Usually it is customary to use protection before sexual intercourse, but different situations happen in life... The condom burst... Your head turned and you forgot about everything... The interrupted act did not work out... There are doubts about the contraceptive used...
For all these situations, there are emergency methods of protection called post-coital.
Such tablets can be taken within three days after intercourse. The less time passes after the act, the higher the effectiveness.
Table of contraceptive effectiveness
To reliably prevent conception after unprotected coitus, a large concentration of hormonal substances is required, so this type of contraceptive cannot be taken constantly. They are for SOS occasions only. According to medical data and WHO recommendations, During the year, a woman can resort to emergency measures no more than three times.
When do women seek emergency help?
It is worth using postcoital contraception in every case when pregnancy is undesirable.
This is necessary even with a permanent partner if contact has taken place, but at the moment you or he are accepting certain medicines that can cause abnormalities in fetal development. These include:
- Antibiotics, especially tetracycline.
- Contraception less than six months ago.
- Valproic acid and medications based on it for the treatment of epilepsy.
- Steroids.
- Beta blockers.
- Antiviral.
- Antihelminthic.
Certain diseases may also be indicated, such as tuberculosis, hepatitis, syphilis, rubella, and serious disorders of the thyroid gland or kidneys. There is a possibility of conceiving if you are taking oral contraceptives but miss several doses. “Casual” sex for one night or violence, after which you do not want to give birth, are also good reasons for emergency protection.
Unplanned pregnancy is a very common event. Of all cases of conception in the world, 66% are unplanned. Therefore, if you are sure that you will interrupt pregnancy in any case, it is better to take the pills. Preventing conception is much more humane for a possible baby and safer for a woman than abortion.
Contraindications
Like any hormonal drugs, contraceptives after sexual intercourse introduce an imbalance into a woman’s body. In this case, a deterioration in well-being may be observed.
- Nausea.
- Weakness, dizziness.
- Bleeding.
- Pain in the lower abdomen.
- Indigestion.
- Dryness in the vagina.
- Skin rashes.
- Swelling.
- Severe headaches.
- Disturbances in the blood flow system, up to a heart attack.
In the future, you may observe changes in the monthly cycle, disruptions in menstruation. The consequences are especially pronounced after 35 years and in those women who smoke. If you use the drugs too often, then over time there is a threat of ectopic pregnancy or miscarriage.
The body will need time to recover and return to a balanced state. The optimal break between tablets is three to six months.
Contraindications to emergency contraception are:
- Problems with blood clotting and tendency to bleed.
- Young age - up to sixteen years.
- Lactation.
- Low hemoglobin.
- Serious liver and kidney diseases.
Mechanism of action
You should know that birth control after sex has two mechanisms of action and the choice may make a fundamental difference on the moral side.
- First group– prevents ovulation, that is, it does not allow the egg to mature and be released, so conception does not occur in principle.
- Second group– prevents an already fertilized egg from attaching to the uterus, which for opponents of abortion and believers is equivalent to murder.
The first group includes drugs with a gestagenic effect. They are similar to female hormones produced by the corpus luteum and adrenal glands during pregnancy. Substances prevent the pituitary gland from producing elements that provoke the maturation of the egg. It is for this reason that women do not have periods during pregnancy. They also make vaginal mucus thick and difficult for sperm to move through. These pills are effective during the first half of the cycle up to three days before ovulation. If the egg has already been released from the ovary, progestin-only contraceptives become useless.
The second group includes substances with an antigestagenic effect. They work in two ways. On the one hand, like the previous group, they inhibit the maturation of the egg, on the other, they block the hormones that make the uterus a suitable place for the maturation of the fetus. In order for the egg to merge with the endometrium, a number of changes occur in the mucous membrane, which are stopped by antigestogens. At the same time, they increase muscle contraction, pushing the zygote out of the organ cavity.
Intrauterine devices with copper also belong to this group. Their installation should take place no later than 120 hours after sex. Protection efficiency is 99%. The IUD prevents the egg from attaching and also changes the environment in and around the uterus, making it unsuitable for sperm. The method is not recommended for nulliparous women. Also, not all women tolerate implantation well; the IUD causes uterine bleeding (24%), severe inflammatory processes (4%) and uterine perforation (0.5%).
Let's take a closer look at the pills from each group and determine which ones are most suitable after unprotected sexual intercourse.
Birth control pills after intercourse for 72 hours
Drugs that delay the release of eggs are based on levonorgestrel. Trade names may vary:
- Eskinor F.
- Escapelle.
- Gravistat.
- Microlute.
- Postinor.
Substances that protect the uterus from the fertilized egg are made using mefipristone.
- Genale.
- Miropriston.
- Mifegin.
Another group is combination drugs with levonorgestrel and estradiol. They are allowed to be taken as permanent oral contraceptives. Thanks to the presence of estradiol, they regulate the monthly cycle and lead to the onset of menstruation before the maturation of the egg - endometrial rejection. When used as an emergency aid, the dosage must be strictly observed so as not to cause uterine bleeding. These include:
- Trisiston.
