A barrier method of contraception involves protecting against unwanted pregnancy and STDs (STIs) by using a variety of barriers to prevent sperm from entering the vagina or cervix.

Barrier contraception is divided into:

• Mechanical means(condoms: male, female; caps and vaginal diaphragms)
• Chemicals(spermicides)

If you combine these means, you get a combined barrier method of protection, for example: spermicidal foam and a cap.

IT IS IMPORTANT TO KNOW! No contraceptive means provides 100% guarantee of protection against conception and sexually transmitted diseases (infections). However, with proper storage and use, the risks are minimized, because Barrier methods of protection are quite effective.

Condoms

The male condom is the most common and unpretentious means of protection. It is a thin sheath made of latex, polyurethane or vinyl, which is rolled out over the man’s penis immediately before sexual intercourse begins.

They became widespread and popular because of their undoubted advantages:

• Availability and relatively low cost
• Huge selection and variety
• Convenience and speed of use
• Can be used during pregnancy (early stages)
• Can be used during lactation (breastfeeding)
• Can be used with other contraceptives
• Sold without a prescription
• No medical examination required before use
• Using a condom you can lengthen the time of erection and prolong the time before ejaculation (ejaculation)

From obvious disadvantages condoms can be distinguished:

• Decreased natural sensations during sexual intercourse
• Not the highest efficiency
• Possible or lubricant

Barrier methods of contraception for women:

Themis

The female condom is not popular in Russia for several reasons:

• Low prevalence (not available in pharmacies)
• High price
• Some possible difficulties with use
• Possible inconveniences during use

The undoubted advantages include the fact that the use of a female condom does not imply the participation of a man, which means that a woman can protect herself on her own.

Vaginal diaphragm

The diaphragm is a dome with a diameter of 50-105 mm, made of latex rubber. At the base of the dome there is a metal spring of a flat, spiral or arched shape, securely covered with a layer of rubber.

The diaphragm is placed inside the vagina in such a way as to prevent sperm from entering the cervix.

ATTENTION! The diaphragm itself does not protect against sexually transmitted diseases (STIs) unless used in conjunction with spermicides.

Pros:

• Quick effect
• Can be used during lactation (GW)
• Can be administered in advance (6 hours before PA)
• No side effects

Minuses:

• Relatively low efficiency
• Before starting use, be sure to visit a gynecologist
• After PA you cannot remove it for 6 hours
• Inconvenience during insertion into the vagina
• Possible infections due to poor hygiene
• There are contraindications (individual intolerance, the presence of infections, anatomical abnormalities of the vagina, pain in the perineum between acts of intercourse, up to 12 weeks after childbirth, bleeding during the intermenstrual period)

Cervical cap

This is a small diaphragm that covers only the cervix. The caps have different sizes, so they are selected only by a gynecologist. Made from rubber.

In general, all the pros and cons are the same as those of the diaphragm.

Mechanical means also include non-hormonal ones.

Spermicides

These are substances (benzenkonium chloride, nonoxylon-9, octoxynol, menphegol, A-gen 53 (A-gen 53) or syn-a-gen (Syn-a-gen)) that partially or completely destroy or deprive sperm of activity.

They have several forms of release:

• Cream, Gel, A aerosol (foam)– applied to the genital area, to diaphragms and caps, and to condoms. Effective immediately.
• Vaginal sponges(oval-shaped synthetic fiber pads 2.5 cm by 5 cm, impregnated with nonoxylon-9) - belong to combined barrier contraceptives, because have both mechanical and chemical effects. By retaining sperm in the sponge, they protect the cervical canal from sperm + secrete spermicide.
• Vaginal tablets, films and suppositories— begin to act 15 minutes after administration.

Pros:

• Fast and easy to use
• There is no need to visit a gynecologist before use
• Provide additional lubrication during sex
• Have an antibacterial effect
• Available without a prescription
• Does not affect pregnancy

Minuses:

• Relatively low effect
• Suppositories and tablets must be administered 10-15 minutes before the start of PA
• The effect lasts only 2-6 hours (sponge up to 24 hours)
• Possible side effect - irritation of the vaginal mucosa or skin of the penis
• Cannot be used during breastfeeding or pregnancy
• There are a number of contraindications (drug tolerance, abnormal development of the genital organs, health problems affecting a woman’s reproductive function)

ATTENTION! When using spermicides, do not wash with soap for two hours before and three hours after. This reduces their effectiveness.

