What are the most effective birth control methods for women. How do different contraceptive options compare in terms of effectiveness and side effects. Which birth control method is best for specific health conditions or lifestyle factors.

Understanding the Landscape of Female Contraception

Birth control, also known as contraception, encompasses a wide range of methods designed to prevent pregnancy. For women, the choices are particularly diverse, ranging from hormonal options to barrier methods and long-acting reversible contraceptives. Understanding these options is crucial for making informed decisions about reproductive health.

When considering birth control, several factors come into play:

• Effectiveness in preventing pregnancy
• Ease of use and convenience
• Potential side effects and health considerations
• Cost and accessibility
• Reversibility and impact on future fertility
• Protection against sexually transmitted infections (STIs)

It’s important to note that what works best for one woman may not be ideal for another. Personal health history, lifestyle, and preferences all play a role in choosing the most suitable contraceptive method.

Intrauterine Devices (IUDs): Long-Term, Reversible Protection

Intrauterine devices, or IUDs, have gained popularity due to their high effectiveness and low maintenance requirements. There are two main types of IUDs:

Levonorgestrel Intrauterine System (LNG IUD)

The LNG IUD is a small, T-shaped device that releases a low dose of progestin hormone. It offers several advantages:

• Effectiveness: With a typical use failure rate of only 0.1-0.4%, it’s one of the most reliable methods available.
• Duration: Depending on the specific device, it can provide protection for 3 to 8 years.
• Reversibility: Fertility returns quickly upon removal.
• Additional benefits: Many women experience lighter periods or no periods at all while using the LNG IUD.

Copper T Intrauterine Device

The Copper T IUD is a non-hormonal option that works by creating an environment hostile to sperm. Key features include:

• Long-lasting protection: It can remain effective for up to 10 years.
• High effectiveness: The typical use failure rate is 0.8%.
• Hormone-free: Ideal for women who prefer or need to avoid hormonal methods.
• Emergency contraception: When inserted within 5 days of unprotected sex, it can also serve as emergency contraception.

Are IUDs suitable for all women? While IUDs are safe for most, they may not be recommended for those with certain uterine abnormalities or a history of pelvic inflammatory disease. A healthcare provider can help determine if an IUD is appropriate based on individual health factors.

Hormonal Contraceptives: Versatile Options for Pregnancy Prevention

Hormonal contraceptives work by altering the body’s natural hormone levels to prevent ovulation or create other changes that inhibit fertilization. These methods come in various forms:

Contraceptive Implant

The implant is a small, flexible rod inserted under the skin of the upper arm. It releases progestin continuously, offering:

• Extremely high effectiveness: The typical use failure rate is just 0.1%.
• Long-lasting protection: It remains effective for up to 3 years.
• Convenience: Once inserted, no further action is required.

Injectable Contraception

Also known as “the shot,” this method involves receiving injections of progestin every three months. Key points include:

• Effectiveness: The typical use failure rate is 4%.
• Privacy: It’s a discreet option that doesn’t require daily attention.
• Potential side effects: Some women may experience changes in menstrual bleeding or weight gain.

Combined Oral Contraceptives

Commonly referred to as “the pill,” these contraceptives contain both estrogen and progestin. Important aspects include:

• Flexibility: Various formulations are available to suit individual needs.
• Additional benefits: Can help regulate periods and reduce acne for some users.
• Effectiveness: The typical use failure rate is 7%, largely due to inconsistent use.
• Considerations: Not recommended for women over 35 who smoke or have certain health conditions.

Progestin-Only Pills

Also known as the “mini-pill,” this option contains only progestin. It’s particularly suitable for:

• Women who can’t take estrogen due to health reasons or personal preference.
• Breastfeeding mothers, as it doesn’t affect milk supply.

The typical use failure rate for progestin-only pills is also 7%, similar to combined oral contraceptives.

Contraceptive Patch and Vaginal Ring

These methods deliver hormones through the skin or vaginal lining, offering:

• Weekly or monthly application, reducing the need for daily attention.
• Similar effectiveness to oral contraceptives, with a 7% typical use failure rate.
• Potential for more consistent hormone levels compared to oral methods.

How do hormonal contraceptives affect menstrual cycles? Many users experience lighter, more regular periods, while some methods may lead to absence of periods altogether. This varies by individual and specific method used.

Barrier Methods: Physical Prevention of Sperm Entry

Barrier methods work by physically preventing sperm from reaching the egg. They offer the advantage of being used only when needed and typically have fewer systemic side effects compared to hormonal methods.

