What are disadvantages of emergency contraception methods?

Emergency Contraception | Planned Parenthood Hudson Peconic, Inc.

Emergency contraception (the morning-after pill) is a safe and effective way to prevent pregnancy after unprotected intercourse. It can be started up to five days (120 hours) after unprotected intercourse.

You may want to use it if:

• The condom broke or slipped off, and they ejaculated in your vagina.
• You forgot to take your birth control pills, insert your ring, or apply your patch.
• Your diaphragm or cap slipped out of place, and they ejaculated inside your vagina.
• You miscalculated your “safe” days.
• They didn’t pull out in time.
• You weren’t using any birth control.
• You were forced to have unprotected vaginal sex.

Emergency contraception is also known as the morning-after pill, emergency birth control, backup birth control, and by the brand names Plan B One-Step, ella, and Next Choice.

Many people call emergency contraception the “morning-after pill.” But that name is a little confusing. You can use emergency contraception up to five days after unprotected intercourse — not just the “morning after.”

How Does Emergency Contraception Work?

Emergency contraception is made of one of the hormones found in birth control pills — progestin. Hormones are chemicals made in our bodies. They control how different parts of the body work.

The hormone in the morning-after pill works by keeping a person’s ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm. The hormone in the morning-after pill also prevents pregnancy by thickening a woman’s cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

The hormone also thins the lining of the uterus. In theory, this could prevent pregnancy by keeping a fertilized egg from attaching to the uterus.

You might have also heard that emergency contraception causes an abortion. But that’s not true. Emergency contraception is not the abortion pill. Emergency contraception is birth control, not abortion.  A Paragard IUD can also be used as backup birth control if inserted within 120 hours — five days — after unprotected intercourse. It is 99.9 percent effective. Talk with your health care provider if you’re interested in getting an IUD.

How Effective Emergency Contraception?

Emergency contraception can be started up to 120 hours — five days — after unprotected intercourse. The sooner it is started, the better it works.

Emergency contraception is also known as the morning-after pill, emergency birth control, backup birth control, and by the brand names Plan B One-Step, ella, and Next Choice. Plan B One-Step and Next Choice reduce the risk of pregnancy by 89 percent when started within 72 hours after unprotected intercourse. They continue to reduce the risk of pregnancy up to 120 hours after unprotected intercourse, but they are less effective as time passes.

You need to use emergency contraception to prevent pregnancy after each time you have unprotected intercourse. Emergency contraception will not prevent pregnancy for any unprotected intercourse you may have after taking the pills. If you do not have your period within three weeks after taking emergency contraception, you may want to consider taking a pregnancy test.

Emergency contraception offers no protection against sexually transmitted infections. You may want to consider STI testing if there is a possibility that unprotected sex put you at risk.

How Safe Emergency Contraception?

Emergency contraception is safe. Even though it’s made of the same hormone as the birth control pill, emergency contraception does not have the same risks as taking the pill or other hormonal birth control methods continuously. That’s because the hormone in emergency contraception is not in your body as long as it is with ongoing birth control.

Millions of people have used emergency contraception. It has been used for more than 30 years. There have been no reports of serious complications.

What Are the Disadvantages of Emergency Contraception?

You may have some undesirable side effects while using emergency contraception but many people use Plan B One-Step, ella, and Next Choice with few or no problems.

Nausea and throwing up are the most common side effects. Less than 1 out of 4 people feel sick when they take them. You can use anti-nausea medicine one hour before taking emergency contraception if you are concerned about being nauseous. Many people also find it helpful to take the emergency contraception pills with a full stomach. 

Other side effects of the morning-after pill may include

• breast tenderness
• irregular bleeding
• dizziness
• headaches

If you use emergency contraception frequently, it may cause your period to be irregular. Emergency contraception should not be used as a form of ongoing birth control because there are other forms of birth control that are a lot more effective.

How Do I Get Emergency Contraception?

Plan B One-Step and Next Choice are available from drugstores and health centers without a prescription for people 17 and older. If you are interested in getting emergency contraception and are 17 or older, you can either get it directly from a Planned Parenthood health center or from your local drugstore. If you are younger than 17, you’ll need to go to a health center or private health care provider for a prescription. ella is not available over the counter at drugstores, but you can get it with a prescription.

We all like to be prepared. That is why it’s a great idea to keep some emergency contraception in your medicine cabinet or bedside table in case of an accident. Having emergency contraception on hand will let you take it as soon as possible after unprotected intercourse, when it is most effective. If you are younger than 17, you can ask your health care provider for a prescription that you can fill ahead of time. Emergency contraception is safe, effective, and should be widely available but because of certain policies and personal bias, some people may have a hard time getting it. If you are having trouble getting emergency contraception from your local pharmacy or health care provider, contact your local Planned Parenthood health center. We can help you get the medicine you need.

How Much Does Emergency Contraception Cost?

The cost of emergency contraception varies a great deal. It may cost anywhere from $10 to $70. If you are not 17 and need a prescription, the health center visit may cost up to $250, depending on where you live.

Family planning clinics usually charge less than private health care providers and drugstores.

Planned Parenthood works to make health care accessible and affordable. Some health centers are able to charge according to income. Most accept health insurance. If you qualify, Medicaid or other state programs may lower your health care costs. 

How Do I Use Emergency Contraception?

Take emergency contraception as soon as possible after unprotected intercourse. The sooner you start it, the better it will work. But it will reduce your risk of pregnancy if you start it up to 120 hours — five days — after unprotected intercourse.

You can use anti-nausea medicine one hour before taking emergency contraception if you are concerned about getting nauseated. Many people also find it helpful to take the emergency contraception pills with a full stomach.

After you take emergency contraception, it’s normal for your next period to be different from usual.

• It may be earlier or later than usual.
• It may be heavier, lighter, more spotty, or the same as usual.

Be sure to tell any health care provider that you may see before your next period that you have taken emergency contraception. If you do not have your period within three weeks after taking emergency contraception, or if you have any symptoms of pregnancy, take a pregnancy test or schedule an appointment with your health care provider.

Can I Use Regular Birth Control Pills as Emergency Contraception?

Yes, certain brands of birth control pills can be used in increased doses as emergency contraception. The Emergency Contraception Website has information about what brands of pills can be used and how to use them.

What You Should Know About the Morning-After Pill – Health Essentials from Cleveland Clinic

You probably think of emergency contraception as the “morning-after pill,” but that’s actually a bit of a misnomer. There are different kinds of emergency contraception that a woman can use as many as five days after unprotected sex, and some of them aren’t actually pills.

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Ob/Gyns don’t recommend using emergency contraception as a
primary form of birth control, but in an unexpected or emergency situation,
there are options.

Ob/Gyn Diedre McIntosh, MD, addresses some common and important questions.

Q: What are options for emergency contraception?

A: There are currently four available methods:

• Levonorgestrel (Plan B One-Step ® and generics). These pills contain a synthetic hormone called progestin and are available over-the-counter. They prevent pregnancy by delaying the release of the egg from the ovary to prevent fertilization. They will not work if you are already pregnant.
• Ulipristal acetate (ella®). This medication also suppresses or delays ovulation but is only available by prescription.  It will not work if you are already pregnant.
• Copper-releasing IUD. Once it’s placed in the uterus by a healthcare professional, it offers additional pregnancy protection for as long as you keep it in, up to 10 years.
• Yuzpe regimen. This method calls for a woman to take multiple birth control pills that total 100 mcg of estrogen and 1 mg of progesterone twice in a 12-hour period. It is the least effective method of emergency contraceptive, and will not work if you are already pregnant.

Q: How long can you wait to take the morning-after pill?

A: It’s ideal to take Plan B One-Step® within 72 hours (that’s three days) of having unprotected sex. You can take it up to five days after, but there’s a higher failure rate the longer you wait. Ella® can be taken up to five days later without a drop-off in effectiveness.

The copper IUD can also be placed up to seven days later. The Yuzpe method is best used within three days of unprotected sex.

Q: How does the copper IUD work as an emergency contraceptive?

A: It’s the most effective form of emergency contraceptive. It causes an inflammatory reaction in the uterus, so it creates an unfavorable environment for sperm and for implantation to occur.

The one big difference
with the IUD is that it could disrupt a good pregnancy. If a woman is considering
a copper IUD and has had abnormal periods, she should make sure to do a
pregnancy test first.

Q: Can the morning-after pill make you spot?

A: Yes. Emergency contraceptive pills tends to delay ovulation, so you might have a delay in your regular menstrual cycle and have irregular bleeding for that first month afterward.

Q: Can the morning-after pill make your period late?

A: Yes, you might find that your period is pushed back one or two days.

Q: Does the morning-after pill make you sick?

A: It can make people nauseous, but most people tolerate it pretty well. If you vomit within an hour of taking it, contact a healthcare professional.

Q: Can you take the morning-after pill twice in one month?

A: You can take it more than once a month, but we do not recommend using it as a main form of birth control – not only because of the cost but because you will have irregular cycles.

Additionally, with the pills there’s a higher failure rate the greater your BMI. So for women with a BMI over 30, those medications will be less likely to be effective.

Your Ob/Gyn can help you find the most appropriate
contraceptive option for you.

After Morning Pill – Plan B

Table Of Contents

What is the Morning After Pill (Plan B Pill)?

The morning-after pill (also known by the brand name Plan B), is emergency contraception that a woman takes to prevent pregnancy. It’s a form of birth control which is used after unprotected sex takes place. 

 The traditional morning after pill is effective if taken up to 5 days after having unprotected sex. However, it is usually the most effective the sooner it’s taken. 

You may consider resorting to an emergency contraception because you neglected to use a condom during sex, the condom broke during sex, you neglected to maintain your regular birth control method, or you were forced to have unprotected sex. 

