The latest generation of contraceptives. How to choose good birth control pills for women. Combined oral contraceptives with natural hormones

In this article, we will look at 2 "sides of the coin" - the positive aspects of taking oral contraceptives and the potential health hazards:

• at the beginning of the article, we will consider the classification, contraindications, side effects and all the positive aspects of taking hormonal contraceptives
• then about the potential risk of developing long-term consequences of taking such drugs, even for a healthy woman.

By doing this, we want to draw the attention of women to a longer-term prognosis of their health and think about the fact that any intervention in the natural processes in the female body is fraught with consequences - for someone insignificant, subtle, for someone much more serious, even tragic.

In no case do we call for abandoning the drugs prescribed by the doctor, the article is for informational purposes and the decision to take oral contraceptives is made by a woman after consultation and examination by a gynecologist. But, every woman should be aware of the possible risks that she is exposed to when taking oral contraception for a long time.

Groups of contraceptive pills, names and their action

Despite the rather rich assortment of contraceptives presented in the pharmacy, hormonal contraceptive pills today occupy a leading position (and bring billions of dollars a year to their manufacturers). Unfortunately, not everyone knows about contraindications to taking them, side effects, rules for taking pills, that they should not be taken for a long time and the choice of oral contraceptives should be made only by a doctor after a thorough diagnosis and collection of the patient's history.

All contraceptive hormonal pills are divided into two "companies": combined oral contraceptives (COCs) and mini-pills.

Monophasic tablets In these tablets, the percentage of estrogenic and progestogen components does not change in each tablet.
Desogestrel and ethinylestradiol: Regulon (400-1100 rubles) prices 2018.	Ethinylestradiol and dienogest: Jeanine (price 1000 rubles) Silhouette (price about 680 rubles)	Gestodene and ethinylestradiol: Lindinet (380-500 rub.), Logest (800 rubles), Femoden (950 rubles)
Rigevidon (price 280 rubles)	Microgynon (380 rubles)	Minisiston (450 rubles)
Biphasic drugs In them, the dose of estrogen is the same in all tablets, and the dose of progestogen changes in the 1st and 2nd periods of the menstrual cycle.
Femoston Dydrogesterone + Estradiol (900 rubles).	(Ethinylestradiol + Levonorgestrel): Anteovin, Binordiol, Sekvularum, Adepal, Sequilar, Bifazil	Binovum (Ethinylestradiol + Norethisterone) Neo-Eunomine (Ethinylestradiol + Chlormadinone Acetate)
Triphasic Tablets In the OK data, the doses of hormones are changed three times in one package, which is associated with a change in the periods of the menstrual process.
Tri-Regol (280 rubles)	Three merci (120 rubles)	Triziston

The main point in the mechanism of action of COCs is the blocking of ovulation, due to inhibition of the formation of FSH and LH in the pituitary gland. In parallel, ovarian function and local obstruction of ovulation are blocked. In addition, “glandular regression” occurs in the structure of the uterine mucosa, which makes implantation of a fertilized egg impossible. Changes also occur in the mucus of the cervical canal, it thickens, which disrupts the movement of spermatozoa deep into the uterus.

COCs are also divided into 3 groups according to the quantitative content of active components:

Microdosed OK

The dose of hormones in these pills is minimal, so they are ideal for young women up to 25 years old, and, in addition, for those who are faced with the need to take birth control pills for the first time. Examples of drugs: Zoeli (monophasic), Qlaira (3-phase) and other monophasic ones - Jess, Dimia, Logest, Mercilon, Minisiston, Lindinet, Novinet.

Low-dose OK

Such tablets are recommended for young and mature representatives of the weaker sex, including those who have gone through childbirth, or are prescribed to those patients who, when using microdosed drugs, experience intermenstrual bleeding. According to manufacturers' studies, a group of low-dose tablets has an antiandrogenic effect (hair growth in uncharacteristic places decreases, acne and increased skin greasiness disappear, decreases). The list of contraceptive pills includes: Diana, Yarina (Midiana), Femoden, Siluet, Jeanine, Trimerci, Lindinet, Silest, Minisiston, Regulon, Marvelon, Microgynon, Rigevidon, Belara, Chloe, Demulen.

High-dose OK

The dose of hormones in these contraceptive pills is quite high, so they are prescribed either for the purpose of treatment (for example, endometriosis), or at the stage of therapy for hormonal disorders (Non-ovlon, Triquilar, Ovidon, Triseston, Triregol) only as directed by a doctor.

It can be said about mini-pills that they contain only progestogen. The mechanism of their action lies in the local influence on the peripheral parts of the reproductive system. Firstly, mini-pills affect the composition of cervical mucus and its quantity. So, in the middle of the cycle, its volume decreases, but the viscosity of the mucus remains high in any of the phases of the menstrual cycle, which prevents the free movement of spermatozoa. There are also changes in the morphological and biochemical structures of the endometrium, which create "bad" conditions for implantation. About half of women are blocked from ovulation. Mini-pills include: linestrenol (Exluton, Microlut, Orgametril), desogestrel (Lactinet, Charozetta).

Charozetta (1300 rubles) desogestrel	Lactinet (600 -700 rubles) desogestrel	Orgametril (3300 rub.) linestrenol	Exluton (3300 rubles) linestrenol

How to choose good birth control pills

Which contraceptive pills are good, the best, you can’t deal with this issue on your own, especially buying them at a pharmacy on the recommendation of friends or a pharmacist. To find the best birth control pills, you need to visit a doctor. The gynecologist will collect an anamnesis, dwell separately on a family history, existing diseases or past ones, since all of the above may be a contraindication to the use of hormonal contraceptives.

After that, the doctor will conduct an examination, during which he will evaluate:

• skin (telangiosis, petechiae, signs of hyperandrogenism, presence / absence of hypertrichosis, etc.)
• measure weight and blood pressure
• palpates the mammary glands
• prescribe tests for liver enzymes, blood sugar, blood coagulation, hormonal levels, ultrasound of the mammary glands, ultrasound of the pelvic organs, if necessary, mammography
• then perform a gynecological examination with swabs
• a woman should also visit an ophthalmologist, since long-term use of OK increases the risk of developing other eye diseases.

For the appointment of tablets that are most favorable for this patient, her constitutional and biological type is taken into account, which takes into account:

• height, appearance
• milk glands
• pubic hair
• skin, hair
• menstruation and premenstrual symptoms
• cycle irregularities or lack of menstruation
• as well as existing chronic diseases

There are 3 phenotypes:

The prevalence of estrogens

Women of short or medium height, very feminine in appearance, skin and hair are prone to dryness, menstruation with significant blood loss and long, and the cycle is more than four weeks. Medium and high-dose COCs are suitable for patients with this phenotype: Rigevidon, Milvane, Triziston and others.

Milvane (ethinylestradiol and gestodene): Logest (720 rubles) Femoden (600-650 rubles) Lindinet (average price 320 rubles)	Rigevidon (price 180 rubles), Microgynon (320 rubles), Minisiston (370 rubles) Tri-regol (200 rubles), Triquilar (530 rubles), Triziston

Balanced type

Women of average height, feminine, mammary glands of medium size and developed, skin and hair of normal oiliness, no premenstrual signs, menstruation 5 days after 4 weeks. Such women are recommended second-generation drugs: Marvelon, Silest, Lindinet-30, Microgynon, Femoden and others.

Ethinylestradiol and desogestrel: Marvelon (630 rubles), Novinet (330 rubles), Regulon (280-320), Tri-merci (650r) Mercilon (630 rubles)	Ethinylestradiol and Norgestimate: Silest	Eethinylestradiol and Gestodene (Milvane): Lindinet (280-350 rub.), Logest (720 rubles), Femoden (600-650 rubles)	Ethinylestradiol and levonorgestrel: Rigevidon (180r), Tri-regol (200r) Microgynon (320r), Minisiston (370r) Triquilar (530r), Triziston

The prevalence of gestagens / androgens

Women are tall, “boyish” in appearance, underdeveloped mammary glands, skin and hair with increased fat content, depression on the eve of menstruation and pain in the abdomen, in the lumbar region, menstruation is scanty, less than 5 days, the cycle is short, less than 28 days. In this case, the doctor will advise hormonal preparations with an antiandrogenic component: Diane-35, Janine, Yarina, Jess.

