All the most effective contraceptive methods you should know
article by Dr. Mariangel Leota
Its contraceptive capacity lies in the use of estrogen and progestin compounds in different forms of presentation, the first of which is the famous contraceptive pill. In recent years new presentations have appeared that administer the contraceptive through other routes than the oral one.
Its contraceptive action is based on several mechanisms. On the one hand estrogens prevent ovulation and, on the other, progestogens prevent regeneration of the lining of the uterus, which prevents the implantation of the ovum and also thicken the mucus of the cervix, which hinders the advance of sperm.
Currently, the most used is the combination pill of estrogen and progestogens at low or ultra low dose, composed of synthetic estrogens and progesterone that can be single-phase (all pills have the same amount of hormones) or triphasic (with different doses of hormones).
It is sold in packages of twenty-one or twenty-eight units. The first one is taken on the first day of the period. The following, one every day at the same time. If the container is of twenty-one tablets, when it is finished they are left to take for seven days called rest, during which the rule comes. Twenty-eight packets do not rest on any day and the rule usually occurs on the days when the last seven pills are being taken.
It is the most effective contraceptive method and the annual failure rate is just one pregnancy for every 200 women who use it. With the use of oral contraceptives should be avoided other drugs such as antibiotics, barbiturates, antituberculosis and antiepileptic drugs because they reduce their effectiveness.
Although an obvious relationship between birth control pill use and breast cancer has not been demonstrated, experts recommend, as a precautionary measure, that women whose mothers or sisters have had this type of cancer avoid using it until data become available. conclusive. It is important to remember that the pill does not protect against HIV-AIDS or other sexually transmitted diseases.
Injectable hormonal contraceptives
Most effective methods
There are several types in use and their effectiveness is similar to that of the pill. Injectables that ensure contraception of one or three months with a single dose of treatment are used.
Due to its high hormonal content, its use entails a greater risk of undesirable effects. In fact, they can produce weight gain and intermenstrual bleeding.
They have the disadvantage that it is not possible to suspend their action until they are eliminated by the organism (one or three months).
It consists of a small elongated cylinder composed of progestins that is implanted under the skin in discrete places. The insertion and extraction should be done by a trained doctor. It facilitates long-term contraception (3 years) and is also useful for women who have not been pregnant and for those who have intolerance or contraindication to estrogen.
Its main advantages are the reduction of menstrual pain (dysmenorrhea) and its comfort of use, without risk of forgetting. As a disadvantage, he says that the bleeding can be variable and unpredictable, although in general there is a tendency to have less bleeding or not.
It contains the same hormones that are used in the contraceptive pill and acts in the same way in the prevention of pregnancy, which prevents ovulation and thickens the cervical mucus in order that the sperm has less chance of reaching the uterus.
The transdermal patch is another contraceptive option, which is applied once a week and is as effective as the pill (99% effectiveness) if used correctly. It is small and thin and can be placed on the buttocks, abdomen, back and the outside and top of the arms. The manufacturer informs that with it you can swim, exercise or shower because wet or hot conditions do not affect their adhesive capacity.
The most effective methods, except the condom and vasectomy, have as a protagonist the woman who can choose between numerous possibilities
It is changed once a week for three consecutive weeks and does not apply in the fourth week. If you forget to change the patch on the day that corresponds, there are 48 hours of security during which it is not necessary to adopt an additional contraceptive method.
It is a flexible and colorless ring that contains estrogen and gestagens, which once released at very small doses are absorbed by the vagina.
The first day of menstruation should be inserted and removed after 3 weeks, during which period it should not be removed. The woman herself can put it on. It is very simple; it requires a technique similar to that of inserting a tampon. Its contraceptive effectiveness does not depend on the position in the vagina, given its shape and its material is perfectly adapted. The woman does not feel that she is wearing it, and unlike other methods, she is not required to cover the cervix.
Intrauterine device (IUD)
They are small objects that are inserted into the uterus through the vagina and cervix and whose mechanism of action varies according to their composition, generally of two types: copper IUD or hormones. The first works by preventing the passage of sperm in its intrauterine path, thus preventing fertilization and preventing the implantation of the ovum in the uterus if fertilization had occurred. The hormone-releasing IUD combines the effects of the copper IUD with the hormonal ones of progestins.