- Triquilar.
- Trinordiol.
- Gravistat 125.
- Klimonorm.
- Microgynon.
- Minisistron.
- Miranova.
- Anteovin.
- Silest.
- Non-Ovlon.
Despite the use of the same active ingredient, different drugs are tolerated differently. This depends on the auxiliary components, the degree of purification, and the concentration of the active component. Let's look at the most effective ones in the opinion of women and doctors.
Good and effective birth control pills after intercourse: list with names
Postinor
Counts the best drug in terms of effectiveness and tolerability by the body. Contains synthetic levonorgestrel, an analogue of the natural hormone. Helps avoid unwanted pregnancy by slowing down ovulation. Well suited for women with regular cycles.
It is not used as permanent protection, since the dose of progestogen in it is higher than in conventional medications for every day. However, less than in some drugs of similar action.
It is best to take the tablet in the first two days after contact. Drink the remedy twice. The first tablet during the first or second day and another one twelve hours after the first. If vomiting occurs and two hours have not passed since using the contraceptive, the dose is repeated. Due to the low concentration of the active substance, this combination is allowed twice a month.
The drug is not prescribed to women with cholecystitis and liver diseases. Treatment with antibiotics (tetracyclines and ampicillins) reduces the effectiveness of protection. After using Postinor, nausea is observed, absence of menstruation is observed for some time, and spotting between menstruation. The cost of a package containing two tablets of the product is about 350 rubles.
Escapelle
Two pills include a high concentration of the active ingredient - levonorgestrel (1.5 mg). Take them simultaneously or sequentially with an interval of 12 hours. However, the effectiveness will vary. If you take two tablets at once within three days, the chance of getting pregnant will be 16%. When taken at intervals, everything depends on the start date of treatment. By the last third day, the probability of protecting yourself from an unplanned pregnancy is only 58%.
It should be understood that the expression side effects at double the dose it is significantly higher. They consist of migraines and loss of consciousness, weakness, pain in the lower abdomen and nausea, bleeding in 10% of cases and more often.
There is evidence of a decrease in the effectiveness of treatment in obesity. Do not use Escapelle if there is severe liver failure. The drug does not affect the development of the child; if you did not know about the pregnancy that had already occurred, the medicine will not affect the baby. Three hundred rubles costs one package of 2 pieces of 0.75 or one piece of 1.5 mg.
Gynepristone
Includes 10 milligrams of mifepristone. According to research, this is the optimal dose; increasing the concentration does not increase the effectiveness of the drug. The pills work by blocking receptors for progesterone, the pregnancy hormone. As a result, the body does not undergo the changes necessary for the baby to begin to develop. It starts to work very quickly. The maximum concentration in the blood is observed after an hour and a half.
Do not use for inflammation of the genital organs, anemia, bronchial asthma and renal failure. The effect is opposite to glucocorticosteroids (inhalations for asthma, drugs for the treatment of joints), therefore Ginepristone is not used in therapy with these drugs. Also, after a course of contraception, non-steroidal anti-inflammatory drugs (analgin, ibufen) are not prescribed for two weeks.
To get the maximum effect, you should not eat for two hours before and after taking Gynepristone tablets. One tablet costs 180 rubles.
Mifepristone
Concentrated preparation based on mifepristone - 10 or 200 mg in each pill. It is used not only for contraception, but also for medical abortion, up to 1.5 months of pregnancy, as well as induction of labor. The active substance prevents the egg from implanting, delays ovulation, and significantly increases the contractile activity of the uterus. In combination with prostaglandin, muscle strength increases. The drug is used in the treatment of certain cancers and uterine nodes by blocking progesterone receptors.
For protection, use 10 mg once. May lead to exacerbation of inflammatory processes in the genital organs, vomiting, and diarrhea. It is considered a strong drug and is available in pharmacies with a prescription.
Combined birth control pills after sex
Ovidon
A combined product based on ethinyl estradiol (0.05) and levonorgistrel (0.25). Causes changes in the fallopian tubes, cervical canal, endometrium, ovaries. The latter are at rest, and the endometrium temporarily atrophies. Acts most effectively - prevents pregnancy 100%.
However, there is a large list of contraindications, including:
- Feeding the baby.
- Heart pathologies.
- Diabetes.
- Hypertension.
- Thrombosis.
- Anemia.
- Gallbladder diseases.
For permanent oral contraception, use one tablet, and for urgent use up to 4 tablets at once, for example, 2 tablets with a 12-hour break.
Consequences of taking postcoital birth control pills
You should be careful when choosing partners and monitor your safety. Unprotected sexual intercourse is dangerous for a woman due to its consequences, both in the case of abortion and emergency care. The use of postcoital contraception can unsettle you for a long time and harm your health. Many women experience:
- Severe paroxysmal migraine-type headaches.