Yarina (price 800 rubles)	Ethinylestradiol and drospirenone: Jess (820 rubles)	Ethinylestradiol and drospirenone: Dimia (550 rubles)	nomegestrol and estradiol Zoely (1000 rubles)

Ethinylestradiol and dienogest: Janine (800 rubles), Silhouette (400 rubles)		Ethinylestradiol and cyproterone: Diana 35 (820 rubles), Chloe 35 (450 rubles), Erica 35 (360 rubles)

How to take hormonal oral contraceptives correctly

Standard blisters with COCs contain 21 tablets. There are only a few exceptions, for example, Jess - a new generation of birth control pills, in which there are 24 pills and which are often prescribed by gynecologists to young women. For women after 35 years, the doctor may recommend Qlaira tablets, a new generation of oral contraceptives containing 28 tablets.

How to take birth control pills:

• Tablets should be taken every day, at about the same hour, starting on the first day of menstruation.
• In order not to forget about taking the next pill, it is better to put them in the place where a woman looks every day (in a cosmetic bag, on a toothbrush or attach a magnet to the refrigerator).
• Every day one tablet is drunk until the blister is over.
• Then you need to take a break for a week.
• During this time period, menstrual-like bleeding will begin.
• At the end of 7 days, start taking COC again, regardless of whether the period has ended or not.
• In case of vomiting, it is necessary to take an extraordinary tablet.
• If you miss taking a pill, you need to drink it as soon as possible.
• In these two cases, during the day you need to additionally protect yourself.
• At the very beginning of taking COCs, if they have not been used before, additional protection should be taken during the first 14 days.
• Intermenstrual bleeding is not considered a reason to stop taking pills (see)
• Usually they are noted in the first 2 - 3 months, and indicate a reconfiguration of the body from hormones that are synthesized in the ovaries and pituitary gland to hormones that come from outside.

Taking hormonal combination drugs after medical termination of pregnancy should be started either on the day) or a month later, when the first menstruation begins.

The contraceptive effect of hormonal drugs may decrease when used simultaneously with a number of drugs, for example, rifampicin (it stimulates the activity of liver enzymes). Therefore, when prescribing treatment for any disease, inform your doctor about taking oral contraceptives, carefully study the instructions for using the drugs prescribed to you. In the case of prescribing drugs that reduce the effect of COCs, additionally use other methods of protection (condoms).

The standard mini-pill blister contains 28 tablets. These tablets are drunk without a break for 7 days, just like COCs, at the same hour. Mini-pills are suitable for women who are breastfeeding. If a woman is not lactating or prefers artificial feeding, then low-dose COCs (Belara, Miniziston, Regulon and others) are recommended to her. You can start taking COCs as early as 21-28 days after delivery.

It is worth knowing that the contraceptive effect begins to manifest itself after 2 weeks of taking the pills, and the 100% effect and reliability of such a contraceptive method as OK occurs in the second month of taking the drugs. Ovarian blockade begins as soon as hormones begin to flow from the outside, but the maximum guarantee comes after a month's course of their use.

Side effects of birth control pills

Side effects are signs or conditions that develop when using contraceptives, but do not threaten the health of women. They are divided into 2 groups:

In the event of serious, as well as persistent small side effects, contraceptives are canceled.

Regardless of the chosen OK, a woman needs a periodic assessment of her health in connection with possible side effects from their use, namely:

• Blood pressure: measure every 6 months
• Physical examination (breast, liver palpation, gynecological examination), urinalysis: 1 r / year
• Monthly breast self-examination.

It is no secret that regular checkups are unlikely in many developing countries, and there are programs (in some countries) to distribute OCs to women who do not have access to medical care. This indicates a high likelihood that OCs will be used by high-risk groups of women. Consequently, it will be more difficult for such women to receive medical attention in case of dangerous side effects.

Absolute contraindications to oral contraceptives

Diseases in which the appointment of oral contraceptives is not desirable: (congenital hyperbilirubinemia), bronchial asthma, rheumatoid arthritis, multiple sclerosis, thyrotoxicosis, myasthenia gravis, sarcoidosis, retinitis pigmentosa, thalassemia, renal dialysis.

At the end of the article there is a video of a TV show detailing the dangers of using OCs by any woman, because even in the absence of the above contraindications (the woman and the doctor may not know about them), a seemingly healthy woman has an extremely high risk of developing pulmonary thromboembolism, developing oncology.

Hormonal contraceptives and possible pregnancy

Can you get pregnant while taking birth control?

This question worries many women. Of course, pregnancy against the background of the use of hormonal oral contraceptives is not excluded, but its probability is too small.

• First of all, an unwanted pregnancy occurs when the rules for using pills are violated (missing, irregular, taking at different times, the expiration date of the drug has expired).
• You should also take into account the possible vomiting in case of poisoning or co-administration with drugs that reduce the contraceptive effect of hormonal pills.

Is it possible to take contraceptives when pregnancy has already occurred or is suspected?

The answer to this question is negative. If pregnancy after taking contraceptives has happened, it is desirable, then there is no indication for its termination (interruption). You just have to stop taking the pills right away.

Taking hormonal pills in late childbearing age

Currently, in economically developed countries, about half of married couples after 40 years of age prefer sterilization. Of the hormonal drugs, COCs or mini-pills are used. Women who are over the age of 35 should stop using hormones with existing cardiovascular pathology, coupled with smoking, a high risk of oncology. A good alternative for women after 40 - 45 years old are mini-pills. These drugs are indicated for uterine fibroids, endometrioid inclusions and endometrial hyperplasia.

Emergency and non-hormonal contraception

• emergency contraception

If sexual intercourse has occurred without the use of means that protect against pregnancy, emergency (fire) contraception is carried out. One of the well-known and widely used drugs is Postinor, Escapel. You can take Postinor no later than 72 hours after coition without the use of contraceptives.

First you need to drink one tablet, and after 12 hours, the second is taken. But COCs can also be used for fire contraception. The only condition is that one tablet must contain at least 50 micrograms of ethinylestradiol and 0.25 mg of levonorgestrel. First, you should drink 2 tablets as soon as possible after intercourse, and repeat the intake of 2 more after 12 hours.

These drugs can only be used in emergency cases (rape, condom breakage), WHO does not recommend their use more than 4 times a year, but in Russia they are popular and used by women much more often (see). In fact, they have an abortive effect, of course, this is not a surgical procedure like a medical abortion, but it is no less harmful from the point of view of the further reproductive function of the female body.

• Non-hormonal contraception

They are spermicides that are used topically to prevent unwanted pregnancy. The active component of such tablets inactivates spermatozoa and “does not let” them into the uterine cavity. Moreover, non-hormonal tablets have anti-inflammatory and antimicrobial effects. These tablets are used intravaginally, that is, they are inserted deep into the vagina before intercourse. Examples of non-hormonal tablets: Pharmatex, Benatex, Patentex Oval and others.

Arguments FOR taking hormonal birth control pills

Contraceptive pills, especially new birth control pills (new generation) have advantages over barrier contraceptives. The positive aspects of using OK, which are promoted by gynecologists:

• one of the most reliable and high-quality methods of contraception (efficiency reaches 100%);
• can be used at almost any age;
• against the background of taking contraceptive pills, the menstrual cycle becomes regular, pain may disappear during menstruation (see);
• good cosmetic effect (disappearance of acne, oiliness or dryness of hair and skin disappear, reduction of pathological hair growth);
• peace of mind (no fear of getting pregnant);
• the possibility of accelerating the onset of menstruation or its delay;
• therapeutic effect - endometriosis, uterine fibroids, ovarian cysts (whether OCs have a therapeutic effect is still a very controversial issue, since most studies are carried out by manufacturers of hormonal contraceptives);
• after refusing to take pills, fertility is usually restored within 2-6 menstrual cycles (with rare exceptions up to a year).

But despite all the advantages, there are much more negative consequences from taking hormonal contraceptives and they outweigh the arguments FOR. Therefore, the decision to drink birth control pills is made by the doctor and the woman herself, based on the presence of contraindications, possible side effects of these drugs, general health, and the presence of chronic diseases. According to the results of many studies, taking oral contraceptives (long-term) has long-term negative consequences for the health of a woman, especially those who smoke and have any chronic diseases.