The market and range of barrier contraceptives is huge. You can choose any contraceptive method that suits you. When choosing, you should take into account the individual characteristics of your body and the desires of your partner.

Barrier methods of contraception (BMC) are a group of methods to prevent the development of unwanted pregnancy, which prevent sperm from entering the uterus using a mechanical barrier.

Types, advantages and disadvantages of barrier methods

There are 2 types of means:

• mechanical;
• spermicides.

There is a combined method, when mechanical means are combined with medications. This method improves the reliability of both methods.

Mechanical contraceptives prevent sperm from entering the cervix. Their main advantage is that they do not have any harmful effects on women, unlike hormone-containing medications, and protect against contracting sexually transmitted diseases. The efficiency is about 85%.

You can use barrier-type products without first consulting a doctor.

Barrier methods of contraception are quite cheap, accessible and most often have no contraindications. They can also be used in the following cases:

• during breastfeeding, since they will not affect either the volume of synthesized milk or its quality;
• if taking oral contraceptives is contraindicated;
• if you need to take medications that are not combined with oral contraception;
• after an abortion, before the onset of a favorable period for conception;
• during the use of oral contraceptives, during a period when ovarian activity is not completely suppressed;
• as a temporary means of preventing conception before sterilization.

The disadvantages of mechanical contraceptives include their lower degree of effectiveness compared to oral hormone-containing drugs, and the possibility of an allergic reaction to certain materials (latex, rubber). The products must be used before each sexual intercourse.

In most cases, the use of barrier contraceptives will not have a negative effect, but there are contraindications for use: with inflammatory diseases, deformation of the cervix, a history of toxic shock syndrome, etc.

Contraceptives of both types can be for women or men.

Read also:

The best and most effective.

Symptoms.

Read about how genital herpes is transmitted.

Female barrier contraceptives

Barrier contraceptives for women are a more preferable option for many, as they do not require consultation with a doctor, the involvement of specialists for administration (unlike spirals) and systemic changes. These devices include the diaphragm and cervical cap.

The diaphragm is a small cap made of special rubber that must be inserted before sexual intercourse. The size of the diaphragm can be different (50-100 mm), and is selected individually at a doctor’s appointment. For nulliparous women, a diaphragm of 60-65 mm is usually prescribed. After childbirth - up to 75 mm. After the birth of a child or weight changes (weight loss, weight gain), you need to re-size. The effectiveness of this product is quite high.

Before using the diaphragm, you must ensure that there are no cracks or other damage. After intercourse you need to leave it for 7 hours. Immediately after removal, rinse and dry. You can store it in a dry, dark, cool place, but without using talc. When used correctly, the diaphragm efficiency can reach 85%.

Its advantages are:

• harmlessness;
• protection from STDs;
• ease of use;
• possibility of repeated use.

The use of this remedy is contraindicated in case of allergies to rubber and certain diseases, such as erosion or prolapse of the cervical walls, colpitis, and developmental anomalies.

Cervical (cervical) caps are made of soft rubber. Available in 3 types depending on the shape. The cap is held in place by the vaginal walls and covers the cervix. It is not recommended to set it for longer than 4 hours. Efficiency ranges from 73 to 90%. The type and optimal size are determined by a gynecologist during examination, depending on the size and shape of the cervix. Used in combination with spermicide: it is applied to the surface of the cap.

Barrier type contraceptives for men

The release of barrier contraceptives for men is carried out in only one version - condoms. They allow you to protect yourself from infections with a high degree of probability. Produced from elastic thin rubber in the form of a bag-like formation. This method is considered quite common today, despite the emergence of more effective means of such contraception.

This barrier method has the following advantages of use:

• simplicity - used immediately before sexual intercourse;
• protects against STDs, including HIV, which is currently of great importance;
• can be purchased at any pharmacy and many stores;
• There is no need to consult a doctor before use.

