Emergency contraception during Emergency contraception: methods and means

In a fit of passion, many couples forget about contraception, deliberately do not use them, or use them incorrectly. Nevertheless, such “playing with fire” often leads to unwanted pregnancy. Emergency contraception may help in this case. However, women's parts often suffer from such assistance.

What to do if everything happened by accident?

First of all, there is no need to panic. This will only make the situation worse. In addition, you should not immediately run to the bathroom and do douching. This practice will be useless in 99% of cases, since the part that gets into the vagina almost instantly ends up in the cervix. And even one lost cell already increases the risk of pregnancy.

You should not resort to others folk methods contraception. Using lemon, potassium permanganate and boric acid It will only harm your sexual health and will not protect you from pregnancy.

Usually, used in tablets within 72 hours after unprotected intercourse. After this time, the effectiveness of such protection decreases, and its further use is simply pointless. If you take the drug within the first 12 hours after sex, it will significantly reduce your chance of getting pregnant. Moreover, after some time, taking the drug is often repeated to consolidate the contraceptive effect.

Facilities emergency contraception mostly suppress hormone production, responsible for ovulation and a woman’s ability to conceive. By the way, conception itself occurs in the first 72 hours after sexual intercourse. That is why it is important to take the pill before the end of this period, before pregnancy occurs.

Is emergency contraception always necessary?

Not every sexual intercourse ends in conception, even with complete refusal from contraceptives. The fact is that the birth of a new life occurs only during the period ovulation– during the release of the egg from the ovary into the fallopian tubes. This process is relatively rare and very short: the egg does this only 1 time per month and is located in fallopian tubes Oh about 24 hours. After this time, the egg simply dies.

Since the egg lives only for a day, a woman is actually unable to get pregnant on other days menstrual cycle. However, in practice pregnancy can occur when having sex on any day of the cycle, even during menstruation. But the probability of conception will be significantly lower than during the period of ovulation.

As a rule, in women with an even menstrual cycle, pregnancy does not occur if sexual intercourse occurs during the non-fertile phase (in safe days). Typically this period lasts from 1st to 7th, and also from 20th to 28th day(provided that the cycle is constant and its duration is 28 days). In this case, you can refuse funds at your own peril and risk emergency contraception. However, the likelihood of pregnancy will be much higher.

What are the methods of emergency contraception?

Typically used to prevent pregnancy oral medications containing hormones. Emergency contraception- these are funds based levonorgestrel (Postinor, Escapel, etc.) And mifepristone (Agesta, Zhenale). In addition to them, drugs with ulipristal acetate, which also prevent conception. The mechanisms of action of the listed contraceptives are somewhat different. However, despite this, they are all effective in preventing pregnancy.

Besides emergency medications used to prevent pregnancy combined oral contraceptives (COOK). Typically, COCs are used for permanent basis as contraception. But in in case of emergency, if the woman has not previously taken them, these drugs can be used to prevent conception.

Note that emergency contraception includes not only pills, but also intrauterine device With contraceptive effect. However, to get the latter, you need to install it within 5 days after intercourse, since then its effectiveness will decrease significantly. However, it is not recommended to install a spiral nulliparous women. In addition, this method of contraception requires the intervention of a doctor.

The dangers of emergency contraception

Emergency contraception dangerous for women's health, especially if drugs of this group are used more than 2 times a year. First of all, taking such drugs is a serious blow to hormonal system. By interfering with the balance of hormones, emergency contraceptives can lead to a temporary cessation of ovulation, and then completely infertility.

Moreover, the imbalance female hormones using emergency contraception leads to decreased bone density and early menopause . Because of frequent use these drugs reduce the level of and responsible for mineralization bone tissue. A decrease in these two hormones in a woman’s body promotes development, which significantly increases the risk.

In addition, in half of the cases of taking “emergency” contraceptives, uterine bleeding, similar to menstruation. However, women may experience severe pain lower abdomen, vomiting, nausea, headaches, and pain in the mammary glands.

Special danger presents during breastfeeding. Use of hormonal drugs during this period may harm the baby's health, since part of the drug enters the child’s body with mother’s milk.

The intrauterine device also has a lot of disadvantages. Its long-term use increases the risk gynecological diseases. In this case, the IUD itself can grow into the uterus and cause many complications. In addition, its installation is not suitable for every woman. And the procedure itself requires careful preparation with tests and diagnosis of the pelvic organs.