Arguments AGAINST oral contraceptives

In the modern world, the pharmaceutical industry is the same business as any other sector of the economy, and the material benefit from the sale of drugs that a woman needs every month is fabulous. Over the past decades, several studies have been conducted by independent American experts, the results of which suggest that taking hormonal contraceptives by a woman before the birth of 1 child increases the risk, and increases the cervix. In addition, OK cause depression, contribute to the development of osteoporosis, hair loss, and the appearance of pigmentation on the body.

The hormones produced by the body perform certain functions in the body, controlled in the higher hormonal centers - the pituitary and hypothalamus, which are associated with the adrenal glands, thyroid gland and ovaries (peripheral organs). The ovaries have a clear hormonal interaction with the whole body, the uterus waits for a fertilized egg each cycle, and even small doses of hormones coming from outside disrupt this fragile interaction.

With prolonged use of hormonal contraceptives, the functions of the genital organs completely change. Every day, taking a pill suppresses ovulation, the release of an egg does not occur, ovarian function is suppressed, which in turn depresses the regulatory centers. With prolonged use of tablets (for years), a woman in the uterus changes the inner layer, since it is rejected unevenly (hence bleeding and). The mucous layer and tissue of the uterus gradually change, which in the future (more often during menopause) threatens with oncological degeneration.

With prolonged use of oral contraceptives, the amount of sex hormones is reduced, the ovaries are reduced in size, their nutrition is disturbed - this is a powerful blow to the reproductive function of the body. Both at the beginning of the intake and after stopping the intake of OK, a failure occurs in the hormonal system, therefore, in some women, the restoration of reproductive function occurs within a year, and in some cases it may not recover at all. So:

• women who have the contraindications listed above should never take oral contraceptives, since serious complications may develop, up to death (development of vascular thrombosis), oncology;
• with prolonged use of OK, the excretion of vitamin B6 from the body is accelerated, which can lead to hypovitaminosis B6, as well as vitamin B2 (see), which adversely affects the nervous system (weakness, insomnia, irritability, skin diseases, etc., see);
• OK also disrupt the absorption of folic acid, which is very important for the body, which is very necessary 3 months before conception and during a future desired pregnancy and (see), the addition of which to some hormonal contraceptives is only a marketing ploy;
• With prolonged use (over 3 years), the risk of developing glaucoma increases by 2 times. Studies by scientists at the University of California showed that (3500 women over 40 years old, from 2005 to 2008 took contraceptives) when taken for 3 years without interruption of oral contraception, women are more likely to be diagnosed with glaucoma.
• oral contraceptives significantly increase the risk of developing osteoporosis in women in the future (after 40 years, see);
• taking OK for 5 years or more increases the risk by 3 times (see). Researchers attribute the growth of this disease to the "Era of hormonal contraception";

Today, in the age of oncological tension and unimproved early diagnosis of the initial asymptomatic stages of oncology, a woman taking OCs may not be aware of her early stages of oncology, in which contraceptives are contraindicated and contribute to aggressive tumor growth;

• studies by Danish scientists show that long-term use in women is 1.5-3 times;
• oral contraceptives contribute to thrombosis in any vessels, incl. and vessels of the brain, heart, pulmonary artery, which increases the risk of stroke and death from pulmonary thromboembolism. The risk increases depending on the dose of hormones, as well as additional risk factors - high blood pressure, smoking (especially over 35 years old), genetic disposition, see;
• taking oral contraceptives increases the risk of developing chronic venous insufficiency - pain in the legs, night cramps, feeling of heaviness in the legs, transient edema, trophic ulcers;
• increases the risk of developing inflammatory diseases of the cervix, breast cancer
• in some cases, the return of fertility is delayed (1 - 2%), that is, the body gets used to the intake of hormones from the outside and in the future, some women may have difficulty conceiving;
• do not provide protection against genital infections, so their use is not advisable if there are many partners, women who have a promiscuous sex life (only condoms protect against genital infections and viruses, including), syphilis, etc.);
• taking oral contraceptives can provoke the appearance of a woman's body;
• according to American studies, in women taking oral contraceptives, the risk of early development of multiple sclerosis increases by 35% (see, which today can be in both a 20-year-old and a 50-year-old woman);
• one of them may be taking oral contraceptives;
• the risks of developing transient increase;
• women taking OCs are more likely to develop depression;
• some women have significantly reduced libido;
• the need for self-monitoring and daily intake;
• errors are not excluded when using contraceptive pills;
• the need to consult a gynecologist before taking;
• the price is quite high

According to WHO, about 100 million women use oral contraception, which brings fabulous profits to drug cartels. Manufacturers of hormonal contraceptives are extremely uninterested in disseminating truthful information about the dangers of products that bring them huge profits.

Today, there is strong public opposition around the world to ban the sale of dangerous drugs, and information about their potential harm is publicly available. The result of this is that European and American gynecologists strongly recommend condoms, which protect not only from unwanted pregnancy, but also from genital infections. Next in popularity is the hormonal patch and then the spiral.

After reports of the dangers of OK, several deaths and lawsuits, Diane-35 is banned in some countries (USA, Germany, France), and surveys of Europeans showed that 67% of people aged 15-63 try to protect themselves with condoms, this is married couples and single women, 17% prefer the patch, 6% use the spiral, the remaining 5-10% continue to use OK.

Russian doctors actively continue to offer (advertise) oral contraception to women, moreover, they prescribe them to girls from the age of 14-18, without reporting a potential and very real threat to their health.

Hormonal preparations are medicines containing hormones or substances that have an effect similar to a hormonal one. Natural hormonal medicines are obtained from the glands, blood and urine of animals, as well as from the blood and urine of humans.

Synthetic hormones are produced in pharmacological shops and laboratories. They can either be structural analogues of true hormones, or differ from them in chemical structure, but exhibit a similar effect.

Almost the largest number of threatening myths have been created around hormonal pills for various purposes: patients are afraid of infertility, weight gain, excessive body hair growth, and loss of potency. The list of negatives is frightening and alarming.

How true are the myths, and what types of hormone therapy are there?

Hormonal preparations are classified depending on the origin (producing gland) and purpose. By origin, drugs are divided into:

• adrenal hormones (cortisol, adrenaline, glucocorticoids, androgens);
• pancreatic preparations (insulin,);
• pituitary hormones (TSH, human gonadotropins, oxytocin, vasopressin, etc.);
• thyroid and parathyroid hormones;
• sex hormones (estrogens, androgens, etc.).

Human hormones regulate the body's metabolism. However, if one of the organs of the endocrine system malfunctions, the perfectly adjusted mechanism of correction and interaction can fail, which will have to be eliminated by the introduction of synthetic analogs of hormones.

By appointment, hormonal drugs are divided into:

• synthetic substances for replacement therapy (levothyroxine sodium, insulin, estrogens);
• means for hormonal contraception (synthetic analogues of estrogen and progesterone);
• hormonal agents that inhibit the production of hormones (for example, therapy with pituitary hormone analogues for prostate cancer);
• symptomatic drugs (anti-inflammatory, antiallergic drugs).

Hormonal drugs often also include antidiabetic and other non-hormonal drugs.

What is treated with hormonal drugs?

Hormone-based drugs are used for both chronic and treatable conditions. Without the help of hormonal drugs can not do with:

• hypothyroidism;
• hyperthyroidism;
• diabetes mellitus of the 1st, sometimes of the 2nd types;
• hormone-dependent tumors of the reproductive system;
• prostate cancer;
• asthma and other diseases associated with an immune response to allergens (including allergic rhinitis);
• endometriosis;
• hormonal disruptions;
• menopause;
• sleep disorders;
• other diseases associated with hypofunction of the glands.

Inflammation and allergic manifestations are treated with glucocorticoids. Preparations based on them - Prednisolone, Metipred, Dexamethasone - reduce inflammation and suppress leukocyte function.

They can be used both inside (if necessary, systemic action) and externally (for hemorrhoids, thrombophlebitis, dermatological diseases, allergic rhinitis). When applied externally, they are practically not absorbed into the main bloodstream and do not have a negative effect on the body.

Even if the cause of the inflammation is unknown, adrenal hormones help relieve swelling, pain, and redness. Hormonal anti-inflammatory drugs are among the life-saving drugs.

Vasopressin and epinephrine may be administered along with anesthetics. Due to their ability to constrict blood vessels, these hormones are actively used in anesthesia (including local anesthesia).

