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Birth control operation side effects: Permanent Methods of Birth Control: Tubal Ligation and Vasectomy

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Pictures, Types, Side Effects, Costs, & Effectiveness

IMAGES PROVIDED BY:

1) Asia Images Group / Getty, PhotoAlto / Ale Ventura, Thomas Tolstrup / Photographer’s Choice

2) Hemera / Getty               

3) Kat-Ka / Getty Images

4) Steve Pomberg / WebMD

5) Steve Pomberg / WebMD

6) Peggy Firth and Susan Gilbert, CMI, for WebMD, Keith Brofsky / Thinkstock

7) Peggy Firth and Susan Gilbert, CMI, for WebMD, Maggie Murray / Photolibrary

8) Steve Pomberg / WebMD, Peggy Firth and Susan Gilbert, CMI, for WebMD

10) Don Farrall / Photolibrary

11) Philippe Garo / Photo Researchers, Inc.

12) sodapix / Photolibrary

13) ERproductions Ltd / Blend Images

14) PHANIE / Photo Researchers, Inc.

15) Peggy Firth and Susan Gilbert, CMI, for WebMD

16) Peggy Firth and Susan Gilbert, CMI, for WebMD

17) Peggy Firth and Susan Gilbert, CMI, for WebMD

18) Cordelia Molloy / Photo Researchers, Inc.

20) George Diebold / Getty

21) iStockphoto / Thinkstock

22) Corbis

SOURCES:

American College of Obstetricians and Gynecologists.
American Pregnancy Association.
CDC.
FDA.
Guttmacher Institute.
HRA Pharma briefing document, June 17, 2010, meeting of Advisory Committee for Reproductive Health Drugs.
Jones R. Contraception,June 2009.
FDA briefing document, June 17, 2010, meeting of Advisory Committee for Reproductive Health Drugs.
Keoniger-Donohue, R. Women’s Health Care: A Practical Journal for Nurse Practitioners, 2006.
Lannon B.V. Fertility and Sterility, August 2007.
Liletta.
Mirena.
National Women’s Health Information Center.

National Women’s Health Network: “Fact Sheet: Phexxi Contraceptive Gel.”
Hatcher, R. A. et al., eds. Contraceptive Technology, 19th ed. New York: Ardent Media, 2007.
Speroff, L., Darney, P.D. A Clinical Guide for Contraception. Philadelphia: Lippincott Williams and Wilkins, 2005.
Skyla.
The Nemours Foundation.

Birth Control Options & Types: Risks & Effectiveness

What is birth control?

Birth control is a way for men and women to prevent pregnancy. There are many different methods of birth control. By learning more about the options, you can decide which method is right for you and your partner.

If you are sexually active and don’t want a baby, don’t wait to use birth control. An unintended pregnancy can happen any time you have unprotected sex.

What are the types of birth control?

The following information describes many different birth control methods. Before you choose a method, you should discuss birth control with your partner and your healthcare provider.

Birth control methods are only effective if used properly. Make sure that you understand how to correctly use the method you choose.

Abstinence

Abstinence is the only birth control that is 100 percent effective and is also the best way to protect you against STDs. You may not be ready to have sex. Don’t let someone pressure you into having sex if you don’t feel ready. It is an important decision with serious emotional and physical consequences.

Female sterilization – tubal ligation (surgical)

What is it? Tubal ligation is surgery to “tie the tubes” (fallopian tubes) of a woman. This causes permanent sterility by preventing transport of the egg (ovum) to the uterus. This also blocks the passage of sperm up the tube to the ovulating ovary where fertilization normally occurs.

How is it done? Tubal ligation is done in a hospital or outpatient surgical clinic while the patient is asleep (given anesthesia). One or two small incisions (cuts) are made in the abdomen at the navel, and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted. Using instruments that are inserted through the laparoscope, the fallopian tubes are burned or sealed shut. The skin incision is then stitched closed. Tubal ligation can be performed immediately after childbirth through a small incision near the navel or during a Cesarean section (C-section).

How is it available? Tubal ligation must be performed by a healthcare provider.

How effective is it? Except in rare cases, this procedure is almost 100 percent effective. Depending on the technique your doctor uses, tubal ligation has about three to 17 failures in 1,000 procedures.

You should know: Female sterilization is not reversible. Sterilization does not protect against STDs, including HIV (the virus that causes AIDS). The male condom provides the best protection against most STDs.

Male sterilization – Vasectomy

What is it? A vasectomy is a simple, permanent sterilization procedure for men. The operation, usually done in a physician’s office, requires cutting and sealing the vas deferens, the tubes in the male reproductive system that carry sperm. A vasectomy prevents the transport of sperm out of the testes. This surgery does not affect the man’s ability to achieve orgasm or ejaculate (potency). There will still be a fluid ejaculate, but there will be no sperm in this fluid. Studies have shown that vasectomy increases sexual satisfaction between couples.

How is it done? Vasectomy is usually done in the surgeon’s office while the patient is awake but pain-free (using local anesthesia). A small incision is made in the upper part of the scrotum. The tubes (vas deferens) are tied off and cut apart. The skin incision is stitched closed. The patient is able to return home immediately. Vasectomy is a much simpler procedure than tubal ligation.

How is it available? Vasectomy must be performed by a healthcare provider.

How effective is it? Except in rare cases, this procedure is nearly 100 percent effective. Although vasectomy has a failure rate of less than 1 percent, failure, while rare, is possible.

You should know: Sterilization does not protect against STDs, including HIV (the virus that causes AIDS). The male condom provides the best protection against most STDs.

Progestin arm implant – Nexplanon®

What is it? Nexplanon® is a single rod of hormone (the size of a matchstick) that is placed directly under the skin of the upper arm by a physician. It delivers a progestin hormone (no estrogen), over a three-year period.

How can I get it? Nexplanon® is placed by a physician who is certified in this procedure.

How effective is it? Nexplanon® is almost 100 percent effective. It is the most effective form of reversible contraception, with less chance of failure than even female sterilization.

You should know: The side effects of Nexplanon® are similar to other progestin-only (no estrogen) methods. The most common side effect is irregular bleeding, though the bleeding tends to be light. This typically improves after six to 12 months, with many women having no further bleeding (which is safe). Nexplanon® will need to be removed via an office procedure after three years, but can removed at any time before that time if desired.

Intrauterine device (IUD)

What is it? An intrauterine device (IUD) is a small, flexible, T-shaped device that is placed into the uterus (womb). There two types of IUDs:

  • An IUD made of copper
  • An IUD made of plastic with very low doses of progestin (no estrogen)

The copper ParaGard T380A®, can be kept in place for 10 years. The copper stops the sperm from making it through the vagina and uterus to reach the egg, preventing fertilization.

The progestin IUDs include Mirena® (five years, highest progestin dose), Kyleena® (five years, medium dose), and Skyla® (three years, lowest progestin dose). The progestin dose of the IUDs are so low, that they have minimal absorption into the body. These IUDs work by causing the cervical mucus to become thicker so the sperm cannot reach the egg. The hormone also thins the lining of the uterus, so menstrual bleeding becomes lighter.

How is it used? Once the IUD has been inserted, the woman does not need to take any further steps to prevent pregnancy.

How is it available? After a pelvic exam, the IUD is placed into the uterus through the cervix by a trained healthcare provider.

How effective is it? The IUD is close to 100 percent effective. Progestin containing IUDs and the arm implant are the most effective contraceptive options.

You should know: Side effects are different for the different IUDs. Copper IUDs may cause more painful and heavy periods in some women. The advantage is that it can be used in women who can’t use any hormones (such as breast cancer survivors). The side effects of progestin containing IUDs are similar to other progestin-only (no estrogen) methods. The most common side effect is irregular bleeding, though the bleeding tends to be light. This typically improves after six to 12 months, with many women having no further bleeding (which is safe). IUDs will need to be removed via a simple office procedure at the expiration time, but can removed at any time before that time if desired. In the rare chance pregnancy occurs while having an IUD, there is greater risk of ectopic pregnancy (pregnancy outside the uterus).

Combined hormonal contraception

Includes estrogen containing birth control pills, the contraceptive vaginal ring (NuvaRing®), and patch (Xulane®)

What is it? The pill, patch and ring are medications that women take to prevent pregnancy. The pill is taken daily, the vaginal ring is used once a month, and the patch is changed weekly.

How is it used? A pill is taken at the same time every day. There are several different types of pills. Some are designed to allow the woman to have a period every month and others allow the women to have period every three months or not at all. All of these methods require that a woman use it regularly. If you forget to use the contraceptive, irregular menstrual cycles are common, and you can get pregnant.

How can I get it? In most states, the pill must be ordered for you by your healthcare provider. It is obtained by prescription. In a growing number of states it is available over-the-counter without a prescription, under the supervision of a pharmacist.

How effective is it? Combined hormonal contraceptives have the potential to be 99 percent effective if used correctly. However, in the real world with typical use, nine out of 100 women will get pregnant each year on the pill because they do not use it correctly. Some studies show that women who are overweight might be more likely to get pregnant while on the pill than normal weight women. However, the pill is much more effective than the barrier methods such as condoms, diaphragm, cervical cap, contraceptive foam, etc.

You should know: The pill can cause minor side effects in the first several months of use, including:

  • Breast tenderness/pain
  • Nausea
  • Headaches
  • Irregular menses

Typically these symptoms resolve. Estrogen containing contraceptives can increase the risk of blood clots. Estrogen containing contraceptives are not recommended for women who are over 35 years of age if they smoke, but can be used until menopause if you don’t smoke cigarettes and are in good health. There are many health benefits to these contraceptives, including lighter, regular periods, as well as less menstrual cramping. Pill users also will notice improvement in acne, PMS, menstrual headaches, as well as a lower risk of uterine and ovarian cancer in pill users.

Progestin only pills (mini pills)

What is it? These are pills that contain only one hormone (progestin).

How do they work? Mini pills work by thickening the cervical mucus so the sperm cannot reach the egg. The hormone in the pills also thins the lining of the uterus, so menstrual bleeding is lightened. A pill is taken every day with no placebo (break).

How is it available? In most states, the pill must be ordered for you by your healthcare provider. It is obtained by prescription. In a growing number of states it is available over-the-counter without a prescription, under the supervision of a pharmacist.

How effective is it? With typical use, nine out of 100 women will get pregnant each year on the pill because they do not use it correctly. It is important to take it daily, at the same time each day. Some studies show that women who are overweight might be more likely to get pregnant while on the pill than thinner women. However, the pill is much more effective than the barrier methods such as condoms, diaphragm, cervical cap, contraceptive foam, etc.

You should know: The side effects of progestin only pills are similar to other progestin-only (no estrogen) methods. The most common side effect is irregular bleeding, though the bleeding tends to be light. This typically improves after six to 12 months, with many women having no further bleeding (which is safe). The mini pill is a good alternative for women who are breastfeeding or who cannot take estrogen in the traditional pill.

Depo-provera®

What is it? Depo-Provera® is a form of the hormone progestin.

How is it used? It is given as an injection into the woman’s buttocks or arm. Each injection provides protection against pregnancy for 12 to 15 weeks.

How is it available? Depo-Provera® must be ordered by a healthcare provider. It is taken every three months, usually given at the doctor’s office. There is a lower dose formulation that is available to be injected at home by the patient.

How effective is it? The Depo-Provera® shot has the potential to be 99 percent effective if used correctly. However, with typical use, six out of 100 women will get pregnant each year on the shot because they do not get the four injections per year on time.

You should know: Depo-Provera®’s bleeding profile is similar to other progestin-only (no estrogen) methods. Fifty percent of women who use Depo-Provera for more than a year stop getting their periods while on the medication. However, some irregular bleeding can occur, especially in the first year. In a small percentage of women, Depo-Provera can cause some weight gain. This is the only contraceptive that may do this. However, most women on Depo-Provera® do not gain any weight. A healthy lifestyle can prevent chance of weight gain.

Emergency contraception (or “morning after pill”)

What is it? Emergency contraception is a form of birth control that may be used by women within 120 hours (five days) of having unprotected sex. This may be necessary in the case of contraceptive failure (broken condom), rape, or any other situation where highly effective contraception was not available. It is most effective when taken soon after unprotected intercourse. A copper IUD is the most effective form of emergency contraception, and also provides ongoing birth control. There are two types of emergency contraceptive pills available. The more effective pill is called ulipristal (brand name: ella). It is only available by prescription. Several over-the-counter options are available and all contain levonorgestrel (many generic names including Plan B, Next Choice, etc).

How does it work? The pills prevent pregnancy by temporarily blocking eggs from being produced (delaying ovulation). The copper IUD makes it difficult for sperm to get to the egg.

How is it available? Over-the-counter levonorgestrel pills can be purchased at a pharmacy without a prescription by men and women of any age (including those under age 16). Ulipristal (ella) has to be prescribed by a provider. Because many pharmacies will need to order ella (delaying when you’ll receive it), consider asking your doctor for an advanced prescription to have on hand in case of emergency. An IUD requires an office visit for procedure within five days of intercourse.

How effective is it? Emergency contraceptive pills can be up to 90 percent effective when taken within 72 hours of unprotected intercourse. However, no pills will work if you have already ovulated. This is why it’s important to take it as soon as possible after intercourse. Ella is two times more effective than the over-the-counter pills. A copper IUD is almost 100 percent effective.

You should know: You do not need to take a pregnancy test before taking emergency contraception pills. Menstrual irregularities are common for the few weeks after the pills have been taken. However, if you do not get your menstrual cycle within a few weeks of taking emergency contraception, you should take a pregnancy test since these methods are not 100 percent effective. It is important to use condoms or abstain from intercourse for the next five days after taking emergency contraception, otherwise you can get pregnant. If you find yourself taking emergency contraceptive pills frequently, speak to your doctor about more effective ways to prevent pregnancy.

