Conception

Contraceptive methods: which are the most common?

What are the most common birth control methods and how do they work? They are divided into three groups, let’s see what they are and their effectiveness.

What are the most common birth control methods and how do they work? Two main subgroups can be distinguished in the field of contraception: contraceptive methods that prevent ovulation and methods that instead go to prevent the continuation of the pregnancy

Contraceptive methods , as the name suggests, are methods that prevent conception , i.e. they prevent the sperm and egg from meeting.

The interceptive methods : they prevent the implantation of the embryo in the uterus thus causing a very early abortion. The copper IUD and morning-after pill are interceptive methods.

Contragestative methods : they detach the embryo nestled in the uterus causing an interruption of pregnancy (see Ru486).

There are different schools of thought on the topic of abortifacient/interceptive/contragestative methods. It always depends on when life is intended to begin. If it is understood to have begun at the time of sperm-oocyte fusion, all abortifacient methods are those which prevent the implantation of the embryo in the uterus and the continuation of the pregnancy.

Here we will focus only on contraceptive methods.

The most common contraceptive methods

  • Condom : Barrier method that must be used correctly to ensure successful contraception. This means that it must be used from the beginning of intercourse and must be removed immediately after ejaculation to prevent it from slipping off. Failure rates are due to breakage or incorrect use.
  • Diaphragm : Like the condom, it is a barrier method. It is a sort of cup that is applied to the vagina in combination with a spermicidal cream. Its effectiveness depends on the correct use and associated use of spermicides
  • Birth control pills : These are hormonal-type drugs. They can be combined (based on estrogen and progesterone) or progestogen only. They act by preventing ovulation but also by making the uterus unsuitable for implantation.
  • Vaginal ring : this is a ring that is inserted into the back of the vagina, and which releases a low-dose progestogen.
  • Patches : they release hormones similar to those present in pills transdermally and pass directly into the bloodstream.
  • Medicated coil (IUD): The levonorgestrel coil works by releasing a small amount of the hormone that inhibits tubal motility and thickens cervical mucus. Both of these activities are contraceptive. However, it also reduces the thickness of the endometrium, thus making it unsuitable for a possible implantation of the fertilized egg (interceptive activity)
  • Subcutaneous contraceptive implant:    it is inserted by the gynecologist subcutaneously in the inner area of ​​the upper arm. Releases barium sulphate (3%, 15mg) and etonogestrel (60% 68mg). The insertion and removal of the implant must be performed by the gynecologist, with a subcutaneous injection. The only hormonal contraceptive implant currently on the market in Italy is called  Nexplanon .
  • Intramuscular injection : This is an injection of medroxyprogesterone acetate every 3 months.

Birth control pills may have a reduced contraceptive effect when taken with antibiotics. Those taken orally also become ineffective in case of vomiting and diarrhea.

The coitus interruptus and the forms of surgical sterilization (tubal ligation for women and ligation of the vas deferens in the male = vasectomy) deserve a separate discussion, which are not strictly contraceptive methods but birth control methods.

Coitus interruptus has a failure rate of about 20-30%, which means that 20-30 out of 100 women get pregnant in a year if they adopt this method with their partner. The pregnancy risks associated with this method are the difficulty of managing ejaculation correctly, and the presence of sperm in the pre-ejaculatory fluid. 

Natural methods are not contraceptive methods but are non-contraceptive methods for natural birth control. They allow us to understand if and when we are fertile in order to be able to make decisions with our partner aimed at avoiding, seeking or postponing a pregnancy.

Effectiveness of the most common contraceptive methods

Let’s see below what these methods are and their effectiveness which is measured with the Pearl index.

Pearl’s index of a total of 100 women measures how many became pregnant over the course of a year using that method. Practically it defines the failure rate of the method used, from the safest to the least safe.

 

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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