Diaphragm and Cervical Cap

These devices are inserted into the vagina to cover the cervix. Key points include:

• Used with spermicide for increased effectiveness.
• Reusable and cost-effective over time.
• Requires proper fitting by a healthcare provider.
• Typical use failure rate for diaphragms is 17%.

Contraceptive Sponge

The sponge is a soft, disk-shaped device containing spermicide. Important aspects include:

• Can be inserted up to 24 hours before intercourse.
• Effectiveness varies: 14% failure rate for women who have never given birth, 27% for those who have.
• No prescription required and available over-the-counter.

Male Condoms

While not a female-specific method, condoms play a crucial role in contraception and STI prevention:

• Only method that also provides protection against most STIs.
• Widely available and affordable.
• Can be used in combination with other contraceptive methods for added protection.

Do barrier methods affect sexual spontaneity? While some planning is required, many users find that with practice, these methods can be incorporated smoothly into sexual activities.

Natural Family Planning: Understanding Fertility Cycles

Natural family planning methods involve tracking fertility signs to avoid or achieve pregnancy. These methods require no medications or devices but demand careful attention and consistency.

Fertility Awareness-Based Methods

These techniques involve monitoring various fertility indicators:

• Basal body temperature changes
• Cervical mucus consistency
• Calendar tracking of menstrual cycles

Effectiveness varies widely based on correct and consistent use, with typical use failure rates ranging from 2% to 23%.

Lactational Amenorrhea Method (LAM)

This method relies on the natural postpartum infertility that occurs when a woman is exclusively breastfeeding. It’s effective for up to six months postpartum if specific criteria are met.

Can natural methods be as effective as other contraceptives? When used perfectly, some natural methods can approach the effectiveness of hormonal methods. However, they require significant commitment and may not be suitable for women with irregular cycles.

Emergency Contraception: Options for Unprotected Intercourse

Emergency contraception is used to prevent pregnancy after unprotected sex or contraceptive failure. Options include:

Emergency Contraceptive Pills

• Levonorgestrel pills: Available over-the-counter, most effective when taken within 72 hours of unprotected sex.
• Ulipristal acetate: Prescription-only, can be effective up to 5 days after unprotected sex.

Copper IUD

When inserted within 5 days of unprotected intercourse, the Copper IUD is the most effective form of emergency contraception and can provide ongoing contraception for up to 10 years.

How often can emergency contraception be used? While safe for occasional use, emergency contraception should not be relied upon as a regular method of birth control due to lower effectiveness compared to consistent use of other methods.

Considering Health Conditions and Contraceptive Choices

Certain health conditions can influence the safety and effectiveness of contraceptive methods. It’s crucial to discuss medical history with a healthcare provider when choosing contraception.

Cardiovascular Health

Women with a history of blood clots, high blood pressure, or certain heart conditions may need to avoid estrogen-containing contraceptives. Non-hormonal methods or progestin-only options may be safer alternatives.

Migraine with Aura

Combination hormonal contraceptives are typically not recommended for women who experience migraines with aura due to an increased risk of stroke.

Breast Cancer History

Hormonal methods are generally contraindicated for women with a history of breast cancer. Non-hormonal options like the Copper IUD or barrier methods are often preferred.

Obesity

Some studies suggest that certain hormonal methods may be less effective in women with a high body mass index (BMI). Higher doses or alternative methods may be considered.

How do chronic conditions affect contraceptive efficacy? The impact varies depending on the condition and the contraceptive method. Regular follow-ups with a healthcare provider can help ensure the chosen method remains safe and effective.

Balancing Effectiveness and Personal Preferences

Choosing the right contraceptive method often involves balancing effectiveness with personal preferences and lifestyle factors. Consider the following:

Desired Duration of Use

• Short-term: Condoms, oral contraceptives, patches
• Medium-term: Injectable contraceptives
• Long-term: IUDs, implants

Frequency of Administration

Methods range from those requiring daily attention (pills) to those that can be “set and forget” for years (IUDs, implants).

Hormonal vs. Non-Hormonal

Some women prefer to avoid hormonal methods due to side effects or personal beliefs. Non-hormonal options include the Copper IUD, barrier methods, and natural family planning.

Impact on Menstrual Cycles

Certain methods can alter bleeding patterns, which may be desirable or undesirable depending on individual preferences.

Future Fertility Plans

Consider how quickly fertility needs to return after discontinuing the method.

Is there a “best” contraceptive method? The ideal method varies for each individual based on their specific needs, health status, and preferences. Regular discussions with a healthcare provider can help in finding and adjusting the most suitable option over time.