There are also disadvantages to this method of contraception: the need to use it at a certain stage, a possible decrease in sensations and the appearance of an individual allergic reaction. The possibility of a break remains. Low efficiency requires the use of additional chemical protection agents (spermicides).

Condoms can be used as an “insurance” for couples who have irregular sexual relations, as well as in the presence of more than one partner. It is not recommended to use this method of protection during regular sexual intercourse. It should not be used if you are allergic to the materials used in the manufacturing process of the condom and if pregnancy may pose a danger to the woman (due to age, health problems, etc.).

Chemical methods of protection

Chemical methods are represented by spermicides - agents that reduce the activity of sperm or destroy them. The composition includes active substances (nonoxylon, benzolkonium chloride), which reduce sperm motility and reduce their ability to fertilize. They may also protect against certain types of sexually transmitted diseases.

Spermicides are produced in the form of aerosol foam, suppositories, gels, and tablets. Aerosol foam requires strict adherence to the instructions, otherwise the effect will inevitably decrease. For example, the effectiveness will decrease if the foam canister is not shaken well or if too little foam is applied before administration.

Creams and gels are intended for use by women before sexual intercourse. Creams are not recommended for use as a stand-alone product due to their low effectiveness. Therefore, they are recommended to be used only as an addition to mechanical means.

Tablets and suppositories can guarantee reliable protection, but are not convenient enough to use, since they must be administered approximately 15 minutes before intimacy. The protection lasts for about an hour, so if it occurs again, you will have to reintroduce the suppository.

The effectiveness of most chemical products cannot be called high: from 5 to 25 pregnancies out of 100 are observed per year (depending on the type of spermicide used). Therefore, you should not use them as the main means. Before using chemical barrier contraceptives, you should consult your doctor.

The essence of barrier contraception is to prevent sperm from entering the cervix. The simplest and most well-known method of such contraception is male condoms. However, let's consider barrier contraception for women. There are two methods: mechanical and medicinal. In this way, the cervix is ​​isolated from the vagina or methods are used that kill sperm.

There are a great variety of contraceptive methods available today. Today there are enough means to prevent unwanted pregnancy for both men and women. Barrier methods of contraception are intended for women and are intended primarily for those who, for some good or bad reason, do not want to take birth control pills, for example. The principle of operation of such barrier contraceptives is to introduce chemicals directly into the vagina, which prevent sperm from penetrating further into the vagina, simply destroying them. That’s why the products are called “barrier”, since they essentially create a barrier for sperm, enveloping the walls of the vagina. Substances that destroy sperm are called spermicides. Barrier contraceptive drugs have been created based on these substances. So let's look at the most popular drugs and how they work.

Barrier contraceptive drugs and methods of exposure

The two main substances that are present in contraceptives for women are nonoxynol and benzalkonium chloride. Barrier contraceptives or barrier contraceptives based on these elements for local use. That is, they are inserted directly into the vagina. Also, such contraceptives are safe for the child if the mother is breastfeeding the baby and uses such products (in particular the drug Pharmatex), since the active elements do not enter or be absorbed by the female body into breast milk. Let's consider main barrier contraceptive drugs:

• One of the most popular drugs today is Pharmatex. This contraceptive drug very effectively protects against unwanted conception - 99%. At the same time, it has a protective effect against infection with sexually transmitted diseases, destroying chlamydia, herpes, candida and other pathogenic flora. Pharmatex is practically free of side effects. For convenience, the drug is available in the form of cream, vaginal balls, tampons, and suppositories.
• Gramicidin paste. This paste contains gramidin, an antibiotic that, in addition to its direct contraceptive effect, also has a bactericidal effect. This drug changes the environment in the vagina, killing microbes, so for women who have inflammatory processes in the reproductive system, doctors prescribe gramidicidin paste.
• Contraceptin. Disinfects, destroying sperm along with pathogenic bacteria. Available in the form of vaginal suppositories.
• Barrier patch. By sticking such a patch on your skin, you cause hormonal changes in your body, which leads to a contraceptive effect. A very unusual method and a new one, not fully studied, therefore there is no need to talk about the high effectiveness of this method.
• Barrier contraceptive ring. Also an unusual type of birth control. The hormonal effect of such a ring, after being placed in the vagina, lasts about three weeks. Quite a long lasting effect.
• Traceptin. Just like other barrier contraceptives, in addition to the main effect, this drug also has a bactericidal effect. Sold in the form of vaginal tablets. May have side effects, causing irritation in the vagina.
• Nonoxylol. Antiviral, spermicidal (destroying sperm) action. Available in the form of candles.

