Entry overview: Contraception is the application of scientific means to prevent women from becoming pregnant temporarily. It mainly controls the three links in the reproductive process: 1. Inhibiting the production of sperm and eggs; 2. Preventing the combination of sperm and eggs; 3. Making the uterine environment unfavorable for sperm capacitation and survival, or unsuitable for implantation and development of fertilized eggs. Common contraceptive methods include: use of contraceptives, condoms, contraceptive films, rhythm contraceptives, in vitro ejaculation contraceptives, compression urethral contraceptives, surgical contraceptives and so on.
Basic Information
Chinese name: contraception
Foreign name: Contraception
Concrete: Apply scientific methods to make women temporarily infertile
Object: female
definition
Four conditions must be met for conception:
①The man can produce healthy and active sperm that can be discharged into the vagina of the woman.
② After the sperm enters the vagina, it can maintain its mobility, and can pass through the cervix and uterine cavity to reach the fallopian tube and combine with the egg.
③ The woman can release a healthy egg, the egg can enter the fallopian tube, and get the chance to meet with the sperm.
④ The fertilized egg must develop into an embryo in time to reach the uterine cavity, and the environment of the uterine cavity is suitable for the growth of the embryo.
The purpose of contraception is achieved by artificially inhibiting ovulation, preventing the combination of egg and sperm, or preventing the fertilized egg from implanting in the uterus and growing.
Contraception is the application of scientific methods to prevent women from becoming pregnant temporarily. It mainly controls the three links in the reproductive process: 1. Inhibiting the production of sperm and eggs; 2. Preventing the combination of sperm and eggs; 3. Making the uterine environment unfavorable for sperm capacitation and survival, or unsuitable for implantation and development of fertilized eggs.
contraception history
Squat down to discharge semen, sneeze, and jump up and down after sex. The ancient Greeks believed that using alum, wine, sea water, creosote or vinegar to flush the vagina could also achieve contraceptive purposes.
One of the earliest references to contraception comes from the Bible. In the book of Genesis, God requires human beings to interrupt sexual intercourse, commonly known as "withdrawal".
From 384 to 322 BC, the ancient Greek philosopher Aristotle is considered to be the first person to propose the use of natural chemicals such as cedar oil, lead-containing ointment or frankincense oil as spermicides. Pliny, the ancient Roman writer who wrote Natural History from AD 23 to 79, advised readers to restrain sexual desire to avoid pregnancy. He was the first to advocate abstinence as a method of contraception. In the 17th century AD, the physician Condom, the imperial physician of King Charles II of England, invented the male condom. Its raw material is lamb's cecum, and the thickness of the best product can reach 0.038 mm (now the latex condom is generally 0.030 mm). this was a great event that shocked the world at the time. Dr. Condom was awarded a knighthood for this invention, and the United Kingdom also earned a lot of foreign exchange from it. From 1725 to 1798, the swinger Casanova introduced the details of the trial contraceptive method in his autobiography. He recounted that he had attempted to use the rind of half a lemon as a primitive cervical cap. In 1827, scientists discovered the existence of eggs, or egg cells, which was a major scientific breakthrough. Previously, it was only known that a woman could get pregnant after the sperm entered her body. This discovery is the first step in understanding human reproduction. In 1832, Massachusetts physician Charles Norton invented a contraceptive solution that could be injected into the uterus through a syringe after intercourse. This solution comes in a variety of formulations and includes salt, vinegar, liquid chlorine, zinc sulfite, or potassium aluminum sulfate. The injection method was widely used in the next 40 years. In 1838, German doctor Friedrich Wilde prescribed a small cervical cap to his patients, which could cover the cervix during menstruation. This contraceptive method was never widely used, but the so-called "Wilde cap" became the precursor to the modern cervical cap. In 1839, Charles Goodyear invented the rubber vulcanization technology and put it into practical application to produce rubber condoms, intrauterine devices, vaginal douches and cervical caps. In 1843, scientists figured out that when sperm meets an egg, pregnancy occurs. Before, people thought that men create life; women only provide the place where life is born. In the 1970s, a wide variety of contraceptive devices appeared in the United States, such as condoms, contraceptive sponges, douches and cervical caps. These are available from catalogues, pharmacists, dry goods stores and even rubber vendors. On March 2, 1873, the U.S. Congress passed the Comstock Act, an anti-obscenity bill expressly stipulating that contraceptives are obscene and prohibited from being distributed through the post office or interstate commerce. The United States was the only Western country at the time that had a law outlawing contraception. Catherine Dexter McCormick, the funder of the 1875 Abolition Movement, was born into a prominent family in Dexter, Michigan.
ancient contraception
Long, long ago, when humans were primitive, men and women were figuring out how to get rid of birth control. The methods they use are extremely dangerous and at the same time most likely to be ineffective. It is not difficult to find that with the development of civilization, various methods of contraception came into being.
