It is necessary to take organized and conscious precautions to protect against pregnancy, otherwise an unwanted pregnancy may occur at the most unexpected moment.
A-Contraception methods (protects against pregnancy as long as the method is used, becomes pregnant when use is stopped). the ability to stay alive returns)
The features sought in birth control methods can be listed as follows; It should be easy and cheap to apply, It should be a reversible method, that is, the ability to become pregnant should start again when the use of the method is stopped, It should not have side effects, It should be reliable.
1-Hormonal contraception: OCs (birth control pills) injection applications, implants placed under the skin, and hormone-secreting substances placed inside the vagina.
Oral birth control pills were one of the safest methods, provided they were used regularly. Its protection reaches its highest level after the first month of use and continues as long as it is used. This is the most widely used method of contraception in the world today. Even though modern oral contraceptives are quite free from side effects, there are still some conditions that should be taken into consideration in their long-term use. The most important of these are cardiovascular side effects (side effects on the heart and vessels). These drugs have the same arteriosclerotic side effects as diabetes, hypertension and smoking. They are excreted from the body through the liver. Therefore, its use should be limited in women who have any of the arteriosclerotic factors listed above or who have liver problems. Your doctor will guide you in this regard.
Injection applications provide birth control with the same mechanism as oral pills. Although they have been on the market for many years, they have not been widely used anywhere in the world. The most important reason for this is that it often causes menstrual irregularities due to the irregularity in its hardening in the body after the application, and more importantly, there is no chance of giving up the application until the drug effect disappears on its own.
Implants placed under the skin can also be administered hormonally, such as contraceptive tablets or injectable drugs. from the ovaries They create a contraceptive effect by preventing egg release. The situation in these is the same as in injectable preparations. In order to abandon the treatment, the implant must be removed with even a minor surgical intervention. Menstrual irregularities are common during use. Both implants and injectable preparations are methods considered for patients who cannot take medication regularly.
Recently, substances that are inserted into the vagina and temporarily stop ovarian functions by secreting a certain dose of hormones as long as they remain in the body have also been introduced. These are placed into the vagina by the patient every month after a short training and are left in the vagina for a month. Its use has not become widespread yet.
2-Intrauterine devices.
These devices, classically known as "spiral", have been in use for many years. Although their reliability is less than birth control drugs, they are widely used due to their ease of use. Its logic is to create a foreign body effect inside the uterus, ensuring the presence of many cells involved in body defense in the region and ensuring the destruction of sperm by these cells. It can be left in the uterus for up to 7 years. The loss of its protective effect is due to the fact that the device is not covered by the intrauterine tissue and does not create a foreign body effect, or the patient does not perceive the device as a foreign body due to its constitutional characteristics. There are many speculations in society about intrauterine devices. One of them, as I mentioned before, is that its reliability is not 100%. Patients usually think that this is due to application error or the quality of the spiral, but the real mechanism is as I mentioned above. In other words, neither the application method, nor the identity of the practitioner, nor the quality of the IUD directly affects its protection. Another speculative factor limiting its use is society's beliefs. Especially in Anatolia, some clergy influence the public with thoughts such as "If you die with an IUD, you will be considered as dead". Ask anyone in practice, but people still think that intrauterine devices (IUDs) can only be inserted during menstrual periods. However, the biggest joke about inserting an IUD during menstruation is that one of the most important indicators that a woman is not pregnant is that she is menstruating. This is because r is . Nowadays, IUD can always be applied to women who can easily be determined not to be pregnant by other methods. Another factor that limits the application is that the procedure seems frightening to patients, which is absolutely not true. Midwives and doctors trained in this field can insert the device into the uterus very easily and without hurting the patient, if we ignore a few exceptional cases.
Side effects. These include occasional extra-menstrual bleeding or heavy menstrual bleeding, groin pain, and the possibility of ectopic pregnancy being slightly higher in IUD users. Especially since ectopic pregnancy constitutes one of the important problems of obstetrics and gynecology, patients who undergo IUD should be warned about this issue. In case of a possible menstrual delay, they should not avoid going to the doctor thinking "I have an IUD anyway". On the contrary, they should be more sensitive about this issue.
3-Barrier methods
These are methods that will prevent sperm from reaching the uterus and from there to the egg. It is the most commonly used condom for this purpose. There are also diaphragms placed inside the vein for the same purpose, but they have not become widespread due to difficulties in application. Apart from protecting against unwanted pregnancies, condoms are also more commonly used to avoid sexually transmitted diseases.
4-Calendar method and pulling out.
They are the least reliable methods. The calendar method can be summarized as avoiding intercourse 3-4 days before and 3-4 days after the possible ovulation date. It is a very unreliable method because the day of ovulation cannot be calculated incorrectly or exactly. Likewise, practices called pulling out or ejaculation are far from being an analytical method, although they are widely used in society.
5-“Morning-after pills”
Commonly known as “morning-after pills”. Drugs known as: are drugs taken within 24 hours following sexual intercourse in cases where an appropriate contraceptive method is not used. With the hormonal effect, it sheds the woman's endometrium, that is, the tissue inside the uterus, with a bleeding that mimics menstruation, thus preventing possible pregnancy. It allows you to avoid trouble. It is not possible to protect yourself regularly with this method. It may also cause bleeding disorders. However, in extraordinary cases, it is one of the secondary methods that can be used only once during a menstrual period.
6-Curettage (Carmen Aspiration):
It is the last resort to get rid of unwanted pregnancies. It is not included among the Protection Methods in any classic book because it is truly one of the inappropriate ways of protection. The procedure called Karmen aspiration is inserted into the uterus with a plastic cannula and the uterine content is evacuated by pulling it with a vacuum system. Although it can be easily explained in a few sentences, the practice is invasive. In other words, it is a surgical procedure, even if it is a minor one. As with all surgical procedures, there are some risks (if we try to summarize briefly and understandably, the pregnancy continues intact despite the procedure, some of the pregnancy product remains in the uterus, infections, perforation of the uterus during the procedure, the uterine wall sticking together depending on the procedure, etc.). .) Apart from this, we should not forget the negative psychological impact it has on women. It can never be used for regular protection purposes; it should be kept in mind as a last resort that can be used infrequently in extraordinary situations. According to the law, it is possible to remove pregnancies up to 10 weeks with this method. Even if there are no legal restrictions, the ability to destroy larger pregnancies with these and similar methods creates more serious medical risks.
B-Sterilization methods (once the method is applied, the effect continues permanently, but pregnancy can only occur with treatments using special methods). )
In this context, a surgical procedure called "vasectomy" can be performed in men, while a procedure called "tubal ligation" can be tied to the tubes in women. As you can see, although we have a method that can be applied to men, unfortunately, in our country, "protection" is perceived as a woman's responsibility, so men in our country generally tend not to allow this practice to be performed on them. Tubal ligation is commonly performed in women as part of a cesarean section during their last pregnancy, when the family will complete the number of children. Although it is performed manually, it can be performed laparoscopically at any time other than pregnancy, that is, by opening two holes in the abdominal wall, each with a diameter of 0.5 cm, without making a large incision in the patient's abdomen. It does not require hospital stay and the patient can be sent home on the same day. It should not be forgotten that this method is irreversible. In cases of necessity, a new pregnancy can only be achieved through the IVF (in vitro fertilization) method.
Prevention of unwanted pregnancies is basically examined under two headings
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