Undoubtedly, concern for the health of women has reached unprecedented heights in our days. In recent years, the development of reproductive medicine has been successfully progressing by leaps and bounds; perinatal and family planning centers are opening in different parts of the country. The achievements of biologists and specialists in the pharmaceutical industry allow the modern woman of humanity to be not only a loving mother and guardian of the home, but also having received a decent education, to reach career heights in the chosen profession, becoming the pride of her family.
All this is great, but it was not always so. Not so many years have passed since women, who did not have such an impressive arsenal of contraceptives, went to all sorts of tricks in order to plan childbirth, using the possibilities inherent in the body by nature. So, based on physiology, natural or biological methods of contraception appeared in the life of adults.
What is natural contraception?
In the modern world, adherents of this direction most often remain couples who reject other contraceptives out of religious or any other beliefs, and are also very confident in the abilities of their own body.
Like other contraceptive methods, biological has a number of pros and cons. To get started, it's better to familiarize yourself with the benefits:
- The process provides for the mutual participation of partners.
- There is an additional opportunity to know your body.
- No side effects have been observed.
- There are no financial costs.
As negative points, the partners using the considered tactics noted the following:
- The added responsibility and self-control of both natural protection adherents is not beneficial to their sexual pleasure.
- The need from the partner to scrupulously observe and record changes in the ovulatory cycle every day.
- Lack of barriers to sexually transmitted diseases.
- The dependence of intimate relationships on the work schedule, time frame, temperature regime, human characteristics, and more.
So, if a man and a woman completely trust each other and are going to practice physiological contraceptive methods, they need to choose the optimal one for themselves, which means to study the options that are most popular.
Interrupted intercourse
One of the well-known is the interrupted coitus technique. The mechanism of such protection from conception is not complicated: during intercourse, a man needs to have time to remove a penis from the vagina just before ejaculation, preventing sperm from getting there.
Despite the general availability and, at first glance, extreme simplicity, such a tactic cannot serve as a worthwhile barrier against unwanted fertilization. This is also evidenced by the Pearl index, which determines the effectiveness of a particular contraceptive by the number of pregnancies that occurred in a hundred women in 12 months. In this case, the indicator is quite high and reaches 25.
It is worth considering the risks:
- Viable spermatozoa can be contained not only in the semen during its eruption, but also in the urethral lubricant released during frictions.
- Long-term use by a male partner of an interrupted act does not have the best effect on his reproductive system, provoking the onset of prostatitis.
- Such sexual contact does not bring complete relaxation to the stronger sex and is not approved by sexologists.
Symptothermal or multicomponent method
The above method of family planning is usually understood as the following methods of contraception:
- temperature;
- calendar;
- control of cervical secretion.
Temperature method
Its essence lies in the daily recording of the readings of the thermometer, measured in the rectum, in order to then establish the time interval of fertility based on temperature changes.
At the beginning of the ovulatory cycle, the readings on the thermometer fluctuate between 36.5-36.6, and immediately before ovulation itself (from 12 to 24 hours), a pre-ovulatory fall occurs. The readings drop sharply in order to rise again to the level of 37.0-37.5 after ovulation. The last numbers continue to hold until menstruation.
Fertile time is determined by taking into account the viability of male and female germ cells. It is important to remember that sperm cells live in a woman's genital tract for 3 to 7 days. With a 28-day menstrual cycle, the fertile period occurs from 6-7 to 12-14 days. At this time, the probability of conceiving a child is maximally high. After ovulation is completed, the egg dies and pregnancy becomes impossible. The days after ovulation and before the onset of menstruation are considered absolutely safe.
Doctors obstetricians-gynecologists usually give their patients several tips to properly apply this technique:
- Rectal temperature is measured every morning after sleep with the same thermometer at the same hours with an exposure of at least 7-10 minutes.
- Monitoring must be carried out for 6-12 cycles.
- For clarity, a kind of graph should be built from the recorded data.
- Abnormal behavior of the temperature curve may indicate any pathological processes, stressful situation and other problems.
The Pearl index, with the correct use of the temperature method, ranges from 0.3 to 6.6.
Calendar method
The name suggests that this idea is related to the calendar of women's periods. It is based on the determination of the days of fertility, when the partner ovulates. This is important because on the days of ovulation, the egg from the follicle moves to the fallopian tube and stays there for up to a day. The meeting at this moment of the egg with the sperm is fraught with inevitable fertilization.
Further, the question will be logical: how to calculate the "dangerous" time period? You need to be patient, as initially you will need careful observation and keeping a "menstrual diary" for 6 or more cycles.
Scheme for determining fertile days:
- Select the longest cycle from the recorded ones and subtract 8-10 from the total number of days in it, but not more than 11.
- After the last ovulation, before the onset of menstruation, it should take from 12 to 16 days (an average of 14), but for greater confidence in the result, it is recommended to add a few days. This will calculate the last fertile day of the cycle.
- From the total number of days of the shortest of the past cycle, from 19 to 21 days are subtracted, but not less than 18. This is due to the duration of the existence of spermatozoa in the female genital tract (up to 7 days). This is how the first “dangerous” cyclical day is calculated.
