Birthcontrol

What is Birth Control

Birth control is a complex issue that involves preventing unwanted pregnancy. There are numerous different methods available, each with varying levels of reliability and distinct advantages and disadvantages. These contraceptives work by regulating hormone levels in the body and preventing ovulation and the maturation of the egg.

A commonly used method is hormonal contraceptives, which are taken in the form of pills, patches, or vaginal rings. However, it is important to note that this method is not 100% reliable, and there can still be cases of unintended pregnancies. Therefore, a detailed conversation with a doctor is essential to find the best birth control method for one's individual situation.

Pearl Index:

The Pearl Index is used to rate the effectiveness of a contraceptive method. It indicates how many out of 100 sexually active women become pregnant when using a particular method over one year. The Pearl Index is 85 without contraception. The smaller the Pearl Index number, the more effective the method.

The Female Cycle

In the first half of the cycle (the period between the first day of bleeding and ovulation), several follicles mature in the ovary, one of which is released into the fallopian tube during ovulation. The ovary also produces estrogen, which causes the uterine lining to build up and makes the cervical mucus penetrable for sperm. In the second half of the cycle (the period from ovulation to the beginning of bleeding), the released egg is taken up by the fallopian tube and transported to the uterus. The ovary now produces the corpus luteum hormone (progesterone), the natural gestagen, which prepares the uterine lining for the possible implantation of a fertilized egg.

Recommended contraception methods

A. Hormonal Methods

The Pill - Pearl Index from 0.05 to 0.9

(Oral hormonal contraceptive with estrogens and gestagens) The pill works by preventing the maturation of the follicle in the ovary and ovulation. It also changes the uterine lining and cervical mucus. The pill has many advantages, including high safety, positive additional effects, and easy use for young women. Possible side effects include breast tenderness, mood swings, headaches, and bleeding disorders. Since taking estrogen-containing pills can increase the risk of blood

Vaginal Ring - Pearl Index: 0.65

(Depot preparation with estrogen-gestagen combination)

The ring is inserted into the vagina for 21 days and continuously releases estrogen and gestagen. This, like the pill, inhibits ovulation and changes the cervical mucus and the growth of the uterine lining. The possible side effects are essentially the same as those of the pill.

Hormonal Patch - Pearl Index: 0.88

(Depot preparation with estrogen-gestagen combination)

The approximately 20 cm² patches are stuck on the buttocks, abdomen, the outside of the upper arms, or the upper body. After 3 weeks of use, a patch-free break of 7 days is taken, during which withdrawal bleeding occurs. The patches continuously release an estrogen and a gestagen, inhibiting ovulation and reducing the growth of the uterine lining, and thickening the cervical mucus, similar to the pill. Side effects can include breast tenderness, headaches, nausea, painful bleeding, and skin irritation at the application site.

Mini Pill - Pearl Index: 0.5 -3

(Oral hormonal contraceptive with gestagen)

The mini-pill contains low-dose gestagens without a break in intake. This leads to changes in the cervical mucus and uterine lining, preventing sperm from ascending or a fertilized egg from implanting. The mini-pill does not inhibit ovulation in all cases. Side effects can include menstrual disorders and skin changes.

Depot Injection - Pearl Index: 0.4

(Depot preparation with gestagen)

Every two to three months, a high-dose gestagen injection is administered, for example, into the upper arm muscle. This changes the uterine lining and cervical mucus and also prevents ovulation. Disadvantages include weight gain, acne, menstrual irregularities, or absence of menstruation, even some time after stopping the injections.

Hormone-containing IUD - Pearl Index: 0.05 -0.2

(Depot preparation with intrauterine gestagen)

The gestagen-containing IUD releases very low doses of the substance to the uterus over three or five years. This reduces the growth of the uterine lining. Additionally, a mucus plug forms in the cervix as a barrier to sperm and bacteria. Ovulation is not inhibited. Side effects can include menstrual disorders, headaches, skin changes, and breast tenderness.

Hormone Implant - Pearl Index: 0

(Depot preparation with gestagen)

A gestagen-containing plastic rod is implanted under the skin on the inside of the upper arm. It releases the active substance in low doses over three years. This prevents ovulation and changes the cervical mucus. Side effects can include headaches, weight gain, acne, breast tenderness, and menstrual disorders up to the absence of menstruation.

