Emergency contraception at home. Emergency contraception: methods and means

Main principle actions 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 safe for women's health, as it seems to some. Action pure progestin 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 the 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 background. 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 Yuzpe

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 the strong influence on menstrual cycle global single dose hormones often causes side effects such as 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, contraindications and side effects(including disruption of the ovaries and menstrual cycle) they also have quite a lot.

Majority modern girls and women are quite well versed in issues and know its basic methods. Among which, by the way, there are some that are frankly outdated and completely irrelevant. For example, calendar method when the approximate day is calculated ovulation or the method of interrupted coitus.

According to the scale used to assess the effectiveness of contraceptive methods ( Pearl index ), the above mentioned methods are extremely ineffective. The Pearl index for them is set at 25-40 and 18-27 points, respectively. For comparison, the barrier method of contraception, which uses condoms, and some other means score 2-3 points on this scale.

It is believed that the lower the Pearl index, the higher the protection against unplanned. Perhaps, among all the methods of contraception used to prevent pregnancy, the most effective are birth control pills ( , also known as COOK) , as well as some hormonal drugs, for example, injections or intrauterine devices.

Of course, pregnancy pills also have their disadvantages, however, according to experts, the advantages of such contraception more than cover all of them negative sides. Perhaps the main difficulty faced by women using birth control pills is the need for constant, in other words, daily intake of these drugs.

Otherwise, if you miss the next dose of pills, the risk of becoming pregnant after sexual intercourse, during which, for example, barrier methods of contraception were not used, increases sharply. What to do in such a situation and what to drink to avoid getting pregnant? There is one correct answer to these questions - emergency contraceptives .

In medicine for this term use the name postcoital , i.e. emergency, fire or emergency contraception. This method is effective after unprotected sexual intercourse. In addition, emergency contraceptives can help prevent pregnancy while taking birth control pills. permanent basis in the event that a woman was unable or forgot to take the medicine more than two times in a row.

All in all, emergency contraceptive pills used if and only if the main method of protection against unwanted conception has failed. Moreover, you need to have time to take such contraceptive pills after the act within 72 hours. Otherwise, even these emergency contraceptive pills specially designed for such situations will not help avoid unwanted pregnancy.

It is important to emphasize that, in accordance with the recommendations World Organization health (hereinafter referred to as WHO) emergency contraceptives after unprotected act should not be used by women on a regular basis. Since the hormonal compounds included in such drugs can negatively affect not only reproductive function, but also for the entire body as a whole.

Emergency contraception is still a gentler alternative surgical termination pregnancy . But like everyone else medications they should be taken correctly and not abused.

Before we look at emergency contraceptive pills in more detail and talk about how such drugs affect the body, it is worth dwelling on some basic issues related to the process of conception. In order to better understand in the future the mechanism of action of anti-pregnancy pills on the female body.

So, for pregnancy to occur, it must happen. This is the fusion of reproductive cells of partners (male spermatozoa and women's eggs ), resulting in the formation of cells zygotes (diploid cell, capable of “giving birth” to another cell). Sexual intercourse itself cannot be associated with the act of fertilization. Because not every contact between a man and a woman is for the purpose of procreation.

During unprotected intercourse, the man's sperm naturally Fall into female vagina. It is noteworthy that Wednesday female body harmful to sperm. This is due high level acidity in the vagina. Therefore, after ejaculation, the vast majority of sperm die. However, their most mobile part still penetrates into uterus and can lead to fertilization. How long before you can get pregnant after unprotected intercourse?

To answer this question, you need to understand that for conception the stars must, as they say, “align”, namely:

It is during this period that a woman should ovulate; this phenomenon is characterized by the state of maturity of the egg. If for some reason during a break follicle the egg did not “release” in fallopian tube or has not reached its maturity, fertilization will not occur;
a man’s sperm must be strong and mobile enough to overcome the acidic environment of the vagina and penetrate the structure of the egg;
When the sperm and egg unite, the process of division should begin ovum;
Implantation of the fertilized egg must occur during the process of its division into the walls of the uterus.

