No contraception. Folk means of contraception. Recipes. Non-hormonal drugs for emergency contraception

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 for a long time. 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 it for several years unwanted pregnancy, 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, the occurrence of adhesions in the intestines, fallopian tubes Oh. 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 heavy menstruation. Therefore, non-hormonal intrauterine systems It is not recommended to use it for women who have 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 they appear allergic reactions. 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 effect 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 various substances on it in the form of a lubricant that are not intended for this. 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, as emergency contraception can be used intrauterine device. It should be installed a maximum of 5 days after unprotected sexual intercourse. Naturally, this method is 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. The chemical method of contraception also has pros and cons.

Some advantages.

1. Availability. 10 vaginal tablets (or suppositories), 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. When 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 on the endometrium. Hormonal contraception is also a means of preventing 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 taking hormonal contraception provokes 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 use of lubricants on water based decide this problem. In some cases, women switch to triphasic drugs or without 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 to combat unwanted conception.

Undoubtedly, some folk remedies worked, but most of them were real obscurantism. Unfortunately, despite modern developments in 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 there is nothing to say about the dangers of abortion for women’s health. 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. Standing sex. 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: lemon 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 similar cases This method of contraception is completely pointless.

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), truly “sterile days” begin; 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 “drive out” the infection from the urethra, which he could get as a result of sexual intercourse. How is the female urethra connected to 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 nimbles will enter the 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 bacteria there. pathogenic microorganisms, 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?

Preventing abortion is key to maintaining 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. Do not forget that the main tasks of contraception are not only to provide prevention 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 contraception, female contraceptives must be highly effective, safe for health, easy to use and available for purchase.

Modern methods 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. Similar changes are observed only 1–2 days after completion ovulatory phase. Having determined the day of ovulation, the “dangerous period” is calculated.
3. Cervical. By the nature of the changes 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 involves 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 implementation and absolute safety for the female body, since there are no consequences or adverse reactions there is no need to expect. 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 a barrier or mechanical contraceptive method. It is known that barrier contraceptives are provided for both women and men. Most common types barrier protection from an 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. The main disadvantage of the method is the frequent rupture 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 introduce a spermicidal substance into the vagina and/or apply oral contraceptive for emergency postcoital 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, foams, gels, etc.

Various models and sizes are available, so individual selection is recommended. 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. It can remain in the vagina for 6–9 hours (maximum period – 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 the cell membrane of male germ 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. To completely destroy 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 the following forms for vaginal use:

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

Each form has its own characteristics of use, which can be found by reading the official instructions for the drug. It should be remembered that Pharmatex is contraindicated in case of 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 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, the motility of sperm in the direction of the uterine cavity is inhibited.

Taking oral contraception stops ovulation and prevents the 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 three-phase drugs have different amounts of 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 cause serious harm to the 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 contraceptive drugs boast a fairly long list various kinds contraindications. Most attention those that have a high lethal risk deserve it. Diseases that are absolute contraindications for the use of hormonal oral contraceptives:

• Heart and vascular diseases (uncontrolled high 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 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 schemes for the use of hormonal drugs have been developed. contraceptive drugs. 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 mode 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 innovative approach to taking hormonal contraceptives, called quick start, is being actively developed. What are its features:

1. It is allowed to start taking combined oral contraceptives at absolutely any period of the menstrual cycle.
2. The absence of a significant negative impact on pregnancy and fetal development from the latest 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 read 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 such situations the only thing they can do is wait to see whether the next period will come or not.

However, using methods emergency contraception, 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 clinical experience shows, 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 of high doses of oral contraceptives and is associated with a high risk 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 action. 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.
• Violation natural changes in the endometrium.

Some scientific studies have found that mifepristone is 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 low dosage 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, excluding the period of the menstrual cycle. If there have been repeated coitus after taking the drug, 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 “urgent” contraception are intended exclusively for emergency cases 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. In case of suspected infection venereal infection After intimacy, you should immediately consult a specialist.

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 of contraception also help combat 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 of contraception have 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

Foreign objects placed in the uterine cavity are used. Intrauterine contraception is widespread in China, Russia, and Scandinavian countries.