These are the main barrier type contraceptive drugs. Be that as it may, be sure(!) to consult your doctor about the possibility of using a specific drug. So as not to have any serious problems in the future. And remember that many contraceptives, in addition to the main effect of preventing unwanted pregnancy, can also have the opposite effect of treating

Content

For every family, the birth of a child is happiness, but not everyone can provide him with good conditions and proper upbringing. 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 are divided into female and male. Using this technique, they not only prevent pregnancy, but are protected from:

• various sexually transmitted diseases (syphilis, herpes, chlamydia or gonorrhea);
• human immunodeficiency virus.

Contraceptives for women

For women, there are many contraceptive options for safe sex, all of them have a different Pearl index. This is a special study that 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 earlier people simply abstained from sex to avoid having a child, 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 in the early stages), which can lead to problems and diseases of the reproductive system, infertility and other complications. The products help to avoid early pregnancy: at this age, a girl cannot always carry 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. To select the optimal contraceptive option, it is recommended to contact your treating 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 the 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; 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. The Pearl index of chemical methods of protection is 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 hormonal contraceptives are distinguished: 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 for girls who smoke (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. An 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 of inflammatory processes in the uterus and appendages increases;
• During menstruation, menstrual blood loss increases and periods last longer than usual;
• the likelihood of an ectopic pregnancy increases;
• vaginal discharge appears;
• 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 of contraception are ways to protect against unplanned pregnancy. They are used only by women who have a regular and stable menstrual cycle. 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 in order to avoid sex on these 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 means of 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: Gestodene, Desogestrel, Regividon, Microgynon, Miniziston.
• The following drugs are classified as biphasic: 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 refers to combined hormonal methods of contraception. At the moment, Evra is considered the most popular patch, and among vaginal rings, Nova-Ring is distinguished. The latter remedy is used frequently: 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 classified as progestogen hormonal contraceptives. 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 of combined 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 for which other hormonal contraceptives are strictly prohibited.

Postcoital contraception

Emergency contraception is 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 is a vasectomy, and for women it is tubal occlusion. During the surgical operation, an artificial obstruction of the fallopian tubes is created for a woman, and the vas deferens is ligated for men, while the testicles and ovaries are not removed, and there is no negative impact on the couple’s sex life.

Modern methods of contraception

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

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Contraception(from Latin contraceptio - against conception) - protection against conception.

In the modern market of medical and pharmaceutical services, there are a huge number of methods and means to prevent unwanted pregnancy or contraception.

They began to think about contraception back in primitive society, which led to the creation of many unique methods of protection.

In ancient Africa, for example, interrupted coitus and the introduction of a “cocoon” of various plant substances into the vagina were used as a means of contraception.

From the works of Aristotle it is known that in Ancient Greece they used various oils and incense to hinder the penetration of sperm into the uterus. In addition, men rubbed their penis with juniper berries, and women drank an infusion of copper sulfate.

There are several types of contraception:

• mechanical using condoms, which is also a means of protection against sexually transmitted diseases and HIV;
• interrupted sexual intercourse is one of the common methods of contraception, but it disrupts the physiology of sexual intercourse and negatively affects female and male orgasm;
• surgical methods of sterilization of men and women are not often used, which is due to the impossibility in most cases of restoring reproductive function after surgery;
• intrauterine contraception using intrauterine devices - foreign bodies to the body that keep the uterus in good shape and prevent a fertilized egg from attaching to it;
• chemical, which is based on acidifying the vaginal environment with the help of special suppositories, tablets, creams that have a detrimental effect on sperm, this group includes the drugs Contraceptin-T, Pharmatex, Benatex, Patentex-oval;
• hormonal, based on the introduction into the woman’s body of certain sex hormones that protect against pregnancy for the period of taking the pills, the effect of the Evra patch (7 days), the NuvaRing vaginal ring (3 weeks) or the Mirena intrauterine system (5 years); this group also includes a method of emergency contraception developed for women who have been raped using the Postinor or Escapelle tablets;
• physiological, taking into account the phases of a woman’s menstrual cycle, which is also called natural family planning methods.

