What happens if you drink a lot of hormonal pills. What does the use of contraceptives lead to? Hormonal oral contraceptives

Elena Berezovskaya

How impossible to imagine modern world without a computer and the Internet, it is impossible to imagine the life of a modern woman without hormonal contraceptives. Hormonal contraceptives have appeared on the market for a long time - since the creation of a tablet form of synthetic progesterone - ethisterone in 1938 by German chemists, although the Second World War prevented the widespread use of the first hormonal contraceptive. However, we can safely say that for almost 60 years, women in the world have been using hormonal contraception. Is it possible to draw conclusions about its safety, taking into account the side effects that occur while taking hormones and after a certain period of time after the end of their use? This question is also relevant because talking about growth malignant formations what is popularly called cancer are heard everywhere. Are levels really rising? different crayfish or diagnostic technologies can detect many types of cancer on early stages What was missed and not treated before?

At hormonal contraception there are many supporters, but there are many opponents - and all make allegedly convincing arguments about the benefits and harms of this type of contraception. I, as a doctor who does not want to be a hostage to myths and rumors, must provide my patients with accurate and truthful information about everything related to human health, including hormonal contraception, often leaving my personal views and preferences aside. But when in the thousandth once the question arises, how long can you take hormonal contraceptives and whether it harms women's health, I decided it was time to express my point of view, which will be a mixture of the point of view of a doctor and a woman.

We often make false conclusions just because we do not know much about what we are making conclusions about. Therefore, in order to answer the question of how long you can take OK without harm to the body, we will discuss several important facts.

Another 100-150 years ago average duration life of women was 35-40 years. Many married in adolescence(14-18 years old) and fell into a repeating cycle of pregnancies, childbirth, breastfeeding, giving birth to 7-12 children. Such women did not need contraception - their destiny was predetermined by Nature itself: a woman was created to be a mother. For many, even menstruation was rare due to repeated pregnancies and periods of lactation (milk production). The cessation of menstrual cycles in the majority occurred at 35-37 years old, and many did not live up to menopausal age at all.

With the increase in life expectancy, women began not only to menstruate earlier (from 12-13 years), but also longer (up to 50-55 years). This means that the reproductive age of a modern woman, when it is possible to become pregnant, has increased significantly and is about 40 years old. If the level of conception of offspring is not high in adolescence (up to 18-19 years) and premenopausal (after 37-38 years) ages, one way or another, almost 20 reproductive years of life remain. Most women in Europe, North America, Australia do not want to have more than 1-3 children, which takes from 1 to 6 years of their life, when reliable contraception is not so important. Many people postpone childbearing until a later age. average age of women giving birth for the first time in developed countries is 29-32 years. And before and after that, they try to use the methods of contraception that are optimal for them.

Before the advent of hormonal contraception, affordable price in many countries, especially in those where there were no other contraceptives, artificial abortions flourished - abortions, both legal and criminal. The world leader in the number of abortions since 1964 (possibly earlier) was the USSR, until its collapse - up to 80% of all conceived pregnancies were interrupted. These figures did not include the level of criminal abortions, which were also common in the Soviet republics, since far not all women advertise unwanted pregnancies.

Until now, in many post-Soviet countries, up to 65-70% of unplanned pregnancies are interrupted, despite the fact that almost any pharmacy has several types of hormonal and other contraception, and the younger generation of women constantly abuse emergency hormonal contraception. Why are there so many abortions? The still unaltered mentality of society is that prevention of pregnancy and getting rid of an accidental "flight" is the prerogative of a woman, not a man, against the backdrop of the high cost of hormonal contraceptives (many of our women still cannot afford these drugs).

Looking at the data from the UN report on contraceptive use in different countries world, published in 2011, about 67% of Ukrainian women aged 15-49 use different methods contraception, of which only 4.8% use hormonal contraceptives (2007 figures). The most popular form of birth control is the intrauterine device (17.7%) and the male condom (23.8%).

Hormonal contraception was created to prevent pregnancy and nothing more. The fact that it is used for other purposes, and quite often not justified, without any evidence, is another story.

In all hormonal contraceptives, the main contraceptive role is played by a synthetic progestin. In fact, the main purpose of obtaining progesterone in the past and producing it on an industrial basis was to create a contraceptive "medicine", because progesterone is an excellent contraceptive (that's right, I did not make a reservation).

Estrogens can also be used as contraceptives, because in large doses inhibit the maturation of germ cells in the ovaries, but have a more pronounced negative effect on a number of hormone-dependent organs and tissues, so they have not been used as contraceptives. They were added to progestins to better mimic natural menstrual cycle and getting better withdrawal bleeding (artificial periods), especially with the onset of 28 day mode taking hormones (hormone pills are taken for 21 days and pacifiers for 7 days, or a 7-day break without hormones is taken). Such a regimen in the early 50s made it possible to calm the nerves of most women who, against the background of continuous intake hormonal pills did not have periods, and therefore worried whether the pills work or not. He also allowed the adoption of hormonal contraceptives by the Catholic and other churches without major opposition and criticism. And the boom of hormonal contraception began!

There are many supporters and opponents different modes taking hormonal contraceptives, but clinical researches showed that none of the methods has advantages.

There are a lot of progestins, on which the action of oral contraceptives (OCs) is based, and it is they that determine the additional action of OCs, which is based on how the drug is absorbed, with which cell receptors it binds. For example, some OK can suppress the level of male sex hormones, while others, on the contrary, increase, etc. This additional function Hormonal contraceptives are used for therapeutic purposes in a number of diseases.

It's important to know that there are four generations of progestins, which is the basis for the classification of hormonal contraceptives. And it is natural that the younger (newer) the generation of drugs, the better it should be. In fact, there was an improvement in lowering the doses of synthetic hormones that are part of the OK, while maintaining the effectiveness of the contraceptive action. Therefore, the negative effect of hormones on the woman's body decreased with a decrease in the dose. Scientists around the world are constantly looking for such progestins that could be taken less frequently, but at the same time side effects, including long-term ones, were less, and the contraceptive effect did not decrease.

Now let's talk about the safety of using hormonal contraceptives.

