How to protect yourself from pregnancy. Methods and methods of preventing unwanted pregnancy. Effective contraceptives

  • May 08, 2018

Knowing how to protect themselves from unwanted pregnancy, eliminates associated with childbirth for women's health risks, it reduces the percentage of child mortality and the spread of STIs.

Contents

  • How to protect yourself from pregnancy. Pearl Index
  • Traditional methods of protection from pregnancy
    • Coitus interruptus( PAP)
    • Calender protection against pregnancy
  • Modern methods of protection against pregnancy
    • Intrauterine device( IUD)
  • How to protect against pregnancy.
  • Intrauterine Therapeutic System
  • Oral contraceptives
    • Pills( COC)
    • Mini-saws
  • Implants
  • Injectable contraceptives
  • Combined contraceptive patch
  • Combined contraceptive vaginal ring( CAF)
  • How to protect yourself from pregnancy. Chemical contraception( birth control pills, tablets, etc.)
  • How to protect yourself from pregnancy. Barrier contraception
    • Male condoms( condoms)
    • Female condoms( femidomas)
    • Diaphragm( cap)
  • How to protect yourself from pregnancy. . Surgical contraception
    • Male sterilization( Vasectomy)
    • Female sterilization( tubal occlusion)
  • How to protect yourself from pregnancy. Natural contraception method
    • lactational amenorrhea( LAM)
    • days standard method or DPA
    • Method of measuring basal body temperature( BBT)
    • Method two days
    • Symptothermal method
  • As protect against pregnancy. Emergency contraception
  • Conclusion
  • How to protect yourself from pregnancy. Pearl Index

    This number shows the number of women who become pregnant during the year using a single contraceptive method. The lower the indicator, the higher the effectiveness of contraception.

    important to distinguish between "good practices"( proper, consistent use of a variety of contraceptive), and "the efficiency of the method"( misuse of contraception, the use of different contraceptives for a year).Because of these two indicators, the upper and lower boundaries of the Perl index can vary significantly.

    Traditional methods of protection from pregnancy

    Coitus interruptus( PAP)

    PAP principle is to avoid getting semen in the genital tract of the partner: the penis is removed from the vagina before ejaculation.

    • Requires self-control and concentration from the man.
    • In the process of intercourse in men, in one or another quantity, pre-ejaculate is excreted, in which spermatozoa can be contained. Occasionally, this number of "tadpoles" may be sufficient for conception.

    Pearl Index: 4-17.The calendar

    protection against pregnancy

    Calendar method based on the definition of the menstrual cycle and fertile days using contraception / abstinence during this period. The method is suitable only for women with a stable cycle.

    • The calculation takes a semi-annual cycle. The first fertile day is determined by subtracting from the shortest cycle 18, the estimated last fertile day is calculated by subtracting from the longest cycle 11. In the period that elapses, it is necessary to avoid unprotected intercourse or use additional contraception.
    • Ovulation may occur earlier or later than the middle of the cycle.
    • With strong stresses, a change in climate, there is a high probability of a cycle and failure of the method.

    Pearl Index: 4-17

    Modern methods of pregnancy prevention

    Intrauterine device( IUD)

    IUD is a device placed in the uterus of healthy and previously delivered women using a special applicator and mechanically preventing the development of pregnancy. The

    • Navy is made from a variety of materials, can be of different shapes. The most popular copper-containing spirals. Copper is harmful to spermatozoa, which reduces the likelihood of fertilization. Additives of silver and gold have a positive effect on the spermatoxic and anti-inflammatory properties of the spiral.
    • After installing the spiral for 2 weeks, you can not lift weights, play sports and have sex. During this time, the IUD will "settle" in the uterine cavity.
    • The contraceptive effect may decrease with the displacement of the IUD, so it is important to check the length of the antennae to prevent partial loss.
    • Using the IUD slightly increases the risk of implanting a fertilized ovum outside the uterus.
    • The filaments of the spiral remaining in the vagina contribute to infection in the sterile uterine cavity. Therefore, when installing and wearing the IUD, it is important that women have no inflammatory processes in the genital tract.
    • Against the backdrop of a spiral, critical days can be painful and abundant.
    • After removal of the IUD, fertility is restored within a year.

    Pearl Index: 5.

    How to protect yourself from pregnancy. Hormonal contraceptives

    Intrauterine therapeutic system

    The most popular contraceptive of this category is produced under the name "Mirena".This is a contraceptive T-shaped spiral containing 52 mg of levonorgestrel. Can be used for lactating women, as well as for medicinal purposes. The principle of the device consists in oppression of ovulation, thickening of mucus in the cervical canal and thinning of the endometrium.