The entire fertilization process takes about seven days. It is during this period of time that the formation occurs embryo , which with the help chorion (predecessor placenta ) is fixed in the uterus, where it grows and develops over the next nine months. It is important to emphasize that there are often cases when emergency contraceptive pills are not dangerous for conception.

This means that even if you follow all the rules for using emergency contraceptive pills after intercourse (for example, they must be taken after a maximum of 72 hours to avoid pregnancy), fertilization may still occur. Of course, such cases are not the majority, and they are more likely to be exceptions. However, the possibility of “getting pregnant,” as an unwanted pregnancy is popularly called, is always there, even if you use conventional contraceptives.

Pills for unwanted pregnancy after intercourse are divided into two main categories:

pills " next day» , i.e. medications that are best taken in the next 24 hours after unprotected contact. In fact, a woman has a maximum of 72 hours for the pregnancy pills to take effect and help avoid fertilization;
COC or (so-called Yuzpe method ).

As for oral contraceptives belonging to COCs or drugs from the mini-pill series, this is not essentially emergency contraception. After all, birth control pills must be taken constantly. However, there are varieties of such drugs that can be used as pills to prevent pregnancy after an act unprotected by any means of contraception.

As a rule, an increased dosage of birth control pills containing hormones or antihormones is used for these purposes. Also, emergency contraception methods include installation within 120 hours after unprotected sexual intercourse intrauterine device .

Emergency contraceptive pills are dangerous for pregnancy because they contain substances in their chemical composition that prevent fertilization. The main active compounds in tablets against pregnancy after unprotected intercourse can be either or antihormones .

The first compounds are biologically active substances that belong to squirrels or steroids and are produced by organs or tissues of a living organism. Hormones are transported through the bloodstream from organ to organ and are responsible for the physiological activities of the body, for example, its development and growth, metabolism, and so on.

As the name suggests antihormones - These are compounds that act opposite to hormones. They suppress hormonal activity in the body.

It is noteworthy that antihormones by their nature have exogenous or endogenous origin, are often structural analogues hormones that they suppress.

So, before wondering what emergency contraceptive pill to take to avoid getting pregnant, you should remember that drugs of this type may contain:

, i.e. synthetic progestin (steroidal female sex hormone), found in such drugs as: , Tetragynon ;
mifepristone , i.e. synthetic antiprogestin (antihormone), found in such birth control pills How: , Renomelan, Agesta, .

Levonorgestrel-based drugs

First let's talk about how it works levonorgestrel and preparations containing it. So, pregnancy-terminating pills related to emergency contraception after the first dose:

immediately affect the chemical composition of mucus endocervix ( cervical canal cervix) , also increasing its viscosity, thus slowing down the process of sperm penetration into the fallopian tube;
act on the ovaries, preventing the release of a mature egg from the main follicle (subject to taking pills before ovulation), suppressing gonadotropic hormones, which ultimately blocks or delays the ovulation process;
prevent the implantation of an egg fertilized by a sperm into the uterine walls for the further development of the embryo and the formation of a “baby” place. In order for fertilization to fail, levonorgestrel not only changes the structure of the endometrium, thereby preventing it from entering the secretory phase, without which ovulation does not occur, but also affects uterine (fallopian) tubes. As a result, the number of their contractions is significantly reduced, which makes it impossible for a fertilized egg to enter the uterine cavity.

It is important to emphasize that drinking the above listed drugs, which include levonorgestrel , only after consultation with a doctor. In addition, you should definitely read the instructions included with the tablets. The thing is that these contraceptives contain enormous doses of hormones.

After taking them, the female body experiences hormonal imbalance, the consequences of which can be unpredictable. Therefore, experts classify such contraceptive methods as “disposable” means, which are highly recommended not to be used more than 4 times a year. In addition, it is strictly prohibited to use such emergency contraceptive drugs more than once per menstrual cycle.

Emergency contraceptive pills (they are also called “morning-after pills” due to the specific nature of their administration) – although an effective, but rather controversial method of protection against unplanned pregnancy. Doctors say that after just a single dose of such drugs, the body experiences major changes Therefore, it takes time to fully restore the functions of a woman’s reproductive system.

