The diaphragm is a dome-shaped rubber cap. It is selected for each woman in size: from 50 to 150 mm. A vaginal diaphragm measuring 60-65 mm is usually suitable for nulliparous women, and a vaginal diaphragm measuring 70-75 mm is usually suitable for women who have given birth. After childbirth or weight loss, the size must be selected again. The advantages of the “cap” are ease of use, reusability, harmlessness and, to a large extent, protection against sexually transmitted infections. But it has contraindications: endocervicitis, colpitis, cervical erosion, allergies to rubber and spermicides, abnormal development of the genitals, prolapse of the walls of the vagina and uterus.

Condom

Condom - . But this method is considered the most effective against sexually transmitted diseases. Doctors remind that post-coital contraception or termination of pregnancy will still save you from unwanted pregnancy. Sexually transmitted diseases last a long time, and in the worst case, forever. Our article "" describes one of the diseases, the occurrence of which can be avoided by using a condom.

female condoms- such condoms will help a woman out if the thought of sex with a condom makes her partner nervous tic(“after all, this reduces all sensations!”).

latex-free condoms- they do not contain dyes or flavors, which means they cannot cause an allergic reaction during sexual intercourse.

These include special spermicidal preparations

in year

menstrual calendar ovulation programs, which help to maintain this kind of “accounting”. Establish the shortest and longest menstrual cycles, find the first “fertile day” (according to the shortest menstrual cycle) and the last “fertile day” (according to the longest menstrual cycle). Then, taking into account the length of the current menstrual cycle, determine the fertile interval. During this period, you can either completely abstain from sexual activity, or use barrier methods and spermicides.

Temperature method

basal temperature 0.3-6.6 per 100 woman-years.

special thermometer

Symptothermal method

Intrauterine contraception

The contraceptive effectiveness of the plastic “spiral” (Lipps loop) is on average 91 percent, or 5.3 pregnancies per 100 women per year. Many modern intrauterine devices contain copper - the contraceptive properties of this metal have been proven for a long time. Their efficiency increases to 98 percent - 0.4-0.5/100 women-years.

Hormonal contraception

with 100% efficiency. It is customary to distinguish:

The latest contraceptives

“Sadistic” gynecologists call all this the cruelest term: woman of the year. Often this indicator is converted into percentages for clarity and credibility. Is the contraceptive you chose effective enough?”

If your plans do not include pregnancy and you will not read our article with 100% confidence, check out the list of all contraceptives officially available to humanity.

Vaginal diaphragm, or “cap”

The diaphragm is a dome-shaped rubber cap. It is selected for each woman in size: from 50 to 150 mm. A vaginal diaphragm measuring 60-65 mm is usually suitable for nulliparous women, and a vaginal diaphragm measuring 70-75 mm is usually suitable for women who have given birth. After childbirth or weight loss, the size must be selected again. The advantages of the “cap” are ease of use, reusability, harmlessness and, to a large extent, protection against sexually transmitted infections. But it has contraindications: endocervicitis, colpitis, cervical erosion, allergies to rubber and spermicides, abnormal development of the genitals, prolapse of the walls of the vagina and uterus.

The pregnancy rate when using a diaphragm in combination with spermicides is 2 pregnancies per year per 100 women per year. At misuse"cap" the probability of becoming pregnant increases to 10 women-years.

Condom

Condom - the only contraceptive used by men. This contraceptive is quite common and is used in 20-30 percent of cases. Wherein clinical effectiveness condom is low enough: 15-20 pregnancies per 100 woman-years. But this method is considered the most effective against sexually transmitted diseases. Doctors remind that post-coital contraception or termination of pregnancy will still save you from unwanted pregnancy. Sexually transmitted diseases last a long time, and in the worst case, forever. Our article “” describes one of the diseases, the occurrence of which can be avoided by using a condom.

By the way, just recently appeared female condoms— such condoms will help a woman out if the thought of sex with a condom causes a nervous tic in her partner (“after all, this reduces all sensations!”).

At hypersensitivity genital organs of both men and women, you can safely use hypoallergenic latex-free condoms- they do not contain dyes or flavors, which means they cannot cause an allergic reaction during sexual intercourse.

Chemical contraception

These include special spermicidal preparations(tablets, suppositories (candles), gels, ointments, creams, foams). For most modern spermicides active ingredients are potent surfactants that destroy cell membrane sperm. These are nonoxynol-9, menphegol, octoxynol and benzalkonium chloride.

Contraceptive gels are popular because they are an excellent and effective method protection without the use of hormones (which means you don’t have to worry about side effects). For example, the advantage of Options Gynol II spermicidal gel is that it is safe and approved for use even during breastfeeding.

The failure rate of isolated spermicide use ranges from 3 to 5 pregnancies per 100 womenin year. But this is only when correct use this method. Apparently, most couples are still used to protecting themselves haphazardly: the actual effectiveness of spermicides is about 16 pregnancies per 100 woman-years.

Calendar (rhythmic) method

The method is based on the fact that ovulation develops 14 days before the onset of menstruation (with a 28-day menstrual cycle), as well as on the duration of viability of sperm in the woman’s body (approximately 8 days) and the egg after ovulation (usually 24 hours). It is important to accurately calculate your individual fertile (or “fecundity”) period. For 8 months, lead menstrual calendar, noting the length of each menstrual cycle. Today on the Internet you can purchase special convenient ovulation programs, which help to maintain this kind of “accounting”. Set the shortest and longest menstrual cycles, find the first “fertile day” (according to the shortest menstrual cycle) and the last “fertile day” (according to the longest menstrual cycle). Then, taking into account the length of the current menstrual cycle, determine the fertile interval. During this period, you can either completely abstain from sexual activity, or use barrier methods and spermicides.