- Cycle disturbances with delays of up to a week or more.
- Bleeding after taking it and between periods.
- Problems with pregnancy, including infertility.
- Blood clot formation.
- Risk of ectopic pregnancy.
Therefore, if possible, the use of these drugs should be reduced or completely eliminated. If you cannot avoid taking it, you should carefully study the contraindications and accurately calculate the dose without exceeding it.
If you protect yourself with condoms, then it is better to know in advance what to do if they break. In this situation, there is no time to find out the reasons; it is necessary to take measures to prevent pregnancy from occurring. Means emergency contraception are different, their choice must be approached based on the situation.
Before using contraceptives, you need to study their positive and negative qualities.
SOS contraception is used after unplanned intercourse or in situations where the main option for protection against pregnancy has failed. If you are sure that conception has occurred, you need to take action within 3 days. Contraceptives for such cases can be one of the following types:
- next day preparations;
- installation of an intrauterine device;
- combination drugs.
Women should familiarize themselves with these in advance, and remember that they cannot replace basic contraceptives. This is due to the fact that doses of hormones negatively affect not only reproductive function, but also on the body as a whole.
Of the listed options, IUDs have fewer side effects; the risk of conception when using them remains minimal. If conception occurs with these devices, then the woman has to decide what is better: carrying the child and removing the IUD or terminating the pregnancy.
Features of contraceptive drugs
The “morning-after pill” is different in that it must be taken after possible fertilization and before implantation. You only have 72 hours, but you need to understand that delay increases the chances of conception. By 65-72 hours after intercourse, the effectiveness of most drugs decreases to 45-65%.
The 72-hour pregnancy pill is used in cases where the harm from abortion or fetal development to the body is higher than from taking it. Gynecologists recommend using them in cases where, after childbirth, caesarean section less than 3 years have passed, as well as in a number of other cases, for example, after rape.
Since in our country emergency funds sold without a prescription, women often use them to prevent conception when it is undesirable and the usual option of birth control has not worked.
How do they work?
Birth control pills taken within 72 hours after intercourse act immediately in several ways:
- They prevent the onset of ovulation by suppressing the activity of the ovaries.
- Contractions of the fallopian tubes are suppressed, preventing the fertilized egg from quickly entering the uterus.
- They thin the endometrial layer, preventing the fertilized egg from attaching.
- Cervical mucus becomes thicker under the influence of hormones, it clogs the cervix, preventing sperm from entering.
In most cases, these processes occur under the influence of large doses of hormones, which trigger the body’s process of natural endometrial rejection, that is, menstruation.
At this time, the uterus contracts, expelling the fertilized egg. The production of specific hormones that support pregnancy is blocked.
Is it possible to use vaginal capsules in SOS cases?
Doctors recommend, if a little time has passed after intercourse, to use local rather than oral options. There are special pregnancy pills for the vagina after intercourse that do not have a pathogenic effect on the liver and digestive system women.
They can be used when the absorption of nutrients in the intestines is impaired. The only drawback of local capsules is their low effectiveness; even with timely use, they help only in 85% of cases.
The most popular drugs are:
- "Benatex";
- "Pharmatex";
- "Ginakotex".
The main advantage of vaginal capsules is that they are safe as they are not hormonal. However, to increase effectiveness, you should use the Yuzpe method or emergency contraceptives taken orally. Without the use of other means, the risk of conception is high.
Emergency contraceptives
To interrupt fertilization, options from two groups can be used:
- non-hormonal;
- containing large doses of estrogens.
Side effects are possible when using hormonal drugs, but the risk of pregnancy after using them is lower. If complications occur, you should always consult a doctor. This is due to the fact that some symptoms may indicate an ectopic pregnancy.
If after taking estrogen you feel pain in the limbs, aching joints, then this means the dosage was incorrectly chosen. Most often, the body reacts this way to high doses of hormones, but this condition quickly passes.
What is the Yuzpe method?
Yuzpe method – unusual option using oral contraception to prevent pregnancy. It does not use SOS drugs, but regular oral pills, which can be bought at any pharmacy at an affordable price. The effectiveness when taken in the first 24 hours after sexual intercourse reaches 94%.
The most commonly used in emergency situations are:
- "Novinet";
- "Femoden";
- "Miniziston."
At one time you need to take 4-5 birth control pills, and after 12 hours repeat the procedure. Emergency contraception using the Yuzpe method is recommended to be carried out under the supervision of a doctor, since it is necessary to select the correct dosage of oral hormones.
The right choice The drug should also be entrusted to a specialist. If pregnancy does occur, it is necessary to have an abortion, since contraceptives negatively affect the condition of the fetus.
Active ingredient: levonorgestrel
Most common hormonal contraceptives, taken in the first 72 hours after unprotected intercourse, most often contain artificially synthesized progesterone - levonorgestrel. Their names:
- "Postinor" is a remedy in which the dose of the hormone is divided into 2 doses. To prevent conception, you need to take 2 tablets, each containing 0.75 mg of levonorgestrel. The drug is well tolerated and side effects are rare. You should not take it if you have problems with bile drainage and poor liver function. When taken after 72 hours, its effectiveness will be only 58%; when used on the first day after unprotected intercourse, the chance of not getting pregnant is higher than 95%.
