Barrier method contraception - protection from unwanted pregnancy by preventing sperm from entering the vagina or cervix mechanical (condoms, vaginal diaphragms and caps) or by chemical (spermicides). The combination of these two paths is called combined, for example, a combination of spermicides with diaphragms, condoms, caps, etc. There are the following types of barrier contraceptives: male - condoms, preventing the access of sperm into the vagina and female - diaphragms, caps, spermicides, preventing the flow of sperm from the vagina into the uterine cavity. Barrier methods contraception protect against pregnancy and sexually transmitted diseases. These contraceptives practically do not have an adverse effect on the body of women and men, but at the same time, modern hormonal drugs are 10-20 times less effective.
Condoms
The most common mechanical the barrier contraceptive is the CONDOM. The male CONDOM is a thin case made of latex, vinyl, polyurethane, etc. Advantages:
- Fast effect.
- The ability to use in combination with other contraceptives.
- Wide availability (in pharmacies and non-medical institutions).
- Sold without a prescription and do not require a medical examination before use.
- Low cost.
- Promote male involvement in family planning.
- The only family planning method that provides protection against sexually transmitted diseases (Latex and vinyl only).
- May lengthen erection time and time to ejaculation (ejaculation).
- May help prevent cervical cancer by protecting the cervix from sexually transmitted microorganisms that contribute to the development of cancer. These include herpes simplex virus, papilloma virus and chlamydia virus.
Disadvantages:
- Low contraceptive efficiency (3-14 pregnancies per 100 women per year), modern hormonal drugs are 10-20 times less effective.
- Requires use during every intercourse
- May reduce sexual feelings
- Having an adequate supply of condoms
- Possible allergic reactions to latex, spermicides and lubricants
- in need of immediate contraception;
- having rare sexual intercourse when a safety method is needed;
- if you have more than one sexual partner.
- with regular sex life, preferring a long-term method of contraception;
- if you are allergic to the materials used to make condoms;
- women whose age, number of births or health problems make pregnancy dangerous;
- if it is impossible to use condoms during each sexual intercourse.
The condom must be placed on the erection of the penis before it is inserted into the woman's vagina, because the released lubricant contains active sperm. Condoms should be used that follow the contours of the erect penis, with a pocket-like end (accumulator) intended for the outflow of semen. Putting on a condom should be very careful when the foreskin is as far as possible from the head of the penis. In no case should the product be pre-untwisted. It must be applied to the head of the penis and pulled over the penis with smooth movements. If a condom without a storage device is used, then it should not be put on completely, but should be left at the end of 1–2 cm for semen. Mineral oils, edible fats, creams or petroleum jelly should not be used for lubrication, as they destroy the material from which condoms are made. Spermicides or special gels are most suitable for lubrication. After ejaculation, holding the condom by the base (ring), the penis is removed from the vagina while it is still erect. This prevents the condom from slipping and getting sperm on the woman's genitals. Each condom should only be used once. Do not use expired condoms.
If the condom breaks or there is a suspicion of a violation of its integrity, use emergency contraception... The types of emergency contraception are:
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| It should be noted that condoms for women are already being produced, marketed and used in some countries. It is longer and wider than a man's, made of elastic polyurethane plastic, and is a cylinder 15 cm long and 7 cm in diameter, one of the ends of which is closed and contains a fixing ring. The female condom must be inserted into the vagina some time before intercourse. Due to imperfect design and high cost, it has not yet received widespread use. At the same time, presumably, further developments with the aim of improving the condom for women will continue. Using it, a woman will not depend on a man in this matter and will be calm about her health. |
Diaphragms
For a young woman who regularly has sex with one partner, the use of DIAPHRAGM is quite acceptable - mechanical a barrier contraceptive made of latex rubber, dome-shaped with a diameter of 50-105 mm. At the base of the dome is a flat, spiral or arc-shaped rubber-coated metal spring. A diaphragm is inserted into the vagina, the spring rests against its walls and thus the cervix is closed, preventing sperm from entering the uterine cavity. The diaphragm is especially effective in combination with spermicidal agents, because with combined use, in addition to enhancing the contraceptive effect, there is also the effect of lubrication for the introduction of the diaphragm. Advantages:
- Fast effect.
- No effect on breastfeeding.
- No need to insert the diaphragm immediately before intercourse (can be entered 6 hours before intercourse).
- No side effects.
Disadvantages:
- The need for use during each intercourse. Before each next one, a new dose of spermicide should be administered.
- A gynecological examination is required for the initial and postpartum diaphragm fitting.
- It is possible that a urinary tract infection occurs if the rules of personal hygiene are not followed (through dirty hands).
- Should not be removed within 6 hours of intercourse.
- A spermicide must be used every time the diaphragm is used.
Contraindications for using the diaphragm:
- individual intolerance to the material from which the diaphragm and spermicide are made;
- the presence of a chronic urinary tract infection;
- pain in the perineum between intercourse;
- the first 12 weeks after childbirth;
- menstruation or uterine bleeding during the intermenstrual period.
Using a diaphragm is possible: Using a diaphragm is not recommended: women whose age, number of births or health problems make pregnancy dangerous; if it is impossible to use during each intercourse. The selection of the diaphragm by size is carried out by a gynecologist. The diaphragm is used during every intercourse. Before its introduction, the bladder is emptied, hands are washed. The integrity of the diaphragm is checked by filling it with water. Then, a small amount of spermicidal cream or gel is squeezed into the diaphragm cup. It is used as follows: the edges of the diaphragm are brought together, one of the positions is taken (lying on the back or squatting, one leg is raised on a chair), inserted deep into the vagina behind the pubic bone. After that, a finger is inserted into the vagina and the cervix is felt, it is checked whether it is completely closed. The diaphragm is inserted no earlier than 6 hours before intercourse. After intercourse, it must also remain in the vagina for at least 6 hours (but not more than 24 hours). Before each subsequent sexual intercourse, additional administration of spermicide is required. Removed with a finger at the front edge. If necessary, a finger is inserted between the diaphragm and the pubic bone before removal to disrupt the suction effect. After use, the diaphragm is washed with soap and water, dried, and stored in a special box.