Advice for women when using emergency contraception pills

To avoid harming yourself when using emergency contraception, you must adhere to the following recommendations.

Don't use the funds emergency contraception more often than once every six months.
Second tablet emergency contraceptive should be taken exactly 12 hours later. A delay of 2–3 hours can significantly reduce the contraceptive effect.
To avoid nausea and vomiting, it is recommended to take the tablets with milk or big amount water.
In the future, take care of the methods barrier contraception(it is better to use condoms, caps, etc.).
If your period is late, you should visit a doctor, as this may indicate pregnancy due to the ineffectiveness of contraceptives.
For supporting hormonal health and maintain bone density, take natural ones. An additive that preserves even with long-term use COC and funds emergency contraception.

For young mothers after the appointment contraceptives You should stop breastfeeding your baby for 36 hours so as not to worsen the baby’s health.

USEFUL TO KNOW:

ABOUT JOINT DISEASES

Main operating principle emergency contraception(it is also called postcoital) - in disruption of the process of ovulation, fertilization or movement of the egg, as well as its implantation and further development embryo. This can be achieved different ways, both quite effective and not very effective. Moreover, we should not forget that the more effective a method of postcoital contraception can be, the more it can harm health.

Method one: immediately take a shower

The simplest, cheapest, practically harmless and ineffective way is douching, for example spermicide, boiled water with addition lemon juice or very weak solution vinegar. Yes, sperm must die in an acidic environment. But since some of them only need one and a half minutes to get to the cervix and fallopian tubes, the effectiveness of this “folk” method of contraception is questionable. According to statistics, in approximately 60% of cases, such “emergency contraception” ends in pregnancy.

Method two: install a spiral

Intrauterine device (IUD) Usually administered within 5 days of unprotected sex, this method is quite effective (about 99%), but is not suitable for everyone. And it’s difficult to call this method of preventing pregnancy “emergency” contraception. It is advisable to insert the IUD at the beginning of the menstrual cycle, when the cervix is softened and there is the least risk of injury. An ultrasound and tests are required in advance; the IUD is also not recommended for those who have not given birth, those who have a large number of sexual contacts, infections or inflammatory processes pelvic organs.

Method three: POC

The method is effective, popular and far from being as safe for women’s health as some people think. Action progestin-only oral contraceptives(they are gestagens, ChPOK, ChPK), containing a very large amount levonorgestrel (postinor, escapelle) based on the so-called blockade of ovulation (slowing down or preventing the release of the egg) in the first phase of the cycle and blocking fertilization or implantation of the egg in the second, as well as preventing the penetration of sperm into the uterine cavity (due to the fact that hormones cause thickening of the mucus in cervical canal). The sooner the pills are taken, the better. It is recommended to take such contraceptives in the first 24-72 hours after sexual intercourse. It is believed that in the first day the effectiveness of such emergency contraception is up to 95-97%. A larger dose has a similar effect. progestin COCs (mini-pills).

The main danger of such post-coital contraception is that it greatly affects hormonal levels. It is no coincidence that it is considered undesirable to resort to this method more than once or twice a year. And, even more so, POCs cannot replace planned contraception.

Larisa Ivanova

gynecologist, Central Clinical Hospital No. 13, Moscow, doctor highest category, Ph.D.

Such pills do not provide a 100% guarantee against pregnancy. Such drugs contain a large dose of hormones, which, roughly speaking, are aimed at causing premature menstruation. They often cause severe bleeding and cycle disorders, ovarian dysfunction, normal operation which then takes a very long time to recover.

Method four: according to Yuzpa

Yuzpe method, proposed more than 30 years ago by a Canadian doctor Albert Yuzpe based on reception loading dose combined estrogen-progestogen drugs (COCs), approximately 3-6 times greater than the amount of hormones that enters the body during routine contraception. You should also take the pills no later than 72 hours after unprotected sex. In addition to its strong influence on the menstrual cycle, global single dose hormones often cause such side effects like nausea, vomiting, headache, dizziness. Doctors estimate the effectiveness of emergency contraception using the Yuzpe method at 75-90%, and even less on days close to ovulation.

Method four: progesterone steroid

Pills are again used as emergency contraception, but only based on a steroid mifepristone– an antagonist of the pregnancy hormone progesterone. Same active substance, by the way, is also the basis of drugs for medicinal abortion ( medical abortion). The effectiveness of similar emergency contraceptives (eg gynepristone) is assessed by doctors as quite high, according to some data up to 97-98%. However, they also have quite a lot of contraindications and side effects (including disruption of the ovaries and menstrual cycle).