However, there are several contraceptives invented by ancient people that apparently proved to be very effective, such as an ancient contraceptive prescription written in Egyptian hieroglyphs on a 3,500-year-old Egyptian papyrus. The prescription says that a woollen swab soaked in gum arabic, coconut and honey can be implanted into a woman's body to prevent pregnancy. Although this prescription is so old, experiments have shown it to be very effective. "Because gum arabic contains lactic acid, which is a natural spermicide," Goldhead said.
In addition, some ancient contraceptive methods are full of dangers to the human body. For example, ancient people used to drink graphite or mercury to achieve contraceptive effect, but this dangerous method can easily lead to death. In the 1930s, Westerners also invented a small hexagonal wooden block - something similar to a "uterine condom" to prevent women from getting pregnant, but this contraceptive was later called "a torment of women" appliance".
In the collection of the museum, there are also condoms made of sheep intestines by ancient people, which are obviously a bit close to the prototype of modern condoms.
The ancient Greeks and Romans stuffed all sorts of things into women's vaginas. For example, lump honey, cedar gum, even crocodile dung, elephant dung (the acidity of elephant dung can kill sperm).
In ancient China and Japan, silk oiled paper, rags, and sponges were inserted into the female vagina as a barrier. The ancient Chinese also used fish fat as condoms. It is conceivable that it is not easy to find a suitable fish fat due to the different sizes of men's words.
contraceptive method
tubal ligation
The inner side of the fallopian tube communicates with the uterus, the outer end is free, and is close to the ovary, and the egg runs from the fallopian tube to the uterine cavity. Tubal ligation is an operation to ligate the fallopian tubes to block the passage of eggs to the uterus, so as to achieve permanent sterilization of women. This procedure is suitable for adult women who desire permanent sterilization and have no contraindications to surgery. Women who only want temporary or reversible contraception are not suitable for this procedure.
In recent years, minimally invasive techniques have become generally applicable, and the use of laparoscopic tubal ligation has become more and more popular, because compared with traditional surgery, the damage is small, safe, and the recovery is faster. The difference between the two is:
1. In laparoscopic surgery, the hole is inserted into the abdominal cavity by means of instrument expansion, and the integrity of the abdominal wall is basically preserved. However, the incision is an incision, and the abdominal wall muscles and the corresponding blood vessels and nerves are damaged. After the operation, the skin around the incision will be numb, and the abdominal wall muscles will become scarred and weakened, and abdominal wall incisional hernia may occur.
2. Laparoscopic abdominal wall poke holes are small (ranging from 3-10mm), scattered and concealed, and will not affect the appearance after healing. And we often see, surgical incisions form centipede-like proliferative scars.
3. Incision infection or fat liquefaction and incision dehiscence in traditional surgery have always been unavoidable problems. Laparoscopic surgery is the best way to solve this problem.
IUD
definition
IUDs are generally made of anti-corrosion plastic or metal, and some are added with some drugs (such as feminin or indomethacin, etc.). The uterine ring has various shapes such as round, uterine cavity, T-shaped, etc. The doctor can choose the appropriate uterine ring according to the situation of each person's uterus.
principle
After the uterine ring is put into the uterine cavity, the environment in the uterine cavity is changed, causing inflammation of the uterus, which is not conducive to embryo implantation, thereby causing early miscarriage to achieve the purpose of contraception. The effective rate of contraception with a uterine ring is about 94 to 99%, second only to oral contraceptives, sterilization, dermal implants, condoms and contraceptives.
advantage
The use of the intrauterine device (IUD) as a non-permanent method of contraception dates back to ancient times, but it was only in this century that it developed into an effective contraceptive widely used around the world. Since Scott reported in 1968 that critical illness and death were associated with the IUD, a large number of studies have reported the dangers of this contraceptive method to users, including pelvic inflammatory disease (PID), uterine perforation, abnormal Pregnancy (commonly known as ectopic pregnancy), spontaneous abortion or infectious abortion are particularly important comorbidities. An IUD is a long-acting contraceptive method that is valid for anywhere from one year to several years. After the uterine ring is removed by the doctor, you can become pregnant again. After wearing the ring, you don't have to do anything before having sex. Women who wear the ring do not feel the presence of the uterine ring, so it is suitable for women who need regular contraception.
unsuitable crowd
Genital malformations or tumors, dysmenorrhea or heavy menstrual flow, pelvic inflammatory disease, gonorrhea and women with multiple sexual partners, severe anemia, heart disease, and a history of ectopic pregnancy should not wear an IUD. It should generally be left to the doctor to decide whether it is appropriate.
use date
The uterine ring can basically be placed by a doctor as long as it is determined that there is no possibility of pregnancy. It is usually best to wear the ring within two or three days of a clean period. A postpartum check-up is done six to eight weeks after the birth and the ring may be worn if the doctor thinks it is appropriate.
put and take out
Placing and removing the uterine ring is simple. First, the doctor will sterilize it, and then use the "ring feeder" to send the uterine ring into the uterus. After exiting the "ring feeder" and shortening the nylon thread tied to the uterine ring, the placement is completed. When taking the ring, just gently pull the nylon thread at the end of the ring or use the "ring remover" to drag the ring out of the uterus. There is usually only mild lower abdominal pain when placing and removing the uterine ring.