Caps
The CAP is a small diaphragm that only covers the cervix. The caps are made of rubber and have different sizes. Selected by a gynecologist.
Advantages:
- Possible introduction 6 hours before sexual intercourse.
Suitable for women who cannot use a diaphragm. Disadvantages:
- Low contraceptive efficiency (6-20 pregnancies per 100 women per year).
- A pelvic examination is required for initial and postpartum cap fitting.
- Inconvenience of insertion into the vagina.
- The need for the simultaneous use of spermicides.
Contraindications for using the cap:
- individual intolerance to the material from which the cap and spermicide are made;
- anatomical changes in the vagina (narrowing, developmental abnormalities);
- pain in the perineum between intercourse;
- the first 12 weeks after childbirth;
- menstruation or intermenstrual uterine bleeding.
The use of the cap is possible: in women who do not want or cannot use hormonal birth control pills or IUDs; in nursing mothers who have rare sexual intercourse. The use of the cap is not recommended: women whose age, number of births or health problems make pregnancy dangerous; if it is impossible to use during each intercourse. Caps and a diaphragm are used in combination with spermicides, which enhance the contraceptive effect, protect against some sexually transmitted diseases and solve the problem of vaginal dryness, which is often in lactating women. Currently, vaginal diaphragms and caps with a view contraception are used extremely rarely due to the availability of more effective and safer methods.
Spermicide
SPERMICIDES - substances (benzene chloride, nonoxilone-9), partially or completely inactivating, or destroying sperm. Refer to chemical barrier means contraception... Usually used in combination with other contraceptives, such as diaphragms, caps, condoms... Release form:
- aerosol (foam) ;
- vaginal tablets and suppositories, films ;
- cream, gel .
Vaginal lips
Vaginal sponges (small pads, oval in shape, measuring 2.5x5.0 cm, made of synthetic fiber and impregnated with spermicide - nonoxilone-9) have a combined effect: mechanical and chemical, and belong to combined barrier means contraception... Vaginal sponges prevent sperm from entering the cervical canal, retaining sperm in the sponge, and also release a spermicidal substance. Mechanism of action: destruction of the sperm membrane, which reduces their mobility and the ability to fertilize an egg. Advantages:
- Fast effect.
- No effect on breastfeeding.
- Ease of use.
- Additional hydration (lubrication) during intercourse.
- Do not require a preliminary medical examination (a doctor's consultation is advisable when choosing any remedy contraception, but this method does not apply to mandatory consultation).
- They have antibacterial activity against many microorganisms that cause sexually transmitted diseases.
- Many spermicides have no effect on pregnancy. are topical preparations.
Disadvantages:
- Low contraceptive activity (6-26 pregnancies per 100 women per year).
- The need to use during every intercourse.
- Vaginal tablets, suppositories must be inserted 10-15 minutes before intercourse, otherwise the contraceptive effect decreases.
- Each injection of spermicide is effective only for 2-6 hours (vaginal sponge - 24 hours).
- You must have a contraceptive before intercourse.
- Irritation of the vaginal mucosa or the skin of the penis is possible.
- Spermicide should not be used during breastfeeding or pregnancy.
Contraindications for the use of spermicides:
- individual intolerance to spermicide.
The use of spermicides is possible: in women who do not want or cannot use hormonal birth control pills or intrauterine devices; in nursing mothers who have rare sexual intercourse. The use of spermicides is not recommended: women whose age, number of births or health problems make pregnancy dangerous; if it is impossible to use during each intercourse; women with genital anomalies Spermicide selection:
- Aerosols (foams) and vaginal sponges are effective immediately after insertion.
- Vaginal tablets and suppositories require injection 15 minutes before intercourse.
- Spermicidal creams and gels are commonly used only in combination with a diaphragm, cap, or condom.
How to inject spermicides correctlyAerosol (foam) is introduced as follows: The container is shaken 20-30 times before use. It is placed vertically and an applicator is put on the valve, which is retracted to the side to be filled with foam. In the supine position, the applicator is inserted into the vagina so that its end is near or in contact with the cervix. The trigger is pulled and the foam is released. There is no need to wait for the action (the effect occurs immediately). After use, the applicator must be washed with warm water and soap, rinsed and dried. Vaginal tablets and suppositories or film are introduced as follows: The vaginal tablet, suppository or film is removed from the package. Lying on your back, it is inserted deep into the vagina. You need to wait 10-15 minutes before starting intercourse. Cream, gel: squeezed into the applicator before filling. The applicator is inserted into the vagina so that its tip is near or in contact with the cervix. The release is pressed and the content is entered. There is no need to wait for the start of the action (the effect occurs immediately). After use, the applicator must be washed with warm water and soap, rinsed and dried. Vaginal lips The sponge is removed from the package. Before insertion into the vagina, the sponge should be moistened with two tablespoons of water and squeezed out until foam appears. In the supine position, it is inserted deep into the vagina up to the cervix. The effect occurs immediately and lasts for 24 hours, i.e. the sponge can be used with multiple intercourses. Discard the sponge after use. |
Spermicides are substances that partially or completely inactivate or destroy sperm.