Emergency (urgent) postcoital contraception is carried out after unprotected sexual intercourse (within 1-3 days) to prevent unwanted pregnancy.

Usually used for emergency contraception hormonal method(antigestagens, gestatens) or intrauterine contraception(intrauterine device insertion).

Emergency contraception is used if:

rape has been committed;
unprotected sexual intercourse occurred;
interrupted sexual intercourse was performed incorrectly;
the condom broke during sexual intercourse;
other similar situations.

Hormonal method

Attention! Before using the drug, carefully read the instructions for use. It should be remembered that when large quantities sexual intercourse, the effectiveness of the drug decreases.

1) Antigestagenic drugs

Gynepristone or Agest - a modern hormonal postcoital drug. Compared to Postinor, it is almost harmless. Used within 72 hours after unprotected intercourse.

2) Progestin drugs

Escapelle is an exclusive new means for emergency contraception. Recommended for use within 96 hours after unprotected sex. The earlier the pill is taken, the more effective it is.
Mifegin (Mifepristone) - modern drug, with the help of which medical (non-surgical) termination of pregnancy is performed for a period from the first day of missed menstruation to 8 weeks. To carry out this procedure, you must contact a gynecologist licensed to use the drug.
Postinor - a hormonal drug for emergency contraception from the “last century”. The earlier the pill was taken, the more pronounced the contraceptive effect. Postinor contains very high dose the hormone levonorgestrel, which very noticeably hits the ovaries. Therefore, after using the drug, the menstrual cycle may be disrupted. This drug should not be used more than 2 times a year and should not be considered as one of the possible contraceptives! This especially applies to young women under 18 years of age whose hormonal balance has not yet been established. .

After taking emergency contraception:

your next period may start earlier or later than usual;
menstrual flow may be more abundant, in which case you should consult a doctor;
be sure to consult a gynecologist before starting next menstruation for examination for sexually transmitted infections, at the appointment, inform that you used emergency contraception;
if three weeks after taking emergency contraception you have not started menstruation or have signs of pregnancy, immediately visit a gynecologist;
if pain occurs in the lower abdomen, you should immediately consult a gynecologist;
Before the next menstruation, it is necessary to use barrier methods (condom).

Contraindications:

thromboembolism and uterine bleeding in the past;
severe liver diseases;
severe attack of headache (migraine);
age over 35 years;
long smoking history.

Possible side effects of hormonal emergency contraception:

headache;

pain in the mammary glands;

stomach ache;

various menstrual cycle disorders;

thrombosis.

Side effects of emergency contraception usually decrease or disappear completely within two days.

Due to the possible damaging (teratogenic) effect of hormones on the fetus, medical abortion is recommended if emergency contraception fails and pregnancy occurs.

Intrauterine contraception

Intrauterine emergency contraception involves the insertion of an intrauterine device (IUD) in the first 5-7 days after unprotected intercourse, which prevents implantation of an already fertilized egg.

The method is somewhat more effective than the hormonal emergency contraception method, however, when using it, it should be taken into account individual characteristics woman, her desire to continue to use this particular method of protection against unwanted pregnancy for a long time, as well as all possible contraindications to the introduction of intrauterine devices.

Emergency insertion of intrauterine devices is not recommended for young nulliparous women, as well as for large number sexual contacts and partners, during casual sexual intercourse. If a woman wants to get an intrauterine device, but has been sick often in the past inflammatory diseases genital organs, you need to use antibiotics immediately before inserting the intrauterine device and in the next 5 days.

Although emergency contraception is harmful to the body, and many women know about it, despite this it remains very, very popular. In some situations, the use of these types of drugs is really the only way out from the situation, in others - unjustified harm to the body. Let's look at the most popular emergency contraceptive drugs recommended by gynecologists, how to take them correctly, what side effects they have, what contraindications, etc.

When is emergency contraception needed?

Main reason for taking medications for this purpose is unprotected sexual intercourse. Yes, despite the widespread use of modern contraceptive methods and their convenience, some couples forget about it. At the most necessary moment there is no condom at hand or... it just breaks. Should we panic in this case?