Calendar method contraception is ineffective for irregular menstrual cycles. The efficiency of the calendar method is 14.4-47 pregnancies per 100 woman-years.

Temperature method

Based on determining the rise time basal temperature corpus luteum by measuring it daily. The period from the beginning of the menstrual cycle until the basal temperature is elevated for three consecutive days is considered fertile. Although the need for daily temperature measurement and a period of prolonged abstinence limit the prevalence of the method, its effectiveness is 0.3-6.6 per 100 woman-years.

To freely use the temperature method of contraception, every woman should have in her medicine cabinet special thermometer, with which you can take measurements in the mouth, vagina or rectum to measure basal temperature (this is the name of body temperature at rest or sleep).

Symptothermal method

This method combines elements of calendar, cervical and temperature (taking into account such signs as the appearance of pain in the lower abdomen and scanty bleeding during ovulation). A study of the effectiveness of the symptothermal method showed the following: with sexual intercourse only after ovulation, the pregnancy rate is 2 per 100 woman-years, while with sexual intercourse before and after ovulation, the pregnancy rate increases to 12 pregnancies per 100 woman-years.

Intrauterine contraception

The various wires and “coils” that the doctor installs inside you for a long time differ in materials, active substances and duration of action. Their effectiveness is quite high, but it should be remembered: all “spirals” are based on injury to the uterine tissue. Complications when using spirals are very different: from pain and bleeding to perforation of the uterus. Even if you don’t feel any discomfort, think about whether your precious health and reproductive function will be happy with this method.

The contraceptive effectiveness of the plastic “spiral” (Lipps loop) is on average 91 percent, or 5.3 pregnancies per 100 women per year. Many modern intrauterine devices contain copper - the contraceptive properties of this metal have been proven for a long time. Their efficiency increases to 98 percent - 0.4-0.5/100 women-years.

If pregnancy occurs while using an IUD and the woman desires to continue the pregnancy if the threads are present, the IUD should be removed. If there are no threads, extremely careful monitoring of the course of pregnancy is required. It should be noted that in the literature there is no indication of an increase in the incidence of malformations or any damage to the fetus if pregnancy occurs against the background of an IUD. In women using IUDs, the generative function is not impaired. Pregnancy occurs after removal of the IUD within a year in 90 percent.

Hormonal contraception

Hormonal contraception is based on the use of synthetic analogs of natural ovarian hormones and is a highly effective means of preventing pregnancy.

Oral contraceptives are the only way pregnancy prevention with 100% efficiency. It is customary to distinguish:

• theoretical effectiveness, which involves using the method without errors and missing tablets,
• clinical effectiveness, which is calculated based on the number of pregnancies occurring in real conditions, taking into account the errors made by women.

The advantages of oral contraceptives also include ease of use (independence of sexual intercourse), as well as reversibility of the effect (do not affect the ability to become pregnant in the future). But hormonal pills have a huge list of contraindications, including: cardiovascular diseases, diabetes, smoking, overweight, age over 40 years. Also, oral contraceptives do not combine well with many medications, including antibiotics, analgesics and sleeping pills.

The latest contraceptives

The latest miracles of medicine are “long-lasting” contraceptives in the form of injections and implants. Their effectiveness ranges from 0.0 to 1.5 pregnancies per 100 woman-years. The following types should be considered among the newest contraceptives: contraception, How prolonged injectable drugs and implants.

Voluntary surgical contraception (sterilization)

At first glance, this irreversible method of protection is considered the most reliable. However, there are exceptions to its use. I don’t want to scare anyone, but the rate of contraceptive failure in this case can be 0.8 percent for women and 0.5 percent for men.

Constantly taking oral contraceptives does not make sense if the woman is not active sex life. It is better to choose methods that have less impact on the body, which can reliably protect against unplanned pregnancy and sexually transmitted diseases. In pharmacies today you can easily find various modern contraceptives that are quite effective and convenient.

What types of single-use contraceptives are there?

For irregular relationships, they are best suited one-time funds. In every special case they must be selected individually. For women with irregular sexual activity, it is important that the chosen contraceptive has the following properties:

• reliability;
• convenience and ease of use;
• safety of use;
• availability;
• protection against unplanned pregnancy;
• protection against sexually transmitted diseases.

There are 3 main methods of protection:

• barrier;
• chemical;
• hormone.

Which ones are better to choose? It all depends on many factors: personal preferences, risk, contraindications, and the situation itself. Each of them has its own pros and cons, so we’ll try to understand it in more detail.

Barrier method

The barrier method is the oldest and, perhaps, the most widespread among the population, because it has many advantages, such as:

• relative cheapness;
• availability;
• ease of use;
• quite high reliability;
• no contraindications (except for allergies to the material);
• absolute safety for the body;
• protection not only from pregnancy, but also from infections.

Barrier methods can be used by everyone: nursing mothers, young girls, older women. In some cases, they are even recommended for pregnant women (to protect against infection).

The essence of the method is a mechanical obstacle that prevents sperm from penetrating the cervix. Use requires some attention from partners before and during sexual intercourse. Barrier methods include not only the well-known condoms, but also some other products.

Condoms

Everyone knows about condoms - this is perhaps the most accessible and simple means of protection. Its main advantage is protection against various sexually transmitted infections, which is why the condom has been and remains the number one remedy against unprotected sex.