Content
For every family, having a child is happiness, but not everyone can give him good conditions and proper upbringing. To avoid unwanted pregnancy, there are means, methods and methods of contraception that enable a woman and a man to maintain a safe sex life, these are oral and hormonal contraceptives. The types of contraception and their percentage of safety are described below.
What is contraception
This is the prevention of unwanted pregnancies. Means are divided into mechanical, chemical and other drugs for safe intercourse. Modern contraceptives are divided into female and male. With the help of this technique, they not only prevent pregnancy, but also protect against:
- various sexually transmitted diseases (syphilis, herpes, chlamydia or gonorrhea);
- human immunodeficiency virus.
Contraceptives for women
For women, there are many contraceptive options for safe sex, they all have a different Pearl index. This is a special study that determines each year what percentage of women who have used one or another method of protection become pregnant. Means of protection (contraceptives) are subdivided into:
- physiological;
- barrier;
- spermicidal;
- hormonal;
- non-hormonal;
- emergency protection equipment;
- folk methods.
Male contraceptives
There is no such range of contraceptives for men, but scientists are actively developing methods of contraception for men. Basically, a man can use a condom or sterilization - these methods are not always comfortable, so there are little-known protection options: these are subcutaneous implants, contraceptive pills for men and a male spiral. In order to use one of these methods of contraception, the man needs to discuss them with his doctor.
Modern contraception
If earlier people simply abstained from sex in order to avoid having a child, today there are many ways to protect against various diseases or pregnancy. For example, modern oral contraceptives for women have become popular now. They are convenient, and if the couple decides to have a baby, the pill can be stopped and the percentage of getting pregnant rises.
Why do we need
Such funds are needed in order to avoid abortion (early termination of pregnancy), which can lead to problems and diseases of the reproductive system, infertility and other complications. The funds help to avoid early pregnancy: at this age, a girl cannot always bear a child. Contraceptive methods can be used by women over 40 years of age. Pregnancy at this age can cause the birth of a child with abnormalities in the chromosomes.
Contraceptive effectiveness in percent
In total, there are 3 groups of contraceptives: barrier, chemical, mechanical. A wide range of contraceptives allows women and men to choose the most convenient methods of protection. To select the optimal contraception option, it is recommended to contact your gynecologist. Next, we will consider the groups and types of contraceptives, determine their effectiveness, advantages and disadvantages.
Barrier methods of contraception
The most common and simplest methods of contraception today are barrier contraceptives. These include:
- male condoms;
- female condoms;
- vaginal diaphragms.
The mechanism of action of this group is that the products block the penetration of spermatozoa into the cervical mucus. The male condom comes in the form of a thin, oblong latex sheath. The product for women is a polyurethane tube (dimensions: diameter - 8 cm; length - 15 cm). Vaginal diaphragms or cervical caps are available in latex or silicone. Pearl Index (efficiency):
- male / female contraceptives - from 7 to 14%;
- cervical caps - 5%;
- vaginal diaphragms - from 6 to 20%.
The principle of the male condom: it is put on the penis during an erection. Its advantages: protects the mucous membranes of partners in direct contact; prevents the occurrence of infections, hepatitis, HIV, pregnancy; has different sizes and surfaces. Cons: may tear; requires a steady erection. The principle of the female condom is inserted into the vagina. Pros: the contraceptive is used for weak erection; can be left in the vagina for several hours. Cons: These funds are not sold in the CIS countries.
Vaginal diaphragms and cervical caps: Placed in the vagina using special spermicidal creams. Pros:
- reduce the risk of transmission of infections;
- can be used multiple times;
- prevent pregnancy.
Cons of cervical caps: you can get HIV; not always effective for women who have given birth; May be uncomfortable during sex Sizes with recommendations are available from your gynecologist. Disadvantages of the diaphragm: after childbirth, you need to select a different size, as when changing a woman's weight from 5 kg; the risk of cervical inflammation increases; infection is possible.
Chemical methods of protection
In addition to barrier, chemical contraceptives are popular. These are: vaginal creams, suppositories (suppositories), tampons. Means have contraceptive properties, protect against viruses, bacteria (staphylococcus, herpes, chlamydia, candidiasis). Candles, vaginal tablets and films are inserted into the girl's vagina 25 minutes before sex: during this time they have time to dissolve. Popular products are Patenteks Oval and Pharmatex. Pearl index of chemical methods of protection - from 6 to 20%. The funds are used 15 minutes before sex. Foam, gel and cream take effect after use.
Spermicides (contraceptives) have the following advantages: increase protection against herpes, chlamydia and other sexually transmitted diseases; have a bactericidal effect. Cons: increase the permeability of the vaginal walls (there is a possibility of HIV infection); on contact with soap, the active action is destroyed; short-term action (except for tampons); requires replacement at the next intercourse.
The following hormonal contraceptives are distinguished: combined oral contraceptives, injections, mini-pills, emergency contraception. They help protect against unwanted pregnancy by "replacing" the work of the ovaries. According to the principle of action, there are multiphase, two-phase or three-phase, according to the form of release - tablets, implants, injectables. Efficiency:
- combined contraceptives (oral) - from 0.15 to 5%;
- mini-drank - from 0.6 to 4%;
- injections - from 0.3 to 1.4%;
- implants - up to 1.5%.