Is contraception possible immediately after wearing a uterine ring?
When the uterine ring is just placed, some women are prone to get pregnant by wearing the ring, so the doctor will instruct the use of external contraceptive methods one to two months after the ring is placed to ensure safe contraception.
Do you want to check regularly?
Routine examinations should be performed after the first menstrual cramp after wearing. Then check once a year when there are no special problems.
What should be paid attention to?
Women's initial menstrual period after wearing the ring can be extended by two to three days, and the menstrual volume may also be slightly larger. Some women experience abdominal discomfort or menstrual cramps. This is an initial unadapted response. However, individual women may experience a significant increase in menstrual flow, a small amount of bleeding outside the menstrual period, and obvious abdominal pain. If these conditions persist, they should return to the hospital for examination.
Unwanted pregnancy how to do?
There is still a 3% chance of unintended pregnancy using an IUD, so if your period is delayed or you suspect pregnancy, you should consult your doctor.
When is it taken out?
Different uterine rings have different periods of use, ranging from three to eight years. Usually about five years. When in Sheung Wan, keep the medical records of Sheung Wan. According to the doctor's instructions, the ring should be removed or replaced on time. It is easiest to get pregnant when the ring is removed and replaced, and other contraceptive methods should be used at the same time.
Internal contraceptives
Principles of contraception
Contraceptives are divided into two categories: internal use and external use. The main components of internal contraceptives are synthetic estrogen and progesterone, which are divided into three types: long-acting, short-acting and quick-acting (visiting relatives) according to the duration of contraceptive action. Contraceptives work by inhibiting ovarian ovulation, thickening cervical mucus, interfering with endometrial development, changing fallopian tube peristalsis, inhibiting sperm capacitation, and inhibiting or killing sperm.
type:
1. Long-acting contraceptive injection
It is a compound hexanoate progesterone and a compound megestrol that contain estrogen and progesterone. The first injection is on the 5th and 10th to 12th day of the menstrual cycle, and then on the 10th day of each menstrual cycle. Progestogen-only contraceptive injections, mainly medroxyprogesterone acetate (DMPA), are injected on the 5th day of menstrual cramps and every 3 months thereafter. about two-thirds of women have irregular bleeding after the use of a simple pregnancy needle. Can be used for lactating women.
2. Short-acting contraceptives
It is easy to take, reliable in contraceptive effect, harmless to human body and does not affect future fertility.
How to take: Generally, take the medicine after dinner and before going to bed on the fifth day of menstrual cramps. Take one tablet every day for 22 days without interruption. Take the medicine for one month, you can contraception for one month.
3. Family visiting contraceptives
It is suitable for those who visit relatives and live for more than 10 consecutive days. It can be taken after intercourse and is not restricted by the menstrual cycle. If you are visiting relatives for more than two weeks, you can change to contraceptive pills.
4. Long-acting oral contraceptives
Take one tablet after lunch on the fifth day of menstrual cramps for the first time, and take the second time at an interval of 20 days. After that, take the second day as the monthly taking date, and take one tablet every month.
Precautions
Before choosing contraceptives, you should go to the hospital for a physical examination to find out whether you are suitable for using contraceptives. No matter which contraceptive pill is used, it must be taken strictly in accordance with the instructions in the instructions, and the method of taking and the dosage cannot be changed at will, otherwise the contraceptive effect will be affected. Birth control pills should be kept in a cool, dry place, and if there are children at home, keep them out of the reach of children.
A small number of women will experience nausea, vomiting, dizziness and other reactions after taking contraceptives. Short-acting contraceptives can be taken after dinner or before going to bed, while long-acting contraceptives can be taken after lunch to reduce the reaction.
If vaginal bleeding occurs during taking the medicine or menstruation is absent for 3 months, you should go to the hospital to check the cause. Long-acting contraceptives cannot be stopped suddenly, and short-acting contraceptives should be taken after the withdrawal for 2-3 menstrual cycles as a transition to avoid irregular vaginal bleeding. Women who have been taking birth control pills for a long time should go to the hospital for regular health checks. If you want to have children, you should stop taking the drug for six months before getting pregnant. It is best to use condoms for contraception during the six months after stopping the drug.
Not suitable for people
① Women with acute and chronic hepatitis and nephritis, because contraceptives are metabolized in the liver and excreted by the kidneys.
②Women with heart disease and poor heart function, because the contraceptive pill makes the body water and sodium retention, which increases the burden on the heart.
③ Women with high blood pressure cannot use it.
④ Those with diabetes and family history of diabetes should not use.
⑤ Women with hyperthyroidism should not use it until they are cured.
⑥ It is not suitable for patients with benign breast tumors, uterine fibroids and various malignant tumors.