Male condoms

What is it? The male condom, or “rubber,” is a thin covering made of latex, plastic or animal membrane that is rolled over an erect penis. The covering prevents semen, the fluid that contains sperm, from entering a woman’s vagina. Latex condoms are best for most people. Use plastic condoms if you or your partner is allergic to latex. Condoms made from animal skins may not provide good protection from sexually transmitted diseases (STDs).

How is it used? The condom is rolled over the erect penis before sexual activity begins. If the condom does not have a built-in nipple, leave ¼-inch of the condom free at the tip of the penis so that semen has a place to collect. A new condom must be used each time you have sex. The condom must be in place before the penis gets near the vagina.

How can I get it? Condoms can be purchased at most drug stores. Condoms also are sold in vending machines in restrooms.

How effective is it? About 18 percent of women will get pregnant each year when condoms are used. However, condoms can be more effective when they are used exactly as intended.

You should know: Latex condoms provide protection—although not 100 percent protection—from STDs by preventing the infected area from coming into contact with the partner. Even though they do not provide 100 percent protection, they are one of the best options available. Use only water-based lubricants, such as K-Y Jelly® or Astroglide®. Oil-based lubricants (Vaseline®, baby oil) can cause condoms to leak or break. If a condom breaks, a woman is at increased risk of getting pregnant. She should consider emergency contraception.

Diaphragm

What is it? A diaphragm is a round piece of flexible rubber with a rigid rim. The woman places the diaphragm in her vagina and against her cervix. The diaphragm prevents semen from entering the womb. Spermicide must be used with a diaphragm.

How is it used? Spermicide is put in and around the rim of the diaphragm no more than two hours before intercourse. The diaphragm is then inserted into the vagina. More spermicide should be inserted into the vagina each time you have sex without removing the diaphragm.

How can I get it? You must visit your healthcare provider and get a pelvic exam so that you can be fitted for a diaphragm that is right for you. There is one diaphragm that is “one-size-fits-all,” called Caya, which can be purchased online.

How effective is it? About 12 percent of women get pregnant each year despite using a diaphragm, but it can be more effective when used exactly as instructed.

You should know: Do not remove the diaphragm for at least eight hours after intercourse. Using a diaphragm and spermicide may not protect against some STDs, including HIV (the virus that causes AIDS). The male condom provides the best protection against most STDs. If you gain or lose 10 to 15 pounds, you may have to be refitted for a new diaphragm.

Cervical cap

What is it? The cervical cap is a thimble-shaped cup made out of plastic or soft rubber that fits snugly over the cervix.

How is it used? It is used the same way as a diaphragm. The woman coats the cup with spermicide, and inserts the cap into her vagina and up to her cervix before sex. The cap blocks the cervix, and the spermicide paralyzes the sperm. More spermicide must be inserted into the vagina each time you have sex. (Do not remove the cap each time you have sex.)

How can I get it? You must visit your healthcare provider and get a pelvic exam so that you can be fitted for a cervical cap.

How effective is it? About 21 percent of women get pregnant each year despite using a cervical cap, but it can be more effective when used exactly as instructed.

You should know: Do not remove the cervical cap for at least eight hours after intercourse. The cap can be kept in place for up to 48 hours, but spermicide must be applied inside the vagina no more than two hours before sex. Using a cervical cap and spermicide may not protect against some STDs, including HIV (the virus that causes AIDS). The male condom provides the best protection against most STDs.

Female condom

What is it? The female condom is a lubricated polyurethane (plastic) tube that has a flexible ring at each end. One end of the tube is closed.

How is it used? Before sexual activity begins, the woman inserts the condom into her vagina so that the closed end of the tube covers the cervix, and the other end slightly covers the labia (lips on the outside of the vagina). The condom blocks sperm from entering the womb.

How can I get it? Like the male condom, the female condom is available at drug stores without a prescription.

How effective is it? About 21 percent of women get pregnant each year despite using a female condom, but the condom can be more effective when used exactly as instructed.

You should know: Female condoms provide some protection against STDs, but the male condom provides the best protection. Female condom can be used while menstruating. It needs to be removed immediately after sex.

Sponge

What is it? The sponge is a small, donut-shaped device that is coated with spermicide.

How does it work? The sponge is moistened with water and inserted into the vagina. It is made of polyurethane foam that feels like natural vaginal tissue. The sponge protects against pregnancy in three ways:

  • The sponge releases a spermicide to kill sperm cells.
  • The sponge is constructed to trap and absorb semen before the sperm have a chance to enter the cervix.
  • It acts as a barrier between the sperm and the cervix.

How is it available? The sponge is available without a prescription at most drug stores.

How effective is it? About 32 percent of women who have had babies in the past will get pregnant each year despite using the sponge, but they can be more effective when used exactly as instructed. In comparison, nine to 16 percent of women who have never had a child will get pregnant each year using the sponge, depending on how correctly it is used.

You should know: The sponge provides a continuous presence of spermicide throughout a 24-hour period, allowing for multiple acts of intercourse within that time without the need for additional spermicide. The sponge is associated with higher rates of vaginal infections, and is less effective than a diaphragm.

Withdrawal (pullout) method, spermicides (film, jelly, foam, etc.)

These are not effective methods of birth control when used on their own. Out of every five women using these methods to prevent pregnancy, one will get pregnant by the end of the year. Spermicides are used with other barrier methods such as diaphragms and cervical caps to help improve their effectiveness.

Rhythm

What is it? A woman practices rhythm, or natural family planning, by learning to recognize the days she is fertile, and then abstaining from sex before and during those days.

How is it done? Methods include keeping track of changes in body temperature and vaginal discharge (fluid from the vagina.)

How is it learned? Your healthcare provider can describe how to practice natural family planning.

How effective is it? Using the rhythm method, up to 25 percent of women get accidentally pregnant in one year (some studies quote failure rates as high as 50 percent). If done properly, it can be 90 percent effective.

You should know: Natural family planning also can be used to help a woman get pregnant by pinpointing her most fertile times. It also has no side effects and is inexpensive. The rhythm method does not work for all couples. Women who have regular menstrual cycles and who are very careful about when they have sex usually find it to be effective. Women who have irregular cycles and who are not so careful often end up becoming pregnant.

Birth Control – Types, Side Effects, Cost & Effectiveness

Birth control allows people to stop pregnancy before it begins. It is also called contraception. About 99 percent of American women ages 15 to 44 who have ever had sexual intercourse have used contraceptives.

Some birth control methods are more effective than others. Their cost varies, too. Abstinence is the only method that is 100 percent effective and free.

Not all types of birth control protect people from sexually transmitted diseases, or STDs. Only latex condoms and abstinence protect people from STDs.

Most types of birth control are relatively safe for women’s health and men’s health. But some may have serious side effects.

Certain birth control side effects led women to file personal injury lawsuits.

Types of Birth Control

There are several types of birth control. These range from birth control pills to sterilization by tubal ligation or vasectomy. Most types of birth control are for women, but there are also options for men.

Each type of contraception has its own side effects, benefits and effectiveness.


Main Types of Birth Control

  • Hormonal (birth control pills, NuvaRing, patches and shots)

  • Barrier methods (condoms)

  • Intrauterine devices (IUDs) (copper and hormonal)

  • Surgical (tubal ligation, vasectomy)

  • Implants (Essure, Norplant, Nexplanon)

  • Emergency contraception (Plan B)

Hormonal Birth Control: Pills and NuvaRing

Hormonal birth control is the most popular type of birth control in the U. S. These methods include the pill, the patch, a shot and NuvaRing.

They work by releasing estrogen, progestin or a combination of both. These hormones stop the woman’s body from releasing an egg.

They may also thicken cervical mucus. Thick mucus makes it difficult for the sperm to reach the egg.

Yaz Birth Control and Other Birth Control Pills

Several brands of birth control pills are available to women in the U.S. Women must take the pill every day to prevent pregnancy.

Most side effects of birth control pills are mild and go away after two or three months.

But some brands might have more side effects than others. For example, all combination birth control pills, including Yaz, have a warning for an increased risk for blood clots and strokes, especially in women who smoke cigarettes and are over the age of 35. Yaz and other birth control pills that contain the hormone drospirenone may have a greater risk for these side effects than other birth control pills.

Older oral contraceptives “appear to be a safer choice with regard to venous thromboembolism (blood clots) than preparations containing drospirenone,” Dr. Susan Jick of Boston University’s School of Medicine said in a study in British Medical Journal.

There have been thousands of Yaz lawsuits. Women accuse the pill’s maker, Bayer, of intentionally hiding the drug’s risks.

Yaz is one brand of the birth control pill.


Birth Control Pills at a Glance

  • Effectiveness: 91 percent effective

  • Side Effects: Headaches, changes in sexual desire, bloating, changes in mood, weight changes, irregular bleeding, breast tenderness, blood clots

  • Average Cost: $0 to $50

NuvaRing Birth Control

NuvaRing is a flexible ring that contains estrogen and progestin hormones. Women insert a new ring into their vaginas every month.

They may choose to wear it all month and not get a period. Or women can remove NuvaRing in the fourth week to get a period.

Minor NuvaRing side effects go away in a few months. Serious side effects can have lasting effects. Nuvaring increases the risk of heart attack, stroke and blood clots, especially in women over 35 who smoke.

NuvaRing is a type of hormonal birth control.


NuvaRing at a Glance

  • Effectiveness: 91 percent

  • Side Effects: Irregular period, depression, headache, changes in weight, breast tenderness, increased body hair, loss of scalp hair, increased vaginal wetness

  • Average Cost: $0 to $200

Birth Control Patch

The birth control patch contains estrogen and progestin. Women may wear it on their buttocks, upper arm or lower abdomen. The birth control patch gets changed every three weeks.

Women over 35 who smoke may have an increased risk of blood clots or heart problems with use of the patch.

The patch is a hormonal birth control method.


The Patch at a Glance

  • Effectiveness: 91 percent

  • Side Effects: Headaches, changes in sexual desire, bloating, changes in mood, weight gain, irregular bleeding, breast tenderness, blood clots, skin irritation

  • Average Cost: $0 to $150

Birth Control Shot

The birth control shot (Depo-Provera) is a progestin injection. A doctor or a nurse administers the birth control shot.

Women using this method get a birth control shot every three months. It causes an increased risk of bone thinning.

The birth control shot is a progestin injection given by a doctor or nurse every three months.


The Shot at a Glance

  • Effectiveness: 94 percent

  • Side Effects: Headaches, changes in appetite, weight gain, increased spotting, irregular periods (first six to 12 months), nausea, changes in sex drive, bone thinning, depression

  • Average Cost: $0 to $100

Barrier Method: Condoms

After the pill, condoms are the most popular type of reversible birth control. Condoms are small pouches made of latex, plastic or lambskin.

Men wear condoms over the penis. Female condoms (FC2 Female Condom) go inside the vagina. Both types prevent sperm from entering the vagina.

Generally, condoms don’t have many side effects. But, some manufacturers cover condoms in talcum powder.

Some studies show genital exposure to talcum powder may increase the risk of ovarian cancer.

Condoms are a popular birth control method.


Condoms at a Glance

  • Effectiveness: 79 percent to 85 percent

  • Side Effects: Skin irritation (from lubricants, spermicides or latex) and possible ovarian cancer (from talcum powder)

  • Cost: $0 to $2

Intrauterine Devices (IUDs): Mirena and Paragard

Intrauterine devices or IUDs are small, T-shaped plastic devices inserted into the uterus. The FDA approved five IUD brands for sale in the U.S.: Mirena, Kyleena, Liletta, Skyla and Paragard.

Mirena, Kyleena, Liletta and Skyla

Mirena, Kyleena, Liletta and Skyla use progestin hormones to prevent pregnancy. They stop egg production in the ovaries.

The most popular IUD on the market is Mirena (levonorgestrel). It is very effective at preventing pregnancy. But, women have reported serious side effects from using Mirena.

It is also linked to a rare disorder called intracranial hypertension. This is also called pseudotumor cerebri. The condition mimics the effects of a brain tumor.

Paragard

Unlike Mirena birth control and other IUDs, Paragard doesn’t contain hormones. It uses copper to prevent pregnancy for up to 12 years. The copper prevents sperm from getting to the egg.

Paragard also works well for emergency contraception. Health care providers must insert it within five days of unprotected sex for it to work.

Mirena is an intrauterine device, or IUD.


IUDs at a Glance

  • Effectiveness: 99 percent

  • Side Effects: Infections, device migration, device expulsion, ectopic pregnancy (pregnancy outside the uterus), organ perforation, cramping, irregular periods, heavy bleeding (ParaGuard), pain during sex, removal may require surgery, pelvic inflammatory disease (PID)

  • Cost: $0 to $1,300

Paragard Removal Complications

Some patients experience serious side effects upon removal of their Paragard IUD. Read more about potential complications.

Learn More

Permanent Birth Control Surgery: Tubal Ligation and Vasectomy

Tubal ligation (tying the tubes) and vasectomy are two main birth control surgeries. Both procedures are permanent.

Tubal ligation permanently closes or blocks the fallopian tubes. Vasectomy cuts or blocks the tubes that carry sperm.

Generally, vasectomy costs less and has fewer complications than tubal ligation.

Tubal ligation and vasectomy are permanent birth control surgeries.


Surgical Birth Control at a Glance

  • Effectiveness: 99 percent

  • Side Effects: Surgical complications, ectopic pregnancy, infections

  • Cost: $0 to $1,000 (vasectomy), $0 to $6,000 (tubal ligation)

Birth Control Implants: Essure, Nexplanon

Birth control implants can be permanent or temporary. For example Essure is a permanent birth control implant. It is a non-surgical form of female sterilization.

Doctors insert a metal coil with plastic fibers in each fallopian tube. After three weeks, scar tissue blocks each tube.