Combined oral contraceptives are used daily for 21 days, at the same time, starting on the first day of menstruation. Mini-pills are used immediately before intercourse for half an hour. Injections are administered 2-3 times a month. Benefits: improves the condition of the facial skin; the menstrual cycle is normalized; the risk of ovarian cancer is reduced; the breast increases, becomes elastic; protect against unwanted pregnancy; application is possible in the absence of various diseases. Disadvantages:
- there is no protection against sexually transmitted diseases;
- with long-term use, the risk of developing candidiasis, heart attack, breast, liver and cervical cancer increases;
- there are many contraindications; during a break between doses, the risk of getting pregnant increases;
- side effects may appear.
Mechanical contraception
The most popular mechanical contraceptives are vaginal ring (NuvaRing), contraceptive patch (Evra). Their main purpose is to prevent the conception of a child. The ring is made of elastic material, the plaster is made of thin soft polyurethane. Efficiency:
- hormonal ring - from 0.4 to 0.65%,
- hormonal patch - from 0.4 to 0.9%.
The ring is inserted into the vagina, adjusting to the contours of the girl's body; the plaster is glued to different parts of the body (under the scapula, below the abdomen, on the buttock or on the forearm). Benefits: does not reduce the sensitivity of partners during sex; does not prevent the girl from playing sports; does not affect blood clotting; designed for 1 cycle (21 days). Disadvantages: Does not protect against STDs and HIV.
The contraceptive patch has the following advantages: changes every week; can be glued to any part of the body, convenient for travel, natural conditions where it is not possible to use another method of contraception. Its disadvantages: contraindicated for smoking girls (10 or more cigarettes per day); does not protect against STDs, effective for women from 18 to 45 years old.
Intrauterine contraceptives
The following are the most popular intrauterine contraceptives:
- Mirena Navy;
- hormonal IUD Levonov;
- hormonal Nova-T;
- CooperT 380 A;
- MultiloadCu-375.
Mechanism of action: The fertilized egg does not attach to the wall of the uterus when using this type of contraceptive. Installation is carried out only by a gynecologist. Contraception for women of this type is installed in the uterine cavity. An IUD or coil is considered a reliable method of protection, but there are possible complications and contraindications:
- inflammatory processes in the pelvic organs;
- latent chronic or acute infections;
- the presence of tumors of the reproductive system;
- dysplasia of the cervix;
- anemia;
- uterine bleeding;
- diseases of the endocrine glands.
Complications:
- the risk of exacerbation of inflammatory processes in the uterus and appendages increases;
- with menstruation, menstrual blood loss increases, and menstruation lasts longer than usual;
- the likelihood of an ectopic pregnancy increases;
- smearing vaginal discharge appears;
- perforation of the uterus.
Advantages: the spiral is installed for 5 years; it is possible to extract it if necessary; contraceptives are suitable for nursing mothers. Disadvantages: Increases the risk of infection and the development of inflammation and infection. All questions regarding the installation must be discussed with the doctor, such a decision is not made independently (it depends on the hormonal background and other points).
Natural methods of contraception
Natural biological methods of contraception are methods of preventing an unplanned pregnancy. They are used only by those women who have a regular and stable menstrual cycle. Girls keep records of unsafe and safe days for unprotected intercourse. These methods are divided into calendar, temperature, cervical methods and coitus interruptus.
Calendar
The calendar method is the calculation of the day of ovulation. Suitable for girls and women with regular menstruation. Ovulation falls in the middle of the menstrual cycle, from this day the girl can calculate the period when she can become pregnant (2-4 days and 2-4 days after). Unfortunately, the method is not always effective, because ovulation can occur on other days of menstruation.
Temperature
The temperature method consists in plotting a basal body temperature graph, that is, when a woman is at rest. It can be measured with a rectal thermometer. In the 1st phase of menstruation, the woman's temperature is slightly lower, and during ovulation it rises and remains so until the next. By making this timetable, one can understand when to ovulate in order to avoid sex on these dangerous days.
Cervical method
The essence of this method is that during the day the girl should observe the vaginal mucus after the end of her period. If the endometrium does not contain mucus, then you can continue to have sex without restriction. It becomes stringy during the maturation of the egg. On such days, it is better to use additional means of protection.
Interrupted intercourse
Coitus interruptus is the termination of sexual intercourse before ejaculation, outside the girl's vagina. It is a safe method of contraception because, for example, hormonal contraception can cause side effects. However, the probability of getting pregnant always exists: during sex, pre-seminal fluid is secreted (it contains up to 20 million sperm).
Hormonal methods of contraception
There is a classification of hormonal methods of contraception: gestagenic and combined. The first group includes monophasic, multiphase oral contraceptives, as well as injections, patches, and a vaginal ring. Combinations include implants, IUDs, and vaginal rings with progestogen. Next, consider the contraceptives, and which of them belong to one of the two groups.
Oral contraceptive pills
The progestogenic oral contraceptive pill is divided into monophasic, biphasic, and triphasic:
- Monophasic drugs include: Gestodene, Desogestrel, Regividon, Mikroginon, Minisiston.
- The following drugs are biphasic: Femoston; Binovum, Neo-Eunomin, Adepal and Bifazil.
- The following drugs are referred to as three-phase: Three merci, Triziston, Tri-Regol.
Vaginal rings and patches
The group refers to combined hormonal methods of contraception. At the moment, Evra is considered the most popular plaster, and Nova-Ring is distinguished among the vaginal rings. The latter is often used: there are few side effects, and more benefits than in oral contraceptives. The contraceptive patch Evra is more convenient to use: you do not need to insert anything into the vagina, which can damage its walls, you also do not have to swallow, like pills, which can lead to liver problems.