The two most popular after morning pill brands are: 

• Plan B – Available over the counter, without a prescription 
• Ella – Only available with a prescription 

There is one other kind of emergency contraception and it’s not in pill form. It’s the Paragard IUD, which is also effective if taken up to 5 days after having unprotected sex. It is considered to be one of the most effective forms of emergency contraception. 

The morning-after pill is not the same as an abortion pill and will not end an existing pregnancy. It can only reduce the risk that a woman will become pregnant. 

How does it Prevent Pregnancy?

Pregnancy does not happen during sex. Sperm can live inside your body for up to 6 days, waiting for an egg. 

The morning after pills work in the time between the act of having sex and becoming pregnant. This can take anywhere up to 6 days. The pill temporarily stops the ovary from releasing an egg, thereby not allowing sperm the access it needs for fertilization. Without fertilization, a woman is unable to become pregnant. 

What are the Benefits?

The benefits include: 

• Easy to use 
• Convenient, only one time use required 
• Some types do not require a prescription 
• Can be used up to 5 days after having sex 

• Effective backup method for emergencies (condom breaking for example) 

What are the Disadvantages?

There are a few disadvantages with the morning after pill. It is not considered to be as effective as other types of birth control (like an IUD, the patch, the shot, or birth control pills). 

It can also be quite expensive (as much as $50 for one set of pills) depending on your location and medical coverage. Therefore, it is not recommended to be a person’s sole form of birth control. After morning pills should only be used in emergency situations. 

Side effects of the morning after pill can include nausea, vomiting and cramping. This is because after morning pills may contain a high dose of estrogen and progesterone.  

In addition, after morning pills won’t work if your body has already started ovulating. 

Lastly, Plan B pills may not be as effective for those with a Body Mass Index above 25. For those women, Ella or the Paragard IUD is recommended. 

Morning after pills are not intended for long-term use. Read about recommended birth control methods available for daily use and only use after morning pills in emergency situations. 

How Effective is it?

The after morning pills effectiveness depends on which method is used. 

Levonogestrel based pills, like Plan-B, are up to 89% effective when taken less than 3 days after unprotected sex. It will continue to work up to 5 days after protected sex, but it’s less effective as time passes. Therefore, the sooner this pill is taken, the more effective it is. 

Ella is 85% effective for up to 5 days after sex and stays just as effective throughout that time period. Therefore, it is more effective after 3 days than levonogestrel based pills. 

Finally, the Paragard IUD is 99% effective for up to 5 days after unprotected sex . It can also function as a normal birth control method after it is applied, lasting up until 12 years. However, it is much more invasive compared to taking after morning pills. 

Is it Safe?

This emergency contraception is completely safe and can be used multiple times. However, after morning pills can cause some mild side effects including nausea, cramping, vomiting and unexpected bleeding between periods. 

Morning-after pills are not intended for long-term use. Read about recommended birth control methods available for daily use and only use morning after pills in emergency situations. 

How do I Use Morning After Pill?

Using the morning after pill is not as tricky as other methods of birth control. 

With most after morning pills, like Plan-B pills, all you have to do is take the pill at the time indicated on the packaging, within 5 days of having sex.  

Most importantly, you should not mix two kinds of emergency contraception or take a higher dosage than suggested. Neither of these actions will increase your chances of preventing pregnancy. In fact, they may increase your chances of getting pregnant and also make you sick. 

Tips for Using the Pill

Use the morning after pill as soon as possible after having unprotected sex, especially if you are using over-the-counter pills like Plan-B. 

For after morning pills which require two doses, set an alarm so you do not forget to take the second pill. 

In conclusion, do not rely on after morning pills to prevent pregnancy long term. There are more effective and less expensive ways to do that. 

Check out long-term Birth Control Options to avoid needing emergency contraception in the future. 

Emergency Contraception | ACOG

ABSTRACT:
Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception 1 2 3. Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen–progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises 4 5 6. The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician–gynecologists and other gynecologic providers.

Background

Regimens

Research on the postcoital use of contraceptive steroids began in the 1960s. The first oral regimen, which used a widely available brand of combined estrogen–progestin oral contraceptive pills, was published in 1974 7. Research on progestin-only regimens for occasional postcoital use by women having infrequent sexual inter-course also began at approximately the same time 8. Data regarding the use of IUDs as emergency contraceptives were initially published in the 1970s and, more recently, selective progesterone receptor modulators were introduced.

The most commonly used oral emergency contraceptive regimen is the progestin-only pill, which consists of 1.5 mg of levonorgestrel Table 1. This product can be purchased over the counter and is available without age restriction as of 2013. The product using two levonorgestrel doses of 0.75 mg has fallen out of use in favor of the simpler one-dose regimen, which is at least as effective as the two-dose product 9 10. The levonorgestrel regimen is labeled for use for up to 72 hours after unprotected sex but is best used as soon as possible after unprotected sex 10 11 12 13 14 Table 1.

A second dedicated emergency contraceptive, a pill containing 30 mg of ulipristal acetate, was approved by the FDA in 2010 and requires a prescription. This selective progesterone receptor modulator, or antiprogestin, has demonstrated effectiveness up to 120 hours after unprotected sex 14 Table 1.

Combined estrogen–progestin emergency contraceptive regimens are no longer sold as a dedicated product. However, they can be formulated from a variety of standard oral contraceptives http://ec.princeton.edu/questions/dose.html#dose 15.

The copper IUD also can be used for emergency contraception, although the FDA has not labeled it for this indication. The IUD is highly effective if placed within 5 days of sexual intercourse and in some studies was used as many as 10 days later 16 17 18. The levonorgestrel-containing IUDs are currently being investigated for use as emergency contraception.

Method of Action

No single mechanism of action has been established for emergency contraception; rather, the mode of action varies according to the day of the menstrual cycle on which sexual intercourse occurs, the time in the menstrual cycle that the emergency contraceptive is administered, and the type of emergency contraceptive 19 20 21 22. Ulipristal acetate and the levonorgestrel-only regimen have been shown to inhibit or delay ovulation 23 24 25 26 27 28 29. Levonorgestrel delays follicular development when administered before the level of luteinizing hormone increases. Ulipristal acetate inhibits follicular rupture even after the level of luteinizing hormone has started to increase. Review of the evidence suggests that emergency contraception is unlikely to prevent implantation of a fertilized egg 24 27 29 30 31 32 33 34 35. The copper IUD prevents fertilization by affecting sperm viability and function. It also may affect the oocyte and endometrium 36.

Emergency contraception sometimes is confused with medical abortion 37. Medical abortion is used to terminate an existing pregnancy, whereas emergency contraception is effective only before a pregnancy is established. Emergency contraception can prevent pregnancy after sexual intercourse and is ineffective after implantation. Studies of high-dose oral contraceptives indicate that hormonal emergency contraception confers no risk to an established pregnancy or harm to a developing embryo 38.

Adverse Effects

No deaths or serious complications have been causally linked to emergency contraceptive pills 39. Short-term adverse effects include the following:

• Nausea and headache—Ulipristal acetate and levonorgestrel products have similar adverse effect profiles. The most frequently reported adverse effects are headache (19%) and nausea (12%) 14. The combined estrogen–progestin regimen has a significantly higher rate of nausea than the ulipristal acetate and levonorgestrel regimens 40.

• Irregular bleeding—After emergency contraceptive pill use, the menstrual period usually occurs within 1 week of the expected time 41. Some patients experience irregular bleeding or spotting in the week or month after treatment; one trial of the levonorgestrel-only regimen found that 16% of women reported nonmenstrual bleeding in the first week after use 10. If emergency contraception is taken earlier in the cycle, it is more likely that a woman will experience bleeding before the expected menses 42. Irregular bleeding associated with emergency contraception resolves without treatment.

• Other adverse effects—Some patients have reported experiencing other short-term adverse effects with oral regimens, such as breast tenderness, abdominal pain, dizziness, and fatigue 43.

Copper IUD insertion carries a risk of uterine perforation of approximately 1/1,000, is associated with uterine cramping, and may cause increased duration of menstrual flow or dysmenorrhea 44.

Effects on Pregnancy

No studies have specifically investigated adverse effects of exposure to emergency contraceptive pills during early pregnancy. However, numerous studies of the teratogenic risk of conception during daily use of oral contraceptives (including older, higher-dose preparations) have found no increase in risk to either the pregnant woman or the developing fetus 45.

Existing data indicate that use of levonorgestrel emergency contraception does not increase the chance that a subsequent pregnancy will be ectopic. Emergency contraception, like all other contraceptives, actually reduces the absolute risk of ectopic pregnancy by preventing pregnancy overall 46.

Barriers to Use

Women seeking emergency contraception typically are younger than 25 years, have never been pregnant, and have used some form of contraception in the past 1 47 48. Numerous studies have shown that making emergency contraception more available does not encourage risky sexual behavior or increase the risk of unintended pregnancy 49. Several published randomized trials have evaluated the policy of providing emergency contraception to women at the time of a routine gynecologic visit so that they will have the medication immediately available if a contraceptive mishap occurs 2 50 51 52 53 54 55 56. These trials compared this policy of advance provision with a policy of instructing women to contact a clinician if emergency contraception is needed. All but one of these trials showed no difference between the groups regarding self-reported frequency of either unprotected sexual intercourse or use of contraception 56.

Surveys have documented that a large number of women are unaware of the existence of emergency contraception or have insufficient knowledge to allow them to use it effectively 57 58 59 60 61 62. In a recent survey of adolescents who received care at urban emergency departments, only 64% had heard of emergency contraception 63. Other research has indicated that women who are poor, foreign born, or who are not high school graduates are less likely to have knowledge of emergency contraception 47 64. In a 2007 study, few women who received information about emergency contraception remembered discussing it 12 months later 65. In addition, many obstetrician–gynecologists and other gynecologic providers are poorly informed about this method of contraception 66 67 68. In a 2008 U.S. survey, almost one in five practitioners were reluctant to provide education on the subject of emergency contraception to sexually active adolescents 69. Three studies that evaluated females who were sexually assaulted and received care at emergency departments indicated that only 21–50% of eligible women received emergency contraception (70– 72). A survey of emergency medicine residents found that 71% reported that they always offered emergency contraception after sexual assault, but only 19% always offered it after consensual, unprotected sex. More studies to evaluate barriers to use in specific populations are needed so that appropriate policy interventions can be implemented 73 74.

