What types of contraception can lead to infertility. Types of contraceptives
Only one out of four million pregnancies that occur annually in Russia ends in childbirth. Two thirds are medical abortions. About 60 percent of the country's population knows that contraception exists. Moreover, every third woman, according to surveys, believes that abortion is a method of contraception. Doctors are convinced: best prevention unwanted pregnancy- knowledge of how and with what to protect yourself. Associate Professor of the Department of Obstetrics and Gynecology of the Amur State Medical Academy, Candidate of Medical Sciences Irina Zhukovets told AP about modern methods of contraception - their pros and cons.
Abortion leads to infertility
Medical abortion leads to a number of complications. First of all, this is trauma to the endometrium during the procedure, which will subsequently lead to chronic endometritis in the woman and the inability to become pregnant. Abortion can lead to disruption of neuroendocrine regulation, disruption of menstrual function, ovulation and infertility. Serious complications such as uterine perforation and bleeding may occur, which can lead to removal of the reproductive organ. Women who are at a young age undergoing medical abortions, from the “I can get pregnant, but I don’t want” group, smoothly flows into the “I want to, but I can’t” group at a later age. Abortion leads to infertility. This is an indisputable, scientifically proven fact.
The best prevention of abortion is knowledge. Knowledge about family planning, reproduction and prevention of unplanned pregnancy.
There are so many types of contraception. Contraception can be low-effective or highly effective.
LOW EFFECTIVE METHODS
Calendar method and coitus interruptus
percent of Russian women use low-effective methods of contraception
These methods have only one advantage - they are free. They have many more disadvantages. The pregnancy rate with interrupted sexual intercourse is more than 70. This is due to the fact that ejaculate is produced not only at the end, but also during the entire sexual intercourse. Another drawback of this method, as urologists say, is that men who use interrupted sexual intercourse are at risk for the development of impotence.
The calendar method has the same degree of effectiveness as interrupted coitus. Ovulation on average in a 28-day menstrual cycle occurs on the 12-14th day, but nature has made it so that the sperm remains viable for 72 hours. If a woman is sexually active before ovulation, then the pregnancy rate is very high. Each body is individual, women have different duration menstrual cycle, which means that the days of ovulation are different, which increases the percentage of unplanned pregnancies.
Spermicidal agents
percent of Russian women use highly effective methods
Spermicides are considered low-effective methods of contraception because girls and women often do not read the instructions for them. The annotation states that the spermicide is used before each sexual intercourse. Based on the anamnesis of those who became pregnant while using spermicides, it turns out that women used them once a day, regardless of the number of sexual intercourses.
Condom
A condom is a low-effective method only because it tends to break during sexual intercourse. If you use high-quality condoms, then the percentage of the condom breaking is reduced to zero.
HIGHLY EFFECTIVE METHODS
Combined oral contraceptives
Today, combined oral contraceptives not only protect against pregnancy, but also help solve a number of problems that women have. First of all, this is the regulation of the menstrual cycle, body weight, treatment of androgen-dependent dermopathy - reduction of hair growth on the legs, arms, face, treatment of juvenile acne, strengthening of nails and hair.
There are contraindications for taking oral contraceptives. Complications occur more often in women at a later age. For example, thromboembolic complications, which occur primarily in women who smoke, women who are overweight, or with diabetes mellitus.
It should be noted that long-term use of hormonal contraceptives prevents the development of endometrial, ovarian and rectal cancer.
The last five years in Amur region There has been a decrease in the number of medical abortions. In 2014, there were 43.7 abortions per 1,000 women of childbearing age, compared to 50.7 in 2013. However, this figure significantly exceeds the all-Russian one.
You cannot start using oral contraceptives on the advice of a friend or mother. Today, more than 20 of their names are represented in Russia. You cannot use the same oral contraceptive as your friend. Because everyone's body is different. The rhythm of the menstrual cycle, increased hair growth on the body and face, body weight - all this affects the doctor's prescription of oral contraceptives. One tablet contains both estrogens and gestagens. Depending on the dose of estrogen, oral contraceptives are divided into microdose and low-dose. Depending on the gestagenic component, oral contraceptives can be used in the treatment of various diseases. For example, if the drug contains dienogest in the gestagen component, it is used in women with initial manifestations of adenomyosis, uterine fibroids; if a woman is prone to obesity, then we will prescribe a drug containing drosperenone. Hormonal contraceptives do not cure diseases, they prevent their development.
Vaginal ring
This method of contraception has the same effect as combined oral contraceptives. The only difference is in the application - the ring is used once a month, inserted into the vagina at the beginning of the menstrual cycle and removed at the end. It is used by women who are uncomfortable taking pills every day.