The Essure procedure “took a long time, and it was painful,” Angie Firmalino, who underwent the procedure in 2009, told Drugwatch.

Thousands of women say they experienced serious side effects from Essure birth control. Reported injuries range from severe pelvic pain to autoimmune disorders. There are about 35,000 women in one support group called Essure Problems.

Nexplanon is a matchstick-size hormonal birth control implant that goes into the upper arm. It releases a progestin hormone and prevents pregnancy for up to four years.

An older, similar birth control implant called Norplant is no longer available in the U.S. Women filed lawsuits claiming the company did not warn them of serious side effects.
One woman told Drugwatch she developed a tumor from Norplant.


Implants at a Glance

  • Effectiveness: 99 percent

  • Essure Side Effects: Pelvic pain, autoimmune disorders, dizziness, cramping, vomiting, device expulsion, device migration, abnormal bleeding, painful intercourse, headaches, body pain, additional surgeries for removal, hysterectomy.

  • Nexplanon Side Effects: Changes in period, weight gain, liver disease, weight gain, depression, increased blood sugar, gallbladder disease, ovarian cysts, acne.

  • Cost: $0 to $2,500

Essure is a permanent birth control implant.

Emergency Contraception: Plan B

Emergency contraception can prevent pregnancy after unprotected sex. These contraceptives are also called “morning after pills.”

The most popular brand is Plan B. Other brands are Take Action, Next Choice One-Dose and My Way.

Emergency contraception is available without a prescription. This is unlike most other types of birth control.

Women have to take emergency contraception within five days of unprotected sex for it to work. It works best within three days.

Paragard copper IUDs also work as emergency contraception.

Plan B is emergency contraception that can prevent pregnancy after unprotected sex.


Plan B at a Glance

  • Effectiveness: 75 percent to 89 percent

  • Side Effects: Nausea, vomiting, abdominal pain, dizziness, menstrual pain, breast tenderness, headache, fatigue, irregular bleeding

  • Cost: $0 to $60


Please seek the advice of a medical professional before making health care decisions.

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If you do not want to get pregnant, there are many birth control options to choose from. No one product is best for everyone. Some methods are more effective than others at preventing pregnancy. The only sure way to avoid pregnancy is not to have any sexual contact. This page lists FDA-approved and cleared methods for birth control. Talk to your healthcare provider about the best method for you.

Types of Medicines and Devices for Birth Control
Other Contraception
Some things to think about when you choose birth control:
  • Your health.
  • If you want to have children in the future.
  • How often you have sex.
  • How many sexual partners you have.
  • If you will need a prescription or if you can buy the method over-the-counter.
  • The number of pregnancies expected per 100 women who use a method for one year. For comparison, about 85 out of 100 sexually active women who do not use any birth control can expect to become pregnant in a year.
  • This page lists pregnancy rates based on typical use. Typical use shows how effective the different methods are during actual use (including sometimes using a method in a way that is not correct or not consistent).
  • For more information on the chance of getting pregnant while using a method or on the risks of a specific product, please check the product label or Trussell,J. (2011).”Contraceptive failure in the United States.” Contraception 83(5):397-404.
Tell your doctor, healthcare provider, or pharmacist if you:
To avoid pregnancy:
  • No matter which method you choose, it is important to follow all of the directions carefully. If you don’t, you increase your chance of getting pregnant.
  • The best way to avoid pregnancy is to not have any sexual contact.

Sterilization Surgery for Women (also called trans-abdominal surgical sterilization)

 

What is it?

  • One way is by tying and cutting the tubes — this is called tubal ligation.
  • The fallopian tubes also can be sealed using an instrument with an electrical current.
  • They also can be closed with clips, clamps, or rings.
  • Sometimes, a small piece of the tube is removed.

How does it work?

  • The fallopian tubes are blocked so the egg and sperm can’t meet in the fallopian tube. This stops you from getting pregnant.
  • It is supposed to be permanent.
  • Sometimes it is possible to reverse the sterilization. Reversal involves another surgery that might not work.

How do I get it?

  • This is surgery.
  • You will need general anesthesia.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, less than 1 may get pregnant.

Some Risks

  • Pain
  • Bleeding
  • Infection or other complications after surgery

Does it protect me from sexually transmitted infections (STIs)? No. 


Sterilization Surgery for Men (Vasectomy)

This method is for men who are sure they never want to have a child or do not want any more children. If you are thinking about reversal, vasectomy may not be right for you. Sometimes it is possible to reverse the operation, but the likelihood of reversal decreases the more time passes between vasectomy and reversal.  Reversal involves complicated surgery that might not work.

What is it?

  • This is a surgery a man needs only once.
  • It is permanent.

How does it work?

  • The surgery blocks a man’s vas deferens (the tubes that carry sperm from the testes).
  • After this surgery, the semen (the fluid that comes out of a man’s penis) has no sperm in it.
  • It takes about three months to clear sperm out of a man’s system. You need to use another form of birth control until a test shows there are no longer any sperm in the seminal fluid.

How do I get it?

  • This is surgery.
  • Local anesthesia is used.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women whose partner has had a vasectomy, less than 1 may get pregnant.

Some Risks

The success of reversal surgery depends on:

  • The length of time since the vasectomy was performed.
  • Whether or not antibodies to sperm have developed.
  • The method used for vasectomy
  • Length and location of the segments of vas deferens that were removed or blocked.

Does it protect me from sexually transmitted infections (STIs)? No.


Long-acting Reversible Contraceptives (LARC)

These methods last for several years. If you want to get pregnant, you can stop using them at any time.

IUD or IUS (intrauterine device or system)

Copper IUD

What is it?

  • A T-shaped device containing copper that is put into the uterus by a healthcare provider.

How does it work?

  • The IUD prevents sperm from reaching the egg, from fertilizing the egg, and may prevent the egg from attaching (implanting) in the womb (uterus).
  • It does not stop the ovaries from making an egg (ovulating) each month.
  • The copper IUD can be used for up to 10 years.
  • After the IUD is taken out, it is possible to get pregnant.

How do I get it?

  • A doctor or other healthcare provider needs to put in the IUD.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, less than 1 may get pregnant.

Some Side Effects

  • Cramps
  • Heavier, longer periods or spotting between periods.

Some Less Common Risks

  • Pelvic inflammatory disease
  • Ectopic pregnancy (a pregnancy outside of the uterus) 
  • Uterine perforation
  • Expulsion – the IUD is no longer in the uterus and therefore there is no pregnancy protection

Does it protect me from sexually transmitted infections (STIs)? No.


 

IUD with progestin

What is it?

How does it work?

  • It may thicken the mucus of your cervix, which makes it harder for sperm to get to the egg, and also thins the lining of your uterus.
  • The IUD with progestin can be used for up to 3 to 5 years, depending on the type.
  • After the IUD is taken out, it is possible to get pregnant. 

How do I get it?

  • A healthcare provider needs to put in the IUD.
  • You may need local anesthesia.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year

Some Side Effects

  • Irregular bleeding
  • No periods (amenorrhea)
  • Abdominal/pelvic pain

Some Less Common Risks

  • Pelvic inflammatory disease
  • Severe infection
  • Ectopic Pregnancy
  • Uterine perforation
  • Expulsion – the IUD is no longer in the uterus and therefore there is no pregnancy protection
  • Ovarian cysts 

 

Does it protect me from sexually transmitted infections (STIs)? No.

 


Implantable Rod

What is it?

  • A thin, matchstick-sized rod that contains a progestin hormone.
  • It is put under the skin on the inside of your upper arm.

How does it work?

  • It stops the ovaries from releasing eggs.
  • It thickens the cervical mucus, which keeps sperm from getting to the egg.
  • It can be used for up to 3 years.

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

Some Side Effects

  • Changes in menstrual bleeding patterns
  • Weight gain
  • Headache
  • Acne

Some Less Common Risks

  • Complication of insertion and removing including pain, bleeding, scarring, infection or movement of the implant to another part of the body.
  • Ectopic pregnancy
  • Ovarian cysts
  • It is rare but some women will have blood clots, heart attacks or strokes.

Does it protect me from sexually transmitted infections (STIs)? No.


Contraceptive Injection

This method is given as a shot (injection) every 3 months. If you want to get pregnant, you can stop using this at any time.

Progestin Shot/Injection (Depo-Provera)

 What is it?

How does it work?

  • The shot stops the ovaries from releasing eggs
  • It also thickens the cervical mucus, which keeps the sperm from getting to the egg.

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, including women who don’t get the shot on time, up to 6 may get pregnant.

Some Side Effects

  • Loss of bone density
  • Irregular bleeding or bleeding between periods
  • Headaches
  • Weight gain
  • Nervousness
  • Dizziness
  • Abdominal discomfort

Some Less Common Risks

  • Ectopic pregnancy
  • It is rare, but some women will have blood clots.

Does it protect me from sexually transmitted infections (STIs)? No.


SHORT ACTING HORMONAL METHODS

Prevent pregnancy by interfering with ovulation and possibly fertilization of the egg. If you want to get pregnant, you can stop using them at any time.

Combination Oral Contraceptives
“The Pill”

 What is it?

  • A pill that has two hormones (estrogen and a progestin) to stop the ovaries from releasing eggs
  • It also thickens the cervical mucus, which keeps sperm from getting to the egg.

How do I use it?

  • You should swallow the pill at the same time every day, whether or not you have sex.
  • If you miss one or more pills, or start a pill pack too late, you may need to use another method of birth control, like a condom and spermicide  

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

Some Side Effects

  • Spotting or bleeding between periods
  • Nausea
  • Breast tenderness
  • Headache

Less Common Serious Side Effects

  • It is not common, but some women who take the pill develop high blood pressure.
  • It is rare, but some women will have blood clots, heart attacks, or strokes.

Does it protect me from sexually transmitted infections (STIs)?  No.

 


Oral Contraceptives (Progestin-only)

“The Mini Pill”

What is it?

  • A pill that has only one hormone, a progestin.
  • It thickens the cervical mucus, which keeps sperm from getting to the egg.
  • Less often, it stops the ovaries from releasing eggs.

How do I use it?

  • You should swallow the pill at the same time every day, whether or not you have sex.
  • You may need to use another method of birth control, like a condom and spermicide if:
  • you are several hours late taking your pill
  • you miss one or more pills
  • you start a pack too late

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year

Some Side Effects

  • Irregular bleeding
  • Nausea
  • Breast tenderness
  • Headache

Some Less Common Risks

Does it protect me from sexually transmitted infections (STIs)? No.

 


Patch

What is it?

  • This is a skin patch you can wear on the lower abdomen, buttocks, upper arm or upper back.
  • It has two hormones (estrogen and progestin) that stop the ovaries from releasing eggs.
  • It also thickens the cervical mucus, which keeps sperm from getting to the egg. 

How do I use it?

  • You put on a new patch and take off the old patch once a week for 3 weeks (21 total days).
  • Don’t put on a patch during the fourth week. Your menstrual period should start during this patch-free week.
  • If the patch comes loose or falls off, you may need to use another method of birth control, like a condom and spermicide.

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

Some Side Effects

  • Spotting or bleeding between periods
  • Nausea, stomach pain
  • Breast tenderness
  • Headache
  • Skin irritation

Some Risks

  • It will expose you to higher levels of estrogen compared to most combined oral contraceptives.
  • There may be an increased risk of blood clots among women who use the patch as compared to women who use certain combined oral contraceptives.

Does it protect me from sexually transmitted infections (STIs)? No.


Vaginal Contraceptive Ring

What is it?

How do I use it?

  • You put the ring into your vagina.
  • Keep the ring in your vagina for 3 weeks and then take it out for 1 week. Your menstrual period should start during this ring-free week.
  • If the ring falls out and stays out for more than 3 hours, replace it but use another method of birth control, like a condom and spermicide, until the ring has been in place for 7 days in a row.

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

Some Side Effects and Risks

  • Vaginal discharge, discomfort in the vagina, and mild irritation.
  • Headache
  • Mood changes
  • Nausea
  • Breast tenderness

Some Less Common Risks

  • It is not common, but some women who take the pill develop high blood pressure.
  • It is rare, but some women will have blood clots, heart attacks, or strokes.

Does it protect me from sexually transmitted infections (STIs)? No.


BARRIER METHODS:

Block sperm from reaching the egg.

Diaphragm with Spermicide
Spermicides containing N9 (nonoxynol-9) can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

What is it?

  • A dome-shaped flexible disk with a flexible rim.
  • Made from silicone.
  • It covers the cervix.

How do I use it?

  • You need to put a spermicidal jelly, cream or foam on the inside of the diaphragm before putting it into the vagina.
  • You must put the diaphragm into the vagina before having sex.
  • You must leave the diaphragm in place at least 6 hours after having sex.
  • It can be left in place for up to 24 hours. You need to use additional spermicide every time you have sex.

How do I get it?

  • You need a prescription.
  • A healthcare provider will need to do an exam to find the right size diaphragm for you.
  • You should have the diaphragm checked after childbirth or if you lose more than 15 pounds because you might need a different size.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

Some Side Effects

  • Irritation
  • Allergic reactions
  • Urinary tract infection

Some Less Common Risks

Does it protect me from sexually transmitted infections (STIs)? No.


Sponge with Spermicide

Spermicides containing N9 (nonoxynol-9) can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

 

What is it?

How do I use it?

  • Put it into the vagina before you have sex.
  • Protects for up to 24 hours.
  • You do not need to use more spermicide each time you have sex.
  • You must leave the sponge in place for at least 6 hours after last having sex.
  • You must take the sponge out within 30 hours after you put it in. Throw it away after you use it.

How do I get it?

  • You do not need a prescription.
  • You can buy it over-the-counter.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, 12 may get pregnant.
  • It may not work as well for women who have given birth. Childbirth stretches the vagina and cervix and the sponge may not fit as well. Out of 100 women who use this method who gave birth, 24 may get pregnant.