Melatonin also belongs to hormonal drugs. This substance, produced in, has an anti-stress effect, regulates circadian rhythms, affects metabolism, slows down the aging process and weight gain, and also stimulates the production of antibodies to infectious agents and tumor cells.

What is Hormone Replacement Therapy?

In chronic conditions associated with dysfunction of the glands or their partial removal, drugs with synthetic and natural hormones provide a high quality and longevity of the patient.

There are several types of hormone replacement therapy:

• treatment with synthetic thyroid hormones;
• insulin therapy;
• taking analogues of sex hormones.

Deficiency and excess of thyroxine and triiodothyronine are fraught with mood disorders, sleep, dry skin, problems with memory and performance, growth of gland tissues and other unpleasant symptoms.

Clinical hypothyroidism is most often associated with diseases and tumors of the thyroid gland, so replacement therapy with analogues of iodine-containing hormones is prescribed for life.

Substitution therapy uses drugs such as:

• "Eutiroks";
• "L-thyroxine" (one of the Russian or German brands).

The treatment of hyperthyroidism has a somewhat more complex scheme: thyreostatics are used to reduce the synthesis of own iodine-containing hormones, and in especially difficult cases, removal of a part of the gland or radioiodine therapy is justified. Then the normal level of triiodothyronine is restored with the help of their synthetic analogues.

Insulin is a pancreatic β-cell hormone, the main task of which is to lower blood glucose levels by regulating its entry into cells and stimulating the conversion of monosaccharide into glycogen.

Violation of the functionality of the cells that secrete this hormone is called type 1 diabetes mellitus. Patients with such a pathology must be prescribed replacement therapy with Humodar, Apidra, Novorapid, Actrapid, Humulin, Insulin Tape, etc.

In type 2 diabetes, which is associated with a violation of the sensitivity of tissues to insulin, the administration of hormones can also be prescribed.

Finally, female hormonal replacement therapy (HRT) is a pharmacological replacement for the function of the sex glands (ovaries) lost during their removal or menopause. The most commonly used drugs are:

• "Climodien";
• "Divina";
• "Ovestin";
• "Trisequens";
• "Femoston";
• "Estrofem" and others.

During treatment, androgens, estrogens and gestagens can be used (mainly the last two subtypes of hormones are involved in the preparations).

oral contraception

Oral contraceptives are the most well-known hormonal pills for women. The action of OK is based on their ability to prevent ovulation (the maturation of the egg and its release from the follicle). Synthetic hormones thicken the mucus on the cervix, which complicates the movement of the sperm, and also thin the uterine lining (endometrium), which prevents the fertilized egg from firmly attaching.

The triple mechanism of action of hormones reliably protects the patient from unwanted pregnancy: the Pearl index for oral contraceptives (the percentage of pregnancies that occur while taking OK) does not exceed 1%.

When using oral contraceptives, menstrual bleeding does not stop, but it becomes more regular, less heavy and painful. A certain scheme of taking hormones allows, if necessary, to delay the onset of menstruation.

Modern contraceptives are classified into three categories:

• One-component preparations (Continuin, Micronor, Charozetta, Exluton).
• Combined oral contraceptives (COCs). COCs are the most reliable means. They include synthetic estrogen () and progestogen (levonorgestrel, desogestrel, norgestrel, etc.).
• Postcoital (emergency) hormonal pills (Postinor, Escapel). Emergency contraceptives contain an increased dose of hormones, but have a lower effectiveness.

The dosages of active hormones in modern contraceptives are much lower than in the drugs of the last century, so the side effects of taking estrogen do not appear or appear slightly.

Combined hormonal contraceptives

COCs are divided into mono-, two- and three-phase. Single-phase COC tablets contain a strictly defined amount of hormones that does not change during the cycle. Multi-phase agents are conceived as more physiological: the dosages of active ingredients in tablets for different days of the cycle are not the same.

Three-phase COCs (with three types of tablets changing per cycle) are often recommended by doctors, but two-phase drugs are practically not used.

Combined contraceptives:

A different dosage of the active substance (levonorgestrel) allows you to adjust to hormonal fluctuations during the menstrual cycle and provide a high degree of protection against unplanned pregnancy at low concentrations.

Hormonal remedies for men

Male hormonal preparations are classified into means for gaining muscle mass, directly drugs for inhibiting the pathological process, and hormones for replacement therapy.

In practice, hormones of the adrenal glands (in particular, testosterone), the pancreas (insulin) and the anterior pituitary gland (somatropin or growth hormone) are actively used. They are used to form muscle relief, accelerate mass gain and burn fat. Taking hormonal drugs without a doctor's prescription has a number of negative consequences, including damage to the organs of the excretory system and possible gynecomastia (swelling of the mammary glands) due to the conversion of excess testosterone into the female hormone estrogen.

For medical purposes, hormonal agents are used for hormone-dependent tumors (for example, for prostate cancer). Injections with analogues of pituitary hormones dramatically reduce the production of testosterone, which accelerates the growth of a malignant neoplasm. This procedure is called "medical castration". The introduction of hormones allows you to slow down the development of the tumor and resort to more radical methods of treatment. Despite the menacing name, patients should not be afraid of the irreversibility of the procedure: some time after the end of treatment, erectile function and normal testosterone levels are restored.

Replacement therapy with male hormones can be used both with the complete removal of the gland producing them, and with a decrease in its functionality. After 40-45 years, the level of testosterone in the blood of a man begins to decline, which leads to problems in the genital area. To restore potency, the following drugs are used:

• "Undecanoate Testosterone" and "Andriol" (tablets with one active ingredient - testosterone undecanoate);
• "Sustanon" (injection solution with four active ingredients-esters - decanoate, isocaproate, phenylpropionate and);
• "Nebido" (injectable oil solution of testosterone undecanoate);
• "Androgel" (a product for external use, the active ingredient is testosterone).

After the complete removal of the testicles (due to a tumor of the prostate or gonad), replacement therapy is required.

The attitude towards hormonal drugs among people who are unfamiliar with medical reference books is predictably biased. Many drugs in this group have strong and a number of contraindications - for example, with prolonged use of Prednisolone, rapid weight gain occurs, the face of a patient receiving premedication with this drug swells.

However, this is not a reason to refuse any means containing hormones, including effective birth control pills. By following a few simple rules, the risk of complications from taking hormonal drugs is minimized.

Rules for taking hormonal drugs (GP):

• You can not take GP without the appointment of the attending physician (endocrinologist or gynecologist). Especially dangerous when self-administered are drugs that are classified as synthetic analogues of adrenal hormones.
• Before prescribing hormonal treatment to a patient or a patient, a specialist should carefully study the history, the results of blood tests for the concentration of sex hormones and biochemical parameters, the results of pelvic ultrasound, mammography, cytological smear. It is necessary to inform the doctor about existing chronic diseases: some of them are contraindications for taking COCs and other synthetic drugs.
• All changes in the state of health should be reported to the attending physician.
• Having missed the dose of the drug, it is strictly forbidden to “compensate” for negligence with a double dose of the drug in the next dose.
• It is necessary to take hormone pills strictly at the same time with minimal errors. Some drugs (for example, L-thyroxine) are drunk in the morning, on an empty stomach.
• The duration of the course and dosage (including its change during treatment) is determined by the attending physician.

The effectiveness and safety of hormonal treatment depends on the competence of the endocrinologist, the interaction of the doctor with the patient and strict adherence to the rules for taking drugs.

There comes a time in every woman's life when she thinks about protection against unwanted pregnancy. Currently, pharmacy shelves offer a wide range of hormonal pills that are highly effective. However, in the minds of Russian women, the memory of their side effects associated with gaining excess weight is still alive.

In this regard, many representatives of the beautiful half of humanity prefer to use contraceptives that do not contain hormones, despite their low effectiveness. What non-hormonal contraceptive pills do pharmacists offer women, and what new-generation hormonal contraceptives do not have side effects on the female body?

Nowadays, women of reproductive age are increasingly resorting to chemical protection against pregnancy provided by non-hormonal pills. However, they justify their name only by the form, although they are not tablets as such. These drugs are not taken orally, like traditional hormonal contraceptives, but are inserted into the vagina.