B. Metal-containing Device

Intrauterin IUD - Pearl Index: 0.5 – 3

(Metal-containing IUD: Copper - Gold - Silver)

The metal-containing IUD works, among other things, by the damaging effect of the ions of gold, copper, and silver on sperm and by a foreign body reaction in the uterine cavity. Possible side effects include prolonged or more painful bleeding. Inflammation in the area of the fallopian tubes and ovaries can occur, leading to infertility.

C. Natural Contraception Methods

These require a regular cycle, discipline, and a willingness to invest time in getting to know one's body. On fertile days, an alternative method of contraception must be used, or sexual intercourse should be avoided.

Temperature Method - Pearl Index: 1, for the extended form: 3

By measuring body temperature every morning, the fertile days are determined. The basis of this method is that after ovulation, the body temperature rises due to the production of gestagen. Sexual intercourse should be limited to the definitely infertile days after ovulation. Extended form: Sexual intercourse also occurs on the less reliably infertile days from the first day of the cycle up to six days before the earliest measured temperature rise.

Billings Mucus Structure Method - Pearl Index: 2 – 15

Determines ovulation by assessing cervical mucus. Due to the rise in estrogen before ovulation, the mucus increases in quantity and becomes clearer and more "stretchable".

Symptothermal Method by Roetzer - Pearl Index: 1 – 2

The temperature method and mucus structure method should always be used together. It is one of the safest ways to naturally prevent pregnancy

Computer-Assisted Contraception - Pearl Index: 2 – 10

These methods are based on temperature values (Pearl Index: 5 – 10), measurement of hormones in urine (Pearl Index: 6), or a combination of both (Pearl Index: 2 – 6).

D. Chemical Methods

Spermicides - Pearl Index: 3 – 25

Foam, tablets, suppositories, creams, gels, or sponges limit sperm mobility and kill them.

E. Barrier Methods

These methods use a mechanical barrier to prevent sperm from entering the uterus. Possible side effects include vaginal infections. The effectiveness can be increased with spermicides.

Male Condom - Pearl Index: 2 -12

The condom provides the best protection against infectious diseases (HIV, Hepatitis, and other sexually transmitted diseases). The effectiveness largely depends on correct usage.

Female Condom - Pearl Index: 6 – 10

The latex-free condom is inserted into the vagina before sexual intercourse and secured with a ring at the entrance to the vagina. This allows the woman to protect herself from sexually transmitted diseases.

Diaphragm - Pearl Index: 2 – 20

The diaphragm consists of a flexible metal ring covered with rubber and a membrane of thin, pliable rubber. A spermicide is applied to it and introduced into the vagina.

Cervical Cap - Pearl Index: 6

A plastic cap is placed on the cervix. Spermicides should also be used. The cervical cap additionally provides some protection against ascending infections.

F. Surgical Methods

These should only be performed after family planning is complete, as later surgical restoration of fertility is often not possible.

Female Sterilization - Pearl Index: 0.1

Through a laparoscopy (minimally invasive keyhole surgery), the patency of the fallopian tubes is blocked. This prevents the transport of eggs while not affecting hormone production in the ovaries or sexual sensation.

Male Sterilization - Pearl Index: 0.15 – 0.25

The patency of the vas deferens is blocked, preventing sperm transport. Hormone production in the testes, sexual sensation, and potency are not affected.

G. Postcoital Contraception / Emergency Contraception

"Morning-After Pill" - Pearl Index: 0.1-2.6

(Hormonal implantation inhibition by gestagens)

After unprotected intercourse, a woman can take a hormone-containing pill within 3-7 days for postcoital birth control. However, this should always be an exceptional measure. Possible side effects can include menstrual disorders, breast tenderness, and nausea.

Copper IUD - Pearl Index: <1

Up to 6 days after unprotected intercourse, a copper IUD can be placed, which prevents the implantation of the fertilized egg in the uterine lining.

Not Recommended Contraception Methods

The following methods provide less protection than the presented methods and are therefore not recommended.

A. Extended Breastfeeding - Pearl Index: Unknown

The absence of menstruation during breastfeeding does not provide reliable contraception, as it is unpredictable when the first ovulation will occur.

B. Withdrawal - Pearl Index: 10-38

(Coitus interruptus "Pulling out")

Ejaculation occurs outside the vagina. However, small amounts of seminal fluid are often released before ejaculation, which can lead to conception.

C. Douching - Pearl Index: 31

After intercourse, the vagina is rinsed. However, sperm may reach the uterus before douching.