Mifepristone-based drugs

What can be said about the second group of emergency contraceptive drugs containing an antihormone? mifepristone – they act in almost the same way as levonorgestrel-containing birth control pills, i.e. Also:

inhibit the ovulation process;
change the structure of the endometrium, which makes it impossible for the fertilized egg to attach to the uterine walls;
strengthen uterine contractions, due to such hyperreactivity, the fertilized egg is “expelled” from the uterine cavity.

It is worth noting that to protect against unwanted pregnancy after unprotected sexual intercourse, you can also use non-hormonal drugs , For example, vaginal suppositories containing nonoxynol (Steridil, ) or ( , ). The above drugs refer not only to methods of express contraception, since they have a spermicidal effect, their scope of application is much wider, due to their anti-inflammatory, antibacterial, antiviral and antifungal abilities.

The above names of pills for pregnancy after an act unprotected by any means of contraception are not all. Currently, any pharmacy has a good choice such drugs. You can find out what emergency contraceptive pills are called directly from the pharmacist at the pharmacy, but it is better to ask your doctor about these questions. After all, any medicine (and contraceptives are no exception to this rule) has its own contraindications and side effects.

This is especially true for women when GW ( breast-feeding) or suffering from certain diseases in which large doses of hormones or antihormones can be fatal. Let there be no clear answer to the question of whether birth control pills related to postcoital contraception are harmful, since what will be good and effective for some may turn out to be bad for others big problems health concerns, no woman should use this method of solving the problem of unwanted pregnancy without prior medical consultation.

Only a specialist will be able, firstly, to choose the right drug, taking into account all the individual characteristics of the patient ( a common person may simply get lost in the names of the pills that say nothing about the composition, contraindications or side effects after an unprotected act). And, secondly, the doctor will tell you how to take emergency contraceptives correctly so as not to harm your body and achieve the desired result.

There are several basic rules for taking postcoital contraceptive medications:

It is necessary to strictly adhere to the period of use of such drugs. The vast majority of pills should be taken no later than 72 hours after unprotected intercourse. Many people have a question, how many days is 72 hours? It is well known that there are 24 hours in one day or in one day, therefore, 72 hours are three days or three days. It is believed that the first emergency contraceptive pill should be taken as early as possible, while the second should be taken optimally 12 hours after the first or a maximum of 16 hours. It is important to emphasize that the effectiveness of the tablets depends directly on the period of their use. It is believed that drugs with levonorgestrel most effective within 24 hours after sexual intercourse (95% effective). When taken after 48 hours, the effectiveness decreases to 85%, and after 72 hours - to 58%. Containing mifepristone The tablets are also taken no later than 72 hours from the moment of contact.
It is important to adhere to the dosage indicated in the instructions for the drugs or prescribed by the doctor. As mentioned above, emergency contraceptive pills are taken twice after a certain period of time, for example, Postinor . However, this rule is not relevant for all drugs. Eskinor F or Escapelle (contain levonorgestrel ) And Genale , Gynepristone, (contain mifepristone ) drink one tablet within 72 hours from the moment of sexual intercourse.
It is strictly forbidden to independently adjust the dosage of birth control pills. This can lead to the development of side effects, as well as provoke serious negative consequences ( bleeding, ). It is recommended not to eat food a couple of hours before taking emergency contraceptive pills and after, so that the biologically active compounds are better absorbed in the body. If vomiting occurs after taking the medications, you will have to take the pill again.

Combined oral contraceptives

It is also worth paying attention to the so-called Yuzpe contraceptive method . As stated earlier, as emergency contraceptives you can use well-known ones COCs (combined oral contraceptives). This method can be an excellent solution for those for whom, for some reason, pills related to postcoital contraception are contraindicated.

The following COCs can be used as emergency contraceptives: , Tetragynon, Ovral, and others. As a rule, such tablets contain hormones - estrogen, levonorgestrel, desogestrel, ethinyl estradiol And progestogen .