- “Escapelle” is more convenient to take due to the fact that you only need to drink 1 tablet. Its effectiveness on the third day after sexual intercourse is 58%. After taking it, you may develop vomiting, in which case you will need to take another pill. It is permissible to take the medicine "Cerucal" at the same time - it will save you from vomiting.
- "Eskinor F" is sold in two versions: a package with two capsules of 0.75 levonorgestrel and one with a dosage of 1.5 mg of this active substance. It is easier to tolerate than similar drugs.
All of the options listed are based on a synthetic hormone. Their main disadvantage is their strong impact on the cycle and fertility.
Each anti-pregnancy pill, taken over 72 hours, contains the same amount of hormone as female body produces in a year. Against the background of hormonal shock, ovarian functions are suppressed, which leads to temporary infertility.
Active ingredient: mifepristone
Mifepristone-based contraceptives block the action of progesterone. As a result, the changes necessary for implantation do not occur in the endometrium. Also, against the background of this synthetic steroid, the force of uterine contractions increases, which allows you to quickly get rid of a fertilized egg. The most effective contraceptive pills are “72 hours” with the names:
- "Mifegin";
- "Miropriston";
- "Pencrofton."
All of them are about 50% effective when taken on the third day; on the first day they prevent pregnancy in 85% of cases. Their advantage is that they are not hormonal. They do not affect the menstrual cycle. If pregnancy does occur, you will have to resort to surgical or medical abortion, since a large dose of steroids can harm the fetus and cause developmental pathologies in it.
How are 72 hour contraceptives used?
Preparations based on levonorgestrel and mifepristone must be used in the first three days after sexual intercourse, which could lead to fertilization. If you need to take more than one tablet, then the first dose should be taken within 24 hours after intercourse, and the subsequent ones should be used according to the instructions.
Although they can be used for several days, keep in mind the effectiveness. You should try to take birth control as soon as possible, which lasts for 72 hours. Their effectiveness gradually decreases, by the end of 3 days it reaches 45-55%. If you drink them immediately after intercourse, you are more likely to prevent conception. After using them, you should consult a doctor:
- there is a possibility that the pregnancy will continue,
- do not protect against sexually transmitted diseases.
If you have used mifepristone-based postcoital medications and are still pregnant, you should have an abortion. Large doses of steroids have a negative effect on the fetus. For this reason, you should not delay visiting a doctor.
Of course, it is better not to bring the situation to the point of using methods to prevent conception, but if you compare abortion and taking SOS drugs, the latter have several advantages:
- the body recovers faster;
- if the instructions are followed, complications occur less frequently;
- no hospitalization required;
- With one-time use, serious hormonal imbalances do not occur.
However, SOS tools cannot be considered a panacea. They are not recommended to be used more than 4 times a year. They can lead to infertility if a woman uses them several times over 1-3 months. It is important to follow the instructions so that there is no harm to the body.
What side effects occur?
The most common side effects from taking SOS medications are:
- swelling and discomfort in the mammary glands;
- nausea, sometimes turning into vomiting;
- migraines and severe headaches;
- allergic reactions, most often expressed by rash and itching;
- pulling and cutting pain in the lower abdomen;
- mood swings.
If they pass quickly, there is no need to panic. If these symptoms persist for a week or more, you should consult a doctor. Taking high-dose contraceptives leads to short-term failure of the reproductive system, which affects the entire body.
Complications from using tablets
There are several consequences that can result from the use of emergency medications. It is worth knowing about them before taking the pills, as they may be irreversible:
- Ectopic pregnancy is more common when using levonorgestrel-based drugs, as they reduce the motility of the fallopian tubes.
- Severe bleeding that can only be stopped by surgical cleansing of the uterine cavity. This is a fairly common complication that occurs in women with an unstable cycle.
- Infertility occurs when girls under 16 years of age use SOS contraception, as well as when they are used frequently.
- The risk of Crohn's disease increases 3 times.
- Blood clots - usually occurs when a woman has problems with blood clotting. May lead to negative consequences: stroke, pulmonary embolism and death.
Due to the possibility of dangerous complications, you must carefully study the instructions for the contraceptive pills you want to take. If you have contraindications to the use of such products, it is better to avoid them.
Negative consequences that require medical intervention after using emergency methods are observed in only 2% of women.
When is the use of 72 hour tablets contraindicated?
If there are several cases where contraceptives may not work as expected or become dangerous for the woman. You should not take medications if:
- liver and kidney failure;
- when taking coagulants;
- having problems with blood clotting;
- a decrease in red blood cell mass and the amount of protein containing iron in the blood;
- history of ectopic pregnancy;
- taking synthetic hormones and non-steroidal anti-inflammatory drugs;
- malignant tumors;
- impaired absorption of nutrients in the intestines;
- Crohn's disease.
