A good portion of the free online counseling questions are from teenage boys and girls asking me, “Will I get pregnant this time?” So it suddenly struck me that this was an urgent situation, (and I had previously called out on Twitter to see if any middle school principals would be willing to invite me to give a free talk on contraception to middle schoolers), and that it was incumbent upon me to write specifically and tell people, “The one thing that’s certain is that, except for God, no one is going to know if you’re going to get pregnant this time or not.” In layman’s terms, if you’re not using birth control, even an OB/GYN who is well-versed in reproductive endocrinology can’t know “if you’re going to get pregnant this time.” But if contraception is used, almost all (99.9%) of unwanted pregnancies can be avoided. Feng Xiao of the Department of Gynecology, Shanghai First Maternity and Infant Health Hospital, is sure to ask: “Why can’t we prevent 100% of pregnancies even if we take precautions? Then it’s better to do no measures.” Here to tell you, indeed, do not do measures, normal men and women in the ovulation period intercourse, the chances of pregnancy is only about 25%. So, the reason why you want to get pregnant and don’t get pregnant, and when you don’t want to get pregnant you get pregnant by accident is here; and the reason why patients who don’t get pregnant after just six months of trying to conceive are not advised to rush to the doctor is also here. Of course, the vast majority of contraceptive failures are due to improper use of contraception. One other point to emphasize is that so contraception, especially the pill (rumors are particularly strong), has benefits that far outweigh those of the pill or abortion. There are many types of contraceptives, but we will only talk about the most common ones: condoms, short-acting oral contraceptives, emergency contraceptives, and IUDs for teenage boys and girls. Some people ask: “There are so many kinds of common ones, how should I choose them and how should I implement them?” So let’s talk about when it’s most appropriate for people who are preparing to get pregnant to choose what birth control to minimize the chances of an unwanted pregnancy. Let’s first categorize the situation of young people who are not yet willing to get pregnant, so that it is easy to put them in the right place. The first situation: sex with a regular partner and at a high frequency (for a stable couple, the normal frequency is 2-3 times a week). It is recommended to prefer oral short-acting contraceptives. The principle is simply to inhibit the maturation of follicles and the growth of the uterine lining. So the key to the success of this contraceptive is not to forget to take the pill, and it must be started at the beginning of menstruation (taking it on the sixth day of menstruation and later is necessary to use other contraceptives at the same time)! There are many different brands. For example: Momoflurane, Daying-35, Mexinol, Yosmin, etc. The cheapest is Momoflurane. The method of taking the pill is the same. Starting from the 3rd to 5th day of menstruation, take one pill orally at a fixed time every day, finish the box, and your period will come on its own, very punctual, not much. Then take another box on the 3rd-5th day of your period. Until there is a plan to get pregnant, or there is a plan to stop having sex for a longer period of time, then you also have to finish the last box, and then you can stop taking the medicine. Some statistics found that continuous oral short-acting contraceptives for 3 months, the incidence of ovarian cancer is reduced, and 6 years of continuous use can reduce the incidence of ovarian cancer by 60%. (The incidence rate of ovarian cancer is 1/70). And for people with endocrine disorders, it can also regulate the endocrine system, if you know a lot of teenage girls who do not have a need for contraception are also taking it for a short period of time (for example, 3 consecutive cycles), please do not look at them differently, they are taking it for the purpose of regulating the endocrine system. Now that you’ve accepted the pill, let’s talk about how to prevent leakage. It is recommended to choose the time when you are least likely to forget, before bedtime if you have a regular life. Put it on your bedside, the package of the medicine is labeled from Monday to Sunday, and take it on the day of your choice. The reason why bedtime is better is because if in case you forget, you can take a refill the next morning when you see the pill at your bedside. Or even at night, when you see it, take the one you missed yesterday along with the one you are supposed to take today. If you forget to take the pill for 3 days in a row, this method of birth control fails for the cycle, but you still need to keep taking it when you think about it. And if you continue to have sex, you need to add condoms or emergency contraceptive pills to prevent unwanted pregnancy. If you are not pregnant, your period may come early or bleed irregularly due to stopping the pill early. The second situation: the sex partner is regular, but the frequency is not high (less than once a week). You can still take oral short-acting contraceptives, and if you do not want to take the pill every day, we recommend that you choose to use a condom. The principle is simply to prevent sperm from entering and prevent fertilization. The correct way to wear a condom has been described in many articles and pictures, as well as in the instructions. However, the time to wear it is misunderstood by many people. It is not to be used just before ejaculation, but should be used throughout. If the condom is not used properly and breaks, or if the short-acting oral contraceptive pill is forgotten for 3 days, then it is recommended to take an emergency oral contraceptive pill. It is effective when taken within 72 hours of sex, the sooner the better, and the exact dose should be taken according to the drug’s instructions. Some people ask: “I just took it 4 days ago, and I had a problem today, can I still take it?” The answer is: “You can take it, you need to take it, but next time you must must remember to choose another method in advance!” It is pointed out here that the principle of emergency contraceptive pills is to disrupt the speed of the fertilized egg in the fallopian tube and the development of the uterine lining when fertilization has become inevitable, so that the development of the uterine lining and the fertilized egg are not synchronized, which is not conducive to implantation. So the emergency contraceptive pill is one of your last resort, don’t take it out too often and easily. But remember if you run out of options, emergency contraception is your last line of defense! Only reuse it if necessary. But afterward, find out for yourself how to strategize to avoid this situation from recurring the next time. Third situation: sex with an irregular partner, regardless of frequency, condoms are preferred. This is because condoms have another function, which is to prevent direct contact and infection by STDs and various pathogens. Repeated infections of pathogens will also add obstacles to you when you need to get pregnant later. If it is really frequent, it is advisable to take short-acting oral contraceptives plus use condoms properly every time. Remember to protect yourself while enjoying your happiness! By this point, I seem to have missed something. Someone asked the question, “My mother-in-law-to-be said not to get pregnant now, so I should get an IUD, is that okay?” Although many married women have an IUD after having their first child, and when they want to have their second child, they remove the IUD, and then they get pregnant, which feels easy and convenient. But I still don’t recommend that unmarried girls use the IUD for birth control. First of all, let’s look at the principle of the contraceptive ring, simply put, it is to place a foreign body in the uterus, so that the uterine lining produces aseptic inflammation, changing the environment of the lining and preventing the fertilized egg from bedding. There are IUDs that contain copper and those that contain progesterone. The copper IUD slowly releases copper ions in the uterus that have a spermicidal effect, preventing sperm from entering and thus preventing fertilization. The progestational contraceptive ring releases progesterone slowly and continuously in the uterus to inhibit ovulation, as well as stopping the lining from proliferating and preventing a fertilized egg from being deposited. This ring has additional benefits including the amount of menstruation will be reduced, which can treat excessive menstrual bleeding and reduce menstrual cramps and lower abdominal pain caused by adenomyosis. Some women who do not have a need to have children or who do not have a need to have children in the near future may also be advised to use this ring for medical reasons. Placement of the IUD requires maneuvering into the uterine cavity and therefore brings more side effects than the other contraceptive methods mentioned above, especially in women who have not had children, the cervical canal is very narrow, pain relief is needed during the maneuver, and unnecessary maneuvering potentially increases the risk of uterine infection or pelvic infection. If you’re still not sure or don’t understand something, please feel free to ask me for more information. Stay tuned for the next installment of Contraception for Married Couples. 2015-12-17 Dr. Feng Xiao Medical Consultation : style=”text-indent: 28px;”>WeChat Public Account: drfengxiao Sina Microblog: @DrFengXiao