Contraception

In the context of sex, the term contraception refers to birth control. As the word describes, the aim is to prevent a woman from conceiving during sexual intercourse, i.e., becoming pregnant. Since ancient times, people have felt the desire for self-determination over their reproduction. The connection between the penetration of sperm into the uterus and a resulting pregnancy was always known. At first, attempts were made to prevent this by coitus interruptus, in which the penis is withdrawn from the vagina before ejaculation. Early on, attempts were also made to prevent fertilization by introducing herbal substances into the vagina. In this way, various contraceptive methods developed over thousands of years. All behaviour and precautions are subsumed under the term contraception. Although contraception is about preventing pregnancy, the aim is to maintain fertility. This means that a woman can usually become pregnant without problems after stopping the contraceptive. Surgical sterilisation of a man or woman, on the other hand, is permanent. There are a variety of temporary contraceptive methods that have entirely unique starting points in the biological process of fertilization:

Ovulation inhibitors prevent ovulation in women through hormones such as oestrogen and progestogen. Where there is no egg, fertilization cannot take place. The required hormones can enter the woman's bloodstream in different ways, but regularity is always important. For example, many women take the pill every day, while others get a hormone injection every three months. There are also vaginal rings, hormone coils, contraceptive sticks and hormone patches that steadily release hormones into the woman's body to inhibit ovulation. Hormonal contraception is the most widely used measure in Germany to prevent pregnancy.

Another approach is to prevent the sperm from reaching the egg. This can be achieved, for example, by using a mechanical barrier such as a condom. The sperm are trapped in a thin sheath of latex that is placed over the penis and therefore cannot reach the egg. In fact, condoms are one of the most common contraceptives in Germany. The same approach is taken by the femidom, cervical cap and diaphragm, all of which are inserted into the vagina and trap sperm there. In addition to these mechanical contraceptive methods, some natural methods as well as chemical methods also aim to prevent fertilization. Spermicides, for example, are chemical substances that kill sperm.

Nidation inhibition is also a way to successfully prevent pregnancy. However, this only starts after the egg has been successfully fertilized. The implantation of the zygote in the uterus can be prevented by an intrauterine device (colloquially known as an IUD) or the morning-after pill.

So-called natural contraception (fertility awareness) combines different methods, as contraception is only used on the fertile days in the female cycle. Consequently, on the days when there is no egg in the genitals, unprotected sex can take place. The fertile days can be determined very precisely by taking the temperature, observing the calendar, observing the cervical mucus and determining the hormones. However, this type of contraception requires more effort for the woman than other methods.

A certain natural protection against conception also exists during the breastfeeding period, at least if the woman breastfeeds regularly and a lot (lactational amnorrhoea method). The success and reliability of contraceptive methods are indicated by the Pearl Index. It refers to how many out of 100 women who use the respective method for one year become unplanned pregnant. According to the Pearl Index, these are the ten safest contraceptive methods:

1. Contraceptive sticks (progestogen implant in the upper arm) 0.05

2. Male sterilisation (vasectomy) 0.15

3. Three-month injection (oestrogen & progestogen) 0.2

4. Hormone coil (in the uterus) 0.2

5. Vaginal ring (oestrogen and progestogen) 0.25 – 1.18

6. Female sterilisation 0.26 – 0.5

7. Copper IUD (intrauterine device) 0.8

8. Fertility awareness (natural contraception) 1.8

9. Lactational amnorrhoea method 2

10. hree-month injection (progestogen) 3

11. The widely used birth control pill, with a Pearl Index of 9, is far ahead of the latex condom, which has a comparatively high Pearl Index of 18.

By the way, contraception is not the same as safe sex. Safe sex is about protection against infectious diseases that can be transmitted during sex (abbreviation STI). HIV, hepatitis, syphilis, and gonorrhoea are known STIs that you can protect yourself from by practising safe sex (through a condom). Because a condom protects equally against parenthood and infectious diseases, it is the first choice for sex outside a committed partnership.