Types of contraceptives for women after 30 years: what to choose, application
With the onset of sexual life, a reliable and safe contraceptive in terms of side effects becomes relevant for every member of the fair sex. It should be noted right away that there is no universal means. At each age, taking into account the state of health, the regularity of sexual relations and other factors, some methods are more appropriate. For a woman after 30 years, their choice becomes particularly important, as her health is no longer ideal, and some funds, for example, improperly selected hormonal drugs, can further exacerbate the situation.
- Varieties of methods of contraception
- Birth control pills
- Other hormonal contraceptives
- Barrier methods of contraception
- Intrauterine device
Varieties of methods of contraception
The concept of "contraception" implies a set of methods aimed at preventing unwanted pregnancies. All currently used contraceptive drugs are divided into the following groups:
- natural (calendar method, interrupted sexual intercourse, daily measurement of basal temperature for ovulation control, and others);
- barrier (condoms, uterine cap, vaginal diaphragm);
- hormonal (tablets for internal administration, intramuscular injections, subcutaneous implants, vaginal rings, intrauterine devices and systems, plasters, postcoital means);
- chemical (pastes, suppositories, ointments and topical tablets, intrauterine devices containing copper, gold or silver);
- surgical (blocking the patency of the fallopian tubes).
The main criterion by which their effectiveness is assessed is reliability. The first place with the result of 99.9% is occupied by the surgical method, in which the woman performs an operation to bandage the fallopian tubes, which excludes the possibility of becoming pregnant. After 30 years, it can be recommended only to women with absolute contraindications to pregnancy for health reasons or those who more clearly do not want to have children. To restore the patency of fallopian tubes, a complex operation will again be required, or a costly IVF procedure will have to be resorted to for childbirth.
The second place with a level of reliability of 99.7% is the hormonal birth control pills, followed by the intrauterine device (IUD) and intrauterine systems with a degree of protection of 99.2% and higher. Relatively new methods of contraception are the hormonal patch and ring, the level of their reliability is about 92%. Barrier contraception is reliable at 85-90%, and the lowest level of protection against unwanted pregnancy (80% or less) has natural methods and local chemicals or spermicides.
The choice of acceptable contraceptive options for a woman in each specific case should be performed by a gynecologist after an appropriate examination, especially in the case of a choice of hormonal tablets.
Birth control pills
On the shelves of pharmacies you can find a wide range of oral contraceptives. Despite the fact that they are released without a prescription, their independent appointment on the advice of friends or advertising is unacceptable. Hormonal pills are indicated to prevent pregnancy with a regular sex life married or having a regular sexual partner to women. Their high efficiency is due to the fact that the contraceptive effect is realized by several mechanisms in parallel. They suppress ovulation, change the structure of the endometrium in such a way that the egg can not attach to the wall of the uterus in the case of fertilization, increase the density of cervical mucus, making it difficult to advance the spermatozoa.
The active substances of the contraceptive hormonal tablets are synthetic analogues of female sex hormones estrogen and progestogen. They are:
- monophasic, with the same unchanged dose of estrogen and progestogen;
- biphasic, with a constant content of estrogen and variable content of pogestagen;
- three-phase, with varying doses of estrogen and progestogen;
- mini-drank, contain only progestogen in the minimum dosage.
By the quantitative content of hormones, combined oral contraceptives (COCs), that is preparations based on both estrogen and progestagen, are divided into micro-, low- and high-dosage.
To properly choose hormonal pills to prevent unplanned pregnancy, you need to contact a gynecologist. The specialist will assess the patient's general health, her constitution, perform an examination on the gynecological chair, take swabs on the flora and oncocytology, find out whether she had had a pregnancy before. If necessary, will appoint additional studies: ultrasound of the pelvic organs, a general and biochemical blood test, blood tests for hormones to determine the state of the hormonal background in the irregular menstrual cycle .
Microdosed COCs (claira, jes, logest, novinet, zoeli, mersilon) can be recommended to nulliparous women for 30 years, who have not previously used hormonal contraceptive methods. They will also suit those who are already 35 years before the onset of menopause .
Low-dose birth control pills (jarina, janin, marvelon, regulon, diane-35, siluette) are prescribed to the above categories of patients in case of inefficiency of microdosed drugs for them and to women giving birth.
High-dose COCs (tri-regol, triziston, ovidon, non-ovolon, trikwilar) are usually prescribed only for therapeutic purposes to treat hormonal diseases of the female reproductive system. In the absence of such pathologies, they are not used only for contraception.
Mini-pili have a slightly lower contraceptive effect, compared with COC, but they are characterized by a smaller list of contraindications and side effects. They can be recommended to nursing mothers, women after the age of thirty who smoke and have contraindications for the appointment of COCs. The drugs of this group include microlut, charozetta, ireth, exlutton, lactinet and others.
The benefits of birth control pills are:
- presence of not only contraceptive, but preventive and therapeutic effect in some gynecological diseases (myoma, endometrial hyperplasia , breast cancer );
- mitigation or elimination of unpleasant symptoms of premenstrual syndrome;
- decreased morbidity of menstruation ;
- normalization of the menstrual cycle;
- later onset of menopause;
- reducing the fat content of the skin and hair, a tendency to acne.
Tablet hormonal contraceptives are easy to use, they do not require special preparation for sexual intercourse (as opposed to local drugs) and do not reduce the level of pleasant sensations during it.
The disadvantages of this method include the need for a woman to take the drug every day according to the instructions and prescriptions of the doctor at the same time. If the package contains 28 tablets, they are drunk continuously, and if 21, then take a break for 7 days, during which menstruation occurs, and then begin a new pack. Oral contraceptives do not protect against sexually transmitted infections.
