The contraceptive method is the necessary protection against unwanted pregnancy and sexually transmitted diseases at the time of intercourse. The human being reproduces naturally through the sexual act once it has reached the biological capacity to produce children, which is known as sexual maturity. This reproduction is controlled through the use of contraception, which allows the couple to decide the right moment to conceive the children they have planned.
What is a contraceptive method
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A contraceptive method represents the mechanisms used to prevent reproduction or pregnancy as a result of sexual intercourse. In the same way, and depending on the type of method, they can avoid transmitting diseases, although not all contraceptive methods are designed for this purpose.
The ideal method could be one that meets absolute efficacy (no failure), easy to use, does not interfere with the spontaneity and quality of sexual relations, and protects against sexually contagious infections. Most methods are reversible (when they are stopped, they are fertile again); otherwise with surgical methods, which are irreversible.
From the etymology of "contraceptive" it is known that it is formed by the Greek prefix anti ("the reverse"); the Latin prefix with ("combination"); cep, which comes from the Latin verb capere ("to capture", "to stop"); and from the Latin suffix tivus, which refers to activity or passivity.
History of contraceptive methods
The methods for contraception come from ancient times, when man discovered that there was a connection between the sexual act and the reproduction of the species. This allowed the search for methods that avoided conception.
The origin of some of them dates from about two thousand years BC. One of the oldest is coitus interruptus, even mentioned in the Bible, in Genesis. Other dangerous methods were applied in China, when women ingested lead and mercury, often causing death.
Other chemical contraceptive methods such as spermicides were used two millennia ago: substances such as vinegar, crocodile excrement, honey were introduced into the vagina. Ancient texts were known that reviewed and showed images of contraceptive methods, such as the use of vaginal tampons; they were cotton soaked with honey or acacia roots. In ancient Egypt, plant and animal based creams were used.
Condoms were used for contraception for centuries. Animal tissues in the penis were used during intercourse to retain semen. Over the centuries, they evolved in the material used.
Among other more modern ones are intrauterine devices, although whose origin dates back to the 4th century BC, it was not until the 20th century that the first recent models were created. In the 20th century, the first oral contraceptive was created by the Mexican Luis Ernesto Miramontes.
Types of contraceptive methods
The classification of contraceptive methods according to their nature are as follows.
Natural contraceptive methods
- Abstinence: This is the most radical of all contraceptive methods, since abstinence is the deprivation of sex. But this can be total (absence of vaginal penetrative sex and other sexual activities) or partial (non-penetrative sexual practices). In this practice, sperm cannot enter the vagina and reach an egg. It does not protect against sexually transmitted diseases (STDs), unless abstinence is absolute.
- Rhythm method: the rhythm method consists of not having sex on fertile days, in order to avoid the risk of becoming pregnant. By itself, it does not prevent STDs.
- Coitus interruptus: Coitus interruptus consists of interrupting sexual intercourse just before male ejaculation to prevent semen from entering the vagina. This technique requires a lot of concentration, self-control and precision, because if it is not done in time, semen can enter the vagina.
- Lactation: this method infers that during the lactation period the woman cannot become pregnant. It consists of feeding the baby exclusively with breast milk every four hours during the day and every six hours at night. This paralyzes the production of eggs, therefore, there can be no pregnancy.
- Temperature method: the temperature method consists of recording the changes in body temperature in the menstruation cycle, and must be performed with a basal thermometer. Before ovulation, body temperature decreases (in a range between 35.5 and 36.6ºC), but after ovulation it increases (from about 36.1 to 37.2ºC).
- Cervical mucus method: also known as the Billings method, the cervical mucus method consists of observing the cervical mucus, which, depending on its status, can be known if you are ovulating to suspend sexual intercourse during the fertile period. This mucus varies according to each stage of the cycle in its density.
Ovulation occurs between 12 and 15 days before menstruation, estimating that the days with the highest fertility in women with regular 28-day cycles are those between day 9 and day 18, counted from the beginning of the menstrual period. On the other hand, when the menstrual cycle of women lasts between 25 and 35 days, those fertile days are between day 7 and day 21, starting from the first day of the cycle.