Some Side Effects

Some Less Common Risks

Does it protect me from sexually transmitted infections (STIs)? No.


Cervical Cap with Spermicide

Spermicides containing N9 (nonoxynol-9) can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

 

 

What is it?

How do I use it?

  • You need to put spermicide inside the cap before you use it.
  • You must put the cap in the vagina before you have sex.
  • You must leave the cap in place for at least 6 hours after having sex.
  • You may leave the cap in for up to 48 hours.
  • You do NOT need to use more spermicide each time you have sex.

How do I get it?

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, about 17 to 23 may get pregnant.
  • It may not work as well for women who have given birth. Childbirth stretches the vagina and cervix and the cap may not fit as well.

Some Side Effects and Risks

  • Irritation
  • Allergic reactions
  • Aabnormal Pap test

Some Less Common Risks

Does it protect me from sexually transmitted infections (STIs)? No.


Male Condom

What is it?

How do I use it?

  • Put it on the erect penis right before sex.
  • Pull out before the penis softens.
  • Hold the condom against the base of the penis before pulling out.
  • Use it only once and then throw it away.

How do I get it?

  • You do not need a prescription.
  • You can buy it over-the-counter or online.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women whose partners’ use this method, 18 may get pregnant.
  • The most important thing is that you use a condom every time you have sex.
  • It can be used with other barrier methods to decrease your chances of becoming pregnant.

Some Risks

  • Irritation
  • Allergic reactions (If you are allergic to latex, you can try condoms made of polyurethane).

Does it protect me from sexually transmitted infections (STIs)?


Female Condom

What is it?

  • A thin, lubricated pouch that is put into the vagina. It consists of a nitrile (non-latex) sheath, a flexible larger outer ring, and a polyurethane inner ring to place in the vagina. Nitrile is also commonly used to make surgical gloves.

How do I use it?

  • Put the female condom into the vagina before sex.
  • Follow the directions on the package to be sure the penis stays within the condom during sex and does not move outside the condom.
  • Use it only once and then throw it away.

How do I get it?

  • You do not need a prescription.
  • You can buy it over-the-counter or online.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, about 21 may get pregnant.
  • The most important thing is that you use a condom every time you have sex.

Some Risks

  • Discomfort or pain during insertion or sex.
  • Burning sensation, rash or itching.

Does it protect me from sexually transmitted infections (STIs)?


Spermicide Alone

Spermicides containing N9 (nonoxynol-9) can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

What is it?

  • A foam, cream, jelly, film, or tablet that you put into the vagina.

How do I use it?

  • You need to put spermicide into the vagina 5 to 90 minutes before you have sex.
  • You usually need to leave it in place at least 6 to 8 hours after sex; do not douche or rinse the vagina for at least 6 hours after sex.
  • Instructions can be different for each type of spermicide. Read the label carefully before you use a spermicide.
  • For better pregnancy protection, a spermicide may be used with a condom, diaphragm or cervical cap.

How do I get it?

  • You do not need a prescription.
  • You can buy it over-the-counter.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

  • Out of 100 women who use this method, about 28 may get pregnant.
  • Different studies show different rates of effectiveness.

Some Risks

  • Irritation
  • Allergic reactions
  • Urinary tract infection
  • If you are also using a medicine for a vaginal yeast infection, the spermicide might not work as well.

Does it protect me from sexually transmitted infections (STIs)? No.

Other Contraception

Emergency Contraception (EC): May be used if you did not use birth control or if your regular birth control fails (such as a condom breaks). It should not be used as a regular form of birth control.

Levonorgestrel 1.5 MG (1 pill) or Levonorgestrel .75 MG (2 pills) 

 

What is it?

  • These are pills with a progestin hormone.
  • They help prevent pregnancy after a birth control failure or unprotected sex.

How does it work?

  • It works mainly by stopping the release of an egg from the ovary. It may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the womb (uterus).
  • For the best chance for it to work, you should start taking the pill as soon as possible within 72 hours after unprotected sex or birth control failure.

How do I get it?

  • 1-pill version: You can buy it over-the-counter. You do not need a prescription.
  • 2-pill version: You can buy it over-the-counter if you are 17 or older. If you are younger than 17, you will need a prescription.
  • Both the 1-pill and 2-pill options are equally safe and effective.

Chance of getting pregnant

Some Side Effects

  • Menstrual changes
  • Headache, nausea, vomiting, dizzines
  • Lower stomach (abdominal) pain
  • Breast pain
  • Tiredness

Does it protect me from sexually transmitted infections (STIs)? No.   

 

Ulipristal Acetate

What is it?

  • A pill that blocks the hormone progesterone.
  • It helps prevent pregnancy after a birth control failure or unprotected sex.
  • It works mainly by stopping or delaying the ovaries from releasing an egg. It may also work by changing the lining of the womb (uterus) that may affect attachment (implantation).

How do I use it?

How do I get it?

Chance of getting pregnant

Most Common Side Effects 

  • Headache
  • Nausea
  • Abdominal pain
  • Menstrual pain
  • Tiredness
  • Dizziness

Does it protect me from sexually transmitted infections (STIs)? No.

 

This page should not be used in place of talking to your healthcare provider and reading the label for your product. This page is not intended to guide clinical practice. The product and risk information may change. See the product label and talk with your healthcare provider for more information on the risks of a specific product or on the chance of getting pregnant while using a method. 

  • Content current as of:

Myths and facts about.

.. female sterilization

This page was originally published in 2012 and has since been updated.

Female sterilization is an effective form of contraception that permanently prevents a woman from becoming pregnant. Sterilization does NOT protect against sexually transmitted infections (STIs), including HIV.

The operation involves cutting or blocking the fallopian tubes, which carry eggs from the ovaries to the womb. This prevents the eggs from reaching the sperm and becoming fertilized. It can be a fairly minor operation, with many women returning home the same day.

In most cases, female sterilization is more than 99% effective, and all women can be sterilized. However, sterilization should only be considered by women who do not want any more children, or who do not want children at all. Once a woman is sterilized, it is very difficult to reverse the process.

Couples often decide upon sterilization mutually, when they both feel they do not want any more children. If a couple decides upon sterilization as their preferred contraceptive method, either partner could be sterilized. If both options are acceptable, vasectomy is preferable. It is simpler, safer, easier and less expensive.

Myth: Sterilization causes cancer

Some clients incorrectly believe that female sterilization will cause women to develop cancer of the reproductive organs (uterus, cervix, or ovaries).

Fact:

Female sterilization does not increase the risk of cancer of the reproductive organs which are defined below. Very little research has been done to investigate the relationship between breast cancer and female sterilization, but so far there is no evidence of such a link.

Myth: All of a woman’s reproductive organs will be removed

Some clients incorrectly believe that female sterilization involves the removal of some or all of a woman’s reproductive organs, including the vagina.

Fact:

During the sterilization procedure, the ovaries, uterus, and cervix are left in place. Only the fallopian tubes (the tubes which carry eggs from the ovaries to the uterus) are blocked or cut. The two most common surgical approaches are laparoscopy and minilaparotomy.

Myth: There are health risks and side effects

Some clients incorrectly believe that female sterilization leads to health risks or side effects such as hysterectomy, poor health, pain, changes in menstrual bleeding or hormonal imbalances.

Fact:

There are no documented medical side effects of female sterilization. The few complications that do occur during or following sterilization, such as infection or abscess of the wound, can generally be kept to a minimum if appropriate techniques are used and if the procedure if performed in an appropriate setting. Local anesthesia is best for female sterilization because it has lower risks of complications than use of general anesthesia. The risks are lowest when local anesthesia is used without sedatives. If sedatives are used, providers should closely monitor the woman’s vital signs, such as pulse rate and blood pressure throughout the procedure. Also, most research finds no major changes in menstrual bleeding patterns after female sterilization.

Myth: Sterilization means a woman will no longer ovulate

Some people incorrectly believe that female sterilization prevents pregnancy either by stopping ovulation or by killing a woman’s egg.

Fact:

Female sterilization does not stop ovulation or harm a woman’s egg in any way. An egg will still be released each month, but it will dissolve and be reabsorbed by the body.

Myth: You will lose your sex drive

Some clients incorrectly believe that female sterilization causes women to lose their sex drive or lose their sexual ability.

Fact:

After sterilization a woman will look and feel the same as before. There is no loss of sexual drive or interest after female sterilization. She can have sex the same as before. She may find that sex is more enjoyable because she does not have to worry about getting pregnant.

Myth: You will experience weight changes

Some clients incorrectly believe that female sterilization will cause women to lose weight or to gain weight or that female sterilization will disfigure a woman’s body.

Fact:

Sterilization does not cause any changes in weight, appetite, or appearance. However, older women are more likely to choose sterilization for contraception than younger women and most women gain weight as they age.

Myth: Only certain women can undergo sterilization

Some women avoid female sterilization because they incorrectly believe that only women of a certain age or who have a certain number of children can undergo female sterilization.

Fact:

All women can have female sterilization. No medical conditions prevent a woman from using female sterilization.

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Contraception: female surgical sterilisation – MyDr.com.au

What is female surgical sterilisation?

Female surgical sterilisation is a form of permanent contraception that involves sealing off or blocking a woman’s fallopian tubes. It is also referred to as tubal ligation or ‘having your tubes tied’.

How does tubal ligation work?

Tubal ligation works by preventing the sperm from reaching the egg.

Normally, after an egg has been released by one of the ovaries (ovulation), it travels down the fallopian tube towards the uterus. Following ejaculation, sperm normally swim up to the fallopian tubes where an egg can be fertilised. Blocking the fallopian tubes prevents sperm from reaching and fertilising an egg.

The fallopian tubes can be blocked or sealed off during a surgical procedure. This is done by cutting and tying the fallopian tubes or by applying clips, clamps or rings to the fallopian tubes.

How effective is tubal ligation?

Tubal ligation is more than 99 per cent effective at preventing pregnancy.

Tubal ligation is designed to be a permanent form of contraception. While there are procedures that can reverse a tubal ligation, the success rate of fertility returning is only about 50 per cent. In addition, these procedures require surgery and are not suitable for everyone, so sterilisation should always be thought of as a permanent measure.

Which doctor should I see about a tubal ligation?

See your GP (general practitioner) or visit your local Family Planning Clinic if you are considering female surgical sterilisation. You may be referred to a gynaecologist (a doctor who specialises in the female reproductive system) for the procedure.

How is tubal ligation done?

Tubal ligation is usually done as a day surgery procedure. The procedure is usually done under general anaesthetic using a laparoscope (a thin tube with a camera on the end). This is sometimes called keyhole surgery. Laparoscopic procedures allow for much smaller incisions (cuts) to be made in the abdomen (compared with open procedures), meaning that you can recover faster.

There are several different methods of sealing off the fallopian tubes. Clips, clamps or rings can be put on the fallopian tubes, or the tubes can be cut and tied.

Side effects

Side effects from the anaesthetic and surgery are possible. Infection, bleeding and accidental damage to nearby organs (such as the bowel or bladder) are possible but uncommon side effects. The anaesthetic can sometimes cause side effects such as nausea and tiredness.

You may have pain in your tummy or shoulder for a few days after the procedure.

Self-care after a tubal ligation

You’ll probably need to have several days off work after the procedure and will be instructed to avoid heavy lifting for a week or more. Simple pain killers are usually effective at relieving any abdominal or shoulder pain. It may take around a week for you to feel back to normal.

Doctors usually recommend using an alternative form of contraception until you have had your first period after the procedure.

Can female sterilisation be reversed?

It is sometimes possible to reverse a tubal ligation with another surgical procedure. However, the success of reversal procedures is limited, with only about 50 per cent of women having a pregnancy following a tubal ligation reversal.

Therefore, it’s very important that only women who are very sure that they do not want to have children in the future consider having this procedure. You’ll be advised to think carefully about whether a change in your circumstances (such as a new relationship) would potentially alter your decision before having a tubal ligation. It’s also recommended that this procedure is not done at times of stress or straight after childbirth or miscarriage.

A discussion with your doctor, specialist and possibly a counsellor will help make sure that sterilisation is an appropriate form of contraception for you at this stage of your life.

Advantages of tubal ligation

Advantages of surgical sterilisation (tubal ligation) include the following.

  • It is a very effective and permanent method of contraception.
  • It does not affect sex drive. 
  • It doesn’t interfere with spontaneity of sexual intercourse.
  • There is no affect on your normal hormonal rhythms or periods.

Disadvantages of tubal ligation

Some of the disadvantages of surgical sterilisation include the following.

  • It requires surgery, usually under a general anaesthetic.
  • There is a risk, albeit low, of surgical complications such as internal bleeding, infection or damage to other organs.
  • If the procedure fails and a pregnancy occurs (this is rare), there is an increased risk that it will be an ectopic pregnancy (pregnancy outside the uterus), which can cause serious internal bleeding.
  • Reversing the procedure is difficult, so should only be undertaken by women who are absolutely certain that they do not want any (more) children.
  • It does not protect you from sexually transmitted infections (STIs).

1. Family Planning NSW. Permanent contraception: Female sterilisation (updated June 2018). https://www.fpnsw.org.au/factsheets/individuals/contraception/permanent-contraception-female-sterilisation (accessed Oct 2019).

2. Family Planning Victoria. Tubal ligation (sterilisation) (updated 28 June 2018). https://www.fpv.org.au/for-you/i-dont-want-to-get-pregnant/contraception-without-hormones/tubal-ligation-sterilisation (accessed Oct 2019).

3. American College of Obstetricians and Gynaecologists. Sterilization for women and men (March 2019). https://www.acog.org/Patients/FAQs/Sterilization-for-Women-and-Men (accessed Oct 2019).

