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A contraception doesn't choose itself in the same way if one is a teenager, a young mother or if one approaches of the menopause. To every age, to every type of sexuality, her strategy. The choice must permit the best possible compromise between efficiency, security and simplicity. Of the even virgin teenager to family's mother close to the menopause, of the steady couple to the serial playboy, the needs of the couples concerning contraception are very different. There is not a method miracle, according to its risks personal two worries must guide your choice: - To avoid a non wanted pregnancy;
- But also to warn the sexually transferable illnesses (MST).
To adolescence: the double protectionOne conceives the drama that the intervening of a pregnancy can provoke non wanted to adolescence easily. TO this age, more of a pregnancy on two balance itself by an abortion. In France, one would count each year thus, non wanted 10 000 pregnancies and 6 000 abortions at teenagers. The prevention of the AIDS and the other MST is otherwise indispensable, that it is at the time of the first sexual intercourse or in the beginning of all relation. But one knows well that she is sometimes disregarded. The presence of this two risks duct to advise the teenagers the double protection, by the condom and by the pill. The oral contraception seems indeed the best contraceptive method for the girls, who must be able to benefit from a very efficient contraception, because their fertility is optimal, and that have very little risk of complications under pill. On the other hand the local methods (spermicide, diaphragm) must be avoided to this age, because less efficient and, especially, difficult to use in practice. The pill can be taken very well before even that the first sexual intercourse is considered precisely, but this security, on the contraceptive plan, must not drive to disregard the condom the moment come. If the sexual intercourse took place without any efficient precaution, a very good solution of correction exists with the contraception of emergency or pill of the following day. It is about a progestatif that must be taken as early as possible in the 72 hours that follow the report. However more the first tablet is consumed early and more the method is efficient (85% of pregnancies avoided when the first tablet is taken in the first 24 hours, (58% only if it is taken between 48 and 72 hours). This contraception of emergency is over-the-counter in pharmacy and can be distributed by the school nurses. No place to the improvisationTo the United States, the use of the contraceptive implants of long length of action, small short sticks that one introduces under skin and that deliver the progestérone regularly, is the first method proposed to the teenagers. Injections of progestérone delay can also be proposed when a girl or a young woman doesn't seem in measure to assume a regular contraception. Whatever is her sexuality, it is necessary to know that the contraception doesn't improvise itself bit by bit, but must be discussed with a physician. To be sure and efficient shet must obey simple rules Indeed, but very precise. To take a friend's pill, to follow the advice of the buddies risk to drag an illusory protection. The centers of family planning can dispense the necessary information very well. They also have the advantage to distribute some condoms free. To receive anonymous information, a toll-free number exists: thread health youngsters (0800 235 236), that would not know to replace a medical consultation however. Young woman without childIn case of episodic reports, the condom remained indispensable to warn the MST. To note that a feminine condom exists, efficient to warn the infections and whose ministry offers to encourage the use. The spermicides are not a guarantee against the infections, on the other hand they seem more efficient than the diaphragm associated to the spermicidal frost on the contraceptive plan. Their use is however coercive enough, what drives, there again, to underline the interest of the pill, especially when the reports become more frequent. When a steady relation gets settled, it is natural to abandon the condom and to search for a more comfortable contraception. A fairly measured out pill seems a good method, in the absence of contra-indication (diabetes, antecedents of phlebitis, domestic antecedents of breast cancer...). In case of contra-indication to the oestro-progestatifs, a pill microdosee, composed of a progestatif, can be used. But it is not the only method, the girl can also choose the I.U.D., the implant or the contraceptive ring. Attention after a pregnancy Some ovulations can occur before the return of layer, dragging pregnancies very brought closer. To avoid these generally non wished pregnancies, it is indispensable to consider a method of contraception since the exit of the motherhood. It can be about a local or oral contraception. For the women who nurse, a micropilule progestative is preferable. For the other, a pill oestro-progestative can be used. The years passing... When the couple already had several children and didn't want to have some quickly others, the I.U.D. seems a good method, because it is very little coercive, without risk of oblivions, and the I.U.D.s to the progestérone are very efficient. Newly available, the implant and the contraceptive ring permit them also to avoid to think daily about her contraception. Age advancing the contra-indications of the pill becomes more frequent. After 40 years, the tobacco addiction contraindicates the oral contraception thus positively. In the absence of contra-indication, the preference must be granted to pills minidosées. The contraception must be pursued until the complete menopause, because a pregnancy remains possible, even when the rules become irregular. The natural methods (method of the temperatures...), hazardous to all age, are even more dangerous during this period of life because the cycles are irregular. The method of the withdrawal, certainly often used, cannot be counseled seriously. The years passing...When the couple already had several children and didn't want to have some quickly others, the I.U.D. seems a good method, because it is very little coercive, without risk of oblivions, and the I.U.D.s to the progestérone are very efficient. Newly available, the implant and the contraceptive ring permit them also to avoid to think daily about her contraception. Age advancing the contra-indications of the pill becomes more frequent. After 40 years, the tobacco addiction contraindicates the oral contraception thus positively. In the absence of contra-indication, the preference must be granted to pills minidosées. The contraception must be pursued until the complete menopause, because a pregnancy remains possible, even when the rules become irregular. The natural methods (method of the temperatures...), hazardous to all age, are even more dangerous during this period of life because the cycles are irregular. The method of the withdrawal, certainly often used, cannot be counseled seriously. The local contraception or the I.U.D. remain good methods. In the absence of contra-indication, a pill minidosee can have the advantage to suppress the symptoms (puffs of heat, fatigue...) that accompany the périménopause often. Finally, the radical methods, as the vasectomy or the ligature of horns are used little in France, because they have the inconvenience to be irreversible and impose an intervention. Multiple partners: the condomWhatever is age, the fact to have several partners, to have some reports with a person having several partners, to be drug-addicted or to have some reports with a drug-addicted person implies a transmission elevated risk of MST. The use of the condom should be constant in these cases, as well as at the time of all starting relation. It permits to recall that the contraception, as the prevention of the MST, is also man's business. 2009-04-18 
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