Contraceptives
How to protect yourself and not become a victim of myths
According to VTsIOM, 29% of Russians under the age of 60 admit to a lack of knowledge about modern methods of contraception. Post-science decided to fill this gap and talked about protected sex with Candidate of Medical Sciences Anastasia Belova.
What is contraception and what is it like
Contraception is a set of measures that is aimed against unwanted pregnancy or sexually transmitted infections. Some contraceptives protect only from the first, while others protect from both the first and the second.
Contraceptives are divided into male and female, and male ones are represented by a very limited choice: firstly, these are condoms that serve as a barrier to ejaculate, and secondly, these are vasoresection and vasectomy, in which a section of the vas deferens is surgically crossed or excised, through which spermatozoa enter directly from the testicles into the penis. In turn, there are more female options for contraception, this broad class is divided into hormonal and non-hormonal types.
The hormonal type includes combined and progestogenic contraceptives. Combined contain two types of hormones — estrogens and progesterones — and are presented in the form of tablets, patches, vaginal rings and injections, although the latter in They are not approved for use in Russia. Progestogenic drugs in the composition contain only the hormone progesterone and come in the form of tablets, intrauterine spirals or implants that are placed under the skin of the arm from the inside of the shoulder.
The non-hormonal type includes barrier and intrauterine contraceptives. Barrier condoms are female condoms, caps and diaphragms, as well as gels, ointments that contain a substance that destroys sperm. Intrauterine contraceptives are non—hormonal spirals of various shapes made of plastic with copper, silver or gold applied.
There are also biological methods: this is an interrupted sexual intercourse and a calendar method in which the days with the lowest probability of getting pregnant are counted.
At the same time, there is a way to avoid unwanted pregnancy and after sexual intercourse. To do this, emergency contraception is used in the form of spirals or tablets: as a rule, they must be applied no later than 72 hours after sexual intercourse.
How contraceptives work
Both male and female condoms, as well as caps and diaphragms, work mechanically: in this case, an obstacle is naturally created, as a result, the sperm cannot meet the egg.
A non—hormonal spiral is a foreign body in the uterine cavity that causes aseptic (non-infectious) inflammation. Due to the appearance of the products of this inflammation, there is a decrease in mobility and destruction of spermatozoa. If fertilization does occur (which is unlikely, but possible), the egg is destroyed before implantation into the mucous membrane of the uterus body. Some attribute this method of contraception to abortive, but this is a mistake.
The main mechanism of action of hormonal contraceptives is the suppression of ovulation, the process of egg release from the ovary, necessary for meeting with the sperm and further fertilization. The result is clear: there is no ovulation — there is no egg, which means there is no unwanted pregnancy. In addition, hormonal contraceptives thicken the mucus that is located in the cervix, which creates a barrier to the passage of sperm. They also temporarily cause thinning of the inner lining of the uterine body, which prevents the implantation of an egg.
Finally, spermicides are substances that destroy spermatozoa. The effectiveness of spermicides significantly depends on how to use them: it is important to carefully read the instructions and inject the substance at a certain moment, in the specified amount.
Which methods of contraception are most effective
There is a so-called Pearl index, which helps to determine the reliability of the contraceptive method. The Pearl index is equal to the number of unplanned conception within one year in 100 women using one or another method of contraception. Accordingly, the lower this index, the more effective the method.
For example, for a male condom, the Pearl index varies from 2 to 18. This means that with the correct use of a condom, pregnancy can occur in two cases out of a hundred; but if the condom is expired, does not fit or is worn not before, but during sexual intercourse, then pregnancy can occur in almost every fifth case (in 18 out of 100). The index of the calendar method ranges from 9 to 24: in this case, it is important to understand that there is no guarantee of falling into a particular range, so you need to focus on the maximum, that is, on the last digit. But for combined oral contraceptives, the Pearl index varies from 0.1 to 0.9. This is the most effective method of contraception, provided the correct selection of the drug by the doctor and the exact following of the reception scheme.
What protects against sexually transmitted infections
Only male and female condoms protect against sexually transmitted infections (subject to the technique of use). Other contraceptives or folk methods do not provide this: the first protect only from unwanted pregnancy or have very low effectiveness against STIs, and the second do not work at all and pose a danger to health.
Even one unprotected sexual intercourse is enough to face negative consequences: according to the World Health Organization, more than 1 million cases of sexually transmitted infections occur in the world every day.