Mini drank
Small pills are contraceptive for women and are recommended to be taken during lactation, when smoking in older women and for heart pathologies. Mini-pills are progestogenic hormonal contraceptive drugs. This includes drugs such as: Charosetta, Continuin, Exluton, Primolyut-Nor, Micronor, Ovret. For consultation on the choice, it is recommended to contact the attending gynecologist.
Hormonal injections
Injections or hormonal injections belong to the group of combined drugs. The advantage of protection is that the woman does not need to take daily pills or insert new vaginal rings. For injections, drugs such as Nat-en and Depo-Provera are used. The disadvantage of these contraceptives is that you need to use a condom for the first 20 days.
Implant capsules
Special capsules for implantation belong to the group of gestagenic hormonal contraceptives. These capsules are implanted under the skin. Such an implant is called Norplant. When using it, you can not use contraceptives for 3-5 years. The tool can be used during lactation and various diseases in which other hormonal contraceptives are strictly prohibited.
Postcoital contraception
Emergency contraception is used in cases of unprotected intercourse. Such tablets can be used within 1-3 days after the end of intercourse. With their help, you can avoid unwanted pregnancy. Contraceptives are used in cases:
- rape;
- improperly produced interrupted intercourse;
- unprotected sex;
- if a condom breaks.
Sterilization
Complete sterilization is a method of contraception for both women and men. Male sterilization is vasectomy and in women, tubal occlusion. In the process of a surgical operation, an artificial obstruction of the fallopian tubes is created for a woman, and in men the vas deferens are ligated, while the testicles and ovaries are not removed, there is no negative effect on the couple's sex life.
Modern methods of contraceptionAttention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment based on the individual characteristics of a particular patient.
Found a mistake in the text? Select it, press Ctrl + Enter and we'll fix it!Barrier methods of contraception (BMC) are a group of methods for preventing the development of unwanted pregnancies, in which sperm cells are prevented from entering the uterus using a mechanical barrier.
Types, advantages and disadvantages of barrier methods
There are 2 types of funds:
- mechanical;
- spermicides.
There is a combined method when mechanical means are combined with medication. This method improves the reliability of both methods.
Mechanical contraceptives prevent sperm from entering the cervix. Their main advantage is that they do not have any harmful effect on women, unlike hormone-containing medications, and they protect against infection with sexually transmitted diseases. The efficiency is about 85%.
You can use barrier-type agents without first consulting a doctor.
Barrier methods of contraception are quite cheap, affordable, and most often have no contraindications. They can also be used in such cases:
- during breastfeeding, since they will not affect either the volume of synthesized milk or its quality;
- if oral contraception is contraindicated;
- if you need to take medications that are not combined with oral contraceptives;
- after an abortion, before the onset of a favorable period for conception;
- during the use of oral contraceptives, during a period when the activity of the ovaries is not completely suppressed;
- as a temporary means of preventing conception before sterilization.
The disadvantages of mechanical contraceptives include their lower degree of effectiveness compared to oral hormone-containing drugs, the possibility of an allergic reaction to some materials (latex, rubber). The funds must be used before each intercourse.
In most cases, the use of barrier contraceptives will not have a negative effect, but there are contraindications for use: for inflammatory diseases, deformation of the cervix, past toxic shock syndrome, etc.
Both types of contraceptives can be female or male.
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Female barrier contraceptives
For many women, barrier contraceptives are a preferable option, since they do not require consultation with a doctor, the involvement of specialists for the introduction (as opposed to spirals) and systemic changes. These include the diaphragm and the cervical cap.
The diaphragm is a small cap made of special rubber that must be inserted before intercourse. The size of the diaphragm can be different (50-100 mm), it is selected individually at the doctor's appointment. For nulliparous women, a diaphragm of 60-65 mm is usually prescribed. After childbirth - up to 75 mm. After the birth of a child or a change in weight (weight loss, weight gain), the size must be re-sized. The effectiveness of this tool is quite high.
Before using the diaphragm, make sure it is free of cracks or other damage. After intercourse, you need to leave it for 7 hours. Rinse and dry immediately after removal. Store in a cool, dry, dark place, but without the use of talcum powder. When used correctly, aperture efficiency can be as high as 85%.
Its advantages are:
- harmlessness;
- protection against STDs;
- ease of use;
- the possibility of repeated use.
The use of this remedy is contraindicated in case of allergy to rubber and some diseases, such as erosion or prolapse of the walls of the cervix, colpitis, developmental anomalies.
Cervical (cervical) caps are made of soft rubber. Available in 3 types depending on the shape. The cap is held in place by the walls of the vagina and covers the cervix. It is not recommended to install it for more than 4 hours. The efficiency ranges from 73 to 90%. The type and optimal size is determined by the gynecologist during examination, depending on the size and shape of the cervix. Used in combination with spermicide: it is applied to the surface of the cap.
Barrier-type contraceptives for men
The release of barrier contraceptives for men is carried out in only one version - condoms. They help protect against infections with a high degree of probability. It is produced from elastic thin rubber in the form of a bag-like formation. This method is considered quite common today, despite the emergence of more effective means of such contraception.
This barrier method has the following advantages of use:
- simplicity - used immediately before intercourse;
- protects against STDs, including HIV, which is of great importance at the moment;
- can be purchased at any pharmacy and in many stores;
- there is no need to consult a doctor before use.
The disadvantages of this method of contraception also exist: the need to use at a certain stage, a decrease in sensations and the appearance of an individual allergic reaction is possible. There remains the possibility of a break. Low efficiency implies the use of additional chemical remedies (spermicides).