However, this proven tool has its own, very significant, disadvantages:

• average contraceptive reliability;
• they can rub, tear, or jump off;
• decreased sensitivity during intimacy;
• inability to use if you are allergic to latex;
• a certain lack of aesthetics when used.

Some manufacturers produce condoms with spermicidal lubricant to increase reliability.

Despite popular belief, condoms can be used not only by men - there are special female condoms that have certain advantages over classic products:

• polyurethane material is suitable for people allergic to latex;
• you can insert such a condom several hours before sexual intercourse;
• you can even go to the toilet with it;
• he doesn't jump off;
• can further stimulate the female genital organs during sex.

Unfortunately, the female condom can cause local irritation and is somewhat more difficult to put on than a classic condom (this will require a little practice). The product has two flexible rings - an internal one, which expands near the cervix, fixing the product, and an external one, which remains outside.

After sex, the condom is twisted to prevent sperm from leaking out, removed and discarded, just like a male condom. It is unacceptable to use male and female condoms at the same time - there are Great chance that they will tear due to friction.

Vaginal diaphragm and cervical cap

The diaphragm is a dome-shaped rubber product that is inserted deep into the vaginal canal before sexual intercourse so that it covers the cervix. A latex product that is placed directly on the cervix is ​​called a cervical (that is, cervical) cap. The cap is slightly different in shape from the diaphragm, but operates on the same principle.

The diaphragm or cap may cause irritation where it comes into contact with the mucosa. They cannot be protected against inflammatory processes, cervical erosion, or prolapse of the vaginal walls.

To increase reliability, it is recommended to additionally use spermicides. After use, the product is carefully removed, washed and placed in disinfectant solution- it is reusable and proper care can last up to a year. It is imperative to remove the cap immediately after sexual intercourse, otherwise you can cause a strong inflammatory reaction and even the development of toxic shock syndrome.

Before purchasing, it is better to consult a specialist to determine the right size, as well as learn how to insert a contraceptive correctly.

Other means

There are also less common products that are nevertheless quite often used in some countries. One of them is the vaginal sponge. It is a concave hemisphere made of porous material, having a loop for extraction and impregnated with a spermicidal substance. The sponge is inserted into the vagina at the cervix about a day before sexual intercourse and removed no later than 30 hours after that. Thus, it combines barrier and chemical methods of protection.

Chemical method

The chemical method means the introduction of substances that are harmful to sperm - spermicides. The most important spermicides, on the basis of which the mass was developed modern drugs, are nonoxynol and benzalkonium chloride, which reduce the activity and even completely destroy sperm, making fertilization impossible.

There are now many tools available various forms, which are inserted into the vagina a certain time before sexual intercourse. Active substances begin to act in advance, making the cervical mucus thicker so that it is difficult for sperm to penetrate into it. In addition, they create a protective film on the mucous membrane, protecting against the development of infection.

If it was not possible to resort to contraception on time, non-hormonal birth control pills can also be used after unprotected sex - this will significantly reduce the likelihood of pregnancy and infectious diseases(however, only a condom can prevent the transmission of sexually transmitted infections).

Spermicides act exclusively locally - this is the safety of their use even during breastfeeding. In addition, they moisturize the vaginal mucosa, acting as a lubricant. The disadvantages are:

• low reliability;
• inconvenient to use (you need to calculate exact time before sexual intercourse);
• sometimes a burning sensation in the woman and her partner;
• cannot be used frequently (the composition of the vaginal microflora is disrupted);
• After sex, you should not take a shower or bath for a certain time (this will reduce spermicidal properties).

Due to its relatively low effectiveness, this method of contraception is best chosen as additional protection or when ovarian activity decreases (during lactation, at the beginning of menopause).

It is optimal to use it in conjunction with condoms: spermicides will enhance protection against infections, protect against damage to the condom, and also act as a lubricant.

Chemical contraception usually comes in the following forms:

• candles;
• cream;
• foam;
• films;
• jelly;
• tampons;
• balloons.

Which one to choose depends on the situation and type of drug:

• most famous drug- Pharmatex, it is available in various options, the most long-term action(up to 24 hours) tampons have;
• Patentex Oval and Conceptrol in the form of suppositories are administered 10 minutes before intimacy;
• Gynekotex - vaginal tablets, having antibacterial effect and valid for 4 hours after administration;
• Benatex gel will help relieve inflammation of the vaginal mucosa.

Thus, it can be used in various situations different drugs: Genikotex is optimal in case of unprotected sex with a new partner, Benatex - for colpitis, if everything is in order and the woman is more or less confident in her partner, then Pharmatex, Patentex Oval or Coceptrol are suitable. Whatever medications are chosen, it is important to follow the instructions exactly and not hygiene procedures certain time after intimacy.

By the way, it was at the creation unfavorable environment the majority is based on sperm folk remedies. Many recipes advise women to introduce an acidic solution into the vagina by douching. It is better to ignore such advice - commercial spermicides are much more reliable and safer.

Hormonal agents

Conventional oral contraceptives should not be used if you have irregular sex life. What hormonal pills are they rarely used? There are so-called emergency or post-coital remedies that are created specifically in case of unprotected sexual intercourse.

Having taken pills after unprotected sex, a woman can practically not worry about the occurrence of an unwanted pregnancy, however large doses hormones often have an adverse effect on the body: one tablet can cause painful menstruation and on long months disrupt the normal menstrual cycle. That is why such contraception is called emergency - it is created for use in exceptional, extremely in rare cases, it is better not to resort to it more than twice a year.

