Rus Articles Journal

Barrier methods of contraception

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we began to tell

In the previous issues of the magazine about methods of contraception, history of their emergence, physiology of reproductive system and natural methods. In the present article it will be a question of barrier methods of planning of a family.

the Barrier method of contraception - protection from undesirable pregnancy by an obstacle to hit of sperm in a vagina or a neck of a uterus mechanical (condoms, vaginal diaphragms and caps) or chemical (spermitsida [1]) in the way. The combination of these two ways is called combined, for example, the combination of spermitsid to diaphragms, condoms, caps and so forth

is Distinguished by the following types of barrier contraceptives: man`s - the condoms preventing access of sperm to a vagina and female - the diaphragms, caps, spermitsida interfering intake of sperm from a vagina in a uterus cavity. Barrier methods of contraception protect from approach of pregnancy and from diseases, sexually transmitted. These contraceptives practically do not exert adverse impact on an organism of the woman and the man, but at the same time by 10 - 20 times are less effective modern hormonal means.

Condoms

the Most widespread mechanical barrier contraceptive is the condom .

the Man`s condom represents the thin cover made of latex, vinyl, polyurethane and so forth

of Advantage:

Shortcomings:

Condoms are recommended to use to couples: needing an immediate contraceptive; having the rare sexual intercourses when the safety method is necessary; in the presence of more than one sexual partner.

Use of condoms is not recommended by

to couples: at regular sex life, preferring a long method of contraception; in the presence of an allergy to the materials used for production of condoms; to women, whose age, the number of childbirth or a problem with health do pregnancy dangerous; at impossibility of use of condoms during each sexual intercourse.

the Condom has to be put on by

a penis in a condition of an erection before its introduction to the woman`s vagina since to contain in the emitted greasing active spermatozoa. It is necessary to apply condoms which contours repeat contours of an eregirovanny penis, with the karmanoobrazny end (store) intended for the streamed sperm. It is necessary to put on a condom very accurately when extreme flesh is most shifted from a head of the member. The product cannot be untwisted previously at all. It it is necessary, having put to a penis head, the smooth movements to pull on a penis. If the condom without store is used, then it cannot be put on completely, it is necessary to leave on the end 1 - 2 cm for sperm. Mineral oils, food fats, cream or vaseline it is inadmissible to use for greasing as they destroy material from which condoms are made. For greasing are most acceptable spermitsida or special gels.

After an ejaculation, holding a condom for the basis (ring), the penis from a vagina is taken while it still is in a condition of an erection. It prevents sliding of a condom and hit of sperm on genitals of the woman.

Each condom has to be used by

only once. It is impossible to use condoms expired.

If the condom tore, or there is a suspicion on violation of its integrity, the method of the emergency contraception is used.
Types of the emergency contraception are:
  • reception of 4 tablets of the hormonal low-dosed contraceptive (MARVELON, MERSILON) within the first 72 hours, in 12 hours - 4 more tablets;
  • or reception of one tablet of a hormonal contraceptive (POSTINOR) within the first 72 hours, in 12 hours - 1 more tablets;
  • or introduction of a cupriferous intrauterine spiral (Naval Forces) no later than 5 days after the unprotected sexual contact.
the Emergency contraception is applicable only after the unexpected, unprotected sexual contact (a rupture of a condom or rape). In all other cases the emergency contraception is inadmissible in connection with big hormonal load of an organism and possible complications (violations of menstrual function, increase in weight and other hormonal violations).
When developing bleeding against reception of means of the emergency contraception should conduct gynecologic examination.
Is inadmissible use of preparation POSTINOR as means of continuous and continuous contraception (nausea, vomiting, belly-ache, and also shortening or lengthening of a menstrual cycle, intermenstrual bloody allocations are possible).
Should note

that it in some countries is already made, goes on sale and the condom for women is used. It is longer and wider than man`s, is made of elastic polyurethane plastic, and represents the cylinder 15 cm long and with a diameter of 7 cm, one of the ends of which is closed and contains the fixing ring. The female condom has to be entered into a vagina for some time before sexual intercourse. From - for imperfections of a design and high cost it was not widely used yet. At the same time, probably, further developments for the purpose of improvement of a condom for women will be continued. Using it, the woman in this question will not depend on the man and will be quiet for the health.

For the young woman who is regularly leading sex life with one partner application of the DIAPHRAGM - the mechanical barrier contraceptive made of latex rubber, having the form of a dome with a diameter of 50 - 105 mm is quite acceptable

of the Diaphragm. In the basis of a dome there is a metal spring of a flat, turbinal or arc-shaped form covered with rubber. The diaphragm is entered into a vagina, the spring rests against its walls and thus the uterus neck is closed, hit of spermatozoa in a uterus cavity is prevented. The diaphragm is especially effective in a combination to spermitsidny means since at the combined use besides strengthening of contraceptive effect, still there is an effect of greasing for introduction of a diaphragm.

of Advantage:

  • Fast effect.
  • Lack of influence on breastfeeding.
  • Lack of need to enter a diaphragm just before sexual intercourse (it is possible to enter in 6 hours prior to sexual intercourse).
  • Lack of side effects.