Intrauterine device
percent of women believe that abortion is a method of contraception
There are spirals that do not contain and contain hormones. The first ones are used purely for the purpose of preventing pregnancy. The mechanism of action is that implantation does not occur ovum. Gynecologists recommend this method of contraception to women who have already completed their reproductive function and no longer plan to give birth.
The intrauterine device, which contains hormones, is used not only for contraception, but also for treatment. It is most often used in women who have gynecological diseases, such as endometriosis and uterine fibroids.
Subcutaneous implants
This the most modern method, but is not widely used in Blagoveshchensk. It is mainly used by women in Europe and the European part of Russia. Injected subcutaneously hormonal drug, it resolves within three years, during which time the woman is protected from pregnancy.
Double contraception
Most effective method contraception is a method at the intersection of low-effective and highly effective methods. The method was invented in Holland and was called double contraception. This is the use of both a condom, which protects against sexually transmitted infections, and a combined oral contraceptive, which protects against pregnancy.
Emergency methods of contraception
percent of teenagers who have had an abortion are ready to resort to this procedure again
There is a drug that can be taken within 72 hours after unplanned and unprotected sexual intercourse. It should never be used as a planned contraception. A high content of the estrogen component leads to disruption of the neuroendocrine system. Such drugs are used in extreme cases. Mainly if the woman has been raped.
EXPERT'S COMMENT
Irina Zhukovets, Associate Professor, Department of Obstetrics and Gynecology, Amur State Medical Academy, Candidate of Medical Sciences
In all universities in Blagoveshchensk, among students - this is the demographic group of the population that in the near future will be mothers and fathers - we give lectures on contraception. At the medical academy, the coverage of these lectures is almost 100 percent of students. Unfortunately, we do not have the same accessibility to the student community of other universities. In this regard, we have the lowest percentage of medical abortions - 9%, but still quite high. In other universities this percentage is higher: at AmSU - 10.9 percent, BSPU - 13. The most unfavorable situation is among secondary vocational students educational institutions- 54%. That is, every second girl in a secondary school undergoes a medical abortion.
Behind Last year In antenatal clinics at municipal hospitals and commercial medical centers in Yekaterinburg, the number of patients suffering from infertility has increased. According to experts in the regional medical services market, the main reason for this situation is the unsystematic use of contraception by young girls.
“Nowadays, many young girls are starting to lead sex life quite early - from 15-16 years old, and, of course, actively use contraception in order to avoid unwanted pregnancy. Unfortunately, they often use contraceptives, especially hormonal ones, without preliminary consultation with a doctor, which causes serious harm to the body, in particular, inhibits the development of reproductive organs. As a result, by the age of 25, a woman is often infertile. This problem is relevant not only for Russia, but also for other countries of the world,” noted Tatyana Zaitseva, director of the Doctor Plus Medical Center.
According to Tatyana Zaitseva, a woman’s self-prescription of contraception is dangerous even if she has any serious health problems.
“A patient, a 26-year-old girl, once approached the gynecologist at our medical center for advice on the selection of contraceptives. It turned out that at that age she had already suffered a stroke, so the doctor selected a strictly specific combination of contraceptive drugs for her,” said Tatyana Zaitseva.
Also, the director of the Doctor Plus medical center points out another serious problem - the poor awareness of Yekaterinburg residents about what contraceptives exist on the market today, and which of them are the most effective and safe for health.
“Information about this should be given by specialists not only from private clinics, but also, mainly, by doctors from district antenatal clinics, which today account for a large number of female patients. Today, in antenatal clinics, as a rule, they are recommended only the most widely used contraceptive drugs, but little is said about barrier methods, and doctors do not always explain in detail how to use them correctly,” says Tatyana Zaitseva.
Women who want to postpone pregnancy for a while often take oral contraceptives. But it often turns out that after stopping taking the pills, they cannot quickly and easily conceive a child. Why?
Today, for most young women who want to become mothers in the future, but not now, perfect choice become contraceptives in tablets. It is important that the medicine is inexpensive and also harmless. It is desirable that the drug does not reduce performance, does not slow down nervous reactions - especially for those who actively play sports and drive a car, and does not suppress the immune system. Today, not a single drug fully meets these needs. On the other hand, all experiments on the use of condoms, interruption of sexual intercourse or the “calendar of dangerous days” may not live up to expectations.
