Today, unprotected intercourse is common among unmarried couples when pregnancy is not desired. There are also cases of coercion to have sex, contraindications to bearing. In this regard, it is the methods of emergency contraception that are relevant. Often the population and even some medical workers are not fully aware of the principles of preventing pregnancy, therefore there is a risk of untimely, incomplete provision of qualified assistance.
There are several methods of contraception after unprotected intercourse. One of these is the Yuzpe method, which consists of taking combined contraceptive pills.
History of emergency contraception
For many decades, scientists have studied the likelihood of fertilization after unprotected intercourse, and concluded that with irregular sexual intercourse, the percentage of conception is 20-25% during one cycle, that is, 20-25 couples out of 100 become pregnant after such sex.
Every girl, woman should knowconception conditions:
- ovulation period - the most favorable period, occurs with a regular cycle on the 14th day;
- fertilization - 5 days before the release of the egg from the dominant follicle, 1 day after that: if earlier - the spermatozoa of the man's sperm die, if later - the egg cell dies;
- a fertilized egg must be transported by the fallopian tubes, securely attached to the walls of the uterine cavity, and there should be no inflammatory processes in these organs;
- There are 14 days between intercourse and pregnancy.
Even in ancient times, women tried various ways to prevent conception - a hot bath, washing with decoctions of various plants, mechanical methods - bouncing, sneezing after sex. The earliest documented use of contraception was in Egypt, where they first produced spermicidal vaginal suppositories smeared with honey.
At the moment, emergency contraception after the act has nothing to do with past methods, only the name remains, and the tactics are not traumatic, do not threaten the woman's he alth. The technique was named after a doctor from Canada, Albert Yuzpe, and has been used since 1977. Drugs taken in this way are classified as hormonal contraceptives (COCs).
Principles for Pregnancy Prevention
- Means for emergency contraception should be as accessible, safe,efficient.
- Component - estradiol, levonorgestrel, release form - tablets.
- All drugs have the same effect, allowing the woman to choose for herself.
- Risk of pregnancy when taken within 3-5 days up to 3%.
- Accepting funds no later than 5 days after ejaculation.
- Possibility of use for persons with contraindications to hormonal contraception.
Combined hormonal contraceptives for emergency contraception using the Yuzpe method are taken within the first 72 hours after ejaculation. Drugs are taken, which include 100 micrograms of estradiol, 500 micrograms of levonorgestrel twice 12 hours after the first dose. The means that are taken in this case are any low-dose COCs. For example, in America and Canada, women take 4 tablets of Ovral, in Germany - Tetragynon, in our country - Microgynon, Femodena, Rigevidon, Regulon, Minisiston, 5 tablets each - " Mercilon", "Novineta", "Logest".
Mechanism of action of oral contraceptives
The way the Yuzpe Method works in practice depends on when the drugs were taken. Postcoital contraceptives can prevent or delay ovulation, but if pregnancy has already occurred, contraceptives of this group do not affect it, that is, abortion is excluded. On the contrary, intrauterine systems affect conception until the meeting of the egg andsperm.
If we compare the use of COCs as emergency contraception with medical abortion, then in the first case the method is effective in the period before the development of pregnancy, and the second is a method of delivering a woman from the onset of conception. Emergency contraception works up to 5 days after ejaculation, and medical abortion - after 5 days, when a fertilized egg is embedded in the wall of the uterine cavity.
Conditions for the impossibility of embryo implantation under the influence of combined contraceptives - a decrease in the number of receptors for steroid hormones, the absence of nuclear channels in the secretory phase of the menstrual cycle, uneven glandular, stromal parts of the endometrium, a change in the amount of isocitrate dehydrogenase.
Criteria for the admissibility of prescribing postcoital protection
There are 4 categories of a woman's body condition that determine whether emergency contraception can be used.
1st category - no contraindications (during breastfeeding, ectopic pregnancy in the past, repeated use of contraception, rape).
2nd category - the expected result exceeds the risks of prescribing the drug (diseases of the cardiovascular system - strokes, heart attacks; angina pectoris, migraine headaches, liver pathology).
3rd category - the risks of taking contraceptives exceed the results of using medications.
4th category - absolute contraindications to the use of emergency contraception (pregnancy confirmed by an increase in human chorionic gonadotropin inblood, urine, ultrasound results).
Indications for use
- Unprotected sex (no condom, not taking contraceptives).
- Damage to barrier contraception (diaphragm, condom).
- Expulsion of the intrauterine system.
- Indications for coil removal.
- Using only spermicides.
- Impaired use of combined oral contraceptives.
- Recent use of drugs that can affect the development of the fetus - teratogens.
- After the rape.
- First intercourse.
- Taking a contraceptive with progestin more than 3 hours late.
- Using the injectable combination 7 days late.
- Premature removal of barrier contraceptives.
- Violation of the technique of applying spermicides, insufficient formation of a film on the walls of the vagina.
- Sex during ovulation.
Special conditions for prescribing drugs
- Breastfeeding - do not feed the baby 6 hours after taking the pills.
- Unprotected sexual intercourse at least 110-120 hours before using a contraceptive - IUD placement recommended.
- Multiple unprotected acts - the use of emergency contraception is possible in such cases.
- Repeated contraception - no contraindications, doctor's recommendation for planned contraception.
- Emergency contraceptionbefore sex - a recommendation to use other methods of preventing pregnancy.
- Intercourse during a period when a woman cannot become pregnant - with anovulatory menstrual cycles - mandatory use of emergency contraceptives for any unprotected intercourse.
- Influence of other medicines on the contraceptive - the doctor must explain to the patient the features of the interaction of contraceptives with the drugs she is still taking.
Contraindications to the procedure
- The woman is over 35 years old.
- Severe headache to migraine.
- Pregnancy.
- Pathology of the liver.
- Smoking for a long time.
- Pulmonary embolism, history of uterine bleeding.
Side effects of methods
Emergency contraception brings a woman's body a powerful blow to the hormonal background. The main side effects are nausea, repeated vomiting, soreness in the chest area. Menstruation after emergency contraception can come very early or vice versa, late. Perhaps the development of uterine bleeding, menstrual irregularities, allergic reactions.
Uzpe method: women's reviews
Female sex often resorts to the use of "fire" contraception after unprotected intercourse. Reviews about emergency contraception are positive, especially often found on blogs, on various forums, inin social networks. This is all due to the fact that the effectiveness of the appointment of this method is quite high - in 70-98% of cases, pregnancy does not occur, which underlies the reviews about this method.
Thus, emergency contraception is an important aspect of preventing unwanted pregnancy after unprotected intercourse. Positive feedback from patients who use this method in life is due to the high efficiency of the method.