Availability of levonorgestrel emergency contraception has improved since it was approved for over-the-counter use. A study of 1,087 pharmacies in Philadelphia, Boston, and Atlanta found that even when availability was limited to behind-the-counter status (ie, being available without a prescription, but only after consultation with a pharmacist), the percentage of pharmacies unable to provide Plan B within 24 hours decreased from 23% in 2005 to 8% in 2007 75. However, previously documented barriers such as limited access to emergency contraception through pharmacies, student health centers, urgent care centers, and other sources remain 74 76. Despite the fact that the single-dose 1.5-mg levonorgestrel regimen is now available over the counter for individuals of all ages, a recent evaluation of telephone calls made to pharmacies by females posing as adolescents requesting emergency contraception revealed that significant barriers remain for adolescents seeking this product 77. Consequently, obstetrician–gynecologists and other gynecologic providers need to pay particular attention to barriers for emergency contraception use in this at-risk population.

Clinical Considerations and Recommendations

Who are candidates for emergency contraception?

Emergency contraception should be offered or made available to women who have had unprotected or inadequately protected sexual intercourse and who do not desire pregnancy. The Centers for Disease Control and Prevention’s U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 include no conditions in which the risks of emergency contraception use outweigh the benefits 78. These criteria specifically note that women with previous ectopic pregnancy, cardiovascular disease, migraines, or liver disease and women who are breastfeeding may use emergency contraception. Therefore, any emergency contraceptive regimen may be made available to women with contraindications to the use of conventional oral contraceptive preparations. Reproductive-aged women who are victims of sexual assault always should be offered emergency contraception.

What screening procedures are needed before provision of emergency contraception?

No clinical examination or pregnancy testing is necessary before provision or prescription of emergency contraception. Emergency contraception should be offered or made available any time unprotected or inadequately protected sexual intercourse occurs and the patient is concerned that she is at risk of an unwanted pregnancy. Emergency contraception should not be withheld or delayed in order to test for pregnancy, nor should it be denied because the unprotected coital act may not have occurred on a fertile day of the menstrual cycle.

When should emergency contraception be initiated?

Treatment with emergency contraception should be initiated as soon as possible after unprotected or inadequately protected sexual intercourse to maximize efficacy. Emergency contraceptive pills or the copper IUD should be made available to patients who request it up to 5 days after unprotected or inadequately protected sexual intercourse.

Ulipristal acetate’s effectiveness is maintained for 5 days after sexual intercourse 14. Levonorgestrel has decreasing efficacy with time after unprotected sex and is labeled for use up to 72 hours 10 11 12 13 14. However, studies have shown it is still moderately effective when the first dose is taken up to 5 days after sexual intercourse 10 79 80 81 82 83 84. Insertion of a copper IUD should be performed as soon as possible after unprotected or inadequately protected sexual intercourse. It is effective when placed up to 5 days after sexual intercourse and, in some studies, was used up to 10 days afterward without failure 18.

How effective is emergency contraception in preventing pregnancy?

For emergency contraception, efficacy can be defined in one of two ways: the first is the proportion of women becoming pregnant after use of the method. The second is the number of pregnancies observed after treatment divided by the estimated number of pregnancies that would occur without treatment. When this proportion is subtracted from one, the resulting statistic is the “prevented fraction,” which represents the estimated percentage of cases averted by the treatment. Reported figures on the efficacy of emergency contraception vary considerably and are imprecise.

The copper IUD was evaluated in a multicenter trial among women who requested emergency contraception up to 5 days after unprotected sex. Among 1,893 women, there were no pregnancies within the first month 17. A systematic review of the published literature regarding the use of IUDs as emergency contraception identified 42 studies over a 35-year time frame 16. The pregnancy rates reported were between 0% and 2%, of which the aforementioned study was the largest 17. The second largest study, which involved 1,013 women, had one pregnancy for a rate of 0.1% 16 85.

The oral regimens also have been evaluated thoroughly. Studies have found that ulipristal acetate is more effective than the levonorgestrel-only regimen and maintains its efficacy for up to 5 days. A meta-analysis of comparative efficacy trials found a lower pregnancy rate among users of ulipristal acetate (1.4%) compared with users of the levonorgestrel-only regimen (2.2%) 14. Phase III studies had an overall pregnancy rate of 1.9% for women who used ulipristal acetate 86. Six studies comprising a total of more than 8,000 women who used the levonorgestrel-only regimen calculated prevention rates ranging from 60% to 94% 9 10 11 41 87 88. Similarly, eight studies including a total of more than 3,800 women who used the combined estrogen–progestin regimen yielded prevention rates ranging from 56% to 89%; a meta-analysis of pooled data from these studies concluded that the combined estrogen–progestin regimen prevents at least 74% of expected pregnancies 89.

Two studies have examined the efficacy of the levonorgestrel-only regimen compared with the combined estrogen–progestin regimen. The first study found no statistically significant difference in pregnancy rates between the levonorgestrel-only regimen and the combined regimen (2.4% versus 2.7%, respectively) 11. However, a second larger trial reported that the levonorgestrel-only regimen was significantly more effective for preventing pregnancy than the combined regimen (85% versus 57% of pregnancies prevented, respectively) 41. Estimates based on combined data from these two studies show a reduced relative risk of pregnancy (relative risk, 0.51; 95% confidence interval, 0.31–0.83) with the levonorgestrel-only regimen 90. The levonorgestrel-only regimen for emergency contraception is more effective than the combined hormonal regimen and is associated with less nausea and vomiting 40. Therefore, the levonorgestrel-only regimen is preferred to the combined estrogen–progestin regimen.

Body weight influences the effectiveness of oral emergency contraception. Levonorgestrel emergency contraception may be less effective in women who are overweight (body mass index [BMI] 25–29.9 kg/m²) or obese (BMI of 30 kg/m² or greater) 91 92. Additionally, some research suggests that ulipristal acetate has lower effectiveness among obese women 86. The efficacy of the copper IUD is not affected by body weight 16 93. Therefore, consideration should be given to use of a copper IUD as an alternative to oral emergency contraception in obese women. However, oral emergency contraception should not be withheld from women who are overweight or obese because no research to date has been powered adequately to evaluate a threshold weight at which it would be ineffective.

To maximize effectiveness, women should be educated about the availability of emergency contraception in advance of need. Multiple randomized controlled trials have failed to demonstrate a reduction in unintended pregnancy or abortion with increased access to emergency contraception 94. These data highlight the importance of counseling patients about the appropriate use of emergency contraception as an episodic intervention rather than an effective long-term method. Information regarding effective long-term contraceptive methods should be made available whenever a woman requests emergency contraception, and consideration should be given to the use of the copper IUD, which is highly effective as an emergency contraceptive and an ongoing contraceptive. Use of highly effective long acting reversible methods should be encouraged.

Is emergency contraception safe if used repeatedly?

Data are not available on the safety of current regimens of emergency contraception if used frequently over a long period. However, oral emergency contraception may be used more than once, even within the same menstrual cycle. Information about other forms of contraception and counseling about how to avoid future contraceptive failures should be made available to women who use emergency contraception, especially those who use it repeatedly.

Hormonal emergency contraception is less effective for long-term contraception than most other available methods. In addition, continued use of hormonal emergency contraception would result in exposure to higher total levels of hormones than would ongoing use of either combined or progestin-only oral contraceptives, and frequent use also would result in more adverse effects, including menstrual irregularities. Therefore, emergency contraception should not be used as a long-term contraceptive.

What clinical follow-up is needed after use of emergency contraception?

No scheduled follow-up is required after use of emergency contraception. However, clinical evaluation is indicated for women who have used emergency contraception if menses are delayed by a week or more after the expected time or if lower abdominal pain or persistent irregular bleeding develops. The woman should be advised that if her menstrual period is delayed by a week or more, she should have a pregnancy test and seek clinical evaluation. Clinical evaluation also is indicated for women who have used emergency contraception if lower abdominal pain or persistent irregular bleeding develops because these symptoms could indicate a spontaneous pregnancy loss or an ectopic pregnancy. Women should be referred as needed for the provision of ongoing contraception, sexually transmitted infection testing, and well-woman care.

When should regular contraception be initiated or resumed after use of emergency contraception?

Treatment with emergency contraception may not protect against pregnancy in subsequent coital acts 10 unless the copper IUD is the method chosen. In fact, because emergency contraception may work by delaying ovulation, women who have taken emergency contraceptive pills are at risk of becoming pregnant later in the same menstrual cycle. Women should begin using barrier contraceptives to prevent pregnancy (eg, condoms, diaphragms, and spermicides) immediately after using emergency contraception. The U.S. Selected Practice Recommendations for Contraceptive Use, 2013 advise that any regular contraceptive method can be started immediately after the use of ulipristal acetate emergency contraception, but the woman should abstain from sexual intercourse or use a barrier method of contraception for 14 days or until her next menses, whichever comes first 95. However, subsequent to the publication of the U.S. Selected Practice Recommendations for Contraceptive Use, 2013, the FDA changed the ulipristal acetate labeling to include a new warning about its use with hormonal contraceptives and a recommendation to delay initiating hormonal contraception until no sooner than 5 days after intake of ulipristal acetate 96. This labeling change was based on data from two pharmacodynamic studies 96. Although these studies suggest that coadministration of ulipristal acetate and progestins may reduce the contraceptive effect of either product, there have been no clinical studies demonstrating an increased rate of pregnancy. Any regular contraceptive method can be started immediately after the use of levonorgestrel or combined estrogen–progestin emergency contraception, but the woman should abstain from sexual intercourse or use barrier contraception for 7 days 95.