First, you should calm down and try to calculate which day of the menstrual cycle is currently underway. After all, emergency contraception is not so safe; pills taken can lead to unpleasant consequences. So, if you have unprotected sexual intercourse in the first or last 7-8 days of the menstrual cycle, and its (menstrual cycle) duration is the classic 28-30 days and it is regular, then most likely you should not take pills, since ovulation (the day when pregnancy may occur) falls in the middle of the menstrual cycle.

Another frequently asked question- Can emergency contraception be used in conjunction with planned contraception? For example, in the first 14 days of the first cycle of taking oral contraceptives, you should use another method of contraception at the same time, since the first one has not yet fully “taken effect”. Or took place simultaneous administration OK with antibiotics or other drugs that tend to reduce the effectiveness of contraceptives. In this case, take additional medications “on top” emergency order" do not do it. In addition to OCs, non-hormonal contraception should be used. Another thing is the use of spermicides (if, for example, a suppository was inserted into the vagina not before sexual intercourse, but after or immediately before sexual intercourse, without waiting the recommended time interval of 5-10 minutes) or condoms (they tend to sometimes tear).

What to do if a woman is breastfeeding? Is emergency contraception necessary in this case? Of course, it is better to avoid such situations, but if something goes wrong, you can use medications urgent order. But in this case you will have to postpone breast-feeding for one day, until the drug is completely eliminated from the body.

Emergency protection options

Gynecologists offer several possible schemes There is also a whole range of medications taken and the medications themselves.

The most famous and still popular is postinor. But it is considered an “old generation” drug that has a huge amount side effects. Reception is carried out in the following way: within 48 hours (but no later than 72 hours) after sexual intercourse, a woman takes one tablet, and after 12 hours - another one. Moreover, the earlier the first pill is taken, the higher the likelihood that emergency contraception will take effect, the drugs are taken for a reason, and pregnancy will not occur.

Escapelle is a more modern drug. His distinguishing feature- 1 tablet contains 1.5 mg of levonorgestrel. In connection with this, there is no need to take a second pill (previous generation emergency contraceptive drugs contained 2 times less of this hormone, which is why a double dose was required). WHO advises giving preference to drugs that contain 1.5 mg of levonorgestrel. Although both have side effects. Reactions different women taking pills is individual. Excapel should be taken no more than 72 hours after unprotected sexual intercourse.

And finally, the third option is to take regular combined oral contraceptives at higher dosage according to a special scheme. Or take 3 tablets of Silest at a time (or its analogues - Regividon, Miniziston) and after 12 hours take 3 more tablets. Or take 4 tablets of Marvelon, and after 12 hours - the same amount.

The following rule applies to all the drugs described above - if vomiting or diarrhea occurs within 2-3 hours after taking them, it is likely that the tablets have not been fully absorbed and, accordingly, will not have a full effect, which means pregnancy is possible. You need to repeat the procedure.

By the way, what happens if pregnancy occurs? Will this emergency contraception affect her and the health of her unborn child? Doctors agree that an abortion should not be done due to taking drugs; they will not have any effect on the child’s health. Another thing is if the drug is taken already during pregnancy (thus some people try to cause a miscarriage on their own), in which case problems may arise. However, in the early stages, the “all or nothing” principle applies, therefore, if a miscarriage did not occur in the early stages, most likely, everything turned out well, or rather, the screenings that the woman will undergo if she wants to continue the pregnancy will show.

Side effects and frequency of use

Emergency contraception should be used only in force majeure situations when there is no other option. It is advisable - no more than 2-3 times a year, and even better - if less often. The most common side effect from emergency contraceptive pills is uterine bleeding, which usually occurs a few days after taking them. But other women, on the contrary, experience delays in their periods and the menstrual cycle is disrupted. Other common side effects are headaches, dizziness, diarrhea and vomiting, and various allergic reactions.

Other emergency contraception options

There are other methods of postcoital contraception - effective, and not very effective. The first includes emergency installation intrauterine device(not always feasible in short time, since you need to pass a number of tests and undergo an ultrasound; In addition, there are many contraindications to installation). If this is done within 3 days after unprotected sexual intercourse, then even if the egg is fertilized, it most likely will not be able to implant into the wall of the uterus. This option is suitable for women who were already planning to install a spiral. A significant disadvantage is that the cervix may be injured, since only at the beginning of the menstrual cycle the cervix is softened and more adapted to the safe insertion of an IUD.