According to the instructions, you need to take one COC every day. However, this rule can be broken in an emergency to prevent unwanted pregnancy. The main thing is not to overdo it, so as not to harm the body. The following dosages of COCs are considered safe for:

from 2 to 4-5 tablets (depending on the type of COC) at the first dose, which should take place no later than three days or 72 hours after sexual intercourse;
the same number of tablets should be taken 12 hours after the first COC intake.

Efficiency this method also depends on the time of taking the drugs. That is, than formerly a woman I took the pills, so Great chance that ovulation will not occur and fertilization will not occur.

Contraindications

We talked about how not to get pregnant after a “no strings attached” act. Now it’s time to discuss the negative aspects of emergency contraception and determine who should not resort to the help of such an uncompromising method.

There is no benefit from emergency contraceptive pills, apart from, of course, the psycho-emotional peace of mind of a woman - this is a fact. How much and what harm can they do?

levonorgestrel drugs:

at pathologies of the biliary tract ;
for liver diseases, for example, liver failure ;
in cases where the pregnancy was confirmed by a gynecologist, i.e. the fertilized egg was successfully implanted into the uterine walls;
when the patient’s age is 16 years or less;
at lactose intolerance ;
in case of malabsorption galactose and glucose ;
for some gastrointestinal diseases, for example, Crohn's disease ;
at ;
in the presence of tumors sensitive to changes hormonal levels ;
at menstrual irregularities ;
at ;
in case of malfunctions hemostasis systems .

It is prohibited to use containing mifepristone drugs:

at liver failure ;
at porphyria ;
at renal failure ;
in case of malfunctions hemostasis (blood clotting) systems ;
upon admission glucocorticoids , For example, , and so on;
upon admission anticoagulants ;
at adrenal insufficiency ;
with confirmed pregnancy;
when breastfeeding; P
in the presence of certain diseases in the chronic stage;
at anemia ;
women over the age of thirty-five;
at ectopic pregnancy.

Of course, any woman has the right to independently decide what modern methods contraception or even traditional methods Use to protect against unwanted pregnancy. However, you always need to think about what harmful effects may occur to the body when taking certain medications.

Emergency or fire contraceptive pills can be dangerous:

risk of developing later ectopic pregnancy , which is caused by a disruption in the process of transporting a fertilized egg to the place of its attachment in the uterus for further development;
risk of uterine bleeding , which even medical workers do not always cope with successfully;
risk infertility , this is especially true for young women whose menstrual cycle has not yet established;
risk of developing Crohn's disease , a chronic inflammatory disease of the gastrointestinal tract that affects all its parts (from oral cavity to the rectum);
risk of increased thrombosis , which is provoked by high doses of hormones contained in all “next” day pills without exception, which leads to , and even lethal effect.

According to reviews from women who have experienced the effects of emergency contraceptive pills, the most common side effects of these drugs are:

nausea;
allergic reactions as rash And skin itching;
swelling or breast tenderness (mastalgia);
lower abdominal pain;
severe headaches;
stress ;
emotional instability.

Abortion pills. Price, where to buy, how to use correctly

So-called pharmabort or medicinal often associated with emergency contraception. However, this is far from the same thing. Of course, both drugs help to avoid unwanted pregnancy, but the mechanism of action and the time of taking the so-called abortion pills are different.

Let's talk about the main differences between medical abortion, which, according to many experts, is safer than surgical intervention, For example, vacuum aspiration or scraping. Until what time can abortion pills be effective in terminating an unwanted pregnancy?

So, as we previously mentioned, after an unprotected act, birth control pills, which are classified as emergency contraception, can protect you from pregnancy for 72 hours. Medicines for medical abortion are used when pregnancy has already occurred.

So, when can you use abortion pills or until when? These medications can be taken in the early stages of pregnancy (up to 42 days amenorrhea -the first day of the last menstrual cycle).

This means that abortion pills have an effect on the course of pregnancy up to the sixth week and up to the seventh week.

It is worth noting that abortion pills are most effective on the fertilized egg that is still weakly attached to the uterus for up to four weeks.

During this period, the hormonal background of the female body has not yet reached the peak of its changes and you can resort to the help of medications to terminate an unwanted pregnancy.

