Methods of long-term contraception, i.e. long-acting contraceptives (methods other than the contraceptive pill) - are considered to be one of the most convenient and, at the same time, the most effective forms of preventing unwanted pregnancy. Depending on the method, long-term contraception is used once a month, once every 3 years or even every 5 years. Learn about the methods of long-term contraception available in Poland.

Long-term contraceptionis recommended for busy (and forgetful) women. They are effective contraceptive methods and do not need to be used every day. They are often chosen as an alternative to birth control pills, which you have to remember every day.

Advantages of long-term hormonal contraception

The comfort of use and the effectiveness of contraception have a significant impact on a woman's decision about which form of protection will be the best for her. Methods of hormonal and mechanical contraception administered in a different way than orally are recommended primarily to women who are not disciplined and who have sometimes forgotten to take hormonal pills regularly.

- In today's society, 24 hours is not enough for duties related to study, work, organizing family life and meeting friends. In this case, it is difficult to remember everything - including taking contraception every day. The solution for a woman who lives intensively are convenient - because unusual - methods of hormonal contraception, which also mean that a woman has one less information to remember - says Dr. Tomasz Sobierajski, a sociologist at the Institute of Applied Social Sciences of the University of Warsaw.

When using long-acting contraceptive methods, it is easier to ensure the effectiveness declared on the leaflet, because the chance of making a mistake in the scheme of hormone delivery to the body is reduced. The contraceptive pill can be unintentionally forgotten, and intestinal problems causing diarrhea or vomiting can remove the hormones from the body before they can be absorbed, thereby reducing the contraceptive effect of the method used.

Important! Contrary to popular belief, most antibiotics do not affect the effectiveness of the tabletscontraceptives. Only Rimfapicin, used for example in the treatment of tuberculosis, can interact with birth control pills.

Methods of long-term contraception

The methods of contraception with a longer duration of action include:

  • contraceptive patch,
  • vaginal contraceptive ring,
  • hormone injection,
  • endocrine intrauterine system,
  • intrauterine device (spiral),
  • contraceptive implant.

When selecting each of the above methods of contraception, consultation with a physician is required, who will help you choose the method that is right for you. The patient, on the other hand, may suggest to the doctor that she leads an active lifestyle and would like, apart from being highly effective in contraception, to be comfortable in using contraception and to be safe in terms of as few side effects as possible.

Long-term contraception - contraceptive patch

The contraceptive patch - is a square-shaped transdermal patch that consists of three layers. There is an adhesive in the inner layer, thanks to which the patch maintains proper adhesion to the skin. The hormones (estrogen and progesterone) are continuously released from the patch and, once absorbed through the skin, enter the bloodstream directly. When using a patch, it is necessary to stick it on the same day of the week. After three weeks of using it, you should take a seven-day break, during which there will be withdrawal bleeding. If a woman wants to postpone her period, she can start using another packet of the drug instead of the seven-day break.

Advantages:The contraceptive patch is easy to use and you can stick it on yourself without visiting a gynecologist. Hormones penetrate the skin directly into the blood, thanks to which they bypass the digestive system. If you make a mistake in using the method (e.g. you forget to apply a new patch), the old patch gives you 48 hours of additional contraceptive protection.

Efficiency- 99%. The Pearl Index for the contraceptive patch's effectiveness is 0.6-0.9 .

Disadvantages:Too high BMI (>30) can affect the level of hormones delivered by the patch and affect their effectiveness. In some women, the contraceptive patch may irritate the skin, cause spotting or bleeding.

What don't you know about contraception?

Long-term contraception - vaginal contraceptive ring

The vaginal contraceptive ring is made of flexible, soft plastic materi althe shape of a "bracelet" with a diameter of slightly more than 5 cm and a cross-section of 4 mm. It is resistant to mechanical damage. Its innovation lies in the fact that it contains a small amount of two female hormones: progestogen and estrogen, which are released all the time after being placed in the vagina and penetrate into the bloodstream. During the visit, the doctor teaches the woman how to insert the contraceptive ring in the future. The ring should be squeezed with your fingers and inserted into the vagina on the first day of the menstrual cycle. It is put on and removed in a similar way to inserting a hygiene tampon. After three weeks, the user removes the ring on her own, and then takes a seven-day break for withdrawal bleeding. During the twenty-one days that the ring must be in the vagina, it can be removed for up to three hours. If the ring falls off spontaneously, wash it in cold or lukewarm water and put it back on as soon as possible.