When is an intrauterine device appropriate for emergency contraception?

Insertion of a copper IUD is the most effective method of emergency contraception. The copper IUD is appropriate for use as emergency contraception in women who meet standard criteria for an IUD and who desire long acting contraception. Obese women may have higher failure rates with the use of levonorgestrel and ulipristal emergency contraception than women of normal body weight 86 91 92. The efficacy of the copper IUD for contraception is not affected by body weight 16 93. Therefore, consideration should be given to the use of the copper IUD for emergency contraception among obese women.

Another advantage of using the copper IUD for emergency contraception is that it can be retained for continued long-term contraception. One study found the continuation rate after insertion for emergency contraception was 94.3% for parous women and 88.2% for nulliparous women 17. Another study demonstrated a much lower cumulative pregnancy rate within the following year among women who selected the IUD over levonorgestrel as emergency contraception 97. No randomized controlled trials have compared IUD insertion with oral regimens for emergency contraception.

Side effects of emergency contraceptives (the morning after pill)

Find a Morning After Pill Provider Near You

Answers to Frequently Asked Questions About…

Side Effects

What are the side effects of emergency contraceptive pills?

Emergency contraceptive
pills (also known as “morning
after pills” or “day after pills”) have no long-term or serious side effects, and emergency
contraception is safe for
almost every woman to use. In general, progestin-only
(like Plan B One-Step, Next Choice One Dose or Take Action) and ulipristal acetate (ella) emergency contraceptive pills have fewer side effects than combined
emergency contraceptive pills (pills containing both estrogen and progestin, such as regular birth control pills used as EC).

You might find yourself feeling queasy and some women throw
up after taking emergency
contraceptive pills. You might also get a headache, feel tired
or dizzy, have some lower abdominal pain, or find your breasts are
more tender than usual. If you do feel this way, it should stop within
a day or two. Some women also find that the pills cause unexpected bleeding; this is not
dangerous and should clear up by the time you have your next period.
The pills might also cause your next period to come early or late.
(For more information about how emergency contraception might affect
your monthly cycle, click
here).

A study comparing levonorgestrel (such as Plan B One-Step, Next Choice One Dose or Take Action) and ulipristal acetate (ella) showed generally similar side effects for the two medications¹. About 20% of women in each group experienced headaches following EC treatment, 13-14% experienced painful menstruation, and 11-12% experienced nausea. Women taking ulipristal acetate had their next period on average 2.1 days later than expected, while women taking levonorgestrel began their next period 1.2 days earlier than expected, but the duration of periods was not affected.

To prevent
nausea and vomiting, you can take the non-prescription anti-nausea
medicine meclizine (also sold under the brand names Dramamine II or
Bonine). Research shows that taking two 25 mg tablets 1 hour before
using combined emergency
contraceptive pills reduces the risk of nausea by 27% and vomiting
by 64%, but this drug doubles your chances of feeling drowsy (to about
30%). If you happen to throw up within 1 hour of taking a dose of
either type of emergency
contraceptive pills, some health care providers recommend repeating
that dose just in case your body didn’t have a chance to absorb
all of the medication.

For a thorough and up-to-date academic review of the medical and social
science literature on emergency contraception, including side effects,
click here .

1 Glasier A, Cameron S, Fine P et al. Ulipristal acetate versus levonorgestrel for emergency contraception: a randomized non-inferiority trial and meta-analysis. The Lancet 2010; 375:555-562.

———-

Emergency contraception | Morning after pill

Emergency contraception can be used if a contraceptive method fails (for instance a condom splits or a pill is forgotten or taken late) or no contraception is used. Emergency contraception does not protect against sexually transmitted infections (STIs). There are two forms of emergency contraception;

• Emergency hormonal contraception (the morning after pill)
• Emergency intrauterine device (IUD).

Emergency contraception is available free from:

• GPs
• Contraceptive/Sexual Health Clinics
• NHS walk-in centres
• Sexual health services/GUM clinics
• Some Accident and Emergency Departments
• You can find a list of pharmacies providing emergency contraception for free on Public Health Dorset’s website, visiting either EHC Bournemouth, EHC Poole, or EHC Dorset.

Emergency Hormonal contraception (Morning after pill)

There are two kinds of emergency contraceptive pill. Levonelle has to be taken within 96 hours of sex, and ellaOne has to be taken within 120 hours (five days) of sex. Both work by preventing or delaying ovulation (release of an egg) and they may stop an egg from being fertilised or they may stop a fertilised egg from implanting in the womb.

Benefits

• Emergency contraception does not cause an abortion
• There are no serious side effects of using emergency contraception
• One of the pills, Levonelle, can be taken whilst breastfeeding
• There is no limit to the number of times a person can take the morning after pill, however, as it is not as effective as other forms of contraception, it should not be relied upon

Disadvantages

• After taking the emergency contraceptive pill, most women will have a normal period at the expected time. However, you may have your period later or earlier than normal. If your period is more than seven days late, or is unusually light or short, contact us for help to exclude pregnancy
• It can make you feel sick, dizzy or tired, or give you a headache, tender breasts or abdominal pain

How effective is it?

Emergency contraception is more effective the sooner after sex it is taken. Evidence suggests that oral emergency contraception taken after ovulation is ineffective. An IUD is the most effective form of contraception. About 1 in 1000 women will become pregnant after having an emergency IUD fitted.

What makes it less effective?

• Because emergency contraception is more effective the sooner after sex the pill is taken, it is important that you seek emergency contraceptive advice as quickly as possible
• If you vomit within 3 hours of taking it or have further unprotected sex
• Some medicines (including those used to treat epilepsy, HIV and TB, and the herbal medicine St John’s Wort)

Want to know a bit more? Try NHS Choices website, they have pages full of useful information about emergency contraception.

Emergency intrauterine device (IUD)

The intrauterine device (IUD) is a small, T-shaped contraceptive device made from plastic and copper. It’s inserted into the uterus by a trained health professional. It may prevent an egg from implanting in your womb or being fertilised. If you’ve had unprotected sex, the IUD can be inserted up to five days afterwards, or up to five days after the earliest time you could have ovulated, to prevent pregnancy.

Benefits

• The most effective type of emergency contraception
• If you use the IUD as emergency contraception, it can be left in as your regular contraceptive method
• The IUD can be used safely if you’re breastfeeding, but the risk of complications during insertion is slightly higher
• Not affected by other medicines
• Your fertility returns to normal once the IUD is removed
• The IUD is hormone free

Disadvantages

• If left in as a method of contraception, it can make your periods longer, heavier or more painful
• May get cramps and spotting/bleeding for a few days after fitting
• Small risk of infection within 20 days of fitting
• An IUD doesn’t protect against STIs

How is an IUD fitted?

Before you have an IUD fitted, you will have an internal examination to determine the size and position of your womb. This is to make sure that the IUD can be positioned in the correct place.
You may also be tested for any existing infections, such as STIs. It is best to do this before an IUD is fitted so that any infections can be treated. You may be given antibiotics at the same time.

It takes about 15 to 20 minutes to insert an IUD:

• the vagina is held open, like it is during a cervical screening (smear) test
• the IUD is inserted through the cervix and into the womb
  The fitting process can be uncomfortable or painful for some women, and you may also experience cramps afterwards.

How effective is it?

Less than 1% of women who use the IUD get pregnant, making it the most reliable form of emergency contraception.

What makes it less effective?

If the IUD moves out of place it will be less effective. A check-up 6 weeks after fitting is recommended.

For more information check out NHS Choices website and their emergency contraception pages.

90,000 We understand the types of contraception, their pros and cons with an obstetrician-gynecologist

Questions of how to prevent unwanted pregnancies and protect themselves from sexually transmitted infections are of concern to every woman. Choosing reliable contraception is not an easy task and should be discussed with your doctor. Obstetrician-gynecologist of EuroMed Clinic Marina Pavlovna GLUSHENKOVA talks about existing methods of contraception, their pros and cons.

Contraception is barrier, hormonal and intrauterine.Methods such as coitus interruptus and calendaring cannot be considered reliable and effective. Fortunately, in the 21st century, there are many ways and means of protection against unwanted pregnancies and unpleasant diseases.

Barrier methods

Condoms

Pros

• reliable protection against sexually transmitted diseases (STDs) and unwanted pregnancy (if used correctly)
• affordable price
• no systemic effect on the body
• ideal for those who have an irregular sex life
• do not require preliminary examinations for the selection of

Cons

• desensitization
• Possible latex allergy

Spermicides

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

Pros

• partial protection against sexually transmitted infections (does not work for some viruses)
• suitable for those who cannot use hormonal and intrauterine contraception

Disadvantages

• low efficiency (60-70%), this method cannot be used as an independent method
• very strict control of compliance with the rules of use

is required

• Possible irritation, allergic reactions of the genital skin

Intrauterine methods

Copper-containing intrauterine system (spiral)

The spiral thickens cervical mucus and forms a barrier to sperm. Copper acts toxic to sperm, immobilizing them, and also inhibits ovulation.

Pros

• prolonged action, allowing you to forget about contraception for several years
• no systemic effect on the body
• can be used during lactation

Minuses

• should not be given to nulliparous, since against the background of the spiral there is a risk of intrauterine synechia and adhesions formation, which can lead to infertility; also in nulliparous, due to anatomical features, a narrower cervical canal, which makes it difficult to install the spiral.
• the spiral does not protect against STDs, accordingly, it is suitable only for women who have one permanent healthy sexual partner;
• against the background of the use of a copper-containing coil, the risk of inflammatory diseases of the uterus and appendages increases by 5-6 times compared to women who do not have coils;
• a spiral can provoke a longer and more painful menstruation;
• if a woman has a history of multiple abortions, invasive interventions, curettage, there is a risk of cervical insufficiency, i.e.e. failure of the cervix, which can lead to expulsion (prolapse) of the spiral.