4. NHS Choices. Female sterilisation (updated 22 Feb 2018). https://www.nhs.uk/conditions/contraception/female-sterilisation/ (accessed Oct 2019).

Birth control methods | Office on Women’s Health

Method

Number of pregnancies per 100 women within their first year of typical use1

Side effects and risks*

*These are not all of the possible side effects and risks. Talk to your doctor or nurse for more information.

How often you have to take or use

Abstinence (no sexual contact)

Unknown

(0 for perfect use)

No medical side effects

No action required, but it does take willpower. You may want to have a back-up birth control method, such as condoms.

Permanent sterilization surgery for women (tubal ligation, “getting your tubes tied”)

Less than 1

  • Possible pain during recovery (up to 2 weeks)
  • Bleeding or other complications from surgery
  • Less common risk includes ectopic (tubal) pregnancy

No action required after surgery

Permanent sterilization implant for women (Essure®)

The Essure® birth control device will no longer be sold or distributed in the United States after December 31, 2018.

Less than 1

  • Pain during the insertion of Essure; some pain during recovery
  • Cramping, vaginal bleeding, back pain during recovery
  • Implant may move out of place
  • Less common but serious risk includes ectopic (tubal) pregnancy

No action required after surgery

Permanent sterilization surgery for men (vasectomy)

Less than 1

  • Pain during recovery
  • Complications from surgery

No action required after surgery

Implantable rod (Implanon®, Nexplanon®)

Less than 1

  • Headache
  • Irregular periods
  • Weight gain
  • Sore breasts
  • Less common risk includes difficulty in removing the implant

No action required for up to 3 years before removing or replacing

Copper intrauterine device (IUD) (ParaGard®)

Less than 1

  • Cramps for a few days after insertion
  • Missed periods, bleeding between periods, heavier periods
  • Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.

No action required for up to 10 years before removing or replacing

Hormonal intrauterine devices (IUDs) (Liletta, Mirena®, and Skyla®)

Less than 1

  • Irregular periods, lighter or missed periods
  • Ovarian cysts
  • Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.

No action required for 3 to 5 years, depending on the brand, before removing or replacing

Shot/injection (Depo-Provera®)

6

  • Bleeding between periods, missed periods
  • Weight gain
  • Changes in mood
  • Sore breasts
  • Headaches
  • Bone loss with long-term use (bone loss may be reversible once you stop using this type of birth control)

Get a new shot every 3 months

Oral contraceptives, combination hormones (“the pill”)

9

  • Headache
  • Upset stomach
  • Sore breasts
  • Changes in your period
  • Changes in mood
  • Weight gain
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35

Take at the same time every day

Oral contraceptives, progestin-only pill (“mini-pill”)

9

  • Spotting or bleeding between periods
  • Weight gain
  • Sore breasts
  • Headache
  • Nausea

Take at the same time every day

Skin patch
(Xulane®)

9

May be less effective in women weighing 198 pounds or more2

  • Skin irritation
  • Upset stomach
  • Changes in your period
  • Changes in mood
  • Sore breasts
  • Headache
  • Weight gain
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35

Wear for 21 days, remove for 7 days, replace with a new patch

Vaginal ring (NuvaRing®)

9

  • Headache
  • Upset stomach
  • Sore breasts
  • Vaginal irritation and discharge
  • Changes in your period
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35

Wear for 21 days, remove for 7 days, replace with a new ring

Diaphragm with spermicide (Koromex®, Ortho-Diaphragm®)

12

If you gain or lose than 15 pounds, or have a baby, have your doctor check you to make sure the diaphragm still fits.

  • Irritation
  • Allergic reactions
  • Urinary tract infection (UTI)
  • Vaginal infections
  • Rarely, toxic shock if left in for more than 24 hours
  • Using a spermicide often might increase your risk of getting HIV

Insert each time you have sex

Sponge with spermicide (Today Sponge®)

12

(among women who have never given birth before)

or

24

(among women who have given birth)3

  • Irritation
  • Allergic reactions
  • Rarely, toxic shock if left in for more than 24 hours
  • Using a spermicide often might increase your risk of getting HIV

Insert each time you have sex

Cervical cap with spermicide (FemCap®)

233

  • Vaginal irritation or odor
  • Urinary tract infections (UTIs)
  • Allergic reactions
  • Rarely, toxic shock if left in for more than 48 hours
  • Using a spermicide often might increase your risk of getting HIV

Insert each time you have sex

Male condom

18

  • Irritation
  • Condom may tear, break or slip off
  • Allergic reactions to latex condoms

Use each time you have sex

Female condom

21

  • Irritation
  • Condom may tear or slip out
  • Allergic reaction

Use each time you have sex

Withdrawal — when a man takes his penis out of a woman’s vagina (or “pulls out”) before he ejaculates (has an orgasm or “comes”)

22

  • Sperm can be released before the man pulls out, putting you at risk for pregnancy

Use each time you have sex

Natural family planning (rhythm method)

24

  • Can be hard to know the days you are most fertile (when you need to avoid having sex or use back-up birth control)

Depending on method used, takes planning each month

Spermicide alone

28

Works best if used along with a barrier method, such as a diaphragm

  • Irritation
  • Allergic reactions
  • Urinary tract infection
  • Frequent use of a spermicide might increase your risk of getting HIV

Use each time you have sex

90,000 “Birth control pills made my life a nightmare”

Millions of women are taking birth control pills, and many are quite happy. However, there are times when these pills have a detrimental effect on the psyche.

Vicki Spratt, associate editor of The Debrief, describes how she battled depression, anxiety and panic attacks for years, trying to find the right drugs for her.

How it all started about

Together with my mother I came to my local doctor complaining that my period has not ended for three weeks already. She recommended birth control pills to me – with some reservations, of course. The pills do not protect against sexually transmitted diseases, the doctor emphasized, and unprotected sex can lead to the development of cervical cancer. She had to say this, although I was only 14 years old, and I thought about sex last.

Photo author, VICKY SPRATT

The nurse filled out the prescription, and so I became the owner of a three-month supply of oral contraceptives. I took the trip to the pharmacy for green blisters with tiny yellow pills as a kind of rite of passage into a woman. These were not just pills, but a sweetened concentrate of feminism, the struggle for women’s rights, medical progress.

This is how it all began. That was 14 years ago, and since then I have been “playing medication roulette” for more than ten years, testing various drugs on myself with varying success.At the same time, I began to experience anxiety, depression, and mood swings that followed me throughout my adult life with minor interruptions.

I had a few unsuccessful romances and had to skip a year at university. I explained all this by my shortcomings. Like, this is the kind of person I am: unadapted to life, insecure, unhappy. Only after 20 years, when I had already graduated from university and my mental and behavioral problems could no longer be attributed to “difficult adolescence”, I first seriously thought about the side effects of the pills.

Photo author, BSIP / Getty

Types of contraceptive pills

There are two main types of contraceptives: combined – they contain estrogen and progestin (a synthetic form of progesterone) – and “progestin-only pills” or “mini-pills”, which contain only one hormone (progestin).

  • Combination tablets are available under many different names. They differ in dosage and ratio of estrogen to progestin.
  • Progestin tablets are also different, depending on the combination of norethisterone or desogestrel in their composition.
  • Many women have individual intolerance to certain components of hormonal contraceptives.

Once, after another panic attack and as a result of a sleepless night, I sat down at my computer and started looking for information on Google. The day before, I switched to new progestin-only contraceptives that were prescribed to me for migraine headaches. As it turned out, combined pills are contraindicated for those who suffer from migraine headaches with aura.

I entered the name of my drug and the words “depression” and “anxiety” into the search.The internet immediately showed me threads on forums and posts from bloggers who were suffering from the same symptoms as me.

By that time, I had already several times turned to my GP with complaints of unexpected and powerful panic attacks – this had never happened before. In the conversation, the topic of contraceptives never came up, despite the fact that the attacks occurred simultaneously with the transition to new pills. But I was prescribed a significant dose of beta-blockers – drugs that treat anxiety – and advised to take a course of cognitive-behavioral therapy.

So I lived for about six to eight months. I can’t say for sure, because this period in my memory is very blurred and accelerated, because the feeling of anxiety and danger constantly pulsed in my veins.

Photo by BSIP / Getty

Learn more

The Debrief surveyed 1,022 female readers aged 18 to 30:

90,038 90,039 93% of respondents took birth control pills at or before the survey …90,040 90,039 Of these, 45% suffered from anxiety, the other 45% from depression. 90,040 90,039 46% said the pills reduced their sex drive.

  • 58% believe the pills have a negative impact on their mental health.
  • 4% speak about the positive effect of the tablets.
  • I would like to laugh at the thought of this. This is how all good stories should end, isn’t it? But there was nothing and nothing funny about what I went through. It was horror. I felt fear all the time.I did not recognize myself, did not love and could not live in peace. I didn’t know what to do, who to turn to and whether this would be the end. Apart from anxiety, apathy seized me. I felt like a complete mediocrity and blamed only myself for what was happening.

    Thinking that I had lost my mind, I told my doctor that “I do not feel myself, but someone else,” as if my brain had become moldy and dry.

    “Don’t you think it has something to do with my pills?” I asked. I remember the look on her face: she tried to maintain a neutral look, but she could hardly contain her sarcasm.I explained that six of the seven types of pills I took were negatively affecting my well-being. The only exceptions were the high estrogen pills, which made me feel like a superwoman for a year until they stopped taking them (partly because of migraines, partly because long-term use of this drug increases the risk of thrombosis).

    Taking control of herself, the doctor said a categorical “no”: my problems are not related to the pills.

    However, I did not listen to either her or my therapist and stopped taking progestin-only pills.

    What happened next, I can only call a gradual and careful return of my “I”. After three to four weeks, I stopped taking beta blockers. To this day, I always carry them with me in my purse in case I fall again “from the high cliff of my consciousness.” However, for three and a half years they have never been needed.

    Of course, my problems did not disappear overnight, but the panic attacks stopped. Over the years, not a single one has happened. From time to time I feel depressed, anxious and stressed, but not to the same extent as when I took progestin-only pills.I remembered what joy is. My sex drive returned. I stopped being afraid of everyone and everything.

    A year after the end of the panic attacks, I went on a solo trip to the other side of the world. A year earlier, that would have been unthinkable. Sitting on a distant tropical beach under a warm thunderstorm shower, I suddenly burst into tears of joy. What a relief it was that I became myself again, that I can control my thoughts, that I was not mistaken – I really know myself better than the doctors assured me.

    I am now 28 years old and no longer take hormonal contraceptives. With the exception of mild mood swings during the day before my period, I completely got rid of anxiety, depression and panic attacks.

    Photo by VICKY SPRATT

    Ever since I lost myself on progestin-only pills and regained myself on the beach in South Asia, my problem gradually began to attract more and more attention. In 2013, Holly Grigg Spall’s book Sweetening The Pill was published, in which the author stated the effect of hormonal contraception on women’s mental health.

    In addition, an important study was carried out: Professor Oyvind Lidegaard from the University of Copenhagen found that women who take birth control pills (both combination and progestin) are more likely to be prescribed antidepressants. This difference was especially noticeable among young women 15-19 years old who took the combination pill.

    Lidegaard was able to carry out this study because more than a million Danes aged 15 to 34 were given access to medical records.

    After reading about this study, I sent an information request to the National Health Service. As a journalist for The Debrief, I knew that many British women also suffer from the same effects of pills – our readers complained to us about this almost daily. I asked how many women were taking birth control pills at the same time as antidepressants or beta blockers. I was told that their system does not yet allow sampling of this data.

    Pills and Depression

    Here is what Professor Helen Stokes-Lampard, Chairman of the Royal College of Physicians, says:

    “Hormones have been shown to affect mood, both positively and negatively.For most women, having reliable contraception and menstrual regulation are undeniable benefits that outweigh the side effects, if any. In addition, many women claim that hormonal drugs improve their mood.

    If a woman thinks contraceptives are negatively affecting her mood, she should see a doctor. ”

    Depression is now considered a possible but rare side effect of hormonal contraceptives, the instructions accompanying the pills say.The National Health Service website mentions “mood swings” without naming depression, anxiety, or panic attacks directly.

    You don’t have to give up pills, but you don’t have to put up with the negative side effects that prevent us from living. We need information to make a choice. More thorough research is needed on the effect of hormonal contraceptives on the female psyche, observation of the reaction of patients, more support for those who suffer from serious side effects.Women should not feel ignored or taken seriously.

    Vicki Spratt is associate editor of The Debrief, of the website for women in their 20s and 30s. Now this site publishes a series of materials “ Mad About The Pill” (Mad About The Pill).

    Possibilities of using combined oral contraceptives in prolonged mode

    Possibilities of using combined oral contraceptives in prolonged mode

    D.MD, prof. A.L. Tikhomirov, Ph.D. Ch.G. Oleinik, Ph.D. E.V. Zaleeva

    One of the most significant scientific achievements of the last century is the discovery of the synthesis of female sex steroids – hormones responsible for reproductive function. The discovery of sex hormones has become a new stage in the development of contraception. 38 years have passed since the first in 1923 the Austrian physiologist Ludwig Haberlant proposed the use of hormones for “hormonal sterilization”, and until the appearance in 1961 of the first FDA-approved contraceptive, Enovid, containing 150 mcg mestranol and 10 mg norethinodrel acetate.Thus, the creation of OGKs was a revolution in contraception, since they were almost 100% effective.

    The history of the OGK’s existence is characterized by continuous development, the search for new funds. In the process of improvement, their quantitative and qualitative composition changed. The first OGCs contained high doses of both estrogens and progestogens. Considering that estrogens, when taken, can increase the procoagulatory factors of the hemostatic system in the 60s, this led to an increase in the frequency of thrombosis and thrombophlebitis in women taking OGK, and the risk of death from thromboembolism increased by 40%.Reducing the dose of ethinyl estradiol to 50 μg was accompanied by a significant decrease in these side effects. However, recent data have shown that gestagens also play a role in the occurrence of cardiovascular complications. Therefore, the researchers concluded that it is advisable to reduce the dose of both hormones.