In conclusion, the landscape of female contraception offers a wide array of options to suit diverse needs and preferences. From long-acting reversible contraceptives like IUDs to hormonal methods and barrier options, each method comes with its own set of benefits and considerations. By understanding these options and considering personal health factors and lifestyle needs, women can make informed decisions about their reproductive health. Regular consultations with healthcare providers remain crucial in navigating the evolving world of contraception and ensuring that the chosen method continues to align with individual health goals and life circumstances.

Contraception | CDC

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Family planning services during COVID-19: Clinical considerations for service delivery and COVID-19 treatment and vaccination

The Reproductive Heath National Training Center has also compiled a list of suggestions and accompanying resources to help family planning providers meet their clients’ needs while keeping themselves and clients safe during this nationwide COVID-19 public health emergency.

• Birth Control Methods
• Resources for Providers
• Resources for Consumers

Birth Control Methods

Many elements need to be considered by women, men, or couples at any given point in their lifetimes when choosing the most appropriate contraceptive method. These elements include safety, effectiveness, availability (including accessibility and affordability), and acceptability. Voluntary informed choice of contraceptive methods is an essential guiding principle, and contraceptive counseling, when applicable, might be an important contributor to the successful use of contraceptive methods.

In choosing a method of contraception, dual protection from the simultaneous risk for HIV and other STDs also should be considered. Although hormonal contraceptives and IUDs are highly effective at preventing pregnancy, they do not protect against STDs, including HIV. Consistent and correct use of the male latex condom reduces the risk for HIV infection and other STDs, including chlamydial infection, gonococcal infection, and trichomoniasis.

Reversible Methods of Birth Control

Intrauterine Contraception

Levonorgestrel intrauterine system (LNG IUD)—The LNG IUD is a small T-shaped device like the Copper T IUD. It is placed inside the uterus by a doctor. It releases a small amount of progestin each day to keep you from getting pregnant. The LNG IUD stays in your uterus for up to 3 to 8 years, depending on the device. Typical use failure rate: 0.1-0.4%.¹

Copper T intrauterine device (IUD)—This IUD is a small device that is shaped in the form of a “T. ” Your doctor places it inside the uterus to prevent pregnancy. It can stay in your uterus for up to 10 years. Typical use failure rate: 0.8%.¹

Hormonal Methods

Implant—The implant is a single, thin rod that is inserted under the skin of a women’s upper arm. The rod contains a progestin that is released into the body over 3 years. Typical use failure rate: 0.1%.¹

Injection or “shot”—Women get shots of the hormone progestin in the buttocks or arm every three months from their doctor. Typical use failure rate: 4%.¹

Combined oral contraceptives—Also called “the pill,” combined oral contraceptives contain the hormones estrogen and progestin. It is prescribed by a doctor. A pill is taken at the same time each day. If you are older than 35 years and smoke, have a history of blood clots or breast cancer, your doctor may advise you not to take the pill. Typical use failure rate: 7%. ¹

Progestin only pill—Unlike the combined pill, the progestin-only pill (sometimes called the mini-pill) only has one hormone, progestin, instead of both estrogen and progestin. It is prescribed by a doctor. It is taken at the same time each day. It may be a good option for women who can’t take estrogen. Typical use failure rate: 7%.¹

Patch—This skin patch is worn on the lower abdomen, buttocks, or upper body (but not on the breasts). This method is prescribed by a doctor. It releases hormones progestin and estrogen into the bloodstream. You put on a new patch once a week for three weeks. During the fourth week, you do not wear a patch, so you can have a menstrual period. Typical use failure rate: 7%.¹

Hormonal vaginal contraceptive ring—The ring releases the hormones progestin and estrogen. You place the ring inside your vagina. You wear the ring for three weeks, take it out for the week you have your period, and then put in a new ring. Typical use failure rate: 7%.¹

Barrier Methods

Diaphragm or cervical cap—Each of these barrier methods are placed inside the vagina to cover the cervix to block sperm. The diaphragm is shaped like a shallow cup. The cervical cap is a thimble-shaped cup. Before sexual intercourse, you insert them with spermicide to block or kill sperm. Visit your doctor for a proper fitting because diaphragms and cervical caps come in different sizes. Typical use failure rate for the diaphragm: 17%.¹

Sponge—The contraceptive sponge contains spermicide and is placed in the vagina where it fits over the cervix. The sponge works for up to 24 hours, and must be left in the vagina for at least 6 hours after the last act of intercourse, at which time it is removed and discarded. Typical use failure rate: 14% for women who have never had a baby and 27% for women who have had a baby.¹

Male condom—Worn by the man, a male condom keeps sperm from getting into a woman’s body. Latex condoms, the most common type, help prevent pregnancy, and HIV and other STDs, as do the newer synthetic condoms. “Natural” or “lambskin” condoms also help prevent pregnancy, but may not provide protection against STDs, including HIV. Typical use failure rate: 13%.¹ Condoms can only be used once. You can buy condoms, KY jelly, or water-based lubricants at a drug store. Do not use oil-based lubricants such as massage oils, baby oil, lotions, or petroleum jelly with latex condoms. They will weaken the condom, causing it to tear or break.

