Gynecology And Obstetrics-

prevention

Under contraception of pregnancy (contraception) one understands all methods that aim at that after sexual act (Cohabitation) to no fertilization (Fertilization) the egg cell (Oocyte) comes through the sperm.

The types of contraception

There are currently different methods of contraception (Contraceptives) on the market that either:

on hormonal
on chemical or else
on a mechanical basis

the onset of pregnancy (Pregnancy) can prevent.

An example of a hormonal contraceptive would be the pill. Chemical contraception are, for example, contraceptive sprays or contraceptive jellies. Mechanical contraception means condoms or diaphragms.
There are also so-called natural contraception, such as the calendar method, and sterilization, which can prevent fertilization. The morning-after pill is also used.

How safe are the individual contraceptive methods?

How safe the individual methods of contraception are is checked in clinical studies. The reliability of a particular contraceptive can be assessed using the Pearl Index (PI).

The Pearl Index shows how many out of 100 women got pregnant using a single specific method of contraception in a specific period of time. A Pearl Index of 5, for example, means that 5 out of 100 women became pregnant using a certain method of contraception. Ever greater is the numerical value of the Pearl Index, the more unsafe is the contraceptive.

When specifying the Pearl Index, however, it is usually not stated whether the number of pregnancies that occurred was simply due to an uncertainty of the method of contraception itself or whether the improper use of the means of contraception also had an influence on the pregnancies that occurred. The Pearl Index is therefore to be viewed critically and only as an approximate guide value.

Some of the Pearl Indices of the most common contraceptives are listed here:

Anti-baby pill: 0.1-0.9
Mini pill: 0.14 - 3
Hormonal IUD: 0.16
Three-month injection: 0.3 - 1.4
Vaginal ring: 0.65 - 1.18
Hormonal patch: 0.72-0.9
Temperature method: 0.8 - 3
Copper spiral: 0.9 - 3
Condom: 2-14
Diaphragm: 1 -20
Spermicide: 3-21
Portion cap: 6 -30

Mechanical contraceptive methods

Mechanical contraception is the prevention of pregnancy through mechanical barriers.
Methods for doing this are listed below.

You can also read more about individual contraception under our topic: mechanical contraceptives

condom

The condom is a form of contraception that men use by slipping it over their erect limbs. It is considered the first choice contraceptive because when used correctly it not only offers very good protection, but also protects against sexually transmitted diseases.

For more information on this topic, read: The condom or How do I put the condom on?

Diaphragm

The diaphragm, also known as the vaginal pessary, consists of a spring ring covered with a silicone membrane. It is adjusted by the doctor so that it completely covers the cervix and can be inserted before sexual intercourse. An additional gel is used to try to stop the mobility of the sperm.

GyneFix® copper chain

The copper chain is attached to the upper part of the uterus and consists of a surgical thread to which copper elements are attached.As with the copper coil, the copper ensures that the sperm are restricted in their mobility and cannot fertilize the female egg. The method is considered to be very safe and can even stop the egg cell from being fertilized as an emergency contraceptive after the sexual act.

Please also read the article: GyneFix® copper chain

Copper spiral

The copper spiral consists of a plastic anchor wrapped with copper wire. The spiral is inserted by a gynecologist and then checked using ultrasound. These examinations should be carried out at regular intervals. It is believed that the copper changes the mucus in the female genital tract in such a way that the sperm are restricted in their mobility. With a Pearl Index of 0.9-3, it is a very safe contraceptive.

Read more at: spiral and What does the IUD cost?

LEA contraceptive

The LEA contraceptive is inserted into the vagina and can remain there for approx. 48 hours. With an additional gel further security is guaranteed. It is important that the LEA remains in the vagina 8 hours after intercourse, although the maximum wearing time has been exceeded. The safety is controversial due to the sub-optimal study structure.

Cervical cap

It can be placed over the cervix before intercourse and thus protects against the penetration of the sperm into the uterus. Before use, the size should be adjusted by a gynecologist to ensure optimum protection. The security varies a lot. In general, it can be said that the cervical cap works worse in women who have already given birth.

Chemical contraceptive methods

Chemical contraception is the prevention of pregnancy by chemically killing the sperm. This is done using so-called spermicides. They are available in different dosage forms:

gel
ointment
Suppositories
foam
spray

The spermicide should be applied at least 10 minutes before intercourse. Some agents kill sperm completely, while others only restrict mobility or stop the sperm from entering the cervix. With a Pearl Index of 3-21, this method of contraception is considered to be relatively unsafe. Combination with other contraceptives is therefore recommended.

Find out more about this at: natural contraceptive methods

Hormonal birth control methods

There are different methods of contraception with the help of hormones. Usually the hormones estrogen and / or progestin are used here. These play an important role in ovulation. If their concentration in the blood remains constantly high due to the contraceptive, ovulation usually does not occur and the secretion of the uterus changes in such a way that the sperm cells are restricted in their movement.