It is extremely important to understand that hormonal contraceptives are medications , not lollipops, chocolates, vitamins. These are medicines! And that says a lot. This means that, like any medication, hormonal contraceptives have their own indications and contraindications for use, the method and forms of use, side effects. Also, drugs can interact with other substances, including medicines. The most important thing is that familiarization with the instructions for using the drug is somehow missed. The answer to the question of what "the future holds for me if I start taking hormonal contraceptives" is presented in the rubric side effects in the instructions. How many women read this column? How many women read the instructions for use of the drug?

The most interesting thing is that the side effects section includes a description negative impact hormonal contraceptives only for the period of taking the drug. But there are also long-term effects of any drugs. However, most often they are not mentioned, because this can significantly reduce the level of sales and use of medicines. Hormonal contraceptives also have long-term side effects, which we will talk about later.

So, the fact that hormonal contraceptives (any) are drugs is understandable. But many do not pay attention to the word "hormonal". When a person is told: "You need to take hormones," this often causes backlash and fear. “Hormones? And it's not dangerous? It's all hormones! It doesn't matter what hormones they are - for the treatment of diabetes, diseases of the joints, the thyroid gland, etc. "I was put on hormones" - often sounds like a sentence. But when we are talking about hormonal contraception, the perception of the word “hormone” changes dramatically. “I have pimples on my skin. What do you recommend from hormonal contraceptives? “My one friend took “”, and the other - “”, and my doctor says that it is better to insert Mirena into the uterus, but I have not yet given birth. What do you think should be preferred?"

Hormonal contraceptives are hormonal drugs, and in most countries of the world they are not prescribed in absentia without examining the woman, and they also require a prescription to purchase them.

All hormones, unlike other drugs, in a small amount can affect, including negatively, cells, tissues, organs and organ systems that have special sensors - receptors through which hormones exert their effect. Hormonal contraceptives are no exception, therefore they have contraindications. How many women, looking at the instructions, thought that if the list of contraindications is so impressive (impressive in terms of different systems organs, and not for one group of diseases), then these are really not vitamins, and not pills for headaches or to lower body temperature. Even most antibiotics, which are prescribed right and left by many doctors, have much fewer contraindications and side effects than hormonal contraceptives (for the sake of interest, open the instructions for use and compare).

The traditional phrase "Millions of women have been taking hormonal contraceptives for years and nothing bad happens to them" can be used as a "knock-off" if the doctor does not want to answer the woman's question, "What threatens taking OK for my health?" A more professional answer: “Read the instructions” (and figure it out for yourself). But, after reading the instructions, the woman will again ask how then millions of other women take these hormones, will she enter the percentage of those who will have side effects whether taking hormones will increase the risk of developing some kind of cancer in the future...

What is important to know in such cases? The assimilation of hormonal contraceptives and their impact with the development of side effects in each woman is individual and unpredictable in most cases. The only guaranteed OK action that works in 99% of cases when they correct reception, there will be a contraceptive effect - for this they are created. Everything else as an additional or side effect, sometimes even positive (improved skin condition, for example), appears as an individual reaction of the body to taking OK.

Now let's talk about the long-term effects of hormonal contraceptives. As mentioned above, modern women have long periods of life when the conception of children is not planned, but there are sexual relations. And regardless of the frequency of these sexual relations, regardless of age and chances of getting pregnant, they want to be sure that there will be no pregnancy.

To answer the question of what threatens long-term use hormonal drugs many factors need to be weighed.

1.What kind of OK or other types of hormonal contraceptives does a woman take? Very often women post-Soviet space prefer older high-dose OCs, many of which have been discontinued in developed countries. They are cheaper than OK of new generations, so it is more profitable to buy and sell them. For a long time already the countries of the "second and third worlds" have become a convenient testing ground for fusion of everything that the "first world" refuses.

Thus, the higher the dose of hormonal components of OK and the longer they are taken, the risk of developing side effects and long-term effects above.

Also, different types progestins can have side effects in different ways - this must also be taken into account by both doctors and women.

2. Woman's age plays important role selection OK. How older woman, the more urgent the question becomes optimal dose estrogens and progestins, as well as the advisability of taking hormonal contraception. Indeed, many women do not really need this type of contraception, but live with false beliefs imposed by doctors that the ovaries “rest” while taking OK, that hormonal contraceptives “preserve the ovarian reserve”, “prolong youth”, “rejuvenate the ovaries and the body ”, “increase the sexuality of a woman”, etc. No, hormonal contraceptives only protect against pregnancy, but do not prevent the aging of the ovaries, and the whole organism as a whole, and even more so, do not rejuvenate.

3.Aging of the body with age is accompanied by the appearance of various diseases. especially if the woman does not lead a healthy lifestyle. Some diseases can be aggravated by taking hormonal contraceptives. For learning and manifestation of action, OCs require good work. gastrointestinal tract(through which hormones enter the bloodstream, and the products of their metabolism are excreted with feces), the liver (here they partially decompose and partially bind to special proteins) and the kidneys (through which the products of hormone metabolism are excreted from the body). Adipose tissue plays an important role in the metabolism of hormones and often the role of a warehouse (depot), where they can accumulate in the form of metabolic substances (metabolites) and be stored for many months and years. It is the cumulative effect of hormone metabolites in adipose tissue that plays a negative role in the development of some serious illnesses, including a number of crayfish.

4. Although a woman at the time of taking OK may not have diseases and conditions that are included in the list of contraindications, but there is such a thing as hereditary predisposition to develop the disease. This does not mean that a person will necessarily get sick with what his close relatives get sick. healthy image of a life that includes a healthy diet, physical activity, and a healthy mental and emotional state can prevent the occurrence of most diseases, even if there are cases of such diseases in the family. Hereditary predisposition is found in diabetes, high blood pressure blood (hypertension), migraine, blood and vascular clotting diseases, some diseases of the liver and kidneys. The list of diseases can be expanded, and most of them will be on the list of contraindications for the use of OK. It is rational to undergo periodic examination while taking hormonal contraceptives in order to timely detect deviations that can lead to the development of diseases.

It is also important to remember that hormonal contraceptives can interact with drugs and other drugs, worsening the woman's condition and the course of the disease.