Female condom—Worn by the woman, the female condom helps keeps sperm from getting into her body. It is packaged with a lubricant and is available at drug stores. It can be inserted up to eight hours before sexual intercourse. Typical use failure rate: 21%,¹ and also may help prevent STDs.

Spermicides—These products work by killing sperm and come in several forms—foam, gel, cream, film, suppository, or tablet. They are placed in the vagina no more than one hour before intercourse. You leave them in place at least six to eight hours after intercourse. You can use a spermicide in addition to a male condom, diaphragm, or cervical cap. They can be purchased at drug stores. Typical use failure rate: 21%.¹

Fertility Awareness-Based Methods

Fertility awareness-based methods—Understanding your monthly fertility patternexternal icon can help you plan to get pregnant or avoid getting pregnant. Your fertility pattern is the number of days in the month when you are fertile (able to get pregnant), days when you are infertile, and days when fertility is unlikely, but possible. If you have a regular menstrual cycle, you have about nine or more fertile days each month. If you do not want to get pregnant, you do not have sex on the days you are fertile, or you use a barrier method of birth control on those days. Failure rates vary across these methods.^1-2 Range of typical use failure rates: 2-23%. ¹

Lactational Amenorrhea Methods

For women who have recently had a baby and are breastfeeding, the Lactational Amenorrhea Method (LAM) can be used as birth control when three conditions are met: 1) amenorrhea (not having any menstrual periods after delivering a baby), 2) fully or nearly fully breastfeeding, and 3) less than 6 months after delivering a baby. LAM is a temporary method of birth control, and another birth control method must be used when any of the three conditions are not met.

Emergency Contraception

Emergency contraception is NOT a regular method of birth control. Emergency contraception can be used after no birth control was used during sex, or if the birth control method failed, such as if a condom broke.

Copper IUD—Women can have the copper T IUD inserted within five days of unprotected sex.

Emergency contraceptive pills—Women can take emergency contraceptive pills up to 5 days after unprotected sex, but the sooner the pills are taken, the better they will work. There are three different types of emergency contraceptive pills available in the United States. Some emergency contraceptive pills are available over the counter.

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Permanent Methods of Birth Control

Female Sterilization—Tubal ligation or “tying tubes”— A woman can have her fallopian tubes tied (or closed) so that sperm and eggs cannot meet for fertilization. The procedure can be done in a hospital or in an outpatient surgical center. You can go home the same day of the surgery and resume your normal activities within a few days. This method is effective immediately. Typical use failure rate: 0.5%.¹

Male Sterilization–Vasectomy—This operation is done to keep a man’s sperm from going to his penis, so his ejaculate never has any sperm in it that can fertilize an egg. The procedure is typically done at an outpatient surgical center. The man can go home the same day. Recovery time is less than one week. After the operation, a man visits his doctor for tests to count his sperm and to make sure the sperm count has dropped to zero; this takes about 12 weeks. Another form of birth control should be used until the man’s sperm count has dropped to zero. Typical use failure rate: 0.15%.¹

References

1. Trussell J, Aiken ARA, Micks E, Guthrie KA. Efficacy, safety, and personal considerations. In: Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken ARA, Marrazzo J, Kowal D, eds. Contraceptive technology. 21st ed. New York, NY: Ayer Company Publishers, Inc., 2018.
2. Peragallo Urrutia R, Polis CB, Jensen ET, Greene ME, Kennedy E, Stanford JB. Effectiveness of fertility awareness-based methods for pregnancy prevention: A systematic review. Obstet Gynecol 2018;132:591-604.

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Resources for Providers

CDC Contraceptive Guidance for Health Care Providers

U.S. Medical Eligibility Criteria for Contraceptive Use (US MEC), U. S. Selected Practice Recommendations for Contraceptive Use (US SPR) and Providing Quality Family Services (QFP) can assist health care providers when they counsel women, men, and couples about contraceptive method choice and family planning services.