SOS drugs can aggravate the listed pathologies and also lead to their complications. In particular, when cancerous tumors large doses of steroids and hormones provoke the growth of tumors, especially those that affect the organs of the female reproductive system and mammary glands.
Can medications be used during lactation?
Most drugs cannot be used during pregnancy and lactation. Mifepristone is used to induce labor later pregnancy. He is able to penetrate breast milk Therefore, it is recommended to stop breastfeeding the baby for 36 hours.
Levonorgestrel negative effects on pregnancy early stages does not provide.
It is not recommended to use it after confirmation of implantation, since hormonal imbalance can harm the woman herself. During lactation, this drug can be used in extreme cases. After you drink it, you must refrain from breastfeeding for 8 hours.
Today there is simply a huge variety of contraceptives, which allows every woman to choose the best option for herself, taking into account her needs and characteristics of the body. Ideally, contraceptives should protect not only from unwanted pregnancy, but also from dangerous infections. Therefore, next we will consider in more detail ways to protect against pregnancy for women.
Navigator by methods
1. Condoms
The most popular and available method. Condoms should be purchased from trusted pharmacies. They allow you to protect not only from unwanted pregnancy, but also from deadly diseases. In this case, you need to learn how to use condoms correctly, following the instructions from the manufacturer. Every woman and man is advised to always carry quality condoms with them to protect themselves in any situation.
2. Caps
The caps are made of high-quality latex and are inserted directly into the cervix. The material from which the cap is made helps protect partners from dangerous infections, such as syphilis or gonorrhea. At the same time, you need to learn how to use them. Not every woman will be able to correctly insert the cap into the cervix, which is the main disadvantage of this method. In addition, allergic reactions are also possible.
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3. Coitus interruptus
This method is used by all those who want to save on contraceptives. However, this method is not reliable, and most importantly, does not protect against sexually transmitted infections. The effectiveness of the interrupted act will depend on the dexterity of the partner. It is not recommended for anyone who does not want to get pregnant.
4. Calendar method
This method is only suitable for women with regular menstruation. We set up a calendar and track safe days. Regular menstruation allows you to accurately track your ovulation days and safe days to conceive. Every modern person should know popular methods of protection against pregnancy.
5. Temperature method
In this case, immediately after sleep in the morning, you need to measure your basal temperature in anus. This method allows you to determine the period of ovulation, before which the temperature drops slightly by half a degree. All other days when the temperature is stable are safe.
6. Cervical method
In this case, you need to monitor the condition of the mucus that is released from the vagina. Just before ovulation begins, the mucus becomes thicker and more viscous. At the same time this method is not accurate. After all, the state of mucus can be influenced hormonal changes in a woman's body. Therefore, it should not be used by anyone who wants to protect themselves from unwanted pregnancy.
7. Lactational amenorrhea
During breastfeeding, a woman’s body produces a unique hormone that protects against unwanted pregnancy. In other words, ovulation does not occur during this period, which guarantees safe sex.
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8. Spiral
Most modern method contraception. The spiral is made of silver or copper plates, which prevent unwanted pregnancy. The IUD is inserted directly into a woman’s uterus for a period of five years. This method is characterized high level effectiveness if the coil is inserted correctly. Of course, there are exceptions to the rules, and pregnancy can also occur with the IUD. Therefore, you need to choose only a high-quality and proven spiral.
Every woman should know how to prevent pregnancy.
9. COCs
This hormonal pills, which protect a woman from unwanted pregnancy. However, most women are afraid to use this method because of possible side effects, for example, weight gain or blood thickening. The use of cocci is completely safe and effective if the woman does not have serious contraindications.
10. Vaginal ring
A special ring that contains estrogens is inserted directly into the cervix. Hormones are released and prevent ovulation from occurring. In this case, the ring must be inserted correctly to protect yourself from unwanted pregnancy. In addition, it may also fall out, which is a disadvantage of this method.
11. Hormonal patch
The patch needs to be glued to the skin and estrogen hormones will enter the body through the blood and prevent unwanted pregnancy.
12. Mini-pill
These are special pills that contain the hormone progestogen. Compared to the previous type, this method is characterized by a low level of effectiveness, although there are practically no side effects.
13. Subcutaneous implants
A special implant is sewn under the skin to prevent unwanted pregnancy. The hormone progestogen enters the body, which prevents the egg from developing. This implant is installed for several years.
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14. Hormonal IUD
In addition to the usual one, there is also a hormonal intrauterine device. It secretes a hormone that prevents the embryo from attaching to the walls of the uterus and also paralyzes sperm activity.
15. Chemical contraception
There are also products that simply destroy sperm. These can be tablets, gels, creams or suppositories. Such drugs are used mainly a few minutes before sexual intercourse. Benefits also include protection against infections. However, they are characterized by a low level of effectiveness compared to other methods of contraception.
