Contraceptives Veselības projekti Latvijai

Contraceptives

Contraceptives are the remedies, which are helpful in the protection against unwanted or unplanned pregnancy. As far as the person's needs differ subject to his/her age, frequency of sexual contacts, change of partners and number of existing children, a wide range of contraceptives is offered nowadays, and everyone can choose a most suitable method of contraception. At present, contraceptives are mainly designed for women. Usually, they are used for a longer time; that is why the health should not be damaged.

Choosing a most suitable contraceptive for oneself and one's partner, it is important to be informed about

  • principles of functioning;
  • proper use;
  • efficiency of the remedy;
  • most frequent side effects or potential risks for health;
  • symptoms, on manifestation of which one should consult a doctor;
  • prophylaxis of the sexually transmitted diseases (STD) on the use of a particular contraceptive;
  • fertility recovery on termination of use of a particular contraceptive method.

Hormonal methods: tablets, implants, injections, hormonal plasters, hormonal rings.

The most efficient contraception (other than radical sterilization) is nowadays considered the hormonal methods. Nevertheless, it should be pointed out that they affect the whole body – blood pressure, metabolism, digestive system, hepatic function, etc. Although the remedies perform their task very well and protect against unwanted pregnancy, the hormonal contraception is a method which is assessed controversially, as far as there are doubts about safety of lasting use of hormones and impact on the body.

Hormonal tablets (divided into combined and progesterone tablets)

(Risk of unwanted pregnancy, if used for one year, is 0.3–8%*)

- They are deemed to be a good remedy for prophylaxis of uterine and ovarian cancer, as well as extrauterine pregnancy;

- They reduce premenstrual syndrome (PMS), from which many women suffer before menstruation beginning (mood swings, bloating, breast enlargement and swelling);

- They are helpful in the establishment of a regular and painless menstrual cycle;

- Certain hormonal tablets are helpful in the solution of facial skin problems;

- To take the tablet every day at a fixed time, one should maintain discipline;

- Combined tablets are not suitable for breastfeeding women;

- Combined tablets increase the risk of cardiovascular diseases for smoking women;

- They are not suitable for women having high blood pressure;

- They could increase the risk of vein thrombosis;

- Side effects could arise – nausea, headache, weight gain, libido decrease (if such symptoms persist for three months, one should think over a change of the contraceptive);

- Certain researches show a connection between the use of progesterone tablets and bone density loss, especially for young girls;

- The contraception effect could be reduced by vomiting and diarrhea;

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Hormonal implants

(Risk of unwanted pregnancy, if used for one year, is 0.05%)

- They function for years;

- The menstrual cycle could be troubled – discharges or light bleeding in the middle of the menstrual cycle, heavy or long bleeding on the menstruation days;**

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Combined hormonal injections

(Risk of unwanted pregnancy, if used for one year, is 0.05–3%)

- Effective period - 3 months;

- If essential side effects appear, the effect of injections cannot be blocked during those 3 months;

- Side effects could arise – irregular menstrual bleeding, depression, weight gain, libido decrease, breast tenderness increase;

- Menstruations can stop, but smearing secretions can appear;**

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Hormonal plasters

(Risk of unwanted pregnancy, if used for one year, is 0.3–8%*)

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Hormonal vaginal ring

(Risk of unwanted pregnancy, if used for one year, is 0.3–6%)

- It is not suitable for women having high blood pressure or other risks of cardiovascular diseases;

- The menstrual cycle could be troubled – discharges or light bleeding also on other days of the menstrual cycle, heavy or long bleeding at the time of menstruation;**

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Intrauterine spirals (IUS)

Copper containing intrauterine spiral

(Risk of unwanted pregnancy, if used for one year, is 0.6–0.8%)

- Effective period - up to 5 years;

- It is recommended for monogamous relations, as far as it could be a serious threat for the woman's health and even life when combined with STS, especially with gonorrhea and Chlamydia infection;

- When partners are changed, it is advisable to use a condom for protection against STS/HIV;

- It is recommended for parous women;

- There is a risk of infection, which could cause infertility and chronic inflammation;

- It could cause increased menstrual bleeding and pain; that is why it is not recommended for women having strong and painful menstruations;

- It facilitates ovarian enlargement and irritation; it could give rise to ovarian cyst formation;

- Discharges or light bleeding are possible also on other days of the menstrual cycle;

- There is a risk of ectopic pregnancy;

- It could be only installed/removed by a gynecologist.