Hormonal pills single use most often contain levonorgestrel - synthetic analogue progesterone. It has the following effects on the reproductive system:

• delayed ovulation;
• thickening of cervical mucus;
• thinning of the uterine endometrium.

If the drug is taken on time, then pregnancy is practically excluded - even if ovulation has occurred and fertilization has occurred, the egg will not be able to attach.

The drug should be taken as quickly as possible after unprotected sexual intercourse: no later than three days later, the first tablet is taken, then after 12 hours - the second. Taking two tablets at once just to be on the safe side can be life-threatening - high doses of hormones can cause thrombosis and other terrible consequences.

Emergency hormonal contraception most often causes a number of unpleasant symptoms, such as:

• nausea and vomiting;
• diarrhea;
• abdominal pain;
• pain and engorgement of the mammary glands;
• menstrual irregularities;
• headache;
• feeling tired.

It must be taken into account that the contraceptive effect of the pill may decrease after vomiting and severe diarrhea. You need to carefully study the instructions for contraindications, possible interaction with other medications and side effects.

Another common group is tablets based on mifepristone, a progestogen antagonist. It means that this substance blocks the action of the hormone progesterone, as a result of which the fertilized egg cannot attach to the endometrium, and in large dosages, contractions of the uterus occur, expelling it. Mifepristone and medicines based on it (Gynepristone) are taken within 72 hours after unprotected contact to protect against unwanted pregnancy, and even to terminate pregnancy (in very high doses, no later than 42 days of delay, strictly under the supervision of a doctor)

is a very reliable remedy, but it greatly affects a woman’s health, despite the fact that it cannot be considered a hormonal agent (in fact, this substance is only a hormone blocker), so its use unless absolutely necessary is unacceptable. In case of heavy bleeding and pain, it is better to consult a specialist. Strong post-coital medications should never be used as regular contraception.

Whatever remedy you choose, the main thing is to take care of your health in a timely manner. It would be optimal to combine barrier and chemical methods contraception, since they can perfectly complement each other, protecting against pregnancy and infections. Moreover, these funds local application and do not provide negative impact on the body.

Whenever discomfort after unprotected sexual intercourse, as well as if you suspect pregnancy, it is better to consult a doctor without delay.

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Contraception is a way to prevent unwanted pregnancy. Throughout the history of mankind, many of these methods have been invented: from the usual “depending on your luck” to the idea of ​​protecting yourself with the droppings of domestic animals. Fortunately, contraceptive methods have now been developed, the description of which does not make you want to faint.

How to choose contraception

Before choosing a method of contraception, you need to remember that safe sex is not one that does not lead to pregnancy, but one that prevents you from catching sexually transmitted infections, including HIV and hepatitis.

If you do not have a regular partner, if you both do not know your HIV status (that is, there is no certificate), if you have a new partner, then you can only protect yourself with condoms.

For those who have been in a relationship for a long time and do not forget to get tested or are interested in donating, the choice of contraception is much wider, and the choice must be based on the effectiveness of the method.

• Theoretical effectiveness shows how many women out of a hundred who used this method became pregnant within a year. Moreover, they used this method perfectly: according to the instructions.
• Practical effectiveness shows how many women get pregnant in the real world, where even contraception cannot be used perfectly. For example, partners don’t put on a condom on time, women miss pills or forget to go to the doctor to replace the contraceptive on time.

We will show only data close to reality. The lower the number under “efficiency” in the description of each method, the better: this means that fewer women got pregnant while using this remedy. Since the figures differ slightly between sources, we indicate the maximum number of pregnancies - just in case.

And don’t forget to consult your doctor which method is right for you.

Hormonal methods

About hormonal contraception Many people know it, but they usually understand it only as tablets. But hormones can be delivered to the body in different ways.

Pills

Efficiency: 9.

How does it work

Advantages

Very high efficiency when used correctly.

Flaws

Tablets are expensive, especially new ones and the safest ones, they have many contraindications and side effects. Due to a number of factors (medicines, illness, stress), drugs become less effective.

Injections

Efficiency: 6.

How does it work

Just like pills, only you need to take hormones in the form of injections not every day, but once every few weeks.

Advantages

The same as tablets, but you don’t have to think about taking the drug every day.

Flaws

The same as for tablets, plus you need to come to the clinic often for repeated injections.

Rings

Efficiency: 9.

How does it work

The ring, which contains a dose of hormones, must be inserted into the vagina and changed once a month.

Advantages

Same as tablets, plus whole month no need to remember the drug.

Flaws

It may be inconvenient to install the ring, sometimes there is a feeling foreign body inside.

Plasters

Efficiency: 9.

How does it work

A patch with a dose of hormones should be glued to the skin and changed once a week.

Advantages

The same as for tablets, plus you don’t have to remember about the drug every day.

Flaws

It’s not always convenient to walk around with a patch; it’s an unusual method.

Implants

Efficiency: 0.09.

How does it work

An implant is implanted under the skin with a dose of hormones for three years.

Advantages

It works effectively, you can forget about contraception for a long time.

Flaws

The same as for tablets, in addition, the place where the implant is inserted may become inflamed.

Barrier methods

Barrier methods create an obstacle to the path of sperm to the uterus. These are some of the most ancient methods of contraception, with varying effectiveness.

Male condoms

Efficiency: 18.

How does it work

Before sexual intercourse, a condom made of latex or other materials is put on the penis (they were invented for those who are allergic to latex). The condom retains sperm and creates a barrier to germs that are transmitted from biological fluids and in close contact.

Advantages

Condoms are inexpensive and are sold in any pharmacy or supermarket, they are effective, they have no contraindications, and they are easy to use. And this method of contraception best protects against sexually transmitted infections.

