What methods are recognized as the most effective by the World Health Organization? Where (and why) to look for female condoms? Should you trust a hormonal patch? Are emergency contraceptives serious harm to health? We answer these and other questions in the educational program on the most popular means of protection against unwanted pregnancy. Interruption of sex
According to the World Health Organization (WHO), in a year 27 women (!) Out of 100 can face an unplanned pregnancy if partners practice interrupted intercourse as a method of protection. In some cases, men overestimate their ability to determine the very point of no return. But even if sex is interrupted on time, there is still a risk of pregnancy. Not all sperm comes out at the time of ejaculation, some may be released earlier. Some experts note that pre-ejaculate, which acts as a lubricant, may contain a sufficient amount of semen remaining in the urethral canal from previous ejaculation. High risks do not stop fans of the natural method of contraception - according to VTsIOM, 45% of Russians use interrupted intercourse as their main method of contraception.
Effectiveness *: Pregnancy in 27 women out of 100 with typical use, 4 women with absolutely correct use.
* hereinafter, the proportion of women who had an unplanned pregnancy during the first year of using the contraceptive method. Calendar method
Some women resort to the calendar method and refuse unprotected sex during fertility - the day of ovulation and the five days before it are considered the most favorable for conception. There are three fertility signals that need to be monitored - menstrual cycle length, daily body temperature readings, and changes in cervical secretions (cervical mucus). These indicators need to be noted daily, and to study the whole picture, it takes 3 to 6 menstrual cycles. With menstrual irregularities and increased anxiety, it is quite dangerous to practice the calendar method. Especially when you consider the fact that about 24 out of 100 women during the year are faced with an unplanned pregnancy, resorting to such introspection.
At the same time, the calendar method formed the basis of the Natural Cycles application, which the FD (American Food and Drug Administration) recognized as a full-fledged contraceptive last year. The app's algorithm calculates when it is safe to have sex and when it is not. The user is required to measure the temperature with a basal thermometer every morning and enter this data into a smartphone. The results of clinical studies with the participation of 15 thousand women showed that when using the application as a contraceptive with minor errors during the year, on average 6.5% of women will become pregnant. With perfect use without errors - 1.8% of women. The developers note: if pregnancy is associated with serious risks to a woman's health, it is worth considering another method of contraception. And of course, the app will not protect you from sexually transmitted infections.
Calendar method - pregnancy in 25 women out of 100 with typical use, in 2-9 women with absolutely correct use. Mobile application - pregnancy in 7 women out of 100 with typical use, 2 women with absolutely correct use.
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Condoms - female and male
The only method of contraception that will help protect against unwanted pregnancy and sexually transmitted diseases. After all, even the presence of a permanent partner is not a guarantee that you are insured against infections - as the doctors of the City AIDS Center say, St. Petersburg women contract HIV from their husbands even during pregnancy.
Polls and research show that condoms do not actually negatively affect arousal and orgasm. In the event that they are selected correctly in size. If even ultra-thin samples from the mass market seem superfluous during sex, you can look for alternatives - for example, Japanese-made weightless contraceptives 0.02 cm thick. They are made not from latex, but from polyurethane. If you prefer classic latex models and don't want the consequences of torn condoms, set aside oil-based lubricants. Also, doctors recommend buying condoms in pharmacies, not supermarkets - to be sure of their storage conditions.
In addition to male condoms, there are also female condoms. They are also a barrier method of contraception, that is, they mechanically prevent the penetration of sperm to the egg. Female condoms cannot be found in your local supermarket, but can be ordered from Amazon. True, they provide a lower level of protection than classic men.
Male Condoms - Pregnancy in 15 women out of 100 with typical use, 2 women with absolutely correct use. Female condoms - Pregnancy in 21 women out of 100 with typical use, 5 women with absolutely correct use.
The first contraceptive pill was released almost 60 years ago, since then dozens of drugs have appeared, but they all work according to the same principle: they prevent ovulation, which allows you to avoid pregnancy. As a rule, the composition of combined oral contraceptives (COCs) includes synthetic analogs of female sex hormones - estrogen and progesterone. Their ratio may be different depending on the age of the woman and the individual characteristics of her body. COCs are widely used not only to protect against pregnancy, but also to restore menstrual irregularities, their use reduces bleeding and pain during menstruation, reduces ovulatory syndrome and the risk of inflammation of the female genital organs.