5. Availability bad habits primarily smoking. Smoking itself is a risk factor for the development of many diseases, primarily such dangerous ones as lung cancer and cardiovascular disease. Smoking is also a risk factor for 13 other types of cancer: throat, esophagus, stomach, mouth and lips, pharynx, nasal cavity, Bladder, pancreas, kidneys, liver, intestines, ovaries, cervix, some types of blood cancer (leukemia). There is evidence of increased levels of breast cancer in women who smoke.

Probably, many people do not know that the first publications about the relationship between smoking and lung cancer appeared in the 1930s, and tobacco companies conducted a thorough verification of these data through their own research. The data were confirmed, but instead of presenting the results to the public, every effort was made to conceal and falsify them.

Today, the warning on cigarette packages that smoking increases the risk of developing lung cancer is no surprise. But it took more than fifty years of struggle for brave scientists, doctors, public figures, many of whom lost their jobs, positions, positions, reputations, families and even lives, to issue this warning. It took about thirty years to pass a law banning smoking in public places.

Of course, doctors often warn that smoking while taking OK is not desirable (hardly speaking, not compatible). But many women "naughty" periodically, smoking and ignoring the warnings of doctors.

In addition to smoking, the use of alcohol and drugs also increases the risk of developing serious diseases, especially in combination with OCs.

Interestingly, many women, especially those planning a pregnancy, know that alcohol is a teratogen, that is, it is involved in the appearance of fetal malformations. Not everyone knows that there is a proven link between alcohol intake and the risk of developing cancer of the neck and head (throat, larynx, mouth, lips), esophagus, liver, mammary glands, and large intestine. For example, daily consumption of 2 bottles of beer (350 ml each), or 2 glasses of wine (300 ml), or about 100 ml of strong alcoholic beverage increases the risk of developing breast cancer twice as compared to those who do not drink alcohol (data from the National Institute of Cancer, USA However, such warnings on labels alcoholic beverages you won't find.

And here I would like to draw your attention to such a concept as carcinogens. Many people know that carcinogens are substances that are directly or indirectly involved in the development malignant processes. The fact that smoking (more precisely, a number of substances contained in smoke) and alcohol are classified as carcinogens is no surprise to anyone - they write and talk about it a lot. Natural estrogens and progesterone can also cause the growth of certain malignant tumors in a woman's body (however, in men too), which we often call hormone-dependent tumors. Therefore, estrogens and progesterone are classified as carcinogens.

It's hard to believe, isn't it? If about the carcinogenic effect of estrogens (both natural and synthetic forms) and the risk of developing breast and uterine cancer, doctors have known for a long time and try not to prescribe them without strict indications, especially at an older age, many doctors have created a panacea for almost all women's diseases from progesterone and its synthetic forms.

The WHO, in the monograph of the Human Carcinogenic Risk Study Program, together with the International Agency for Research on Cancer (IARC), argued back in 1999 that both hormones, estrogen and progesterone, are not without reason considered human carcinogens. This claim has been supported by the US Department of Health and Human Services National Toxicology Program in carcinogen reports for nearly 15 years. In the latest report of this program (13th edition), progesterone is still on the list of carcinogens - not gone anywhere.

Synthetic hormones that are part of OK and replace the action of estrogen and progesterone do not fundamentally differ from the action of natural hormones. They are also carcinogens, which means they can be put on a par with smoking and alcohol.

Moreover, manufacturers of hormones, including progestins and progesterone, have long been no longer hiding the information that these are carcinogens. For example, in information about the products of Sigma-Aldrich Corporation, one of the world's largest manufacturers of progesterone, which has offices in 40 countries of the world, in the description of biochemical and physiological properties progesterone it is said that the hormone “Causes the maturation and secretory activity of the endometrium of the uterus, suppresses ovulation. Progesterone is involved in the etiology (occurrence) of breast cancer.” The same company, like many others, conducts its own research, the results of which are not hidden, as was done before.

Numerous clinical studies have proven an association between increased levels of breast, cervical, and liver cancer and OC use. Positive effect observed in a decrease in ovarian and endometrial cancer in women taking hormonal contraceptives. At the same time, substitute hormone therapy, which contains a smaller dose of the same synthetic estrogens and progestins, on the contrary, increases the level of endometrial and ovarian cancer in premenopausal and menopausal women.

How long can I take OCs without causing serious side effects and increasing the risk of developing a number of malignant tumors? There is no exact answer, because it all depends on individual features body and all of the factors listed above. But data from a number of studies have shown that, for example, taking OCs for more than 5 years increases the risk of developing precancerous conditions and cervical cancer (the level drops to the average 10 years after stopping hormonal contraceptives).

In assessing the impact of something on something in medical statistics, there are different types of risk, but most often they use relative and individual risks. The risk of developing a disease under the influence of some risk factor is the ratio of cases of the disease in two groups of people - with and without a risk factor. This risk can be calculated taking into account other risk factors for a group of people or for a specific person, taking into account his risk factors (individual risk).

Over the past fifteen years in medical literature appeared great amount publications on the relationship between breast cancer and the use of hormonal contraceptives, with some data suggesting existing risk for the period of taking hormonal contraceptives (not only tablet forms) and a short period after the end of the intake, others - about the risk for a long period after the end of the hormone intake. Independent from pharmaceutical companies and medical institutions organizations also conduct their own research, and the evidence from such studies is not encouraging.

In general, the risk of developing cancer increases by 50% after one year (12 months) of taking hormonal contraceptives, and slowly decreases over the next 10 years after stopping hormones to the level of risk of those who did not take hormones. Such data relate primarily to OK containing high doses of estrogen (the old generation of hormonal contraceptives). Also, some types of progestins (ethinodiol diacetate) can double the risk. Three-phase hormonal contraceptives, especially those containing norethindrone, which are rarely used in developed countries, but are still widely prescribed (due to cheapness) in post-Soviet countries, increase the risk of developing breast cancer by three times (already within a year of taking the drug). Modern low-dose drugs have a lower level of risk. Since low-dose OCs have been on the market for a relatively short time and breast cancer occurs in older women (pre-menopausal and menopausal), studies on the effect of these types of contraceptives on the occurrence of cancer require more time.