Flaws

You have to learn how to put them on. And the main thing is to convince your partner that “it doesn’t feel the same with a condom” - this is a very bad excuse.

Female condoms

Efficiency: 21.

How does it work

The principle is the same as that of male condoms: there is a polyurethane tube, only female condoms have harder rings at the ends. Before sex, you need to insert a latex bag into the vagina and remove it after sexual intercourse.

Advantages

Protects against STIs.

Flaws

They are not convenient for everyone and cause psychological discomfort.

Cervical caps and diaphragms

Efficiency: 12.

How does it work

These are mini versions of the female condom: they do not cover the vagina, but only the cervix, so that sperm cannot penetrate it. Diaphragms are larger, caps are smaller.

Advantages

It is not necessary to install it immediately before sex - it can be done earlier (a few hours before).

Flaws

When you first start using it, it can be difficult to get the hang of how to install and remove them. You need to consult a doctor to choose the size, but the effectiveness of the method is low.

Sponges

Efficiency: 18–36(the first number is for women who have not given birth, the second number is for women who have given birth).

How does it work

A contraceptive sponge is a kind of cap made from a sponge soaked in spermicide. That is, the sponge simultaneously creates a barrier and reduces sperm activity.

Advantages

Can be installed a few hours before sex.

Flaws

Same as caps and diaphragms, plus possible allergy for spermicide.

Spermicides

Efficiency: 28.

How does it work

Spermicides are substances that close the entrance to the uterus and suppress sperm activity, thereby reducing the likelihood of pregnancy. Active ingredients are different and depend on the specific drug. Available in different forms: candles, creams, aerosols.

Advantages

Inexpensive, with few contraindications and side effects.

Flaws

Sometimes they are inconvenient to use: for example, if you need to introduce spermicide for some time certain time before sexual intercourse, and this time cannot be calculated accurately. Sometimes they cause allergic reactions and discomfort in a partner.

Intrauterine devices

Intrauterine devices are exclusively a woman's business. IUDs can be installed at any age; after their removal there are no problems with pregnancy, but there is a practice in which nulliparous women and women under 25 years of age are not given IUDs - they are afraid of complications.

Spirals with copper

Efficiency: 0.8.

How does it work

A foreign body - a copper coil - in the uterus causes a local inflammatory reaction and prevents the egg from implanting.

Advantages

Installs for a long time, does not interfere with Everyday life, highly effective.

Flaws

There are contraindications and side effects: irregular bloody issues, menstruation intensifies. Only a doctor can determine it.

Spirals with hormones

Efficiency: 0.2.

How does it work

A dose of hormones is added to the action of the spiral, this enhances the contraceptive effect of the spiral.

Advantages

Very high reliability, long lasting effect.

Flaws

There are contraindications and side effects from the installation, as is the case with a regular spiral.

Cycle calculation methods

These methods of contraception are often practiced together in order to enhance the others by the action of one. But even in such cases, these are not the most effective solutions.

Calendar method

Efficiency: 20.

How does it work

To get pregnant, you need a mature egg that is ready for conception within about a day. Therefore, if you time ovulation, when the egg is released from the ovary, and do not have sex for several days before and after ovulation, you will not be able to get pregnant.

Advantages

The method does not require any costs, you only need a calendar to monitor the cycle.

Flaws

This is an imprecise method. It can only work in women whose cycle is ideal and ovulation always occurs at the same time. And such women are not easy to find, especially since various factors - from stress to medications - can affect the cycle. Therefore, a woman can become pregnant on any day of the cycle.

Temperature measurements

Efficiency in theory: 20.

How it works

Essentially this is a calendar method, only with additional dimension for fidelity. In theory, on the day of ovulation, basal temperature rises sharply. That is, if for several months you measure the temperature in the vagina or rectum every morning without skipping, then on the day of ovulation you can notice an increase.

Advantages

The method is 20 rubles more expensive than the calendar method: you need to buy a thermometer.

Flaws

It takes a very long time to measure the temperature without skipping, and it is better immediately after waking up, without getting out from under the blanket. Many factors have to be taken into account, because the temperature rises not only due to ovulation. The method is labor-intensive, but also not very accurate.

Coitus interruptus

Efficiency: 22.

How it works

You need to end sexual intercourse before the sperm enters the vagina. This is not exactly contraception, because sperm are also contained in lubricant.

Advantages

Worthless.

Flaws

You always have to worry about whether you can stop sex for real. interesting place, and then worry whether it happened this time or not.

Sterilization

Sterilization is a surgical procedure after which it is impossible to have children naturally at all. Since there are no absolute numbers in medicine, a ghostly chance remains, but it is just that, ghostly (in the event of an error in a procedure, for example).

In Russia there is a restriction on sterilization: it can only be done by people over 35 years old with two children.

Women's

Efficiency: 0.5.

How does it work

During surgery, the fallopian tubes are ligated or removed so that the egg from the ovary does not enter either the tube or the uterus.

Advantages

Highly effective, contraception for life.

Flaws

Surgical intervention; conceiving a child after the procedure is possible only with the help of IVF.

Men's

Efficiency: 0.15.

How does it work

During the operation, the surgeon ties or partially removes the vas deferens, so sperm do not enter the ejaculate.

Advantages

Highly effective, no side effects or contraindications, and does not require attention for the rest of your life.

Flaws

Surgery, you cannot change your mind and conceive a child.

Traditional methods

Numerous remedies such as douching with lemon or any other juice may have a slight spermicidal effect, but their effectiveness tends to zero. But unpleasant consequences in the form of inflammation, allergic reactions and you are guaranteed to have unpleasant sensations.