Mechanical methods of contraception

Mechanical methods of contraception physically interfere with the fertilization process by preventing the sperm and egg from meeting. This group includes the use of condoms, both male and female, cervical caps and membranes, intrauterine devices (Navy), interrupted coitus and sterilization.

One of the first contraceptives in the world was the condom. Historians claim that the first condom was leather and was worn by Pharaoh Tutankhamun. You can see this by visiting the National Museum in Cairo. Then they used bull bladders and sheep caecum. Moreover, it recently became clear that condoms were also used by the ancient Romans, who made them from resin.

In 1564, when almost the entire adult population of Italy suffered from syphilis, the outstanding physician and anatomist Gabriel Fallopius proposed using a canvas bag to protect against this vile disease. It was proposed to soak the bag with medicines and inorganic salts.

It is believed that the word “condom” comes from the name of the English doctor Condom, the court doctor of the English king Charles II (1630-1685). The king ordered his doctor to come up with something to protect against syphilis.

The doctor suggested using oiled sheep intestine caps. The doctor’s invention came to the court, and soon the entire aristocracy used these means of contraception and protection from love ailments. True, they were used several times, so the diseases continued to spread. But fewer illegitimate children were born.

The rules for purchasing and using condoms are written in hundreds of booklets distributed by volunteers and employees of various institutions and organizations. It remains to be recalled that condom is a means of protection not only against accidental pregnancy, but also against sexually transmitted infections (STIs).

Interrupted act and sterilization

One of the oldest methods of preventing pregnancy was coitus interruptus - that is, removing the penis from the vagina before ejaculation. The Bible describes how Onan “spilled his seed on the ground,” providing an example of coitus interruptus. Many ethnographers, describing the customs of the primitive tribes of South Africa, noted that coitus interruptus had been known since time immemorial and was practiced by the Tonga and Massai tribes.

Sterilization involves tubal ligation in women or surgical division of the seminal ducts in men.

This is one of the contraceptive methods that is currently used by over 170 million couples in more than 100 countries. Scientists have found that British men decide to undergo sterilization more often than others. Every year in England there are 64 thousand male sterilization operations and 47 thousand female sterilization operations. The UK is among four countries, along with New Zealand, Holland and Bhutan, where the number of men sterilized exceeds the number of women.

In Russia, sterilization has become an increasingly popular solution to the problem of contraception in recent years. Since 1990, the use of sterilization in women with their consent and for medical reasons has been legally permitted, and since 1993 - in both men and women.

In accordance with Article 37 of the Fundamentals of the Legislation of the Russian Federation on the protection of the health of citizens: “Medical sterilization as a method of contraception can be carried out only upon a written application from a citizen who is at least 35 years old or has at least two children, and if there are medical indications and the consent of the citizen - regardless of age and presence of children.”

When choosing this method, it is necessary to remember that this method is irreversible and after the operation a person forever loses the ability to have children. Therefore, this method is only suitable for those who are absolutely sure that they will no longer want to have children. If there is the slightest doubt, it is better to postpone making a decision and use other methods of contraception at this time.

Intrauterine contraception

The modern history of intrauterine devices begins in 1926, when the German doctor Ernst Gräfenberg proposed using a ring made of an alloy of bronze and brass with a small copper content as an IUD. Later, an important discovery was made that it was copper, and not gold or silver, that was part of the spiral that made it effective.

In 1960, the American Jack Lipps developed the so-called “Lipps Loop,” the uniqueness of which lay in the fact that for the first time elastic materials were used for the manufacture of IUDs, which made it possible to minimize trauma to a woman during the installation of the spiral. It was from this moment that spirals became widespread.