The composition of such drugs includes spermicides - substances that destroy spermatozoa for a short period of time, preventing their penetration to the fallopian tube. Their active substance is benzalkonium chloride or nonoxynol.

How exactly do non-hormonal contraceptives work?

• Coming into contact with the spermatozoon, spermicides destroy the flagellum, preventing its further movement.
• When interacting with the head of the sperm, the membrane is damaged, which leads to its death.
• Causes thickening of mucus in the cervical canal of the cervix, which becomes a reliable obstacle to the advancement of weakened spermatozoa.

Spermicide-based preparations are also available in other substances, which include the following forms:

• vaginal suppositories;
• vaginal creams and gels;
• tampons;
• diaphragms in the form of soft dome-shaped caps covering the cervix.

Regardless of the form of release, the use of non-hormonal contraceptives allows you to create a reliable protective barrier against fungi and other diseases transmitted during unprotected intercourse. This is facilitated by the substances that are part of the preparations, which have a bactericidal and antimicrobial effect.

A distinctive feature of non-hormonal methods of contraception is that they must be used immediately before intimacy. At the same time, they retain their effectiveness for several hours.

Degree of reliability

Evaluation of the effectiveness of certain contraceptive drugs is made on the Pearl scale. The study is conducted among 100 women using this particular method of contraception. This indicator is based on information about how many women among the subjects managed to become pregnant despite protection. And the lower the indicator, the higher the effectiveness of the evaluated group of drugs.

In this case, this indicator is 8-36. And this means that from 8 to 36 women out of 100 become pregnant even with protection from unwanted pregnancy.

When is the use of non-hormonal drugs indicated?

Despite the rather low efficiency, non-hormonal contraceptive pills have a number of advantages compared to hormonal methods of contraception.

• They can be used for various gynecological diseases, for example, uterine fibroids, as well as in the presence of hormone-dependent tumors.
• These drugs do not enter the stomach and are not absorbed into the blood, and therefore are not able to affect the liver, blood vessels and other body systems.
• They can be used for rare sexual contact.
• They have a bactericidal and antimicrobial effect, which hormonal agents are deprived of.

Non-hormonal contraception will be a reliable protection for women who are breastfeeding babies. They are used if women are contraindicated in the use of COCs or other types of contraceptives.

These drugs will help prevent pregnancy in women of Balzac age (40-45 years). In this age period, the menstrual cycle is already irregular. However, the possibility of pregnancy is not excluded yet.

Disadvantages and contraindications

Such drugs are injected into the vagina. Moreover, this must be done at least 10 minutes before the intended sexual contact. This means the absence of any unpredictability in sex and the need to discuss with the partner the time of each intercourse. When using these drugs, it is not recommended to take a shower immediately before and after sexual intercourse. The time to wait is specified in the instructions for each drug.

As part of non-hormonal drugs, there is an acid that can irritate the mucous membrane, causing itching and burning in the vagina. At the same time, these funds are not recommended to be used regularly, since their long-term use can lead to a violation of the microflora in the vagina, causing the development of dysbacteriosis. There are no contraindications for the use of these contraceptives. The only exception is the individual intolerance of their components.

Overview of popular contraceptives

All non-hormonal tablets are divided into groups, based on which of the active ingredients is included in their composition.

Names of contraceptives based on benzalkonium chloride:

• Pharmatex is the most popular because of its low cost, combined with high efficiency. It is available both in the form of vaginal tablets, and in the form of a cream, suppositories and even tampons. Regardless of the dosage form, the drug begins to act 10 minutes after ingestion, without losing its properties for 3-4 hours.
• Ginotex are ring-shaped tablets. It is recommended to enter them no later than 5 minutes before contact. The action of the tablet lasts for 4 hours.
• Genoteks are tablets, the action of which is identical to the previous drugs.
• Erotex - non-hormonal contraceptive suppositories, the action of which begins after 10 minutes and ends after 3 hours.
• Contratex are candles that begin to perform their functions after 10 minutes and finish after 4 hours.

Names of contraceptives based on nonoxenol:

• Patentex Oval - highly effective suppositories that are inserted into the vagina 10 minutes before the intended intimacy. They keep their action up to 10 hours.
• Nonoxenol is a contraceptive suppository that has the same characteristics as the previous drug.

It should be remembered that before each subsequent sexual intercourse, non-hormonal contraceptives must be reintroduced.

Features of choice

How to determine which non-hormonal birth control pills are best? Given their low cost, when choosing the price is not a decisive factor. However, as the experience of women who have already experienced all existing forms of non-hormonal contraceptives shows, candles are suitable for ladies suffering from vaginal dryness. When using them, there is no need to use lubricants.

There are also unpleasant phenomena associated with the fact that when the tablet is dissolved, a characteristic hiss is heard, and foam is released from the vagina. In addition, even using the best preparations, it is possible that irritation, itching and burning can occur not only in women, but also in their partners. Every woman's body reacts differently to certain substances. Therefore, it will be necessary to determine which of the non-hormonal contraceptives is better through trial and error.

Hormonal birth control

Every year, an increasing number of women prefer the use of hormonal oral contraceptives, which is explained by their high efficiency. They not only reliably protect against unwanted pregnancy, but also have a beneficial effect on the female reproductive system. Among other contraceptives, a new generation of contraceptives took pride of place on the pedestal.

All modern hormonal preparations for oral administration are divided into four types, based on the amount of hormones they contain.

• Microdose contraceptives contain a minimal amount of hormones, which practically deprives them of side effects. The active substance in such preparations is a synthetic analogue of estradiol. Because of this, they are used to treat acne and painful menstruation that occurs due to imbalance of hormones. Such drugs can be used by both very young nulliparous girls and mature women who have never taken hormonal contraceptives.
• Low-dose contraceptives also contain synthetic in combination with. Such drugs will be an ideal means of preventing unwanted pregnancy for young women who have already given birth. In addition to the contraceptive effect, these drugs help to eliminate the manifestations caused by excessive levels of male sex hormones in the body. These include hair growth in inappropriate places, acne, and male-pattern baldness.

• Medium-dose contraceptives contain synthetic analogues of estradiol with progesterone. They are intended for mature women who have given birth. Like the previous version, these drugs are designed to normalize hormonal levels. However, they should not be used during breastfeeding.
• High-dose contraceptives contain high doses of estradiol and progesterone. Such drugs are most often used for medicinal purposes to restore hormonal levels. To protect against unwanted pregnancy, birth control pills of a new generation are recommended for women who have given birth after 35 years of age.

emergency contraception

These funds are used in emergency situations, and allow you to prevent pregnancy after unprotected intercourse. They are recommended for use in the following cases:

• in case of violent actions, or if the condom is damaged;
• with infrequent sexual intercourse.

Contraindications to their use include a violation of blood clotting, heart and vascular disease, liver and kidney failure, malignant tumors and smoking.

Features of taking pills

How long can oral contraceptives be taken, and do they need to be changed? They must be taken daily and preferably at the same time. And it is recommended to start taking them on the first day of menstruation. These drugs are intended for long-term use. However, women taking hormonal contraceptives need to visit a gynecologist every year. In the absence of any contraindications, contraception can be continued.

With long-term use of COCs, menstruation may stop altogether, and this is not a pathology. However, if a woman forgot to take a birth control pill, and the last day of menstruation is long gone, this may be a sign of pregnancy. After the abolition of contraceptives, the menstrual cycle is fully restored within 1-2 months. In this case, pregnancy can occur immediately or after a short period of time. You can drink birth control pills for several years. If they do not cause any side effects in a woman, they should not be changed. Otherwise, the body will experience stress.

Natural ways of protection

Methods of protection against unwanted pregnancy without hormones have been used since ancient times. Despite the wide range of modern contraceptives offered by pharmacists, they still do not lose their relevance today.

One of them is based on counting the days of ovulation. The average menstrual cycle is 28 to 30 days long. In its first half, the follicle matures. And ovulation occurs in the second half of the cycle. The ability to fertilize a mature egg remains for 2-3 days. In this case, spermatozoa can take a wait-and-see position for 4 days. Therefore, special care must be taken only about a week in the middle of the cycle.

In some cases, it is possible to determine the days of ovulation by measuring the basal temperature, which rises on the most dangerous days. However, the reliability of calculations and measurements of temperature in the rectum cannot guarantee full protection.