The method was proposed at the beginning of the twentieth century, when, to prevent pregnancy, it was proposed to insert a ring of different materials. In 1935, intrauterine contraception was banned due to large number 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;
• viscosity increase cervical mucus due to a hormone that prevents sperm;
• endometrial atrophy under the influence of levonorgestrel; ovulation and the effect of estrogen on the female body are preserved, and menstruation becomes shorter, less frequent or disappears completely;
• abortifacient 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 – The best way intrauterine contraception.

Introduction of a contraceptive

An intrauterine device is installed after an abortion or removal of a used one, 1.5-2 months after the birth of a child or six months after caesarean 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 issues;
• 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 of the genital organs, blood diseases, large, allergies to metals, severe associated conditions. For nulliparous women use intrauterine contraception it is possible, but the risk of future pregnancy pathologies is higher.

pros this method contraception - possible use during lactation, no side effects caused by estrogens, less impact on body 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 from venereal diseases. Therefore they are widespread. They are divided into chemical and mechanical methods of 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 (candles, 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 cycles. 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.

Today, every couple can control their sex life and consciously plan their pregnancy. The existence of such freedom in life is a huge merit of scientists and pharmacists, who regularly invent more and more advanced methods of contraception. Of course, even the most reliable method sometimes fails. In addition, there are many myths that make it difficult to understand the true reliability of a particular method.

Let's try to figure out which methods of contraception are the most reliable.

Sterilization - 99.9%

The most effective method of contraception is sterilization. In men it is a vasectomy, in women it is tubal ligation. These procedures require surgery and exclude the possibility of having a child in the future, so, naturally, they are not particularly popular among young men and women. In terms of reliability, sterilization is surpassed only by complete abstinence.

Features: Recommended only for women who already have several children and in case of medical contraindications to pregnancy, because the ability to become pregnant is not restored. There is also a risk of ectopic pregnancy.

Oral contraceptives - 99.7%

Hormonal pills are one of the most reliable methods of contraception.

Their main feature consists in the mechanism of action on the woman’s body. They provide complex action for women's reproductive system: ovulation is suppressed, mucus thickens cervical canal, the endometrial layer in the uterus becomes thinner. While taking the pills, the woman’s ovaries “rest”, and the required dose of the hormone is provided by the drug. Thickening of cervical mucus in the cervix prevents not only sperm from entering the uterus, but also bacteria, thereby reducing the risk of infectious diseases. However, it should be understood that oral contraceptives do not protect against sexually transmitted infections. Also, when using this method of contraception, a woman’s blood loss during menstruation is reduced by reducing the inner layer of the uterus. This effect has a positive impact on overall health, especially for women suffering from iron deficiency anemia.

Features: Combined oral contraceptives are qualitatively different from others hormonal drugs contraception, because different tablets contain different dosages and combinations of hormones. This allows for an individual approach and the choice of exactly those tablets that can solve problems specific woman. Naturally, a gynecologist should select them. Hormonal pills latest generation, in addition to the contraceptive effect, have a pronounced non-contraceptive effect: they have a positive effect on the condition of the skin and hair, eliminate PMS, shorten the duration of menstruation and reduce pain during this period. Of the many oral contraceptives available in pharmacies, we can highlight tablets with innovative dosage regimens 24+4 and 26+2. They shorten the non-hormonal period, which allows minimizing negative symptoms. Also Special attention It is worth paying attention to the latest generation of oral contraceptives, which contain active form folic acid. This component allows a woman to take care not only of her health, but also of the future generation. Once a woman decides that she is ready to have a baby, she can stop taking the pill, confident that her body is already prepared for pregnancy.

Intrauterine contraception - 99.2-99.8%

This type of contraception includes an intrauterine device and an intrauterine hormonal system. Both in terms of reliability and mechanism of action, they differ from each other. The spiral is installed in the uterine cavity and prevents the implantation (attachment) of a fertilized egg.

The intrauterine hormonal system is introduced in the same way, but acts differently - it regularly releases a certain amount of hormone, which, acting locally, has several effects: increases the viscosity of mucus in the cervical canal, suppresses sperm motility, thins inner layer uterine cavity (endometrium).