    New generation progestogens deserve special attention: desogestrel, gestodene, norgestimate. The high affinity for progesterone receptors has made it possible to use them in low doses for reliable contraception.Their main advantage lies in the insignificant effect on the lipid spectrum of the blood. This makes it possible to ensure almost complete safety of modern low-dose OCs, taking into account the contraindications to their use. It became obvious that for reliable contraception there is no need to use high doses of steroid components, and metabolic and other adverse effects on the functional state of various organs and systems of the female body are significantly reduced with a decrease in the dose of steroids in the OC.Currently, the doses of the estrogenic component in contraceptives are reduced by 3-5 times, and the progestogenic component by 5-20 times compared to monophasic contraceptives of the first generation. Currently, according to WHO recommendations, the dose of the estrogenic component in COCs should not exceed 35 μg of ethinylestradiol.

    When the first contraceptive drugs were created in the 60s of the last century, no one could have thought that the contraceptive effect from their use would soon compete with the therapeutic and prophylactic effect on the entire body of a woman.Long-term comparative studies of women who took and did not take oral contraceptives have shown that women who used OC did not face a number of gynecological and general somatic problems. Therefore, modern OK have firmly entered the gynecological not only as a tool to regulate fertility, but also as a means to preserve and restore reproductive function.

    However, in the process of improving OK, in addition to changing the quantitative and qualitative composition, in order to achieve the greatest non-contraceptive effect, an idea arose about the advisability of creating alternative schemes for taking OK, in particular, a prolonged mode of their use.

    Prolonged COC use is the use of COCs in a continuous mode, without the usual 7-day interval, in order to delay the next menstruation. Accordingly, the total number of periods decreases. This not only effectively prevents unwanted pregnancy, but also reduces the risks of developing a number of diseases (Sulak P. J., 2002).

    If earlier a woman had about 160 ovulations in her life, now this number has increased almost 3 times – 450 ovulations.Such a number of ovulations and menstruation leads to sharp fluctuations in hormone levels, and, as a result, to desynchronization of the hypothalamic-pituitary-ovarian system. As a result, the risks of developing various gynecological diseases increase.

    Historically, in order to simulate a normal menstrual cycle, COCs are taken according to the standard scheme: 21 days followed by a 7-day break. This mode of administration makes it easier for the doctor to explain, and for the woman – to understand the mechanism of action of COCs.Among women who prefer to have regular withdrawal bleeding while taking COCs, the main reason for this decision is the fear of pregnancy, infertility and side effects, as well as the opinion that menstruation is a natural process. Regular withdrawal bleeding while taking COCs resembles a normal ovulatory cycle, and therefore allows the woman to make sure that she has not developed a pregnancy. However, women taking COCs and believing that they have a normal menstrual cycle are wrong, because monthly bleeding occurs not as a result of a series of successive hormonal and physiological changes in the body, but as a result of a sharp drop in the concentration of hormones in the blood after drug withdrawal.In fact, menstrual cycles while taking COCs are artificial cycles and are accompanied by reversible sterility, so if a woman does not plan a pregnancy, there is no need for regular bleeding for her.

    At the beginning of the XXI century, a group of famous scientists and doctors published the concept that monthly ovulation and menstruation are not necessary, and in certain cases, due to significant fluctuations in hormone levels, they pose a health risk: anemia, arthritis, bronchial asthma, dysmenorrhea, endometriosis , uterine fibroids, PMS (Thomas et al., 2000).

    In addition, most women prefer extended cycle regimens to conventional COC regimens. According to various studies, only 30% of women prefer monthly bleeding, 27% prefer to have a period every 3.6 or 12 months, and 40% do not want to have a period at all (Wiergatz, Kuhl, 2004). The reasons for refusing regular menstruation were: a decrease in clinical manifestations associated with menstruation, a decrease in blood loss, an improvement in personal hygiene, sexual reasons, an increase in the quality of life.

    All this in aggregate served as the basis for resolving the issue of the need and feasibility of introducing a prolonged regimen of COCs into practice.

    The use of COCs in prolonged mode has been known for a long time. For many years, doctors have prescribed COCs to delay menstruation for medical reasons, such as dysmenorrhea or excessive blood loss, but also to prevent pregnancy during holidays or other social or professional reasons.Extended cycle regimens are an example of a medical intervention that doctors and patients began to use widely even before its in-depth clinical research. Recently, the use of COCs in a prolonged mode has become more and more popular. Large pharmaceutical companies are developing new drugs that initially provide for a prolonged dosage regimen. For example, in late 2003, a new low-dose COC containing levonorgestrel (LNG) was approved in the United States with an extended dosage regimen specifically designed to reduce the total number of periods (from 13 to 4 per year).

    The mechanism of action of COCs is quite complex. Today, it is generally accepted that COCs act on 5 different levels: direct on the central nervous system and indirectly on the ovaries, fallopian tubes, cervical mucus and endometrium.

    • First, COCs act centrally at the level of the hypothalamic-pituitary system. It is known that the estrogenic component of COC, which is an ovulation suppressor, suppresses the cyclic secretion of gonadotropin-releasing hormone in the hypothalamus, further suppressing the secretion of the gonadotropin hormone FSH, which leads to a decrease in ovarian activity and maturation of follicles.As a result of this action of estrogens, there is no cyclical rise in the level of estradiol in the blood plasma. As a consequence, there is no stimulation of the LH peak in the middle of the cycle, which, together with the absence of mature follicles, leads to the suppression of ovulation. A number of studies have also shown a correlation between the ability of steroids to activate dopamine metabolism in dopaminergic neurons of the tuberoinfundibular zone of the hypothalamus and their ability to block ovulation (Fuxe K. et al., 1971). These data allow considering COCs as drugs of neurotropic action.

    • Secondly, COCs have a direct effect on the ovaries (“ovarian mechanism of action”). The secretion of estrogen is reduced by 2 times. Plasma estradiol is very low and usually corresponds to the early proliferative phase. The appearance of the ovaries is similar to that of postmenopausal women – they are reduced in size and contain many atretic follicles. The direct effect of OC on the ovary is proved by the fact that, against the background of their intake, the response to the introduction of exogenous gonadotropins is disturbed and, as a rule, follicular cysts disappear.

    • Thirdly, under the influence of COCs, the peristalsis of the fallopian tubes and the passage of the egg through them slow down.

    • Fourthly, under the influence of COCs, the content of sialic acid in the mucus of the cervical canal decreases, which contributes to a change in its biochemical properties. The mucus becomes more viscous and resistant to sperm penetration.

    • Fifth, COCs can affect the endometrium, disrupting blastocyst implantation. Under the influence of COC, the endometrium undergoes rapid regression in the proliferative phase, and premature secretory transformation of the glands appears in it, and sometimes atrophic changes; a decidual-like transformation is noted in the stroma.When COCs act on the endometrium, the stromal component always predominates over the glandular component. The glands do not reach full development, as is the case in the normal menstrual cycle, which leads to the appearance of abortive secretion in the epithelium. The vasculature of the endometrium also undergoes significant changes: there is a complete inhibition of the development of spiral arteries, and instead of them a branched network of capillaries develops, especially in the superficial layers of the uterine mucosa. All these changes lead to the fact that the endometrium becomes unsuitable for implantation and blastocyst development.

    Hormonal contraceptives also affect other body systems, providing biochemical, metabolic and immunological effects.

    When using COCs according to the standard scheme, there is an increase in FSH from 3-4 days of a 7-day interval, which can lead to the growth of follicles up to 8-10 mm in diameter, and as a consequence, an increase in the production of endogenous estradiol. This is especially important to consider in such gynecological diseases as polycystic ovary syndrome, uterine fibroids, endometriosis.

    When using COCs in a continuous mode (without a 7-day interval), there is a better suppression of FSH and the absence of follicular growth, which indicates stabilization of the hormonal activity of the hypothalamic-pituitary-ovarian system and, as a consequence, a decrease in the risk of developing dyshormonal gynecological diseases.

    The composition of COCs includes synthetic estrogens and progestogens, the structure of which is close to natural, and the activity is much higher. The main estrogenic component of COCs is ethinyl estradiol.And according to the incoming progestogenic component, COCs are divided into drugs:

    • the first generation, containing norethynodrel, norethynodrone acetate, ethynodiol diacetate;

    • second generation, containing norgestrel, norethisterone, or levonorgestrel as a progestogen;

    • third generation, containing gestodene, desogestrel and norgestimate.

    The effectiveness of progestogens is determined by the following parameters: the ability to block ovulation, bind progesterone receptors, cause histological changes in the tissues of the uterus and delay menstruation.Progestogens, along with gestagenic influence, have other biological effects.

    Biological action of some progestogens

    Progestogens

    Estrogenic

    Antiestrogenic

    Androgenic

    Antiandrogenic

    Anabolic

    19-nortestosterone derivatives:

    Norethisterone acetate

    Linestrenol

    Norethinodrel

    Etinodiol diacetate

    Levonorgestrel

    Desogestrel

    Gestodene

    Norgestimate

    +

    +

    +++

    +

    +

    +++

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    +

    The main difference between modern progestogens is their high selectivity and low androgenic activity, which together made it possible to minimize the effect of COCs on metabolic parameters.A measure of progestogen selectivity is the ratio of its maximum concentration at which the progestogen begins to show its androgenic properties to the minimum amount required for a progestogenic response. That is, the less the amount of progestogen required for the manifestation of its progestogenic properties, and the greater the amount when it begins to show its androgenic properties, the higher the selectivity of the progestogen. And the higher the selectivity of the progestogen, the fewer side effects associated with the androgenicity of the drug.In a study by H. Kloosterboer (1988) the relative affinity of binding to progesterone receptors for gestodene was 350%, for 3-keto-desogestrel (an active metabolite of desogestrel) – 260%, for levonorgestrel – 135%. The sensitivity to testosterone receptors for 3-keto-desogestrel is 6.5%, for gestodene – 13.4% and for levonorgestrel – 15.3%.

    The selectivity index, presented as the ratio of the concentration of progestogen required to displace the ligand from binding to receptors for progestogens and testosterone, was 40 for 3-keto-desogestrel, 25 for gestodene, and 8.8 for levonorgestrel.Most of the progestogens that make up modern COCs retain their activity in 80-100% after passing through the liver.

    At present, the schemes of prolonged COC use are widely used all over the world, in particular, the use of Marvelon.

    Marvelon is a progestogen-dominant contraceptive, because contains desogestrel (third generation progestogen), which has high progestogenic activity, high affinity for progesterone receptors (Nikitin, 2003).Even a very small dose of desogestrel is sufficient to effectively suppress ovulation. Back in 1998, Kloosterboer noted that the active metabolite of desogestrel, etonogestrel (3-keto-desogestrel), has the highest affinity for progesterone receptors and lowest for androgen receptors. Despite the emergence of new progestogens, recent studies (Kuhl 1991) have shown that 3-keto-desogestrel has a pronounced antigonadotropic effect and the highest progestogenic activity (Nikitin, 2003).Thanks to this, desogestrel effectively suppresses ovulation, and a dose of 60 μg per day is already sufficient to suppress ovulation 100% (Cullberg et al, 1982, Kuhl H., 1991). Each tablet of Marvelon contains 150 mcg of desogestrel, which is equivalent to the 2.5 doses required to completely suppress ovulation. Such a strong inhibitory effect of Marvelon on ovulation was shown by van der Vange et al (1986), who studied the effect of seven low-dose OCs on ovarian function by means of ultrasound studies and the determination of 17 b-estradiol and progesterone.Follicular development was significantly lower among women taking Marvelon than with other oral contraceptives.

    Studies carried out in recent years indicate a positive therapeutic and prophylactic effect of COCs, which is not directly related to their contraceptive effect. Due to the fact that OCs consist of synthetic analogs of natural sex steroids that have the ability to influence the hypothalamic-pituitary and reproductive system of a woman, they have found wide application for the treatment of various gynecological pathologies.Both the contraceptive and therapeutic effect of OC are due to the same mechanism of action based on the suppression of ovulation as a result of a decrease in the cyclic secretion of gonadotropins. Due to the fact that the mechanism of action of COCs on individual links of the reproductive system is ambiguous and may vary depending on the type and dose of drugs, the duration of administration and the initial state of the hypothalamic-pituitary-ovarian system, the clinical aspects of their use are different.

    The therapeutic aspects of combined monophasic oral contraceptives are currently the best studied:

    • The frequency of ectopic pregnancy is more than halved.

    • The frequency of inflammatory diseases of the pelvic organs is reduced by 50-70%. This is due to the effect of the progestogenic component of the drugs on the cervical mucus, which makes it difficult for the ascending penetration of various infectious agents into the uterus, fallopian tubes, and ovaries.

    • The incidence of ovarian retention formations decreases (up to 90%).

    • Decreases the incidence of benign neoplasms and ovarian cancer. The percentage of risk reduction is associated with the duration of the use of COCs: their use for 5 years or longer leads to a 50% reduction in risk.Continuous ovulation is known to be a risk factor for ovarian cancer. Frequently repeated re-traumatization of the surface epithelium of the ovaries as a result of ovulation with subsequent repair of the epithelium throughout the reproductive period can become a factor predisposing to the development of a tumor. Considering that when using COCs, ovulation is blocked, it seems quite logical to report their preventive action against the development of ovarian cancer. The protective effect persists for at least 10 years after discontinuation of COC use.