⑦Patients with vascular embolic diseases in the past or present, such as cerebral thrombosis, myocardial infarction, vasculitis, etc., cannot use it, so as not to aggravate the condition.
⑧ Women with chronic headaches, especially migraine and vascular headaches, should not use it.
⑨Long-term use of contraceptives can make the endometrium atrophy, so it is best not to use it for those with oligomenorrhea in the past.
⑩ Contraceptives can reduce milk secretion and reduce the quality of milk; contraceptives can also enter milk, which has adverse effects on newborns, so lactating women should not use them. Another point is that people over the age of 40 or smoking women over the age of 35 should not use it.
Do not take other medicines at the same time
Women who are taking contraceptives, if they take certain other drugs due to illness, can accelerate the metabolism of contraceptives, interfere with the effect of contraceptives, and lead to contraceptive failure. So far, the drugs known to affect the effect of contraceptives are roughly as follows: antibiotics include ampicillin, tetracycline, chloramphenicol, neomycin and erythromycin. Anti-TB drugs such as rifampicin. Antirheumatic drugs. Antiepileptic drugs and sedatives include phenytoin sodium, preeclampone, chlordiazepoxide, sucanimian, and hypnotic. Other drugs that affect the efficacy of contraceptives include sulfonamides, clotrimazole, insulin, and furandamidine. Therefore, women who are taking contraceptives and need to use the above drugs, it is best to temporarily discontinue the contraceptives and use contraceptive methods such as condoms, external contraceptives and birth control rings.
Effects of oral contraceptives on the body
The ingredients of oral contraceptives are hormones, hormones, also known as hormones. The estrogen and progesterone contained in oral contraceptives are the two hormones most closely related to women. The main function of progesterone is to complete a woman's vocation - conception, pregnancy, and lactation. And estrogen is the key to maintaining a woman's youth and health, making people more feminine. once a woman's estrogen decreases, the skin will become rough, wrinkles will appear early, and the menopause will be at least 2 to 3 years earlier. It is for this reason that the hormones contained in oral contraceptives not only do not cause harm to the human body but also do not affect the endocrine. On the contrary, there are many benefits for women.
Women who use birth control pills appropriately have a 20-80% lower risk of developing uterine and ovarian cancer; the longer the pill is taken, the lower the risk. A recent study pointed out that estrogen in contraceptive pills before menopause does not predispose women to breast cancer.
topical contraceptives
definition
External contraceptives are chemical preparations that are placed deep in the vagina, near the cervix, so that sperm lose their mobility here and cannot pass through the uterus to reach the fallopian tubes and combine with eggs, so external contraceptives are also called spermicides.
External contraceptives include external contraceptive suppositories (Love contraceptive suppository, Wife's friend) contraceptive film (Leputer topical film), contraceptive tablets (Leputer topical contraceptive tablet) and Lelethane jelly.
Instructions
External contraceptives are mainly placed deep in the woman's vagina, near the cervix. about 10 to 12 cm deep from the vaginal opening. If the ointment is used, it should be injected into the pump first according to the dosage on the instructions, and then the ointment should be injected through the vagina into the position near the cervix with the pump, and intercourse can be performed. After use, the pump should be washed with soap and water and dried. Save it for next use. If using suppositories, tablets or films, the drug should be hand-injected into the depths of the vagina for 10 to 12 cm. After 10 to 15 minutes, the drug should dissolve before intercourse. The ointment should not be used alone as contraception. Now there is also a disposable Fangxin Coloplast liquid contraceptive cream in the market, which can be directly injected into the vagina, about 4.2ml each time, and the contraceptive effect is up to 8 hours.
advantage
External contraceptives are used before each intercourse and do not require a doctor's prescription or surgery, so they are more flexible. Medicines are not absorbed by the body and therefore have no effect on the body. Women who use topical contraceptives have lower rates of sexually transmitted diseases. Adding these drugs to condoms can improve contraceptive effectiveness. Women who use uterine rings, oral contraceptives, and injectables can also improve contraceptive effectiveness by adding these drugs within the first month of starting their use.
Precautions
The use of external contraceptives must be used correctly before each sexual intercourse, because human factors such as careless or wrong use may lead to contraceptive failure. When using suppositories, tablets, and films, you must wait for the drug to dissolve before having sex. It should be placed before each intercourse, and if it is placed for more than an hour without ejaculation or another intercourse should be placed again. The woman should use the supine position during intercourse (the drug will flow out of the vagina and reduce the contraceptive effect when the woman is in the upper position or upright position). The woman should lie on her back for 15 to 30 minutes after intercourse. It is not advisable to rinse the vagina for six hours after intercourse.
Compared with other contraceptive methods, the use of topical contraceptives has a higher risk of pregnancy, such as when the woman is using it when her period is overdue, or when problems occur, the possibility of pregnancy must be considered.
