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CONTRACEPTIVE METHODS

THE SAFEST:

DIAPHRAGM WITH SPERMICIDE

It consists of a flexible rubber dome which introduced in the vagina covers the cervix. It should always be used with a spermicidal cream. Before using it, the spermicidal must be placed in both sides of the dome. Place ten minutes before sexual intercourse and keep inside until eight hours later. When having more than one sexual intercourse, it is required to reapply the spermicidal. Although it may seem cumbersome, everything depends on how you take the matter. Try to “play” with the diaphragm and your partner. The fundamental advantage of this system is that it lacks side effects. To purchase your diaphragm you must go to a health centre. They will take your measurements and indicate the size you need. They will also teach you how to put it in and to verify that you have done it correctly. The diaphragm can help you to learn more about your body, remove the fear that sometimes we have about our genitals. After using it you must wash it with neutral soap and water, drying it and store it covered in talcum powder. Check occasionally that the rubber is in good condition. Every two years you must change it. Used correctly, always with creams, it is a fairly safe method even though it does not protect you against sexually transmitted diseases.

It has an effectiveness of 80%

CONDOM

It is a lubricated rubber made covering that is placed on the penis when this is erect. Once in place, there must be space at the tip of the condom for the semen to be deposited. Most of the condoms you can purchase at pharmacies already have incorporated a small deposit for this purpose. The man, once he has ejaculated, must hold it at the base with the fingertips to prevent it from unfolding and letting the semen out. Remove from the penis before the erection ends. This method is almost the only one for men. It is good that they can also take responsibility for preventing pregnancies. The fundamental advantage is that it lacks side effects. Always buy at a pharmacy and not leave it too long in your pocket or in the glove box of the car. It is sufficiently safe if used properly and it is the only method that protects you against sexually transmitted diseases.

It has a 90 % effectiveness.

INTRAUTERINE DEVICE (SPIRAL)

Intrauterine devices are small objects that are introduced in the uterus. They have three effects: impede the passage of sperm into the fallopian tubes. They increase mobility of the tubes, making fertilization more difficult. It prevents the nesting of the egg on the assumption it has been fertilized. It is fairly safe. It must be put in by the doctor and remains inside you between two and five years, depending on the class of IUD use. The problems with this approach are the side effects. It is neither recommended for women who have never been pregnant, nor for those who have had more than five. The body might reject it. It is normal during the first three months to have a heavier period than usual. After that time, everything returns to normal, although you may have some discharges between periods. This is not a major issue. Before placing it in we must verify that you have no infection of the uterus or vagina. The doctor places it when you are menstruating, since then there is certainty that you are not pregnant and the neck of the cervix is wider. When you are using a IUD you must watch more closely than ever any small vaginal infection since the contact between the vagina and the uterus via the string of the IUD, can create complications. If you feel a stinging in the vagina or smelly vaginal flux, you must go to the doctor. It is not appropriate to use tampons during your period, as they could get rolled up with the string of the IUD. After each period you can check, by entering your fingers into the vagina, the string remains in place, and therefore also the IUD. This is an effective and comfortable method but it does not protects you against sexually transmitted diseases.

It has an effectiveness of 95 %

THE PILL

It is a medicine composed of two substances: synthetic estrogen and progesterone similar to female hormones. These substances are distributed throughout the body by the blood, preventing the ovaries from producing an egg. Therefore, there can be no fertilization. It is the safest method and does not interfere in sexual relations. However we must take into account that neither women with circulatory and cardiovascular disorders (from varicose veins to cerebral haemorrhage) should not take it nor those who have liver or gallbladder disorders, or those with diabetes. We must always take it under medical supervision. It does not protect you against STDs.
It has a 97 % effectiveness.

Rules for correct use:

** Do not take it without prior medical examination.

** The packs usually contain 21 pills: take the first one on the 1st or 5th day of menstruation, and then every day at the same time, approximately.  After finishing the pack, rest for seven days and start the next set of 21 pills.  You should have your period during those seven days. If one day you forget to take the pill at the required time, you must take it within twelve hours and then take the next one at the usual time. If more than 12 hours go by, effectiveness is no longer guaranteed. Keep taking them, but use a complementary method for that month.

-During the week of rest between packs you still remain protected. In case of vomiting or diarrhoea during the hours after taking the pill, it is recommended to take another one

-You must tell your doctor that you are taking the pill should if you are having surgery.

There are medications that you should not take while taking the pill: ampicillin (antibiotic), rifampin (tuberculosis), barbiturates and anti-epileptics. Consult your doctor. Alcohol in large quantities is contraindicated because it interferes with the action of the pill.

Above the age of thirty-five and especially smokers or obese women, this method is discouraged. It is crucial to use this method with serious medical control and for periods not exceeding five years.

Sterilization: a definitive method

It is legal since June 1983. Male sterilization is called vasectomy and the female: tubal ligation. None of them protects you against sexually transmitted diseases.

