Other contraception methods
Today there are several birth control methods to choose from for both women and men, still the birth control pill is one of the most popular option that is also one of the most reliable methods available. Another similarly effective solution is offered by the intrauterine device, and the diaphragms/cup pessaries applied in combination with spermicides. Of the physical contraceptives condoms should also be mentioned. The withdrawal method and the calendar method have proven to be the least reliable methods. However, we should be aware that 100% protection is only offered by sterilisation. If anything goes wrong with the application of any of the methods, then unwanted pregnancy, or - even worse - abortion can be avoided by the morning after pill.
The use of birth control pills is undoubtedly one of the most convenient and perhaps the cheapest method of contraception. Pills with extremely high hormone content producing several unpleasant side effects that were available at the beginning are now replaced by pills that have less side effects and lower oestrogen content but are just as effective at the same time. The reliability of individual methods of contraception can be characterised by the formula of Raymond Pearl, which indicates how many fertile women using the given method have become pregnant within a year, with the calculation projected to 100 women. The primary advantage offered by the pill is that in the case of perfect administration as specified the Pearl index of this method is very low (less than 1%). However in practice typically 8 oral contraceptive users out of 100 get pregnant in one year. How is this possible?
The major risk is represented by use contrary to the specifications, for example if we forget to take one or more than one pills in the last week of the cycle. By that the risk of becoming pregnant increases to a considerable extent. The patient information sheet included in the medicinal product’s package provides a detailed description of the method of administration, the side effects, and also about what to do when we forgot to take one or more pills. Another problem may be if in the course of regular administration we suffer from vomiting or diarrhea. In such cases the absorption of the pill is not guaranteed, so essentially there is no protection provided for that particular period. If sexual intercourse takes place during that time period, then emergency contraception may help in such situations.
The intrauterine device is a method considered to be one of the most reliable ones after the birth control pill, which is also indicated by the Pearl index between 0,8. However, when using the intrauterine device on a continuous basis, there may still be occasional accidents: the most frequent cause is when ladies “taking a break” from using the IUD (a couple of months’ rest is recommended every 5-10 years) forget that the device providing protection is not in place. In such events unwanted abortion can be prevented by the morning after pill. Diaphragms/cup pessaries used in combination with spermicides may also be effective. These are also physical methods of contraception. In these cases the Pearl index ranges between 16-6, depending on standard use. Female and male condoms are also popular means of contraception, which also have to be used with due care. It can be established with no doubt that if physical contraceptives have been displaced, got torn or damaged, then it is worth preventing unwanted pregnancy by the use of the morning after pill in any case.
In the case of the use of the least reliable methods of withdrawal and of the calendar method one must consider that their Pearl index is 27 and 25, respectively, i.e. every one in four women using these methods will become pregnant. In such cases the morning after pill may be necessary, and then it is recommended to apply a more reliable method of birth control.
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