It should be noted that abortion pills should not be taken without medical supervision. Although this method of abortion is considered safer than surgical intervention, not everything always goes smoothly and without negative consequences for the female body.

In order to exclude possible harm For your health, you should definitely consult a gynecologist, and also take of this kind pills only in his presence, so that qualified specialist was able to provide quick help(for example, if it opens heavy bleeding) and prevent the severe outcome of medical abortion. Unfortunately, not many people think about how dangerous abortion pills can be.

After all, you can even die from them if complications arise and the doctors do not provide urgent care to the woman. medical care. Therefore, drugs for medical abortion containing mifepristone (steroidal antiprogestogen substance synthetic origin), for example, or taken once in a dosage of no more than 200 mg exclusively under medical supervision.

Mifegin , a drug produced by a French manufacturer, like his domestic analogue Mifeprex contain in their chemical composition the same biologically active substance mifepristone , which blocks production progesterone due to its effect on progesterone receptors. At normal course pregnancy like progesterone , produced yellow body ovaries , forms endometrium , main function which is the creation the best conditions for development embryo .

The action of mifepristone-containing drugs gives the exact opposite effect ( myometrium shrinks, increases in growth prostaglandins ), which ultimately leads to the prevention of unwanted pregnancy. After a maximum of 48 hours have passed after using the abortion pills, the woman should stop the medical abortion and take the following medicines like or Gemeprost .

These are analogs of prostaglandins that stimulate the process of “expulsion” of the fetus from the uterus. It is very important to understand that in order to avoid severe complications the patient must be under mandatory medical supervision within 2 hours after taking the above medications.

In order to be completely sure that a termination of pregnancy has occurred, the woman needs to undergo an ultrasound two days after the procedure, and then re-appear for an appointment with the gynecologist two weeks later. According to experts, the effectiveness of this method reaches 99%. However, in some cases, abortion pills do not completely help get rid of the fetus, and then the woman has to undergo such unpleasant procedures as:

abrasion (in common parlance scraping ) is an operation aimed at removing the fertilized egg, as well as some pathological formations on the mucous membranes of the uterus;
vacuum aspiration (in everyday life the name is more common mini abortion ) is a method of abortion in which the fetus is removed from the uterus using a special vacuum suction.

As we said above, medical abortion is considered the most gentle way to terminate an unplanned pregnancy, since there is no mechanical impact to the uterus. As a result, its mucous membranes are not damaged, which eliminates many possible complications. However, this method also has a number of contraindications for which the use of abortion pills is prohibited:

inflammatory diseases of the ovaries or uterus;
ectopic pregnancy ;
scars on the uterus , due to previous operations;
some gastrointestinal diseases .

The following complications may occur during a medical abortion:

bleeding in the uterus;
allergic reactions;
nausea;
sharp pain in the abdomen;
incomplete abortion, those. a situation in which pregnancy progresses because fetal rejection has not occurred;
blood pressure surges;
vomit.

Price of birth control pills

The price of postcoital contraceptive pills depends on several factors. Firstly, the cost is influenced by the manufacturer of the drugs, secondly, the number of tablets in the package, and thirdly, the region where the contraceptives are sold. For example, such popular and widespread tablets as Postinor in Ukraine the average price is 200 hryvnia, and in Russia 350 rubles.

How much do abortion pills cost? The price of this type of drug depends primarily on its manufacturer. Moreover, as we mentioned earlier, pharmacological abortion- This medical procedure which should only take place under the supervision of a physician. Therefore, to the cost of the abortion pills themselves is added the price of the services of a gynecologist who will monitor the patient and be able to provide her with timely assistance if something does not go as planned.

Most modern contraceptives are intended for use before sexual intercourse in order to prevent unwanted pregnancy, but in a fit of passion or because various reasons You can simply forget about precautions.

It is for such cases that emergency post-coital contraception has been developed, which is used after unprotected sexual intercourse.

Emergency contraception - what is it?

Postcoital contraception is a means designed to prevent unwanted pregnancy in emergency and unforeseen cases. Such drugs are used after sexual contact.

Emergency contraception can be used at any age, even by teenagers, if necessary. It is important to resort to this type of protection in time, because necessary action such remedies can only be provided within 72 hours after unprotected sex.

