Overview of contraception methods
Synonyms in a broader sense
Medical: contraception
Contraception, birth control, contraception, contraceptives
definition
Pregnancy prevention (contraception) is understood to mean all methods that aim to ensure that after sexual intercourse (cohabitation) there is no fertilization of the egg cell (oocyte) by the sperm.
How safe are the individual contraceptive methods?
To indicate the safety of contraceptive methods, the so-called Pearl Index is usually used. This value is calculated from the pregnancies that occurred in 100 women over a period of one year in spite of the respective contraceptive method.
Therefore, a particularly low Pearl Index indicates that the contraceptive is very safe.
When specifying the Pearl Index, however, it is usually not stated whether the number of pregnancies that occurred was simply due to an uncertainty of the method of contraception itself, or whether the improper use of the contraceptive also had an influence on the pregnancies that occurred. The Pearl Index is therefore to be viewed critically and only as an approximate guide value.
You will also find a list of some contraception methods and their Pearl Index values:
- Calendar method = Knaus - Ogino - contraceptive method - 3 if used correctly, otherwise 9
- Temperature method - 3
- Billings Method - 15
- Symptothermal method (SMT) (Rötzer method) - 1-2.2
- Coitus interruptus = interrupted sexual intercourse shortly before ejaculation - 35
- The condom - 0.6-10
- Birth control pill - 0.2
- Hormonal IUD - 0.1
- Copper chain - 0.2
- Sterilization - 0.2
- Three-month syringe - 0.4
- Female condom - 12
Attention: Depending on the literature, you will find slightly different values.
The condom
The condom is one of the best-known and most common contraceptive methods and offers a decisive advantage:
It is the only contraceptive that not only prevents pregnancy, but also protects against sexually transmitted diseases.
The condom is slipped over the erect penis before sexual intercourse, so that ultimately the penetration of sperm into the female vagina is prevented.
The safety of this contraceptive depends crucially on correct use and the right size selection.
Avoid mistakes when using the condom by reading our article Put the condom on properly to inform.
The pill
The birth control pill is one of the hormonal contraceptives that prevent ovulation and thus a possible pregnancy by interfering with the female hormonal balance.
The conventional pill contains the hormones estrogen ’and progestin’ and is generally considered a very safe contraceptive.
Interfering with the hormonal balance can - as with any other drug - possibly lead to side effects.
Are you particularly interested in this? Find out more through our article: Side effects of the pill
The IUD belongs to the group of so-called intrauterine devices.
This means that it is inserted into the woman's uterus and takes effect from there.
The insertion of an IUD is mainly recommended for women who have already given birth.
The IUD releases the hormone progestin ’at regular intervals and prevents the woman from becoming pregnant.
You can find more detailed information about spirals on our category page: spiral
The copper chain
The copper chain also belongs to the group of so-called intrauterine devices, which are inserted into the woman's uterus.
Compared to the conventional hormone IUD, however, it unfolds its effect without interfering with the female cycle and offers a good hormone-free alternative to this.
The copper chain is smaller than, for example, the copper spiral and, due to its shape, can adapt better to the female body.
It is therefore particularly suitable for young women who have not yet given birth.
Find out more about the copper chain at: GyneFix® copper chain
sterilization
The possibility of sterilization as a contraceptive method is mainly only carried out at an advanced age after the desire to have children has been fulfilled.
In men, the so-called sperm duct is cut through for this purpose, so that ultimately no sperm can get from the testicles into the ejaculate during ejaculation.
In the woman, the fallopian tubes are cut so that fertilization cannot occur.
It is very important to remember that undoing the sterilization is extremely difficult and will not always work.
Sterilization should therefore never be carried out hastily, but should be carefully considered and planned.
Three-month syringe
The three-month injection is a hormonal contraceptive method in which the woman is injected with a hormone-containing substrate every three months by her attending gynecologist.
The advantage is that there is no need to think about contraception in the period between injections and you don't have to take a pill every day.
For more information, read on: Everything about the subject of three-month syringes
The female condom
The female condom is a hormone-free contraceptive and, like the male condom, prevents sperm from entering the uterus.
It is a tubular structure in which the open end protrudes from the vagina and the closed end covers the cervix.
Calendar method = Knaus - Ogino - contraceptive method
The calendar method was introduced as a natural method of contraception by Hermann Knaus and Kyusaku Ogino in the 1930s. According to the WHO (World Health Organization), however, this method should be used today Not can more be counted among the natural contraceptive methods because it is very unsafe.
The calendar method is based on using the natural menstrual cycle to determine when the "fertile days" will take place. During these fertile days you should then refrain from sexual intercourse and thus prevent pregnancy.
The idea is based on the fact that fertilization of the egg cell (oocyte) can only occur within a certain period of time, namely around ovulation.
With a cycle of 28 days, ovulation occurs around the 14th day (more precisely between the 12th and 14th day) after the start of the last menstrual period.
The egg cell can only be fertilized 5 to 12 hours after ovulation. Sperm, on the other hand, have a survival time of around three days. So the idea of the calendar method is that you cannot get pregnant with a safety margin of three days to either direction from ovulation.
In practice, women who want to use this method of contraception have as regular a menstrual cycle as possible and have to record it for over a year.
The records are then used to determine how long the shortest and how long the longest menstrual cycle was. If you have this data, the beginning and the end of the fertile days can be calculated.
Using the Knaus method, 17 days are deducted from the shortest cycle. The result then corresponds to the first fertile day. 13 days are deducted from the longest cycle. The result in turn corresponds to the last fertile day.