It also prevents menstrual bleeding (lactational amenorrhea). This will be effective only in the following six months from the birth of the baby, whose feeding must be exclusively by breastfeeding. Milk should not be expressed with a pump.
It consists of taking the temperature daily upon waking before any activity (even before speaking) and keeping track of the numbers on a fertility observation chart. However, eating habits, stress and vices can alter the numbers. Before use, the temperature must first be recorded for three months. Infertile days are those when the temperature remains high.
This indicates that from the fourth and fifth day of the beginning of the cycle, there will be about five safe (dry) days; From the ninth day, the production of cervical mucus begins, which will make it easier for the ovules to descend and prolong the life of the spermatozoa and this period of greater fertility ends around the sixteenth day; and finally the cycle is closed with fourteen dry days in which it is safe to have sex with a lower risk of pregnancy.
Barrier methods of contraception
- Male and female condoms: they are linings whose function is to prevent semen from entering the vagina, producing fertilization. There are male and female condoms. Among the contraceptive methods for men, the condom is the best known and it can be made of various types of plastic, latex or sheepskin, which will cover the male member, holding the semen there until the penis is withdrawn from the vagina. This method is recommended to avoid sexually transmitted diseases (with the exception of lambskin; and they can be spread if there is skin-to-skin contact).
- Cervical Caps: Cervical caps are a cup made of silicone that must be placed deep into the vagina so that it can cover the cervix. This will prevent the passage of semen, and is used with spermicide smeared on it for greater effectiveness. This should not remain inside the woman for a period greater than two days. Its use does not prevent sexually transmitted diseases.
- Diaphragms: It is similar to the cervical cap, with the difference that the diaphragm is slightly larger and is shaped like a plate. It must be folded and inserted into the vagina to cover the cervix. Another similarity with the cervical cap is that the diaphragms must be accompanied by chemical contraceptive methods, such as spermicides to increase their effectiveness.
- Contraceptive sponges: These are soft polyurethane foam sponges that contain spermicides and cover the cervix. Although its use does not require a prescription, contraceptive sponges can cause allergies in some women. For use, it must first be moistened and squeezed to activate the spermicide.
On the other hand, the internal or female condom provides practically the same level of protection, with the difference that these must be inserted into the vagina. Like men, these reduce the risk of STD infection and that the sperm reach the egg.
Its use does not help prevent STDs. It is important to note that after sexual intercourse, it should be left in for about six hours and removed before twenty-four hours.
After intercourse, it must remain in place for at least six hours and must be removed in a period of no more than thirty hours. It does not offer protection against STDs.
Hormonal contraceptive methods
- Birth control pills: these are pills with hormones that prevent ovulation. The woman should ingest one daily and represent an effective option to avoid unwanted pregnancies. Some contraceptive pills can cause headaches, changes in appetite, weight gain, changes in the menstrual cycle, mood swings, nausea, among others; so it is important that a gynecologist prescribe the most appropriate for each woman.
- Subdermal implants: Subdermal implants are small flexible bars that measure approximately 4 centimeters and are inserted subcutaneously into the arm. This must be inserted by a doctor or nurse and works almost immediately. Its duration is approximately five years from the moment it is placed and they release progestin, which is a hormone that prevents ovulation and at the same time thickens the cervical mucus.
- Injections: injections as a technique to prevent pregnancy are those that must be given once every 3 months and are given by a doctor or nurse. Like the implant contraceptive method, these contain the hormone progestin, responsible for preventing ovulation and thickening the cervical mucus, which hinders the passage of sperm.
- Hormonal patches: these are transdermal patches that, placed in a specific part of the body, release hormones through the skin that prevent pregnancy. These hormones are the previously mentioned progestin and estrogen. These hormonal patches can be placed on the belly, back, forearms, or buttocks.
- Intrauterine devices: Intrauterine devices (IUD birth control) represent a method that involves inserting a small flexible T-shaped device that is inserted into the uterus to prevent sperm from reaching the egg. There are those that have a thin copper wire wrapped around them, a material that repels sperm, lasts up to twelve years and does not contain hormones; and hormonal ones that, depending on their brand, can last between 3 and 7 years.
