The development of medicine in many directions has not gone in vain. In addition to new methods of treatment, medicines and medical specialties, scientific progress has presented people with many contraceptive methods, previously unknown. Their effectiveness is measured using an indicator known as the Pearl Index.
Modern contraception
Sexual literacy in the 21st century is an important component of a mature personality. Understanding how to protect yourself and your partner from illness or an unwanted pregnancy is the first step towards a healthy, intimate life. A variety of contraceptives opens up a huge number of options and possibilities. But there is still a difference between them: firstly, their action is based on different principles, and secondly, not every method will suit any situation.
For example, condoms are more suitable for single and periodic use, they with a sufficient degree of effectiveness protect against various diseases and infections, although not from all. Caps working on the same principle will no longer become a barrier to pathogenic bacteria and viruses, and therefore are more suitable for couples who are confident in each other.
Hormonal contraceptives are convenient to use and can help women cope with some gynecological diseases. However, they have zero effectiveness in protecting the body from infection. Thus, they are usually used by couples who have long been in a relationship.
Another category is spermicides. Their action is based on the neutralization of sperm with the help of various kinds of substances. This method also does not protect against diseases if it is not combined with barrier contraception.
So what to choose? It is worth, among other things, to pay attention to how well these or other methods cope with their task.
Performance Indicator - Pearl Index
When choosing a contraception suitable for you, it’s worth considering not only how convenient it will be to use it, but also taking into account the degree of its reliability. To evaluate it, there is a Pearl index. Another name for it is the failure rate. As the name implies, the lower it is, the better.
For the first time, this method of calculating the effectiveness of contraceptives, used so far, was proposed in 1933 by the American biologist R. Perl. Based on this indicator, as well as personal preferences and some other factors, it is worth choosing a way to protect each specific pair.
How is it calculated?
The evaluation method is very simple: 100 women use the same method of protection during each contact throughout the year. After this period, the number of pregnancies is fixed. The lower the Pearl Index, the more effective the study method of contraception is considered.
Nevertheless, it is worth distinguishing between theoretical and practical reliability. Incorrect or careless use may cause the method to simply not work. So, the reliability of condoms, for example, depends on whether they were put on in time, whether there was any contact of the genitals before that, whether the size was suitable, etc. That is why often the failure rate is indicated not as an exact number, but as a period of values.
So how does it all look in practice? The main methods of contraception are listed below, and the Pearl Index is opposite each item. The table is selected for greater clarity.
| Method | Performance indicator |
| Barrier contraceptives (condoms, caps) | 2-25 |
| Hormonal (tablets, patches, injections, rings) | 0.1-5 |
| Natural methods (calendar, PAP, etc.) | 0.3-40 |
| Spermicides and spirals | 0.9-21 |
| Surgical | 0.01-0.4 |
Only large groups of family planning methods were listed above. We will talk a little more about some of them, including their effectiveness.
Hormonal contraceptives
Special injections, plasters, tablets, rings, intrauterine devices - a huge variety of forms. Some of them require daily attention, others need to be remembered once a month or even a quarter. For example, a hormonal ring - a contraceptive that has become relatively popular recently - is placed in the vagina and stays in it for 3 weeks.
The essence of this category of contraceptives is to regulate the woman’s reproductive system - she’s “falling asleep”. As a result of this, ovulation does not occur, cervical mucus thickens, and often libido decreases. And although the latter is not a very welcome consequence, all these factors lead to a significant reduction in the likelihood of pregnancy.
Hormonal contraception is good for everyone, the only negative is that it has a lot of contraindications and side effects. Smoking women, for example, risk the health of the hematopoietic system and blood vessels. There are other serious problems, so the appointment of any kind of hormonal drugs should be carried out only by a doctor after examination. An external examination, an ultrasound scan, a smear, several blood tests - this is what you may need to understand which contraceptives are suitable. The Pearl Index in theory for funds in this category is quite low - less than 1.
The exception is some methods of postcoital or
emergency contraception, they can be neglected. However, in practice it is still higher, since many women are not too careful when taking, miss or are late with the pills, forget about the decrease in their effectiveness while using certain antibiotics, etc. Nevertheless, it still remains one of the most reliable ways.
Condoms
Barrier contraceptives are less diverse compared to the previous group. And the most popular means of this category are condoms. By the way, there are their female counterparts, as well as special caps that are worn on the cervix, but they are much less common.
The undeniable advantage of condoms is that, with sufficient effectiveness, they also protect against some STDs. This does not mean that you can not be afraid of any infection at all, but the likelihood of catching it is significantly reduced. Reliability of condoms, according to various sources, ranges from 2 to 12. In fact, this is just the case when it all depends on the correct application. The product must be put on time and correctly, and then the likelihood of pregnancy will be minimal. In addition, modern manufacturers often immediately put it in a spermicidal lubricant, thereby further reducing the chances of an unexpected outcome.
Spermicides
Two completely dissimilar methods belong to this group at once. The first is gels, suppositories, lubricants and other means aimed at the chemical neutralization of sperm. The second is an intrauterine device containing copper. The first, with all its ease of use, has several disadvantages. Firstly, it requires patience - in order for the funds to take effect, you need to wait 10-15 minutes, and secondly, it has a relatively low efficiency - 3-21. The second requires a mandatory visit and consultation with a doctor. But the reliability of the spiral is quite large - 0.9-3.
Surgical
This group includes extremely effective methods when, with the help of operations, a man or a woman with almost 100% guarantee is deprived of the opportunity to acquire offspring. Such interventions have a number of social limitations in many countries and are considered quite serious. Fortunately, in most cases they are reversible.
Natural
The complex of methods that belong to this category includes those that are based primarily on how well a woman knows and feels her body. The fact is that the probability of pregnancy changes throughout the menstrual cycle. It is quite large during ovulation, which lasts about 72 hours, a week before it and the same amount after. The rest of the time it’s almost impossible to get pregnant.
Almost all methods of natural contraception are based on the fact that a woman in various ways fixes the time of ovulation and refrains from contact at this time. With the skillful application and combination of several methods, this can be quite effective, but not everyone wants to bother with daily schedules when you can simply take advantage of the achievements of medicine. For example, the already mentioned contraceptive ring can be picked up only once every 3 weeks, and in the case of injections, remember only 4 times a year. However, some people prefer to use their natural resources, and this choice must also be respected.