An IUD is a small, flexible device inserted into the uterine cavity for a long time to protect against pregnancy. There are two types of IUDs: non-medicated and medicated. The latter are made of plastic and contain a drug that is gradually released from them in small quantities (copper or progestin). Intrauterine devices come in a wide variety of shapes (T-shaped, ring-shaped, spiral, etc.).

Scientists still have not established exactly how the IUD protects against unwanted pregnancy, so there are many hypotheses:

• Hypothesis of the abortifacient action of the IUD. Under the influence of the IUD, the endometrium is traumatized, prostaglandins are released, and the tone of the uterine muscles increases, which leads to the expulsion of the embryo in the early stages of implantation.
• The hypothesis of accelerated peristalsis. The IUD increases contractions of the fallopian tubes and uterus, so the fertilized egg enters the uterus prematurely. The trophoblast (embryo) is still defective, the endometrium (uterine mucosa) is not prepared to receive a fertilized egg, as a result of which implantation is impossible.
• The hypothesis of aseptic inflammation. The IUD, as a foreign body, causes leukocyte infiltration of the endometrium. The resulting inflammatory changes in the endometrium prevent implantation and further development of the embryo.
• Hypothesis of spermatotoxic action. Leukocyte infiltration is accompanied by an increase in the number of macrophages that carry out phagocytosis of sperm. Adding copper and silver to the IUD enhances the spermotoxic effect.
• Hypothesis of enzyme (enzymatic) disorders in the endometrium. This theory is based on the fact that IUDs cause changes in the content of enzymes in the endometrium, which has an adverse effect on the implantation process.

Chemical contraception

There are descriptions of ancient methods of chemical contraception. For example, in America, women washed their vaginas after intercourse with decoctions of mahogany bark and lemon. In ancient Egypt, a tampon soaked in a decoction of honey and acacia served as protection against pregnancy. In China, mercury served as a means of contraception.

Even in the recent past, such a method of contraception as douching was widespread in the USSR - washing the vagina from an Esmarch mug (a large rubber “hot water bottle”) immediately after sexual intercourse with a large amount of liquid acidified with a weak solution of potassium permanganate or acetic acid.

A method of chemical contraception in the absence of anything else at hand can be a slice of lemon, cut off in the same way as for tea and inserted into the vagina before sexual intercourse. When using this method, you must remember that after the end of sexual intercourse, the remains of the lemon drop must be removed from the vagina so that the mucous membrane does not burn.

The mechanism of contraceptive action of spermicides (or chemical contraceptives) is based on the ability of the active ingredient included in their composition to destroy sperm within a few seconds (no more than 60). Such a strict requirement for the time interval is explained by the ability of sperm to penetrate the cervical canal just a few seconds after ejaculation, and after 90 seconds to reach the fallopian tubes.

Spermicidal substances are available in the following forms: jelly, foam, melting suppositories, foaming suppositories, foaming tablets, soluble films - all of them are used only topically, i.e. inserted into the vagina before sexual intercourse.

In addition to their contraceptive effect, many spermicides protect against sexually transmitted infections, since they kill all microorganisms in their path, but this has only been studied in vitro. There were no volunteers who were willing to use spermicide during sexual intercourse with an HIV-infected partner. Therefore, doctors insist that there is no better protection against STIs than a condom.

Hormonal contraception is the most widely used method in the world today. In ancient times it was not used, since they did not even suspect the existence of hormones.

A major turning point in the development of contraception was the discovery of sex hormones - estrogen in 1929 and progesterone in 1934. However, it took scientists many decades to clarify the role of hormones in the functioning of the female body and to understand how they influence the onset of pregnancy and learn to obtain them artificially.

All this led to the creation in 1960 of the first hormonal contraceptive pills, which made a real revolution in contraception. Since then, contraceptive drugs have been constantly improved, the dose of hormones they contain has been reduced, and combined contraceptives containing several types of hormones have appeared.