Are you interested in other hormone-free contraception methods? Find out more about the topic on our overview page:
- Hormone-free contraception
Pearl Index
How safe the individual contraceptive methods are is checked in clinical studies. The reliability of a particular contraceptive can be assessed using the Pearl Index (PI).
The Pearl Index shows how many out of 100 women got pregnant using a single specific method of contraception in a specific period of time. A Pearl Index of 5, for example, means that 5 out of 100 women became pregnant using a certain method of contraception. The bigger is the numerical value of the Pearl Index, the more unsafe is the contraceptive.
Example menstrual cycle
Shortest cycle = 25 days? 25 days - 17 days = 8th day
Longest cycle = 28 days? 28 days - 13 days = 15th day
This means that the first fertile day is the 8th day after the beginning of the last Menstrual period and the 15th day after the start of the last menstruation would be the last fertile day. So you should abstain during this period.
Ogino's method is based on the same principle, but subtract 18 days from the shortest cycle and 11 from the longest cycle.
The calendar method is rated overall with a Pearl index from 15 - 38 (!), depending on the study, than rather unsure to watch. It is also tied to strict discipline and respect on the part of the partner. This method can generally only be used for women with a regular cycle. But even for women with a regular cycle, this can be drastically lengthened or shortened due to illnesses, psychological stress or various environmental influences, so that the calculated fertile days do not match the actual fertile days and therefore no sufficient protection is guaranteed.
Temperature method
The principle of temperature measurement for contraception is based on the fact that after ovulation there is an increase in body temperature of approx. 0.5º Celsius. This happens around the 14th day after the last menstrual bleeding. On this day, the corpus luteum also begins its function. The corpus luteum produces the sex hormone progesterone, the rise of which leads to an increase in temperature.
The determination of the temperature can thus be used to determine the time of ovulation. Since pregnancy cannot normally occur about three days after ovulation, it can be assumed that an egg cell will no longer be fertilized after a three-day increase in temperature of 0.5º Celsius.
In practice it looks like the woman has to determine the basal temperature. This is the temperature shortly after you wake up and before you get up.
The temperature should therefore be measured in bed in the anus (rectal) or under the armpit (axillary). You should always determine it in the same place on the body in order to have the most accurate possible comparison of the basal temperatures of the different days.
If possible, it should also take place under the same conditions. This means that, ideally, the temperature should be measured at approximately the same hour, after approximately the same number of hours of sleep, etc.
Overall, the temperature method, with a Pearl Index of about 3, is a method that not necessarily sure is.
The disadvantage is certainly that you have to keep a temperature calendar consistently. Failure to take a measurement renders the method unusable. The measured temperatures can also be inaccurate for a variety of reasons. An illness that is accompanied by a fever, too few hours of sleep or psychological stress can quickly lead to incorrect temperature measurements. Also, some women do not have such a clear basal temperature that increases in the second half of the cycle and therefore cannot use this method.
Read more on the subject at: Ovulation and temperature
Billings Method
The Billings method uses the consistency of the uterine mucus (cervical mucus) to determine the infertile days.
The idea is based on the fact that the uterine mucus becomes more fluid and clearer shortly before ovulation, during ovulation and shortly afterwards. It is so to speak "spinnable". This means that during this time the mucus can be pulled into a thread between two fingers, for example. During this time the woman is capable of fertilization.
During the rest of the cycle, however, the mucus is thicker and more crumbly. The amount of mucus is less. During this period, which takes place with a decent distance from ovulation, no pregnancy occurs.
If you use the method, you have to check and note the consistency of the uterine mucus every day. This is the only way to ensure that the time of ovulation can be determined and that the fertile days can be distinguished from the infertile ones.
The Billings Method has a Pearl Index of around 15, which is relatively high compared to other contraceptive methods.
The high Pearl Index can in part be explained by the fact that the consistency of the mucus can be incorrectly assessed by women and thus sexual intercourse is not avoided during the fertile days and the egg cell is fertilized.
Another explanation for the high Pearl Index is that due to a hormonal imbalance, the mucus becomes spinnable at a time other than ovulation.
The woman can then mistakenly interpret this time as the time of ovulation. She then refrains from sexual intercourse during this time, but then unknowingly has sexual intercourse at the actual time of ovulation and then possibly becomes pregnant.
It is also worth mentioning that about a third of all women do not have this phenomenon of the spinnability of the cervical mucus and for this reason cannot use this method.
Overall, this method is called not very sure to watch.
Symptothermal method = Rötzer method
The symptothermal method of contraception is a combination of the Billings method and the temperature method.
The days on which the cervical mucus can no longer be spun and the temperature has risen by approx. 0.5 degrees Celsius for three days are considered to be definitely sterile.
This method has a Pearl Index between 2.2 - 1.
Are you interested in other hormone-free contraception methods? Find out more about the topic on our overview page:
- Hormone-free contraception
coitus interruptus
Coitus interruptus is the term used to describe the interrupted sexual intercourse shortly before ejaculation. The man pulls his penis out of the woman's vagina shortly before orgasm and ejeculation. As a result, no semen should get into the vagina and the egg cell will not be fertilized.
With a Pearl Index of around 35, coitus interruptus is a very unsafe method. On the one hand, the man cannot pull his penis out of the woman's vagina in time, and on the other hand, sperm cells get into the vagina even before the ejaculation occurs.
It is also a great psychological burden for both partners, especially for the man, as he has to stop intercourse at the greatest moment of his sexual pleasure.
More about coitus interruptus from our partner
Read more on the topic: The first visit to the gynecologist