HORMONAL CONTRACEPTIVE RING

NUVA RING ©is a flexible plastic ring:

Releases etonogestrel and ethinyl estradiol

Monthly: 3 weeks of use and 1 week rest

5.4 cm. outside diameter

4 mm. cross-sectional diameter

Controlled release of hormones:

-The membrane regulates the rate of hormonal release

Hormonal diffusion from the largest concentration inside

ring towards the lower concentration outside the ring.

-Vaginal absorption

Predictable bleeding pattern = ideal bleeding pattern

Bleeding from deprivation in the week rest

without episodes of irregular bleeding during the cycle.

•                                 Neutral weight effect

•                                 Very well tolerated with low incidence of adverse effects

Easy to use:

-It Is inserted and removed easily by the user.

-The effectiveness of NUVA RING is independent of its location in the vagina

More information on NUVA RING… expand

The placement of

NUVA RING… expand

CONTRACEPTIVE PATCH

EVRA ® (norelgestromin / ethinyl estradiol) is a small thin skin patch, beige colour, which is applied directly on the skin and can be discreetly used under the clothes. It combines its highly effectiveness for preventing pregnancy with the convenience of a single weekly application. Adheres perfectly to the skin of the user being effective even when performing activities involving contact with water or sweating such as swimming, bathing, exercising, the sauna, etc.

EVRA ® available from pharmacies in two presentations: one with three patches for a cycle and another containing nine patches for three cycles. Each patch must be worn for seven days and then must be replaced by a new  one (the same day of the week and at any time of day), repeating the process for three

consecutive weeks. The fourth week of the month no patch is required.

It is recommended to alternate each new patch on different parts of the body.

EVRA ® must be applied on clean, dry (exempt from creams and lotions) and without hair part of the skin. We recommend the application in one of these four areas: buttocks, abdomen, upper arm and upper body (not on the breasts).

EVRA ® uses a transdermic method that releases continuously a progestin (norelgestromin) and a estrogen (ethinyl estradiol) that are passed to the bloodstream after being absorbed through the skin.

Efficiency and safety of EVRA ®

According to studies carried out in Europe and USA, at which participated more than 3,300 women with more than 22,000 menstrual cycles, EVRA ® has demonstrated effectiveness over 99 % in the prevention of pregnancy and also an excellent adhesion to the skin.

The observed side effects in these studies were similar to those of contraceptve pills.

EVRA ® patch benefits

•One of the great benefits of the contraceptive patch is being a convenient method to use that only requires a single weekly application, avoiding the inconvenience of having to remember the pill daily decision-making. This fact makes women who have chosen this contraceptive method more constant, completing the entire cycle and, therefore preventing disorders caused by the feared “omissions”.

• Another big advantage of EVRA ®, compared to contraceptive pills, is that it releases medication continuously and constantly, which leads to the elimination of minimum and maximum levels observed in the body with oral drugs, levels which are the cause of side effects or disturbances regarding their effectiveness.

•. Unlike the pill, vomiting or diarrhoea does not alter the amount of medication liberated by the patch, so the occurrence of these episodes does not reduce its effectiveness as a contraceptive method.

• It is, therefore, a flexible, convenient and easy to apply method that fits the needs of women. It is being used successfully in the United States, where it has become the second most used contraceptive method and one of the most popular. At European level, women from countries such as Belgium, Britain, Germany, Netherlands, Finland and Austria are also using successfully.

INTRAUTERINE DEVICE (DIU)

Intrauterine devices are small objects that are introduced in the uterus.

They have three effects:

1) Impede the passage of sperm into the fallopian tubes.

2) Increase the mobility of the tubes, making fertilization more difficult.

3) Prevent the nesting of the egg on the assumption that there has been fertilization. It is fairly safe.

It must be put in by the doctor and remains inside you between two and five years, depending on the class of IUD use. The problems with this approach are the side effects. It is neither recommended for women who have never been pregnant, nor for those who have had more than five. The body might reject it. It is normal during the first three months to have a heavier period than usual. After that time, everything returns to normal, although you may have some discharges between periods. This is not a major issue. Before placing it in we must verify that you have no infection of the uterus or vagina. The doctor places it when you are menstruating, since then there is certainty that you are not pregnant and the neck of the cervix is wider. When you are using a IUD you must watch more closely than ever any small vaginal infection since the contact between the vagina and the uterus via the string of the IUD, can create complications. If you feel a stinging in the vagina or smelly vaginal flux, you must go to the doctor. It is not appropriate to use tampons during your period, as they could get rolled up with the string of the IUD. After each period you can check, by entering your fingers into the vagina, the string remains in place, and therefore also the IUD. This is an effective and comfortable method but it does not protects you against sexually transmitted diseases.

It has an effectiveness of 95 %

HORMONAL IUD

This method attempts to combine the advantages of the hormonal contraception with those of the intrauterine device.