Protected hormone-containing coils

The hormones contained in the system act in the uterine cavity, make the mucous membrane thinner, and immobilize sperm. All this makes it impossible for fertilization and the introduction of the ovum.

Pros

• Reliable contraceptive effect within five years
• No system action
• has a therapeutic effect: indicated for patients with a history of hyperplastic endometrial processes, uterine myoma
• can be used during lactation

Cons

• No STD protection
• Higher price compared to Copper Coil

Hormonal contraception

This is perhaps the most effective method of all that exists today.

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

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

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

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

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

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

The patch is changed every 7 days.

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

Pros

• reliable contraceptive effect (if a woman does not miss taking pills, the guarantee is almost 100%)
• active protection of the ovaries and endometrium (mucous membrane) of the uterus from cancer
• regulation of the menstrual cycle
• reduction of painful sensations during menstruation
• cosmetic effect (some OK help to cope with acne, normalize the skin condition)
• therapeutic effect (the doctor will help you choose hormonal contraceptives that are indicated for patients with uterine fibroids, with endometriosis).

Disadvantages

• The need for strict discipline, control of drug intake at the same time (especially important for “mini-pills”)
• do not protect against STDs
• any hormonal drugs affect metabolism (metabolism), which can lead to fluctuations in body weight, although in modern drugs this effect is minimal;
• there is an effect on the vascular link, on the blood coagulation system, therefore, when taking contraceptives, constant control of hemostasis is necessary.If a woman has a predisposition to varicose veins, hypertension, or there have been cases of cardiovascular diseases in the family, accompanied by thrombosis, heart attacks, strokes, then the patient needs a comprehensive examination of the hemostasis system before taking hormonal contraceptives;
• there is a period of adaptation to hormones. Within 2-3 months, nausea, headaches and pain in the mammary glands can sometimes be observed, there may be minor spotting in the middle of the cycle, changes in libido, mood swings.Therefore, medical supervision of the use of drugs is mandatory during the first months of admission.
• hormonal contraceptives have a number of contraindications: active smoking (more than 5 cigarettes per day), severe somatic diseases, severe decompensated diabetes mellitus, thrombosis, varicose veins, heart attacks, strokes, arterial hypertension, frequent migraines, etc.

Sterilization

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

After the operation, the ability to conceive in women can no longer be restored; in men, there may be a small (less than 30%) chance of restoring reproductive function through a second operation within five years after the intervention.

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

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

Pros

• 100% protection against unwanted pregnancy
• the issue is resolved once and for all

Cons

• irreversibility of the operation
• need for surgical intervention
• there are legal restrictions for this operation

Medical sterilization as a special medical intervention in order to deprive a person of the ability to reproduce offspring or as a method of contraception can be carried out only upon the written application of a citizen over the age of thirty-five years or a citizen with at least two children, and in the presence of medical indications and informed voluntary consent citizen – regardless of age and presence of children.
Article 57. Federal Law of November 21, 2011 N 323-FZ “On the Basics of Health Protection of Citizens in the Russian Federation”

Emergency contraception

In the case of unprotected intercourse, you can use the so-called emergency contraception. These drugs are aimed at contraception, they are not termination of pregnancy. The tablet contains a large dose of gestagenic drugs that cause rejection of the mucous endometrium.

Pluses

• The ability to avoid an unplanned pregnancy even in a critical situation

Cons

• This is a colossal dose of gestagens, which can lead to malfunctions, disruptions in the cycle. Such a remedy cannot be used on a regular basis – it is a huge stress for the body.

When choosing contraception, you must definitely contact a gynecologist. Before prescribing this or that drug, the doctor will conduct an examination, which includes examination on a chair, taking a smear for oncocytology. Also, if there are signs of endocrinopathy (increased hairiness, acne), it is necessary to examine the hormonal background. Since hormones thicken the blood, affect hemostasis (blood coagulation system), it makes sense to conduct a comprehensive examination of the state of the hemostasis system. In addition, it is recommended to do an ultrasound examination of the pelvic organs (uterus and appendages) and mammary glands. All these procedures are minimally invasive, painless, they are easy to go through, and they will help to avoid possible complications against the background of long-term use of contraceptives.

90,000 Modern methods of contraception and their role in family planning

Tuesday,
26
September
2017

On September 26, 2007, at the initiative of a number of organizations working on reproductive health and family planning issues, World Contraception Day was celebrated for the first time and has been held annually since then.

In Russia, most women begin to think about protection from unwanted pregnancy (about the method of contraception) after the first abortion, but what prevents them from doing this in advance, with the onset of sexual activity?

Planning a pregnancy means giving birth to the desired children in the desired quantity, avoiding unwanted pregnancies, regulating the interval between births, choosing the time of childbirth.All this can be done using contraceptive methods.

Calculating “safe” days, the calendar method, interrupted intercourse, douching and douche – do not have a contraceptive effect and are not methods of contraception. However, they continue to be the most popular among the people. Of course, the main reason is their availability. The following are real methods of contraception that have a more or less pronounced degree of reliability.

Contraception is a deliberate, voluntary, individually tailored system of measures to regulate the birth rate.

Contraception in the modern world is considered as one of the most important areas of maintaining a woman’s health. First of all, this refers to the prevention of unwanted pregnancy and, as a consequence, abortion and complications after it. Also recently, some types of contraception have been used for therapeutic purposes.

Contraceptives are classified into:

• hormonal: tablets, skin patch,
• intrauterine devices: copper-containing, hormone-containing,
• barrier: condom,
• chemical: candles,
• surgical: sterilization.

Currently, the most effective method of preventing unwanted pregnancies is hormonal contraception (HA) , based on the use of synthetic female sex hormones. Hormonal pills are among the most common and reliable types of HA; their advantages:

• high reliability (99.5%),
• availability and ease of use,
• regularity of the menstrual cycle,
• rapid recovery of reproductive function after discontinuation,
• removal of “fear of unwanted pregnancy”,
• therapeutic effects (elimination of PMS, elimination of ovulatory pain, reduction of the incidence of inflammatory diseases, improvement of skin and hair condition (acne, oiliness, hypertrichosis),
• prevention of the development of oncological diseases of the female genital organs and breast, anemia, ectopic pregnancy.

It is believed that birth control pills affect weight. In fact, weight does not increase from hormones, it increases from food intake. On the background of taking hormones, metabolism changes. Therefore, taking combined oral contraceptives, you need to be more strict about your diet and not forget about the gym.

The next type of HA is skin patch , in which hormones enter the body through the skin, which ensures a constant level of the drug in the blood. The patch is glued to the skin in a convenient place for 7 days. The package contains 3 patches, which are enough for 28 days, taking into account a seven-day break.

Intrauterine contraception (“spiral”, IUD) is the most popular method of contraception in our country. The bulk of intrauterine devices are copper-containing IUDs. It is a T-shaped device made of polyethylene and braided with copper wire. In some models, silver is added to the wire to slow down copper corrosion and increase the durability.According to studies, the pregnancy rate with the use of an IUD is less than 1 in 100 women in the first year of use (i.e., out of 100 women with an IUD, only one became pregnant within 1 year).

The next stage in the development of IUD was the creation of a hormone-releasing IUD (intrauterine hormonal system), in which the copper wire was replaced with a reservoir containing the hormone. The hormone is constantly released into the woman’s body at a dose of 20 μg / day for 5 years.The intrauterine hormonal system combines the advantages of two methods of contraception – OC and IUD.

The IUD is suitable for women who have given birth (but there are models for those who have not given birth) who do not plan to become pregnant in the next 5 years.

Condom . In addition to the contraceptive effect, it protects against sexually transmitted diseases. Efficiency 85%. Benefits:

• ease of use,
• low cost,
• broad availability,
• absolutely harmless to health (with the exception of latex allergy),
• can be used as an additional safety method.

Disadvantages:

• average contraceptive reliability, which largely depends on the ability to use,
• must be used with every intercourse,
• you need to have a supply of condoms,
• Ability to use emergency contraceptive methods when a condom breaks or slips off.

Chemical methods of contraception (spermicides) – reduce the motility of sperm, which prevents it from entering the uterus.Efficiency 82%. Disadvantages:

• low efficiency, begin to act only 10-15 minutes after injection,
• effect lasts no more than 1 hour,
• possible irritation of the vaginal mucosa or allergies,
• must be used with every intercourse.

Benefits:

• can be used at any age,
• can be combined with other methods,
• protect against sexually transmitted diseases.

Voluntary surgical sterilization is an operation to ligate the fallopian tubes, i.e. creating an obstacle to the meeting of the egg with sperm (fertilization does not occur). Efficiency 100%. The operation is carried out on a written request, for women with more than two children or over 35 years old. Benefits:

• toll free,
• lifetime effect,
• does not require any effort on the part of the spouses.

Disadvantages:

• irreversible procedure,
• the need for hospitalization in the gynecological department,
• is a surgical operation.

Emergency contraception (hormonal) is used within 48 hours after unprotected intercourse, when a condom breaks or slips, or rape. Any method of emergency contraception is significantly safer than abortion, but routine contraception is preferable to emergency contraception.

Dear women! You can always get detailed advice on methods of contraception in the family planning office of the antenatal clinic of the BU “Kogalym City Hospital”.

M.A. Koreneva, head of the antenatal clinic

15 stupid questions about contraception

Contraception is, first of all, preventing pregnancy with the help of various contraceptives. Some types of contraceptives protect against sexually transmitted diseases.

