New generation contraceptives for women. Hormonal contraceptives of the new generation - a list. Hormonal intrauterine system

Unwanted pregnancy is what worries many women the most. Everyone knows that abortion is injurious to health, and that is why prevention is the most topical issue. Gynecologists, in turn, are ringing the bells, because taking some of the new generation of contraceptives, unplanned pregnancies still end in abortions.

Medicine and pharmacology do not stand still. New modern drugs that protect against pregnancy are being developed and improved. This allows you to reduce the number of abortions and the consequences after them. Now there are not only hormonal pills, but also a whole group of topical preparations.

How do modern contraceptives work?

Vaginal contraceptives work very simply - once in the body, the chemical kills sperm. Oral contraceptives prevent the development of eggs in the ovaries. They affect the uterine mucus, make it viscous and impassable for spermatozoa. Birth control pills inhibit or completely prevent the attachment of the embryo to the cervix. All this does not allow pregnancy to occur.

Topical preparations, such as suppositories, are a local and chemical method of contraception. They contain nanoxinalon or benzalkonium in their composition. It is these active substances that act on spermatozoa and make them immobile by violating the integrity of the membrane.

The vaginal ring is one of the methods of contraception, belongs to the group of hormonal drugs. It is made of elastic material, which contains a small dose of progesterone and estrogen. The dosage is such that the release of a mature egg is prevented. There are other contraceptives of high efficiency and safety.

Are modern contraceptives harmful?

If the contraceptive is not chosen correctly, it can harm the female body. For example, there will be side effects, will begin to gain weight, increase hairline. This applies only hormonal drugs, which are contraindicated in diseases of the cardiovascular system, diabetes. Even with problems in the liver and kidneys, such drugs are contraindicated. Women who smoke need to choose other contraceptives, because hormonal agents put a heavy strain on the heart. There is also an increased risk of thrombosis.

For medical reasons, if taken regularly long time hormonal drugs, then sexual activity gradually decreases. This is due to a decrease in testosterone production.

What are contraceptives?

Contraceptives are the most different types and forms: hormonal pills, intrauterine devices, condoms, topical preparations, injections.

"Jess" is a popular new generation of contraceptives. These are not only birth control pills, but also a drug that treats some disorders in the field of gynecology and hormone dependence. This remedy cures acne and other skin imperfections. The contraceptive effect is achieved due to the estrogens and progestogens that make up the drug. They are the ones that stop ovulation.

"Jess" affects the state of health during menstruation. Its composition acts to reduce anemia and pain symptoms. Menstruation is faster. Very often, gynecologists prescribe this remedy for severe symptoms PMS. The advantage of these tablets over similar drugs is the low concentration of active substances. The drug is prescribed to women aged before the onset of menopause.

"Jess plus" is an effective contraceptive. In addition to hormones that inhibit sperm patency and block ovulation, the drug contains folate (calcium levomefolate). This is a type of folic acid that is essential for a woman's normal health. B9 is rapidly absorbed into the bloodstream and affects the nervous system. This drug is unique in that, unlike all contraceptive drugs, it gives the biggest guarantee. In addition, the composition of the product protects a woman from all troubles if a pregnancy suddenly occurs. Her body will be prepared for this, and active form the drug will help to eliminate shortcomings in the formation of the neural tube of the future fetus, that is, to exclude the development of a violation of the baby's nervous system. It is safe for women of reproductive age. It can be used from the age of 18 until the onset of menopause.

"Marvelon" is a new generation of contraceptives after 35 years. Women who have already given birth and are of childbearing age should take low-dose drugs with hormonal composition. Marvelon can also be taken by women who have not given birth. It has a low content of hormones. This drug belongs to the group of oral hormonal contraception. Designed for women who are active sexual life. The composition of the tablets provides high-quality and complete protection against pregnancy. Medical indicators– 99% protection. Marvelon is safe for health, easy to use, helps to eliminate the problems of women during menstruation. If a woman has a serious PMS syndrome, then gynecologists often resort to the appointment of this remedy. The low-dose drug in its composition contains ethinylstradiol, gestodene, norhistimat. These hormones are great for women over 35, as they improve the condition of the skin of the face, normalize hormonal balance and reduce growth. unwanted vegetation. The drug is recommended for women after 25 years and before menopause.

Depo-Provera is a new generation of contraceptives after 40 years. He appeared on the pharmacological market not so long ago. This is a synthetic means of progesterone hormones. Currently, the drug is prescribed to women for contraception, treatment of a number of gynecological pathologies and even oncological pathologies. Women over 40 can also take oral contraceptives, but doctors prefer special injections. Depo-Provera is a suspension containing medroxyprogesterone acetate. Once it is injected under the skin, it acts as a contraceptive and blocks ovulation. The injections are very effective, they are administered intramuscularly, it has a number of positive therapeutic effects. It belongs to the group of safe drugs with minimal side effects. Recommended for use by women over 40 and before menopause.