During the period of risk established by the above calculations, it is necessary to avoid sexual contact or resort to additional protection.
The Pearl index in this case ranges from 14 to 40.
It's important to know:
- The calendar method is not suitable for a woman with irregular menstruation and within six months after termination of pregnancy.
- The viability of male germ cells may be longer than expected, and pregnancy cannot be avoided.
Control of cervical secretions
It was the turn to mention such a technique as determining the viscosity of the cervical secretion. The nature of the cervical mucus lining the cervix varies with the phase of the menstrual cycle.
- As ovulation approaches, the amount of secretory secretions increases, and its viscosity decreases.
- At the end of menstruation, there is little cervical mucus, and soon it begins to resemble a viscous paste in consistency. This habitat is unfavorable for sperm.
- In the first phase of the cycle, the secret acquires a light creamy whitish or yellowish texture and becomes suitable for male germ cells.
- During ovulation, mucous discharge becomes liquid, abundant, in appearance similar to the protein of a raw egg. The mucous membrane of the vulva is maximally moisturized. This is the best time to conceive.
The Pearl index of this protection scheme is relatively low - 6-39.
There are restrictions:
- A sufficient length of "dangerous" time is unacceptable for couples with intense sex life.
- The technique is not suitable for a woman suffering from inflammatory diseases of the genital area, since the nature of the cervical secretion changes.
- Insufficient experience interferes with the correct assessment of secretion, and, therefore, there is no confidence in the effectiveness of the method.
Lactational amenorrhea method
In conclusion, it is worth paying attention to such a method of preventing unwanted fertilization as lactational amenorrhea. This method has come down to our times, passed from mouth to mouth through the maternal line. It is no coincidence that in Russian villages, peasant women most often stayed in two roles: a nursing mother or awaiting offspring.
With the active feeding of the baby with breast milk, the woman's body inhibits the production of hormones that cause ovulation. At the end of breastfeeding, the woman can successfully become pregnant again.
The effectiveness of the lactational amenorrhea method is 98%, but for a successful result, it is worth observing some conditions:
- The baby should only eat breast milk. Water supplementation, supplementary feeding with a mixture, introduction of complementary foods are not allowed. In this case, an actively and often sucking baby will be the best guarantee of the effectiveness of the method.
- A good contraceptive effect lasts for six months from the moment the baby is born. Further protection measures are shown below.
It is not forbidden to let natural contraception into their intimate life for couples in whose relationship mutual understanding reigns. At the same time, in making a decision to apply biological protection, it is better not to be independent, but to use the help and advice of a qualified obstetrician-gynecologist.
Let's dwell on physiological methods of contraception... They do not involve the use of drugs, various devices and manipulations. Knowing the characteristics of her body, a woman can plan her intimate life in such a way as to protect herself from unwanted pregnancy. Who are these methods shown to and how effective are they?
Physiological, or biological contraceptive methods belong to the natural methods of family planning. They consist in abstaining from intercourse during the fertile phase of the menstrual cycle (the period during which a woman can become pregnant).
During the menstrual cycle, the woman's body prepares for conception and pregnancy. If conception does not occur, this process is repeated again. The duration of the menstrual cycle is determined from the first day of menstruation (the onset of spotting) to the first day of the next and is 21-36 days, more often 28 days.
Phases of the menstrual cycle
Phases of the menstrual cycle. In the first phase of the menstrual cycle (in the first 14 days with a 28-day cycle) in ovaries the growth and maturation of the follicle (a bubble with an egg inside) occurs. The growing bubble gives off estrogens(female sex hormones). Under the influence of estrogens, the mucous membrane grows uterus - endometrium... On the 14-16th day of the cycle, the follicle bursts, and a mature egg, capable of fertilization, comes out of its cavity, that is, it begins ovulation.
Natural family planning methods can use:- women of reproductive age who have regular menstrual periods
- couples who are not allowed to use other methods of contraception by religious, ethical and other convictions;
- women who, for health reasons, etc., cannot use other methods;
- couples willing to abstain from intercourse for more than one week in each cycle.
Shouldn't use these methods:
- women whose age, number of births or health conditions make pregnancy dangerous for them;
- women with an unsteady menstrual cycle (breastfeeding, immediately after an abortion);
- women with irregular menstrual periods;
- women who do not want to abstain from sexual activity on certain days of the menstrual cycle.
Types of physiological methods
To biological (physiological) or natural methods family planning (EMP) include: calendar (or rhythmic), temperature, cervical mucus method, symptothermal (a combination of the two methods listed above), interrupted intercourse, lactational amenorrhea method (during lactation, there is a physiological suppression of ovulation due to the baby's breast sucking), abstinence (abstinence from sexual intercourse).
Calendar (rhythmic) method of contraception
To determine the fertile phase, it is necessary to analyze at least 6-12 menstrual cycles. During this period, abstinence from sexual activity or protection is necessary. barrier methods of contraception.