All have about 90% efficiency. According to the table from the Uptodate.com website, which contains the most relevant data in the field of medicine around the world, the most reliable methods of contraception are surgical: male and female sterilization. Hormonal ones are less effective – these are combined oral contraceptives, a vaginal ring, a Mirena hormonal intrauterine device, an implant, a patch, postcoital emergency contraception.Barrier condoms include male and female condoms, a diaphragm, a uterine cap, a contraceptive sponge, and a latex disposable wipe. By chemical – non-hormonal copper-containing intrauterine devices and spermicides, which kill sperm outside the body of a man. They can be in the form of creams, suppositories, gels. Another method is behavioral: interrupted intercourse and calendar contraception.

It is important to distinguish between STDs (Sexually Transmitted Diseases) and STIs (Sexually Transmitted Infections).The first includes diseases that can be transmitted in several ways: through blood, household items, sexually. It can be HIV, hepatitis, syphilis and other diseases. STIs include four types of infections that are exclusively sexually transmitted: gonorrhea, ureaplasmosis, chlamydia, and trichomoniasis.

An STD test can be taken free of charge at any skin and venereal dispensary. But for this you need to get a referral from a urologist, gynecologist or therapist working in a state clinic.To detect an STD, you need to donate blood from a vein. It should be borne in mind that after infection, HIV infection may not immediately appear in the blood. Therefore, in order to make sure that it is absent, after the first test, it is necessary to check again in a month. Tests like these are rarely wrong. If the infectious disease specialist has doubts when checking the test, he will write in the certificate that it is necessary to retake the tests again.

For testing for STIs in men, a swab is taken from the urethra, and in women from the cervix.It is checked by PCR diagnostics, which is able to most accurately detect the infection. Test results can be obtained in three to four days.

All tests for STDs and STIs are taken anonymously, and the information does not fall into the hands of third parties. Doctors are responsible for maintaining confidentiality, so those who want to get tested do not need to be afraid that their test results will be made public.

The risk of contracting STDs in men with homosexual intercourse is higher than with traditional intercourse, and in women it is the same as with heterosexual intercourse.

The first reason lies in the human anatomy – the vaginal mucosa differs from the rectal mucosa in that it is covered with stratified epithelium and its barrier function is higher. The rectal mucosa is single-layered, and it is much easier to injure it, so the infection can get faster. The second reason is that many people use condoms only to avoid unwanted pregnancies, and homosexual people rarely use them due to the absence of such a risk. Only some barrier contraceptives, primarily condoms, can help prevent STDs.Although HIV was initially considered a disease of gay men – and in 1982 the term Gay-related immune deficiency was even introduced – today homosexual people have become more concerned about their health, so the number of homosexual and heterosexual people with STDs has leveled off.

Contraceptives are needed for any kind of sex. During fingering and oral sex, the risk of infection is lower than with traditional intercourse, but it is there. For the infection to be transmitted, you need an “entrance gate”: a wound in the mouth or on the genitals.If you do not use protection during oral sex, you can contract the human papillomavirus. A prime example of this is the famous actor Michael Douglas, who was diagnosed with HPV-induced laryngeal cancer. For protection during oral sex, condoms or latex wipes must be used. Few people know about napkins as a method of contraception, and they are difficult to find in Russian pharmacies, but they can be ordered on the Internet. It is not worth using a condom cut lengthwise or a latex glove – no one can guarantee that a cut of a condom is as effective as a whole condom or a special napkin.Sex toys must be clean before use. After use, they must be treated with a special disinfectant. Also, some of them can be worn with a condom. Latex gloves or condoms are recommended for fingering.

The risks of getting infected and getting pregnant remain the same. It is necessary to use the usual methods of contraception, but it must be borne in mind that spermicides will be less effective due to menstruation. Also, if a woman takes COCs, then during intercourse during menstruation, additional protection is needed – this is written in the instructions.If Mirena or Implanon is used in continuous mode, then nothing additional is needed.

The effectiveness of this method of contraception is one of the lowest – 24 women out of 100 can get pregnant. Calendar contraception can only be trusted if the menstrual cycle is regular and works like clockwork. For example, if the cycle lasts 30 days, then from 9 to 18 are considered fertile days, that is, dangerous.

Its efficiency is about 80%. Adherents of this method may say: “We have been using PPA for five years and have never had a pregnancy.”But in fact, the reason may be that one of the partners is infertile. Sperm are contained not only in the ejaculate, but also in the pre-seminal fluid of men (this is a clear viscous fluid that is released from the urethra when excited, – approx. Enter). During intercourse, it acts as a lubricant, and also evens out the acidity in the female vagina so that the sperm feel better. Sperm can also be in the urethra if intercourse is the second in a row.

Spiral versus birth control pill: which is better?

In the modern world, there is a great choice of everything and everyone, including contraceptives. Moreover, each manufacturer praises its own means of protection, usually emphasizing only the advantages and keeping silent about the disadvantages.

It is quite difficult to independently understand such a flow of varied and sometimes contradictory information, however, in this article we will try to objectively highlight all the pros and cons of basic contraceptives.

To begin with, it is worth noting that there are quite a few methods of contraception, but only 2 of them are used for long-term protection from pregnancy: intrauterine devices and hormonal contraceptives .

Intrauterine devices: advantages and disadvantages

Intrauterine devices are:

• hormonal
• non-hormonal

Hormonal coils have all the advantages and disadvantages of non-hormonal coils and, in addition, include the advantages and disadvantages of hormonal contraceptives.

The hormonal intrauterine device deserves a separate consideration.

In this article, we will consider in detail the principles of operation, the advantages and disadvantages of only non-hormonal spirals.

Non-hormonal intrauterine devices: mechanisms of action

Coil mechanisms of action:

1. spiral affects the composition of cervical mucus , making it thicker, which makes it difficult for sperm to move into the uterus
2. affects the sperm cells themselves , reducing their motility
3. enhances the peristalsis of the fallopian tubes (i.e.That is, it accelerates the movement of the egg through the tubes), and with the accelerated movement of the egg, it enters the uterus without having time to mature. An immature egg is not able to implant (integrate) into the uterus.
4. if fertilization did occur, then prevents the fertilized egg from attaching to the walls of the uterus

The latter property allows the use of an intrauterine device as means of emergency contraception , which is much safer for the body than the use of special emergency contraceptive pills containing large doses of hormones.

Advantages of non-hormonal intrauterine devices

1. High degree of protection – above 95%
2. Can serve as an emergency contraceptive (however, it must be installed no later than 120 hours (5 days) after unprotected intercourse)
3. Long service life from 3 to 10 years depending on the composition of the spiral
4. The onset of pregnancy is possible immediately after the removal of the coil
5. Does not affect the hormonal background women (there are no problems such as decreased libido, menstrual irregularities, amenorrhea, breast tenderness, mood swings, depression, headache, nausea, inherent in hormonal drugs)
6. Suitable during lactation (breastfeeding mothers)
7. Instantaneous efficiency (starts working immediately after insertion)
8. Suitable for women with certain diseases when hormonal contraceptives are contraindicated

Disadvantages of non-hormonal intrauterine devices

1. Insertion and removal possible by gynecologist only
2. It is necessary to check for the presence of the threads of the spiral in the vagina after each menstruation in order to notice in time spontaneous loss of the spiral (which happens quite rarely)
3. More than profuse and prolonged periods in the first few months after the installation of the spiral
4. Possible development of endometriosis pelvic organs (rare)
5. Increased risk of developing inflammatory diseases of the uterus and appendages
6. Installation of the spiral is not recommended for nulliparous women

Contraindications for the installation of the spiral

1. pregnancy
2. inflammatory diseases of the pelvic organs
3. malignant formations in the cervix or uterine body
4. bleeding of unknown etiology (cause of occurrence is not established)
5. deformation of the uterine cavity for various reasons

Birth control pills: advantages and disadvantages

Birth control pills (oral contraceptives) are the most common method of hormonal contraception.

Oral contraceptives use synthetic hormones similar in effect to those produced by the body itself.

The composition of contraceptive pills without fail includes the hormone progestogen , which provides protection against pregnancy.

By composition, oral contraceptives are divided into:

• gestagenic (contain only the hormone gestagen)
• combined (contain two hormones: gestagen and estrogen (needed to control the menstrual cycle))

Principles of operation of oral contraceptives

Birth control pills:

1. inhibit or inhibit ovulation
2. affect the composition of the cervical mucus of the cervix, making it more viscous and thick, which prevents the passage of sperm into the uterus
3. acts on the endometrium (mucous membrane) of the uterus so that the fertilized egg cannot be fixed in it
4. gestagenic tablets additionally reduce the mobility of the fallopian tubes , which slows down the movement of the egg through them and, as a result, the likelihood that the sperm has time to fertilize falls

Benefits of birth control pills

1. High degree of protection – up to 99% when used correctly
2. Possibility of getting pregnant in the next cycle after the abolition of oral contraceptives, however, it is recommended to wait 3 months before pregnancy
3. Possible use by nulliparous women
4. Can be used to treat hormonal disruptions and some gynecological diseases

Disadvantages of contraceptive pills

Many disadvantages of oral contraceptives stem from their principle of action:

1. Mood Swings
2. nausea , sometimes vomiting
3. breast tenderness
4. weight gain (may be caused by fluid retention or changes in carbohydrate-fat metabolism)
5. decreased libido
6. acne intensification (quite rare)
7. increased excretion of trace elements from the body .With a lack of trace elements in the body, serious diseases can occur. When taking oral contraceptives, it is important to take vitamin complexes .
8. impairment of glucose uptake (rare)
9. headaches
10. spotting (especially typical for oral contraceptives with one hormone progestogen)
11. The hormone estrogen in the combined contraceptive pills increases blood clotting (hypercoagulation), which leads to unpleasant consequences: the risk of thrombophlebitis, heart attack, stroke increases, the existing cardiovascular problems are aggravated.
12. the need to take pills at the same time according to a strictly established scheme , otherwise the risk of getting pregnant increases sharply
13. in order to avoid negative consequences prescribe contraceptive pills should a gynecologist after all the necessary studies

Depending on the type of progestogen (about a dozen different progestogens are used in pharmaceuticals) and on the presence or absence of estrogens (ethinyl estradiol is usually used) in the composition of oral contraceptives, various side effects can be observed.A list of all side effects is indicated in the instructions for the tablets.