Also, there are more and more disputes, especially in medical circles, how safe it is to take hormonal contraceptives for women after 40 years, which lead active sex life, and therefore can become pregnant, despite the low conception rate in this age category. Some doctors suggest using more alternative methods contraception. Others, on the contrary, argue that there is nothing wrong if a woman takes OK before menopause (which may not be noticed while taking hormones). I believe that if a woman still wants to take OK, then it is best to switch to low-dose hormonal drugs with regular monitoring of the state of those organs for which the risk of cancer is increased.

The data presented may cause some shock to readers, especially women. There will also be many opponents, especially among proponents of hormonal contraception and those who prescribe and take hormones (estrogens and progesterone) for other reasons, who would be outraged by such a review of hormonal contraception. But, even if we do not take into account the risk of developing cancer, hiding behind the phrase “there is, but minimal,” I would like to ask each reader a question: would you take a substance (any, including a drug), if you knew that it is a carcinogen, then is involved in the development of cancer? Would you buy a product that says, like on a cigarette package, that it increases your risk of developing cancer (any)? Of course, a lot people who smoke does not pay attention to such warnings - this is their personal choice. Many carcinogens are present in our lives all the time. Some drugs can also cause cancer, but fortunately, their dose and intake are limited, and people do not take them for months and years most often. But hormonal contraceptives have been taken by women for years...

Why are millions of women around the world taking hormones for so many years? Because it's profitable

(1) Manufacturers of hormonal contraceptives,

(2) Sellers of hormonal contraceptives,

(3) Men, because they do not need to take or share responsibility with women for the consequences of unprotected sex,

(4) Women, because they have gained some independence from men and now they can control their own reproductive function.

The most indignant readers will say: “Well, if hormonal contraceptives are so bad, then what remains for women? To return to the era of abortions again or to refuse sexual life in general?

Indeed, abstinence or renunciation of sexual activity is the most reliable remedy protection against unplanned pregnancy, but it is not suitable for most couples. It can also undermine and break up the relationships of many men and women. Of the reliable methods of contraception, the same male condoms remain, but they require the active participation of a man in this type of protection. In developed countries (USA, Canada, some European countries) and Latin American countries, male and female sterilization has begun to grow rapidly (20-25% of contraceptive cases), which also has its pros and cons and is not suitable for all people (most often those who has completed childbearing and no longer plans to have children). The popularity of the intrauterine device (IUD, but without hormones) is also increasing worldwide. Other methods of contraception have different level effectiveness, require certain skills from sexual partners, therefore, they also cannot be used by all people.

The decision is always up to the woman (this is her personal decision), however, if doctors provided truthful information about what they prescribe (this applies not only to hormonal contraception), then many diseases and complications of direct treatment and medication can be avoided.

Thus, my answer as a doctor to the question of how long you can take hormonal contraceptives in a safe mode for health will be as follows: hormonal contraceptives are hormonal drugs, so their degree of safety will be determined by the type constituent parts, dose, regimen, method and duration of administration, compliance with indications and contraindications, individual tolerance, the presence of other diseases, bad habits and timely detection side effects.

Like a woman, in the depths of my soul there is a hope that modern men will not only enjoy sexual relations with women, but will increase their level of responsibility by taking a more active role in protecting their beloved and dear women (sex partners) from unplanned pregnancies.

No. Hormonal preparations are medicines obtained synthetically. They act like natural hormones produced in our body. There are many organs in the human body that secrete hormones: female and male reproductive organs, glands internal secretion, central nervous system and others. Accordingly, hormonal preparations can be different, and they are prescribed for a variety of diseases.

Female hormonal preparations (containing female sex hormones) may both have contraceptive action, and not to possess. Sometimes, on the contrary, they normalize the hormonal background and contribute to the onset of pregnancy. Preparations containing male sex hormones are prescribed to men with a decrease in the quality of the ejaculate (that is, sperm motility), with hypofunction, and a decrease in the level of male sex hormones.

Myth 2: Hormones are prescribed only for very severe diseases

No. There are a number of non-severe diseases in which hormonal drugs are also prescribed. For example, decreased thyroid function (hypofunction). Doctors often prescribe hormones in this case, for example, thyroxine or eutiroks.

Myth 3: If you do not take a hormonal pill on time, then nothing bad will happen.

No. Hormonal preparations should be taken strictly by the hour. For example, a hormonal contraceptive pill works for 24 hours. Accordingly, it is necessary to drink it once a day. There are drugs that you need to drink 2 times a day. These are some male sex hormones, as well as corticosteroids (eg, dexamethasone). Moreover, it is recommended to take hormones at the same time of day. If you drink hormones irregularly, or forget to drink at all, the level of the necessary hormone can drop sharply.

For example, if a woman forgot to take a hormonal contraceptive pill, the next day she should drink the forgotten evening pill in the morning, and another pill in the evening of the same day. If the interval between doses was more than a day (recall: a hormonal contraceptive pill is valid for 24 hours), then the level of hormones in the blood will decrease very much. In response to this, slight spotting will certainly appear. In such cases, you can continue taking birth control pills, but additionally protected during the next week. If more than 3 days have passed, it is necessary to stop taking hormones, use other means of contraception, wait for the onset of menstruation and additionally consult a doctor.

Myth 4: If you take hormones, they accumulate in the body

No. When the hormone enters the body, it immediately breaks down into chemical compounds which are then excreted from the body. For example, a birth control pill breaks down and “leaves” the body during the day: that is why it needs to be taken every 24 hours.

Need to know: mechanism prolonged action hormones is not associated with their accumulation in the body. This is simply the principle of action of these drugs: "work" through other structures of the body.

However, hormonal drugs continue to "work" after they have stopped taking them. But they work indirectly. For example, a woman takes hormonal pills for several months, then stops taking them, and in the future she has no problems with her cycle.

Why is this happening? Hormonal medications act on different target organs. For example, female birth control pills affect the ovaries, uterus, mammary glands, and parts of the brain. When the pill "left" the body, the mechanism that it launched continues to work.

