Contraception: who is responsible for contraception?
Sometimes it seems that modern society is divided into two camps: the representatives of the first are sure that only women should be responsible for contraception, the representatives of the second, accordingly, are sure that this is the lot of men. Meanwhile, the issue of contraception has quite a few aspects - both psychological and legal and, of course, medical.
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Who should be responsible for the safety of sex: a man or a woman? In terms of such a common result of unprotected intercourse as pregnancy, the consequences for a man and a woman will be different, but not very pleasant if the child is unwanted. For a man, this is the establishment of paternity and the payment of alimony, for a woman - raising a child and all the accompanying delights of life.
But abortion is not prohibited in our country - advanced contemporaries will say and they will be absolutely right. Only, according to official statistics, about 2 million abortions are performed in Russia every year. Many doctors believe that this figure is underestimated by two, or even three times. It's worth considering: how many people don't actually care about contraception?
Abortion is not a "trifling procedure" as some people still believe. Unfortunately, the consequences of abortion are many, the saddest of them is infertility. In addition, men should know that there are contraindications to abortion - as to all surgical operations. Even a sparing medication.
Surgical contraception
To maintain a woman's health, you should use available methods of contraception. There are quite a few of them, and scientists are developing more and more new ways to protect against unwanted pregnancy. Meanwhile, only two methods provide 100% protection, and few people will like them. This is male or female sterilization - the so-called surgical method of contraception. However, the abstinence method also gives a 100% result.
Just in case, it should be clarified that sterilization in men - vasectomy - in theory is considered a reversible operation, but only for five years. There are no exact statistics on this issue in Russia. The decision on a vasectomy should be balanced: it is necessary to take into account whether the man already has children and whether he is a carrier of genetic diseases.
Female sterilization consists in creating an artificial obstruction of the fallopian tubes by ligating them, placing clamps or excising them. Voluntary sterilization is allowed for women over 35 years of age who have two or more children.
Surgical contraception does not affect hormones and libido. It does not protect against sexually transmitted diseases.
Male contraception
The vast majority of men use only two methods of contraception - condoms and coitus interruptus (PA). Thousands of articles have been written about the mythical level of protection of the latter, and it accounts for more than half (and according to some sources, up to 75%) of unwanted pregnancies. Do not be surprised: its efficiency does not exceed 80%. After all, a certain amount of sperm can be released at the very beginning of sexual intercourse. Such a method of contraception can be allowed only in combination with the method for calculating safe days for a woman, but even then the reliability will not increase much.
The effectiveness of contraception with condoms is much higher - up to 98%. Nevertheless, punctures happen here too. Firstly, condoms break, secondly, their quality decreases under improper storage conditions, and thirdly, only a certain water-based lubricant can be used. However, a condom protects against genital infections as much as possible, and this is its great advantage.
There are also lesser known methods of contraception developed for men, such as hormonal pills or subcutaneous implants, which last 3-5 months.
It is very dangerous to use some traditional methods, such as daily hot baths. Indeed, when the testicles overheat, the production of sperm is disrupted, but only the risk of cancer increases dramatically.
Wide selection for women
It seems that women with contraception are incomparably more fortunate. If a woman is completely healthy in terms of gynecology, this is true. The effectiveness of hormonal contraceptives and the intrauterine device reaches 99%. However, contrary to the opinion of men, not every woman can use these types of contraception.
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The spiral should not be installed in nulliparous women, as well as in the presence of malformations of the genital organs, inflammatory diseases, tumors. There are much more contraindications to taking oral contraceptives (OC):
- the risk of thrombosis and thromboembolism;
- ischemic heart disease, stroke;
- hypertension (above 160/100 mm Hg);
- increased blood clotting;
- transferred surgical operations with prolonged bed rest.
Risk factors for cardiovascular diseases while taking OC are liver and endocrine system diseases, smoking, a woman's age over 35 and much more. It should be borne in mind that even a healthy woman does not always easily tolerate OC - side effects may occur, and the contraceptive intake will need to be stopped.
All other methods of contraception are far from those listed in terms of effectiveness. For example, spermicides - creams, pastes and suppositories - are only 60-70% effective, according to doctors. Diaphragms - 70-80%. The Safe Days method can only be quite effective with the classic 28-day cycle, so you shouldn't be limited to it.
The good news: there are already special female condoms on sale that are comparable in effectiveness to male condoms. However, they have not yet received wide distribution in Russia.
Emergency contraception
Every woman, however, like every man, should remember that with unprotected intercourse, there are still ways to prevent unwanted pregnancy. And this, of course, is not about douching with lemon.
The first method involves taking postcoital hormonal contraceptives, but this must be done within 24–72 hours after intercourse, and the earlier, the higher their effectiveness will be. Such drugs cannot be used more often than twice a year, they contain a very high dose of hormones.
The second method is to install an intrauterine device in the first 5-7 days after unprotected intercourse. This method prevents the implantation of a fertilized egg. But in a number of cases, which we described above, the spiral may be contraindicated.
For the onset of pregnancy, the participation of both men and women is necessary. Therefore, the only correct decision would be to discuss contraception issues and remember that no method other than the surgical one gives a 100% guarantee. This means that both partners are always responsible for pregnancy.
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
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