Contraception is now seen by many women as a natural way to plan their lives and reconcile career goals with the desire to have a family. A wide range of different methods offers individually tailored optimal contraception, but on the other hand often presents women with a difficult choice. Assistance in finding one’s way through the jungle of numerous, often new options is provided by the gynecologist.
Mode of action of contraception
Banally said, a contraceptive is a means to prevent pregnancy, thus a “contraception“. Hence the foreign word contraception (against conception). The possibilities are now so varied that it makes sense to find a classification for the different methods. First of all, a distinction can be made between contraception for men and for women.
At present, men can only use sterilization or condoms for contraception. A further distinction can be made between reversible and irreversible methods of contraception. Usually the former is meant when one speaks of contraceptives. However, sterilization of the woman or man are also – usually irreversible – methods of protecting against pregnancy.
Another classification is according to the way contraceptives work:
- Mechanical
- Chemical
- Hormonal
- Natural
The different methods can be combined. An ideal contraceptive method would have to be 100 percent safe and fast-acting, reversible, without side effects, easy to use and without affecting sexuality. So far, such a method does not exist. Therefore, various factors play a role in the question of which means are used.
Not only the Pearl index, i.e. the safety or failure rate, must be taken into account, but also age, concomitant diseases, rhythm of life, costs and – last but not least – individual preferences.
The Pearl Index
This important parameter reflects the safety of a contraceptive. The Pearl index indicates how many out of 100 women who use contraception for one year with a particular agent become pregnant during this period.
The higher the index, the higher the failure rate, i.e. the less safe the method. The reference value is the Pearl index without contraception, which is 85 (i.e. 85 out of 100 women become pregnant within one year without contraception).
The safest method is the contraceptive stick (Pearl index 0.1-0.9), and the most unsafe is coitus interruptus with 4-18. Very safe are also, above all, the other hormonal methods.
