Contraception

Definition

Contraception is the term used to describe methods that cause a temporary and reversible loss of fertility, thereby preventing unplanned pregnancies. Choosing the right method of contraception is a highly individual decision. It depends primarily on the patient’s age and health, her body type, her medical history, and other factors.

How reliable is it

Great emphasis is placed, above all, on the reliability of contraception; this parameter is indicated by the so-called Pearl Index, which specifies the number of unintended pregnancies among 100 women per year while using a given method of contraception. The figures in the table represent the percentage of women who experience an unintended pregnancy during the first year of using a given method.

Estrogen-progestin hormonal contraceptives

- consists of a combination of hormones containing estrogen and progestin.

Forms: tablets, patch, vaginal ring

Progestin-only hormonal contraceptives

- estrogen-free, containing only progestin.

Forms: tablets, intrauterine device (IUD) effective for 3 or 5 years

Intrauterine device (IUD)

Locally, 1,000 times fewer hormones are released compared to oral contraceptives, so there is no risk of side effects. The hormone acts directly on the uterine lining, ensuring high contraceptive efficacy while preventing inflammation.

An intrauterine device (IUD) is small and can be easily inserted into the uterus on an outpatient basis. The IUD can be removed at any time, and fertility is restored immediately after removal. It is also suitable for women who, for medical reasons, cannot take any hormones.

It is a combination of the gentlest, most reliable and cheapest method.

Non-hormonal contraception

- condom, pessary, diaphragm, intrauterine device, measuring temperature during the menstrual cycle

Local preparations

- inserted into the vagina before intercourse in the form of a pessary or cream

Short-term contraception

Short-term birth control methods can be further divided into those that are taken daily (pills) and those that do not need to be taken every day. The latter can be administered once a week (patches), once a month (vaginal rings), or once every few months (injections).

• pills containing the female hormones estrogen and progestin, or those containing only a low dose of progestin (so-called “mini-pills”). These are tablets that are taken every day, ideally at the same time each day
• the contraceptive patch contains estrogen and progestin and is applied by sticking it to the skin (buttocks, lower abdomen, shoulder, etc.). The patch is replaced with a new one every week.
• a vaginal ring that is inserted into the vagina once a month; it is removed after 3 weeks, followed by a 7-day break during which menstrual bleeding occurs
• progestin injections, which are administered once every three months

Long-term contraception

Long-term contraception methods can be further divided into reversible (fertility returns after contraception is stopped or removed) and irreversible (fertility does not return).

With reversible methods, fertility is restored after contraception is stopped or removed. These include:

• a hormonal intrauterine device (IUD) that is inserted into the uterus. The IUD contains progestin (a hormone produced by the corpus luteum), which thickens the cervical mucus. This makes it impenetrable to sperm, preventing them from reaching the egg and thus preventing fertilization. For more details on this type of IUD, see the separate page dedicated to the hormonal intrauterine device.
• a non-hormonal intrauterine device (IUD), which is also inserted into the uterus but does not contain hormones. It is usually made of copper, silver, or gold. A gold-based IUD has a positive effect on the length and intensity of the menstrual cycle
• subdermal implants, which are currently not available on the Czech market
• the irreversible method, which includes sterilisation, leads to permanent loss of fertility, but at the same time preserves the normal function of the sex glands

Problems when using contraception

If you are not satisfied with the chosen contraceptive method, you bleed outside your cycle, or you experience irregular bleeding or other side effects, continue taking the contraception and discuss your problems with us.

Factors affecting the effect of contraception

Some factors can affect the effectiveness of contraceptive pills, and pregnancy can occur even with regular use of contraception.

This can happen with:

• acute diarrhea
• vomiting
• taking antibiotics
• cleansing treatments such as chlorella
• drinking certain herbal teas (St John's wort)
• taking laxatives
• taking certain antiepileptic drugs

Contraception and thrombosis

Hormonal contraception can increase the risk of thrombosis, but the absolute risk for patients without risk factors is small.

Symptoms and warning signs of acute thrombosis / pulmonary embolism:

• shortness of breath
• chest pain
• severe one-sided pain in the calves
• rapid pulse, dizziness, tachycardia
• visual disturbances
• severe headaches
• fainting with or without convulsions

Circumstances that rule out the use of contraception

Hormonal contraception can increase the risk of thrombosis, but the absolute risk for patients without risk factors is small. There are circumstances that rule out the use of any contraceptive method; it always depends on the doctor's assessment. For example:

• arterial or venous thromboembolic events
• predisposition to venous or arterial thrombosis
• migraine with aura
• malignant tumours of the genital organs
• unexplained vaginal bleeding outside the cycle
• suspected or confirmed pregnancy
• hypersensitivity to any component of the product