Tips from the gynecologist

Which method of contraception is best for you

Young women in particular often lack information about contraception.

(Bild: stock.adobe.com/drubig-photo )

Young women are often unclear about contraceptive options and come across many false reports when searching for information on the internet. However, not every method of preventing pregnancy is equally suitable for everyone. A gynecologist explains.

Basically, Prof. MR. Dr. Friedrich Gill, gynaecologist in Vienna, sees a trend towards hormone-free contraception - for example in the form of the copper IUD. The small, flexible, T-shaped plastic structure is inserted into the uterus and remains in the body for between three and five years, depending on the copper content. Copper IUDs, chains or balls work according to the same principle. "The release of copper ions influences the mobility of the hairs in the fallopian tubes, where fertilization takes place, and of course also serves as a mechanical obstacle in the uterine cavity," explains the expert

What speaks for or against the pill, IUD, hormones 
"With a hormonal IUD, the release of the hormone progesterone causes the mucous membrane in the uterus to shrink, preventing the implantation of any fertilized egg. In addition, the mucus in the area of the cervix thickens, making it more difficult for the sperm to ascend," the gynecologist continues.

Pill, coil or condom? Different factors are decisive for the choice of contraceptive.

(Bild: stock.adobe.com/JPC-PROD )

A prerequisite for contraception with an IUD is an examination of the uterine cavity, as Dr. Gill emphasizes. "Certain uterine shapes are a contraindication. This applies in particular to a heart-shaped uterine cavity or a two-part uterine cavity. In these cases, the IUD comes to rest in one corner and pregnancy is likely to occur via the other half of the uterus."

Sometimes, however, a hormonal IUD would be preferable, for example in the case of heavy or very painful menstrual bleeding. "With this, there is little to no bleeding in the uterus during the time it is in place and this results in no or greatly reduced menstrual cramps," says Dr. Gill. Other hormonal contraceptive methods include the contraceptive pill, contraceptive patches, rings or sticks.

A prerequisite for contraception with an IUD is an examination of the uterine cavity, as certain types of uterus are contraindicated.

Prof. MR. Dr. Friedrich Gill, Frauenarzt in Wien,

Bild: Gill

Don't underestimate the influence of lifestyle!
"Until a few years ago, the majority of women chose contraception in pill form, but this has led to problems due to changes in lifestyle. The greatest potential risks include increasing cigarette consumption and an unhealthy diet, sometimes resulting in massive obesity. Hormonal contraception, in particular oestrogen, can have a negative effect on blood clotting, meaning that women often suffer thrombosis or, in the worst case, an embolism, which can lead to sudden death."

Before taking the pill, it is essential to determine the APC resistance index, which indicates an increased risk of a blood clotting disorder. Another limiting factor for this contraceptive method is severe obesity, where Dr. Gill advises the patient in question against a combined pill. 

A detailed gynecological consultation is important.

(Bild: stock.adobe.com/Siphosethu F/peopleimages.com )

"The so-called mini-pill could reduce the risk of thrombosis somewhat in smokers because, unlike oestrogen, progesterone has hardly any effect on blood clotting. The advantage of the mini-pill over a combined pill, as with the hormone coil, is that the mucous membrane in the uterus shrinks and there is hardly any menstrual bleeding if the pill is taken exactly."

However, you have to stick very precisely to the times when you take the pill, otherwise you will experience recurring bleeding between periods. "The effect can also be achieved by placing a contraceptive stick subcutaneously (note: under the skin) on the inside of the upper arm. This has a shelf life of three years and eliminates the need to take a pill every day."

Contraception is still a woman's issue
When asked when the male pill will finally be available, Dr. Gill explains: "As it is more difficult to prevent millions of sperm from being fertilized every day, it will probably take many more years of research to develop safe contraception for men."

The gynecologist is skeptical about men's willingness to move in this direction. "There are already new developments on the market, but they are unlikely to be popular. One of them is a reversible closure of the vas deferens by means of a 'clamp', which is placed in the scrotum and clamps off the vas deferens before sexual intercourse, preventing sperm from swimming into the ejaculate. However, I don't believe that the inventor will sell a large number of them to men."

Although all these methods can prevent an unwanted pregnancy, they cannot prevent infection with a sexually transmitted disease. Only the condom offers the best possible protection.