    • There was a decrease in the risk of developing and the frequency of benign neoplasms of the mammary glands in women using COCs, due to their inhibitory effect on proliferative processes in this organ (fibrocystic mastopathy decreases by 50-75%) (La Vecchia C., Et al ., 1996).

    • The use of COCs has been proven to reduce the risk of endometrial cancer. This is due not only to the specific antiproliferative effect of COCs on the endometrium, but also to the direct inhibitory effect of COCs on the mitotic activity of endometrial cells.This effect is associated with the duration of the use of COCs. The risk of disease is reduced by about 20% after a year and by about 50% after 4 years of use. It is said that the protective effect lasts up to 15 years after the interruption of COC use.

    • Reduces the risk of developing colorectal cancer (up to 40%).

    • The use of COCs reduces the incidence of dysfunctional uterine bleeding. The use of COCs leads to morphological changes in the endometrium: mitotic activity of cells, the number and diameter of glands decreases, and stromal edema decreases.

    • Relief of dysmenorrhea symptoms. In the development of dysmenorrhea, the leading role is played by a local increase in prostaglandins F 2a and E2, metabolites of arachidonic acid, thromboxane A2, and vasopressin. COCs lead to a decrease in the estrogenic effect on the endometrium and a decrease in the release of the above substrates.

    • COC relieve symptoms of overt ovulation.

    • Monophasic COCs are effective in the treatment of PMS by stabilizing ovarian steroid levels throughout the menstrual cycle.

    • Positive effect (up to 50% when taken within 1 year) with iron deficiency anemia. This is due to a decrease in blood loss during menstrual-like reactions, which are generally much shorter and less profuse than menstruation.

    • Positive effect on endometriosis (Parazzini F. Et al., 1994). According to Pshenichnikova T.Ya. (1993), the effectiveness of treatment for minor forms of endometriosis and adenomyosis of the first degree was 58%.

    • COCs have a therapeutic effect in hyperandrogenism and associated pathological conditions of the skin of women (hirsutism, acne, alopecia, seborrhea).

    • The positive effect of COCs on bone mineral metabolism has been proven. Women using COCs have a large bone mass, which is associated with an increase in the concentration of C a + in the blood plasma and its deposition in the bones, which contributes to the prevention of postmenopausal osteoporosis. Long-term use of COCs contributes to an increase in bone mass, which, in turn, leads to a decrease in the risk of osteoporosis in postmenopausal women (Baird D., Glasier A., ​​1993).

    • COCs are the optimal method for women with congenital and hereditary coagulopathies: von Willebrand disease, factor VII deficiency, carriage of hemophilia A, thrombocytopathy.The use of COCs reduces the hemorrhagic manifestations of the disease, including hypermenorrhea and the frequency of ovarian apoplexy, reducing the level of disability in such patients.

    • Positive effect on peptic ulcers of the stomach, duodenal ulcer, rheumatoid arthritis, idiopathic thrombocytopenic purpura.

    • The risk of uterine fibroids decreases by 17% every 5 years of use, and COCs are one of the stages of complex conservative treatment.

    • In polycystic ovary syndrome, COCs lead to a decrease in LH and testosterone levels, providing a certain therapeutic effect.

    According to various authors, all of the above non-contraceptive effects of COCs are also inherent in the prolonged regimen of their intake. Moreover, the prolonged regimen enhances the positive effect and creates an additional therapeutic effect in PMS, polycystic ovary syndrome, uterine myoma, endometriosis.

    As a result of a 2002 study, involving 318 women, it was also found that an increase in the duration of COC use and a shortening of the interval between packs reduces by 4 times the severity and frequency of “withdrawal symptoms” (dysmenorrhea, headache, swelling, breast tenderness) …It was noted that almost all the side effects encountered with the use of COCs were expressed mainly during the 7-day break in admission. When switching to a prolonged regimen, there is a decrease in the number of “withdrawal symptoms” (Sulak P. J., 2002).

    Thus, the prolonged COC regimen (in particular Marvelon) has a number of advantages over the traditional regimen. They are in:

    • Reduction in the number of periods, which meets the wishes of most women.

    • Reducing the number of side effects associated with the use of COCs (nausea, headache, etc.) associated with a 7-day break.

    • Additional therapeutic effect in PMS, polycystic ovary syndrome, uterine myoma, endometriosis.

    Today, modern COCs, due to their high efficiency, as well as minimal biochemical, metabolic and immunological effects on the body, worthily occupy a leading place among oral hormonal contraceptives (OGC).Today, more than 90% of women using OGK use low- and micro-dose COCs, which include third-generation progestogens. However, given the above positive aspects of prolonged use of COCs (in particular, Marvelon), it is necessary to widely implement this regimen to achieve a more effective contraceptive and therapeutic effect of COCs, which will certainly improve the quality of life of women.

    Male contraception | GBU RO “OTSOZS and R”

    Due to the established traditions, for some reason, protection from pregnancy is considered almost a purely female problem in our country!

    Contraceptives for men are more difficult to develop than similar products for women, since their task is to stop the flow of a million sperm, while female contraceptives must block an egg from penetrating only once every cycle (an average of 28 days).

    In medical practice, there are quite effective modern methods of contraception for men, including not only condoms, but also male contraceptive pills, injections, implants, vasectomy and much more. Knowing about this will not hurt both a teenager entering adulthood and not ready to take on the burden of fatherhood, and a large family man who, together with his wife, decided that they would not have more children yet.

    Some of the methods used by men to prevent pregnancy are widely known and need not be described.These are interrupted sexual intercourse, latex and liquid condoms, hormonal contraception.

    Male hormonal contraceptives are aimed at ensuring that, after their use, the hormone contained in them has an overwhelming effect on spermatozoa.

    They can be administered as tablets, by injection, with subcutaneous implants, in capsules or in gels.

    The majority of modern hormonal contraceptives for men include the hormone testosterone.It must be injected into the body in large doses.

    And although the effectiveness of this method of hormonal control, according to some data, can reach 99%, this is not the best option, since there are side effects:

    hair loss on the head;

    enlargement of the prostate;

    · an increase in the hairline on the trunk;

    · the appearance of various skin rashes;

    · enlargement of the mammary gland in men;

    Hormonal contraception is the basis for the use of contraceptive injections, implantations in the anterior abdominal wall of drugs with their possible effect within 5-6 months.

    In recent years, male sterilization, or as it is commonly called vasectomy, has become increasingly popular. It should be noted that the operation to sterilize men has nothing to do with the castration procedure. Voluntary male sterilization does not require the removal of the testicles, its essence is the excision of the vas deferens from the testicles. After such an intervention lasting 25 minutes, carried out under local anesthesia, the man retains the ability to fertilize for several more months or until 20 ejaculations (ejaculations) occur.After that, you can safely have sex with your partner, without worrying that she may become pregnant.

    Within five years, the patency of the vas deferens can be restored.؟

    Describes folk methods of male contraception, which came to us from the East.

    Their essence is simple: every day a man needs to lower his testicles into water at a temperature of 40-46 C for 15-40 minutes. This technique makes sense: for normal sperm formation, a temperature below the average human body temperature is required, so the testicles are brought out.The artificial influence of heat will interfere with the normal formation of sperm. However, for the method to be 100% effective, the effect of water of the highest possible temperature is necessary, otherwise it is impossible to speak of high protection.

    The idea of ​​creating male drug contraception has long been of concern to researchers (and women especially). Promising directions in the development of male contraception are the creation of an inoculation against pregnancy based on antibodies to sperm that are formed in men and women and cause immunological infertility, and male drug (hormonal and non-hormonal) contraception, which includes such ways as inhibition of spermatogenesis, a decrease in sperm activity , inhibition of the function of the epididymis.

    Many medicinal substances affect the activity of spermatozoa. For example, the “male” contraceptive properties of such a well-known drug as nifedipine have recently been discovered. Nifedipine has no real prospects of becoming a contraceptive, and it has a large number of side effects. But this drug almost for the first time demonstrated a real possibility to modify the biochemistry of spermatozoa so that they lose their fertilizing ability. It remains only to find other, safer points of application of chemical action on these cells – and the problem of creating contraceptive pills for men will be solved.

    Male anti-sperm drugs are still under development. And so far, no country in the world has a male contraceptive drug that has completely passed all the necessary clinical studies and was approved for sale.

    However, the above factors indicate the prospects for further development of drugs in this group

    Shevchenko D.N.

    90,000 Questions and myths about hormonal preparations

    Quite often, the cause of chronic pain in the lower abdomen in women is gynecological pathology, for example – endometriosis or cysts on the ovaries .In such a situation, the gynecologist may suggest taking hormonal drugs to alleviate the condition and treatment. For many patients, these drugs cause a number of fears and questions. Let’s take a look at the most common ones.

    1. They recover from hormonal preparations.

    Previously, when hormonal preparations contained more hormones, this was the case. Now, modern drugs contain the minimum possible amount of hormones, which does not affect weight in any way.If, while taking the pills, the woman noticed that she began to gain weight, this is a reason to contact the gynecologist to change the drug, since the prescribed drug is not suitable for her.

    2. You cannot get pregnant after taking hormonal drugs.

    This is also not true, because most hormonal drugs at the time of administration block the onset of ovulation – the release of the egg from the ovary and thus “save” the egg.After discontinuation of hormones, ovulation resumes with renewed vigor, and the likelihood of pregnancy increases, especially in the first 3 months of cancellation.

    3. Hormonal drugs bring down the menstrual cycle.

    If these are combined oral contraceptives (COCs), then at the time of taking the pills, menstruation comes on schedule. If your period against the background of taking pills is irregular, and also changed its intensity, became very scarce or, conversely, abundant, you need to come to the gynecologist to select the drug that is right for you.Also, sometimes women have hormonal disorders that cannot be cured (for example, polycystic ovary syndrome), they can only be controlled and complications (for example, the appearance of cysts) can be avoided by taking COCs. Against the background of taking the pills, the cycle stabilizes, but after the pills are canceled after some time, the cycle will again become irregular. But pills aren’t the cause of unstable periods.

    If these are progestins (Visanne, Implanon) without estrogen, then the change in menstruation is a variant of the norm.Most often, the interval between menstruation becomes longer (30-45 days) and menstruation is not abundant.

    4. Hormonal drugs harm the liver.

    For a healthy person, without liver diseases, modern low-dose and micro-dose (contain less than 30 μg of ethinylestradiol) tablets do not harm. If you have liver problems, tell your doctor so that alternative medications can be found.

    5. It is harmful to the body

    Self-medication is harmful to the body. If taking pills helps to avoid surgeries and hospitalizations for endometriosis, ovarian cysts, uterine fibroids, then the benefits outweigh the possible harm. The tablets must be taken according to the scheme prescribed by the gynecologist and cannot be canceled on their own.

    In practice, quite often we are faced with the situation that patients themselves cancel the pills due to bad mood, headaches or unreasonable fears.Then they start taking pills again and after 2-3 months they stop taking them. It’s harmful to do that. This causes hormonal fluctuations, which can lead to side effects.

    6. There are many side effects and complications from hormonal drugs.

    Any drug, if it is considered a drug and not a dietary supplement, undergoes long and serious tests for tolerance, efficacy and safety before being placed on the market.The period from the moment the drug is created and the start of its sales in pharmacies can be 10-15 years. During this time, tests are carried out on volunteers and all complaints are recorded and entered into the instructions, even if they are not related to taking a new medicine. Otherwise, the drug will not be registered. Therefore, hormonal drugs (and not only) have such a long and sometimes frightening instruction, indicating ALL side effects and complications that have ever happened. So it should be.

    Of course, there are diseases and conditions in which hormonal drugs cannot be taken, for example, with breast cancer or ovarian cancer.

    7. You need to “rest” from hormones.

    Previously, when the pills had a high content of hormones (50 mcg or more), long-term use of such drugs suppressed their own work of the ovaries and so that the ovaries did not “forget” how to work, they took breaks every 6-9 months. Now this does not need to be done, since the dosage of hormones in the pill has been significantly reduced. The work of the ovaries is not affected. In addition, taking breaks on your own to give the body “rest” and then starting to take COCs again, this causes constant fluctuations in the level of hormones in the body, which can provoke a cycle failure or cysts on the ovaries.

    8. There are “bad” (from which they get fat, menstruation gets lost), and there are “good” (on which everything is good, which is accepted by a friend and everything has become good) hormonal pills.

    There are no bad and good drugs with hormones. All pills are different and we are all different. Therefore, taking the drug that suits your friend and not taking the pills from which your sister has recovered is wrong. The main task of the gynecologist is to choose the drug that will help and suit you.If something does not suit you in the prescribed treatment – weight gain, headaches, mood, the nature of the menstrual cycle, changes in libido – contact your gynecologist. Based on your complaints, the doctor will understand which drug you need to switch to in order for your condition to improve.

    The first safe male contraceptives were created: Events: From life: Lenta.ru

    American researchers have proposed a substance that can be used in contraceptive pills for men.This is reported by Science Daily, citing work published in the scientific journal PLOS ONE.

    The basis of a new contraceptive can be an organic compound EP055, which binds the EPPIN protein on the surface of male germ cells. According to biologist Michael O’Rand, who led the research team, this limits sperm motility, and the likelihood of successful fertilization drops dramatically.

    Scientists have tested the effect of EP055 on animals.Thirty hours after the injection, given to a group of male rhesus monkeys, their germ cells have lost their mobility. After 18 days, the effect of the remedy ceased, and the monkeys again acquired the ability to reproduce. No negative side effects were observed.

    The PLOS ONE article believes that more research will be required before the EP055 can be used by humans. Its effectiveness in preventing unwanted pregnancies has not yet been confirmed. In addition, the product should be available in tablet form for ease of use.Researchers are working on a solution to this problem.

    The main means of male contraception are condoms and vasectomy – a surgical operation in which a ligation or removal of a fragment of the vas deferens is performed. Hormonal contraceptives for men are being tested.