Some people may experience mild local irritation due to allergy to the drug, and the drug should be discontinued if it occurs.
preservation method
The expiry date is printed on the packaging of external contraceptives. When receiving and purchasing, pay attention to whether it has expired and whether the packaging is complete. Store in a cool, dry place protected from light, out of the reach of children. The period of validity of the external tablet of alloxan in Guangzhou is one and a half years, and the period of validity of the external suppository and external drug film produced in Tianjin is two years.
subcutaneous implant contraception
Subcutaneous implant contraceptive method is a new type of contraceptive method, which has been promoted and used all over the world.
This contraceptive method is to put a certain dose of progesterone in a silicone tube, and then bury the tube under the skin, so that it slowly releases a small amount of progesterone to play a contraceptive role. In 1984, China introduced this contraceptive, and it was first used in Beijing, Shanghai, Tianjin, Shenyang and other cities. At present, 15 provinces and cities across the country have established clinical experimental centers for subcutaneous implants to perform this operation. According to relevant statistics, the pregnancy rate within 2 years is only 0.1%, and the pregnancy rate within 3 years is 0.24%.
The implant used in the subcutaneous implant contraceptive method consists of 6 silicon capsule tubes the size of a matchstick. Each capsule tube contains 34 mg of L-18 A implant (also known as Nopram), and the capsule tube is embedded in the subcutaneous tissue. After 24 hours, start to slowly release the contraceptive pill immediately, and the contraceptive effect can be achieved after 24 hours, and the effective contraceptive time is 5 years.
Subcutaneous implant contraceptives achieve contraception by changing the viscosity of cervical mucus, preventing sperm from entering the uterine cavity; inhibiting endometrial growth, which is not conducive to the implantation of fertilized eggs; inhibiting ovarian ovulation and other functions.
people suitble
Women under the age of 40 who need long-term contraception, as long as they are healthy, can use this method of contraception. It is especially suitable for women who are prone to failure in using birth control rings, women who cannot take contraceptives on time, and women who are concerned about sterilization.
unsuitable crowd
Patients with severe anemia, hypertension, frequent headaches, hyperthyroidism, breast cancer, diabetes, uterine fibroids, ovarian tumors, severe skin diseases, hepatitis, nephritis and other diseases, as well as those with a history of ectopic pregnancy, lactating women , Women who weigh more than 70 kg or are taking anti-epileptic drugs and anti-tuberculosis drugs are not suitable for this contraceptive method.
Instructions
Subcutaneous implant contraceptive surgery is generally performed within 7 days of menstrual cramps or at the same time as abortion. The operation is simple. A small incision is made on the inner side of the contraceptive's upper arm, and a special trocar is used to push 6 silicon capsule tubes from the incision into the subcutaneous (in a fan-shaped arrangement), and the operation is over. The incision does not need to be sutured. The operation can be completed in a few minutes.
There may be bruising and swelling in the local area within a few days after the operation. In this case, no treatment is required, and it will disappear on its own after a few days. Seek immediate medical attention if the wound has bleeding, infection, or the silicone tube comes out. You can have sex 24 hours after surgery.
Embed a set of silicone tubes to prevent birth control for 5 years, at which time they are removed. If you need to continue to use this method of contraception, you can re-embed a set of silicon capsule tubes; if you are planning to give birth, take out the silicon capsule tube half a year before the planned pregnancy, during this period, condoms and external contraceptives can be used for contraception.
During the period of subcutaneous implant contraception, if amenorrhea occurs, irregular vaginal bleeding and lower abdominal pain occur, you should seek medical attention immediately to check for pregnancy.
advantage
(1) The contraceptive effect is good, and the contraceptive effective rate is over 99%.
(2) The contraceptive effect is long, and a single implant can prevent contraception for 5 years.
(3) The drug reaction is small. This contraceptive only contains progesterone and does not contain estrogen, so the side effects are smaller than that of oral contraceptives.
(4) It is reversible, and fertility can be quickly restored after the silicon capsule tube is taken out.
shortcoming
about 20% of women have menstrual disorders such as irregular menstrual periods, prolonged menstrual periods and increased menstrual blood volume at the beginning of use; some women also have amenorrhea. Most of these phenomena can be gradually improved after half a year.
rhythm contraception
definition
In the first half of the menstrual cycle, the egg develops in the ovary, which mainly secretes estrogen, which thickens the lining of the uterus (endometrium), cervix and vagina, and enlarges the breasts. Then comes ovulation. The follicles in the ovary release mature eggs, which are manifested by an increase in basal body temperature and changes in cervical mucus. At this time, the follicles mainly secrete progesterone; ovulation is the "fertile period". If the egg is not fertilized, progesterone decreases and causes the lining of the uterus to shed and menstruation occurs. Natural contraception, also known as rhythm contraception or cyclical abstinence; refers to a means of preventing pregnancy by avoiding sex during the "fertile period" of each menstrual cycle.
Pregnancy detection
There are three detection methods.