Other methods are folk, with unproven effectiveness and even dangerous. With their help, women try to provoke the onset of menstruation ahead of schedule, but in fact, they want to cause a miscarriage in the early stages of pregnancy. Folk methods of emergency contraception include a “food” of sugar with iodine, ascorbic acid, parsley, hot baths, herbs like tansy and much, much more. But we do not recommend using these means.

Always remember that emergency contraception is quite dangerous, but less dangerous than abortion. To own experience do not check neither the first nor the second, select reliable method planned contraception.

Concept postcoital contraception unites different kinds contraception, the use of which in the first 24 hours after sexual intercourse prevents unwanted pregnancy. This method of protection in the literature is also called emergency contraception (emergency contraception, immediate, urgent, extreme, fire, “morning after”). Emergency contraception should be used when emergency situations: women who have been raped, or when there is doubt about the integrity of the used condom, in cases where the protective diaphragm is displaced during sexual intercourse, or when planned methods of contraception cannot be used.

Types of postcoital contraception

COOK(combined oral contraceptives): must be taken within 72 hours of unprotected intercourse. Preparations containing 30 mcg ethinyl estradiol(MARVELON, MICROGENON, MINIZISTON, RIGEVIVIDON, FEMODEN) apply 4 tablets 2 times every 12 hours (total 8 tablets). Preparations containing 50 mcg ethinyl estradiol(BISEKURIN, NON-OVLON, OVULEN, OVIDON, ANOVLAR) apply 2 tablets 2 times every 12 hours (4 tablets in total).
PSC(pure progestin oral contraceptives) must be taken within 48 hours after unprotected intercourse. Effective dose – 750 mcg levonorgestrel, what is equal to 1 tablet POSTINORA or 20 mini-pill tablets – EXCLUTON, MICROLUT or OVRETA. After 12 hours, another tablet is taken POSTINORA or 20 “mini-pill” tablets (a total of 2 tablets are taken POSTINORA or 40 mini-pill tablets).
MIFEPRISTONE – non-hormonal drug, blocking the action of progesterone (female sex hormone) at the level of receptors (specific nerve endings, with which hormones bind and exert their effects; Each hormone has its own receptors; in this case, receptors in the uterus are blocked). Besides, MIFEPRISTONE increases contractility myometrium (uterine muscles). This is the most effective drug of all of the above. It prevents the implantation (introduction) of the egg into the uterine mucosa and causes its rejection. Its other indication for use, in addition to emergency contraception, is termination of pregnancy at early stages. Prescribed once, 3 tablets or one tablet (600 mg) per day for 72 hours after unprotected intercourse or one tablet during the 23rd, 24th, 25th, 26th, 27th menstrual days cycle.
Navy(intrauterine devices) how Alternative option emergency contraception. Copper T-shaped IUD inserted by a qualified medical worker within five days after unprotected sexual intercourse are effective means pregnancy prevention. When prescribing an IUD as a postcoital contraceptive, it is necessary to take into account the individual characteristics of the woman, all possible contraindications to the insertion of the IUD, and the patient’s desire to continue to use this IUD for the entire recommended period of use. It is necessary to clarify that the IUD as a means of postcoital contraception is not suitable for everyone: it is not recommended to be used by those who have not given birth or by those women who suffer from infectious diseases. gynecological diseases or are at risk of contracting AIDS and other STDs. IUDs also should not be recommended to women who suspect pregnancy (in particular, those who may have become pregnant as a result of earlier sexual intercourse without using contraception).

Postcoital contraception cannot be recommended for constant use , since each of the methods is an emergency intervention in functional state reproductive system women with subsequent development of ovarian dysfunction. At daily intake combined or purely progestin oral contraceptives, low doses of a hormonal drug enter the body, designed for the entire menstrual cycle and without disturbing its duration and cyclicity, and thereby improving ovarian function, eliminating existing disorders hormonal levels. And when taking these same pills for the purpose of emergency contraception, the body simultaneously receives enormous doses of the drug, regardless of the phase of the menstrual cycle. For example, POCs take 40 tablets, POSTINOR, belonging to the same group of drugs, contains the same amount in 2 tablets active substance, as at 40. This leads to a sharp hormonal disruption and ovarian dysfunction. As a result of repeated receptions hormonal drugs for the purpose of emergency contraception, women develop menstrual cycle disorders with its shortening or lengthening, the cycles become anovulatory (an egg is not formed), which is the cause of infertility. Ovarian dysfunction leads to the development of the syndrome metabolic disorders(increase blood pressure, increased blood sugar, excess weight).