When analyzing the menstrual calendar for 6-12 months, the shortest and longest cycles are distinguished. From the number of days of the shortest, the number 18 is subtracted and the day of the beginning of the "dangerous" period is obtained, and the number 11 is subtracted from the number of the longest menstrual cycle and the last day of the "dangerous" period is found.
Let's give an example of calculating the "dangerous" period with a constant menstrual cycle of 28 days.
- The beginning of the "dangerous" period: 28 - 18 = 10th day of the cycle.
- End of the "dangerous" period: 28 - 11 = 17th day of the cycle inclusive.
- The duration of the "dangerous" period is 8 days. It starts on the 10th day of the menstrual cycle and ends on the 17th day.
Attention! This method can be used only with strict accounting of all menstrual cycles in the calendar and with a small variation in the menstrual cycle throughout the year. If for 6-12 months you have not marked the duration of the menstrual cycle on the calendar and cannot say with certainty about the stability of the cycle, then this method is not suitable for contraception, as well as for calculating the most favorable days for conception.
Temperature method of contraception
The temperature method of contraception is based on determining the time of the rise in temperature in the rectum ( basal temperature).
It is known that at the time of ovulation, the temperature in the rectum decreases, and the next day it rises. By daily measurement basal temperature for several (at least three) months and abstinence from sexual intercourse in the first phase of the menstrual cycle, including the first three days of a rise in temperature after ovulation, a woman will be able to determine when she is ovulating. The effectiveness of the method depends on the accuracy of determining the timing of ovulation.
Therefore, it is necessary to measure the temperature, observing the following rules: always in the morning, within 10 minutes, immediately after waking up, without getting out of bed, using the same thermometer and with closed eyes, since bright light can provoke the release of some hormones and contribute to a change basal temperature... The thermometer is inserted into the rectum to a depth of 4-6 cm. The temperature value is marked on the graph.
Schedule
basal temperature
(see graph 1): normal from the very beginning of the menstrual cycle (its duration is calculated from the first day of the previous menstruation to the first day of the next) and before the onset of ovulation, the basal temperature is below 37 degrees C and can fluctuate within small limits, for example, from 36 , 6 degrees C to 36.8 degrees C. At the time of ovulation, the temperature decreases slightly (for example, to 36.4 degrees C), the next day basal temperature rises above 37 degrees C (37.2-37.4). At this level, she keeps until the beginning of the next menstruation. A decrease in temperature and the next jump beyond the 37 degrees C line allows us to determine ovulation time... With a 28-day cycle in a healthy woman, ovulation usually occurs on days 13-14 of the cycle. It should be noted that due to an increase in body temperature with various diseases, the figures basal temperature are also getting high.
But can only these two days be considered "dangerous"? Not at all. Even having clearly defined your individual term for ovulation, you can not protect yourself from accidents. If you are nervous, overworked, drastically changed the climate, and sometimes for no apparent reason at all, ovulation may occur 1-2 days earlier or later than usual. In addition, the duration of the viability of the egg and sperm must be taken into account. If, on the eve of the expected menstruation, and especially during the expected, but delayed menstruation, a slightly increased temperature in the rectum persists, then this allows one to suspect an already occurring pregnancy.
Temperature method of contraception determining the period of increased fertility presupposes sufficient discipline of the woman and the exclusion of haste in the morning. The disadvantages of the method are associated with the need for daily temperature measurements, and rather long abstinence. Nevertheless, when used correctly, the effectiveness is quite high. In women suffering from diseases of the genital organs, the basal temperature graph may change. In this case, the question of the appropriateness of using this method should be discussed with your doctor.
Cervical (cervical) mucus method
In different phases of the menstrual cycle, cervical mucus, different in quantity and consistency, is produced in the cervix. Its quantity and consistency is influenced by female sex hormones (estrogens and progesterone). At the beginning of the cycle, just after menstruation, when estrogen levels are low, mucus is low, thick and sticky. This thick and sticky mucus forms a fibrous network that "clogs" the cervix and creates a barrier to sperm entry.
In addition, the acidic environment of the vagina quickly destroys sperm. Rising estrogen levels gradually alter the cervical mucus, which becomes clearer and thinner. In the composition of mucus, nutrients appear to maintain the vital activity of sperm, and its reaction becomes alkaline. This mucus, when it enters the vagina, neutralizes its acidity and creates an environment conducive to sperm. This mucus is called fertile, and its amount increases 24 hours before ovulation. The last day of slippery and wet mucus is called peak day. This means that ovulation is near or has just occurred. After ovulation, under the influence of the hormone progesterone, the cervical mucus forms a dense and sticky plug that impedes the movement of sperm. The vaginal environment becomes acidic again, where the sperm lose their mobility and are destroyed. 3 days after the appearance of sticky, viscous mucus, the phase of absolute sterility begins, during which, until the start of the next menstruation, pregnancy will be impossible. Application method of cervical (cervical) mucus with the aim of contraception involves keeping records. In this case, you can use a number of codes (see graph 1).