Some couples practice coitus interruptus. However, in this case, the onset of pregnancy is not excluded, since a small amount of sperm may be contained in the lubricant secreted by the partner's penis. In this case, the likelihood of pregnancy increases depending on how many sexual acts were performed.

Bibliography

1. Venereal diseases. Directory. Ed. N. 3. Yagovdika. - Minsk: "Belarusian science", 1998. - 342 p.
2. Emergency conditions in obstetrics. Sukhikh V.N., G.T. Sukhikh, I.I. Baranov et al., Publisher: Geotar-Media, 2011.
3. Pregnancy and childbirth with extragenital diseases. Certification of UMO for medical education, Apresyan S.V., Radzinsky V.E. 2009 Publisher: Geotar-Media.
4. Rakovskaya I.V., Vulfovich Yu.V. Mycoplasma infections of the urogenital tract. - M.: Medicine, 1995.
5. Diseases of the cervix, vagina and vulva / Ed. V.N. Prilep-

She graduated from the Kirov State Medical Academy in 2006. In 2007, she worked at the Tikhvin Central District Hospital on the basis of the therapeutic department. From 2007 to 2008, he worked at a hospital for a mining company in the Republic of Guinea (West Africa). From 2009 to the present, he has been working in the field of information marketing of medical services. We work with many popular portals, such as Sterilno.net, Med.ru, website

Methods of contraception for women are considered. The names of the most common contraceptives that are sold in pharmacies are presented.

Contraceptives are drugs that protect a woman from unwanted pregnancy. There are a lot of myths around hormonal pills. Many believe that their intake is accompanied by weight gain and the inability to become pregnant in the future. We will try to dispel or confirm dubious information regarding female contraceptives.

Why should women use contraceptives?

If you ask about the most popular contraceptive, most will answer that it is condoms. But this method is inconvenient and quite expensive if you have a permanent sexual partner whom you trust.

Accordingly, contraceptives are used by women to prevent pregnancy and to get more vivid sensations during sex. Oral contraceptives are used for medicinal purposes and allow you to get rid of skin problems and female ailments.

What are the types of contraceptives for women?

Types of female contraceptives:

• Spermicides- ointments or gels containing substances that slow down the movement of spermatozoa. These drugs thicken cervical mucus and prevent male cells from entering the uterus.
• Spiral- a small piece of plastic or metal. Placed by a doctor inside the uterus
• Oral contraceptives- pills based on female hormones. They can block ovulation or thicken cervical mucus.
• Patch- hormonal contraceptive. Hormones enter the body through the skin
• vaginal ring- a silicone or plastic ring that contains a small dose of hormones. Set for 21 days. You can do it yourself without the help of a doctor
• natural way- calendar method. It is used based on the calculation of periods of pregnancy and fertility
• Coitus interruption method- before ejaculation, the partner removes the penis from the vagina

Barrier contraceptives for women. Pros and cons

Barrier contraception is a method of preventing pregnancy by using mechanical barriers that prevent sperm from entering the uterine cavity. Barrier contraception includes local chemicals that inhibit the activity of spermatozoa. Barrier contraceptives include: sponge, diaphragm, cap, female condom, candles, ointments, gels.

Advantages:

• Can be used immediately before sexual intercourse
• Protects against most sexually transmitted diseases (spermicides)
• High reliability
• Can be used by women who have given birth and have not given birth
• Low price
• Rapid recovery of reproductive function

Flaws:

• Less reliable than hormonal contraceptives
• Often cause allergies and itching
• Reduce sensitivity

Chemical contraceptives for women

This is a barrier contraception, based on the reduction of sperm activity with the help of chemicals. Often cause allergies and burning. High degree of protection and low price. Below is a list of popular spermicides.

Non-hormonal contraceptives for women, list

These substances are means of barrier contraception. Their effectiveness is due to a decrease in sperm activity. Some of the drugs generally kill spermatozoa.

List of chemical non-hormonal contraceptives:

• Pharmatex- a drug produced in the form of candles, sponges, cream and gel. This is a common spermicide that contains benzalkonium chloride - an antiseptic. Accordingly, the drug can be used when having sex with casual partners. Period of action 3 hours after insertion into the vagina
• Benatex- available in the form of vaginal tablets and gel. Contains spermicide and antiseptic. There are no hormones in the preparation, so the substance does not affect the menstrual cycle
• Pantex Oval- spermicide based on nonoxynol. It has antimicrobial and antiviral properties. Inserted into the vagina 15 minutes before sexual intercourse
• Concepttrol- available in the form of suppositories and contains nonoxynol
• Gynecotex- spermicide based on benzalkonium chloride. This is a combined substance that kills viruses and bacteria, and also reduces the motor activity of spermatozoa.

Local contraceptives for women

These are chemical and mechanical means that either reduce the mobility of sperm, or simply prevent their penetration into the uterus.

Mechanical local contraceptives:

• female condom- analogue of the male, inserted into the vagina. One edge is fixed on the cervix, and the second will remain outside. Accordingly, it protects not only from pregnancy, but also from infection with diseases transmitted during sex.
• Diaphragm- This is a domed cap made of latex or rubber. It is worn on the cervix and simply prevents the penetration of sperm into the uterus. Can be used multiple times. The doctor selects this contraceptive, since the sizes of the diaphragm are different. After childbirth or due to weight gain, you need to purchase a larger diaphragm
• cervical cap- a product made of soft rubber. It is put on the cervix according to the suction cup principle. Negative pressure is created due to compression of the cap, and it is securely fixed. Low degree of protection due to the possibility of warping the cap during intercourse.

Hormonal contraceptives for women

• Preparations containing the hormones estrogen and progestin. They change the composition and viscosity of the cervical mucus, making it impossible for sperm to enter the vagina. Some combined contraceptives inhibit ovulation. Accordingly, the egg does not mature, so pregnancy is impossible
• Mechanical products with a low content of progestins: plaster, injections and subcutaneous implants. The patch can be considered the most convenient - this is a relatively new contraceptive. It contains ethinylestradiol and norelgestromin, synthetic analogues of female hormones. Hormones enter the blood through the skin. Small amounts of hormones are released every day. The effect of the patch is based on a decrease in the thickness of the uterine mucosa, to which the embryo cannot attach. In addition, the patch inhibits the work of the ovaries and prevents the growth of the dominant follicle containing the egg.

Contraceptive injections for women. Pros and cons

In our country, this method of contraception is unpopular. This is due to the high price of the drug and the distrust of women. The injection is given once every 3 months intramuscularly. It is necessary that the injection was administered on the 5th day of the menstrual cycle.

The essence of using the drug is that it contains progesterone, which thickens the uterine mucosa and thickens the cervical mucus.

In addition, ovulation is suppressed. Injections can be used by women who have given birth and who have not given birth. In the world, not a single case of infertility after drug withdrawal has been registered. Although the reproductive function is restored in 6-12 months.

Advantages:

• Efficiency is 99%
• No need to constantly calculate the days of the menstrual cycle
• Suitable for women who smoke
• Has healing properties and contributes to the disappearance of endometriosis, endometrial hyperplasia

Oral contraceptives for women, video

Oral contraceptives are well-known contraceptive pills with a combined hormonal composition. On the video you can watch the speech of a gynecologist regarding COCs.

Video: Oral contraceptives

Contraception for women after childbirth

Please note that combined contraceptives should not be taken during breastfeeding. They affect the amount of breast milk.

• mini pili
• Hormonal injections
• Intrauterine device
• Remember, you can’t have sex for a month after giving birth, so after the discharge stops, you can resume sexual activity.
• If you have a permanent sexual partner, then it makes sense to put a spiral or take hormonal contraceptives based on progestogens. These are synthetic hormones similar in their action to progesterone. It does not suppress lactation, does not harm the health of the baby, since a very insignificant amount of the drug penetrates into the milk.
• Previously, it was believed that it was possible to protect yourself after the birth of a child by a natural method. That is, because of the development of lactational amenorrhea, when there is no menstruation, it is safe to have sex. But now many doctors note the inefficiency of the method. Some women ovulate spontaneously, leading to an unplanned pregnancy

Contraceptives for nulliparous women

Many young girls are wary of taking hormonal oral contraceptives. they believe that they will gain a lot of weight and become unattractive. This is not true, since in most women there is no increase in body weight at all or there is a slight weight gain of 2-3 kg.

