Medications to prevent pregnancy

Definition

There is talk of a state of pregnancy when a woman, in her fertile period, carries the fruit of fertilization in her womb. According to the thought of some authors, the pregnancy begins at the precise moment when the spermatozoon, reached in the fallopian tube, meets the egg and fertilizes it; others, on the other hand, believe that we can talk about pregnancy only when the embryo is implanted in the endometrium of the uterine wall.

Symptoms

Pregnancy is one of the most shocking and extraordinary periods that a woman encounters during her life: every woman reacts differently to what is happening to her, both emotionally and physically. It is difficult to describe a precise symptom picture that accompanies pregnancy, especially if the woman is facing her first gestation; the amenorrhea (the absence of menstruation) is undoubtedly the symptom common to the vast majority of pregnant women, often associated with breast tenderness with pain on palpation, asthenia, increased frequency of urination, dizziness, hypersensitivity to odors and / or food, increased basal temperature, urinary incontinence, nausea, vomiting. Other women do not realize that they are pregnant because they do not complain of any appreciable symptoms: what has been said highlights how each organism reacts in a completely subjective way to this wonderful experience.

Information on Pregnancy - Drugs to avoid pregnancy is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Pregnancy - Medications to prevent pregnancy.

Drugs to avoid it

Paradoxically, to date, in our modern civilization, unexpected pregnancy is still seen as a taboo: unmarried couples who give birth to a new life are sometimes looked at with a strange eye. Children, young people, should be carefully instructed about contraceptive methods to avoid (or prevent) pregnancy, when (clearly) it would be undesirable; some women may even decide to terminate the pregnancy if it has already started, usually by the 16th week of gestation. Clearly, the subject is very delicate and risks leading to equally thorny reflections: therefore, the objective of this article is certainly not to make the reader reflect, but rather to describe, in an objective and detached way, all the preventive methods to pregnancy, to avoid it both before implantation (hormonal, mechanical or natural contraception), and when the implant has already occurred (chemical abortion methods).

Hormonal contraceptives (prevention of pregnancy to avoid conception)

Hormonal contraceptives prevent ovulation, therefore inhibit the release of the egg from the ovaries; in addition to this fundamental concept, hormonal based contraceptives also act by increasing the density of the cervical mucus, which prevents the passage to spermatozoa. Furthermore, the hormonal contraceptive, by modifying the environment of the fallopian tubes and the intrauterine site, prevents implantation and fertilization. Let's see below what are the most commercialized contraceptive methods:

• transdermal patch (formulated with progestins and / or estrogens): it is a drug that acts transdermally by releasing ethinyl estradiol and norelgestromin (respectively, estrogen and progestin hormones) which, through the skin, reach the bloodstream avoiding ovulation.

For example:

• Evra: the trans dermal patch (4 cm per side) contains 6mg of norelgestromin and 600mcg of ethinyl estradiol. Apply the patch on the first day of menstruation and keep it in that position for a week. Replace it the following week, on the same day you started. Repeat the application until the third week. During the fourth week, menstruation takes place. After the fourth week, repeat the therapy pattern just described.

• Vaginal ring :
  • ethinyl estradiol + etonogestrel (eg Nuvaring): the contraceptive ring, flexible with an external diameter of 54 mm and a transversal diameter of 4 mm, contains 11.7 mg of etonogestrel and 2.7 mg of ethinyl estradiol. Insert the ring deeply into the vagina on the first day of the menstrual cycle and hold it for three weeks. After 21 days, remove the appliance for 7 days, during which menstruation takes place. Then proceed with the treatment scheme described above.

• Spiral or IUD : alternative contraceptive method, introduced into the woman's uterus by a gynecologist during menstruation and left there for a few years. The method prevents fertilization or obstructs the implantation of the embryo in the woman's uterus. The device contains progesterone, which is released gradually.

• Contraceptive or contraceptive pill : estro-progestinica (combined) or mini-pill (formulated only with progestins). It is one of the most widely used hormonal contraceptive methods ever, preferred by young and very young people with a fixed partner. The contraceptive pill has a high margin of contraceptive reliability (up to 99.9%), but does NOT protect in any way from sexually transmitted diseases.
  • Ethinyl estradiol / Levonorgestrel (eg Loette, Microgynon, Miranova, Egogyn): these are useful contraceptive pills to avoid conception and to inhibit the overproduction of gonadotropins, which as we know is the main triggering cause of polycystic ovary. These drugs are available in packs of 21-28 tablets: each tablet consists of 0.02 mg of ethinyl estradiol and 0.1 mg of levonorgestrel. The pharmacological treatment involves taking one tablet a day, for 21 days, possibly at about the same time each day, followed by a free one-week interval.
  • Desogestrel / Ethinylestradiol (eg Gracial, Novynette, Lucille, Dueva, Securgin): these are coated tablets, consisting of 20 mcg of ethnyl estradiol and 150 mcg of desogestrel. The dosage and method of administration reflects the one described above.
  • Desogestrel (eg. Cerazette): it is the minipillola, formulated with progestogen hormones only (it is not formulated with estrogens). The effectiveness of the mini-pill is comparable to that of the common combined contraceptive pills; in general, fewer side effects occur from the administration of a similar drug.
  • Norethisterone enanthate (eg Primolut NOR): long-acting progestin given by injection; causes complete contraception for eight weeks. Used only as a short-term hormonal contraceptive method. The drug is also useful for preventing ectopic pregnancy and ovarian cysts.
  • Medroxyprogesterone acetate (eg Farlutal, Provera G): it is a long-acting progestin, administered intramuscularly to the woman: its effectiveness is comparable to that of combined hormonal contraceptives, although it can create unpleasant side effects ( eg menstrual alterations and delayed recovery of fertility after its suspension, reduction of bone density, osteoporosis). The administration of this drug in young women is recommended only if the other contraceptive methods are not appropriate. It is recommended not to use the drug for over two consecutive years and not to use in case of a tendency to osteoporosis.