Condoms can be used as “insurance” for couples who have irregular intercourse, as well as when there is more than one partner. With regular sexual intercourse, it is not recommended to use this method of protection. Do not use it if you are allergic to materials used in the process of making a condom and if pregnancy can be dangerous for a woman (due to age, health problems, etc.).
Chemical methods of protection
Chemical methods are represented by spermicides - means that reduce the activity of spermatozoa or destroy them. The composition includes active substances (nonoxilone, benzene chloride), which reduce sperm motility and reduce their ability to fertilize. In addition, they can protect against certain types of sexually transmitted diseases.
Spermicides are produced in the form of aerosol foam, suppositories, gels, tablets. Aerosol foam requires strict adherence to the instructions, otherwise the effect will inevitably decrease. For example, the effectiveness will decrease if the foam canister is shaken poorly or too little foam is applied before insertion.
Creams and gels are intended for use by women before intercourse. Creams are not recommended for use as an independent product due to their low effectiveness. Therefore, it is recommended to use them only as an addition to mechanical means.
Tablets and suppositories can provide reliable protection, but they are not comfortable enough to use, since they must be injected about 15 minutes before proximity. The protection lasts for about an hour, so when you repeat the act, you will have to re-enter the candle.
The effectiveness of most chemicals cannot be called high: from 5 to 25 pregnancies out of 100 are observed per year (depending on the type of spermicide used). Therefore, you should not use them as a basic tool. Before using chemical barrier contraceptives, you should consult your doctor.
For a long time, barrier contraception was the only relatively reliable method of preventing unwanted pregnancy and was used only for this purpose. Its popularity in recent decades has significantly decreased for a number of reasons, one of which was the emergence of other means, more reliable and convenient to use.
However, the presence in the latter of certain contraindications and complications associated with the effect on the body, the lack of the ability to protect against common pathogens of sexually transmitted diseases (STIs), forced to improve the traditional barrier method.
What is barrier contraception
Barrier contraception is a method of preventing sperm from entering the vagina and / or the cervical canal.
Barrier methods of contraception, in comparison with other methods, are characterized by the following advantages:
- They not only reduce the likelihood of conception, but also significantly reduce the risk of contracting STIs, some of which contribute to the development of cancer. These pathogens include gonococcus, human immunodeficiency virus, treponema pallidum, hepatitis viruses, etc.
- They do not have a negative effect on the organs and systems of the body.
- They have a short-term effect, and therefore do not require time to restore reproductive function after the termination of their use (unlike).
- Affordable price and no need for medical advice (for most funds).
Indications for use:
- Intermittent sexual intercourse.
- Contraindications to the use of hormonal contraceptives, etc.
- Pause in the use of hormonal and intrauterine (coil) protection.
- Breastfeeding.
- Prevention of STI diseases.
- Prevention of premature ejaculation in men.
- Prevention of allergic reactions to ejaculate, if diagnosed.
Types of barrier contraceptives
Mechanical means
Depending on the purpose, they are divided into male and female.
Barrier contraception for men
The most common male barrier contraceptives are male condoms (condoms), which are an elongated cylinder at the closed end (for collecting sperm). They are available in various lengths, widths and thicknesses, smooth, contoured, textured and in various colors and are intended for single use.
Materials for production are latex, polyurethane, polyisoprene, lambskin (from lamb fabrics). The most reliable are latex products, the material of which does not allow not only water to pass through, but also air and microorganisms.
After specifying the expiration date and quality (visually), the condom is put on in a state of erection, and after use, its integrity is checked. In case of its violation, a woman should use spermicidal agents or oral contraceptives according to an abbreviated scheme. Latex products can only be combined with water-based lubricants (if necessary) or lubricants (special lubricants that facilitate friction), since grease will destroy the material.
The main disadvantages of this method of protection are:
- low contraceptive effect - among women with regular use of condoms by their partners, the possibility of conception within 1 year is 12-20% (for combined oral contraceptives - 0-1%);
- a high degree of probability of violation of the integrity of the product (0.3-0.7%);
- the possibility of an allergic reaction to latex;
- weakening of erection due to a significant decrease in sensitivity in both partners during sexual intercourse.
The main advantage is the most reliable, in comparison with other methods, prevention of STI infection.
A wider choice of methods of protection is provided for women. They can use mechanical and chemical barrier methods of contraception or a combination of both, as well as combination means.
Female mechanical contraception
- Female condoms.
- Vaginal diaphragms.
- Cervical caps.
Female condoms
They are a relatively new barrier method of contraception. They are made of plastic polyurethane materials, like male condoms, designed for single use and have the form of a cylinder with a diameter of 70-80 mm and a length of up to 150 mm with one closed end. The female condom in the upper and lower sections is provided with more rigid structures in the form of rings, one of which fixes the product in the vagina, and the second prevents direct contact of the glans penis with the skin of the female labia.
Female condoms protect not only from unwanted pregnancies, but also from contracting sexually transmitted infections. In addition, unlike men, they have certain advantages:
- can be introduced several hours before sexual intercourse;
- do not create discomfort for a man, since there is no rigid fixation of the penis;
- do not reduce the sensitivity of the latter;
- provide better protection against STIs.
Vaginal diaphragms
Made of thin latex material and shaped like a domed cap with an elastic flexible rim. They are available in various sizes - from 5 to 15 cm in diameter. The most suitable size for nulliparous women is about 6.5 cm, for those who have given birth - about 7.5 cm. After childbirth or a change in the woman's body weight by more than 5 kg, it is necessary to choose a product with a different size. The diaphragm is inserted with two fingers into the vagina in a compressed form and straightened on the cervix along the vaginal vaults. This is done in the position of the woman on her back with bent legs or squatting.