Gradually, birth control pills became more and more effective, the number of side effects decreased, and the number of additional advantages increased. And today, oral contraceptives are often prescribed to women even for medicinal purposes, because they not only help prevent unwanted pregnancy, but also have a therapeutic effect on the body.

It may be necessary, for example, for various hormonal disorders, irregular or difficult periods. Many birth control pills make menstruation so short that it ceases to cause discomfort to the woman at all.

Hormonal contraceptives

Hormonal contraceptives are used in the form of tablets, patches, vaginal rings or intrauterine systems.

Modern oral (taken by mouth) contraceptives are divided into three groups: microdose, low-dose and mini-pills.

Microdosed combined oral contraceptives (COCs), predominantly monophasic, contain the very minimum amount of estrogen (20 mcg ethinyl estradiol) in combination with progesterone, are indicated for young girls who are starting to use hormonal contraception for the first time. Among the COCs of this group, Miniziston 20 fem, Logest, Lindenette, Mercilon and Novinet can be distinguished.

Low-dose COCs contain the estrogenic component ethinyl estradiol at a dose of 30-35 mcg. These drugs provide reliable contraception, control of the menstrual cycle, good tolerability and, for the most part, have a therapeutic effect. Low-dose contraceptives, such as Femoden, Microgynon, Triquilar, Zhanin, Yarina, etc., are recommended for young and middle-aged women.

Mini-pills are a type of oral contraceptives that are an alternative to COCs. Mini-pills contain only one component - progestin (a synthetic analogue of the hormone progesterone, which is produced in the ovaries), while combined oral contraceptives consist of synthetic analogues of two female sex hormones - estrogen and progesterone.

In this regard, progestin-only drugs are considered less reliable than COCs. If there are contraindications for the use of COCs, mini-pills can become an indispensable method of protection. The contraceptive effect of the mini-pill is based on changing the quality of cervical mucus, which becomes thicker and forms an impenetrable barrier for sperm.

Under the influence of the mini-pill, the uterine mucosa changes, and the embryo is not able to attach to it. In addition, the peristalsis (movement) of the fallopian tubes, through which the egg enters the uterine cavity, slows down.

Thus, mini-pills have a less pronounced contraceptive effect in contrast to COCs - 5 pregnancies per 100 (95%) women during a year of use (COCs are 99% effective). Mini-pills include the following drugs: Exluton, Microlut, Charozetta.

Emergency contraception

Hormonal drugs are also used for emergency (postcoital) contraception. Coitus (from Latin coitus - intercourse) sexual intercourse. This method of contraception can hardly be called protection against pregnancy.

Its essence is to prevent the fertilized egg from attaching to the wall of the uterus and continuing its development. This is a kind of “micro-abortion”, since a real, but only very small, miscarriage occurs in the woman’s body.

Emergency contraception is resorted to in situations where:

• rape has been committed;
• unprotected sexual intercourse occurred;
• interrupted sexual intercourse was performed incorrectly;
• the condom broke during sexual intercourse;
• the diaphragm was removed from the vagina early;
• other similar situations.

Emergency contraception is Gynepriston, or Agest (Gynepriston). This is a modern hormonal post-coital drug. Compared to Postinor, it is almost harmless, because This is an anti-progesterone, it is no less effective in preventing pregnancy. This is not a huge dose of hormones, but a small dose of an antihormone that does not cause damage to the ovaries.

Another remedy is Escapelle. This is an exclusive new emergency contraceptive product. Recommended for use within 96 hours after unprotected sex. The earlier the pill is taken, the more effective it is.

It must be remembered that under no circumstances should you use emergency contraception regularly. It is better to never take them, because they were created primarily to help women who have suffered rape.

In recent years, contraceptives in the form of patches or transdermal therapeutic agents have become increasingly common. Such a remedy is the Evra patch, which combines the effectiveness of oral contraceptives and the convenience of a patch.

It refers to prolonged (long-acting) combined methods of hormonal contraception. Evra ensures uniform supply of hormones; 150 mcg of norelgestromin and 20 mcg of ethinyl estradiol enter the bloodstream every day. The action of these hormones is to prevent ovulation by reducing the gonadotropic function of the pituitary gland and suppressing the development of the follicle.