    • When wearing a hormonal IUD, menstruation may be completely absent or scarce.
    • The term of protective and therapeutic action is 5 years.

    Pearl Index: 0.2.

    "Jaides" - IUD with less levonorgestrel( 13.5 mg).The principle of action is mainly local impact on the uterus.

    • The period of protection is three years.

    Perl index: less than 1.

    Oral contraceptives

    • For each particular patient, based on the results of the tests, the best contraceptive pills are selected by the doctor. Unauthorized designation of an OC can adversely affect a woman's health.
    • Very not recommended to combine smoking and taking OK: in this case, the risk of thrombosis increases. Also, with caution, it is OK to use women older than 35 years, especially with a tendency to varicose veins.
    • Modern correctly selected oral contraceptives do not contribute to weight gain. At inclined to fullness of ladies in the first months there can be an increase of weight in kg-another in a zone of a breast and hips, but in due course also she will leave.
    • Contraceptive pills favorably affect the condition of the skin, hair.
    • The risk of uterine and ovarian cancer has been reduced with the use of hormonal contraceptives. Data on the increase in the risk of breast cancer due to the use of OK at this time have not been confirmed.
    • Modern good birth control pills do not require a break more than the standard seven days even after many years of use.
    • Some medicines may affect the effectiveness of QA, so the doctor who prescribes treatment should be aware of the taking of the pills. Also reduce some of the contraceptive effect of certain foods, such as grapefruit juice.

    Pills( COC)

    They are also combined oral contraceptives. The very name of the group of drugs says that there are several active substances. Modern pills contain estrogen and progestin. The principle of the COC is to prevent ovulation.

    • Combined oral contraceptives are not recommended for breastfeeding women, and in the first six months of feeding is completely prohibited.

    Perl index: when used correctly - 1, in normal use - 8.

    "Mini-drank"

    So-called tablets that contain only progestin alone. The principle of these contraceptives in preventing fertilization by thickening the mucus in the cervix, as well as preventing ovulation.

    • The huge plus of "mili-drank" is that they are allowed for contraception to lactating women.
    • The disadvantage is that the reception of contraceptives must be carried out at the same time.

    Pearl Index: when used correctly - 1, in normal use - 3-10.

    Implants

    These are small-sized capsules or elastic rods injected under local anesthesia under the skin of the shoulder. Implants contain one kind of hormone, the term of protection from unwanted pregnancy to 3-5 years.

    • On the territory of CIS countries, "Norplant" is popular - an implant containing levonorgestrel. The term of protection against pregnancy is 3 years. The principle of operation of implants is the same as that of oral contraceptives of "mini-pili".
    • The method is very convenient to use.
    • The contraceptive is placed and removed in a hospital setting.

    Pearl Index: 1-3.

    Injectable contraceptives( IR)

    IR are progestogens of prolonged action. In the domestic market are presented under the names "Depo-provera"( depo-medroxyprogesterone acetate 150 mg) and "NET-EN"( norzsterone enanthate 200 mg).

    • "Depo-Provera" is cast on the 5th day of the cycle. The protective effect lasts exactly 12 weeks.
    • One injection of "NET-EN" protects against pregnancy for 8 weeks.
    • After cancellation of injections, fertility is usually restored after 4-24 months.

    The Pearl Index: 0.5 - 1.5.

    Combined Contraceptive Plaster

    Contraceptive patches are modern contraceptives containing progestin and estrogen. In domestic pharmacies the patch is presented under the name "Evra".

    • The patch is adhered exactly and tightly on the first day of the cycle on the abdomen, back, shoulders or buttocks. In no case should the contraceptive patch be glued to the mammary glands.
    • The term of protection for one patch is a week. The effectiveness of the method can be reduced if the woman is overweight( 90 kg or more).
    • The plaster does not affect the habitual way of life, does not interfere with taking water procedures. Fertility after the abolition of the use of the patch is restored almost immediately.

    Pearl Index: 0.9.

    Combined Contraceptive Vaginal Ring( CAF)

    The vaginal ring for protection from pregnancy is a special elastic membrane that secretes hormones estrogen and progestogen in small concentrations. In the CIS countries it is issued under the name "NovaRing".