The diaphragm is put on immediately before the act and is removed no earlier than 6 hours after it, but no later than 1 day. It is better to combine the product with spermicides and inject the latter additionally with repeated sexual contacts. Multiple use of the diaphragm is possible if, after removal, it is washed with soap in hot water and kept in a 70% alcohol solution for 20 minutes.
The frequency of cases of conception, subject to the rules for using this barrier contraceptive, is 2-5% in 1 year, with improper use - up to 10%. This method is less reliable in terms of infection with sexually transmitted infectious agents, but it helps to reduce the risk of cervical tumors by almost 5 times.
Contraindications to the use of a vaginal diaphragm are:
- prolapse of the walls of the vagina;
- genital developmental anomalies;
- inflammatory processes of the mucous membrane of the vagina and cervix;
- an allergic reaction to latex and spermicides;
- up to 1.5 months after childbirth.
Cervical caps
There are several types. The process of their introduction is rather complicated. They are held not by fixation on the cervix, but by the walls of the vagina. The type and size of the cap must be precisely matched to the size and shape of the cervix. The parameters are determined when examined by a gynecologist, who teaches the woman the rules of imposition. The principles of the protection they create are the same as when using a diaphragm. It is necessary to remove the cervical cap after 4-8 hours.
Chemical barrier agents
- Gels, tampons and creams (“Pharmatex”), injected immediately before intercourse;
- vaginal tablets (“Pharmatex”), as well as non-foamy and foamy suppositories (“Cotraceptin-T”, “Sterilin”, “Pharmatex”), which are introduced 10-20 minutes before the act of intercourse; they require additional introductions during repeated sexual acts, since they retain their activity for no more than 1 hour;
- aerosol foam, the effectiveness of which decreases with insufficient introduction or insufficiently active shaking of the balloon before administration, as well as with early toilet of the genitals.
The main components of these contraceptive forms are spermicides, which are chemicals that make sperm cells unable to move or pass through the membrane of the egg. Such substances are, for example, the natural polyphenol gossypol or octoxynol-9, benzalkonium chloride, nonoxynol-9i. They have a high degree of surface activity, due to which they contribute to the destruction of the sperm membrane. As a result of this effect, male germ cells lose their ability to fertilize.
Douching after using chemical contraceptives is possible after 8 hours. These products can be used on their own, but more often they are recommended in combination with condoms, vaginal diaphragms or cervical caps. In this case, the risk of pelvic inflammation is reduced.
It is preferable to use spermicides in combination with rhythmic contraception or at a later age of a woman, rare sexual contacts, that is, with a low risk of conception, as well as in the first cycle of taking oral contraceptives, during breaks in their use or use of an intrauterine device.
Disadvantages:
- low efficiency in terms of contraception (up to 30% of pregnancies in 1 year);
- insufficient activity against infectious pathogens (affect mainly gonococcus and treponema pale);
- the need for repeated injections before each sexual intercourse;
- the need for artificial termination of pregnancy, if the woman did not suspect about it and used spermicides, since the latter doubles the risk of developing fetal malformation.
Combined barrier contraceptives
These include products that combine both mechanical and chemical properties, such as vaginal contraceptive sponges impregnated with a spermicidal substance. It enters the vagina within 24 hours. The sponges are inserted before the act and placed in front of the cervix, which contributes to the retention of sperm. The frequency of unwanted pregnancies with this method is up to 15% at 1 year.
Contraindications for the use of barrier methods of contraception are erectile dysfunction, allergic reactions to the material of products or chemicals, inflammation of the mucous membranes and deformation of the neck (for diaphragms and caps).
Barrier contraception is historically the oldest method of preventing unwanted conception. Its use is known even in the civilizations of Ancient China and Egypt. For a long time, the only alternative to a mechanical barrier method of contraception were abortive drugs, taken orally when an already accomplished fact of pregnancy was detected and fraught with unpredictable consequences for the health of the female body.
The essence of this group of contraceptives is to create a barrier on one of the sections of the path of the sperm to the egg. The barrier can be of different localization (including located in the vagina) and of a different nature (mechanical and chemical).
Currently, the contraceptive market has diversified with other types of protection, due to which the popularity of the barrier mechanical method of contraception has slightly decreased. On the other hand, the advantage of barrier methods of contraceptives over hormonal contraceptives and surgical operations that artificially create obstruction of the fallopian tubes, and other non-barrier methods is to prevent the possible spread through sexual intercourse of sexually transmitted infections (including HIV, Epstein-Barr virus and other infections that have dire consequences for the body), thus providing a double protective effect.
They are also the best choice for young girls, say, for use at the age of 17, since the use of oral contraceptives (with the exception of postcoital drugs for emergency single use) at this age can lead to problems with hormonal levels. These factors force manufacturers of new generation of barrier and chemical contraception to expand and improve their product range.
For men, it is especially advisable to use condoms and spermicides in case of an increased rate of ejaculate ejaculation, fraught with its uncontrolled premature release. Barrier contraceptives for women are recommended in the following cases:
- (starting from the second month after the birth of the baby);
- If there are contraindications to the use of IUDs (intrauterine devices, such as Multiload), vaginal ring, and contraceptive medications;
- For women who have sex irregularly or infrequently, or do not have a permanent partner;
- If you have an allergic reaction to ejaculate.
Barrier methods of contraception
Barrier methods of contraception include several groups of contraceptives, which, in accordance with the nature of the created barrier, are combined into groups: mechanical and chemical methods.
