Injectable and implantable contraception
Long-acting hormonal methods provide high reliability and eliminate the need for daily medication intake.
- Injectable agents: Have therapeutic effects in uterine myoma, adenomyosis, and hyperplastic processes. Disadvantages include delayed return of fertility (from 6 months to 2 years) and the risk of acyclic bleeding.
- Implants: Subcutaneous capsules and rods containing progestogens (levonorgestrel or etonogestrel) release hormones gradually. They suppress ovulation, thicken cervical mucus, and alter the endometrium. The duration of action is 5 years for Norplant and 3 years for Implanon.
Chemical methods (spermicides)
Spermicides disrupt sperm cell membranes. Active substances include nonoxynol-9 and benzalkonium chloride.
- Dosage forms: suppositories, tablets, gels, creams, films, and foams.
- Application features: suppositories and tablets require waiting for dissolution (10–20 minutes), whereas creams and gels act immediately.
- Impact on STIs: provide partial protection; however, the use of spermicides may increase the risk of HIV transmission due to increased permeability of the vaginal wall.
Mechanical protection methods
Mechanical devices create a physical barrier preventing spermatozoa from entering the uterus.
- Condoms: Male and female devices made of latex or vinyl, sometimes additionally treated with spermicides.
- Additional devices: Vaginal diaphragms and cervical caps.
This category of methods is particularly relevant due to the increasing incidence of sexually transmitted infections.
Briefly: answers to topical questions
What legal conditions (age, presence of children) are required to undergo voluntary surgical sterilization in the Russian Federation?
The legal conditions for performing voluntary surgical sterilization in the Russian Federation upon the citizen's written application are reaching the age of at least 35 years or having at least two children. In the presence of medical indications and patient consent, the operation is performed regardless of age and the number of children. A mandatory requirement before the intervention is a comprehensive examination and obtaining written informed consent from the patient.
What are the medical indications for surgical sterilization in women?
Medical indications for surgical sterilization in women are diseases or conditions in which pregnancy and childbirth are associated with health risks. The exact list of such conditions is regulated by the relevant order. In addition, sterilization is used as a method of surgical hormone therapy in the treatment of hormone-dependent tumors, specifically in breast cancer.
What is the essence of vasectomy as a method of male surgical sterilization?
The essence of vasectomy is the ligation and transection of the vas deferens. As a result of this intervention, spermatozoa are prevented from entering the ejaculate, making the fertilization process impossible. This is a one-time surgical procedure providing long-term protection against pregnancy. Inability to conceive occurs 12 weeks after the procedure. The method is considered irreversible, but it is characterized by the absence of side effects and is simpler compared to female sterilization.
Class and exam questions
What is the difference between Norplant and Implanon in duration of action?
Norplant is designed for 5 years of use and consists of 6 silastic capsules, whereas Implanon is a single-capsule implant with a duration of action of 3 years.
What is the efficacy of chemical contraceptive methods?
Chemical methods (spermicides) have low contraceptive efficacy, with a Pearl index ranging from 6 to 20.
Is re-administration of spermicides required during repeated acts of sexual intercourse?
Yes, when using suppositories, tablets, creams, gels, and foams, repeat application of the product is required. The exception is polyurethane sponges, which do not require re-administration.
What else to study on this topic
- Pharmacokinetics of levonorgestrel and etonogestrel
- Technique of insertion and removal of subcutaneous implants
- Classification and clinical application of cervical caps and diaphragms
- Impact of various contraceptives on STI transmission risk
- Comparative analysis of Pearl indices for various groups of agents
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