16. Emergency contraception
There are special pills that need to be taken within one or two days after sexual intercourse. This method is harmful to health, so it should be used only as a last resort.
17. Traditional methods
Folk remedies involve creating an acidic environment in the vagina in which sperm die. So it can be used lemon juice or potassium permanganate. You need to know that this method has a low level of effectiveness, and the acid also irritates the delicate mucous membrane of the cervix. Therefore, there may be irritation and even wounds.
18. Hormonal pills
There are pills that prevent the embryo from attaching to the wall of the uterus. Such hormonal drugs should be taken for several days after unprotected intercourse.
19. Emergency installation of a spiral
Today, after unprotected intercourse, you can make an intrauterine device for five days. Silver or copper plates prevent the development of the egg and destroy sperm.
20. Medical sterilization
This method is only suitable for those who are sure that they do not want more children. In other words, after medical sterilization, a woman will never be able to become pregnant. The fallopian tubes are simply tied, preventing the egg from meeting the sperm.
These are all the popular ways to protect yourself from unwanted pregnancy during sex.
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One of the main causes of many gynecological diseases and infertility is artificial termination of pregnancy. Abortions that are accompanied by instrumental dilatation of the cervix, vacuum aspiration and, especially, curettage are characterized by a particularly high risk of complications and trauma to the genital organs.
Termination of pregnancy using pills in the early stages of gestation allows you to avoid mechanical trauma to the cervix and uterine body, significantly reduce the risks of bleeding and acute and chronic inflammatory processes, which often complicate abortions performed by surgical methods. In addition, medical abortion completely eliminates the risks associated with anesthesia and significantly reduces the degree of psychological trauma.
Drugs for medical abortion
The medication technique is based on the use medications, belonging to different groups, which affect the function of the luteal (yellow) body and increase the contractility of the uterine myometrium. These include:
- Synthetic derivatives of prostaglandins.
- Progesterone antagonists (antiprogestins).
Prostaglandin derivatives
This group includes the only drug registered in Russia, Misoprostol, produced in tablets in a dose of 200 mcg, which can also be under the trade name Mirolut. It is a synthetic analogue of prostaglandin E 1. Misoprostol initiates contractions of smooth muscle fibers, which not only facilitates the opening of the cervical canal and stimulates myometrial contractions, but also increases the strength and frequency of uterine contractions, which leads to the expulsion of the contents of its cavity.
The mechanism of action of misoprostol is explained by the fact that it binds, like oxytocin, to the specific receptor apparatus of the muscle cells of the uterus, as a result of which calcium ions are released from the endoplasm of the latter, increasing the contractile activity of smooth muscle fibers. In addition, it enhances impulse transmission in the presynaptic membrane of adrenergic nerve endings, which leads to an increase in their release of norepinephrine.
Progesterone antagonists
Misoprostol, a synthetic analogue of prostaglandin E 1, is used in combination with the antiprogestin mifepristone. The names of abortion pills of this group are “Mifepristone”, “Pencrofton”, “Mifolian”, “Mifegin”, “Mifeprex”. All of these products, equally effective, contain 200 mg of mifepristone as an active ingredient.
The latter is a synthetic steroid drug intended for oral administration. Abortion pills early pregnancy containing mifepristone are characterized by a high degree of affinity for progesterone receptors. By binding to them, it leads to a specific blocking of the effects of progesterone on the corresponding receptors located in the endometrium and myometrium. Mifepristone also causes a significant decrease in blood levels, which may be due to its destructive effect on the corpus luteum and its ability to reduce human chorionic gonadotropin levels in the blood.
All this, in turn, becomes the reason:
- inhibition of the development of cells of the nutrient layer (trophoblast) of the embryo and necrosis of the fetal egg;
- hypoplasia and necrosis of the transformed functional layer of the uterine mucosa (decidua of the embryo) with its subsequent rejection;
- the occurrence of uterine contractions and the development of bleeding similar to menstrual bleeding or slightly exceeding it in blood volume, which (clinically) is the essence.
In addition, mifepristone increases the sensitivity of the muscular layer of the uterus to the effects of endogenous (own) and exogenous (additionally administered in the form of misoprostol) prostaglandins. Thus, drugs for abortion in the early stages, when used simultaneously, act as synergists.
Basic regimen for the use of Mifepristone and Misoprostol
It consists of a single dose of three tablets (600 mg) of mifepristone in the presence of a gynecologist, after which 36-48 hours later the prostaglandin misoprostol is prescribed at a dose of 2 - 4 tablets (400-800 mcg). After taking the latter, the woman is observed by a doctor for 2 to 4 hours. A repeated examination by a gynecologist with an ultrasound examination is carried out at the end of the second or 3 weeks (14 days) after taking mifepristone.