Vaginal suppositories "Farmateks" are excellent contraceptives of a new generation after 45 years. Since it is very difficult to choose contraceptives for women at this age, as there are various difficulties, Pharmatex is a reliable and safe option.

By this age, a bouquet of acquired diseases is observed, and what could be taken in youth is not at all suitable for 45 years. Closer to the period of menopause, gynecologists prescribe barrier contraceptives to women. It could also be condoms. But for those who are sexually active, the only way not to get pregnant is to use vaginal suppositories. Pharmatex is so effective remedy that it is compared with hormonal contraceptive ballet flats and with an intrauterine device. In addition to protecting against pregnancy, the active ingredients protect a woman from various diseases because they destroy pathogenic microflora. Candles are recommended to be used at the age of 45 and until the full onset of menopause.

"Patentex Oval" - modern contraceptive suppositories. It contains the chemical components nonoxynol and excipients that affect the decrease in the tension of the lipid membrane of spermatozoa. Once in the vagina, candles paralyze the ability to move sperm. A mechanical obstacle causes a spermatocidal substance, which, under the influence of body temperature, is distributed throughout the vagina. Thus, a stable barrier is formed. This prevents sperm from entering the cervix.

The drug has good prevention against various infections. These candles can be used in any reproductive age, including after 45 years.

"Novaring" - modern contraceptive. This is a ring made from a smooth and elastic material; it contains hormonal components that affect the movement of spermatozoa and prevent them from moving into the uterus. The ring is inserted into the vagina. Since it is quite flexible, it accepts desired shape. This method of protection is convenient and safe. The ring does not interfere with leading a full life and having sexual intercourse. There is no discomfort. The ring contains estrogen and progestogen. The ring is valid for one menstrual cycle. An excellent and effective remedy that treats a number of gynecological diseases. It is prescribed for women aged 18 years and before the onset of menopause.

"Laktinet" is a contraceptive called mini-pill. Each tablet contains synthetic analogues of female hormones. Progestin and estrogen prevent the movement of sperm into the uterus. "Lactinent" is not more effective than combined contraceptives and has a number of contraindications, so these drugs should be prescribed only by gynecologists. Mini-pills are prescribed, as a rule, only for lactating women or when combined drugs are contraindicated. These drugs are also prescribed to women after 45 years of age with varicose veins and diabetes. Suitable for women who smoke.

Contraceptive sponges are used more and more often. Some women do not want to use contraceptives and help them save themselves from unwanted pregnancy barrier contraceptives. Contraceptive sponges do not allow sperm to enter the cervix due to a mechanical obstruction and the release of a special spermicidal substance.

Modern contraceptive sponges are made of soft polyurethane. The composition contains benzalkonium chloride, nonoxynol. They are very easy to use. They are prescribed to women at any reproductive age.

The most common method of protection against unwanted pregnancy is intrauterine contraception. The material used is polyethylene, which contains barium sulfate. Modern spirals differ in their shape from those used 10 years ago. The spiral contains a sputtering (copper or silver). Most often applied T-shape intrauterine device.

This method of preventing unwanted pregnancy is not new, but, nevertheless, some forms and types of contraceptives belong to the new generation. Some coils contain progestogen or antibiotics. Inserted deep into the cervix.

Women who are of the progesterone type, that is, have an angular figure, small breasts, who have skin problems and menstruation are accompanied by painful symptoms, should give preference to drugs with an antiandrogenic effect. These are: "Jess", "Jess plus", "Yarina", etc.

If a woman has normal skin, menstruation is painless, then you can choose Mercilon, Regulon, Femoden and others.

It is also important to know that hormonal drugs are addictive, so you should take a break, otherwise side effects may appear.

Modern society and the family set themselves the task of maintaining reproductive health and ensuring safe motherhood. It can be solved by preventing unwanted pregnancy, reducing the number of abortions and the consequences associated with them. Modern female contraceptives successfully cope with this task.

Contraceptives are subject to the following requirements:

• efficiency not less than 97%;
• safety for the health of sexual partners;
• restoration of fertility after the abolition of the contraceptive;
• ease of use;
• affordable price.

Unfortunately, there are no universal means of protection against unwanted pregnancy, they need to be selected individually, so only a doctor can choose a contraceptive.

The reliability of these funds is not less than 97%, since when they enter the body, they create a triple barrier. They have the following effect:

• suppress ovulation;
• contribute to the thickening of cervical mucus, preventing sperm from entering the uterus;
• change the properties of the endometrium, preventing the fertilized egg from attaching to the wall of the uterus.

Combined oral contraceptives

These are contraceptives for women that contain synthetic analogues of male and female sex hormones. They “simulate” an artificial state of pregnancy in the body. There are two-phase and three-phase preparations.

These include Rigevidon, Midiana, Lindinet, Triquilar and others. The advantages of these drugs are the stabilization of the hormonal background, antiandrogenic effect and effective protection from pregnancy.

