Gynecology Contraception: artificial methods

The current contraception methods allow for an efficient family planning and have very little side effects.

Barrier methods

They block the passage of sperms. They include preservatives (female or male), diaphragms and sperm creams. The male preservative is efficient up to 98-99% of cases and also protects against sexually transmitted diseases (STD). The female preservative, which is efficient up to 95%, also protects against STDs.

Hormonal methods

They are hormonal medicines which prevent ovulation, produce modifications at the cervical mucus level by making it hostile to the sperm and reduce the possibilities of endometrium implantation. These methods are very reliable (efficient up to 99%) if the utilization conditions are complied with, along with the counter-indications in each case.

A complete medical check-up (gynecological check) is recommended before starting any treatment.

  • Combined contraceptive pill; it generally contains estrogens and gestagens. The tablets should be taken for 21 days (with a rest week) or 28 days.
  • Contraceptive band: similar to a square bandage, it is applied on the skin, far from the chest. The hormones are absorbed from the skin. Placed once a week for 3 weeks (and one week of rest).
  • Vaginal ring: it is a flexible plastic ring that can be easily placed in the vagina and which absorbs the hormones at the vaginal mucus level. We remove it after 3 weeks and take a break on the 4th week.
  • Emergency contraception (next day pill): its efficiency rate is 80% (it prevents 7 pregnancies out of 8). It should be taken at the latest 72 hours after unprotected sexual intercourse.
  • Oral progesterone pill: mainly prescribed for women in lactation.
  • Contraceptive implant: we place it under local anesthesia under the forearm. Its efficiency reaches 99% for a period of 5 years. It can lead to menstruation problems, headaches, and an increase in tension in the chest area.

Intrauterine Contraception (DIU)

It consists of a small device that we place inside the uterus during the periods. It blocks the passage of sperms by producing an aseptic inflammation in the endometrium. Its reliability is 98-99%. Certain DIUs also contain a device used to release hormones (gestagens). An annual check-up is required and the device is replaced after every 3-5 years.

Tubal sterilization (ligature of tubes)

We coagulate and/or create a section in the two tubes to prevent the egg progression along the tubes and its merging with sperms. This technique is generally applied by a laparoscopy under general anesthesia and requires a few hours of hospitalization. The operation can also be done during a caesarian. Its efficiency rate is immediate and the pregnancy rate achieved is only 1-3/1000 (greater than 99%)

Vasectomy

We cut the different conduits to prevent the exit of sperms in the ejaculated liquid. The operation is done under local anesthesia. Sperm analyses are required to control the presence of sperms, because the efficiency is immediate.

Last Update: 12/09/2014
References:
– ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Long-acting Reversible Contraception: Implants and Intrauterine Devices. 121, July 2011.
– Sociedad Española de Contracepción. Actualización en el manejo clínico de la anticoncepción Hormonal, intrauterina y de Urgencia. Madrid 2011.Disponible en: www.sec.es
– Sociedad Española de Obstetricia y Ginecología. Protocolos: Anticoncepción Hormonal Combinada Oral, Transdérmica y Vaginal (2006)