If pregnancy occurs before the use of emergency contraception, then the pill taken will not have any effect, since it is impossible to cause an abortion with its help, and some drugs will not harm an already developing embryo.

Types of emergency contraception

Contraceptives after unprotected intercourse include:

pills;
intrauterine copper devices.

Postcoital contraceptive pills

Modern medicine offers several emergency contraceptive drugs, but it is recommended to start using any of them only after consulting a specialist.

Postinor

It is Postinor that is known to most women as a means of contraception after sex. The drug prevents the attachment of the released egg to the uterine wall due to the content of a loading dose of the main component - levonorgestrel.

One tablet of the drug contains 750 mcg of active ingredient, but for maximum effect you need to take two tablets. Both can be taken at the same time, no later than 72 hours after sexual intercourse, or can be divided into two doses with a break of 12 hours. The earlier the first tablet is taken, the greater the chance of a successful result.

Escapelle

The effect of the drug is identical to the effect of Postinor, but one tablet of Escapel contains 150 mg at once active substance- levonorgestrel, so it is taken once. A second dose will be required if vomiting occurs after taking the first dose. The maximum effect is observed if this contraception is taken on the first day after unprotected sex.

Side effects

The use of Postinor, like Escopel, may cause side effects such as bloody discharge spotting, chest pain, menstrual irregularities, but if menstruation is delayed by more than 5 days, you need to take a pregnancy test or consult a doctor immediately.

Why are contraceptives dangerous after an unprotected act and how often can they be taken?

Taking emergency contraceptives in to a large extent increases the risk of an ectopic pregnancy, therefore, if pregnancy does occur, it is necessary to urgently undergo an ultrasound and determine exactly where the embryo is located. If after taking hormonal pills emergency contraception has arrived normal pregnancy, its interruption is not required, since the drugs do not have an adverse effect on the unborn baby.

These tablets are intended exclusively for use in in case of emergency and are not suitable for use as permanent, regular contraception. You can take them repeatedly during one cycle, but if the need arises more often, you should consult a doctor and choose suitable methods protection against unwanted pregnancy.

Zhenale and Ginepriston

The drugs belong to the new generation of emergency contraception. The active ingredient, mifepristone, is a steroid, so the tablets showing high efficiency, practically do not cause side effects and menstruation disorders.

The drugs are identical in composition and content of the active substance - 10 mg in one tablet. The only difference is the manufacturing company. The effectiveness of the tablets is high: if taken in the first 12 hours, it is 90-95%. But it is important to take the tablet no earlier than 2 hours after eating, and then not eat for two hours. In addition, after taking Zhenale or Ginepristone, you should not take Indomethacin, Ibuprofen, Aspirin, Diclofenac and other non-steroidal anti-inflammatory drugs for a week.

If pregnancy does occur after using these drugs, it is recommended to terminate it, since the active substance may have an effect on developing embryo negative impact and cause pathologies.

Intrauterine devices

During the first 3–5 days after unprotected sexual intercourse, the introduction of an intrauterine device containing copper can be used as protection against pregnancy. Greatest efficiency This method is observed when the drug is administered during the first day. The spiral can only be inserted correctly experienced doctor, so under no circumstances should you try to install it yourself.

The mechanism of action in this case is to prevent pregnancy by changing the existing chemical composition intrauterine environment, in which the egg and sperm are damaged before contact.

The technique is very effective and, when applied in a timely manner, shows a result of 99%.

Contraindications and medical suitability

Contraceptive pills after sexual intercourse are intended solely to prevent pregnancy, so women whose pregnancy has already been confirmed should not take such drugs.

Breastfeeding women should not take them either, since emergency contraceptive pills greatly change the composition of milk and can cause harm to the baby. If necessary, breastfeeding should be stopped for at least two weeks or completely.

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 with a large number of sexual acts, 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 - 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 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 people nulliparous women, and also when large number sexual contacts and partners, during casual sexual intercourse. If a woman wants to put intrauterine device, but in the past I was often sick inflammatory diseases genital organs, you need to use antibiotics immediately before inserting the intrauterine device and in the next 5 days.