It is believed that the first day of menstruation is the first day of the cycle, subsequent days are numbered. The phase of relative infertility: red squares with an asterisk indicate the days of menstrual bleeding; green squares indicate a period of dryness in the vagina, the so-called "dry days". The fertility phase (yellow squares with the letter M, day 11 of the menstrual cycle) begins with the appearance of mucus in the vagina. Ovulation has not yet occurred, but the sperm that got into the female genital tract at this time can remain viable and "wait" for the egg. As ovulation approaches, the cervical mucus becomes more abundant and elastic. In this case, the tension of the mucus (when it is stretched between the thumb and forefinger) can reach 8-10 centimeters. Next comes the peak day (M). This means that ovulation is close or just happened. The fertility phase continues for another 3 days and its total duration in our case is 7 days (from 11 to 17 days of the menstrual cycle). The phase of absolute sterility begins on the fourth day after the maximum discharge (on our graph from day 18) and continues until the first day of the next menstruation.
Since mucus can change its consistency during the day, observe it several times a day. To do this, the thumb and forefinger are inserted into the vagina and the existing discharge is taken away. The mucus is then graded for consistency and stretch between the toes. On "dry days" there is no discharge. Every night before bed, check your fertility level (see legend) and put the appropriate symbol on the map.
Abstain from intercourse for at least one cycle to determine the days with mucus.
After the end of menstruation during the "dry days", you can safely have intercourse every other night (the rule of alternating dry days). This will prevent the mucus from being confused with semen.
If any mucus or moisture sensation appears in the vagina, you should avoid intercourse or use barrier contraception during this time.
Mark the last day of clear, slippery, stringy mucus with an X. This is peak day - the most fertile period.
After peak day, avoid intercourse for the next 3 dry days and nights. These days are unsafe (the egg is still viable).
Starting in the morning of the 4th "dry day" and before the onset of menstruation, you can have sexual intercourse without fear of becoming pregnant.
The effectiveness of this method is low: 9-25 pregnancies per 100 women within 1 year of use.
Withdrawal of intercourse
consists in removing the penis from the vagina before ejaculation (ejaculation) begins, so that sperm does not enter the vagina and cervix. Its advantage is that it does not require any preparation or special devices, it can be applied at any time and does not require money. The method requires considerable attention on the part of a man, since some men contain sperm in a secret that is released even before orgasm.
In addition, sperm, getting on the skin of the genitals, retains its fertilizing properties for some time. There is a widespread opinion regarding the violation of sexual function of partners using interrupted intercourse. The harmless application of this method is possible with a high sexual culture of partners, with sufficient motivation for choosing. Not recommended for young, inexperienced men and those who have difficulties with erection, potency and premature ejaculation.
Instructions for partners:
- To improve consistency in their actions and to avoid mutual misunderstandings, partners should discuss their intention to use method of interruption before intercourse.
- Before having sexual intercourse, a man should empty his bladder and wipe the glans penis to remove sperm that may have remained after a previous (less than 24 hours ago) ejaculation.
- When a man feels that ejaculation is about to occur, he must withdraw the penis from the woman's vagina so that sperm did not get on her external genitals. A woman can help him by moving back a little at this time.
Lactational amenorrhea method (LAM)
using breastfeeding as a contraceptive for pregnancy. It is based on the physiological effect that the sucking of the mother's breast has on the suppression of ovulation (physiological infertility develops during lactation).
Who can use the MLA
Women who are exclusively breastfeeding who have been less than 6 months after childbirth and have not returned to their period.
Who shouldn't use MLA
- Women who have resumed their periods.
- Women who do not exclusively (or almost exclusively) breastfeed.
- Women whose baby is already 6 months old.
It's important to know!
- Feed your baby from both breasts on demand (about 6-10 times a day).
- Feed your baby at least once at night (the interval between feedings should not exceed 6 hours). Note: The child may not want to eat 6-10 times a day, or may prefer to sleep through the night. This is normal, but if any of them occur, the effectiveness of breastfeeding as a method of contraception is reduced.
- As soon as you start replacing breast milk with another food or liquid, the baby will suck less and breastfeeding will no longer be an effective method of preventing pregnancy.
- The return of your period means that your fertility has recovered and you should start using other methods of contraception immediately.
Contraceptives are drugs used to prevent pregnancy. The purpose of contraception is family planning, preserving the health of a woman, and partly of her sexual partner, the realization of a woman's right to a free choice: to become pregnant or to refuse it.
Why all types of contraception are needed:
- any methods of contraception reduce the number of abortions - the causes of gynecological diseases, premature birth, maternal and infant mortality;
- protection helps to plan the birth of a child, depending on the living conditions of the family, the health of the parents and many other factors;
- some effective methods of contraception at the same time help to fight gynecological diseases, osteoporosis, infertility.
The effectiveness of contraceptives is assessed by the Pearl index. It shows how many women out of a hundred who have used the method during the year have become pregnant. The smaller it is, the higher the protection efficiency. Modern methods of contraception have a Pearl index close to 0.2-0.5, that is, pregnancy occurs in 2-5 women out of 1000.
Classification of contraceptive methods:
- intrauterine;
- hormonal;
- barrier;
- physiological (natural);
- surgical sterilization
Consider the listed types of contraception, their principle of action, effectiveness, indications and contraindications.