Can contraceptives be harmful to health
The Swiss doctor, the forerunner of modern pharmacology, Paracelsus, owns the phrase: "Everything is poison, nothing is devoid of venom. The dose alone makes the poison invisible." In a broad sense, this means that you can harm your health with anything, which means that contraceptives can be dangerous.
For example, condoms, gels and ointments can cause an allergic reaction. Therefore, if complaints arise, you need to consult a doctor and find a competent solution to the problem: for example, there are latex—free condoms - they can be a solution for cases of latex intolerance. When choosing hormonal contraceptives, a doctor's consultation is a mandatory and very important measure, independent selection of the drug can cause disorders in the body. At the reception, the doctor measures blood pressure, conducts an examination, draws up a questionnaire with the patient's personal data and selects the drug based on the medical acceptance criteria recommended by the World Health Organization.
Common myths about contraception
1. A condom is the most effective method to avoid unwanted pregnancy. The Pearl index shows that this is not the case, but a condom is the only method of protection against sexually transmitted infections.
2. Hormonal contraceptives a priori harm health, cause infertility, disrupt hormonal balance and increase body weight. With proper selection of the drug, hormonal contraceptives will not have negative effects on health. Therefore, it is important to consult a good doctor.
3. Interrupted sexual intercourse helps to avoid sexually transmitted infections. In fact, interrupted sexual intercourse does not reduce the risks in any way: the transmission of infections occurs when the mucous membranes of the genitals, sperm, vaginal secretions and even the skin in the genital area come into contact.
4. Oral sex is safe sex. In fact, during such contact, syphilis, gonorrhea, HIV, herpes, chlamydia and other infections can be transmitted, and oral sex turns out to be more dangerous for the "receiving" party.
5. Emergency contraception should be used in exceptional cases, as it can cause serious side effects that are dangerous for reproductive and general health. There is no evidentiary basis in this statement. In practice, the frequent use of emergency contraceptives can enhance their side effects and cause menstrual irregularities, but not lead to fatal health consequences.
Why contraception and information about it are important
Contraception has become a mass phenomenon since the 1950s: the first oral contraceptives appeared at the turn of the 1950s and 1960s, at the same time male condoms were already widely available in developed countries. Researchers evaluate this phenomenon, of course, positively: contraception allows you to plan a family, reduce maternal and child mortality, the number of abortions, and prevent the spread of sexual infections. The advent of contraceptives gave women the right to build their lives without worries, plan pregnancy at a convenient time, and calculate the burden on their own health.
Despite this, there are still a lot of myths and prejudices about different contraceptives in society. That is why it is very important to talk about them, including with teenagers who have not yet had the experience of sexual relations.
At the same time, informing adolescents about contraceptive methods in Russia has its own specifics. Since 2012, amendments to the law "On the Protection of Children from Information Harmful to their Health and development" have been in force in the country, which prohibit "depicting and describing sexual acts" to children under 16, which turns out to be a serious obstacle to sexual education. At the same time , the average age of sexual debut in Russia is 16-17 years old. It turns out that yesterday's children, whom the state protected from negative influence, fall into another trap — a sharp transition into the adult world. And in this world, the first sexual contact without protection can have consequences for life.
Who should be responsible for providing contraception
It is logical to assume that in an equal relationship contraception is a joint task of two partners. This view is shared by 82% of Russians under the age of 60: they agree that partners have equal responsibility.
In practice, with irregular sexual activity and frequent changes of partners, doctors recommend using a condom, since this method works not only against unwanted pregnancy, but also against sexual infections. It is also important to remember that condoms have an expiration date, after which their strength decreases significantly. Also, the reliability of condoms depends on the manufacturer, storage conditions and compliance with the rules of use.
To achieve a high level of protection, it is important to use condoms constantly and correctly. This means that:
— with any type of sexual contact: vaginal, oral or anal;
— a new condom before each new sexual act;
— from the beginning to the end of sexual intercourse, not just at the end;
— paying attention to the selection: shelf life, size, quality;
— do not forget about storage conditions: in a dry and cool place, not in a purse or jeans pocket;
— correctly putting on and taking off;
— using a suitable lubricant: it reduces the likelihood that the condom will break.
At the beginning of sexual life with a new partner, doctors advise discussing the issue of contraception and jointly choosing the optimal protection. In a stable partnership, instead, you can plan a trip to the doctor: in case of negative tests for both partners, worries about the exchange of infections are irrelevant, and you can choose another method of contraception to control an unwanted pregnancy.
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