Not every woman always strives to become pregnant or plans this event in her foreseeable future. To avoid unwanted pregnancy, there are many methods of contraception, including emergency methods called postcoital. They are applicable within 72 hours from the moment of intercourse, which took place without protection or the use of others contraceptives, for example, IUDs or oral medications.

When are postcoital methods of contraception acceptable?

Any means of emergency contraception are not harmless to the body. For this reason, their use is limited and only justified when it is really necessary.

Postcoital contraceptives get their name due to the fact that they must be taken after the act has been completed and sperm has entered the vagina. They will prevent the onset ovulatory cycle or, if conception occurs, they will not allow the embryo to settle in the uterine cavity.

An unwanted pregnancy can occur for a number of reasons, sometimes completely independent of the woman’s wishes. To avoid pregnancy, many people resort to emergency contraception. Situations that can lead to unplanned conception and require postcoital oral contraception include:

unprotected sexual intercourse with an unfamiliar or completely stranger man in the absence of prolonged or Serious relationships with him;
sexual violence;
incorrect use of standard contraceptives;
low-quality barrier contraceptives.

Regarding the last point, examples include:

a condom that breaks during intercourse;
prolapsed intrauterine device;
missed dose of oral contraceptive;
broken, displaced or ruptured contraceptive diaphragm/cap;
incompletely dissolved spermicidal agent.

Emergency hormonal contraceptive pills

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IN modern medicine There are several types of postcoital contraception. A large group consists of hormonal-based drugs. They contain a significant dose of synthetically produced substances that are analogues of sexual female hormones. Hormonal emergency contraception is divided into two subgroups:

Oral. It is represented by birth control pills, which are taken within 72 hours after unprotected intercourse.
Prolonged. Consists of giving injections or injections.

Birth control pills after intercourse for 72 hours of the hormonal type are made with levonorgestrel. This substance prevents fertilization. Cervical mucus provokes a delay in ovulation and prevents sperm from entering the egg. The effectiveness of these emergency contraceptives is affected by how many hours have passed since intercourse. If a day has passed, then the guarantee is 95%, 25-48 hours - 85%, 49-72 hours - 58%.

The most popular options are:

Postinor. You need to take 2 tablets with an interval of 12 hours between doses. There are always two pieces per package. It is prohibited to use the drug more than three times a year due to its severe harm ovaries.
Escapelle. It is enough to take one Escapelle tablet, but if you vomit, you need to take another one. Contraception with Escapel is effective for 4 days from the moment of unprotected intercourse.

Another common representative of hormonal “fire” contraception is the drug Regulon. It contains a large dose of synthetic analogues of hormones such as progestogen and estrogen. Regulon slows down ovulation and inhibits the passage of sperm through the cervical canal. The maximum effectiveness of Regulon is observed during the first 24 hours.

Non-hormonal emergency contraception

Most emergency contraceptive pills, due to their content large quantity hormones negatively affect the body and the functioning of its individual organs, causing imbalance. Because of negative consequences Women often refuse this type of contraception and prefer non-hormonal emergency contraceptives.

Non-hormonal birth control pills after sex are based on mifepristone. It has the following properties:

prevention or inhibition of ovulation if taken within 3 days of sexual intercourse;
changes in the internal uterine lining - the endometrium, which acts as an obstacle to the fertilization of the egg;
increased contractions of the uterus and rejection of the fertilized egg.

Due to the ability to lead to the death of a fertilized egg implanted in the uterus, mifepristone in large doses can be used to terminate early pregnancy up to 6 weeks. If pregnancy occurs after taking it, it will still have to be terminated due to high risk fetal damage. If a woman started taking such contraceptives not in order to avoid getting pregnant, but with the aim of terminating a confirmed pregnancy at early, then it is better to do this not at home, but under the supervision of specialists in a hospital.

The most famous are Ginepriston, Zhenale, Agesta. These contraceptive pills after sex are taken one at a time 2 hours before meals, taking into account that 2 hours must also have passed since the last meal. However, due to the fact that mifepristone is a very strong substance and quite dangerous, causing many side effects, its use should be prescribed exclusively by a doctor.