Its T-shaped structure is similar to the IUD, it does not contain copper but a plastic structure impregnated with barium sulphate to make it visible to x-rays.

The vertical arm is fitted with a small cylinder that serves as a reservoir for a gestagenic: levonorgestrel.

Its contraceptive effectiveness is comparable to that of the tubal ligation.

It works inside the uterine cavity hindering the rise of sperm. For some women (infrequently), inhibits ovulation.

During the first months it alters the menstrual cycle, producing spotting, however after twelve months about 20 % of women presents amenorrhea or absence of period. However this does not cause disorders in fertility that recovers once the IUD is removed.

The change in menstrual bleeding as well as potential side effects arising from the release of the levonosgestrel (mammary discomfort, acne, moods, mild increase in weight etc..) represent major disadvantages.

The biggest benefit is that it reduces bleeding, so it is a good method for women who have abundant menstruation, suffering significant deficits of iron.

This type of IUD produces a protective action on endometrial hyperplasia during a hormonal substitution therapy and an excessive bleeding control.

It is not recommended for cases when insertion can be difficult.

CONTRACEPTIVE IMPLANTS

There are currently two marketed brands; IMPLANON (Organón labs) and JADELLE (Schering labs).

“Expand with official web information”

These subcutaneous contraceptives consist of flexible rods with levonorgestrel, which is freed continuously and offers high contraceptive efficiency for a period of three to five years depending on the brand.

They are implanted into the arm through a small incision, requiring local anaesthetic and you won’t need stitches.

PREGNANCY INTERUPTION METHODS

Techniques for the termination of pregnancy vary according to the time of gestation. The earlier the abortion is performed, the lower the risk and the possibility of complications are. The interruption of a pregnancy before twelve weeks has fewer complications and risks to the health of women than childbirth, provided that is carried out under the right conditions and by trained personnel. The technique used up until twelve weeks is

The aspiration method:

It is used up to ten to twelve weeks of pregnancy. This method does not require hospitalization and occurs usually under local anaesthetic with the minimum risks.

Sometimes it can be done under general anaesthetic, which may involve hospitalization.

Curettage technique:

It is surgery procedure that, sometimes, complements the aspiration method to ensure complete emptying of the uterus. Other times the curettage is performed exclusively as a technique to terminate the pregnancy. It is usually done under general anaesthetic.

Method of induction:

It is used to interrupt pregnancies of over fourteen weeks. Techniques are more complex and require hospitalization. This method uses substances or medicines (usually prostaglandins) causing the expulsion of the contents of the uterus. It is commonly carried out using epidural anaesthetic, which prevents pain without the risks of general anaesthetic.

RU-486 or abortion pill:

The discovery of Mifepristone (RU-486) is the result of the great experience and research capacity of Roussel Uclaf in the field of steroid hormones.

Thanks to the knowledge of various measurement techniques of steroid affinity reception by several hormone receptors, a research programme on steroids with anti hormonal activity was developed in 1975 by the Romainville (France) Research Center. This led in 1980 to the discovery of the mifepristone: a 19 noresteroide replaced on the 11B position.

With a very strong affinity for glucocorticoids and progesterone receptors, the mifepristone behaves as a competitive antagonist of these hormones in vitro and in animal models. This aniprogesterone activity led initially to propose their use for the interruption of pregnancy and later to extend their indications to other applications.

Chemical method

The RU-486 containing Myfegyne, can be taken up to the seventh week of pregnancy, calculated from the first day since the last period (approximately 50 days). This tablet is taken at health centre or hospital authorised for it, always in front of the doctor and usually combined with another product. The RU blocks the action of the progesterone and stops the development of the pregnancy.  The second substance (a prostaglandine), is going to facilitate the contraction of the uterus.

After taking the RU, the woman returns home and after two days she goes back to the clinic so the prostaglandine can be given to her. She should remain under observation for 2-4 hours approximately.  In a great number of cases the embryo is expelled during this period, although in some occasions, the expulsion takes place even in the own residence.  Just like in the previous case for the surgical method, we highly recommend to go for a check up with the gynaecologist around two weeks after using the method.

Secondary effects

-Pain:  The pains that might arise can be sometimes stronger than those of the menstruation but they usually disappear without medication. In persistent cases, a painkiller can be taken.

-Bleeding:  It happens during the expulsion and can be stronger than the period. The duration of the bleeding in this case is longer that with the surgical technique and it can last over a week.

-Nauseas:  The prostaglandine that is taken with the medication can produce nauseas and in some cases diarrhoea.

Complications

– Effectiveness of the method:  In some cases (3-5%) the chemical technique does not work and the woman should then resort to the surgical method. The chemical method will not be repeated a second time

– Incomplete Expulsion: It will also require an intervention to conveniently terminate the process.

 

Noticias y novedades

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