Mechanism of action

The main mechanism of postcoital contraception is desynchronization of the physiology of the menstrual cycle – suppression of ovulation, disruption of the fertilization process, disruption of egg transport and implantation (attachment) of the embryo in the uterus. When taking large doses COOK or PSC in the first phase of the menstrual cycle, the process of maturation of the follicle is disrupted, its atresia occurs ( reverse development). In addition, a single dose of these hormonal contraceptives(in any phase of the menstrual cycle) disrupts the formation of the endometrium (the mucous membrane of the uterine cavity) with its rejection. The effect of COCs and POCs in large doses aimed at hormonal disruption of the ovaries. Mechanism of action MIFEPRISTONE based on blocking the action of progesterone and increasing uterine contractility. As a result, the endometrium (the mucous membrane of the uterine cavity) is rejected. Navy, introduced into the uterine cavity, being a foreign substance, causes:

Effect foreign body– accumulation in the endometrium of the body’s protective cells, which have a detrimental effect on any biological matter, including the egg;
an increase in the production of specific substances (prostaglandins) that increase the contractility of the uterus, which prevents the attachment of a fertilized egg;
increased contractions of the fallopian tubes, as a result of which the fertilized egg ends up in the uterus ahead of schedule, being unable to implant.

Flaws

The use of postcoital agents has no effect in cases where the implantation process has already begun.
COOK are effective only if the first dose of the drug is taken within 72 hours after unprotected sexual intercourse.
First dose PSC must be taken within 48 hours after sexual intercourse.
Navy It is only effective when administered within 5 days of sexual intercourse. The insertion of an IUD is performed by a physician and should not be performed on women at risk infection with sexually transmitted diseases and HIV infection.
Mifipristone is used only in the presence of a doctor, and after its use it is necessary to observe medical institution. Besides, Mifipristone Quite an expensive drug.

Side effects

The above-mentioned regimens for taking oral contraceptives as a means of postcoital contraception differ mainly in side effects, called by them. Approximately 46% of women using to prevent pregnancy COOK or ChPOK, Nausea occurs, and 22% experience vomiting. In addition, you may experience dizziness, a feeling of fatigue, painful sensations in the area of the mammary glands and headaches. When using Mifipristone a feeling of discomfort in the lower abdomen, weakness, nausea, vomiting, dizziness, and increased body temperature may occur. When inserted Navy during the first two days there may be cramping pain in the lower abdomen, the duration increases menstrual flow and their number, the risk of developing ectopic pregnancy, due to disruption of the wave-like contraction of the fallopian tubes and the movement of the egg through them. Sometimes spontaneous expulsion (fallout) of the IUD is possible. Very in rare cases Possible perforation (damage) of the uterus during insertion of the IUD. Follow-up with a gynecologist is not required if the patient is not delaying her next menstrual period (a delay may mean pregnancy), if the woman does not express concern about her health and does not want to start using contraception. If the patient expresses such a desire, she should be warned that after taking a COC or POC as a means of postcoital contraception, it is necessary to use a condom, diaphragm or spermicides (substances that are harmful to sperm) for the entire time until the next menstruation. From the beginning of the next menstrual cycle you can take regularly hormonal agents contraception or use natural family planning. At the same time, you can start using the IUD if the IUD has not already been inserted after sexual intercourse as a method of emergency contraception and the patient agrees to use it for the entire recommended period.

Reminder for those who use OCs as emergency contraception

Try to time the first dose so that it is convenient to take the second (for example, 20:00 and 8:00). However, it is not recommended to delay taking the pills for a long time, since the effectiveness of the method decreases over time.
To alleviate nausea-related discomfort, take the tablets in the evening before bed, during meals, or with milk.
Use a condom or some other barrier method until your next period.
Remember that postcoital contraception is intended for one-time, occasional use only. For regular pregnancy protection, consult your doctor and choose the contraceptive method that is right for you.
If the next expected menstruation occurs more than 7 days late, you should consult a doctor to rule out possible pregnancy.

See the article “In harmony with hormones. Combined oral contraceptives", No. 5, 2006.

See article " Hormonal contraception. Pure proestin oral agents", No. 6, 2006

See article " Modern methods contraception. Intrauterine devices", No. 4, 2006.

See the article “No Trespassing! Barrier methods of contraception", No. 3, 2006.

See article " Natural contraception. How to avoid pregnancy without contraception", No. 2, 2006.