Intrauterine methods
Use foreign objects placed in the uterine cavity. Intrauterine contraception is widespread in China, Russia, and the Scandinavian countries.
The method was proposed at the beginning of the twentieth century, when, in order to prevent pregnancy, it was proposed to introduce a ring made of different materials into the uterine cavity. In 1935, intrauterine contraception was banned due to the large number of infectious complications.
In 1962, Lipps proposed the famous curved plastic device with an attached nylon thread for removing the contraceptive - the Lipps loop. From this point on, intrauterine contraception is constantly evolving.
Intrauterine devices are divided into inert and medication. The inert ones are not currently used. Only medicated contraceptives containing metal or hormone supplements are recommended, including:
- MultiloadCu-375 - Copper plated F-coil designed for 5 years;
- Nova-T - copper-wrapped T-shaped device;
- CooperT 380 A - T-shaped helix, designed for 6 years;
- - the most popular spiral to date, gradually releasing levonorgestrel into the uterine cavity, a progesterone derivative that has a contraceptive and therapeutic effect.
Mechanism of action
An intrauterine contraceptive has the following effects:
- death of sperm that have penetrated into the uterus due to the toxic effect of the metal;
- an increase in the viscosity of cervical mucus due to a hormone that prevents sperm cells;
- endometrial atrophy under the influence of levonorgestrel; ovulation and the effect of estrogen on the female body is preserved, and menstruation becomes shorter, less frequent or completely disappear;
- abortive action.
The abortive mechanism includes:
- active movement of the tubes and the ingress of an immature egg into the uterine cavity;
- local inflammatory process in the endometrium, which prevents the attachment of the embryo;
- activation of uterine contractions, ejecting an egg from the genital tract.
The Pearl index for spirals with copper content is 1-2, for the Mirena system 0.2-0.5. Thus, this hormonal system is the best method of intrauterine contraception.
Contraceptive administration
The intrauterine device is installed after an abortion or removal of the old one, 1.5-2 months after the birth of the child, or six months after the cesarean section. Before this, the patient is examined, paying attention to signs of infection.
After 7 days, the woman visits the gynecologist. If all went well, she should see a doctor at least once every 6 months.
The contraceptive is removed at the request of the patient, with the development of complications or at the end of the period of use, by pulling on the "antennae". If the "antennae" are broken, removal is carried out in a hospital. It happens that the spiral grows into the thickness of the myometrium. If a woman has no complaints at the same time, she is not removed, and the woman is recommended to use other methods of protection.
Complications and contraindications
Possible complications:
- perforation of the myometrium (1 case per 5000 injections);
- pain syndrome;
- bloody issues;
- infectious diseases.
If you experience severe abdominal pain, cramping sensations with bleeding, heavy menstruation, fever, profuse discharge, "loss" of the spiral, you should immediately consult a doctor.
The introduction of the spiral is absolutely contraindicated in pregnancy, infection or tumors of the genital organs. It is better not to use it if the menstrual cycle is disturbed, there is endometrial hyperplasia, anatomical features of the genitals, blood diseases, large, allergic to metals, severe concomitant conditions. It is possible for nulliparous women to use intrauterine contraception, but the risk of pregnancy pathology in the future is higher for them.
The advantages of this method of contraception are the possibility of using it during lactation, the absence of side effects caused by estrogens, and a lesser effect on the body's systems. Disadvantages - less efficiency and the likelihood of metrorrhagia.
Injectable contraceptives and implants
This method is used for long-term protection against unwanted pregnancy. The drug Depo-Provera is used, which contains only a gestagenic component, it is injected into the muscle once a quarter. Pearl index 1.2.
Benefits of injectable contraception:
- fairly high efficiency;
- duration of action;
- good tolerance;
- no need for daily pills;
- you can take the drug for uterine fibroids, and other contraindications for drugs with an estrogenic component.
Disadvantages of the method: the ability to conceive is restored only after 6 months - 2 years after the last injection; a tendency to the development of uterine bleeding, and subsequently - to their complete cessation.
This method is recommended for women who need long-term contraception (which, however, is reversible), while breastfeeding, with contraindications to estrogen drugs, and for patients who do not want to take pills every day.
For the same indications, you can install the implantable drug Norplant, which is 6 small capsules. They are sutured under local anesthesia under the skin of the forearm, the effect develops during the first day and lasts up to 5 years. Pearl index is 0.2-1.6.
Barrier methods of contraception
One of the advantages of barrier methods is protection against sexually transmitted diseases. Therefore, they are widespread. They are divided into chemical and mechanical methods of contraception.
Chemical methods
Spermicides are substances that kill sperm. Their Pearl Index is 6-20. Such drugs are produced in the form of vaginal tablets, suppositories, creams, foam. Solid forms (suppositories, films, vaginal tablets) are inserted into the vagina 20 minutes before intercourse so that they have time to dissolve. Foam, gel, cream act immediately after application. With repeated coitus, spermicidal agents must be re-administered.