Calendar festival law: Women must record the menstrual cycle for 6 to 12 months continuously, and calculate the longest and shortest cycle with the first day of menstrual cramps as the starting day. The fertile period of the abstinence phase is then calculated. The calculation method is as follows:
The first fertile day (the beginning of the fertile period) = the shortest cycle minus 20 days
Last fertile day (end of fertile period) = longest cycle minus 10 days;
For example, the shortest cycle recorded by a woman is 26 days and the longest cycle is 31 days, then her fertile period is: 26-20=6 and 31-10=21, the woman's fertile period (or unsafe day) is Days 6-21 of the menstrual cycle. During this time, sexual activity or the use of another method of contraception should be abstained.
Body temperature method: women take their body temperature immediately after waking up every morning before getting up, and record it on a special body temperature paper. Because 1-2 days after ovulation, the body temperature starts to rise. Therefore, sexual life should not be carried out from the first day of menstruation to the third day after the body temperature rises, and it is considered a safe period for sexual intercourse after 3 days to 10 days before the next menstrual period.
Cervical mucus method (Billings method): Women learn to recognize dry, wet, and moist sensations in the vaginal orifice at various stages of the menstrual cycle. Different types of mucus are to be distinguished during mucus discharge; small and thick secretions indicate elevated estrogen levels, and large and lubricated mucus occurs near ovulation and can be removed with a finger from the vaginal opening before urination mucus to check its appearance and confirm the degree of stretch. The third day after the mucus and mucus peak is the fertile period. This method requires professional guidance and learning to use. It usually takes one to three months to learn to identify the type of mucus. Usually, the calendar law, body temperature method, and cervical mucus method should be integrated to calculate the fertile time in the menstrual cycle more accurately, and the contraceptive effect will be better.
people suitble
This method is natural and does not require instruments, hormones, or surgery. For women whose religious beliefs prohibit the use of artificial contraception. It is also used in women with severe side effects and contraindications to the use of other contraceptive methods. Women who use this method of contraception require a more regular menstrual cycle and a more stable frequency of sex. The relationship of sexual partners is more cooperative and tacit, and both partners have the consciousness of not having sex for a long time.
Are there any contraindications
Natural contraception has no known medical side effects. This method should not be used by women who are unable to observe and record symptoms and signs during pregnancy or who cannot guarantee the cooperation of their sexual partners. Women who have contraindications to pregnancy should not use this method.
efficiency
At present, the three methods of natural contraception in calculating the fertile period are affected by many human factors. And women's ovulation is often affected by living environment, mood, health or sexual life, and sometimes even extra ovulation (ovulation during non-fertile periods). Therefore, natural contraception is not very reliable.
Reliability of rhythm contraception
Rhythm contraception refers to calculating a period of infertility based on the ovulation period and the survival time of sperm and eggs in the female reproductive tract, so sexual intercourse is selected during this period to achieve contraceptive purposes. Usually ovarian ovulation is usually within 2 days before and after the 14th day of menstruation, so the safe period is about 10 days after menstruation, and after the 20th day after menstruation to the next menstrual cramp, the closer to the menstrual period, the greater the possibility of contraception. However, according to relevant information, this method is not safe, mainly due to the following:
1. The success of rhythm contraception depends on the understanding of the ovulation period. Without this knowledge, safety is impossible. Some people in China have done a survey, and they have a correct understanding of rhythm contraception. 1/5 of the surveyed people are still ignorant and do not know how to calculate the ovulation period. This is also the low success rate of contraception in the rhythm period. one of the reasons.
2. The time of a woman's ovulation is affected by factors such as the external environment, climate, personal mood, and health status, which may cause delayed or early ovulation, and additional ovulation may occur. Therefore, the rhythm period cannot be calculated accurately, so the rhythm period is not safe for contraception.
Accurately grasp
Many people know about rhythm contraception, but after all, it is only a general method, and everyone is different. How to accurately grasp it depends on the following three points
The key to safe pregnancy is to master the ovulation period and how to predict the ovulation period. There are many methods at present, and the methods that can be mastered at home are as follows:
1. Cervical mucus
Women can produce more estrogen due to mature follicles. When it reaches a certain level, that is, during ovulation, the cervical glands can secrete more mucus, which is about 3 to 30 times the usual amount. At this time, the mucus is thin and hail. Transparent, low viscosity, watery, easy to pull into filaments. Up to 15 to 20 cm long. If under the microscope, the cervical mucus can be seen as crystals in the shape of fern leaves. At the same time, if the woman can feel the cervix, it can be seen that the external os of the cervix spreads out during the ovulation period. And a large amount of clear, smooth and elastic mucus flows to the vagina, and the vagina is contracted to make the mucus discharge out of the vagina on its own. It can be seen that the mucus is thin and smooth, transparent, and the mucus can be pulled into filaments with thumb and forefinger, reaching more than 10 cm. Be careful not to confuse semen left over after intercourse with this mucus. The closer to ovulation, the smoother, clearer, and more watery the mucus becomes. If an increase in vaginal secretions is found, that is, when cervical mucus increases, immediately avoid intercourse or use condoms and other measures, and pay attention to the changes in mucus. sky. It's a good idea to record the days when you notice an increase or change in mucus every month so that you can explore the pattern.