Intrauterine spiral with hormones

(Risk of unwanted pregnancy, if used for one year, is 0.1%)

- It is recommended for women having long and heavy menstrual bleeding and painful menstruations;

- It is recommended with therapeutic purposes for women having myoma or endometriosis;

- Menstruations could cease, if used lastingly;

- Dense discharges and light bleeding are possible also on other days of the menstrual cycle;

- Increased and longer menstrual bleeding is possible in the initial 3-6 months of use;

- It could be only installed/removed by a gynecologist;

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Barrier methods: male condoms, diaphragms, cervical caps, female condoms, spermicides (foams, creams, gels, suppositories)

Male condoms

(Risk of unwanted pregnancy, if used for one year, is 2–15%)

- Male condom is a sole method providing for efficient protection against STA and HIV;

- If misused, a condom can tear during a sexual intercourse.

Spermicides

(Risk of unwanted pregnancy, if used for one year, is 18–29%)

- They could cause genital irritation and allergic reactions;

- They change the vaginal environment and could encourage fungal diseases;

- They could increase the risks of urinary tract infections.

When barrier methods are used, it is important to follow all directions for use. Improper or non-careful application of these contraceptives reduce significantly the efficiency percentage.

Emergency contraception

An emergency contraceptive is a preparation with a high hormone dose, which prevents ovulation. If fertilization has already occurred, it will be ineffective. Emergency contraception is

- a powerful blow to the hormonal system;

- the preparation should be taken within 72 hours after a sexual intercourse, during which no protection from pregnancy was applied;

- it is advised to take the preparation not more often than 2 times a year;

- side effects could appear – nausea and vomiting;

- menstrual cycle fluctuations could appear after the use.

Another emergency contraception option is IUS introduction to the uterus.

Natural method

Identifying fertile days: calendar method, mucus changes observation, basal temperature

measurement

(Risk of unwanted pregnancy, if used consciously and purposefully for one year, is 2–9%)

Some people think mistakenly that it is possible to conceive in each sexual counteraction. In fact, a woman is fertile just for a couple days a month. It is the most difficult thing to determine which ones. Fertile days are identified by counting days of a menstrual cycle starting from the first day of menstruation. Generally, fertile days (ovulation) are in the very middle of the cycle - around the 14th day. If one's cycle followed purposefully, changes in vaginal secretion (mucus) are observed and basal temperature is measured, it is possible to identify "unsafe" days. At the time of the highest possibility of getting pregnant (it is a period of the 8th to the 19th day for a cycle of 28–32 days), any barrier method (for instance, condom) or interrupted sexual intercourse can be used or one may abstain from sexual contacts. As the natural method aids, one can purchase ovulation tests or menstrual cycle "computers". When the natural method is used, the following factors should be regarded:

- There is no need in the use of chemical preparations and no side effects appear;

- One could rely on the method, when the menstrual cycle is regular;

- To detect changes, one should watch carefully one's body;

- If a woman takes any medicines (such as antidepressants or antibiotics), extra contraception is required, as the medicines could alter the usual menstrual cycle;

- The specialists do not consider it a reliable method of contraception as far as the menstrual cycle length could change being effected by different factors (such as stress);

- One needs training for measuring the basal temperature;

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Breast feeding

- Breast feeding reduces effectively fertility, if the woman has not menstruation restored after the childbirth and the child is younger than 6 months old and if intervals between feeding times do not exceed 3 hours at the daytime and 6 hours at night.

Interrupted (early) sexual intercourse

(Risk of unwanted pregnancy, if used for one year, is 4–27%)

- To have the interrupted sexual intercourse an effective method of contraception, the partner should be motivated, disciplined and experienced;

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

Sterilization: tube torsion for women or vasectomy for men

(Risk of unwanted pregnancy at female sterilization is 0.5%, at male sterilization – 0.1%)

It is not generally recommended for the couples, which have no several children, or for young people.

- Vasectomy is simpler and reversible in most cases;

- Recovery of fertility by a woman is more complicated and expensive and less successful;

- When partners are changed, it is advisable to use a condom for protection against STS/HIV.

* All contraceptive method efficiency data are taken from the WHO Report for 2004.

** Other side effects and risks are also possible and described in detail in the section of hormonal tablets.

When citing, reference to the Society Veselības projekti Latvijai is obligatory.