The practice of birth control has been around for centuries and people have relied on their imaginations and ingenuity to avoid pregnancy.
The myriad of options allows people to prevent pregnancy by selecting the available product that suits their personal situations and lifestyles.
Contraceptive product selection can be influenced by experienced side effects, ease of use, need for personal protection against sexually transmitted diseases (STDs), and sensitivity to latex.
Other considerations include convenience of lifestyle, product accessibility, efficacy and affordability. Contraceptive product options can be categorized in various ways, such as hormonal content, effectiveness, or method of action.
ovulatory cycle
The endometrial cycle or ovulation, which consists of 3 phases, is directly caused by fluctuating levels of ovarian steroids, estrogen, and progesterone.
The 3 phases of the ovulation cycle are the follicular phase, the ovulation phase, and the luteal phase.. The follicular phase is characterized by an increase in estrogen levels.
The increase in estrogen levels experienced during the follicular phase results in a surge in gonadotropins, which is expected to occur 34 to 36 hours before the release of the egg.
During the ovulation phase, progesterone levels rise in response to luteinizing hormone. In the absence of pregnancy after ovulation during the luteal phase, follicle rupture initiates a series of chemical changesincluding an immediate decrease and then a subsequent increase in estrogen levels.
Pregnancy is the result of the successful completion of several basic reproductive biological processes. What contraceptives do is inhibit one or more of these processes, preventing pregnancy. For example, condoms inhibit or block sperm from fertilizing an egg, and oral contraceptive pills exert their contraceptive function by acting on the levels of hormones produced by the ovaries.
Contraceptive methods
There are two types, which would be those without and with barrier, so we will divide the methods into these two types.
Non-barrier contraceptive methods
Various types of contraceptive products exert their effects on hormone levels produced by the ovaries, estrogen and progesterone.
oral contraceptive pills
Oral contraceptive pills consist of synthetic forms of progestin alone or estrogen and progestin in combination. When used correctly, they are considered to be more than 99% efficient.
Combined OCPs are typically packaged as 21 active tablets in monophasic, biphasic, or triphasic formulations followed by 7 tablets for daily administration. Monophasic agents consist of fixed amounts of estrogen/progestin.
In biphasic and triphasictheir formulations, have 2 or 3 different tablets, respectively, containing varying amounts of hormones, which they more closely approximate the levels experienced during a woman’s menstrual cycle.
It must also be said that they have their side effects. The use of hormonal contraceptives places women at increased risk for disorders of the cardiovascular system, including myocardial infarction, stroke, venous thromboembolism, pulmonary embolism, and hypertension.
contraceptive injection
Medroxyprogesterone acetate is a derivative of progesterone, which has been formulated as injectable agent indicated for the prevention of pregnancy.
This product is available in a prefilled syringe containing a single 150 mg dose, to be administered once every three months by a health professional.
The injection has the following 2 main side effects: changes in the menstrual cycle and delayed return to fertility.
The changes are irregular and unpredictable episodes of bleeding and spotting that they last up to seven days during the first months of use. These episodes are less frequent and shorter until the woman has amenorrhea.
The return of fertility is delayed after discontinuation of the injection. It may take 18-24 months, but at least half of women can conceive by the end of the first year.
transdermal patch
The transdermal patch contains norelgestromin and ethinyl estradiol. This patch releases the system 150 ug of norelgestromin and 35 ug of ethinylestradiol each day.
The way to put on the patch is to put on one patch every week for the first three weeks of the menstrual cyclefollowed by a week without a patch.
For your application, you must choose a clean, dry, intact and non-irritated place such as the abdomen, back, buttocks or arm. It should be noted that people do not use oils, powders, creams, lotions, etc. at the site where it is to be applied.
Side effects are similar to those of oral contraceptives with the addition of irritation at the site where the patch is placed. Other side effects can be headache, dysmenorrhea or breast discomfort.
IUD
A non-hormonal IUD is available for women who need avoid the side effects of hormonal contraceptives. The copper intrauterine contraceptive is a T-shaped IUD.
The T-frame is made of polyethylene with barium sulfate and contains copper. The contraceptive efficacy of this IUD is enhanced by the continuous release of copper into the uterine cavity.