The most common products are Pharmatex and Patenttex Oval. Spermicides somewhat increase the protection against sexually transmitted diseases, since they have a bactericidal effect. However, they increase the permeability of the vaginal walls, which increases the likelihood of contracting HIV infection.
The advantages of chemical methods of contraception are the short duration of their action and the absence of systemic effects, good tolerance, protection against sexually transmitted diseases. The disadvantages that significantly limit the use of such funds include low efficacy, the risk of allergies (burning, itching in the vagina), as well as the direct connection of use with coitus.
Mechanical methods of contraception
Such methods hold sperm cells, creating a mechanical obstacle on their way to the uterus.
The most common are condoms. They are male and female. Mens should be worn during an erection. Female condoms are made up of two rings connected by a latex film to form a cylinder that is closed at one end. One ring is put on the neck, and the other is brought out.
The Pearl index for condoms ranges from 4 to 20. To improve their effectiveness, you need to use these accessories correctly: do not use oil-based lubricants, do not reuse the condom, avoid prolonged intense acts during which latex may break, and pay attention to expiration date and storage conditions of the contraceptive.
Condoms protect against sexually transmitted diseases quite well, but do not completely protect against infection with syphilis and some viral diseases transmitted by skin contact.
This type of contraception is most indicated for women with rare or promiscuous intercourse.
What method of contraception to choose for the most complete protection against pregnancy and sexually transmitted diseases? In this case, a combined method is recommended - taking hormonal contraceptives and using a condom.
Vaginal diaphragms and caps are not widely used. These devices are put on the cervix before intercourse, and removed 6 hours after it. They are usually used in conjunction with spermicides. They are washed, dried, stored in a dry place and reused if necessary. The use of these tools requires training. They are not used for deformation of the cervix, vagina, inflammatory diseases of the genital organs. The undoubted advantage of such devices is their reusability and low cost.
Mechanical methods of contraception have the following advantages: safety, protection against sexually transmitted diseases (for condoms). Disadvantages are associated with insufficient effect and the connection between application and coitus.
Natural ways
Natural methods involve abstaining from intercourse on days close to ovulation. Pearl's index reaches 40. The following methods are used to determine the fertile ("dangerous" period):
- calendar;
- measuring the temperature in the rectum;
- examination of cervical mucus;
- symptothermal.
Calendar method of contraception
Only used in women with regular cycles. It is believed that ovulation occurs on the 12-16th day of the cycle with a duration of 28 days, the sperm cell lives for 4 days, the egg cell - 1 day. Therefore, the "dangerous" period lasts from 8 to 17 days. These days, you need to use other methods of protection.
What is natural contraception, I will try to give an accessible explanation. Contraception is the prevention of pregnancy. It can be carried out by various chemical, mechanical methods and methods, and by contraceptives, among which the most common are condoms, uterine caps and oral contraceptives.
Every person entering the time of sexual activity begins to think about methods of protection, that is, options for contraception. In our technological age, scientific minds have come up with many ways and options to prevent the risk of pregnancy and get unwanted viruses and diseases.
Simply put, there are many types of contraception, namely:
- natural contraception;
- contraception using various barriers or mechanical contraception;
- hormonal contraceptive method;
- chemical subspecies of contraception;
- surgical intervention as a method of protection.
Naturally, each species from this list has its pros and cons. In addition, none of them provide one hundred percent guarantee and protection against pregnancy or the option of contracting any disease or virus.
Let's talk about the first type of contraception - natural contraception for women.
The main essence of this method of contraception is to refuse to have sex on the most "dangerous" days for women. That is, during the period when the body is already ready for fertilization - on the days of ovulation of the female egg. This usually requires not only a lot of courage, but also a certain amount of willpower. And also it is necessary to be able to painstakingly calculate the possible "dangerous" female days of ovulation of the egg.
- What methods can be used to calculate when to practice and when not?
- How do you calculate these unfortunate days?
- How to avoid pregnancy without contraception?
Here are a few ways that you will probably find useful.
1. Cervical method (Billing method)
Determining the days of ovulation comes from observing the density of secretions from the female genital organs. So to speak, a woman calculates on which days she gets thicker. This method is statistically reliable about 85%.
2. Calendar method
A woman calculates the ovulation of her egg by the calendar. It subtracts 18 days from the shortest menstrual cycle, thereby obtaining the onset of ovulation. And from the longest menstrual cycle, it subtracts 11 days, thereby getting the end of ovulation. This method is inconvenient, since before starting to use it, you need to strictly calculate and monitor your menstruation throughout the year in order to be able to determine the longest and shortest menstrual cycle. Also, this method is considered the most unreliable, since the female body is very unpredictable. It can easily fail even due to changes in a woman's body as a result of primitive nervous tension.
3. The method of measuring the temperature of the female body from the inside
A girl who chooses this method should measure her basal temperature every morning to determine when it is dropping (this means that ovulation will begin within two days). And note when she is elevated (usually this lasts for several days, while the ovulation of the female egg itself lasts). It is necessary to enter data into the calendar in order not to make mistakes in the future in the calculation of "these" days. This method is popularly considered more reliable (by about 84 percent).