There are rumors of numerous cases of infertility after the abolition of COCs. This is also a myth, since reproductive function is restored after 3-8 months. Some girls managed to conceive a child in the first month after the abolition of contraceptives.

But if you still decide to take COCs, then seek help from a doctor, he will prescribe a drug with minimal doses of progestins and estrogens. Most often, young girls are prescribed Novinet, Jazz, Yarina.

They improve the condition of the skin, make menstruation less painful. COCs are not used for cystic changes in the ovaries and for endometriosis.

Ideal for nulliparous women who have a permanent sexual partner are the following methods:

• Barrier contraceptives
• condoms

An intrauterine device is not installed for nulliparous girls because of the possibility of developing pain and uterine bleeding after removing the device.

Emergency contraception is used in such cases:

• Rape
• Missing COCs
• condom damage
• Sexual contact without protection

These are drugs that cause the endometrium to detach from the uterus. Thus, menstruation begins and the sperm is simply carried away from the uterus along with the blood. It is recommended to take no later than 24-72 hours after sexual contact. Here are the names of some emergency contraceptives: Postinor, Escapel, Mifegin, Miropriston.

The best contraceptives for women over 30. Video

• Usually, by the age of 30, a woman already has a child and a permanent sexual partner. In this case, an intrauterine device is considered an ideal option.
• Often prescribe a spiral containing progesterone. Such contraceptives are indicated for women with endometriosis and other estrogen-dependent diseases. Mirena is considered the most popular hormonal coil. Its cost is high, but its validity period is 3-5 years
• In women who have given birth after 30, medium-dose combined oral contraceptives are used. They contain more hormones, this is due to the physiological characteristics of the body at this age. Among such drugs are Diana, Chloe, Dimulen

VIDEO: Contraceptives for women

Contraceptives for women over 45. Which ones to choose?

• At this age, many women have chronic ailments and are overweight. That is why classic COCs are not prescribed
• For such women, three-phase preparations have been developed, with a minimal androgenic effect. Often, before menopause, mini-pills are prescribed - progestin contraceptives. Since many women who have given birth have endometrial hyperplasia and endometriosis
• It is best to put the Mirena hormonal coil after 45 years. It will help not only not to become pregnant, but also to restore the mucous membrane of the uterus. Such a spiral reduces the risk of developing uterine cancer at times
• After the birth of a second or third child, a woman may be sterilized. This is a tubal ligation operation. Now such an operation is performed without the use of scalpels, by laparoscopy.

Contraceptives for lactating women. Features of the choice of contraceptives for breastfeeding women

• The ideal option is mini-pills or injections of Depo-Provera (progestins). They do not affect lactation, do not affect the health of the baby. But in most cases, women do not want to take any medication during lactation, so they use barrier methods of contraception.
• It is not worth using for contraception the absence of menstruation during lactation. This method only works if you have never missed a feeding, that is, the interval between feedings was no more than 3 hours.

Women's birth control pills. Which ones to choose?

• Low dose drugs. Assigned to nulliparous girls, they contain a minimum of hormones (Jazz, Novinet)
• medium dosage drugs prescribed for women over 30 years old (Diana)
• Progestin drugs should be taken in the presence of endometriosis, endometrial hyperplasia (Norkolut, Mini-pill)

Do not buy birth control pills on your own on the recommendation of a friend or pharmacist.

The doctor must assess your state of health and only then prescribe a specific drug. What suits your friend may not suit you. With endometrial hyperplasia and adenomyosis, drugs with a high content of estrogens should not be taken. From this, the mucosa thickens and the problem worsens.

Folk remedies for contraception. Recipes

• Douching with a slightly acidic solution. Usually a tablespoon of acetic acid or lemon juice is added to a glass of water.
• calendar method. Periods of pregnancy are calculated before and after menstruation. 5 days before and after your period are considered safe.
• Rowan flower remedy. To prepare the substance, pour a tablespoon of flowers with 200 ml of boiling water. Insist an hour and strain. Take 100 ml before each meal.
• Coitus interruption method
• Douching with a weak solution of potassium permanganate

Traditional medicine offers many methods of emergency contraception that cause rejection of the ovum during pregnancy. Almost after using each of these remedies, a woman is taken in an ambulance from uterine bleeding. The hospital is cleaning. There are known cases of death due to blood poisoning due to rotting of the fetus inside the uterus.

The value of contraceptives in maintaining women's reproductive health

Combined oral contraceptives, when used correctly and prescribed by a doctor, prolong a woman's youth. Oddly enough, after stopping the drugs, even women aged 45-55 can become pregnant. This is due to the fact that at birth, every girl in the ovaries contains the rudiments of future dominant follicles.

When taking COCs, there is no ovulation, which means that this potential dominant follicle is stored until the next time. In medicine, this phenomenon is called Anti-Müllerian hormone. With a high content of it, a woman can become pregnant. With a very low concentration of this hormone, a woman will not be able to get pregnant even with IVF, as the supply of eggs has been exhausted.

The effect of contraceptives on a woman's body

If you take the drugs correctly and as prescribed by the doctor, then the effect of the drugs will be positive. Many of the COCs are designed to treat ailments of the reproductive function of women. Try to change the contraceptive once a year, as the body often gets used to it and spontaneous pregnancy may occur.

How to protect yourself without pills and spirals?

Despite their inefficiency, the following methods are still popular:

• Calendar
• Coitus interruption method
• Douching with potassium permanganate or a solution of vinegar after sex
• To be sure, use barrier methods of contraception
• It's easiest to use a condom
• With a regular sexual partner, you can use spermicidal gels and suppositories

About hormonal contraceptives, you can find a lot of positive and negative reviews. In most cases, negative experiences are associated with the use of a drug that was not prescribed by a doctor, but was recommended by a friend or pharmacist.

• Often, after miscarriages, low-dose COCs are prescribed to restore the menstrual cycle. After their cancellation, many women managed to get pregnant.
• In young girls who have not given birth, the condition of the skin improves, acne disappears, and menstruation becomes less painful
• In general, taking hormonal contraceptives has a positive effect on a woman's health. It's much safer than recovering from an abortion or miscarriage.

The final decision on the use of contraceptives is made by the woman. Remember, no persuasion of a partner and the pleasure of sexual intercourse without a condom and contraceptives are not worth your health. Therefore, always protect yourself and consult a good gynecologist. Health to you.

VIDEO: Consequences of hormone therapy

Content

Prevention of unwanted pregnancy is one of the most important issues in maintaining a woman's reproductive health. It is no secret that the consequences of an abortion cause more harm to the body than rationally selected hormonal methods of contraception. Today, each patient is able to find the best way to prevent pregnancy, if necessary, supported by a therapeutic effect.

Modern contraceptive methods for women

To date, there are a huge number of ways to prevent conception. Each method individually has its own advantages and disadvantages. When choosing the safest contraceptive to prevent unwanted pregnancy, the patient should receive the following information:

• the effectiveness of the method, the likelihood of pregnancy;
• rules for the use of contraception;
• mechanism of action, adverse reactions;
• possible health risks;
• degree of protection of the method against STIs;
• symptoms requiring medical attention;
• restoration of fertility if desired.

Despite many myths, modern contraception includes hormonal methods in various variations of the delivery of the main substance. Hormonal pills of the latest generations, in addition to the main effect of preventing unwanted pregnancy, simultaneously have a number of positive effects: they improve the skin, reduce the amount of discharge and pain during menstruation, and eliminate PMS. Some contraceptives additionally include folic acid in the preparation of the patient's body for future gestation.

Rules for choosing a contraceptive method

At a consultation appointment with a gynecologist, after a thorough examination and additional examination, the most appropriate method of contraception is selected on an individual basis. A properly selected contraceptive for women provides the desired result with the least number of undesirable effects, while the patient must be ready to use the selected method for a long time.

There are no special rules for choosing a contraceptive method. During the examination, the woman is informed about all possible protection options, advised to choose the most reliable modern products.

Some patients are indignant that the doctor did not prescribe a hormonal examination before prescribing COCs. WHO recommendations and studies confirm that a healthy young woman does not need to be tested for sex steroids to successfully select a hormonal contraceptive method.

Attention! In routine practice, contraceptives for women under 30 are selected by careful questioning, examination and measurement of pressure in the absence of data on serious diseases.

