BIRTH CONTROL (CONTRACEPTION) METHODS
The contraceptive practices that couples use to have the number of children they want are called "birth control". In this way, families fulfill their responsibilities towards society by having as many children as they can raise well. Approximately 45% of married women worldwide use birth control. There are birth control methods that women and men can apply separately.
We can group birth control methods under 3 headings;
1. Surgical birth control methods:
a- Tubal ligation in women:
In women, the tubes allow the male cell (sperm) to reach the female egg cell, fertilization occurs, and the fertilized egg is transported back to the uterus. All these processes are prevented by tying the tubes. It can be performed laparoscopically (closed), openly or during cesarean section surgery. It is a short process. Pregnancy may occur in up to 1% of women whose tubes are tied. If the woman regrets it, the tubes can be opened surgically with a 50-60% chance of success. In addition, these women still have the chance to have children through in vitro fertilization.
b- Obstruction of the tubes by hysteroscopy:
With hysteroscopy, a spiral-shaped device called Essure, made of stainless steel, nickel and titanium, is placed inside the uterus at the entrance of the canals. Its effect begins in 3 months. Therefore, an additional birth control method is recommended for the first three months. It has been implemented in the world since 2002. After 3 months, a medicated film (HSG) of the uterus should be taken. There is a 98-99% chance of success. It can be applied without anesthesia. There is no chance of the channels being reopened. In case of regret after the procedure, having a child can only be achieved through in vitro fertilization. Fat, adhesions in the abdomen It is a suitable method for women who have surgery and cannot tolerate surgery.
c- Duct ligation (vasectomy) in men:
It is the process of cutting and tying the channels (vasa deferens) that allow the cells (sperm) produced in the male to be expelled. It is easier than tubal ligation in women. It can be applied with local anesthesia. The success rate of reversal with surgery is about 60%. It is recommended to use a condom for 20 intercourse periods after the procedure. Because the cells beyond the connected part must be completely discharged.
2- Hormonal birth control methods:
a- Birth control pills (combined oral contraceptives):
It contains estrogen and progesterone hormones. It suppresses ovulation and protects the inner lining of the uterus (endometrium) and prevents pregnancy by changing the structure of the cervical fluid. Apart from birth control, it treats painful menstruation (dysmenorrhea) and excessive menstrual bleeding (menorrhagia). Rahim ve from ovarian cancer It has a protective effect. It starts to be used on the first day of menstruation. One tablet is taken at the same time every day. In boxes containing 21 tablets, when 21 pills are finished, a 7-day break is taken and the next box is started on the 8th day. When using boxes containing 28 tablets, they are used consecutively, without any breaks. When new birth control pills are started, it is recommended to use an additional birth control method (condom) for the first 2 weeks.
Main side effects:
- Absence of menstruation (amenorrhea): It is recommended to change the medication.
- Fullness and tenderness in the breasts: It may decrease within 4 months, if not, change the medication.
- Depression: The birth control pill is stopped,
- Headache: The birth control pill is stopped,
- Breakthrough bleeding or spotting: If it does not decrease within 4 months, the medication is changed.
It also slightly increases the risk of clotting and blockage in the vessels. It is not recommended for women who have previously had vascular disease.
b- Monthly birth control injection (Mesigyna):
It contains hormones similar to birth control pills. The mechanism of action is the same. Since it is applied from the hip into the muscle once a month, it can provide ease of use for people who forget the pill.
c- Birth control patches:
It contains estrogen and progesterone hormones. A certain amount of hormones are released from the patch into the blood every day. It can be applied to the waist area. It creates its effect by suppressing ovulation. The tape (ortho-evra) remains for 3 weeks, is removed for 1 week, and is applied to a different location every month. 90 kg. Its effectiveness decreases in women heavier than . In addition to the advantages of birth control pills, there is ease of use.
d- Vaginal ring:
Rings (nuva ring) contain estrogen and progesterone hormones, like birth control pills. It secretes a certain amount of hormones into the blood every day. It works by suppressing ovulation. It remains in place for 3 weeks and is removed for 1 week. Menstruation occurs during this period. In addition to the advantages of birth control pills, there is ease of use. About 3% of users abandoned the method due to discomfort during sexual intercourse.