For more information, also read: Hormonal birth control methods

Birth control pills

The conventional anti-baby pill is the most popular hormonal contraceptive. It contains the hormones estrogen and progestin, the waste of which is important for ovulation. However, with regular intake, the level remains consistently high and ovulation does not occur. The Pearl Index is about 0.1-0.9, depending on the preparation, which speaks for a very safe type of contraception. Similar preparations such as the minipill, which only contains the hormone progestin, are very safe with a Pearl Index of 0.14-3.

Read more at:

birth control pills
Pill doesn't work
Pill and alcohol - are they compatible?
Forgot the pill - what should be considered?
Side effects of the pill
Thrombosis while taking the pill
What happens if you stop taking the pill?
Which drugs affect the way the pill works?
Mini pill

Three-month syringe

Here, every three months, a hormone-containing liquid is injected into the muscles of the woman, which suppresses ovulation. The method is very safe and only needs to be refreshed four times a year. However, it is also relatively difficult to get off again, so that a desired pregnancy can sometimes only occur after years, which is why family planning should ideally already be completed.

For more information read: Three-month syringe

Hormonal IUD

The hormone coil consists of a T-shaped plastic coil with a hormone depot from which progestin is continuously released. It is used by a gynecologist and can remain in the body for several years if it is not expelled during the menstrual period. They can thicken the mucus of the female genitals, which significantly restricts the mobility of the sperm.

Read more at: The hormonal IUD

Vaginal ring

The vaginal ring is a plastic ring enriched with estrogen and progestin that is inserted vaginally. Its mode of action is similar to that of the pill, although tablets are not taken every day. However, the ring should be changed very regularly to ensure reliable protection.

You might also be interested in this topic:

Postpone your period without a pill

Hormonal patch

The hormonal patch is worn for three weeks but must be replaced every week. The hormones that are released via the patch migrate into the bloodstream and prevent ovulation and change the lining of the uterus, which restricts the mobility of the sperm and makes it difficult for a fertilized egg to implant. It is a safe method of birth control.

Hormone stick

The hormone stick is about 4cm long and 2mm wide. It is surgically placed in the upper arm and can remain there for up to 3 years. It continually releases the hormone progestin and is very suitable for use after family planning is complete. Even after weaning, fertility is restored very quickly.

Natural birth control methods

Contraception with natural contraceptive methods is on the one hand the method with the fewest side effects, but on the other hand it is also the most risky method with regard to the safety of the contraception.
There are various methods of natural contraception available.

Find out more about the individual methods of contraception under our topic: natural contraception methods

Calendar method

The calendar method, also known as the Knaus-Ogino method of contraception, monitors the menstrual cycle in order to roughly predict the fertile days. With a cycle of 28 days, an average of 5 fertile days is assumed. However, the method is considered to be very unsafe with a Pearl Index of 9-30.

Temperature method

This method is based on the change in basal temperature over the course of the cycle. The basal temperature represents the temperature when you wake up and shows fluctuations. The temperature is slightly lower in the first half of the cycle and increases by at least 0.2 ° C in the second half. If you ovulate, your temperature will rise within 48 hours. The temperature method is reasonably safe when used correctly. However, there are factors that also affect basal body temperature and thus lead to measurement errors.

Billings Method

During this procedure, the cervical mucus is checked daily. In an infertile phase, the mucus is rather thick. The secretion becomes more and more fluid as the ovulation event approaches. After ovulation it becomes viscous again or disappears. However, there are other factors that can affect the nature of the mucus, which can lead to misjudgments. Therefore, the method is not necessarily safe.

Symptothermal Method (SMT)

With this method, which is also known as the Rötzer method, several measurement results are taken into account to determine the most fertile days. The temperature when you wake up, the texture of the cervical mucus and changes in the cervix and cervix are evaluated. The temperature and cervical mucus are assessed as with the temperature method and Billings method. Furthermore, the firmness of the cervix can be determined, which is rather hard and closed in the sterile days in order to increase safety. If used correctly, the method offers good security, but it should be practiced!

coitus interruptus

The coitus interruptus describes a sexual act that is broken off before ejaculation. The point in time at which the male member has to be removed from the female genital, however, is highly dependent on the man's body control and self-assessment and is therefore very uncertain with a Pearl Index of 4 - 27.

sterilization

Sterilization for contraception is a very good method of contraception after the desire to have children in old age has been fulfilled. In Germany, around 7% of women and 2% of men can be sterilized after family planning has been completed.
Further information is available under our topic: sterilization

The morning-after pill

The special thing about the morning-after pill is that if one of the other contraceptives is used inappropriately, it can be taken up to 48 hours after the sexual act and can prevent pregnancy. This form of contraception consists of tablets that contain high-dose gestagens or gestagens and oestrogens and prevent ovulation as well as implantation (Nidation) of the egg cell.
Further information is available under our topic: