Questions about how to prevent unwanted pregnancies and protect yourself from sexually transmitted infections worry every woman. Choosing a reliable contraception is not an easy task, and this issue should be discussed with your doctor.

Contraception can be barrier, hormonal or intrauterine. Methods such as aborted and calendar intercourse can not be considered reliable and effective. Fortunately, in XXI century there is a lot of ways and means of protection against unwanted pregnancy and unpleasant diseases. Among them:

Barrier methods
Advantages of
reliable protection against sexually transmitted diseases (STDs) and unwanted pregnancy (if used correctly)
affordable price
No systemic effects on the body
Ideal for those who lead an irregular sex life
Require no investigations before starting a treatment.

Possible latex allergy
Spermicides are substances that immobilize the sperm, so they do not penetrate the uterine cavity.

Advantages of
Partial protection against sexually transmitted infections (does not work on some viruses)
Suitable for those who cannot use hormonal and intrauterine contraception.

Low effectiveness (60-70%), it cannot be used alone.
It requires a very strict adherence to the rules of use
Irritation, allergic reactions of the genital skin are possible.
Intrauterine methods
The copper intrauterine device (spiral)
The coil thickens the cervical mucus and forms a barrier to sperm. Copper acts toxically on sperm, immobilizing them, and also suppresses ovulation.

Pros of
Prolonged action, allowing you to forget about contraception for several years
No systemic action on the body
It is possible to use during lactation.

It is impossible to put the unmarried, because against the background of a spiral there is a risk of formation of intrauterine synechias, adhesions, which may lead to infertility; also the anatomical features of the unmarried have a narrower cervical canal, which complicates the installation of a spiral.
The coil does not protect against STIs, so it is suitable only for women who have one permanent healthy partner;
against the background of the use of copper-containing spiral increases the risk of inflammatory diseases of the uterus and appendages by 5-6 times compared to women who do not have a spiral;
the coil may provoke longer and more painful menstruation;
If a woman has a history of multiple abortions, invasive interventions, curettage, there is a risk of cervical insufficiency, i.e. cervical insufficiency, which can lead to expulsion (falling out) of the coil.
Protected Hormone-Containing Coils
The hormones in the system act in the uterine cavity, making the mucous membrane thinner and immobilizing the sperm cells. All this makes it impossible to fertilize and introduce the fetal egg.

Pros of
Reliable contraceptive effect for five years
No systemic action
Therapeutic effect: indicated in patients with a history of endometrial hyperplastic processes, uterine myoma
It is possible to use during lactation.

No protection against STDs
Higher cost compared to the copper-containing coil

Hormonal contraception
This is probably the most effective method available today.

Hormonal drugs differ in their dosage (mini-dosed – estrogen content not more than 30 mcg, microdosed – not more than 20 mcg, higher dosages are not currently used), components, method of entry into the body.

Drugs come in two varieties: combined and the “mini-pills” group. Combination contraceptives contain estrogens (ethinyl estradiol) and gestagens, while “mini-pills” contain only gestagens.

Preparations from a group of “mini-pills” are shown to nursing women who cannot take estrogens, but only gestagens. Also “mini-pills” can be taken by women who cannot tolerate the estrogenic component.

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

Methods of administration. The pills should be taken daily, at the same time. It is especially important to take them at the same time for drugs in the “mini-pill” group. The pills are generally taken for 21 days, after which you take a break for 7 days.

The vaginal ring is inserted into the vagina for 21 days, followed by a break for a week.

The patch is changed every 7 days.

The advantage of the alternative routes of administration (ring, patch) is that there is no need to remember to take the pill every day and there is no primary passage through the liver and gastrointestinal tract, which reduces the burden on them. This is especially important if a woman has GI problems or chronic cholecystitis.

Pros of
reliable contraceptive effect (if a woman does not skip taking the pill, it is almost 100% guaranteed)
Active protection of the ovaries and the endometrium (mucosa) of the uterus from cancer
regulation of the menstrual cycle
Reduction of painful sensations during menstruation
Cosmetic effect (some OCs help to cope with acne, normalize the skin condition)
The therapeutic effect (the doctor will help select hormonal contraceptives that are indicated for patients with uterine myoma, with endometriosis).
The disadvantages of
The need for strict discipline, control of taking the medication at the same time (especially important for “mini-pills”)
They do not protect against STDs.
Any hormonal drugs affect metabolism (metabolism), which may lead to weight fluctuations, although in modern drugs this effect is minimal;
there is an effect on the vascular system, on the blood coagulation system, so constant monitoring of hemostasis is necessary when taking contraceptives. If a woman has a predisposition to varicose veins, hypertension or a family history of cardiovascular disease accompanied by thrombosis, heart attacks, strokes, the patient needs a comprehensive examination of the hemostasis system before starting hormonal contraceptives;
there is a period of adaptation to hormones. During 2-3 months, sometimes nausea, headaches and pain in the mammary glands may be observed, there may be minor oozing in the middle of the cycle, changes in libido, mood swings. Therefore, a doctor’s control of the use of drugs during the first months of reception is obligatory.
Hormonal contraceptives have a number of contraindications: active smoking (more than 5 cigarettes a day), severe somatic diseases, severe decompensated diabetes, thrombosis, varicose veins, heart attacks, strokes, hypertension, frequent migraines, etc.

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