- Vaginal ring: the vaginal ring is a 99% effective contraceptive, a long-lasting hormonal method, which consists of a very flexible plastic ring of 5 centimeters in diameter that is placed in the vagina and releases female hormones, such as and as if it were a contraceptive pill, but much more comfortable and effective. It covers the uterus and while it is there it releases hormones that inhibit ovulation. It must be changed monthly.
The hormones present in birth control pills prevent ovulation, so a pregnancy cannot be achieved. To avoid STDs, it must be combined with a condom.
Depending on the body, they can cause side effects, such as headache, ovarian cysts, weight gain, breast pain, and nausea. It does not prevent STDs. It should be noted that once it is removed, the woman can become pregnant.
Possible side effects of injectable birth control are headache, nausea, hair loss, nausea, weight gain, depression, among others.
The duration of each patch is about 7 days, so it must be replaced with a new one. During the week of menstruation its use should be discontinued. Their possible side effects include allergic reactions at the site where they are placed, dizziness, migraines, nausea, vomiting, breast pain, among others. It does not protect against sexually transmitted diseases.
These must be placed by a gynecologist and can function as emergency contraceptive methods within the first five days of the last sexual intercourse (copper only), and after that, continue their use as a method. It does not protect from STDs.
This vaginal ring is not noticeable, since it goes in the upper part of the vagina, so during sexual intercourse it is unlikely that the couple will notice it. It should be noted that the ring does not protect from STDs.
Surgical contraceptive methods
After tubectomy, as this procedure is also called, the woman will not ovulate, so she can no longer get pregnant. The possible side effects of this procedure is the reaction to the own medications of the intervention; that the ligation is not effective and you can get pregnant again; risk of possible ectopic pregnancies (outside the womb); among others. This procedure is irreversible and does not protect against STDs.
There are two types of vasectomy, which are the one that includes the incision and the one that does not make a cut, the latter being less risky. It does not protect against STDs.
Emergency contraceptive methods
Emergency contraceptive methods are pills that are used when there has been an unprotected sexual encounter and there is a risk of pregnancy. They are also used when there has been a violation, when the condom has broken or the contraceptive pills have not been taken correctly.
These can be taken in a period not exceeding 72 hours after the sexual encounter. Possible side effects are nausea, dizziness, headache, increased menstrual bleeding, among others, but they last a few days.
Effectiveness of contraceptive methods
The effectiveness of these is determined by: their correct use; the appropriate choice according to age and partner; what you want to get from them (just prevent pregnancy, protection against sexually transmitted diseases, how long you want to have such protection); the monetary capacity they have to pay for a method; among others.
According to the World Health Organization, the percentage of effectiveness of the methods described above for contraception are the following:
- Abstinence: the effectiveness of this method is 100% as long as the semen does not come into contact with the vagina.
- Rhythm method: is below 60%; and to use it correctly you need to be over 19 years of age, and keep the duration of the last menstrual cycles noted.
- Coitus interruptus: the effectiveness percentage of this method alone is between 15 and 28%, since if there are sperm in the pre-seminal fluid, they can reach the ovum and fertilize it.
- Lactation: its effectiveness is very high, 98%.
- Temperature method: correctly applied, its percentage of effectiveness is 85 to 97%.
- Cervical mucus method: its effectiveness is between 75 to 98.5%.
- Male and female condoms: the former are 98% effective and the latter 95%.
- Cervical caps: its effectiveness is between 84 and 91% in women who have never given birth and decreases to a range of between 68 and 74% for those who have already had a child.
- Diaphragms: their effectiveness is in a range of 88 and 94%.
- Contraceptive sponges: their percentage of effectiveness is 91%.
- Contraceptive pills: their percentage of effectiveness is 98% if they are taken properly.
- Subdermal implants: its effectiveness is 99%, this being one of the most effective methods to prevent pregnancy.
- Injections: its effectiveness, like the implant contraceptive method, is 99%.
- Hormonal patches: their percentage of effectiveness reaches 91%.
- Intrauterine devices: their effectiveness is 98%.
- Vaginal ring: its effectiveness is 91%.
- Tubal ligation: its effectiveness is greater than 99%, since out of every two hundred women, 1 can get pregnant.
- Vasectomy: although it is irreversible, it is more than 99% effective, that is, it has a minimal margin of error.
- Emergency methods: its effectiveness is directly proportional to how soon it is taken after intercourse.