Myth 5: Hormonal drugs are not prescribed during pregnancy

Discharged. If before pregnancy a woman had hormonal disorders, then during the bearing of the fetus, she needs drug support so that the production of female and male hormones is normal, and the child develops normally.

Or another situation. Before pregnancy, the woman was fine, but with her onset, something suddenly went wrong. For example, she suddenly notices that intense hair growth has begun from the navel down and around the nipples. In this case, you should definitely consult a doctor who can prescribe a hormonal examination, and, if necessary, prescribe hormones. Not necessarily female sex - it can be, for example, adrenal hormones.

Myth 6: Hormonal drugs have a lot of side effects, primarily weight gain.

There are almost no drugs without side effects. But you need to distinguish side effects that do not require discontinuation of the drug. For example, swelling of the mammary glands when taking contraceptive hormones considered a normal phenomenon. Scanty spotting in the first or second months of admission in the intermenstrual period also has the right to be. Headache, dizziness, fluctuations in weight (plus or minus 2 kg) - all this is not a pathology and not a sign of a disease. Hormonal preparations are prescribed for a sufficiently long period. By the end of the first month, the body adapts, and everything returns to normal.

But not to be really serious problems associated, say, with blood vessels, before prescribing a medicine and while taking it, it is imperative to be examined and tested. And only a doctor can prescribe you a specific hormonal drug that will not harm your health.

Myth 7: You can always find an alternative to hormones.

Not always. There are situations when hormonal drugs are indispensable. Let's say a woman under 50 had her ovaries removed. As a result, she begins to age and lose health very quickly. In this case, her body until the age of 55-60 must be supported by hormone therapy. Of course, provided that her underlying disease (due to which the ovaries were removed) has no contraindications to such an appointment.

Moreover, with some diseases, female sex hormones can be strictly recommended even by a neuropsychiatrist. For example, with depression.

Hormonal preparations have become firmly established in life modern man. With the help of these drugs, people not only control fertility and treat infertility, but also many other diseases, including those associated with the thyroid gland.

Effect on weight

Hormonal pills for weight gain, more precisely, muscle mass, exist. Probably all athletes know about it. And many people believe that any hormonal remedy will have a similar effect. Meanwhile, this is not so. Moreover, there are even hormonal diet pills, these are drugs for the treatment of hypothyroidism - a pathology of the thyroid gland, when it produces an insufficient amount of hormones. This disease is very reflected in the appearance of a person and leads to weight gain, even if nutrition and physical activity remained the same.

Well, hormonal birth control pills sometimes lead to a set of several extra pounds. True, in the case of new generation drugs, such side effects occur less and less. The way out is to change hormonal contraceptives, at least a drug, or even find another way to protect against unwanted pregnancy.

Impact on appearance

It is known that modern oral contraceptives may or may not have an antiandrogenic effect. talking plain language, reduce or not reduce the level of "male" hormones in a woman's body. At great content testosterone, a woman begins to grow facial hair, acne appears, the skin becomes oily. Hormonal acne pills can be used. But not everyone. AT medicinal purposes are assigned to "Diana-35" (it should be noted that the estrogen content in it is the highest), "Yarina" and "Zhanin". The same drugs are recommended for PCOS to normalize the cycle.

Are there hormonal preparations for breast enlargement or is it a myth? What woman does not dream of an attractive bust? Indeed, there is evidence that contraceptives can cause visual magnification mammary glands. True, this happens due to a slight swelling of the tissues and is temporary. Not observed in all women taking pills.

Impact on women's health and pregnancy

Often, contraceptive hormonal pills for women are also prescribed in order to improve the quality of life of a woman, prevent iron deficiency anemia. This is necessary when heavy menstruation. For the same reason, hormonal pills for endometriosis are very often recommended. After all, it is this disease that most often causes large blood loss. You can take any low-dose combined oral contraceptives for endometriosis. But usually they appoint "Janine", since the manufacturer of this tool assures about its effectiveness in this particular direction. If "Janine" is not suitable for some reason, price, or simply provokes side effects more than three cycles of taking, then you can ask the doctor for the name of hormonal pills that may suit you better than he does.

Often prescribe drugs for the treatment of infertility. If it has an unexplained cause, then doctors suggest trying the so-called rebound effect. This is when hormonal drugs are taken for 3-6 months, and after the drug is discontinued, the woman is actively trying to get pregnant, leads an unprotected sexual life. Indeed, after the abolition of contraceptives, the ovaries almost always begin to work actively, and full ovulation occurs.

Usually, menstruation becomes regular when taking hormonal pills, but taking them for a long time can lead to negative phenomenon in the ovaries, they stop working fully. After stopping the intake, ovulation does not occur. Due to very low level there is no monthly progesterone after hormonal pills, however, this phenomenon is temporary in most cases and does not require treatment. But nevertheless, if there are no real problems, and there is a desire to conceive a child, there is no point in taking contraceptives. The time period when you can get pregnant after taking birth control pills varies greatly, and it is impossible to predict how your body will react to taking and stopping the drug.

With infertility, not oral contraceptives are often used, but progesterone preparations. Especially if laboratory research the lack of progesterone in the second phase of the menstrual cycle has been repeatedly proven. What hormonal pills to drink in this case, the doctor will say. Usually appoint "Dufaston" or "Utrozhestan". Moreover, it is advisable to start taking them only after ovulation, so that they do not interfere with its onset. And take it within 10 days. If pregnancy has not occurred, which is proved by a pregnancy test, but rather a blood test for hCG, then the drug is canceled and menstruation begins. If pregnancy occurs, then progesterone should be continued.

And what hormonal pills can bring harm? Everything is described in the instructions. But from the common - the growth of uterine fibroids, if it is progesterone-dependent. Modern doctors women who have it gynecological disease advised to be very careful with similar drugs and do not take them for prophylactic purposes.

Only one question remained open - these are hormonal pills for menopause for women after 45 years. The so-called hormone replacement therapy during the onset of menopause in a woman is a means to preserve beauty and health for a long time. But unfortunately, HRT has a lot of contraindications and side effects.

Hormonal preparations are intended for the treatment endocrine disorders. They are prescribed for women and men. There are more than 50 drugs for hormone replacement therapy.