It must be inserted by a doctor with the proper preparation. It is recommended that it be done during the days of the period, for having the certainty that there is no pregnancy and because insertion is facilitated because of the greater dilation of the cervix. It can remain without needing to be changed for a period of 3 to 5 years.
It is recommended that it be used by women who have gone through at least one pregnancy and less than five.
Most effective methods
It is a thin latex sheath that sticks to the penis and is placed when it is in erection. At the end they usually have a deposit where the semen is poured, which in the placement of the condom must be pressed to empty the interior air and prevent its deterioration during intercourse.
They are usually presented wrapped in plastic or metalized packages and there are various kinds, including some lubricated and with textures and prominences designed to facilitate the stimulation of women during coital activity. Once extracted from its container, it unrolls gently along the erect penis to its base. It must be removed before the erection has disappeared, holding it from the base to prevent it from remaining inside the vagina.
It is a very accessible method and can be purchased in pharmacies, as well as in automatic vending machines installed in the most diverse places. It is currently the only effective contraceptive method available to man, if vasectomy is excluded, and no medical prescription is needed to acquire it.
It has no side effects and for people allergic to latex there are silicone condoms on the market. We must avoid exposure to high temperatures and review its expiration date because both factors favor breakage during intercourse, which is its biggest drawback.
If used properly, it can protect against HIV-AIDS and other sexually transmitted infections.
Vasectomy is a method of sterilization that consists of sectioning and sealing the vas deferens, which are the sperm that pass from the testes to the male urethra.
Although popular belief is definitive and is rarely reversible, therefore, it is not a contraceptive method, but sterilization. Although man can be artificially fertile because he continues to generate sperm, his nature is sterile.
The intervention is performed under local anesthesia and lasts 15 or 20 minutes. After it, sperm continue to be produced in the testes, but as they do not pass the vas deferens, they are partly absorbed and destroyed by the phagocytes and partly filtered into the scrotum (skin surrounding the testicle), where they disintegrate.
After the intervention there are sperm in the spermatic ducts, above the cut point, so that they have to spend between seven and eight weeks, in which a dozen of ejaculations must be produced so that the semen does not contain them, which it is checked by performing a spermiogram. During this time, some contraceptive method must be used to avoid pregnancy.
Several studies have shown that vasectomy does not cause disorders in the erection or in the production of hormones and many couples report that the sexual relationship is more pleasant because there is no concern about a possible pregnancy or having to use some contraceptive method.
Despite popular belief, vasectomy is definitive, it is a method of sterilization that is rarely reversible
Most effective methods
Although there are numerous surgical variants to achieve sterilization, tubal ligation is the most commonly used method. Also, with the removal of the uterus (hysterectomy) and that of the ovaries (ovariectomy) sterilization is achieved, but these interventions are not carried out for this purpose but to address various pathologies of women.
Tubal ligation is a safe and immediately effective sterilization method and in very rare cases the union of the severed ends is produced. Tubal ligation is the most effective and used method for female sterilization, does not alter the menstrual cycle or cause sexual difficulties
Its application is not recommended in very young women: their personal situation can change and if they want to have children with a new partner it would be very complicated.
Emergency contraception: the postcoital pill
The medicine that contains the so-called morning-after pill is a progestogen, levonorgestrel. It is classified as an emergency contraception and it is important to emphasize that this medication does not interrupt a pregnancy if it is already established, what is done is to prevent conception. If there has been sexual contact without adequate protection, the medication should be taken as soon as possible and certainly not after 48 or 72 hours because its effectiveness begins to decrease after 24 hours.
The recommended regimen is in a single take of two tablets together of 0.75 milligrams, or take one tablet twice with an interval of twelve hours.
It has numerous adverse effects and can cause nausea, vomiting, breast tenderness, menstrual disorders, etc. Your medical prescription is required.
Emergency contraception should be a very occasional method of use and in no case can it replace a regular contraceptive method. There are problems with its use because recent studies indicate that the greatest demand in its use corresponds to young women who resort to the postcoital pill on more than one occasion. It is necessary to remember that laboratories that commercialize levonorgestrel warn that there is not enough data on the safety of their use in women under 16 years of age.