2. Measure basal body temperature
Women's body temperature can vary with the menstrual cycle, the menstrual and follicular phases are lower, while the luteal phase is higher. In the first half of menstruation, the temperature is above 36.8 ℃, which is caused by endocrine progesterone. To predict the ovulation period, it is necessary to draw a basal body temperature curve. You can use some small graph paper to mark the temperature scale at equal distances on the longitudinal axis of the grid, starting from 36°C, taking 0.1°C as the grid, and reaching 37.5°C for a total of 15 grids. On the horizontal axis of the square, mark the first, second, third... days of the menstrual cycle in turn, and the menstrual period is marked with X. From the first day of menstrual cramps, after waking up every morning, put the thermometer under the mouth and tongue before getting up, measure it for five minutes, take it out, and mark the reading on the horizontal and vertical coordinates on the graph paper, represented by black dots. There are also people who urinate in the toilet bowl every morning after getting up, and then measure their urine temperature, and also record the urine temperature reading on a graph paper. Both methods can be used. Note that after each temperature measurement, the thermometer should be thrown below 36°C for the next use. Then, the daily recorded temperature black dots on the graph paper are connected into a curve. In normal women, the body temperature curve begins to change little, and the body temperature rises significantly in the mid-term. According to foreign Jaques and others found that 95% of women's low temperature point appeared within 66 hours before ovulation, of which 70.4% appeared 48 hours before ovulation, and the average ovulation time appeared 33 hours after the low temperature point. Therefore, once a low temperature point occurs, it is necessary to avoid intercourse or take other contraceptive methods. The accuracy rate is generally considered to be 80%.
3. Measuring saliva resistance
In recent years, it has been found that changes in female hormones in the body can cause changes in electrolytes in saliva before and after ovulation. Therefore, the resistance value can be changed periodically. So some people measure the resistance according to this principle to predict ovulation. The method is: spit out some saliva in a container every morning after waking up, measure with a resistance meter or a multimeter, keep a certain distance between the two measuring rods, and record the obtained value daily after measuring the resistance. The body temperature is plotted as a curve. After one cycle, it can be found that after the fifth day of the menstrual cycle, the resistance value can appear the first peak, and after three consecutive low values, the second peak can appear: At this time, ovulation often occurs in the first During the period from the 6th to the 9th day after the peak, attention should be paid to the 4th to 10th day when the resistance value reaches the first peak, abstinence or the use of condoms. According to the same reason, someone abroad measured the resistance of the posterior vaginal fornix and found that the lowest day of the monthly vaginal resistance is the signal that ovulation is about to occur. It is more accurate to use the two methods together.
condom
Sexual health contraception is also the key point. Currently, the problem of unmarried pregnancies is very serious. It is necessary to choose a reasonable method of contraception. Whether it is medicine or rhythm, there are inappropriate condoms. Condoms are very safe. It's like wearing a raincoat to take a bath", but it's not the case. With the development of technology, condoms are getting thinner and thinner. Because of their high safety factor, they are more and more popular among unmarried cohabitants.
It is the most commonly used method at present. The biggest advantage is that it does not interfere with women's physiology at all, and it can also prevent sexually transmitted diseases. The biggest obstacle to insisting on using it is that no matter how the texture of the sleeve is improved, some people still feel that this layer of film affects them. Enjoy sex at its best.
emergency contraception
Emergency contraception, as the name suggests, is a temporary measure, a contraceptive method used in "stressful" situations.
The so-called "emergency" situation means that no protective measures have been taken during sex, or methods have failed. Such as improper use of condoms, condom rupture, slippage, missed pills, or IUD falling off, raped, etc. At this time, some emergency contraceptive protective measures can be taken as a remedy to avoid pregnancy. It must be taken within 72 hours after sex to be effective, and taking the drug once is only effective for a short period of time, and there can be no unprotected sex.
More than 12 emergency contraceptive methods have been tested, among which the main ones that have been confirmed to be effective are levonorgestrel and the low-dose mifepristone under study. The former's trade name is also called Yuting, which is an over-the-counter drug. Each tablet contains 0.75mg of levonorgestrel. Take one tablet as soon as possible after intercourse, and then take one tablet after 12 hours. Mifepristone was first successfully researched by the French in the 1980s. It was also produced by a Chinese pharmaceutical factory a few years ago. Its trade name is Xiyin and Zhuanjing. It is now widely used as a drug for abortion. A promising emergency contraceptive drug, high efficiency, simplicity and safety are its advantages, and the price is relatively cheap, only one tablet of 25mg mifepristone is required orally each time. It is still a prescription drug and is available in every hospital obstetrics and gynecology clinic. In the near future, the drug may be more readily available over-the-counter.