Features: The intrauterine hormonal system is suitable for women who do not intend to become pregnant for a long time, as well as for nursing mothers. It is installed for 5 years, however, if necessary, it is possible to remove it earlier. Unlike the IUD, the hormonal system is not an abortive method of contraception.

Hormonal implants and injections - 90-99%

These methods of contraception work on the principle of hormonal pills, only the hormone is introduced into the body in other ways: intramuscular injection carried out every three months (or monthly), a hormonal implant is inserted into top part hands and provides contraception for 5 years.

Features: Difficult to choose individually, based on the woman’s health status and her individual needs. There are a number of side effects: irregular bleeding, discharge, headaches, weight gain and acne.

Hormonal patch and ring - 92%

The same level of reliability for these two methods does not at all indicate the similarity of their use: the hormonal patch is glued to the skin, and the hormonal ring must be inserted into the vagina independently.

Features: The hormonal patch must be applied every 7 days, starting from the first day of the cycle. Usage hormonal ring it is designed for one cycle. It needs to be installed from the 1st to the 5th day of the cycle, and after three weeks (on the 22nd day) removed. On the 8th day of the break, a new one is introduced. It is the adherence to clear patterns that allows these methods to be effective, so they are only suitable for very organized women.

Barrier methods: condom, diaphragm, cap, sponge - 84-85%

The condom is the only one among all the above contraceptives that protects not only from pregnancy, but also from any infections and bacteria. But its low reliability means that this product often fails (simply breaks).

Diaphragm, cap and sponge - also barrier methods contraception, these devices are installed in the vagina immediately before sexual intercourse.

Features: These methods of contraception require preparation for sexual intercourse - and, therefore, can significantly reduce sexual desire, cause discomfort and reduce sensitivity.

Calendar method - 80%

Involves mathematical calculations of the days on which fertilization can occur, according to a woman’s menstrual cycle. Thus, during the “dangerous” period, you need to either abstain from sexual contact or use other methods of contraception.

Features: Suitable only for women with a regular menstrual cycle who are not embarrassed by “love on a schedule.”

Coitus interruptus 73%

The bottom line is that a man must have time to remove the penis from the vagina before ejaculation. This is one of the most ancient methods of birth control, but far from the most reliable. Please note that it is not a large number of seminal fluid can also be released during sexual intercourse.

Features: When resorting to PPA, a man is forced to deliberately control ejaculation, and this not only distracts from the process itself, depriving him of the opportunity to experience the full range of sensations for the sake of which, in fact, it happens sexual contact, but is also incorrect with medical point vision. Thus, a volitional obstacle to reflex ejaculation leads to problems with potency and ejaculation (for example, among men with prostatitis, half regularly practiced coitus interruptus).

Insufficient reliability of PPA also negatively affects sex life women. She also experiences psychological stress, which does not allow her to relax and receive maximum satisfaction during sexual intercourse. According to statistics, among women who have never experienced an orgasm, 50% used PAPs.

Spermicides 71%

Features: If pregnancy occurs with this method of contraception, this can have a bad effect on the fetus; most often, doctors recommend an abortion. In addition, chemical contraceptives often cause irritation and inflammation of the vaginal mucosa and vaginal candidiasis.

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Contraceptives

Contraceptives are traditionally divided into mechanical, biological and chemical. Different 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

SPIRAL

CONTRACEPTIVE PATCH

VAGINAL RING

LONG-ACTING INJECTIONS

NORPLANT

MALE AND FEMALE STERILIZATION

DIAPHRAGM

BIOLOGICAL REMEDIES

MINI PILL TABLETS

CALENDAR METHOD

Example:
The shortest cycle lasts 28 days, and the longest cycle lasts 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

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).

To the advantages temperature method 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 influenced by a very large number of factors); the need to measure basal temperature daily.

SEXUAL WITHDRAWAL

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:

2) Hormonal contraceptives
The first way to use hormonal contraception is to simultaneously take 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 is 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 that may be caused hormonal methods 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, within three days after unprotected sexual intercourse occurs, 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 prevent unplanned pregnancy is to use intrauterine devices(Navy). 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). Because the frequent use emergency methods contraception may lead to disruption reproductive functions women.