    • One ring protects against unplanned pregnancy for 21 days. The ring is easily installed and removed.
    • A correctly inserted contraceptive ring does not cause discomfort to a woman and is not felt by her partner during sexual intercourse.
    • If the ring is dropped, it must be reinserted, previously rinsed with warm water.

    The Pearl Index: 0.7.

    How to protect yourself from pregnancy. Chemical contraception( birth control pills, tablets, etc.)

    Chemical contraceptives include spermicides - substances that have a harmful effect on spermatozoa. There are creams, pills, jellies, foams, soluble films, candles to prevent pregnancy. The most popular representatives of spermicides are benzalkonium chloride( Erotex, Pharmatex), non-oxylon-9( Conceptrot, Delfin).

    • Spermicides act locally, do not affect the hormonal background. Can be used in tandem with barrier contraception, increasing protection from unplanned pregnancy and STDs.
    • To ensure the effectiveness of the method, it is necessary to know how to protect against pregnancy with spermicides. After using spermitsiditsa must pass at least 10-15 minutes before the sexual intercourse.
    • At least 2 hours before and 2 hours after intercourse, soap-based hygiene products should not be used. Alkaline soap environment neutralizes the acidic environment of spermicides, which reduces the effectiveness of this contraceptive.

    Pearl Index: 18-24.

    How to protect yourself from pregnancy. Barrier contraception

    Barrier contraception is male and female condoms, diaphragms and caps. For unmarried people, the question of which contraceptives to choose, should not be raised. Condoms - the only method of protection, protecting not only from pregnancy, but also from STDs.

    Men's condoms( condoms)

    A condom is a cover placed on an erect penis before intercourse. Often it is made of latex, but also condoms are made from polymeric materials: resin AT-10, polyurethane, polyisoprene.

    • Latex condoms are available in a wide range, have a more affordable price. They are elastic, less prone to slipping. But the material, because of natural origin, allergies occur. Also these condoms are incompatible with fat-based lubricants.
    • Condoms made of polyurethane are much thinner than latex ones. They also conduct heat better, thereby providing a greater naturalness of sensations during sexual intercourse. But such condoms have less elasticity. The price of polyurethane condoms is high.
    • Polyisoprene is an artificial latex. It has all the advantages of its natural counterpart, but it is hypoallergenic and compatible with grease on fat basis. The price of polyisoprene condoms is very high.
    • Condoms are worn on the erect penis prior to commencement of intercourse. After ejaculation, the condom should be removed from the vagina, holding the condom behind the ring at the base to avoid slipping.

    With the correct use of the method, the Pearl index is 2-4, in other cases - 15-25.

    Female Condoms( femidomas)

    A female condom is a tube with a blind end with elastic rings at both ends. It is made of polyurethane or latex. The standard length of the femidom is 18 cm, the diameter is 8 cm.
    The blind end of the contraceptive is inserted deep into the vagina, the larger ring remains outside.

    • Themis gives higher protection against STDs due to the fact that the contraceptive covers part of the vulva.
    • The use of a female condom does not depend on the erection of the penis.
    • Use concomitantly and femidom is not recommended.
    • Themis is not widely distributed in the CIS countries and has a rather high cost.
    • About one third of women surveyed noted discomfort when using femidoma.

    The Perl index for polyurethane femidoms, as well as for condoms, is 5-25.

    Diaphragm( cap)

    The diaphragm is a dome-shaped cap with an elastic rim, worn on the cervix shortly before commencement of intercourse. Remove the device should be 6-24 hours after the end of sexual intercourse.

    • A diaphragm made of rubber, latex, is available in various types and sizes. The optimal option is selected privately by a gynecologist.
    • Diaphragms are reasonable to use in tandem with spermicides.
    • This method does not protect against venereal diseases.
    • Not suitable for nulliparous girls.
    • Contraindicated in the defeat of the epithelium of the cervix, the bend of the cervix.
    • For large variations in weight, the diaphragm will most likely need to be replaced.
    • May cause discomfort and provoke inflammation.

    Pearl Index: 6-20.

    How to protect yourself from pregnancy. . Surgical contraception

    Male sterilization( vasectomy)

    Vasectomy is a simple surgical operation consisting in cutting the vas deferens. Does not affect the ability to make intercourse and sensations during it.

    • In the first 5, maximum 10 years, it is possible to carry out a reverse vasectomy, however, the patency of the vas deferens is not restored often.
    • After carrying out a vasectomy it is important to pass a spermogram because during the quarter after the operation it is still possible the presence of spermatozoa in the ejaculate.