Shortcomings:

  • Low contraceptive efficiency (6 - 20 pregnancies on 100 women a year).
  • Need of use during each sexual intercourse. Before each following - it is necessary to enter a new dose of a spermitsid.
  • to
  • Needs gynecologic survey for primary and postnatal fitting of a diaphragm.
  • developing of an infection of urinary tract at non-compliance with rules of personal hygiene Is possible
  • (through dirty hands).
  • should not be taken within 6 hours after sexual intercourse.
  • At each application of a diaphragm needs to be used spermitsid.

of Contraindication for use of a diaphragm:

  • individual intolerance of material of which the diaphragm and a spermitsida is made;
  • existence of a chronic infection of urinary tract;
  • anatomic changes of a vagina (narrowing, anomalies of development);
  • crotch pain between sexual intercourses;
  • first 12 weeks after the delivery;
  • periods or uterine bleeding during the intermenstrual period.
Use of a diaphragm is possible

: at women who do not want or cannot use hormonal contraceptive tablets or intrauterine spirals; at the nursing mothers having rare sexual communications.

Use of a diaphragm is not recommended to

: to women, whose age, the number of childbirth or a problem with health do pregnancy dangerous; at impossibility of use during each sexual intercourse.

Selection of a diaphragm for the size is carried out by the gynecologist. The diaphragm is used during each sexual intercourse. Before its introduction the bladder is emptied, hands wash. Integrity of a diaphragm by filling by its water is checked. Then, a small amount of spermitsidny cream or gel is squeezed out in a diaphragm cup. It is used as follows: edges of a diaphragm are reduced together, one of positions (lying on a back or squating, one leg is raised on a chair) is accepted, it is entered deeply into a vagina for a pubic bone. After that the finger is entered into a vagina and the uterus neck is felt, checked whether completely it is closed.

the Diaphragm is entered by

not earlier than before 6 hours before sexual intercourse. After sexual intercourse it has to remain in a vagina also not less than 6 hours (but no more than 24 hours). Before each subsequent sexual intercourse additional introduction of a spermitsid is required.

Is removed a finger for a first line. If it is necessary, before removal the finger between a diaphragm and a pubic bone is entered to break effect of suction. After use the diaphragm washes water with soap, is dried up and to be stored in a special box.

Caps

the Cap is a small diaphragm which covers only a uterus neck. Caps are made of rubber, have the different sizes. Is selected the gynecologist.

of Advantage:

introduction in 6 hours prior to sexual intercourse Is possible

is acceptable for the women who do not have an opportunity to use a diaphragm.

Shortcomings:

of Contraindication for use of a cap:

Use of a cap is possible

: at women who do not want or hormonal contraceptive tablets or Naval Forces cannot use; at the nursing mothers having rare sexual communications.

Use of a cap is not recommended to

: to women whose age, the number of childbirth or a problem with health do pregnancy dangerous; at impossibility of use during each sexual intercourse.

Apply caps and a diaphragm in a complex with spermitsida which strengthen contraceptive effect, protect from some diseases sexually transmitted and solve a dryness problem in a vagina that is frequent at the feeding women.

Now vaginal diaphragms and caps for the purpose of contraception are used by

extremely seldom in connection with existence of more effective and safe methods.

Spermitsida`s

Spermitsida`s

- substances (benzolkony chloride, nonoksilon - 9), partially either completely depriving activities, or the destroying spermatozoa.

Treat chemical to barrier contraceptives.

are Usually applied by

in a complex with other contraceptives, such as diaphragms, caps, condoms.

release Form:

Vaginal sponges

Vaginal sponges (small small pillows, an oval form, 2,5§5,0 cm in size, made of synthetic fiber and impregnated spermitsidy - nonoksilon - 9) possess the combined action: mechanical and chemical, also treat the combined barrier contraceptives. Vaginal sponges protect from hit of sperm to the canal of a neck of a uterus, detaining sperm in a sponge, and also emit spermitsidny substance.

action Mechanism: destruction of a membrane of spermatozoa that reduces their mobility and ability to impregnate an ovum.

of Advantage:

Shortcomings:

of Contraindication for use of spermitsid:

Use of spermitsid is possible

: at women who do not want or hormonal contraceptive tablets or intrauterine spirals cannot use; at the nursing mothers having rare sexual communications.

Use of spermitsid is not recommended to

: to women whose age, the number of childbirth or a problem with health do pregnancy dangerous; at impossibility of use during each sexual intercourse; to women with anomalies of development of genitals

the Choice of a spermitsid:

Aerosols (foams) and vaginal sponges are effective
As it is correct to li to enter spermitsida the Aerosol (foam) it is entered as follows:
the Container before use is stirred up 20 - 30 times. It is put vertically and the applicator which is taken aside that it was filled with foam is put on the valve. In a prone position on a back, the applicator is entered into a vagina so that its end was nearby or adjoined to a uterus neck. It is pressed descent and foam is issued. It is not necessary to wait for action (the effect comes immediately). After use the applicator needs to be washed up warm water with soap, to rinse and dry up.
Vaginal tablets and candles or a film are entered as follows:
the Vaginal tablet, a candle or a film is taken out from packing. Lying on a back, it is entered deeply into a vagina. It is necessary to wait 10 - 15 minutes before beginning sexual intercourse.
Cream, gel: Cream / gel is squeezed out by
in the applicator before filling. The applicator is entered into a vagina so that its end was nearby or adjoined to a uterus neck. It is pressed descent and contents are entered. It is not necessary to wait for the beginning of action (the effect comes immediately). After use the applicator needs to be washed up warm water with soap, to rinse and dry up.
Vaginal sponges the Sponge is taken out by
from packing. Before introduction to a vagina the sponge should be moistened with two tablespoons of water and to wring out before emergence of foam. In a prone position on a back, it is entered deeply into a vagina to a uterus neck. The effect comes immediately and proceeds within 24 hours, i.e. the sponge can be used at several sexual intercourses. After use the sponge is thrown out.