4. Lactation period
The most productive way of natural contraception is the lactation method. That is, it is believed that a woman is unlikely to become pregnant during lactation, or simply when she is breastfeeding a small child after childbirth. This method has been confirmed by scientific research. But still, it also does not carry a 100% guarantee of a positive outcome of sexual intercourse, since it is almost impossible to predict exactly when a woman's cycle will normalize.
5. Timely interrupted intercourse
Having chosen this method as a method of contraception, all responsibility rests entirely on men's shoulders. Since it takes a lot of willpower and concentration to stop yourself in time and pull the penis out of a woman a few seconds before ejaculation. Naturally, do not forget that with this method of contraception, you should take great care of personal hygiene every time: that is, do not forget to wash and sterilize the genitals of both the woman and the man. Because this method also does not protect sexual partners from contracting any sexual viral disease or fungus. It should be added that this method of natural protection from pregnancy has very large consequences for your body, namely, disturbances in the central nervous system. As a result of its constant use, neuroses can occur, breakdowns are possible, and even deterioration of erection right up to impotence itself. The specified method of contraception is not recommended if you are not sure that your sexual partner is fully able to control himself. The reliability of this method after long research is up to 80 percent.
Having considered and analyzed the methods of natural contraception, it is worth noting that they are effective only if you are completely confident in your partner, as well as in his loyalty and health.
Natural (biological) contraception is one of the safest methods of contraception for a woman's health, but it is not effective. Even when applied correctly, these methods are not very reliable.
Natural contraception is based on observations of physiological signs, which make it possible to identify cases when a woman is capable of conceiving (fertile) and when she is not capable of conceiving (infertile). The main purpose of this method is to determine the period when the fertility is highest.
Many couples can use natural contraception methods: when a woman cannot use other methods; if a woman has a regular menstrual cycle; couples who may refuse intimate relationships on certain days of the cycle; when other methods of protection are not available.
Natural contraception has several advantages: no side effects; free; both partners are involved, which helps to strengthen the relationship in a couple; can be used to plan pregnancy; for some couples - more pleasure after abstinence on dangerous days.
Natural contraception has the following disadvantages: pregnancy occurs in almost 50% of cases; does not protect against sexually transmitted infections; difficulties in identifying dangerous days, especially for women with an irregular cycle; requires up to three months of instruction and counseling; tensions often arise due to uncertainty about the effectiveness of the methods used; well, etc.
Natural contraception includes: abstinence, interrupted intercourse, calendar method, temperature method, cervical method, symptothermal method.
If you need a reliable method of contraception, if you have contraindications to the use of hormonal drugs, if you are shocked that the spiral does not prevent conception, but only leads every month to mini-abortions at very early stages, if you know that the spiral can lead to infertility, and you want to have children in the future, if your husband does not want or cannot use condoms, if you do not want to use hormonal drugs while breastfeeding your baby, if vaginal pills or calendar / temperature pills are too unreliable for you methods of counting days, then this method is just for you.
Few people know about this method of contraception. Cervical method- This is a method for determining the fertile phase by changes in the nature of cervical mucus.
The method is based on the fact that before and during ovulation, a woman changes the nature of vaginal discharge. These changes are well visible if you know what the matter is. But in order to understand, you will have to spend a month or two on daily measurement of the basal temperature and comparing the changes in this temperature with the change in discharge. But then you can live happily for many years. Later I will write what to do if you feed the chest and the cycle has not yet recovered, but for this you still need to know the theory:
1. The egg after ovulation lives no more than 48 hours, if fertilization has not occurred, therefore, two days after ovulation and up to menstruation, it is impossible to become pregnant (if a woman became pregnant on the 25th day of the cycle, this only means that her ovulation was delayed and did not occur on the 14th, and on the 25th day). The first thing that the method of natural control gives - a woman sees: ovulation occurs or is delayed, or will happen earlier.
2. Spermatozoa after excretion can live up to 5-6 days, but only in fertile cervical fluid, which is secreted from a woman shortly before and during ovulation (usually this is the middle of the cycle). At the beginning and at the end of the cycle, this fluid is absent and the spermatozoa die within a few hours. The second thing that the method gives is that a woman knows exactly on what day before ovulation she needs to start being prevented or not having sexual intercourse if she does not want to get pregnant.
So, only a few days in the middle of the cycle should be reserved, and these days are known for sure.
The first two months you will have to draw up a temperature chart. Basal temperature is measured in the morning, without getting out of bed, preferably at the same time, preferably in the vagina (the main thing is not to fall asleep with a thermometer :-) It is unnecessary to measure the temperature during menstruation.
In addition to basal temperature, you will need to record under the graph the changes in vaginal discharge during the cycle. Like this:
I decode:
1. dry - when there is no discharge or they are very insignificant, the spermatozoa in such an environment die immediately.
Some women never have "dry", immediately after menstruation and after ovulation until the next menstruation - the second type of discharge:
2. sticky discharge - white, in a small amount, not sticky, if you try to stretch it between the fingers, droplets in the form of white bumps remain on the fingertips. This is a barren discharge, the spermatozoa die in a few hours, and a few more days before ovulation.