Among the shortcomings of COC, there are high risks of complications from the cardiovascular system, in mini-pills they are much lower. COCs are contraindicated to women after thirty, if they have bad habits (smoking, alcohol abuse) and identified the following problems in the body:
- increased blood coagulability and a tendency to form blood clots;
- cardiovascular diseases;
- disorders of cerebral circulation;
- severe kidney and liver pathology;
- hormonally dependent neoplasms.
Of the side effects on the background of their reception are possible:
- Spotting spotting in the period between menstruation;
- decreased sexual desire;
- engorgement of mammary glands ;
- appearance of age spots;
- pain in the digestive tract;
- increased hair growth on the body;
There are also mood changes, depressive states.
Video: What you need to know about the use of contraceptive pills
Other hormonal contraceptives
In addition to oral contraceptives, other hormonal contraceptives are used to prevent unplanned pregnancy. These include:
- the vaginal ring;
- subcutaneous implant;
- contraceptive patch;
- postcoital means.
This is a thin silicone ring with a diameter of about 4 cm, containing in the composition of estrogen and progestogen, which enter the systemic circulation through the mucous membrane of the vagina and have an effect similar to oral contraceptives. Their concentration in the blood plasma is maintained at a constant level for 3 weeks, and then gradually decreases.
The ring is inserted into the vagina on the first day of menstruation and is left for 21 days, after which it is removed, and after a week it changes to a new one. His position in the vagina does not affect the pharmacological effect, but can create discomfort during sexual intercourse. The disadvantages of this method are an increased risk of developing the inflammatory process in the vagina, the inability to use tampons with monthly.
Similarly, the contraceptive patch works. It is glued to the skin in certain places for 21 days, and then make a 7 day break. The advantage of the vaginal ring and the contraceptive patch is the absorption of active components into the systemic circulation, bypassing the gastrointestinal tract, which increases the level of their absorption and reduces the number of side effects.
This capsule is about 3.5 cm in length and 2.5 mm in diameter, containing a synthetic progestogen, which for a long time is gradually released into the systemic circulation. A significant drawback of this method of contraception, despite its high efficiency and duration of action (up to 5 years), is the need for minimally invasive surgery for the placement and removal of implants.
Contraindications for a hypodermic implant are the same as for all hormonal contraceptives. Enter into the body gestagenic contraceptives can be injected (drug depot-provera). To ensure the prevention of pregnancy, injections are done intramuscularly every two months.
The most popular drug is postinor, contains very high doses of hormones. Take it no later than 72 hours after unprotected sex. The mechanism of action is associated with a change in the structure of the endometrium and the prevention of the attachment of a fertilized egg to the uterine wall. This method of contraception is used only in emergency cases, it is not recommended for women of any age, not only after 30 years, since it is fraught with serious side effects. It is systematically categorically prohibited from using it.
The local contraceptives used before sexual intercourse after 30 years can be recommended for women giving birth and nulliparous women with irregular sexual life. These include creams, suppositories, tablets (pharmatex, gynecotex, patentex, benatex), containing as active components chemical compounds that exert a destructive and immobilizing effect on spermatozoa.
Enter such a woman's preparations directly into the vagina in the supine position 15 minutes before sexual intercourse. In addition to low efficiency (80%), they have a number of other shortcomings:
- Do not wash with soap immediately after intercourse;
- the need for time intervals;
- a sense of discomfort in both partners;
- repeated introduction before each sexual intercourse.
Advantages include the lack of the need for a doctor, the presence of some drugs antibacterial components that can prevent the infection of certain diseases transmitted sexually.
Barrier methods of contraception
The most popular means of barrier contraception are condoms. Especially relevant is their use in case of accidental sexual intercourse, as only they reliably protect both partners from sexually transmitted infections.
The main disadvantage of condoms is a decrease in sensitivity during sexual intercourse, which can become a significant obstacle for women after 30 years of experiencing the flowering of sexual life. However, today the pharmacies have a wide selection of condoms with different properties, differing in color, smell, material of manufacture, thickness, size, shape, used lubricants, texture, so if desired, each pair will be able to choose the best option for themselves.
The IUD is intended as a method of contraception after 30 years only for women giving birth, if the childbirths occurred naturally and without complications. With caesarean section, this type of contraception is not recommended.
Currently, two types of IUDs are used, containing metals (copper, silver, gold) or hormones. The spiral is inserted into the uterine cavity on the third or fourth day of the menstrual cycle. It prevents the attachment of a fertilized egg to the uterine wall and shortens its life. Spirals with hormones additionally influence the consistency of cervical mucus, increasing its density, and also contribute to the normalization of the menstrual cycle and prevent the formation of uterine fibroids.
The Navy, depending on its type, is set for a period of 5 years, a maximum of 10 years, after which it is removed. If a woman decides to become pregnant, then it can be withdrawn at any time. However, before the conception, a recovery period will be necessary, since during the time of the presence of the spiral, the endometrium is strongly depleted in the uterus, which greatly complicates the attachment of the fertilized egg. Contraindications for the use of IUDs are:
- severe diseases of the cardiovascular system;
- sexually transmitted infections;
- inflammatory diseases of the pelvic organs;
- Malignant neoplasms localized in the cervix or uterine body;
- Fibromioma, accompanied by deformation of the uterine cavity.
Women with IUDs should visit a gynecologist more often, since such a foreign object can provoke inflammation in the uterus and appendages, diagnose and treat which one needs in the early stages. For a long time, during the period of adaptation after spiral placement, women may have spotting and menstrual pain. Also, the IUD increases the amount of bleeding during menstruation.