• Contraceptive Use Among Women at Risk for Unintended Pregnancy in the Context of Public Health Emergencies — United States, 2016
• American College of Obstetricians and Gynecologists (ACOG) Long-A cting Reversible Contraception Program
• Family Planning National Training Center (FPNTC)
• National Clinical Training Center for Family Planning (NCTCFP)
• Tips for Communicating with Female Patients with Intellectual Disabilities

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Resources for Consumers

• Birth Control Methods fact sheet
  Métodos anticonceptivos hoja de datos
• Emergency Contraception (emergency birth control) fact sheet
  Anticoncepción de emergencia hoja de datos
• Office of Population Affairs
• Planned Parenthood

• His Condom + Her Birth Control [PDF – 1 MB]

• Know Your Condom DOs & DON’Ts [PDF – 2 MB]
  En español [PDF – 1 MB]

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CDC Contraceptive Guidance | CDC

New app released in May 2021! Includes new features that allow for the selection of multiple conditions and methods. The US MEC and US SPR app is an easy to use reference for CDC’s contraception guidance for healthcare providers. The app is available for iOS and Android operating systems and can be accessed here.

New US SPR recommendation on self-administration of DMPA-SC can be found in MMWR and here.

• U.S. Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC)
• U.S. Selected Practice Recommendations for Contraceptive Use, 2016 (US SPR)
• Quality Family Planning
• Social Media Tools: Badges to Share

U.S. Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC)

The 2016 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use of specific contraceptive methods by women and men who have certain characteristics or medical conditions. The recommendations in this report are intended to assist health care providers when they counsel women, men, and couples about contraceptive method choice.

Recommendations about the use of hormonal contraceptive methods (including depot medroxyprogesterone acetate) and intrauterine devices among women at high risk for HIV were updated in April 2020 in the MMWR and here.

U.S. Selected Practice Recommendations for Contraceptive Use, 2016 (US SPR)

The 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods. The recommendations in this report are intended to serve as a source of clinical guidance for health care providers and provide evidence-based guidance to reduce medical barriers to contraception access and use.

CDC added a new recommendation on the self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) in May 2021 in the MMWR and here.

Quality Family Planning

Providing Quality Family Planning Services (QFP) recommends how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose to not have children.

Social Media Tools: Badges to Share

CDC has created buttons and badges to promote action and awareness for a number of health topics, campaigns, and health observances. You can become an advocate for health by posting one of the buttons or badges featured below to your Web site, blog, or social networking site.

Copy this code to get the “US MEC” badge (150×180) for your site.
<a href=”https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html” title=”United States Medical Eligibility Criteria for Contraceptive Use”><img src=”http://www.cdc.gov/reproductivehealth/images/contraception/badges/US-MEC-Logo_150x180.png” style=”width:150px; height:180px; border:0px;” alt=”United States Medical Eligibility Criteria for Contraceptive Use” /></a></p><br /><br /><br /><p>

Copy this code to get the “US SPR” badge (150×180) for your site.
<a href=”https://www. cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html” title=”United States Selected Practice Recommendations for Contraceptive Use”><img src=”http://www.cdc.gov/reproductivehealth/images/contraception/badges/US-SPR-Logo_150x180.png” style=”width:150px; height:180px; border:0px;” alt=”United States Selected Practice Recommendations for Contraceptive Use” /></a><br /><br /><br /><br /><br>

Copy this code to get the “QFP” badge (150×180) for your site.
<a href=”http://www.cdc.gov/reproductivehealth/contraception/QFP.htm?s_cid=bb-QFP-01″ title=”Providing Quality Family Planning Services badge.”><img src=”http://www.cdc.gov/reproductivehealth/images/contraception/badges/Badges-QFP-150px.jpg” style=”width:150px; height:180px; border:0px;” alt=”Providing Quality Family Planning Services badge.” /></a><br /><br /><br /><br /><br>

Understanding the types of contraception, their pros and cons with an obstetrician gynecologist

Every woman is concerned about how to prevent unwanted pregnancy and protect herself from sexually transmitted infections.

The questions of how to prevent unwanted pregnancy and protect against sexually transmitted infections are of concern to every woman. Choosing reliable contraception is not an easy task, and this issue should be discussed with your doctor. Obstetrician-gynecologist of the clinic “Euromed” Marina Pavlovna GLUSHENKOVA talks about the existing methods of contraception, their pros and cons.

Contraception is barrier, hormonal and intrauterine. Methods such as coitus interruptus and calendar methods cannot be considered reliable and effective. Fortunately, in the XXI century there are many ways and means of protection from unwanted pregnancy and unpleasant diseases.