The main thing is not to let the sticky discharge begin to transform into the following form:
3. watery (or creamy) - transparent like water or whitish like highly diluted milk, completely liquid, and some more like a liquid cream for hands. This is already a fetal discharge, in them spermatozoa can wait five days before ovulation.
4. "i. b. " - on the day or on the day of ovulation, discharge appears, similar to egg white, the discharge becomes thick, viscous (stretched between the fingers), translucent, there are a lot of them. Many women have such discharge for at least 1 day, for some it is 2, 3 days. This is the most favorable time for conception. In some women, "protein" does not appear at all, but simply the amount of watery discharge greatly increases. It also happens that the discharge appears only on the cervix and almost never comes out. In this case, they can be taken directly from the neck with two fingers with clipped nails. (You should also remember that the sperma can greatly distort the nature of the discharge, do not confuse the remnants of the sperm with the fetal fluid).
On the day of ovulation (on the last day of the greatest amount of discharge), the basal temperature does not rise yet, and for many it even drops by one tenth of a degree - the lowest temperature per cycle (the graph shows a downward wave).
As soon as ovulation has occurred, the discharge becomes sticky again or disappears altogether, and the temperature rises by about 0.5 degrees and remains elevated (about 37 ° C, but not lower than 36.8) until the end of the cycle, that is, for about 16 more days. After ovulation, you can get pregnant for another 48 hours, although there is no fertile fluid anymore, but there is an egg in the uterus, to which the spermatozoa can reach faster than die.
If the body slowly reacts to progesterone, then after ovulation the temperature rises slowly and reaches 37 degrees three to four days after ovulation, BUT during these 4 days there is no decrease in temperature. In this case, the equally infertile period begins 2 days after ovulation, and not 2 days after the highest temperature. If the temperature does not rise, then ovulation has not occurred, then either it will occur later (and the pattern of discharge will repeat) or this cycle will be non-volatile (and this happens).
So, you need to protect yourself or not have sexual intercourse:
Starting on the day the sticky discharge turns into a creamy one, and for even greater reliability - one day before the appearance of a creamy discharge (if the cycle is regular, they will appear on a certain day of the cycle, if irregular, then when "dry" turns into "sticky". however, you do not have a "dry" state, then - when the amount of sticky secretions begins to increase).
Ending on the third day after ovulation - when the discharge decreases, and the basal temperature of the second day is kept at a high level.
To do this, you need to observe your secretions and measure the temperature for 5 days in the middle of the cycle: starting from the day of the greatest secretions - egg white or very strong watery ones (you can start measuring earlier if in doubt about the nature of your secretions) and three days after reducing / stopping secretions to make sure that ovulation has occurred and the temperature does not drop for three days in a row.
When feeding with a chest
Until the cycle is restored, it makes no sense to measure the temperature. After childbirth, when the bloody discharge stops, watch yourself for ~ 2 weeks. If within 2 weeks there is no discharge ("dry") or they are sticky, you do not need to preserve. But sometimes you will observe individual appearances - the sticky liquid can become watery or "dry" turns into "sticky". In the first version, you can consider yourself safe 4 days after the disappearance of the aqueous liquid, in the second version - after 2 days after the disappearance of the sticky one. And so on until the first menstruation appears. It may happen that a sticky liquid appears and remains for at least 2 weeks, then consider this a new version of your infertility, up to the appearance of a watery liquid. (And remember that on the day of intercourse, the remnants of sperm can distort the picture - do not mistake them for fetal fluid). In a small number of lactating women, the discharge is consistently "watery" rather than sticky. In this case, it is recommended to keep the entire time until the cycle is restored.
Additional (not all women have them) signs of ovulation - a slight cutting pain in the lower abdomen (can be felt only with a sharp abdomen), small bloody brown discharge.
With an illness / cold, with an increase in the general body temperature, the basal temperature also rises, and if this happens in the middle of the cycle, it is difficult to determine whether ovulation has occurred or not. In this case, after recovery, it is recommended to wait for three days to measure body temperature (should be 36.6), and monitor the basal (in the region of 37 degrees three days in a row).
There are other signs of ovulation, they are not used in the above method, but maybe someone is useful if the cycle is very irregular or some gynecological problems:
1. there is a test for the determination of glucose in urine, a paper strip that changes color depending on the amount of glucose. In the region of the day of ovulation, the amount of glucose in the composition of the cervical fluid increases, the strip, if you drop this fluid on it, begins to change color two to three days before ovulation and stops changing color two to three days after ovulation. The strip acquires the most intense color on the day of ovulation;
2. during ovulation, the cervix opens and becomes soft, and immediately after ovulation it closes (in women who have given birth, a small gap remains) and becomes hard.
Note: if you do not have sexual intercourse on "dangerous" days, then the reliability of the method is very high - 98%. If, on dangerous days, we use preservatives, then the reliability of the method will be equal to the reliability of the prevention with the help of a preservative.