The “vitality” of sperm may be high, ovulation may occur earlier than expected, and the condom may break. Naturally, correct selection Only a doctor can administer a contraceptive drug. Increasingly, doctors are prescribing to prevent pregnancy. modern drugs with a small dose of hormones that do not completely suppress the formation of follicles in the ovaries. In this case, the uterine cavity becomes unsuitable for implantation of the embryo. In addition, changes occur in the cervix that prevent sperm from penetrating inside. These are the drugs Silest, Microgynon, Logest, which in the West are advised to be taken without a break for quite a long time. This is true, but there is one “but” that is not always taken into account here. The fact is that the duration of taking a contraceptive is a very individual indicator. He may hesitate for different women from several months to several years. While taking the pills, the body gets used to the supply of hormones from the outside. And the production of your own hormones can decrease significantly. For the average woman, after a 3-6 month course, the chances of pregnancy after stopping the drug do not decrease. But taking pills for 3-5 years can lead to troubles - suppression of the reproductive system and, accordingly, the fight against infertility.
Therefore, today experts recommend that women take a three-month break after each year of using oral contraceptives. In the first months after discontinuation of the drug, the body gradually restores its former ability to conceive. At this time, you do not have to resort to stimulation of egg maturation and methods of assisted reproduction. However, trying to conceive can take much longer. If a woman after 22-23 years of age has been continuously taking hormonal contraceptives for several years, then it may take more than a year to restore her reproductive functions. And after the age of 30, this requires an even longer period - up to two years. The thing is that after 30 years in female body the natural process of egg contraction begins. And the passive wait can be longer than for young and young ladies. The next 5-year period, until the age of 35, already threatens the majority of eggs with aging. Trying to conceive a child after stopping the pills in such a situation can be significantly delayed. And a childless family is faced with a rather difficult choice: you can undergo treatment for a long time and not get pregnant at all on your own, or you can get pregnant quickly, but with the help of modern reproductive technologies. Therefore, it is not surprising that women after 35 years of age often choose IVF treatment of their own free will. This method ensures the maturation of several cells and the transfer of an embryo ready for development into the uterine cavity. Usually, everyone who decides to undergo IVF is satisfied with the results of the treatment and their newfound motherhood. In conclusion, we can advise all women who use contraceptives for a long time not to forget about annual breaks in taking them. Otherwise, you increase the risk of suppressing your ability to conceive. This is especially true for those who have crossed the 30-year mark. The tactics in this case are as follows: you need to wait the required year and, if there is no pregnancy, seek help from infertility specialists.
In the clinic " New life"You can get advice from highly qualified gynecologists-endocrinologists on the most suitable method of contraception for you.
Many women are interested in the question: which method of contraception should they prefer? To make a choice, many listen to the advice of friends or simply use “folk” methods familiar to them. But no one can choose the right contraceptive for you the way a competent specialist can.
Pros and cons of different contraceptive methods
The female body was created by nature in order to reproduce and feed offspring. But today, few women are ready to give birth from the moment of puberty until old age, practically without interruptions. Therefore, the issue of contraception is quite acute.
Today there are many different methods contraception. All of them can be divided into two groups: reliable and unreliable. The first group includes only four methods: application birth control pills, use of intrauterine contraceptives, surgical sterilization and refusal of sexual activity. Other methods are unreliable.
Naturally, the woman herself must decide which method to choose; the doctor can only give advice and choose for you the best way protection against unwanted pregnancy.
Modern contraception
. Hormonal pills
These are oral contraceptives, which come in two types: combined estrogen-progestogen drugs and mini-pills containing only progestogen. We will touch on the latter later. But the advantage of combined drugs is their almost 100% effectiveness.
Hormonal pills are the most reliable contraceptives that exist today, with the only exception being voluntary surgical sterilization. Hormonal pills provide a contraceptive guarantee if you start taking them from the first day of your cycle. They are easy to use, and the only thing you need to do is not miss taking them and try to take them at the same time. In addition, many drugs have a cosmetic effect - they can improve the condition of the skin.
It should be noted that such drugs differ greatly from each other in composition, clinical properties and dose of hormones. Therefore, the question of choosing a drug should definitely be entrusted to a doctor.
. Mini-pill
These pills contain only microdoses of progestogens, approximately 15-30% of what is contained in combination pills. The contraceptive effect of the mini-pill is significantly lower than that of the tablets. But due to their lesser impact on the blood coagulation system, they can be used smoking women over 35 years of age, as well as those who suffer from diabetes mellitus and other diseases for which the use of combined oral contraceptives is unacceptable.
. Intrauterine device
The method of intrauterine contraception is based on the introduction into the uterus of a device that prevents pregnancy - a device. It is only suitable for women who have given birth. The procedure for inserting an intrauterine device is carried out by a doctor in the clinic quite quickly and almost painlessly.