A copper-bearing IUD placed within 5 days of sex is highly effective as emergency contraception. It is especially suitable for women who are contraindicated to the above hormonal methods or who plan to continue to use the IUD as a long-term contraceptive method, and have a protective effect on subsequent sexual life within the same period.
To do emergency contraception, you also need to pay attention to the following points: First, have the concept of time. Existing research data shows that the sooner you take the medicine, the better the effect. Don't delay the timing. The drug contraceptive should not exceed 72 hours, especially when you have sex during the ovulation period, you should take the medicine as soon as possible. 2. Emergency contraception is a temporary remedy, and it must be taken within the prescribed period according to the instructions. It cannot replace conventional contraceptive methods. The reasons are: 1. Emergency contraception is not as effective as conventional contraception. Women avoid pregnancy; 2. The dose of emergency contraceptive levonorgestrel (Yuting) is 10 times larger than that of conventional oral contraceptives. If it is used repeatedly after each intercourse, it will have an impact on health in the long run; 3. Emergency contraceptives There are certain changes in the menstrual cycle, which may be early or delayed, and repeated use of emergency contraceptives will lead to menstrual disorders, bleeding or prolonged spotting, which will bring inconvenience to women's life and work. Third, emergency contraception has no effect on preventing STDs and AIDS.
Dos and Don'ts of Emergency Contraception
1. Indications:
1. Unprotected intercourse: (a) No contraception - especially if the first intercourse is unprotected. (b) Intercourse interruption - failure to withdraw the penis from the vagina in a timely manner causes ejaculation to occur in the vagina. (c) ejaculation outside the vaginal opening. (d) Miscalculation of dates in rhythm contraception (periodic contraception, self-controlled natural contraception)
2. The condom ruptures, falls off in the vagina or other improper use.
3. Improper placement of vaginal diaphragm and cervical cap, fall off during sexual intercourse, rupture or premature removal.
4. Partial or complete shedding of the IUD.
5. In some special cases, take the ring in the middle of the menstrual period.
6. Before and after ovulation, women only use spermicide for contraception.
7. Improper use of oral contraceptives - when a missed dose extends the drug-free interval to 9 days or more (ie, 2 or more tablets are missed), and there is unprotected intercourse during this period. If you miss 2 or more pills in the first 7 days, your doctor can give you emergency contraception. If you have taken the pill for 7 consecutive days, the contraceptive protection effect of missing 7 days will disappear. Emergency contraception is not necessary when 1, 2, or 3 pills are missed in the middle of taking the pill. Empirically speaking, emergency contraception is appropriate if more than 3 tablets have been missed or if the patient has severe anxiety.
8. Missing a progestin-only contraceptive pill—emergency contraception is required if unprotected intercourse occurs between 48 hours after the first pill is missed and the pill is restarted.
9. Sexual assault - emergency contraception is required regardless of its nature, in this case do not think about legal process etc. Doctors should consider the possibility of STDs. Long-term psychological support should not be ignored.
2. Contraindications:
1. Suspected pregnancy: Compound tablets and IUD are contraindicated.
2. Ectopic pregnancy: composite tablets are not contraindicated, and IUD is relatively contraindicated if it is to be removed in the next menstrual period.
3. History of thrombosis: composite tablets are relatively contraindicated, and IUD is acceptable.
4. Migraine pain at the time of consultation: The composite tablet is only contraindicated when there is a previous focal migraine, and IUD is acceptable.
3. Emergency contraceptives can only be taken once a month
Emergency contraception refers to the contraceptive method used to prevent pregnancy during a period of time after unprotected sex or contraceptive failure. Drug contraception is the most commonly used method.
A class of drugs commonly used in emergency contraceptives is a single progestogen, represented by Yuting. Each tablet of Yuting contains 0.75 mg of levonorgestrel. One tablet is taken orally after sex, and another tablet is taken 12 hours later. The chance of pregnancy after taking the drug can be reduced to 1%-3%. Patients may experience mild nausea and spotting after taking the drug.
Another type of emergency contraceptive is anti-progestin, the most commonly used is mifepristone (50 mg, 25 mg, 10 mg per tablet), any one tablet is taken orally on the same day, and another tablet is taken 12 hours apart, Fasting for two hours before and after taking the medicine. After taking the medicine, the probability of pregnancy can be reduced to 1%, and there are few side effects, and some people have menstrual changes. If vomiting occurs within two hours after taking the medicine, the medicine should be spit out, and the same dose of medicine should be taken once again.
Here are a few more things to keep in mind about emergency contraception:
First of all, drug emergency contraception can only work on this unprotected sex life, and the drug can only be taken once in a menstrual cycle, and other reliable contraceptive measures should still be taken for sexual life after taking the drug in this cycle.
Second, emergency contraception is only a temporary remedy and should never be used repeatedly as a regular method of contraception.
Third, if emergency contraception fails and become pregnant, the incidence of neonatal malformation is high, and the pregnancy must be terminated.
Finally, I would like to remind everyone that emergency contraception should be carried out under the guidance of a doctor.