Contraindications to the use of contraceptive pills

1. pregnancy
2. presence of malignant tumors
3. thrombosis or thromboembolism – the occurrence of blood clots in the vessels
4. suffered heart attacks, strokes
5. bleeding disorders
6. cardiovascular diseases
7. diabetes mellitus
8. liver disease
9. smoking
10. postpartum period less than 6 months

Terminal

The use of contraceptive pills requires increased responsibility and self-organization, because the effectiveness of this method depends on the frequency of administration.

The contraceptive effect does not occur immediately, but within a week after the start of admission.

Oral contraceptives affect hormonal levels, which leads to both unpleasant and dangerous side effects. However, they can be used in the treatment of certain gynecological diseases.

Intrauterine devices do not affect the hormonal background of a woman, their contraceptive effect is based on the physical properties of the components and manifests itself immediately after installation.

Spontaneous spiral loss is possible, therefore it is necessary to check for the presence of spiral threads in the vagina. It is also quite common to observe an increase in menstrual flow in the first months after installation. In addition, intrauterine devices increase the risk of developing inflammatory processes.

Both methods of contraception are highly effective.

Installation and removal of the spiral is carried out by a gynecologist. After a while, a second examination is required, and if nothing bothers you, further observation by a gynecologist is not necessary.

The selection and appointment of contraceptive pills should be carried out only by a gynecologist. The wrong pills can lead to serious side effects. It is advisable to constantly monitor the state of the body in order to timely identify the lack of trace elements or the development of concomitant diseases and correct their negative manifestations.

Always be healthy! Your Medical Center “36i6”!

90,000 Why are there no male oral contraceptives and are men ready for them?

• Professor Lisa Campo-Engelstein
• Albany College of Medicine, USA

October 28, 2019

Photo Credit, Getty Images

Scientists have been working on the development of male oral contraceptives for more than half a century.Despite the occasional optimistic news, there is still a long way to go to a really working drug.

Lack of funding and the alleged lack of male interest in this type of contraception have led to the fact that such a drug is still not mass produced.

And women are still generally responsible for avoiding unwanted pregnancies.

However, a number of studies have shown that many men would agree to take the contraceptive pill if there was one.

About a third of sexually active men in Britain say they are willing to consider using hormonal contraception – pills or implants.

The same percentage of British women are currently using this method of protection.

According to the opinion poll, 8 out of 10 people believe that contraception should be a common responsibility.

Photo author, Getty Images

Photo caption,

The main means of male contraception today are condoms and vasectomy).

So can social acceptance and weakening of gender roles lead to the emergence of male oral contraceptives?

What are the most common contraceptives and ?

According to the UN, only one third of reproductive-age couples worldwide are not protected at all.

But when contraception is used, it is mostly used by women.

About 19% of women in married or long-term relationships rely on sterilization, 14% on an IUD, 9% on pills and 5% on injections.

Male contraceptives are used much less frequently. 85% of men use condoms and only 2% use vasectomy.

But this was not always the case.

Before the invention of female combined oral contraceptives (COCs), male condoms remained the main method of contraception.

When the mass production of oral contraceptives began in the 1960s, women were able to control their fertility for the first time without the participation or knowledge of their sexual partner.

Today, over 100 million women take pills, the most widely used form of contraception in Europe, Australia and New Zealand.

This is the second most popular method of contraception in Africa, Latin America and North America and the third most popular in Asia.

Over the decades, pills have freed many women, allowing them to delay or prevent pregnancy and motherhood by opening up other options – education or career.

This is one of the reasons why mass production of oral contraceptives is often seen as a key milestone in women’s rights and one of the most important inventions of the 20th century.

Society is moving towards greater gender equality, and in these conditions it is increasingly offensive that it is women who now bear the emotional, social and financial burden of contraception, not to mention its side effects.

Photo author, Getty Images

Photo caption,

More than 100 million women in the world take oral contraceptives

So why are there no male pills?

It took only ten years after the invention of COCs for female contraceptives to become widely available.So why is the story of male pills that were first tried out in the 1970s for so long?

Some scientists argue that the development process for male contraceptives is more difficult than female contraceptives. The pill for men interferes with the production of sperm, but the hormones necessary for this can cause side effects.

Social and economic factors also play a role. The field of reproductive science and medicine is mainly focused on the female body and neglects the male.

For example, almost everyone knows who a gynecologist is, but few have heard of an andrologist – a doctor who specializes in the male reproductive system.

Photo author, Getty Images

Photo caption,

Despite decades of development, there are still no male oral contraceptives in pharmacies

Research and development of male contraceptives not only began 10 years after the creation of female contraceptives, they went very slowly from- for lack of funding.

This is partly due to the fact that pharmaceutical companies, regulators, and men themselves are more intolerant of possible side effects.

Certain side effects are acceptable when using female contraceptives because they are associated with the risk of unwanted pregnancy.

When it comes to male drugs, young healthy men are the control group and any side symptoms are considered unacceptable.

Research on male contraceptives that provide orgasm without sperm ejection has stalled also because ejaculation is seen as an important component of male sexuality.

And will women trust men when it comes to contraception? This is another factor holding back the spread of male COCs.

Research from several decades ago shows that women are more likely to trust partners with whom they are in long-term relationships, but do not want to trust men to choose contraception when it comes to casual sex and short relationships.

Photo author, Getty Images

Photo caption,

Men and women now more often share their responsibilities for housework and childcare

Female Duty ?

Since contraception is often viewed as a woman’s responsibility, it is assumed that men will not use contraception.

However, gender roles are changing, and today men are more likely to share household and childcare responsibilities with women.

Changing this balance may affect attitudes towards contraception, and research shows that young men tend to see it as a shared responsibility.

Certain types of men — those who are better educated, wealthier, who place less emphasis on traditional gender roles — are more likely to support and even strive to use male contraceptives.

The mass availability of tablets for men does not guarantee their use. We see something similar in terms of sterilization rates.

Male vasectomy was invented almost 200 years ago. At the same time, female sterilization is 10 times more common worldwide, despite the fact that it is less effective, more expensive and fraught with serious complications.

Achieving greater gender equality is a necessary first step in removing social and economic barriers to the development of male contraceptives.

We have been waiting for the male pill for 50 years, let’s not wait another 50 years.

What is the 100 Women Project?

This text was written by an expert from an outside organization. It is timed to coincide with the next season of the BBC’s “100 Women” project.

Lyricist Lisa Campo-Engelstein became one of the 100 women of 2019. She is an expert in bioethics and reproductive ethics.

This year, the BBC’s 100 Women Project, dedicated to inspiring and influential women around the world, asks what our future will be if women define it.

Many of the women on this list do not have major fortunes, are not stars of world cinema or social networks, and even in their field of work they often do not occupy leading positions.

But these women, according to the compilers of the list, largely reflect the current trends in the development of society and can tell us a lot about what this society may become in the future.

Contraception

The best method of contraception.Who will help you choose: a girlfriend, the Internet or a doctor?

According to statistics from the WHO (World Health Organization), 50 million abortions are performed every year in the world.

Why is this happening? How is it that millions of modern, knowledgeable, educated young women each year decide on this physically and mentally crippling procedure, fraught with many complications?

We plan our lives, careers, relationships and can plan pregnancy.

The spectrum of dangerous consequences of termination of pregnancy is very wide and includes both immediate (inflammatory diseases of the uterus and appendages, bleeding, traumatic complications) and long-term complications (infertility, ectopic pregnancy, menstrual irregularities, etc.).

In addition, artificial abortion can lead to an increase in the frequency of miscarriage, complicated pregnancy, childbirth, the postpartum period, as well as diseases and even death of a developing (already desired!) Child.

However, despite the growing awareness, the topic of preventing unwanted pregnancies is shrouded in a large number of myths, unsuccessful “instructive” examples and other horror stories.

Among the reasons most often leading to unwanted pregnancy, women are named:

1. Lack of awareness and awareness of this issue, inability to independently deal with a fairly wide choice of contraceptives today.
2. Following the advice of friends and relatives, leading to the choice of outdated and insufficiently effective means.
3. Elementary laziness and the hope that it will “carry it through”, unwillingness to bother at the most inopportune moment or to discuss the method of contraception with a partner who, of course, is against the condom, but does not know about anything and does not want to know.
4. Fear of using modern contraceptives such as hormonal drugs and / or an intrauterine device due to the allegedly frequent various complications.
5. Unwillingness to spend money on modern contraceptives and going to the doctor.

In this article, we want to dispel most of these myths and tell you how, with the help of a specialist, to correctly choose a modern and safe method of contraception, give birth to the desired healthy children at the scheduled time and never face the physical and mental suffering caused by an induced abortion.

Myth one:

Why spend money on going to the doctor and expensive drugs and devices, when there are good proven methods “this is what my grandmother, mother, best friend did”.

As a rule, the range of “good and free” methods is quite wide.

Sometimes very exotic “folk” advice is used, such as douching the vagina immediately after intercourse with soapy water (alkali kills sperm) or, on the contrary, with lemon juice (acid starts to kill here). Unfortunately, often sperm survive, and the organs of the regenerative system suffer: the ecosystem of the vaginal flora is disrupted, which leads to the development of permanent infectious complications.