Barrier methods

Condoms

Pluses

• reliable protection against sexually transmitted diseases (STDs) and unwanted pregnancies (when used correctly)

• affordable price

• no systemic effect on the body

• ideal for those who have an irregular sex life

• do not require preliminary examinations for selection

Cons

Spermicides

Spermicides are substances that immobilize spermatozoa, due to which they do not penetrate into the uterine cavity.

Pluses

• partial protection against sexually transmitted infections (some viruses do not work)

• suitable for those who cannot use hormonal and intrauterine contraception

Cons

• low efficiency (60–70%), this method cannot be used as a standalone method

• requires very strict enforcement of the rules of use

• Possible irritation, allergic reactions of the skin of the genital organs

Intrauterine methods

Copper intrauterine system (coil)

The coil thickens cervical mucus and forms a barrier to spermatozoa. Copper acts toxically on spermatozoa, immobilizing them, and also suppresses ovulation.

Pros

• prolonged action, allowing you to forget about contraception for several years

• no systemic effect on the body

• can be used during lactation

Cons

• it is impossible to put nulliparous, because against the background of the spiral there is a risk of the formation of intrauterine synechia, adhesions, which can lead to infertility; Also, nulliparous due to anatomical features have a narrower cervical canal, which makes it difficult to install the spiral.

• the spiral does not protect against STDs, respectively, it is only suitable for women who have one permanent healthy sexual partner;

• against the background of the use of a copper-containing spiral, the risk of inflammatory diseases of the uterus and appendages increases by 5-6 times compared with women who do not have spirals;

• the spiral can provoke longer and more painful periods;

• if a woman has a history of multiple abortions, invasive interventions, curettage, there is a risk of developing cervical insufficiency, i.e. failure of the cervix, which can lead to expulsion (falling out) of the spiral.

Protected hormonal coils

The hormones contained in the system act in the uterine cavity, make the mucous membrane thinner, and immobilize spermatozoa. All this makes fertilization and implantation of the fetal egg impossible.

Pluses

• Reliable contraceptive action for five years

• No systemic action

• has a therapeutic effect: it is indicated for patients with a history of endometrial hyperplastic processes, uterine myoma

• can be used during lactation

Cons

Hormonal contraception

This is perhaps the most effective method of all existing today.

Hormonal preparations differ in dosage (mini-dose – estrogen content no more than 30 mcg, micro-dose – no more than 20 mcg, large doses are not currently used), components, and the method of entry into the body.

There are two types of drugs: combined and the “mini-drank” group. Combined contraceptives contain estrogens (ethinyl estradiol) and gestagens, “mini-drank” – only gestagens.

Preparations from the “mini-drank” group are indicated for lactating women who should not take estrogens, but only gestagens. Also, “mini-pills” can be taken by women who do not tolerate the estrogen component.

Types of drugs: tablets (taken orally), vaginal ring (hormones penetrate the vaginal mucosa) and patch (transdermal route – hormones enter through the skin).

Reception methods. Tablets should be taken daily, at the same time. It is especially important to take at the same time for drugs from the “mini-drank” group. Tablets are generally taken for 21 days, after which they take a break for 7 days.

The vaginal ring is inserted into the vagina for 21 days, after which there is a break for a week.

The patch is changed every 7 days.

The advantage of alternative routes of administration (ring, patch) is that you do not need to remember to take the pill every day and there is no primary passage through the liver and gastrointestinal tract, which reduces the load on them. This is especially important if a woman has problems with the gastrointestinal tract or chronic cholecystitis.

Pluses

• reliable contraceptive effect (if a woman does not miss taking pills, the guarantee is almost 100%)

• active protection of the ovaries and endometrium (mucosa) of the uterus from cancer

• regulation of the menstrual cycle

• reduction of pain during menstruation

• cosmetic effect (some OK help to cope with acne, normalize skin condition)

• therapeutic effect (the doctor will help you choose hormonal contraceptives, which are indicated for patients with uterine fibroids, with endometriosis).

Cons

• the need for strict discipline, control of taking drugs at the same time (especially important for “mini-pill”)

• do not protect against STDs

• any hormonal drugs affect metabolism (metabolism), which can lead to fluctuations in body weight, although in modern drugs this effect is minimal;

• there is an effect on the vascular link, on the blood coagulation system, therefore, when taking contraceptives, constant monitoring of hemostasis is necessary. If a woman has a predisposition to varicose veins, hypertension, or there have been cases of diseases of the cardiovascular system in the family, accompanied by thrombosis, heart attacks, strokes, then the patient needs a comprehensive examination of the hemostasis system before taking hormonal contraceptives;

• there is a period of adaptation to hormones. Within 2-3 months, nausea, headaches and pains in the mammary glands can sometimes be observed, there may be slight spotting in the middle of the cycle, changes in libido, mood swings. Therefore, mandatory medical supervision of the use of drugs during the first months of admission.