For every family, the birth of a child is happiness, but not everyone can give him good conditions and proper education. To avoid unwanted pregnancy, there are means, methods and methods of contraception that enable women and men to maintain a safe sex life, these are oral and hormonal contraceptives. The following describes the types of contraception and their percentage of safety.

What is contraception

This is to prevent unwanted pregnancy. Means are divided into mechanical, chemical and other preparations for safe sexual intercourse. Modern contraceptives divided into women's and men's. Using this technique, they not only prevent pregnancy, but are protected from:

• different venereal diseases(syphilis, herpes, chlamydia or gonorrhea);
• human immunodeficiency virus.

Contraceptives for women

There are many contraceptive options for women. safe sex, they all have different index Pearl. This special study, which determines annually what percentage of women who used one or another method of protection became pregnant. Means of protection (contraceptives) are divided into:

• physiological;
• barrier;
• spermicidal;
• hormonal;
• non-hormonal;
• emergency protective equipment;
• traditional methods.

Male contraceptives

There is no such range of contraceptives for men, but scientists are actively developing methods of contraception for men. Basically, a man can use a condom or sterilization - these methods are not always comfortable, so there are little-known protection options: these are subdermal implants, birth control pills for men and the male IUD. To use one of these methods of contraception, a man will need to discuss them with his healthcare provider.

Modern contraception

If before people simply abstained from sex to avoid having a child, then today there are many ways to protect against various diseases or pregnancy. For example, modern oral contraceptives for women have now become popular. They are convenient, and if the couple decides to have a child, the pills can be stopped, and the pregnancy rate increases.

Why are they needed?

Such funds are needed in order to avoid abortion (termination of pregnancy at early stages), which can lead to problems and diseases of the reproductive system, infertility and other complications. Remedies help avoid early pregnancy: at this age a girl cannot always bear a child. Contraceptive methods can be used by women after 40 years of age. Pregnancy at this age can cause the birth of a child with abnormalities in chromosomes.

Contraceptive effectiveness as a percentage

In total, there are 3 groups of contraceptives: barrier, chemical, mechanical. A wide range of contraceptives allows women and men to choose methods of protection that are convenient for them. For selection optimal option For contraception, it is recommended to consult your gynecologist. Next, we will consider the groups and types of contraceptives, determine their effectiveness, advantages and disadvantages.

Barrier methods of contraception

The most common and simplest methods of contraception today are barrier contraceptives. These include:

• male condoms;
• female condoms;
• vaginal diaphragms.

The mechanism of action of this group is that the products block the penetration of sperm into cervical mucus. The male condom comes in the form of a thin, oblong latex shell. The product for women is a polyurethane tube (dimensions: diameter - 8 cm; length - 15 cm). Vaginal diaphragms or cervical caps are made from latex or silicone. Pearl index (efficiency):

• male/female contraceptives – from 7 to 14%;
• cervical caps – 5%;
• vaginal diaphragms – from 6 to 20%.

The principle of operation of the male condom: is put on the penis during an erection. Its advantages: protects the mucous membranes of partners during direct contact; prevents infections, hepatitis, HIV, pregnancy; It has different sizes and surfaces. Cons: may tear; requires a stable erection. How the female condom works: it is inserted into the vagina. Pros: the contraceptive is used for weak erections; can be left in the vagina for several hours. Cons: these products are not sold in the CIS countries.

Vaginal diaphragms and cervical caps: Placed into the vagina using special spermicidal creams. Pros:

• reduce the risk of transmission of infections;
• can be used repeatedly;
• prevent pregnancy.

Disadvantages of cervical caps: you can become infected with HIV; not always effective for women who have given birth; may cause discomfort during sex; Sizes with recommendations can be obtained from a gynecologist. Disadvantages of the diaphragm: after childbirth, you need to select a different size, as when a woman’s weight changes from 5 kg; the risk of cervical inflammation increases; possible infection.

Chemical methods of protection

In addition to barrier ones, chemical contraceptives are popular. These are: vaginal creams, suppositories (suppositories), tampons. The products have contraceptive properties, protect against viruses and bacteria (staphylococci, herpes, chlamydia, candidiasis). Suppositories, vaginal tablets and films are inserted into a girl’s vagina 25 minutes before sex: during this time they have time to dissolve. Popular products are Patentex Oval and Pharmatex. Pearl index chemical methods protection – from 6 to 20%. The products are used 15 minutes before sex. Foam, gel and cream begin to act after use.

Spermicides (contraceptives) have the following advantages: increase protection against herpes, chlamydia and other sexually transmitted diseases; have a bactericidal effect. Disadvantages: increase the permeability of the vaginal walls (there is a possibility of HIV infection); upon contact with soap, the active effect is destroyed; short-term effect (except tampons); requires replacement at the next sexual intercourse.

The following are distinguished: hormonal contraceptives: combined oral contraceptives, injections, mini-pills, emergency contraception. They help protect against unwanted pregnancy by “replacing” the work of the ovaries. According to the principle of action there are multiphase, two-phase or three-phase, according to the form of release - tablets, implants, injectable drugs. Efficiency:

• combined contraceptives(oral) – from 0.15 to 5%;
• mini-pills – from 0.6 to 4%;
• injections – from 0.3 to 1.4%;
• implants – up to 1.5%.

