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  • Title: [Contraceptive methods].
    Author: Creus ME.
    Journal: Rev Enferm; 1981 May; 4(34):36-40. PubMed ID: 6914729.
    Abstract:
    This brief article provides a review of the most common contraceptive methods. Contraceptive methods may be classified into primitive, traditional, and modern categories. Among primitive methods, coitus interruptus has a failure rate of 10-38%. It is not recommended by sexologists because of its possible physical and psychic secondary effects. Vaginal irrigation or washing immediately after intercourse are not effective because sperm arrive in the uterus seconds after ejaculation into the vagina. Prolonged lactation is not an effective method because of the impossibility of predicting the return of ovulation. Among traditional methods, the condom and diaphragm are relatively effective but not usually well accepted. Condoms are effective if the material is of high quality and they are properly positioned and removed before detumescence. The failure rate varies from 8-28%. Diaphragms are inserted into the vagina 2-4 hours or immediately before coitus and must remain in place for 6 hours after ejaculation. The correct size is determined by a physician. The proportion of failures is 20% for the diaphragm used alone and 10% when a spermicide is added. Local spermicides have the double objectives of mechanically blocking the cervix and chemically destroying sperm. They should be inserted deep into the vagina immediately before coitus and remain in place for 6 hours. They have a failure rate of 30% when used without other contraceptive methods. They are available in the form of creams, jellies, sprays, vaginal suppositories or tablets, and effervescent pills. Periodic continence methods require total sexual abstinence during the fertile periods of the menstrual cycle. The Ogino-Knaus method is based on a calendar estimation of the fertile days which normally occur between 19 and 12 days prior to the next menstrual period. The proportion of failures is over 14%. The method is without secondary effects but its acceptability is limited because of its interfrence with sexual expression and high failure rate. The basal temperature method requires sexual abstinence between the beginning of the cycle and the 3rd day after the periovulatory temperature rise. The method has a failure rate of 1-4% but is less widely used than the Ogino-Knaus calendar method because of its inconvenience, greater sexual restrictions, and difficulty of interpretation. Among modern methods, combined oral contraceptives (OCs) have the lowest failure rate, .1%. They function by interfering with the mechanism of ovulation. OC formulations vary by dose, hormones utilized, and form of administration. The physician must decide the appropriate formulation for each woman. IUDs have a failure rate of 3%. They are contraindicated for women with alterations of the genital organs, infections, abnormal uterine bleeding or pregnancy. Among permanent methods, vasectomy is a simple and quick operation which provides complete sterility for men about 8-10 weeks after operation. Tubal ligation by various surgical techniques is the most common form of contraceptive surgical sterilization for women. No currently used contraceptive method can be considered ideal.
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