Non-hormonal contraception: barrier method: the use of condoms, from the initial moment of the relationship, is the only method that ensures coverage not only from pregnancy, but also from sexually transmitted diseases. The contraceptive pill, in fact, although it ensures excellent protection from unwanted pregnancies, does not in any way cover the possibility of contracting a venereal disease. From these words we understand how occasional sexual relations, with different partners, should always be protected with a barrier method.

• Condom: barrier-based contraceptive method par excellence, able to ensure protection from unwanted pregnancies and sexually transmitted diseases equal to 98-99.8%.
• Diaphragm: it is a small soft rubber dome, mounted on a malleable and flexible ring, to be inserted near the cervix before sexual intercourse. The contraceptive method is rather complex to insert, besides not being completely safe; consequently it is a contraceptive practice that is now being abandoned. The failure rate is estimated at around 20%.

High-risk contraception :

there are so-called "natural" contraceptive methods (admitted by the church and by religion) to avoid pregnancy; the fundamental point is that they are NOT RELIABLE like hormonal or mechanical contraceptives (condoms). It is therefore recommended to avoid the implementation of similar methods described as "contraceptives" if pregnancy is not desired in any way. However, the natural contraceptive methods are listed below:

1. Interrupted coitus: unfortunately very practiced by young and very young, the highly risky method consists in the immediate and prompt interruption of sexual intercourse a few moments before ejaculation: in this contraceptive practice (only apparently safe), the man avoids that sperm enter the vagina.
2. Basal temperature method: the woman's basal temperature is subject to fluctuations during the 28-day cycle. It seems that during ovulation the basal temperature increases by 0.5-0.6 ° C. The most fruitful period for the woman begins 3 days before the increase in the basal temperature and ends 3 days later: in case the woman wanted to avoid pregnancy, she should refrain from relationships just in this period.
3. Ogino-Knaus method or calendar method: (useful, above all, to obtain the opposite effect, since with this method the woman understands in which days it is more fertile). According to this practice, it seems that the woman is fertile from the 10th to the 18th day of the cycle: in this period of time, the woman should refrain from sexual relations with the partner. The contraceptive guarantee is particularly low: only women with a very regular menstrual cycle of 27-32 days could ideally make use of this practice.
4. Billings method: consists in the evaluation of cervical mucus. When the woman is in the ovulatory phase, the mucus appears more dense and stringy (it coincides approximately with half of the cycle); therefore, to avoid pregnancy, the woman should refrain from reporting during this period.

Post-coital contraception:

Let's clarify immediately a fundamental concept, in order to avoid doubts or perplexities: post-coital contraception should not be considered a first choice contraceptive method, as is the contraceptive pill.

Contraceptive methods that avoid pregnancy after a risk relationship should only be used if you are at high risk of becoming pregnant (when, of course, pregnancy is unwanted). Let's see what the possible methods are:

1. Post-coital oral contraception or morning-after pill : it is a pill that has nothing to do with the ones described above, even though it is formulated with hormones. We are talking about a progestin preparation indicated ONLY for urgent contraception, to be taken - it is good to specify it again - following a potentially and highly risky sexual relationship with a pregnancy. The drug can be sold under a non-repeatable medical prescription, to be taken no later than 72 hours after the relationship at risk. It is NOT an abortive method because it has no effect on the embryo implantation and does not prevent the sperm from entering the egg. Levonorgestrel (eg. Norlevo, Levonelle): the morning-after pill is formulated with 750 mcg of levonorgestrel. Each pack consists of two pills, to be taken simultaneously within 72 hours of the report. The sooner the morning after the pill is administered following a risky relationship, the greater the chances of this effect. The dosage of the progestin in the morning-after pill is 20-30 times higher than that of the common contraceptive pills: the two pills exert their therapeutic action in a different way.

2. Copper IUD spiral (copper exerts a good spermicidal effect): even this contraceptive practice can be considered a post-coital contraceptive method. In this case, the insertion of the spiral must take place within 7 days after a relationship with a risk of pregnancy.

Drug-induced abortion :

1. Abortion pill or RU-486 (eg Mifegyne): which should not be confused with the morning-after pill. The abortion pill is formulated with a synthetic steroid, mifepristone, to be taken within two months of pregnancy. It is formulated as a pill to be taken by mouth and does not require surgery. While the morning-after pill acts on ovulation, the abortion pill is able to stop pregnancy by exerting its action on the implantation of a possible embryo. For the dosage, consult your doctor.

All couples who decide to have sex should be aware that they run the risk of an unwanted pregnancy; therefore, the implementation of natural strategies for the respect of some ethical and moral rules does not make much sense. The safest contraception is certainly the preventive one, using a condom or the contraceptive pill: to underline, however, that no contraceptive method gives a 100% guarantee.

Only complete abstention from sexual relations (ergo chastity) ensures absolute "protection" from pregnancy.