    Pearl index provided that a quarter after the operation of the spermogram is less than 1. Without an analysis of sperm, the indicator is 2-3.

    Female sterilization( tubal occlusion)

    The so-called "piping" is a voluntary, most often laparoscopic operation, which disrupts the flow of the fallopian tubes.

    • There are several methods of conducting the operation: crossing, excising, dressing, blocking, imposing special clips on the fallopian tubes.
    • Theoretically, when using the method of applying clamps, the ability to conceive can be restored, but in practice, the patency of the egg through the pipes after removing the obstruction is restored badly.
    • It is impossible to restore the passability of the crossed fallopian tubes, pregnancy will be possible only by IVF.
    • Sterilization does not affect the libido, hormonal system, psyche.

    Pearl Index: less than 1.

    How to protect yourself from pregnancy. Natural contraception

    The method of lactational amenorrhea( LAM)

    When breastfeeding in the woman's body produces a hormone prolactin, which suppresses ovulation.

    • The LAM works for half a year after delivery, under the conditions that menstruation after childbirth has not been resumed, and the infant is exclusively fed on breast milk.
    • In the daytime, the baby is fed at least once every three hours, at night there is at least one feeding and the interval between feedings does not exceed 6 hours. The more frequent the feeding, the higher the effectiveness of the method.
    • Ovulation precedes menstruation, so when signs of pregnancy appear, a nursing woman should come to the doctor for an examination.

    Pearl Index: 1-2.

    Method of standard days, or MSD

    Suitable for women with a cycle of 26 to 32 days. Women follow "dangerous days" with the help of special beads or rosaries, stringing on them beads of different colors. For example: red - menstruation, white - "dangerous days"( usually from 8 to 19 days), green - all other days.

    Pearl Index: 5-12.

    Method for measuring basal body temperature( BTT)

    Basal temperature is measured daily at the same time immediately after awakening. Before the measurement is completed, it is impossible to get out of bed or even to lower the legs. To measure the thermometer for 5-10 minutes is inserted into the rectum to a depth of about 5 cm. The electronic thermometer is undesirable. Increasing the basal temperature by more than 0.5 degrees for three days indicates ovulation. On the fourth day and until the next menstruation, contraceptives can not be used.

    The Pearl Index ranges from 1 to 25.

    Two Day Method

    Based on a daily study of mucus from the cervix. In the fertile period, the discharge is more abundant, in color and consistency resemble egg white. Open sexual intercourse can be resumed after 2 days with scanty, uncharacteristic ovulation secretions.

    • STDs can change the appearance of the vaginal discharge, making it difficult to use the method.

    Pearl Index: 4-16.

    Symptomatic method

    The symptom-thermal method is what is better to protect when choosing a natural contraceptive. The method combines a calendar, a method of measuring the BTT and a two-day method.

    Pearl Index: 2.

    How to protect yourself from pregnancy. Emergency contraception

    Emergency contraception is a means of preventing pregnancy, which are taken by a woman after unprotected intercourse or with unprotected contraception.

    Postcoital contraceptive preparations:

    1. "Postinor", "Escapel"( levonorgestrel hormone 0.75 or 1.5 mg).
    2. "Ginepristone", "Genale", "Agesta"( antigestagen mifepristone 10 mg).
    3. In some countries, drugs with active substance have also been used to expel acetate at a dosage of 30 mg.
    • Levonorgestrel-based pills prevent the egg from escaping from the ovary. But with the ovulation that has already occurred, the drug will not work. Also, drugs with such an active substance act worse on women with a body mass index of 30 or more.
    • Mifepristone-based pills are considered to be more effective. They inhibit ovulation and prevent the attachment of the blastocyst to the walls of the uterus.
    • Preparations of postcoital contraception should be taken within 3 days of unprotected intercourse. The faster the tablet is taken, the higher the chance of the drug triggering.
    • Postcoital contraception may cause a malfunction of the menstrual cycle and increase the likelihood of developing pregnancy outside the uterine cavity due to disruption of the peristalsis of the fallopian tubes.

    Conclusion

    • At the moment, there are many effective methods of contraception. Before using any
      contraceptive, read the instructions, as the protective effect depends on the correct application.
    • One of the most reliable and affordable contraceptives are contraceptive pills, but which ones are ideal for a particular woman should be determined by the doctor after the examination of the patient.
    • In the presence of several sexual partners, the preferred use of condoms and femidoms is the only contraceptives that protect against "Venus diseases".