Tips to apply the so-called biological methods: rhythmic and temperature, are less dangerous, but, unfortunately, are very unreliable and are suitable only for women with a perfectly clear menstrual cycle.

The essence of the methods is as follows: on certain (“dangerous”) days, and these are the days on which ovulation occurs and a couple of days before and after, you need to refrain from intercourse or use additional methods of contraception. The days of supposed ovulation are determined in the following ways: measuring the basal temperature and finding out the constancy of the days of its rise, using an electronic thermometer and / or special ovulation tests, which make it possible to establish the days of possible conception by the dynamics of the basal temperature, a simple calculation according to the calendar, which, of course, is less reliable …
According to the received data it is necessary to draw up a schedule , according to which the “safe” and “dangerous” days in relation to conception are determined.

The method is good because there are no medicinal effects on the body , it costs nothing (except for the cost of a thermometer if you measure the temperature: by the way, you need to measure it in the rectum every day for several months).

The disadvantage of the method is low reliability. Even if you graduated from the math department and are masterful in drawing up charts, nature is sometimes unpredictable.

Currently, the biological method of contraception is used by about 5% of couples, while in the past its prevalence reached 25%.

Myth two:

Why pay for a visit to the doctor when you can always buy a condom at the checkout in a supermarket.

Condom , as a method of so-called barrier contraception, is relevant at all times. A huge advantage of this method is also protection from almost all sexually transmitted infections.

The main mechanism of action of condoms is to create a barrier to the penetration of sperm into the woman’s vagina.

In some cases, a spermicidal agent (eg Pharmatex) is used to increase reliability with a condom, but there is no reliable data on the effectiveness of spermicide after breaking the integrity of the condom during intercourse.

There are also disadvantages: condoms are moderately effective. The so-called “contraceptive failure” rate is approximately 12.5%.And, as a rule, men dislike them and in long-term relationships they are not a means of choice.

Although we emphasize that this is an ideal means of protection in the event of a romantic night with a mysterious stranger.

There are also vaginal barrier contraceptives (caps, diaphragms), but they do not protect against sexually transmitted infections and definitely require selection by a gynecologist. And yes, they are not for sale at the checkout in the supermarket or even in the pharmacy.

Spermicides, along with condoms, are agents that can help against infections, although they are more expensive and you will have to go to the pharmacy to get them.

Modern spermicides are made up of two components: a sperm-killing chemical and a so-called base, or carrier. Both play an important role in ensuring the contraceptive effect.

The carrier is responsible for allowing the chemical to enter the vagina by enveloping the cervix and holding it in place so that no sperm can escape contact with the spermicidal ingredient.For most spermicides, the active ingredient is non-oxylone-9, the main mechanism of spermicidal action of which is the destruction of the sperm cell membrane. It is undoubtedly better and safer than lemon.

The method has slight inconveniences. When using spermicidal suppositories and tablets, the onset of intercourse is possible only 10-15 minutes after the introduction of the spermicidal substance into the vagina. Spermicidal films are the most convenient and portable, but correct insertion requires skill and a 15-minute interval must be observed.

Myth three:

It is easier to have an abortion than to constantly “poison” with hormonal contraceptives.

This is a key misconception!

According to scientific literature, hormonal contraceptive drugs are truly modern and effective methods of contraception.

Since they began to be used throughout the world (and this happened in the second half of the 20th century), there has been real progress in the field of birth planning.

Therefore, stay with us and be sure to read about modern and effective ways of preventing unwanted pregnancies.

Please do not run to the pharmacy immediately after reading the article.

For the correct selection of ABSOLUTELY ANY means of contraception, you must visit a gynecologist and carry out the recommended examinations!

Believe me, doctor studied for at least ten years and has a huge amount of knowledge and skills to help you choose the most suitable contraceptive method that will be reliable and safe.

Today, depending on the composition, dose and method of application of hormonal preparations , the following types of preparations for hormonal contraception are distinguished:

Combined estrogen-gestagenic oral contraceptives.

This method of contraception is the most widespread.

These are tablets containing synthetic analogs of two female hormones at once: estrogen and progesterone for daily administration.Their advantage is high contraceptive reliability, ease of use, and relative cheapness.

However, these are not the latest achievements in the field of hormonal contraception and they have a lot of contraindications.

It should be noted that the vast majority of complications when taking such contraceptives are due to improper selection of the drug. There is, however, a way out and it is simple: contact a specialist, he will select a drug that is ideal for you.

And one more small drawback: you always need to remember to take the pill, if you miss an appointment, follow the instructions or consult a doctor.

Progestational contraceptives.

Their contraceptive effect, especially at a low dose of gestagen, is primarily associated with changes in the mucous membrane of the uterine cavity, which complicates the possible implantation of a fertilized egg.

In addition, an increase in the viscosity of the mucus secreted by the cervix makes it much more difficult for sperm to penetrate through it.

Also, the drugs cause inhibition of the release of the hormone lutropin by the pituitary gland, which leads to the suppression of ovulation.

These funds can be used by women with diseases (migraines, heart defects, diabetes mellitus, high blood pressure, obesity, as well as women who smoke over 35 years of age and women during lactation), in which taking combined contraceptive pills (about which we wrote above) is contraindicated.

Oral gestagenic hormonal contraceptives (mini-pills).

When using this method of contraception, ovulation occurs in some cases, which explains the lower efficiency compared to combined hormonal pills (contraceptive effectiveness 0.3-9.6 pregnancies per 100 women per year) and, accordingly, the risk of pregnancy increases (including number of ectopic), as well as the development of ovarian cysts.

Injectable gestagenic hormonal contraceptives.

This method is the introduction of the drug (medroxyprogesterone-injection) into the thickness of the muscle tissue and provides gradual absorption with the provision of a contraceptive effect within 3 months.

After discontinuation of the drug, the ability to fertilize is restored in about 5-24 months (usually after 9 months).

The contraceptive effectiveness of the method is 0–1.5 pregnancies per 100 women per year.

Subcutaneous gestagenic implants.

These are capsules implanted under the skin with a length of 35 mm and a diameter of 2.5 mm, secreting an active hormonal substance – levonorgestrel, and a single injection is sufficient to provide a contraceptive effect for 3-5 years.

Contraceptive efficacy is 0.5–1.5 pregnancies per 100 women per year.

Hormone-releasing intrauterine devices (Mirena type).

The pregnancy rate with use is 0.3 per 100 women.

The last two methods are the most modern and convenient methods of preventing pregnancy, but they are only suitable for women who are not planning to become pregnant in the next few years.

Myth four:

An intrauterine device is generally a horror: it hurts, expensive, ineffective and harms the genitals.

There are many different types of intrauterine devices (IUDs), both non-drug (inert) and copper-containing and hormone-releasing, for example Mirena, which we wrote about above.

With the use of the latest generation of non-hormonal copper-containing IUDs, the pregnancy rate is 0.4–0.5 per 100 women.

The contraceptive effect of the IUD is primarily due to its local effect on the endometrium of the uterus.

In fact, this is a foreign body of various forms, which the doctor introduces into the uterine cavity for a long time (from 3 to 7 years).

All IUDs stimulate the development of a foreign body reaction in the endometrium, which is enhanced by the addition of copper.

The obvious disadvantages of this method include the risk of developing diseases such as endometriosis and chronic endometritis.

The very procedure for inserting the IUD is not very pleasant and necessarily requires a study for the absence of infections.

Intrauterine device is indicated for women who do not plan pregnancy in the near future and need long-term (more than 1 year) contraception.

Myth 5:

The next day it is too late … hopefully “maybe”.

If you were planning to get pregnant in June, and the condom broke on the May holidays, then feel free to do so, but if you are not planning a pregnancy, and with your usual method of contraception there was an “overlap” of the type:

• did not use basic methods of contraception at all
• sexual intercourse on “dangerous” days of the cycle
• the contraceptive did not work or was used incorrectly
• Condom tearing, slipping or misuse has occurred
• two or more doses of hormonal contraceptive pills were missed in a row
• unsuccessful retired intercourse
• Slip, rupture, premature removal of the cap, diaphragm or vaginal ring
• Incomplete dissolution of the spermicidal tablet or film prior to intercourse.

In all these cases, we urge you to use the means of EMERGENCY CONTRACEPTION.

Emergency contraception – based on the intake of drugs containing large doses of hormones released intermittently and desynchronizing physiological hormonal changes, which leads to the development of the so-called “menstrual chaos”.

This method is harmful to the body and is an extreme measure when you have to choose the lesser of two evils.

There are cases (forced sexual intercourse, rape) when the method of emergency contraception is used as an emergency measure of protection from both unwanted pregnancy and mental trauma associated with it.

This is single contraception , aimed at preventing unwanted pregnancies, and in NO CASE can it be recommended for permanent use.

Attention should be paid to the high incidence of pregnancy despite the use of this method of contraception.But you need to know about it.

Currently created an effective drug for such situations – Escapel (pharmaceutical company “Gedeon Richter”).

The advantage of this drug is the lengthening of the interval of admission after intercourse from 72 to 96 hours, as well as the fact that the drug is used once.

One Escapel tablet contains 1.5 mg of levonorgestrel, which provides a contraceptive effect: the probability of pregnancy is 1.1% .

Escapel does not have an abortive effect. If pregnancy still occurs while taking the drug, then it can be saved, tk. Escapel does not have a teratogenic (harmful to the fetus) effect.

The drug has no absolute contraindications for use as an emergency contraception and therefore is indicated for any woman of reproductive age.

We told almost all methods of simple, modern and reliable contraception.They also talked a little about contraception that was unreliable and outdated, and completely kept silent about the difficult one (such as ligation of the fallopian tubes).

The choice of funds is large and the choice is yours, but we urge you to make it together with a specialist – a gynecologist.

Family planning / contraceptive methods

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