Side effects and complications
When performing a medical abortion, in 2-10% of cases the following side effects and complications of the combined use of the listed drugs are possible:
- chills and fever (sometimes to high values), which usually lasts no more than 2 hours;
- general malaise and weakness;
- dizziness, headache, fainting;
- a feeling of discomfort and minor pain, mainly in the lower abdomen, associated with spastic uterine contractions (sometimes, in 5-15%, the pain can be quite intense, requiring the use of analgesic and/or antispasmodic drugs);
- bloating, nausea (50%), vomiting (30%), diarrhea (less than 25%);
- allergic reactions in the form of skin rashes (rare);
- incomplete abortion, due to the insufficient effectiveness of the drugs - the longer the pregnancy, the higher the risk of incomplete abortion;
- bleeding after taking abortion medications.
Bleeding is the most serious and dangerous complication. As a rule, this bleeding is longer and more pronounced compared to menstrual bleeding. At the same time, it does not lead to a decrease in blood hemoglobin levels. However, in approximately 0.2-2.6% it can be quite intense. In these cases, hemostatic therapy, surgical stopping of bleeding by performing or curettage, transfusion of blood substitutes, blood plasma, and red blood cells may be required.
Terms of use of tablets
In the instructions for Misoprostol and Mifepristone, registered in Russian Federation, their use for medical abortion on an outpatient basis is limited to 42 days of absence of menstruation. At the same time, the World Health Organization limits this period to 63 days. In addition, the safety and high degree of effectiveness of these funds are noted.
In this regard, a period of 63 days of absence of menstruation is accepted as normative. Drugs for abortion in later stages can be used exclusively in an inpatient gynecological department with the ability to provide medical care to the required extent. It should be remembered that the longer this period, the lower the degree of effectiveness of the drugs.
Contraindications for use
Absolute contraindications are:
- Individual intolerance to one of the drugs or their auxiliary components.
- Availability assumption.
- Long-term use of glucocorticoid drugs due to certain concomitant pathologies, and/or chronic adrenal insufficiency.
- Chronic renal or liver failure.
- Pigment metabolism disorder accompanied by increased level porphyrins in the blood (hereditary porphyria).
- Severe concomitant extragenital pathology, as well as the presence of glaucoma, arterial hypertension, chronic obstructive pulmonary disease, severe bronchial asthma.
- Hormone-dependent tumor formations, as well as dysfunction of the endocrine glands, including diabetes mellitus.
- Exhaustion.
Relative contraindications:
- Absence of menstruation (with confirmed pregnancy) for more than 63 days. The need to use misoprostol and mifepristone during a longer pregnancy requires hospitalization in the gynecological department.
- The presence of significant size, which is a risk factor for bleeding. The use of drugs is possible when the size of the dominant myomatous node is up to 4 cm and there is no deformation of the uterine cavity by myomatous nodes.
- The initial hemoglobin content in the blood is less than 100 g/l, which increases the risk of even more severe anemia due to possible blood loss.
- Bleeding disorders, including taking anticoagulants and non-steroidal anti-inflammatory drugs, which sharply increases the risk of blood loss.
- Acute inflammatory processes of the female genital area (despite the fact that medical abortion does not increase the risk of developing an ascending infection, nevertheless, the simultaneous use of antibacterial agents is desirable).
- Smoking in women over 35 years of age, as they are at risk for cardiovascular diseases. Before prescribing the above drugs, it is necessary to conduct an examination by a therapist.
- Breastfeeding period. It must be canceled for 7 days from the day of taking mifepristone, and for 5 days from the day of taking misoprostol.
- Development of pregnancy during the use of an intrauterine contraceptive device. Before taking mifepristone and misoprostol, the intrauterine contraceptive device must be removed.
- Long-term use of oral hormonal contraceptives, which increase the risk of bleeding disorders. Although this contraindication is relative, a preliminary study of the coagulogram is nevertheless necessary.
Early abortion using these drugs is characterized by longer bleeding and, often, longer pain compared to surgical abortion. However, complications resulting from medical abortions occur much less frequently. In addition, psychologically it is much easier to bear.
It is practically impossible to purchase pills for medical abortion in pharmacies, especially without a prescription. They should be used only under the supervision of a gynecologist, and are distributed mainly to specialized private medical institutions or gynecological inpatient departments that have official permission to perform abortions and have the ability to carry out not only infusion and transfusion therapy, but also to provide emergency gynecological and surgical care or , as a last resort, emergency delivery of the woman to the appropriate medical institutions.
Quite often, during sexual intercourse, damage to protective equipment occurs, which can lead to the penetration of sperm into the female egg.
Even more often, before sex, protection is simply not put on, because sex without the use of protection brings more pleasure. All these facts have one thing in common - unplanned pregnancy. What to do next?
Medicines produced in the form of “emergency pills” will help correct the resulting situation. They were developed specifically to stop unplanned conception caused by unprotected sex.
You need to know: Pregnancy pills should be used only after fertilization has occurred. Using them “for prevention” is extremely dangerous for the body and can greatly harm later life.