Combined oral contraceptives are used daily for 21 days, at the same time, starting from the first day of menstruation. Mini-pills are used immediately before sexual intercourse, half an hour. Injections are administered 2-3 times per month. Benefits: improves facial skin condition; the menstrual cycle is normalized; the risk of ovarian cancer is reduced; the breasts enlarge and become firm; protect against unwanted pregnancy; use is possible in the absence of various diseases. Flaws:

• no protection against sexually transmitted diseases;
• with long-term use, the risk of developing candidiasis, heart attack, breast, liver and cervical cancer increases;
• there are many contraindications; during the break between doses, the risk of becoming pregnant increases;
• side effects may occur.

Mechanical contraception

The most popular mechanical contraceptives are the vaginal ring (NovaRing) and the contraceptive patch (Evra). Their main purpose is to prevent pregnancy. The ring is made of elastic material, the patch is made of thin soft polyurethane. Efficiency:

• hormonal ring– from 0.4 to 0.65%,
• hormonal patch– from 0.4 to 0.9%.

The ring is inserted into the vagina, adjusting to the contours of the girl’s body; The patch is glued to different parts of the body (under the shoulder blade, lower abdomen, buttock or forearm). Advantages: does not reduce the sensitivity of partners during sex; does not prevent the girl from playing sports; does not affect blood clotting; designed for 1 cycle (21 days). Disadvantages: does not protect against STDs and HIV.

The contraceptive patch has the following advantages: changes every week; can be glued to any part of the body, convenient for travel, natural conditions where it is not possible to use another method of contraception. Its disadvantages: contraindicated smoking girls(10 or more cigarettes per day); does not protect against STDs, is effective for women from 18 to 45 years old.

Intrauterine contraceptives

The following are the most popular intrauterine contraceptives:

• IUD Mirena;
• Levonov's hormonal IUD;
• hormonal Nova-T;
• CooperT 380A;
• MultiloadCu-375.

Mechanism of action: the fertilized egg does not attach to the wall of the uterus when using this type of contraceptive. The installation is carried out only by a gynecologist. Contraception for women of this type is installed in the uterine cavity. The IUD or IUD is considered a reliable method of birth control, but there are possible complications and contraindications:

• inflammatory processes in the pelvic organs;
• hidden chronic or acute infections;
• the presence of tumors of the reproductive system;
• cervical dysplasia;
• anemia;
• uterine bleeding;
• diseases of the endocrine glands.

Complications:

• the risk of exacerbation increases inflammatory processes in the uterus and appendages;
• During menstruation, menstrual blood loss increases and periods last longer than usual;
• the likelihood increases ectopic pregnancy;
• appear smearing vaginal discharge;
• perforation of the uterus.

Advantages: the spiral is installed for 5 years; it is possible to remove it if necessary; contraceptives are suitable for nursing mothers. Disadvantages: the risk of infection and the development of inflammation and infections increases. All questions regarding installation must be discussed with a doctor; such a decision cannot be made independently (depending on hormonal levels and other factors).

Natural methods of contraception

Natural biological methods Contraception is a way to protect against unplanned pregnancy. They are used only by women who have a regular and stable menstrual cycle. The girls keep records of dangerous and safe days for unprotected sexual intercourse. These methods are divided into calendar, temperature, cervical methods and interrupted coitus.

Calendar

The calendar method is the calculation of the day of ovulation. Suitable for girls and women with regular menstruation. Ovulation occurs in the middle of the menstrual cycle, from this day the girl can calculate the period when she can become pregnant (2-4 days before and 2-4 days after). Unfortunately, the method is not always effective, because ovulation can occur on other days of menstruation.

Temperature

The temperature method consists of constructing a graph of basal body temperature, that is, when a woman is at rest. It can be measured using a rectal thermometer. During the first phase of menstruation, a woman’s temperature is slightly lower, and during ovulation it rises and remains this way until the next one. By making this chart, you can understand when ovulation occurs, so you can avoid sex during these times. dangerous days.

Cervical method

The essence of this method is that during the day the girl should observe the vaginal mucus after the end of menstruation. If the endometrium does not contain mucus, then you can continue to have sex without restrictions. It becomes viscous during the maturation of the egg. On such days it is better to use additional funds protection.

Coitus interruptus

Coitus interruptus is the cessation of sexual intercourse before ejaculation, outside the girl’s vagina. This is a safe method of contraception, because, for example, hormonal contraceptives can cause side effects. However, the possibility of getting pregnant always exists: during sex, pre-seminal fluid is released (it contains up to 20 million sperm).

Hormonal methods of contraception

There is a classification of hormonal methods of contraception: gestagenic and combined. The first group includes monophasic, multiphasic oral contraceptives, as well as injections, patches and a vaginal ring. Combined ones include implants, IUDs and vaginal rings with progestogen. Next, we will consider contraceptives, and which of them belong to one of the two groups.

Oral contraceptive pills

Progestin oral contraceptive pills are divided into monophasic, biphasic and triphasic:

• Monophasic drugs include such drugs as: Gestodene, Desogestrel, Regividon, Microgynon, Miniziston.
• Two-phase include the following drugs: Femoston; Binovum, Neo-Eunomin, Adepal and Biphasil.
• The following drugs are classified as three-phase: Tri Mercy, Triziston, Tri-Regol.

Vaginal rings and patches

The group belongs to the combined hormonal methods contraception. At the moment, Evra is considered the most popular patch, and among vaginal rings, Nova-Ring is distinguished. The latter remedy is used often: there are few side effects, and there are more benefits than in oral contraceptives. The Evra contraceptive patch is more convenient to use: you don’t need to insert anything into the vagina that could damage its walls, and you also don’t have to swallow it like pills, which can lead to liver problems.