Types of contraception

There are biological, barrier, hormonal and surgical methods of contraception. The first two are considered relatively outdated, ineffective. The degree of protection of the method depends on the rules of use and subjective feelings, which does not always guarantee a high result. The advantage of these tools is security. The remaining methods are classified as modern, effective methods of regulating conception. The disadvantages of such contraception are the existence of contraindications, the development of adverse reactions. In order to avoid serious harm to health, a medical consultation is always carried out to clarify all possible risks.

Important! Only a condom (male and female) can protect a woman from STIs.

Hormonal contraceptives

The most common method of preventing pregnancy in the world is hormonal. The classification of contraceptives divides hormonal preparations into combined and containing only progestin. Combined products contain estrogen and progesterone components. Depending on the concentration of substances in the drug, it differs: monophasic, two- and three-phase contraception.

Taking hormonal contraceptives provides reliable protection against conception. Hormones can enter a woman's body in different ways:

• orally;
• injection;
• to be implanted under the skin;
• applied as a patch to the surface of the body;
• inserted with a spiral into the uterus.

More often, women use the oral method of administering the active substance. However, this technique of contraception requires patients to be systematic. Tablets should be used daily, preferably at the same time of day. Distortion, violation of the regimen, vomiting or diarrhea lead to a decrease in the protective effect.

Mechanism of action of hormonal contraceptives

The basic principle of protecting these drugs from conception is to prevent ovulation. The absence of a monthly egg release makes fertilization an impossible phenomenon, which provides reliable contraception. In addition to blocking ovulation, the method contributes to a change in the properties of cervical mucus, which leads to death, prevents the advancement of spermatozoa into the vagina. The drugs reduce the contractility of the fallopian tubes and prevent the thickening of the endometrium before the proposed implantation.

The regular intake of COC hormones maintains contraception at the proper level, a decrease in the concentration of substances leads to a loss of effectiveness. Therefore, when choosing this method of contraception, it is important to take pills daily.

The appointment of hormonal contraceptives is carried out only by a specialist, which is associated with a wide variety of drugs with different auxiliary effects:

• regulation of the duration of the cycle, the ability to delay the onset of menstruation;
• decrease in blood loss;
• elimination of PMS;
• has a therapeutic effect in endometriosis, androgenital syndrome.

Such drugs are able to simultaneously have a therapeutic effect and prevent conception, so COCs are considered the number one contraceptive method in the world.

Side effects of hormonal contraceptives

When using contraceptives, the following adverse reactions may develop, which often develop in the first months of using drugs due to the restructuring of endocrine regulation:

• headache;
• intermenstrual bleeding;
• mood swings, apathy;
• violation of well-being and performance;
• soreness of the mammary glands;
• puffiness;
• increase in blood pressure.

Important! Hormonal contraception is contraindicated in venous thrombosis, severe arterial hypertension, after 40 years with a long smoking history, with migraine with aura, stage 3-4 obesity, cancer.

New generation hormonal contraceptives

Thanks to long-term research and advances in molecular chemistry, it was possible to minimize the doses of hormones in drugs while maintaining the contraceptive effect. Today, low-dose contraceptives with a minimum number of adverse reactions are considered the drugs of choice. One tablet of this remedy contains up to 35 mcg of the estrogen component.

Gestagens, in turn, are divided into 3 generations. New progestins have no negative effect on carbohydrate, fat metabolism and blood coagulation processes. As a result, modern methods of hormonal contraception are much safer than their predecessors.

List of hormonal contraceptives

Young women concerned about weight control prefer contraception with:

• Lindinet 20;
• Logest;
• Novinet;
• Mercilon.

• Diana -35;
• Jeanine;
• Modell Pro;
• Rigevidon;
• Yarina;
• Qlaira;
• Jess;
• Femodene;
• Silhouette.

During lactation, young mothers use the following protection methods:

• Charosetta;
• Lactinet;
• Microlute.

Barrier contraception

The barrier method of preventing conception is considered preferable for non-permanent sexual contracts, insecurity in a partner. The condom is considered the only method of contraception that protects against most STIs. The rest of the female contraceptives are devoid of this property. Barrier methods are still one of the main means used by adolescents.

Important! Proper use of a condom from the beginning to the end of sexual intercourse is essential. The use of the drug only before ejaculation significantly reduces the contraceptive effect.

Chemical contraceptives

Spermicides are available in different forms: cream, suppositories, gels, aerosol, sponges, tablets for topical application. Thanks to the special composition of the contraceptive, spermatozoa are inactivated. The effectiveness of the method is highly dependent on compliance with the rules for using the drug. If the instructions are not followed, the contraceptive effect of contraception can be completely leveled. Plus, a significant drawback is that such contraception is felt by both partners, sometimes causing a burning sensation.

Mechanical contraception

Cervical caps, diaphragms, condoms for women serve as a mechanical obstacle to fertilization. The effectiveness of the methods depends on the accuracy and correct installation of the protective formation.

Local contraceptives for women

The intrauterine device is considered a fairly simple and reliable modern method of contraception. On average, the device provides protection against unwanted pregnancy for 5 years, and you do not need to worry about taking the drug or the reliability of the condom every time. The method of contraception is acceptable when breastfeeding, and is recommended for use by all women who have given birth.

Single contraceptives

As an emergency method of protection against pregnancy, emergency contraceptives for girls are applicable. This concept involves the use of special methods after sexual contact to reduce the likelihood of conception. This method of contraception is allowed to be taken during forced sexual intercourse, in case of violation of the integrity of barrier contraceptives. The method is not intended for permanent use. The greatest effectiveness of postcoital contraception is shown when taking pills in the first 72 hours after intercourse.

Important! Single-acting drugs use high concentrations of hormones. For permanent use, partners should choose another reliable way to prevent pregnancy.

Surgical methods of contraception

Apart from sexual abstinence, sterilization is considered the most effective contraceptive. The effectiveness of the contraceptive method is close to 100%, but even in this case there is a small risk of conception. The disadvantage of this contraception is irreversibility. In most cases, sterilization is used by women who are categorically contraindicated in bearing. Another option for the use of surgical tubal ligation is when a woman has already given birth to the desired number of children (usually more than 3) and no longer needs offspring or has acquired diseases that worsen during gestation.

Important! If a married couple, for various reasons, decided to have children after sterilization, then independent pregnancy is not possible. For conception, you will need to resort to assisted reproductive technologies.

How to protect yourself without pills and spirals

In addition to the main methods of preventing unwanted pregnancy, there are methods that protect more than 30% of the female population. These include the so-called methods of fertility control. Physiological methods of contraception include the use of coitus interruptus, counting dangerous days and determining the day of ovulation.

Unfortunately, these methods of contraception are considered the least reliable. There is no complete confidence in the correctness of using the method: the sexual partner cannot always restrain himself at the right time, there is a small amount of spermatozoa in the lubricant. The calendar method of contraception is based on measuring basal temperature, controlling sensations and determining the time of release of the egg, which is not always correct. As a result, the calculation is violated, the effectiveness of the contraceptive method decreases.

Important! When determining the period of ovulation, 9-19 days are considered potentially dangerous with a 28-day cycle. During this period, a woman must protect herself from conception in another way or not have sex.

What are the best contraceptives

The safest contraceptive is abstinence. In reproductive age, the most reliable method to prevent conception is the use of hormonal contraception. Birth control pills are among the most effective means. It is acceptable to use COCs in young people, in patients 6 months after childbirth while breastfeeding, in the absence of contraindications. Mini-pills (pure gestagens) are used in cases where the estrogen component is contraindicated.

However, due to the extensive list of contraindications, not every patient can use oral hormonal contraceptives. In such cases, the introduction of contraception in a different way is considered: a spiral, a ring, a patch, an injection.

Important! Intrauterine devices are preferably installed after childbirth to lengthen the periods between pregnancies.

The most reliable contraceptives

If we take into account the number of pregnancies that occurred while taking a particular method of pregnancy management (Pearl index), the list from the most effective to the least effective methods of contraception looks like this:

1. Sterilization.
2. IUD (intrauterine device).
3. COCs (combined oral contraceptives).
4. Hormonal patches and injections.
5. Mini-drank.
6. Emergency pills.
7. Mechanical methods (condoms, diaphragm).
8. Interrupted intercourse.
9. Calendar method for determining ovulation.
10. Spermicides.