All hormonal agents are divided into natural and synthetic. Natural contain hormones derived from fresh or frozen cattle glands, as well as from biological fluids animals or humans. Synthetic analogues obtained by chemical means but perform similar functions.

What are hormones?

• pituitary gland (anterior and posterior lobes);
• thyroid and antithyroid substances;
• pancreas (insulin and glucagon);
• sugar-reducing substances;
• parathyroid gland;
• adrenal cortex;
• sexual;
• anabolic substances.

Hormonal preparations can be in the form of water or oil solution, tablets, ointments. They are administered subcutaneously, intramuscularly, taken orally or rubbed into the skin.

13 Facts About Hormone Therapy

1. Hormones are not always harmful. Hormonal remedies render miscellaneous action often give side effects.
2. Hormonal agents have different effects on people. Those drugs that helped a relative or friend can harm you with the same diagnosis.
3. Young patients and nulliparous girls can take hormones. They are prescribed even from a young age, and hormonal contraceptives are allowed for adolescents.
4. Hormonal drugs do not always have a contraceptive effect. One month after hormone therapy reproductive function is fully restored. It is also possible to conceive twins or triplets, as certain hormones cause multiple eggs to grow.
5. Breaks in hormone therapy are optional. Most often, hormones are prescribed as a continuous course.
6. Breastfeeding women can also take hormonal drugs. The ban applies only to some pills that affect lactation.
7. Not all hormonal drugs cause weight gain. If the patient is inclined to be overweight or began to recover during treatment, the doctor may reduce the number of progestogens in therapy.
8. There are hormones for men.
9. Hormonal drugs are prescribed not only for serious illnesses. They help to cure mild pathologies of the thyroid gland, pituitary gland or pancreas.
10. Hormones do not accumulate in the body. These substances break down almost immediately and are excreted from the body over time.
11. Preparations with hormones are prescribed for pregnant women. If a woman had hormonal disruptions before conception, during pregnancy she needs drug therapy. Without the normalization of the hormonal background, it is impossible to bear a child.
12. Hormones do not always reduce libido. Many patients report an increase in sex drive with hormone therapy. If the desire is reduced, you can ask your doctor to prescribe drugs with less progesterone.

When are hormonal drugs prescribed?

Natural hormones are produced endocrine glands our body. These substances have a distal effect, that is, at a distance from the gland in which they were formed. Hormonal drugs are prescribed for dysfunction of the pituitary gland, thyroid gland, adrenal glands, pancreas and ovaries, as well as some diseases that do not affect endocrine system.

What diseases are hormones prescribed for?

1. Diabetes. The disease is diagnosed in the absence of the hormone insulin, without which glucose does not enter the cells and not enough energy is created for normal life. Insulin preparations solve this problem.
2. Adrenal insufficiency. With adrenal dysfunction, the patient becomes weak, loses weight, and suffers from symptoms of impaired circulation. The hormones glucocorticoids and mineralocorticoids allow to restore the stable functioning of the organ.
3. Hypothyroidism. This condition develops with a decrease in the functionality of the thyroid gland, when levothyroxine ceases to be produced. The hormone itself is inactive, but in cells it turns into triiodothyronine and regulates protein biosynthesis.
4. Hypogonadism. The disease is characterized by insufficiency of the gonads. With hypogonadism, infertility develops in women and men, and hormonal therapy is the only possibility conceive a child.

In addition to glandular insufficiency, there is also excessive activity. Often, patients are diagnosed with an excess of hormones. This condition is no less dangerous and also requires treatment. To reduce the amount of hormones, drugs are prescribed that block secretion or remove the gland itself.

Estrogens and progestins - female hormones - have the effect of contraception. They may also be prescribed during perimenopause to relieve symptoms. Anabolic steroid male hormones effective for the treatment of dystrophic conditions.

Contraceptives are divided into combined with estrogen and progestogen and drugs with progesterone. Hormonal contraception is preferred if a woman has one permanent partner. Protection against infections during chaotic sexual intercourse will only be condoms.

The action of hormonal contraceptives is due to the fact that the substances provoke changes in the cervix that prevent the penetration of spermatozoa. Pathological changes that can cause infertility can develop with long-term use hormonal contraceptives (without stopping for more than 3 years). However, many experts claim that after the abolition of contraception, the likelihood of pregnancy only increases.

Hormonal contraceptives do not affect weight, help cleanse the skin and reduce the amount of body hair. Hormones can regulate the cycle and reduce the risk of ovarian cancer. Some note breast enlargement and an increase in its elasticity when taking hormonal contraceptives.

Modern contraceptives have a minimum of side effects. With the help of hormones, you can postpone the timing of menstruation and reduce the symptoms of SCI.

Hormones for contraception are prescribed for a maximum of a year. It is advisable to take breaks for several months and visit the gynecologist regularly. Oral contraceptives are contraindicated in smokers, patients with tumors and varicose veins.

The main method is hormone therapy. Depending on the severity of the pathology, doctors prescribe contraceptives, drugs with progesterone, drugs with the hormone danazol, or gonadotropin analogues.

Hormonal contraceptives for endometriosis reduce pain syndrome and shrink the endometrium. Usually drugs are prescribed for six months, if necessary, you can extend the course for 3-6 months. At successful treatment areas of endometriosis are significantly reduced.

Popular contraceptives:

• Regulon;
• Yarina;
• Marvelon.

With endometriosis, drugs with progesterone may be prescribed. This substance inhibits the secretion of estrogens, which provoke the growth of the endometrium of the uterus. The course of treatment is 6-9 months. The best drugs groups are considered to be Vizanne and Depo Provera.

The hormone danazol in endometriosis reduces the amount of sex hormones, which reduces the foci of pathology. The optimal course of treatment is 3-6 months

Another method of treating endometriosis is analogues of gonadotropin-releasing hormones. They reduce the functionality of the ovaries and suppress the production of sex hormones. During therapy, menstruation disappears and menopausal symptoms may occur. To prevent this, doctors prescribe small doses of hormones. Treatment is a maximum of six months. After the drug is discontinued, ovarian function is restored.