There are also combined agents that create both types of barriers to sperm. In some cases, it is possible to choose the right method only through consultation with a gynecologist, since ignorance or ignorance of the pathologies of the genital area can be fraught with big problems for the patient in the future. But in any case, before choosing a drug, it is advisable to familiarize yourself with the list of the main modern barrier agents that can help protect against unwanted pregnancy. In addition, other barrier methods can be used - in this case, the likelihood of getting pregnant becomes even lower.
The effectiveness and reliability of contraceptives is expressed by the so-called Pearl index, which indicates the number of unwanted conceptions in 100 women who have used one method or another throughout the year. If a method has a low index compared to others, then its effectiveness is high. Natural methods (not involving the use of any devices or substances), such as abstinence from sexual activity during certain phases of the menstrual cycle (several days after ovulation), have a high index.
Mechanical methods
Methods in this group include the male condom and several types of female barriers.
The male condom is a single-use barrier product made from latex, polyurethane, or lamb cecum. Products made from latex are considered the most preferable, since it serves as a reliable barrier for microorganisms, which cannot be said about intestinal products due to their porosity. However, latex allergy is quite common among the population. The lower end of the product is elongated. It accumulates semen, which prevents it from entering the vagina.
Japanese manufacturer Kanpo produces super-thin products that minimize the intensity of a man's feelings. Until now, polyurethane products have not become widespread in Russia. They have a large wall thickness and are richly impregnated with oil lubricant.
Female condoms are disposable, cylindrical polyurethane devices with rings at both ends. One end is closed. Like men's products, they protect against genital infections.
The vaginal diaphragm is a latex cap that protects the cervix with an elastic ring base. With the correct use of the device, the Pearl index will be 2-5%. In terms of protection against genital infections, this method is less reliable than using a condom.
Cervical caps are also placed over the cervix. In terms of reliability, the same can be said about them as about diaphragms. The correct size of the cap can only be selected by a doctor on the basis of an instrumental examination of the patient. Since the cap can move if it is incorrectly fitted or inserted, it is better to combine its use with another method of contraception.
Chemical methods and combined agents
The chemical group of barrier contraceptives includes vaginal spermicides - drugs based on substances that have the property of killing spermatozoa or suppressing their activity. They are available in various forms - solutions, foaming tablets and suppositories, aerosol foam. To reduce the likelihood that spermicide will provoke an inflammatory process in the body, it is recommended to use it in combination with a cervical cap or a condom (this reduces the amount of contact of body tissues with the substance). The drugs have a very high speed of action, which is necessary when there is a significant speed of movement of spermatozoa.
Important! If a woman becomes pregnant and has previously used spermicides, the pregnancy must be terminated artificially, since these substances have a pronounced teratogenic effect.
Combined remedy - a sponge soaked in a spermicidal preparation inserted into the vagina in front of the cervix. The sponges are inserted just before intercourse, the Pearl index when used is up to 15 unwanted pregnancies per year.
Application of barrier means
For a full understanding of how to protect yourself using barrier means, you need to have an idea of the technique for using different types of contraceptive devices. The general rule is to reject the use of barrier methods, as well as sexual activity in general, during menstruation, and, if possible, during ovulation. To calculate the boundaries of this period, a woman needs to keep a menstruation calendar. The number of days from the first day of the cycle to the first day of the next cycle is calculated and divided by two. It turns out the number of the expected day of ovulation, 3-4 days before and after which abstinence from sex is recommended.
A small ring of a female condom is inserted into the vagina, while a large ring covers the labia, preventing their contact with the head of the penis. The male condom is carefully examined for integrity and is put on the erect penis.
The diaphragm and cap are washed with soap before use. Also, it will not be superfluous to smear the inner layer of any mechanical barrier agent with spermicide. The diaphragm, compressed from the sides, is inserted just before the act while lying on the back and straightened under the dome of the vagina. After 8-12 hours, it must be removed (incidents of toxic shock are described in women who left the diaphragm in the vagina for more than a day). The cap can stay on the cervix longer (up to a day). It is advisable for the gynecologist to select the individual size of the diaphragm and cervical cap and train the woman to insert them into the vagina. If the removed accessories are washed in hot water and soap and then put in alcohol diluted with water (80 to 20) for half an hour, they can be used again after drying.
Disadvantages and Benefits
Compared to other methods of contraception, barrier methods have the following advantages:
- Minimizing the risk of infection with sexually transmitted pathogens;
- Lack of influence on hormones and cardiovascular system;
- The short-term effect (which allows you to resume reproductive function at any desired time, whereas after the hormonal pills are canceled, time must pass for its restoration);
- Female mechanical devices reduce the sensitivity of the penis;
- Male condoms are irreplaceable if a woman is allergic to ejaculate;
- The breadth of distribution and affordability of the price.
Imperfections of barrier contraceptives:
- The effect is inferior to hormonal preparations for oral use;
- Decreased sensitivity and, as a result, weakening of orgasm;
- Possibility of allergy to the materials from which the products are made.
Contraindications
General contraindications to the use of barrier methods can be considered:
- allergy to product material or chemical components of spermicides;
- inflammatory processes in the pelvic organs.
In addition, there are specific contraindications to the use of cervical caps and vaginal diaphragms:
- Deformation or erosive process in the cervix;
- Prolapse of the walls of the vagina or uterus;
- The first month and a half after giving birth.
Despite the development of the contraceptive industry and the emergence of means that reduce the likelihood of unwanted pregnancy to almost zero, barrier means are still relevant because they prevent the penetration of sexually transmitted infections into the body, many of which seriously limit the ability to work and reduce the quality of human life. For maximum protection, barrier methods should be used in combination with other contraceptives.