e- Pills containing only progesterone:
It shows its main effect by changing the structure of the cervical fluid (mucus) and the inner lining of the uterus. It should be taken at the same time every day. It is used constantly. The most important area of use is breastfeeding women. It does not affect the baby or the structure of the milk. Spotting-like breakthrough bleeding may occur.
f- Injections containing only progesterone:
In our country, there is a form (Depo-provera) that is used every 3 months. It is injected into the muscle. In the first year of use, 1% of women develop amenorrhea. It is recommended to use for a maximum of two years. After cessation, the return of fertility may be delayed for up to 50-9 months. It negatively affects blood fat levels and may cause weight gain.
g- Subcutaneous stick (implant) containing only progesterone:
It is available on the market under the name Implanon. It is a stick that is 4 cm long and 2 mm wide.
It is applied to the inner part of the upper arm, under the skin, under local anesthesia. It is effective for 3 years. Birth control effectiveness is very high. Its most important disadvantage is that it requires a minor surgical procedure when inserted and removed.
h- Hormonal emergency birth control method:
In the preparation containing 2 tablets containing only progesterone hormone (Nor Levo), both tablets are taken together. It should be taken within the first 3 days after intercourse. It has few nausea-inducing side effects. Its effectiveness is very high. It should not be used as a permanent method of birth control.
A second alternative that can be used urgently is a drug called Preven, which contains both estrogen and progesterone hormones. It should be used within 72 hours after unprotected intercourse. It contains 4 tablets. It should be taken as 12 tablets every 2 hours.
3- Barrier (mechanical) methods:
These are methods that prevent male and female cells from coming together.
a- Condoms:
There are types for both men and women. It should be applied just before intercourse. In addition to its birth control effect, it provides protection against sexually transmitted diseases, especially Hepatitis-B and AIDS (HIV). Only synthetic condoms have a protective effect against Hepatitis-B and AIDS.
The male condom is in the form of a sheath with a flexible ring at one end and a closed end at the other.
The female condom is in the form of a sheath with flexible rings at both ends. One end is closed and this end is applied to the cervix.
b- Diaphragm:
It is a plastic membrane, the outer part of which is surrounded by a ring, that is applied to the vagina in women. It should be inserted at most 6 hours before sexual intercourse and removed at least 6 hours after. It provides significant protection against many sexually transmitted diseases, but it does not protect against AIDS. It has three sizes according to diameter size. Usually 68-80mm. diameter ones are preferred. It should not be used during menstruation and should not be kept for more than 24 hours.
c- Cervical cap (cervical cap):
It adheres tightly to the cervix. It can remain in place for 48 hours. It should be left in place for at least 8 hours after intercourse. It has four different sizes. A woman can determine the size that suits her by trying it on. It should be discarded after 1 year of use. It has significant protection against sexually transmitted diseases.
d- Spermicide (spermicides):
Sponge, foam, gel, vaginal tablet etc. They have shapes. They contain substances that kill sperm. They do not protect against AIDS and sexually transmitted diseases. It should be applied to the woman's vagina 10-30 minutes before sexual intercourse.
4- Intrauterine device (IUD):
It provides birth control by changing the structure of the uterus in a way that prevents the fetus from attaching. There are different types of shapes. Applying it during menstruation provides ease of application and reduces the possibility of undetected pregnancy to zero. Its effectiveness begins immediately after it is inserted, and its effectiveness ends immediately after it is removed. Ease of use is its biggest advantage. Emergency birth control can be achieved by inserting a copper intrauterine device within 5 days after unprotected intercourse.
After IUD application, it should be checked by a physician every 6 months. If abnormal discharge, groin pain and fever occur, the patient should definitely call his physician.
There is no one birth control method that is best for everyone. People may use different birth control methods at different periods of their lives. The important thing is to get accurate information about the methods before making a decision.
Leave a Reply