• hormonal contraceptives have a number of contraindications: active smoking (more than 5 cigarettes per day), severe somatic diseases, severe decompensated diabetes mellitus, thrombosis, varicose veins, heart attacks, strokes, arterial hypertension, frequent migraines, etc.

Sterilization

Medical sterilization is a surgical technique that can be used by both men and women. This is a reliable method of 100% protection against pregnancy, a good choice for people who are definitely not planning more children.

After the operation, the ability to conceive can no longer be restored for women, in men there is a small (less than 30%) chance of restoring reproductive function by re-operation within five years after the intervention.

Female sterilization is a laparoscopic operation during which the fallopian tubes are cut, which reliably prevents the possibility of pregnancy.

Male sterilization (vasectomy) is a simple operation that takes about 20 minutes. During surgery, the vas deferens are tied up and crossed. Sterilization does not affect the erection, the amount of seminal fluid and the ability to experience an orgasm.

Pluses

Cons

• irreversibility of the operation

• the need for surgery

• there are legal restrictions on this operation

Medical sterilization as a special medical intervention in order to deprive a person of the ability to reproduce offspring or as a method of contraception can only be carried out upon a written application of a citizen over the age of thirty-five or a citizen with at least two children, and if there are medical indications and informed voluntary consent citizen – regardless of age and the presence of children.

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emergency contraception

In the case of unprotected intercourse, you can use the so-called emergency contraception. These drugs are aimed at protection, this is not an abortion. The tablet contains a large dose of progestin preparations that cause rejection of the endometrial mucosa.

Pluses

Cons

When choosing contraception, be sure to contact a gynecologist. Before prescribing this or that drug, the doctor will conduct an examination, which includes an examination on a chair, taking a smear for oncocytology. Also, if there are signs of endocrinopathy (increased hair growth, acne), it is necessary to investigate the hormonal background. Since hormones thicken the blood, affect hemostasis (blood coagulation system), it makes sense to conduct a comprehensive examination of the state of the hemostasis system. In addition, it is recommended to do an ultrasound examination of the pelvic organs (uterus and appendages) and mammary glands. All these procedures are minimally invasive, painless, they are not difficult to pass, and they will help to avoid possible complications against the background of long-term use of contraceptives.

Services

Gynecological consultation

modern methods of contraception, consulted by a gynecologist

01/27/2023

Such different contraception

Contraception is a method of preventing unwanted pregnancy. Every woman knows about this. But the modern medical industry offers so many options that, at times, the head is spinning.

Every day, our patients discuss delicate issues with the gynecologist Gurova Elena Yurievna

When is contraception needed?

Potentially, a young girl is able to become pregnant with the onset of her first menstrual cycles.

Accordingly, it is necessary to protect yourself with the onset of sexual activity.

But women in menopause need to remember that menopause can surprise in the form of an unplanned pregnancy, diagnosed at a decent time, since the absence of menstruation does not alarm a woman. That happens. Therefore, if menopause occurred before the age of 50, then contraception is needed for another 2 years, if after 50 years, then for 1 year.

Contraceptive options

1. Barrier methods of contraception

2. Chemical contraceptives

3. Biological method

4. Intrauterine contraception

5. Modern women are more interested in the method of hormonal contraception. The methods of hormonal contraception include:

• combined oral contraceptives;

• preparations containing only one medicinal component:

• hormone patches

• vaginal contraceptive ring

• subcutaneous implants

• intrauterine systems with hormone (intrauterine devices)

• injectable methods of prolonged contraception

• methods of emergency hormonal contraception (in case of accidental sexual intercourse or in a situation where the condom broke).

BARRIER CONTRACEPTIVE METHODS

Barrier methods are traditional and the most ancient. In the first half of our century, various forms of barrier methods were the only contraceptives available. The emergence of more effective methods of contraception over the past 20 years has significantly reduced the popularity of barrier methods.

There are the following types of barrier contraceptives:

• Women: non-drug barrier and medicated products.
• Male barrier products.

The principles of action of barrier contraceptives are to block the penetration of sperm into the cervical mucus.

The advantages of barrier methods of contraception are as follows: they are applied and act only locally, without causing systemic changes; they have few side effects; they largely protect against sexually transmitted diseases; they have practically no contraindications for use; they do not require the involvement of highly qualified medical personnel.