Preparations with gonadotropin-releasing hormones:

• Buserelin;
• or ;
• Sinarel.

Hormone therapy for menopause

Closer to 50 years, a woman's body undergoes restructuring. Fading in reproductive function, estrogen levels decrease, bones become brittle, and tissues less elastic. woman feels characteristic symptoms: hot flashes, headaches, sweating, emotional instability, osteoporosis.

Hormone replacement therapy for menopause helps to reduce the number of strokes, heart attacks, pathologies musculoskeletal system, as well as maintaining pelvic tone and stabilization nervous system. Menopause symptoms disappear.

If there are no contraindications, replacement therapy can appoint for 5-8 years. Hormones are not recommended in the presence of a malignant tumor, circulatory disorders, uterine bleeding, stroke and heart attack in history, liver disease.

What hormones are prescribed for menopause:

1. Angelique. With estradiol and drospirenone.
2. Femoston. Contains estradiol and dydrogesterone, which improves the natural cycle.
3. Ovestin. Contains estriol - necessary to restore the elasticity of the mucosa.
4. Livial. Includes synthetic tibolone. It has a complex estrogen-gestagenic effect.
5. Norkolut. A progestogen-based agent with norethisterone.

Hormones during pregnancy

One of the main causes of early miscarriage is the instability of the hormonal background of a woman. As a rule, abortion occurs when there is a lack of progesterone or estrogen.

Lack of progesterone is dangerous because the conditions necessary for the development of the fetus are not created, and estrogen deficiency leads to thinning of the endometrium of the uterus and rejection of the embryo. During pregnancy, it is necessary to treat not only problems with sex hormones, but also all hormonal disorders.

Progesterone preparations:

1. Duphaston. The drug contains a synthetic analogue of progesterone - dydrogesterone. It is much more active and stable than the natural hormone, therefore it effectively supports pregnancy. As a rule, the drug is canceled after 20 weeks, when the body's need for progesterone decreases. Duphaston does not affect the skin, hair, sleep and blood glucose levels. When spotting urgently need to see a doctor to increase the dose. Dufaston is incompatible with phenobarbital, which is prescribed for epilepsy.
2. Utrozhestan. The drug contains micronized progesterone. Utrozhestan normalizes the level female hormones and affects androgens (male sex hormones). An excess of androgens in a woman's body can harm pregnancy. The drug can affect the reaction rate and cause drowsiness.

When taken correctly, these drugs do not provoke malformations in the fetus. They help to normalize the endocrine system and hormonal levels, which only support pregnancy and ensure the full development of the child. Refusal of therapy affects not only the mother's body, but also the physical and mental development of the child. However, hormones are not prescribed for diabetes, liver disease, bronchial asthma, circulatory disorders, malignant tumors and epilepsy.

Hormone therapy for men

Already from the age of 25, testosterone levels gradually decrease, and by 45, the indicators fall by 30%. During this period, hormones may be prescribed to relieve symptoms ( fast fatiguability mood deterioration, weakness, decreased libido). Hormones are also suitable for the treatment of erectile dysfunction.

It is possible to use tablets, capsules, gel, injections and even patches with testosterone. Among the most common drugs are Andriol, Methyltestosterone, Androgel, Androderm, Nebido injections, Sustanon-250 and Testenat.

Hormone therapy in men sometimes causes side effects. Can increase risk of cancer prostate, increased oiliness of the skin, problems with sperm and androgenetic alopecia.

It must be remembered that any medication can be dangerous when not correct use. When choosing hormones, it is important to take into account the gender and age of the patient, comorbidities, habits, the presence of allergies, heredity and lifestyle.

Hormonal contraception is modern look protection against unwanted pregnancy, widespread throughout the world. Millions of women trust this method without making mistakes in their choice.

How hormonal contraceptives work complex impact analogues of natural female sex hormones on the body: suppression of ovulation, thickening of cervical mucus and changes in the structure of the endometrium. Suppression of ovulation prevents the maturation and release of the egg, which prevents fertilization. The change in mucus prevents sperm from entering the uterine cavity. Even if fertilization has occurred, then fertilized egg will not be able to gain a foothold due to the special structure of the endometrium.

These 3 mechanisms provide reliable protection from pregnancy - according to the WHO (World Health Association), when used correctly, the effectiveness is close to 100%, however, violations in the intake (missing pills, taking other medicines, violation of the regimen) can lead to conception, which is reflected in the statistics.

There are also male hormonal contraceptives, but their use has not yet become widespread. "Universal tablet" is in the development stage, and existing schemes taking hormones cause serious harm to health.

Any drug should be selected individually, since there is no universal method without drawbacks. Many of the pros and cons of hormonal contraceptives are similar, because they all contain similar active ingredients.

Advantages of hormonal contraception:

• high reliability;
• independence from the time of sexual intercourse;
• method reversibility;
• low frequency of side effects.

In addition, there are non-contraceptive benefits:

• reducing the risk of developing tumors of the ovaries and endometrium;
• weakening of premenstrual syndrome;
• treatment of dysmenorrhea;
• decrease in the abundance of menstruation (prevention and treatment of iron deficiency anemia);
• treatment of acne, hirsutism, seborrhea (when using COCs with an antiandrogenic effect);
• treatment of endometriosis.

Minuses:

• does not protect against sexually transmitted diseases;
• the need for regular use;
• the possibility of serious complications;
• many contraindications;
• incompatibility with certain drugs.

Form classification

According to the method of delivery of the hormone into the body, we can distinguish:

• tablets;
• injections;
• subcutaneous implants;
• skin patches;
• vaginal rings;
• hormone-containing intrauterine devices(Navy).

Classification by hormonal composition

Here is a classification of hormonal contraceptives according to the hormones used:

• Combined funds. They contain an estrogenic and progestogen component. As a rule, these are combined oral contraceptives (COCs), patches, vaginal rings or injections (CICs).
• Not combined preparations. They do not contain estrogens - mini-pills, implants, spirals, one-component injections.