Briefly about contraceptives
These drugs are popularly called “morning-after pills” because they are effective for 72 hours. Immediately at this time after sexual intercourse, the effect of the drug is determined. The highest anti-pregnancy effect obtained from the use of drugs is observed on the first day. The following hours reduce the effectiveness of the drug by almost 20%.
If intimacy does occur and you are afraid of unwanted fertilization, and do not want to allow this to happen, take the chosen drug on the same day. Using the drug every other day, its effectiveness will be 50%. And note: when fertilization is confirmed after sexual intercourse, using the product will not make sense. That is why they are called “emergency”: they are used to prevent the activity of sperm that have entered the female body.
Types of contraceptives
Pregnancy pills are divided into types according to the time of their use, after an unprotected act:
- “24 hour” products. They should be taken immediately after sex or within the time specified in them.
- “72 hour” products. They are used when a day or more has passed since sexual intercourse. In this case, they are the only successful option for resolving the issue.
- Spiral. This product is intended to prevent pregnancy after three days. The main advantage of such a spiral: it gives a positive effect within five days after sex.
Anticonception drugs are divided into 2 types:
- non-hormonal;
- containing estrogen.
Drugs containing estrogen are hormonal. Their use may be accompanied by side effects such as headaches, nausea, and groin pain. When the use of the product is accompanied by a deterioration in the condition, do not hesitate to go to a specialist. This will be necessary to find out the cause of the side effect, because they may indicate an ectopic pregnancy. Sometimes after using drugs, you can feel pain “echoes” in the chest, arms or legs. These symptoms indicate an incorrect dosage of the drug.
Tablets 72 hours
When more than a day has passed since sex, anti-conception medications, better known as 72 hours, will help correct the situation. Using the product within the specified interval will help stop an unwanted pregnancy. They have high hormonal activity and should be consumed no more than four times within 31 days. The use of funds can bring complications:
- noticeable pain in the stomach; appear within a month after using the product. May indicate an ectopic pregnancy. Immediate hospitalization is required;
- difficulty breathing and blurred vision;
- a rash appears on the body and symptoms of chest pain.
To avoid the appearance of such symptoms, take the pills in consultation with a specialist.
Let's look at the names of the most popular medications in the 72 hour series:
- "Escapelle". Used when ineffective means protection, through the use of which sperm entered the body. The drug contains lovonorgestrel. It prevents the fertilization of the egg, and when pregnancy occurs, it rejects the embryo from the body, causing a miscarriage. The effect of Escapelle is regulated by the period of its use after the end of intimacy - there is a greater chance of preventing conception if taken early. There are practically no side effects.
- Genale. The basis of the product is histamine, which acts for three days. It is classified as a potent component because it contains synthetic components. They help slow down the ovulation process and prevent the egg from being fertilized. You should not take the drug if, after taking it, you notice blood clots or unbearable pain in the groin.
- Postinor. It is based on the hormone levonorgestrel. It is a kind of hormone that does not allow the egg to be fertilized after completed intimate contact for three days. Levonorgestrel is used in the development of protective equipment used before sex, only it is contained in smaller doses than in Postinor.
The drug package contains 2 tablets. They should be used like this: one immediately after sex, the second after 12 hours. Postinor is not able to help if pregnancy has already occurred. And remember: when you take the drug after sex, and a few days later you have sex again without a condom, the medication will not protect you from conceiving again.
If, after taking the drug, you still discover an unwanted conception, immediately go to the doctor. Postinor may increase the chance of getting an ectopic pregnancy. The doctor will do the necessary examination and clarify where the fetus is located.
Medicines 24 hours
These are tablets characterized by their effect in the first day after intimacy. The most common cases of their use are:
- carrying out sexual contact without protection;
- damage to contraceptives;
- rape.
Before an embryo has formed, the pills are 95% effective. Using them after 24 hours is pointless. When you decide to take the drug, make sure you are 100% sure that the fetus has not yet conceived. The use of tablets in this series can cause the following side effects:
- Vomit. Pain in the groin. Spasm.
- Fatigue quickly. Dizziness.
- Unstable menstrual cycle.
Vaginal preparations
Vaginal pills will also help you fight unwanted pregnancy at home. They cannot boast of being 100% effective: it is approximately 85%, but they are absolutely safe for women. The substance contained in the medication helps block sperm, reducing the ability of the egg to be fertilized.
The main positive property of such drugs is the complete absence of side effects, which makes it possible to use the drugs at any period of the menstrual cycle. These types of drugs include:
- Pharmatex.
- Benatex.
- Ginakotex.
These products are non-hormonal substances, which makes them completely safe. Just keep in mind that they will only be effective if they are used in combination with other means.
To summarize, it should be noted that the production of remedies for unwanted pregnancy is necessary and extremely necessary. The use of such medications makes it possible to prevent a huge number of unnecessary conceptions, and is still doing so successfully. Before use, carefully read the instructions for use.
Pregnancy pills: the most effective remedies
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