CHEMICAL CONTRACEPTIVES

The mechanism of action of spermicides is to inactivate sperm and prevent it from entering the uterus. The main requirement for spermicides is the ability to destroy spermatozoa in a few seconds. Spermicides are available as creams, jellies, foam sprays, melting suppositories, foaming suppositories, and tablets. Some women use for the purpose of contraception douching after intercourse with solutions that have a spermicidal effect, acetic, boric or lactic acid, lemon juice. Given the data that after 90 sec after intercourse, spermatozoa are determined in the fallopian tubes, douching with a spermicidal preparation cannot be considered a reliable method of contraception.

Benefits of spermicides: ease of use; providing some degree of protection against certain sexually transmitted diseases; they are a simple backup in the first cycle of taking oral contraceptives.

The disadvantages of the method are the limited period of effectiveness and the need for some manipulations on the genitals.

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

BIOLOGICAL METHOD

The biological (rhythmic, or calendar) method is based on periodic abstinence from sexual activity on periovulatory days. Currently, four methods of fertility control are used: calendar, or rhythmic, temperature, symptothermal method and cervical mucus method. The frequency of pregnancies with these methods of contraception is up to 12 pregnancies per 100 women.

INTRAUTERINE CONTRACEPTION

There are three generations of the Navy.

Inert Navy. The first generation of IUDs are the so-called inert IUDs. The most widespread contraceptive made of polyethylene in the form of the Latin letter S. In most countries, the use of inert IUDs is currently prohibited, since their use has a lower efficiency and a higher frequency of expulsions than when using spirals of later generations.

Copper IUDs . They belong to the second generation. The basis for creating an IUD with copper was experimental data showing that copper has a pronounced contraceptive effect in rabbits. The main advantage of copper-containing IUDs compared to inert ones was a significant increase in efficiency, better tolerability, ease of insertion and removal.

Hormonal IUDs. Relate to the third generation of the Navy. The prerequisite for the creation of a new type of IUD was the desire to combine the advantages of two types of contraception – OK and IUD, reducing the disadvantages of each of them. These coils have a direct local effect on the endometrium, fallopian tubes and cervical mucosa. The advantage of this type of spirals is a decrease in hyperpolymenorrhea, a decrease in the frequency of inflammatory diseases of the genitals. The disadvantage is the increase in “intermenstrual daub”.

Intrauterine devices are an excellent reversible method of contraception.

HORMONAL CONTRACEPTION

Combined oral contraceptives

When we talk about hormonal contraceptives, we, in most cases, mean combined oral contraceptives (COCs), which contain two different components in their composition. They are taken daily, preferably at the same time, for 21 or 28 days of the menstrual cycle (depending on the type of drug) from the first day of menstruation. Then a seven-day (or shortened, four-day) break is made.

Daily intake of COCs and the absence of gaps is the key to the desired result!

In addition to a reliable contraceptive effect, all these drugs also have a healing property in relation to such gynecological diseases as endometriosis, ovarian cyst, dysfunctional bleeding, heavy menstruation, accompanied by a decrease in hemoglobin levels. The positive effect of COCs in the treatment of acne has been proven.

Of course, like any medicine, COCs have their own contraindications. These include: thrombosis, heart attacks and strokes in the past, migraine, acute inflammation of the liver, including viral, malignant tumors of the female genital organs and mammary gland, bleeding without an established cause, individual intolerance to the drug.

But the main reason why women are afraid and refuse to take COCs is the fear of weight gain – this is a myth and outdated information.

Numerous international studies conducted indicate that all modern COCs contain medicinal substances that are neutral in relation to metabolism. And weight gain in the case of the use of COCs of the modern generation is associated only with a violation of eating behavior.

Moreover, the latest generation of contraceptives allow you to reduce weight due to a special drug component that helps reduce swelling and remove excess fluid from the body.

Contraceptive patch and vaginal ring work similarly to COCs. Only the drug enters the body in a different way: through the skin or through the mucous membrane of the vagina. This contraceptive option may be recommended for women with digestive problems or liver disease.

EMERGENCY CONTRACEPTIVES

This option of contraception is relevant to prevent the consequences of unprotected intercourse. Unwanted pregnancy can be avoided by choosing the appropriate emergency drug or mechanical contraception option within the first 72 hours after that.

Obviously, contraception improves a woman’s health by preventing abortions and unwanted childbearing, providing an opportunity to plan the future of young patients, reduce the risk of gynecological diseases that affect the ability to become pregnant, and with it the risk of obstetric complications.

Choosing the right method of contraception is a decision that depends not only on your desire, but also on medical indications. By contacting our clinic, you will receive a consultation from highly qualified gynecologists-endocrinologists who will select the best contraceptive for you.