Combined oral contraceptives for emergency contraception (Yuzpe method)

It is worth mentioning another option for emergency protection after sex - oral administration inside combined contraceptive pills. This postcoital contraception is called the Yuzpe method. Similar method consists not in a one-time, but in a double dose of the drug. The interval between taking the medication should be 12 hours. In this case, you need to drink not 1 tablet at a time, but several, from 2 to 4, washed down with a small amount of ordinary clean water.

The contraceptives used for this method are usually taken one pill at a time, but on an ongoing basis. In an emergency situation, their dose is increased to quickly ensure the interruption of a possible unplanned conception. Maximum term when this approach is effective is 72 hours after unprotected copulation.

It is also important to correctly calculate the required dose to achieve the effect. If this is done incorrectly, the reception will be useless or serious harm will be caused to the woman’s body. For this reason, what should be the dosage of the drug as an emergency contraceptive is decided solely by a specialist.

The most likely drugs that a doctor will prescribe for this purpose are: Marvelon, Miniziston, Rigevidon, Microgenon, Silest and others. Taking them according to the Yuzpe scheme gives a 75% guarantee. However, side effects cannot be excluded - nausea, vomiting, migraine and menstrual irregularities.

Emergency contraceptives during lactation

After the birth of a child, the question of preventing a second pregnancy from happening is especially pressing, except in those cases when the family, on the contrary, wants to have the same age.

Which ones exactly? contraception resorting to a young mother is not an easy decision, since she usually breastfeeds the baby, and with breast milk the baby gets everything that the woman eats and takes. As a result, safe contraception is so important for nursing mothers in emergency situations.

Emergency contraception methods during the lactation period are divided into two groups:

Intrauterine device. Its installation does not require the ingestion of tablets, and the woman can continue to breastfeed her baby. For the IUD to be effective, it must be installed no later than 5 days after having sex without using contraceptives. The advantage of the procedure is that after it the effect remains in the future. Preference should be given to coils containing copper, which, when released into the uterine cavity, has a spremicidal property. The most popular are T Cu-380 A and Multiload Cu-375. The latter is considered more reliable.
Taking hormonal pills. Medications with levonorgestrel are recommended, for example, you can take an Escapella tablet once. Having chosen this option, breastfeeding must be interrupted for 36 hours. Regular pumping will help avoid disturbances in the production of breast milk. However, the baby will need to be fed formula milk.

Which contraceptives are the least dangerous?

When choosing a means of emergency protection, the main issue is the safety of its use. Alas, there are no fast-acting contraceptive drugs that are completely safe to use. However, while some of them can cause significant harm to the body, others are considered the least dangerous.

The safest medications contraceptive effect those used according to the Yuzpe scheme are considered. With low dosage they have minimal range side effects without losing efficiency, which remains at 90%.

Consequences of emergency contraceptive pills

All medications are potential sources of side effects or can lead to all sorts of health consequences, and birth control pills are no exception.

uterine bleeding;
disruption of the menstrual cycle;
heavy discharge during menstruation;
ectopic pregnancy;
infertility;
impaired hemostasis and blood clot formation;
allergic reaction;
intestinal damage.

In addition to the high risk of encountering unpleasant consequences from using emergency contraceptives, a woman may experience wide range side effects:

pain in the lower abdomen, in the area of the uterus and genital tract;
drowsiness and lethargy;
nausea;
vomiting reflex;
increased irritability;
migraine and dizziness;
soreness in the mammary glands.

However, according to statistics, the above symptoms are observed only in every 5 women who take the pills. Others tolerate their effects much easier. In any case, before use, consultation with a specialist is required, who will take into account all contraindications and individual characteristics.

Traditional methods of contraception after unprotected intercourse

In addition to contraceptive methods that are used in traditional medicine after unprotected copulations, they are also used traditional methods. Many women, not wanting to deal with pills or get an IUD, prefer their grandmother’s recipes. However, they do not guarantee a 100% result, and it is better to resort to their help only when it is not possible to go to the doctor or buy a pharmacy contraceptive.