Tablets (oral contraceptives)

One pack of tablets is designed for 1 cycle, most often contains 21 or 28 tablets. It should be taken from the 1st day of the cycle. If there are 21 tablets, then a seven-day break is needed before a new pack, if 28 - a break is not required. Combined tablets are mono- and polyphasic, depending on the dosage of hormones on the days of the cycle. From the amount of estrogen, high-, micro- and low-dose hormonal contraceptives (COCs) are isolated.

These drugs are often used in gynecology to treat endometriosis, functional cysts ovaries, dysmenorrhea, infertility. Hormonal contraceptives of the new generation are indicated for hirsutism, acne, seborrhea and can be prescribed even to girls who are not sexually active.

Combination drugs must be taken daily. Efficiency is high - more than 99%. When skipping a tablet, you should refer to the instructions for use and follow the instructions clearly - this will exclude the possibility of pregnancy.

Unfortunately, if more than 2 tablets are missed in dangerous days the chance of pregnancy is quite high. When taking other drugs, you need to carefully study the annotation - they can reduce the contraceptive effect.

Contraindications for hormonal contraception combined pills:

• lactation period;
• age over 35 years, especially in combination with smoking;
• vascular diseases, migraines;
• thrombosis, diseases of the blood coagulation system;
• malignant tumors of the breast;
• liver disease.

Another type of pill "mini-drank". They contain only a progestogen component, which significantly reduces the number of contraindications and side effects. The peculiarity of taking pills is strictly at the same time of day, otherwise the contraceptive effect may decrease.

Reliability is somewhat lower than COCs, but the lack of systemic effects of estrogens on a woman's body makes them safer, expanding the range of patients who can be recommended oral contraception. When prescribing hormonal contraception after 40 years, during breastfeeding, at the risk of thrombosis, they often pay attention to gestagenic preparations.

Contraindications:

• mammary cancer;
• migraine;
• functional cysts.

special look oral contraception – postcoital drugs. This is one or two tablets with high content progestogen analog. Accepted in emergency cases within 72 hours after intercourse.

Contraindications:

• age up to 16 years;
• severe liver disease;
• pregnancy.

Injectable contraception

Injections are one of the methods of long-acting hormonal contraception. Combined preparations (CIC) and gestagenic are used. KIK (for example, Cyclofem, Mesigina) is introduced medical worker Once a month from the 1st to the 7th day of the cycle, the effect develops after 24 hours and lasts for 30 days. After discontinuation of the drug, pregnancy is possible in the first month. Contraindications for use - breastfeeding, diseases of the veins and of cardio-vascular system, liver.

Progestin preparations (Depo-Provera) are well tolerated, have a high degree of protection (0-1 pregnancy per year per 100 women). Introduced intramuscularly 1 time in 3 months. The disadvantage of the drug is that the ability of fertilization is restored about 9 months after the abolition of hormonal contraceptives.

Intrauterine device

The hormonal coil is a small plastic T-tube with a copper coating. It is inserted into the uterine cavity through the cervix, securely fixed inside. It is recommended to use women who have already given birth, since any intervention in the uterine cavity in nulliparous women can lead to secondary infertility.

Spirals are designed for several years of work. They are installed and removed by a gynecologist without anesthesia. Reliability is close to 100%, since the local effect of the spiral and the general hormonal effect are combined.

Contraindications:

• deformation of the cervix and uterine cavity;
• ectopic pregnancy in history;
• mammary cancer;
• functional cysts.

How are hormonal contraceptives chosen?

The use of hormonal contraception is contraindicated without consulting a gynecologist! Very often the question is how to choose hormonal contraceptives on your own. There is an unequivocal answer to it: you should not do this. All hormonal preparations have wide list indications and contraindications, therefore, the doctor should select the remedy after a thorough history taking and (at least) examination on the chair.

After the consultation, the specialist will decide whether an additional examination is necessary (blood for hormones, ultrasound, coagulogram) and will prescribe the best hormonal contraceptives for a particular case.

The selection table for hormonal contraceptives based on phenotype will help to suggest which the remedy is suitable just for you.

Hormonal contraceptives for breastfeeding: mini-pills, subcutaneous implants, intrauterine devices and progestin injections. The same funds are recommended for women after 40 years or smoking women after 35.

Possible reactions and side effects of hormonal contraception

Side effects of hormonal contraceptives in healthy women are extremely rare, but you need to be aware of the symptoms, if they appear, you need to urgently consult a doctor and stop taking the drugs:

• the onset of pregnancy;
• sudden visual disturbances;
• the need for surgical interventions;
• jaundice;
• the appearance of thrombosis;
• severe migraine;
• breakthrough bleeding;
• a sharp increase in weight;
• the appearance of neoplasms in the chest;
• myoma enlargement.

There are a number of side effects that can appear normally. They usually disappear after 2-3 months from the start of therapy. These include:

• spotting when taking hormonal contraceptives;
• lack of menstruation;
• decreased libido;
• perversion of tastes, smells;
• the appearance of skin problems (for example, acne);
• mild headaches.

distant side properties, appearing at a small amount women:

• amenorrhea after taking hormonal contraceptives;
• long-term restoration of fertility;
• irregular cycle;
• if antiandrogenic drugs were taken, resumption is possible acne, hirsutism.

General principles for the abolition of hormonal contraception and the reaction of the body

Most contraceptives can be canceled on your own - stop taking the pills, stop using the patch or ring at the end of the cycle. The spiral and the implant can only be removed by a doctor. A break in taking hormonal contraceptives is recommended every five years. In some cases, the doctor may recommend a different treatment regimen, and then you need to follow the instructions.

The ability to become pregnant is restored in different ways: after the abolition of pills, vaginal ring and patch, fertility returns almost immediately, when using injections, implants, spirals - within 9 months.

During pregnancy, hormonal contraceptives are canceled immediately, but even if the pregnancy was diagnosed belatedly, most drugs do not harm the fetus. The main thing to remember is that many methods of contraception increase the risk of ectopic pregnancy.

Thus, hormonal contraception is a modern, highly effective way to protect against unwanted pregnancy. He suitable for women those who have a permanent sexual partner as the only method of protection, as well as those who want 100% protection in combination with a condom. Why are hormonal contraceptives dangerous? Like any medicines, they have their own contraindications, and if you do not forget about them, the danger of hormonal contraception tends to zero.

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