Advantages:The vaginal contraceptive ring contains a minimal amount of estrogen (15 µg). A small dose of hormones causes that women who use the ring less often than those who use, for example, pills, suffer from headaches, breast tenderness, nausea and get fat. The ring allows good cycle control. It is imperceptible - which is why it is well tolerated by women and accepted by their partners. It is applied once a month. The contraceptive ring remains effective if the ring is removed and reinserted within 3 hours. However, it should not be removed during sexual intercourse.

Efficiency99%. The Pearl Index for the effectiveness of the vaginal method is 0.65.

Disadvantages:Women initially need to learn how to apply the vaginal ring properly, but it becomes easier and easier as pharmacies have applicators to help insert the ring.

Long-term contraception - contraceptive injection

The contraceptive injection is the method of choice for women who are breastfeeding six weeks after giving birth. It is also a good form of contraception for women with systemic diseases. It is given by intramuscular injection once every 12 or 8 weeks. After this time, the next dose is given. The injection contains a large dose of one hormone, the progestogen. The injection stops ovulation by thickening the cervical mucus, which in turn affects its impermeability for sperm and prevents the implantation of the embryo. In Poland, this method is used relatively rarely.

Advantages:All the time in actionThe female injection is practically 99% safe. Used once every three months. Injection reduces premenstrual symptoms (PMS). In nursing women, the injection is indifferent to the composition of the food.

Effectiveness:The Pearl Index for the effectiveness of the contraceptive injection is 0-1.

Cons:The injection must be given by a doctor or nurse. The effect of the injection is at least three months of infertility. Full fertility does not return until several months after stopping the injections. This method may have an impact on weight gain and mood swings.

Long-term contraception - IUD (spiral)

IUD (spiral) - this method is recommended for women who have already given birth and are unlikely to plan to have children, and for those who do not want to or cannot use hormonal methods. The insert is made of polyethylene also with the addition of silver or copper. Its shape resembles the letter T.

The insert is effective for all days of the monthly cycle. Depending on the type, it may perform its function for 3 to 5 years. The device is inserted by a doctor during menstrual bleeding, when the entrance to the uterus is slightly dilated.

Advantages:Prevents pregnancy up to 5 years. The doctor can remove it when the woman wants to become pregnant. Reduces monthly bleeding.

Efficiency:The Pearl index, which determines the effectiveness of the spiral, varies from 1 to 4 depending on the model of the insert.

Cons: Not recommended for women who have not given birth. Increases the risk of vaginitis. After inserting the IUD, the woman's body has to get used to the "foreign body", so pain may appear in the initial period of use.

Long-term contraception - hormonal IUD

Hormonal IUD - is a plastic IUD that is placed in the uterus for up to 5 years. The design is very similar to a regular IUD, but additionally has a tiny reservoir with the hormone progestin, which is evenly released throughout the use of the IUD. The released hormone thickens the cervical mucus, which prevents sperm from getting through it. It is a contraceptive method that combines the advantages (and disadvantages) of a traditional spiral with the contraceptive pill.

Advantages:The hormonal insert, thanks to the local release of a progestogen, causes a significant reduction in the volume and duration of menstrual bleeding, and even in some patients it causes a complete cessation of menstruation.

Effectiveness:Pearl indexdetermining the effectiveness of the hormone insert is from 0.2 to 1.

Disadvantages:The hormone (progestogen) works locally and does not exhibit systemic effects typical of, for example, oral contraceptive pills. The use of a contraceptive coil requires regular visits to the gynecologist three months after inserting the IUD.

Long-term contraception - contraceptive implant

The contraceptive implant is implanted under the skin (on the inside of the arm) for 3-5 years. The implant is the size of a match (4mm x 2mm) and works by preventing ovulation, preventing sperm from reaching the egg, and inhibiting the cyclical maturation of the endometrium. After the contraceptive implant is removed, fertility returns in the next menstrual cycle.

Advantages:The implant constantly releases a small amount of hormone, so that the effectiveness of this method is not reduced by vomiting, diarrhea or taking antibiotics.

Efficiencyover 99%. The Pearl Index describing the effectiveness of the contraceptive implant is 0.01.

Disadvantages:You may experience irregular bleeding when using this method.

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Pregnancy