In some cases, hormonal contraceptives can pose additional health risks. It has been proven that the estrogenic component of combined oral contraceptives activates the blood coagulation system. Because of this, the likelihood of thrombosis, primarily coronary and cerebral, as well as thromboembolism, increases. Therefore, in no case should you prescribe COC yourself - the gynecologist must carefully check the condition of your body and only then choose the appropriate contraceptive. The examination ideally includes a general examination, examination of the mammary glands, measurement of blood pressure, taking a smear and donating blood for coagulation. Be wary of hormonal
Technologies do not stand still - male hormonal contraceptives are also in the process of development. In the medical journal "Journal of Clinical Endocrinology & Metabolism" published the results of a study of a new hormonal contraceptive for men, during which only 4 women out of 270 became pregnant. A potential contraceptive contains a synthetic analogue of testosterone and progesterone - these two hormones reduce sperm production. The production of such drugs is still not launched, but it remains a matter of time.
Effectiveness: 8 women out of 100 with typical use, 1 woman in 300 with absolutely correct use. Vaginal rings and hormonal patches
You get the same effect as in the case of COCs - no ovulation - but avoid the need for daily pills at a strictly specified time. The vaginal ring is made of soft plastic, you need to renew it every month (you do it yourself, at home). The ring continuously releases a daily dose of the hormonal estrogen and progestogen into the bloodstream, preventing unwanted pregnancies. The contraceptive patch is attached to the skin, it is transdermal - the necessary hormones are reliably supplied to the body through the dermis. You need to change it more often than the vaginal ring - you need three patches for one menstrual cycle.
Vaginal rings - Pregnancy in 6 women out of 100 with typical use, 1 woman in 300 with absolutely correct use. Hormone patches - Pregnancy in 8 women out of 100 with typical use, 1 woman in 300 with absolutely correct use.
The spiral is installed at once for several years, and all this time the chances of getting pregnant are reduced to almost zero (to be more precise, to 1%). Most often, this method of protection is recommended for girls 25-35 years old for whom hormonal contraception is contraindicated. In this case, a copper-containing coil is used, which does not disrupt the natural maturation of the egg and does not affect the hormonal background. But there are also spirals with a hormonal drug component. Despite the fact that this method of contraception is considered effective, there are still disadvantages. You are not protected from sexually transmitted infections (STIs). In case of PPI infection and the development of an inflammatory process, the intrauterine device can increase the risk of complications.
Copper Coil - Pregnancy 0.8 out of 100 with typical use, 0.6 out of 100 with absolutely correct use. Levonorgestrel-containing (medicinal) coil - pregnancy in 0.1 out of 100 with typical use, 0.1 out of 100 with absolutely correct use.
Sterilization and vasectomy
In Russia, only women over 35 years old or those who already have at least two children can use the sterilization method (it is often called "tubal ligation"). A well-performed operation does not in any way affect health and hormonal background, does not disrupt the menstrual cycle and does not affect sexual desire, perhaps even, on the contrary, increases it. The method has maximum guarantees of protection against pregnancy, but it has a serious drawback - the process is irreversible.
Male sterilization is called a vasectomy. And this is not castration. During the operation, a part of the vas deferens is bandaged or removed from a man, due to which sperm subsequently do not enter the sperm. After the operation, doctors recommend continuing to use contraception for several months (sperm may remain in the seminal ducts) in order to avoid unwanted consequences. In the clinics of St. Petersburg, the procedure costs around 20 thousand rubles and from a surgical point of view is not very difficult. As in the case of female sterilization, the operation is strictly limited according to the indications - the age is over 35 years and / or the presence of two children.
Female sterilization - pregnancy in 0.5 out of 100. Vasectomy - pregnancy in 0.15 out of 100.
Emergency contraception refers to measures in case of force majeure (for example, unprotected intercourse) to prevent pregnancy. There are many rumors about pills for emergency contraception (for example, Senator Elena Mizulina demanded their ban for more than one year), but some of them need to be dispelled. Yes, just one pill really prevents pregnancy by delaying ovulation, but does not induce an abortion and does not destroy the entire endocrine system. First, emergency contraception in no way can interrupt an established pregnancy or harm the developing embryo. Levonorgestrel, a synthetic contraceptive progestogen, is not an abortifacient. It prevents pregnancy. Undoubtedly, the dose of the drug that enters the body with emergency contraception is quite high, but it does not carry such high risks to the body. The main side effects are nausea, changes in menstruation, headache, breast tenderness and a shock to the microflora. According to the data cited by the WHO, taking such pills within 72 hours after unprotected intercourse reduces the risk of pregnancy by at least 75%. The sooner action is taken, the better. It is impossible to abuse this method - emergency contraception is by no means an alternative to other methods of protection.