Barrieremethods
Condoms
Natural family planing
IUD
Hormonal contraception
Sterilization
Contraception against transmitted diseases
The so-called barrier methods include the diaphragm, the Lea and the condom. These are membranes or coverings made out of latex or silicone, which, together with a spermicidal gel, form a barrier in the vagina or at the cervix. Thus sperm cannot reach the womb.
Barrier methods are established and well tried contraceptive methods. If used consistently they are quite effective. They are inexpensive and their use is not associated with any health risks.
Counselling and fitting in the Family Planning Centre
In case you want to learn more about or start using the diaphragm, the "Lea’s shield" you are more than welcome to contact us and make an appointment for a consultation in our centre. In the first counselling session, a nurse or a female physician will give you instructions on its function, use and care. You will be able to learn how to feel your cervix, so that you can judge on your own whether the contraceptive device completely covers the cervix. Supported by our instruction you will insert the device yourself. Then you will check the correct position supervised by our health care provider. After 1-2 weeks of practise you should make an appointment for check-up.
Condoms are reliable contraceptives, provided they are being correctly and consistently used. They are the only contraceptive which protects both against unwanted pregnancies and sexually transmitted diseases. They are easily available in many different shops (drugstores, supermarkets, sex shops, pharmacies) without medical prescription. There are different sizes; and for people sensitive to latex there are hypoallergenic or latex-free condoms (made out of polyurethane).
When using natural family planning methods (shortly: NFP), different signs such as body temperature, cervical mucus and cervix are checked. By observing these signs you can determine the fertile and infertile days in your cycle. The symptothermal method is the best evaluated method.
If you want to learn using NFP, we at first teach you the basic principles of the method. Thereafter, during a time of practice at home you will check and record the body signs during some cycles. At further appointments, we help you evaluating your records until you feel certain determining the fertile and infertile days. In addition, there are training courses to support you professionally during the learning time. Moreover you can use a special software to analyse your body signs.
The IUD is a method suitable to be used for longer periods of time. It is particularly suitable for women, who have already given birth to children. Nevertheless, it can also be an alternative for women who did not give birth. Depending on the type, the IUD offers a 3 to 5-year protection. There are two different kinds of IUDs: the copper IUD and the hormone-releasing IUD.
Copper IUD
The copper IUD is a good choice for women without heavy menstrual bleeding and pains. It consists of a T- or anchor shaped plastic frame, with a copper wire around the central section. This is releasing small amounts of copper ions into the womb. The copper changes the lining of the womb and causes the contraceptive action. The sperm mobility is blocked and therefore no egg can be fertilized. In case an egg is still fertilized, it cannot implant in the womb. The contraceptive effect of the copper IUD lasts for at least 3-5 years, depending on the type.
Hormone releasing IUD
The hormone releasing IUD is particularly suitable for women with very painful, long or heavy menstrual bleeding. It consists of a t-shaped frame which releases the progestin levonorgestrel.
The action of the hormone releasing IUD is based on thickening of the cervical mucus, so that the sperm cannot enter the womb and fertilize the egg. The hormone also blocks the development of the lining of the womb which results in less strong and painful periods. The periods become often irregular and may sometimes stop completely. The contraceptive effect lasts for 5 years.
The insertion of the IUD
If you consider or have already decided to use the IUD, you can contact us for an appointment for detailed counselling and check up before the insertion. We will discuss which type of IUD would be the most appropriate for you. During the check up we perform an ultrasound examination and we test for infections, in order to avoid to carry infections up to the womb and the tubes during insertion. The best time for the insertion of an IUD is during or a few days after the menstruation. The cervix is a little more open during menstruation, so that the IUD can be inserted more easily and with less pain. Furthermore, at that time one can be certain that an unnoticed early pregnancy is excluded. For women who have never given birth to children, the insertion of the IUD may be somewhat more painful. In these cases, a local anaesthesia of the cervix can relief pains and facilitate the insertion. Women who have given birth usually experience only little pain.
There is a huge selection of different hormonal contraceptives (you can find a comprehensive overview of them on the internet site of Pro Familia).
Here, we will present only the two basic methods:
Combined hormonal contraceptives
Most of the hormonal contraceptives contain two different hormones - Oestrogen and Progestogen. The combined pills belong to this group. When using this method, after three weeks of daily use you stop taking it for 7 days. During this time a withdrawal bleeding occurs. Both the contraceptive patch and the contraceptive ring are combined contraceptives as well.
Progestogen-only contraceptives
These products contain only one progestogen (the progestogen-only pill, the three-monthly injectable and the progestogen implant). They are better tolerated by some women and have fewer side effects. They are taken every day without any break. Usually the menstrual periods become irregular when using progestogen-only contraceptives.
What is a sterilization? The sterilization is a small surgical procedure during which the fallopian tubes (woman) or the spermatic duct (man) is blocked. The sterilization causes permanent infertility and can only be reversed by a complicated surgical procedure which is often unsuccessful. Therefore, this decision should be considered carefully . How is a sterilization being performed? For women, the sterilization is usually performed with a laparoscopy under general anaesthesia. Several hours after the procedure, the woman may go home, if she has someone to take care of her. She can also stay in the hospital for a few days. For men, the sterilization can be performed either with local or with general anaesthesia; 1-2 hours after the procedure the man can leave the clinic. The health insurance companies cover the costs only in exceptional cases. Where can I receive more detailed information? At the Family Planning Centre, you have the opportunity to discuss the decision with a health care provider to find out whether this permanent method is appropriate for your life situation and at the present time. Furthermore, you will receive detailed information as to where the operation can be performed and how much you will have to pay.
In addition to the protection against unwanted pregnancies, you also need to think about protecting against sexually transmitted infections, especially with a new partner.
Condoms are the only method which offers both, contraception and a good protection against most infections. All the other contraceptive methods have to be combined with the use of condoms for protection against infections. The diaphragm and the cervical cap prevent infective agents from ascending into the cervix for some hours after sexual intercourse; however, it is unclear whether their use protects against sexually transmitted infections. Therefore, they should also be combined with condoms if you want to have a complete protection from infections.