The most common side effects are heavier, longer periods and spotting between periods. For most women, these usually go away in 2 to 3 months.
Subdermic implant
This birth control method is found to be one of the most effective forms of contraception.. The subdermal implant releases etonogestrel, and is currently just a rod that is 4 cm long and 2 mm in diameter, and is made up of an inner core of ethylene vinyl acetate.
The rate of hormone release is controlled by a layer of ethylene vinyl acetate that surrounds the inside of the core. The implant contains a total of 68 mg of progestin.
Initially after implantation, progestin is released at a rate of 60 to 70 ug/day. At the end of the first year, the release drops to 35 ug/day.
This device must be surgically inserted by healthcare professionals. Removing this is just as simple, since the operation is very simple and can be completed in 5-10 minutes. It is recommended to remove it at the end of three years of use.
vaginal ring
Intravaginal devices also provide safe contraception options for women. The etonogestrel/ethinyl estradiol vaginal ring is a combined contraceptive device. latex-free, transparent, flexible and non-biodegradable.
The ring is inserted into the vagina and left for 3 weeks to release on average 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinylestradiol in the body for birth control.
After 3 weeks, the ring is removed for 1 week. The main side effects are Headaches occurring in 7% of users. Other side effects include leukorrhea, nausea, weight gain, intercourse problems, and device expulsion.
Tubal ligation
The main function of the fallopian tube is to transport the sperm to the egg and then allow the fertilized egg returns to the uterus for implantation.
It is important to comment that it must be clear that the tubal ligation procedure it is permanent and is not intended to be reversible. Alternatives, such as long-acting reversible contraceptives or vasectomy, should be explored.
Patients should also understand the details of the procedure itself and the associated risks, as well as the risks of anesthesia. Counseling should include a discussion of the risks of failure and ectopic pregnancy.
vasectomy
Vasectomy is a definitive male sterilization procedure that involves interrupt the flow of sperm from the proximal end to the distal end of the vas deferens.
As discussed above, vasectomy is an elective procedure for male sterilization and pregnancy prevention. Therefore, the executing physician must discuss the risks, benefits, and alternatives.
While a vasectomy can be reversed, this should not be used as an argument for a vasectomy. If a patient is considering a vasectomy and is not sure that this is an acceptable permanent solution for them, then they should not have the procedure.
Barrier contraceptive methods
male condoms
The male condom is one of the most popular birth control methods and affordable. Condoms made from latex are the best for preventing pregnancy and also protect against STDs like HIV AIDS and herpes if used correctly.
Today’s male condom has evolved from being made entirely of latex to the availability of various non-latex condoms.
The use of polyisoprene condoms has advantages compared to condoms made of latex. Polyisoprene condoms stretch and are less likely to slip or break.
There are condoms made of lamb intestine. They are beneficial in terms of comfort and transmit heat very well through a porous membrane. Even so, you have to be careful because these They do not protect against STDs.
female condom
The female condom is a smooth, thin sleeve made of synthetic latex that fits loosely in the vagina. It is shaped differently from the male condom and It is inserted vaginally.
It is made up of two flexible rings, a closed end inserted into the vagina and another open end that is outside of it.
the condom effectively protects against the transmission of STDs and HIV. In addition, it can be inserted up to 8 hours before sexual intercourse. The disadvantages are uncomfortable sensations and feel the inside and the closed end during intercourse.
cervical cap
The cervical cap has dome shaped and made of silicone. The concave dome fits snugly over the cervix and is held in place by the muscular walls of the vagina.
The hood It has a strap that runs the length of the dome to
removal from the vagina and must be used with spermicide. This device can be inserted up to 42 hours before intercourse and must remain in the vagina for at least 6 hours after intercourse to ensure that the sperm have died.
The cap can be left on for 48 hours, but it is recommended to remove it before 24 hours to avoid the development of a bad odor.
Spermicidal preparations
Spermicide products are another form of birth control. These chemical agents kill sperm. The ingredient is nonoxynol-9, which can be formulated as gels, creams, spray foam, vaginal film, and sponges.
Typically, preparations need 10 to 15 minutes in the vagina be effective before being exposed to sperm. Disadvantages of spermicidal formulations are low effectiveness. In addition, they can cause irritation in the vagina or penis.
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