phase of the cycle, the drug realizes its contraceptive effect due to:

• Interfering with the release of luteinizing hormone.
• Blocking or delaying ovulation.
• Disruption of natural changes in the endometrium.

During some scientific research mifepristone was found to be more effective and better tolerated than levonorgesterel. One of the main advantages of mifepristone over other methods of emergency contraception for women was that there was no decrease in effectiveness when the interval between sex and use of the contraceptive was increased (up to 120 hours).

In the post-Soviet space, the drug Ginepristone, used for emergency contraception, has become widespread. Its distinctive feature is that it is well tolerated and has a low dosage of the active component, compared to other existing non-hormonal drugs that are used for “quick” protection against unwanted pregnancy. Ginepristone must be taken once for 3 days after intimacy, not taking into account the period of the menstrual cycle. If after taking the drug there were repeated coitus, you should use additional contraceptive methods(for example, a condom). Since the contraceptive effect of Ginepristone during subsequent sexual intercourse is somewhat reduced.

Benefits of emergency contraception

I would like to clarify that hormonal and non-hormonal drugs for “emergency” contraception are intended only for emergency situations, and are not used on a regular basis. The main advantages of postcoital protection against unplanned pregnancy:

1. Ability to take contraceptives occasionally. This method will be especially interesting for girls and women who have an irregular sex life.
2. In most cases, there is a high contraceptive effect.
3. There are no significant adverse reactions.
4. Accessibility for many patients.

It should be remembered that emergency contraception drugs do not affect the implanted egg. Most of the recommended methods are safe for the fetus and the course of pregnancy. Therefore, even if conception occurred while using the above drugs, the pregnancy can be maintained. In addition, do not forget that contraceptives used in emergency situations, do not protect against sexually transmitted diseases. If you suspect a sexually transmitted infection after intimacy, you should immediately contact a specialist.