During one menstrual cycle, 3 Evra patches are used, each of which is applied for 7 days. Evra is glued to dry, clean skin (in the area of ​​the buttocks, abdomen, outer surface of the upper shoulder or upper half of the torso).

The Evra contraceptive patch is a micro-dose contraceptive that combines effectiveness and maximum safety in use. The absence of the “forgetting effect” makes the Evra contraceptive patch one of the most effective methods of contraception.

The effectiveness of the Evra transdermal contraceptive system does not depend on the functional state of the gastrointestinal tract. The Evra transdermal patch is very simple and comfortable to use; it attaches securely to the skin and does not come off during water procedures or exposure to the sun. In addition, the Evra patch is very convenient for visual inspection.

The action of NovaRing vaginal hormonal rings and Mirena intrauterine systems is based on the gradual release of sex hormones from them, which have a contraceptive effect. The NuvaRing ring is inserted into the vagina by the woman herself for 3 weeks each menstrual cycle, and then removed independently. The Mirena system is inserted into the uterine cavity by a gynecologist for a period of five years.

Physiological contraceptive methods

Physiological contraceptive methods are based on abstaining from sexual intercourse during those periods of the menstrual cycle when the likelihood of fertilization is especially high. This is the only method of contraception that the Catholic Church accepts, as it considers it “natural” and not “artificial.”

In the legends of the African Nandi people, as well as among South American Indians, there is a prescription - in order to avoid conception, women should abstain from sexual intercourse on certain days of the menstrual cycle - thus, the calendar method was known for many centuries BC.

The method of natural family planning or calendar is based on the research of Ogino-Knaus, the essence of which comes down to calculating the days during the menstrual cycle in which conception rarely occurs or does not occur at all. Ovulation - the release of an egg from the ovary usually occurs on the 14th day in a 28-day cycle.

Considering that the viability of an egg remains up to 5 days, and a sperm cell’s viability for up to 3 days, the days of potential fertility are considered to be days 9-17, i.e. the very middle of the menstrual cycle, which is counted from the first day of one menstruation to the first day of the next menstruation (Fig. 6).

Rice. 6. Scheme of calendar, temperature and cervical methods of contraception.

With the temperature method, it is necessary to measure basal body temperature (temperature in the rectum) daily. It is measured in the morning before the woman gets out of bed to catch the time of ovulation.

The temperature in the rectum at the beginning of the menstrual cycle is 36.2-36.7 ° C, and at the moment of ovulation it sharply increases by a whole degree - to 37.0-37.2 ° C, after which it gradually decreases towards the beginning of the next menstruation. You should abstain from sexual activity from the day your menstruation ends and for another 2-4 days after the temperature rises.

Sometimes there is no increase in basal temperature during the menstrual cycle, which is called an anovulatory cycle. This means that ovulation does not occur and pregnancy cannot occur in principle. The method of basal temperature measurement, therefore, is necessarily used as a diagnostic method in identifying the causes of infertility.

The ovulation method, or Billings method (developed in 1960 by the Australian couple Evelyn and John Billings) is based on changes in mucous discharge from the vagina, which can be used to determine the days when the likelihood of conception is high. This mucus is produced by the glands of the cervix, which is why the method is also called cervical (cervical).

The onset of these days is indicated by the appearance of whitish or cloudy sticky mucus in the vagina. 1-2 days before ovulation, the secretion of mucus intensifies and becomes more transparent and viscous, and the consistency is very similar to egg white. It is believed that sexual intercourse is “safe” 4 days after the appearance of such mucus, when it becomes cloudy again until the end of the next menstruation.

In general, the effectiveness of physiological methods leaves much to be desired. Scientists have created several devices to detect ovulation at home by the release of sex hormones in the urine; Perhaps, over time, the use of such devices will improve the effectiveness of the physiological method of contraception, but no truly scientific research has yet been carried out in this area.

A highly educated, civilized woman will always be able, with the help of a gynecologist, to choose the appropriate method of contraception for herself and plan the birth of future children without resorting to abortion.