    In 2016, a United Nations-funded trial of a hormonal contraceptive for men was interrupted due to unforeseen side effects.Some patients complained of depression, fast and irregular heartbeats, muscle pain, increased libido and acne. One of the participants in the trials committed suicide, but his death, presumably, was not associated with the use of an experimental contraceptive.

    More dark and strange news in the Telegram channel “Tape of the Bottom”. Subscribe!

    13 effective methods of contraception

    3 Vasectomy

    Type of male sterilization. During the operation, a part of the vas deferens is bandaged or removed from a man so that sperm do not enter the ejaculate.

    FOR Relatively simple operation; local anesthesia; libido, erection, ejaculation, sex drive, orgasm do not change.

    AGAINST It is necessary to carefully consider your decision, since the reconstructive operation is much more complicated, expensive and success is not guaranteed. Does not protect against genital infections.

    PEARL INDEX 0.4 pregnancies per 100 women.

    4 Intrauterine device

    The spiral is a fairly common method of contraception for women 25-30 years old.This is a small device that is inserted into the uterine cavity to prevent conception. Today there are about 50 types of spirals: round, spiral, T-shaped, copper or silver, hormonal, etc. The IUD prevents the implantation of an egg into the wall of the uterus, has a detrimental effect on spermatozoa (copper-containing spirals), and affects their ability to pass through the cervix (hormonal). Average term of use is 2-5 years.

    FOR High protection against unwanted pregnancy.Using an IUD, you can forget about other methods of protection for several years. The coil does not affect lactation, is easily removed by a doctor and is inexpensive.

    VS In some women, heavy menstruation can be provoked. Long-term presence of a foreign body in the body reduces immunity, and can also cause inflammatory processes. The spiral is not recommended for nulliparous girls.

    PEARL INDEX 1 pregnancy per 100 women.

    Hormonal contraception

    5Hormonal implants and capsules

    This type of contraception is a small plastic stick (the size of a match) or a thin capsule filled with hormonal drugs and injected subcutaneously, usually in the inner side of the left forearm.Once inserted, the implants regularly release a hormone that prevents ovulation and also changes the lining of the cervix, making it difficult for sperm to pass through. In 2018, a new progressive product is expected on the American market – a hormonal contraceptive chip, which will be implanted under the patient’s skin and controlled using a smartphone and a special application.

    FOR No need for frequent implant changes. The effect lasts approximately 5 years. The operation is quite simple and painless.

    AGAINST Side effects: nausea, headaches and possible allergic reactions. Implants are not widely represented on the Russian market, hence the high cost. In addition, gynecologists do not recommend installing implants for girls who have not yet given birth.

    PEARL INDEX 0.3 pregnancies per year per 100 women.

    Phlebologist’s recommendations after sclerotherapy – “Institute of Veins” treatment of varicose veins in Kiev and Kharkov

    The operation is finally over.

    Large no swelling, pain and cramps in the legs. I will be able to wear comfortable summer clothes without being ashamed of disgusting swollen veins.

    These thoughts are of concern to patients with completed therapy.

    Unfortunately, the diseased veins have not yet been defeated. Not completely. In order for them to disappear completely and permanently, it is necessary to follow the doctor’s instructions.

    This is important for all operations. Including after sclerotherapy.

    But before diving into this topic, let’s talk about varicose veins and its consequences.

    Blood in the vessels of the lower extremities moves with difficulty. She’s got in the way of gravity. Due to the force of gravity, some of the blood flow flows down and overflows the veins. Nature has armed the vessels of the legs with protection against this problem.

    Some veins have valves. They should allow blood to flow in only one direction and prevent excessive vasodilation. This is how the valve system works ideally.

    But not all people get first-class, durable valves. Some people get a weakened defense mechanism – it seems to work, but under heavy loads it lets a lot of blood down.

    As a result, the vessels dilate. This causes symptoms:

    • Pain
    • Spider veins
    • Heaviness in the legs
    • Itching and burning
    • Discoloration of the skin around distended veins
    • Edema
    • Convulsions

    Symptoms of illness do not appear all at once. It usually starts with heaviness in the legs, and the rest of the symptoms develop on the legs later. The longer varicose veins develop, the more it affects the patient’s quality of life.It is difficult for a person to play sports. An ordinary walk can turn into torment.

    But even these problems do not compare with the possible complications of bloated veins. There are three of them:

    1. Bleeding

    Superficial vessels burst due to strong pressure, and an open wound occurs. A doctor’s help is needed.

    2. Thrombosis

    Blood clots often form inside dilated veins. The doctors called them blood clots. These formations not only impair blood circulation, but sometimes break off from the venous walls and enter the heart into the pulmonary artery…. This is known as embolism. It can lead to respiratory arrest.

    3. Trophic ulcers

    Blood circulation in the dilated vessels is impaired. As a result, neighboring tissues constantly lack the necessary nutrients and slowly die. Non-healing wounds appear. They are difficult to cure as they often come back after therapy. Complication occurs in at least 3% of people with varicose veins.

    We hope this information will help you assess all the hidden threats associated with bloating.

    And it will allow you to heal faster.

    To help you safely get rid of swollen blood vessels, we will describe what to do after sclerotherapy. First, let’s figure out the procedure itself.

    What is sclerotherapy

    During the operation, the doctor injects a sclerosant into the diseased vein. This is the name of a special substance that destroys the venous walls, making them inflamed and blocking the vessel. The blood circulation in it stops.

    The procedure was first performed in the 1930s.Since then, the method has been improved many times over – now the veins are treated with more effective sclerosants. They fill the vessels better and are absorbed faster.

    Of course, the operation does not work miracles. She also has disadvantages.

    One injection is sometimes not enough to treat the entire surface of diseased veins. The number of injections depends on the size and location of the distended vessels. For some, a couple of injections are enough. But patients with advanced forms of varicose veins will have to endure longer.

    The operation takes 15-60 minutes.

    Usually the treatment does not cause discomfort, but some people may experience convulsions for several minutes when injections into large vessels.

    How quickly do veins disappear?

    Spider veins disappear in about six weeks. Large swollen vessels last longer – about four months.

    Sclerotherapy removes varicose veins and spider veins on different parts of the body:

    • Hips
    • Ankle
    • Feet (sometimes).
    • Shins

    Therefore, it is suitable for dealing with cosmetic defects where other operations are powerless. However, it also happens the other way around.

    Now let’s talk about the effectiveness of treatment and the chances of complete elimination of dilated vessels.

    Sclerotherapy is not a surgical operation. It does not leave scars and other visible marks on the skin. This feature attracts many people.

    Unfortunately, the effectiveness of sclerosant treatment is not at all 100% – scientists have calculated that sclerotherapy eliminates varicose veins in 80% of patients or even less.

    This is not the only bad news.

    The procedure does not affect the varicose vessels of some people – there are up to 10% of them. Doctors prescribe them a different therapy.

    No phlebologist can guarantee the elimination of varicose veins using sclerotherapy. And it’s not their fault. Often, the characteristics of the body determine which surgery is suitable for a person.

    Therefore, before getting rid of dilated veins in this way, you will have to go for a diagnosis and get permission for the procedure.

    When is sclerotherapy used?

    Treatment is prescribed by a phlebologist – you cannot sign up for therapy on your own.

    For some patients, surgery is prohibited. So be sure to check with your doctor and check with him about the restrictions for this procedure.

    Sclerotherapy will suit many people, except those who :

    • Breastfeeding
    • Bed rest
    • Carries a child

    As you can see, the restrictions are temporary.It usually takes at least three months after the baby has stopped breastfeeding for a young mother to sign up for therapy.

    Doctors determine the readiness for the procedure individually for each patient.

    For example, past cases of thrombosis. This problem can interfere with sclerotherapy, so doctors have to figure out the origin of the blood clot and how severe the symptoms are.

    Does this apply to you?

    Excellent.Then agree with the doctor about the date of the operation, and we will explain how to help the phlebologist finally eliminate the swollen veins.

    What should be done immediately after sclerotherapy?

    Wear compression hosiery first.

    This is the name of a special underwear that squeezes the legs and blood vessels with a certain force. And prevents varicose veins.

    Compression stockings after sclerotherapy should be worn without stopping for 5 days. Later they can only be used during the day.

    What is knitwear for?

    Treated vessels are very vulnerable. In them, blood circulation is stopped, but it can resume if the diameter of the veins increases. The elastic underwear keeps the vessels closed until they disappear.

    How much to wear stockings after sclerotherapy?

    Up to three months. Much depends on the patient’s recovery rate. Therefore, the attending physician will tell you the exact dates.

    What about walking?

    After the operation, you definitely need to walk a little – at least 30 minutes.Moving the muscles will help to expel the remaining blood from the operated veins and speed up the healing process.

    Your daily life will not change further. You can go to work, do household chores.

    But remember one point – long immobility or strong loads on the vessels can restore bleeding in the closed veins.

    Therefore, when sedentary work, take regular breaks for short walks. And do not lift loads heavier than 10 kg.

    It looks like we started talking about the limitations of therapy.Let’s continue then.

    What should not be done after sclerotherapy?

    In the first two days, the operated patient should avoid a strong increase in body temperature.

    Heat increases blood circulation. And dilates blood vessels.

    After sclerotherapy, excessive enlargement of the treated veins should not be allowed, as this will increase the risk of restoration of blood flow.

    Dangerous for blood vessels in the first 7 days:

    • Warm baths
    • Hot compresses
    • Saunas
    • Direct sun exposure

    So you can’t wash?

    The shower is not dangerous for the veins, but it should be colder than usual.It is better not to water the injection sites with water. Just treat them with soap.

    Another problem is alcohol after sclerotherapy.

    Alcoholic drinks dilate and constrict blood vessels, which interferes with the restoration of veins treated with sclerosant. And not only in the first two days. Doctors recommend not drinking alcohol for at least three months, and preferably six months. This will reduce the risk of disease recurrence.

    We hope you take these bans seriously. Yes, it is not easy to forget about bad habits even for a few months, but you risk the results of treatment.All the work of a doctor may be in vain. And an additional procedure will be required.

    Therefore, do not create additional problems for yourself.

    Moreover, the operation has possible side effects, which we will now discuss.

    What complications are possible after sclerotherapy?

    Slight unpleasant sensations arise already when the sclerosant is injected into the vessels.

    The patient can feel:

    • Convulsions
    • Pain
    • Burning

    Pain after sclerotherapy of veins sometimes indicates drug leakage into adjacent tissues.Fortunately, this rarely happens.

    More common side effects:

    • Edema
    • Skin discoloration
    • Discomfort
    • Redness of the skin around the injections
    • Bruises

    These complications usually disappear within a few days.

    Stains last much longer after sclerotherapy – they appear near the injections and remain up to six months. But this is just a cosmetic defect.

    Much more dangerous serious side effects:

    • Sclerosant allergy
    • Ulcers near diseased veins
    • Blood clots in treated vessels
    • Inflammation near the injection sites

    Tell your doctor about any complications – especially ulcers and allergies.

    Previously, some patients complained of induration after sclerotherapy. This problem arose from inexperienced doctors.They did not enter the vein with a needle. As a result, the sclerosant accumulated in adjacent tissues, causing a painful induration.

    Now such operations are performed using ultrasound – the phlebologist always clearly sees where the needle is inserted.

    Let’s summarize.

    The operation has a number of minor disadvantages, but the side effects are temporary and do not cause severe discomfort. You can tell your doctor about them, but his help is usually not needed. But with ulcers, blood clots and allergies, be sure to consult a doctor.

    Phlebologist’s recommendations for patients after sclerotherapy

    A few more words about the advice of doctors about the operation.

    What stockings to wear after sclerotherapy?

    They must be chosen by a phlebologist, since he will determine the appropriate compression class and size of the linen. Some models are too large. Others, on the contrary, put too much pressure on the legs and harm the vessels.

    Remember – you will be wearing compression hosiery for several months. For such a period, the wrong stockings can cause a relapse of varicose veins, and then you will need additional surgery.

    The success of your treatment depends on you.

    Please take the purchase of compression after sclerotherapy seriously.

    This is almost as important as choosing the right clinic. For example, in some medical centers, procedures are carried out at low prices, but the quality of treatment is not very high. Others employ young professionals.

    We suggest contacting the clinic “Institute of Vienna”. Here vascular diseases are treated by phlebologists with experience of 20 years or more. They have accumulated vast experience in performing operations – over 4,000 successful procedures in 15 years.

    Doctors diagnose veins in 30 minutes. With the help of Toshiba APLIO ultrasound systems, our doctors detect any vascular damage and circulatory disorders.

    In addition to sclerotherapy, the clinic also performs other low-traumatic operations. This allows you to select the appropriate therapy for any patient.

    Come to the “Vein Institute” for a consultation with a phlebologist and treatment of leg vessels without scars and pain.

    Bakai Mikhail Vasilievich

    Doctor Information:

    • Member of the International Union of Phlebologists
    • Examines and treats adults and children
    • Examined over 500 people

    Physicians-phlebologists of the clinic “Institute of Vens”

    Surgeon of the highest category, phlebologist

    Experience: 21 years

    Surgeon of the highest category, phlebologist

    Work experience: 20 years

    Phlebologist of the highest category

    Work experience: 34 years

    Dermatologist higher.cat., director

    Work experience: 20 years

    First category surgeon

    Work experience: 15 years

    Surgeon, phlebologist

    Work experience: 17 years

    Surgeon, phlebologist

    Work experience: 5 years

    First category surgeon

    Experience: 12 years

    Vascular surgeon, phlebologist

    Work experience: 10 years

    Vascular surgeon, chief physician

    Work experience: 11 years

    Vascular surgeon, phlebologist

    Work experience: 8 years

    Vascular surgeon, phlebologist

    Work experience: 5 years

    .