Despite the reliability of such a contraceptive, in Lately many patients refuse to use it, since the spiral can cause an increase in the amount of menstrual flow and painful menstruation.
Our clinic specialists will be able to select for you best view intrauterine contraception and correctly install the device, which is very important for its effective functioning and your comfort.
. Hormonal ring NuvaRing
NuvaRing is a flexible ring made of hypoallergenic EVA material used for the manufacture of implants. It is inserted into the vagina for 21 days and releases hormones, thereby ensuring high contraceptive effectiveness. The convenience of the ring is that it needs to be inserted once a month, whereas tablets need to be taken daily. It allows you to lead an active lifestyle, but some patients note that the ring interfered with them during sex.
. Barrier contraceptives
. Hormonal implant
A special capsule with hormones, which is administered through surgical manipulation on the inner side forearms for a period of 5 years. Good decision for women who are contraindicated to take hormonal pills.
. Hormonal injections
Hormone injections are a highly effective method of contraception. After injection into the buttock, the contraceptive effect lasts 3 months.
. Coitus interruptus
A very common method that has many disadvantages. First of all, sperm can be released before complete ejaculation, in addition, some men find it very difficult to stop, and finally, this method is harmful for men, as it is fraught with the development
Although it is generally accepted that earlier, in ancient times, they had no idea about any means of contraception, one has to doubt this. Even our great-grandmothers knew herbs that could be used to avoid pregnancy. Although previously it was considered the norm in every family to have many children.
Nowadays, many methods of contraception have been invented. These are traditional condoms and caps, which are classified as barrier contraceptives; And intrauterine devices- copper and silver; hormonal (tablets, patches, injections) and chemical (gels, suppositories, creams) drugs.
Review of modern contraceptives
Now, perhaps, the most difficult thing is to make a choice. Indeed, despite the wide choice of such means, each of them has its own advantages and disadvantages. Again it is important to consider individual characteristics everyone. What is suitable for one may be completely unacceptable for others.The price of modern contraceptives, which today can be purchased at any pharmacy, is quite affordable. However, choosing drugs based only on price is short-sighted.
If condoms can be purchased without a prescription and selected independently, by trial and error, then when using vaginal caps and other barrier-type products, it is still advisable to consult a gynecologist.
Such products are suitable for irregular sexual relations and are recommended for allergies to sperm. Although there are also cases of allergies to latex, from which the condoms themselves are made. They are easy to use and can protect against sexually transmitted infections. Manufacturers claim that condoms, caps and other similar products guarantee more than 90% protection against unplanned pregnancy. But there are also failures. So, if used carelessly, the products may tear and then will not be able to protect. Among the disadvantages, many note a decrease in sensitivity during sexual intercourse. But this is individual.
The use of condoms does not in any way affect the ability to conceive, and this is their advantage. The same cannot be said about similar products for women. They may well lead to infertility.
Intrauterine devices
It is also a fairly common method of contraception. And its main advantage is high efficiency - up to 97%. The choice of spirals is also quite rich - both in shape and price. There are cheaper, more expensive, copper and silver-plated ones. And some contain a special hormone, levonorgestrel. Such spirals combine two functions - protection against unplanned pregnancy and prevention of gynecological disorders.
Install the spiral on for a long time- from 3-4 to 7 years, but as soon as the IUD is removed, the ability to become pregnant is restored within six months. And intrauterine devices are more suitable for established couples. Since from infectious diseases she doesn't protect.
Many women choose this method of contraception. Although this has its drawbacks: painful menstruation, the risk of chronic inflammation of the fallopian tubes, benign tumors. They tried to cope with this problem by creating intrauterine devices with levonorgestrel. They are recommended for the treatment of endometriosis, PMS, fibroids.
Hormonal contraception
These include tablets (oral contraceptives), hormonal patches, and injections. In this case, ovulation is suppressed by hormones. This method is more expensive, but can be used for various diseases as a treatment method. And here it is important to take the drugs according to the schedule, only then the effectiveness of the contraceptive method will correspond to what the manufacturer promises. This method may cause hormonal imbalances and is not recommended for women who smoke.
Chemicals
A variety of creams, gels, suppositories that are inserted into the vagina. And they act exclusively locally. They can be used by women who at some point cannot use other methods. For example, nursing. But there are risks here: before using such a product, you cannot use soap before or after it. In the presence of alkali, the drug loses its properties. And it also affects the vaginal microflora.
Whatever method of contraception you decide to use, it is best to consult a doctor you trust. After all, it's your health.