Mini-pill

Small pills are contraception for women and are recommended to be taken during lactation, when smoking in older women and for heart pathologies. Mini-pills are gestagenic hormonal drugs contraception. This includes drugs such as: Charozetta, Continuin, Exluton, Primolut-Nor, Micronor, Ovret. For consultation on the choice, it is recommended to contact your treating gynecologist.

Hormonal injections

Injections or hormonal injections belong to the group combination drugs. The advantage of protection is that the woman does not need to take daily pills or insert new vaginal rings. For injections, drugs such as Net-en and Depo-Provera are used. The disadvantage of these contraceptives is that you need to use a condom for the first 20 days.

Capsules for implantation

Special capsules for implantation belong to the group of progestin hormonal contraceptives. These capsules are implanted under the skin. This implant is called Norplant. When using it, you can not use contraceptives for 3-5 years. The product can be used during lactation and various diseases, in which other hormonal contraceptives are strictly prohibited.

Postcoital contraception

Emergency contraception used in case of unprotected sexual intercourse. Such tablets can be used within 1-3 days after the end of sexual intercourse. With their help you can avoid unwanted pregnancy. Contraceptives are used in the following cases:

• rape;
• incorrectly performed interrupted sexual intercourse;
• unprotected sex;
• in case of condom breakage.

Sterilization

Complete sterilization is a method of contraception for both women and men. Male sterilization- this is a vasectomy, and in women - tubal occlusion. In progress surgery a woman is given an artificial obstruction fallopian tubes, and in men the vas deferens are ligated, but the testicles and ovaries are not removed, no negative influence on the couple's sex life.

Methods of contraception after childbirth

Immediately after childbirth, it is recommended to abstain from sex for 1-2 months to avoid infection of the vaginal sutures. After the period has passed, it is recommended to go to the gynecologist and buy the contraceptives you need. Gynecologists recommend using the following as contraception:

• intrauterine device;
• barrier, hormonal contraceptives;
• sterilization

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obstetrics and gynecology Articles

Ways to prevent unwanted pregnancy

“Russia ranks one of the first places in the world in the number of regularly performed abortions,” says the deputy director of the Federal State Institution “ Science Center obstetrics, gynecology and perinatology" Vera Prilepskaya. “In terms of the rate of decline in the number of abortions, we also lag significantly behind other countries.” Doctors never tire of saying that it is better to prevent “trouble” than to deal with its consequences, especially since nowadays there are many available ways protection against unwanted pregnancy, for every taste and color. We invite you to look into this issue a little more seriously.

Unreliable methods

Experienced gynecologists tend to believe that there are simply no days of the menstrual cycle that are safe for conception. Firstly, accurately determine the moment of ovulation even with the most regular cycle- a task almost impossible. Most often, it is possible to do this only after the fact, while not only the days after ovulation, but also before it will be considered “dangerous”. Secondly, sperm retain the ability to fertilize for up to 6-7 days while in the woman’s genital tract. Consequently, any woman who has at least one sexual contact with a partner per week is not immune from pregnancy. Of course, the methods that we will now list help reduce the likelihood of an undesirable event, but at the same time they can fail at any time due to their extreme unreliability.

Calendar method. Duration of the menstrual cycle different women ranges from 21 to 35 days. The task is to more or less accurately calculate the moment of ovulation. The egg leaves the ovary, on average, on days 11-15 of the cycle. These days the risk of pregnancy is highest. A few days before ovulation and a few after are also “dangerous”.

Interrupted sexual intercourse. This is not only unreliable, but also an extremely harmful method of protection for the body. Let's start with the fact that sperm are contained in male lubricant, which is secreted throughout sexual intercourse, so ejaculation is not the only possibility of conception. In addition, the need to constantly control yourself and be interrupted at the most crucial moment has a negative impact on the health of the stronger half of humanity. According to research, the practice of interrupted acts can lead to impotence.

Douching. Sperm are in the fallopian tubes within 90 seconds of intercourse, so if you plan to “catch up and neutralize” them all, you will have to hurry. Jokes aside, douching with acids or, for example, putting a slice of lemon in the vagina, which some people think of, can be very unsafe. At the very least, these exposures cause chemical irritation and burns.

Shower. A warm shower after sexual intercourse is an excellent means of personal hygiene, but it is not a method of contraception. It is impossible to “wash away” sperm from the vagina.

Medical methods (hormonal, barrier, intrauterine)

So, let's now discuss contraceptive methods, the effectiveness of which has been confirmed by scientific research.

Emergency contraception

Within 72 hours after unprotected sexual intercourse (or if the chosen method of contraception was unreliable: the condom broke or slipped, an error crept in in calculating the days of ovulation, or 2-3 tablets were missed in the course of hormonal contraceptives), it is possible to prevent an unwanted pregnancy by using emergency contraception (for example, Postinor). The first tablet of the drug should be taken no later than 72 hours after sexual intercourse, the second - after another 12-16 hours. The action of the pills is due to the inhibition of ovulation and the prevention of fertilization, as well as changes in the endometrium that prevent the implantation of a fertilized egg. Emergency contraception has long been recognized as extremely unsafe for a woman’s health (including the development of infertility).

Radical methods

Radical methods of contraception are voluntary sterilization procedures: tubal ligation in women and vasectomy in men. TO this method Couples who do not plan further offspring have the opportunity to apply. Required condition is over 35 years of age or having at least 2 children. In the USA, about 20% of men decide to undergo sterilization, in China - about 50%, in Russia the procedure is less popular due to its irreversibility and the strong opinion that it affects potency and hormonal background(which is denied by doctors).