Such contraceptives differ in the amount of hormones, that is, they are low-dose, medium-dose and high-dose (used only with therapeutic purpose), which allows them to be prescribed to women of any age.

Combined oral contraceptives with natural hormones

These are the best contraceptives for women today, containing analogs close to natural hormones and having a gentle effect on the female body. They can be monophasic or multiphase.

For example, Qlaira is a four-phase drug with a dynamic dosage regimen. It not only reliably protects against unwanted pregnancy and has a minimal effect on the body, but also has a therapeutic and prophylactic effect on genitourinary system women.

Mini - drank

These are monophasic preparations containing progestin. Unlike combined oral contraceptives, they have a milder effect on the body.

Mini-pills are used when taking traditional birth control pills is contraindicated.

Restrictions for receiving funds are not:

• lactation;
• diseases of the cardiovascular system;
• smoking and age over 35.

The drugs of this group are Charozetta, Lactinet, Exluton. Among the advantages of the mini-pill, one can note the absence of an effect on libido and blood pressure, fast recovery ability to conceive after discontinuation of the drug.

The disadvantages of mini-pills provoke intermenstrual bleeding during the period of addiction to the drug and a lower contraceptive effect compared to combined contraceptive pills, due to the lack of estrogen in them.

Vaginal hormone ring

A transparent elastic ring with a diameter of 55 mm is inserted into the vagina once a month. Its action is based on combined hormonal contraception. The ring, being in the vagina, releases a small amount of hormones that enter the bloodstream through the mucous membrane.

Unlike oral contraceptives, the vaginal ring does not negative impact on the digestive tract, convenient to use and does not require daily intake. The disadvantages of the vaginal ring are the same as those of estrogen-containing contraceptives.

Hormonal patch

It is a combined hormonal contraceptive. It is glued to the skin once every 7 days.

The patch releases hormones that enter the bloodstream through the skin barrier and have systemic action on the body: they suppress ovulation, contribute to the thickening of cervical mucus and cause changes in the uterine mucosa.

The patch must be replaced weekly with a 7-day break for menstrual bleeding. The advantage of the hormonal patch is the periodic replacement of the contraceptive. The rest of the pros and cons are the same as for other combined hormonal drugs.

Intrauterine contraceptives

Intrauterine devices (IUDs) are female contraceptives, which are a plastic product with the addition of valuable metals. The spiral is inserted into the uterine cavity for up to 5 years. Modern IUDs contain synthetic analogues of hormones that are released in minimal amounts into the bloodstream and prevent ovulation.

The spiral reliably protects against unwanted pregnancy due to the following aspects:

• affects the speed of movement of the egg through the fallopian tubes, reducing it;
• thickens cervical mucus, preventing the penetration of spermatozoa;
• changes the structure of the mucous layer of the uterus, preventing the attachment of a fertilized zygote.

The efficiency of the spiral is close to 98%. It can be used during lactation, as even from hormonal IUD hormones do not pass into milk. You can install a spiral at any time, regardless of menstrual cycle immediately after an abortion or childbirth.

The advantages of the intrauterine device are:

• high efficiency;
• minimal impact on the body;
• rapid recovery of childbearing function;
• lack of control over the regular use of contraceptives;
• economy.

The disadvantages of the intrauterine device include:

• painful procedure for the introduction of a spiral;
• the possibility of use only in patients giving birth;
• limited duration;
• lack of protection against genital infections.

Barrier contraception

Methods barrier contraception create a "mechanical" barrier, protecting a woman from unwanted pregnancy. That is, they prevent the penetration of spermatozoa into the uterine cavity.

These are affordable and easy-to-use products that can be a worthy alternative to hormonal contraceptives. These include:

• female condom;
• vaginal diaphragm;
• neck cap.

Made from latex or silicone. The cap covers the entire cervix, the diaphragm and the condom line the upper part of the vagina during intercourse.

The sizes and models of caps and diaphragms vary, so a gynecologist should choose them for a woman. Female condoms are one size fits all and can be purchased without a prescription. Recommended for women aged 30-50 years.

Disadvantages of barrier contraceptives:

• they should always be at hand, you will have to carry them in your purse to avoid unprotected intercourse outside the home;
• training is necessary to learn how to use the remedy correctly, otherwise an incorrect installation before intercourse can result in an unwanted pregnancy.

Advantages of barrier contraceptives:

• availability;
• no need to depend on a man for contraception;
• high protection efficiency - up to 99% when used correctly;
• The female condom protects against sexually transmitted infections.

Chemical contraception

This type of contraception is based on the action chemical substances. Local preparations - suppositories, tablets, gels are introduced into the vagina before intercourse. They are not absorbed into the blood, so they do not affect the hormonal background of a woman.

The effectiveness of the method directly depends on the correctness of its use. Vaginal tablets and suppositories should be inserted into the vagina at least 10 minutes before sexual intercourse.

The dissolving spermicidal component will create the necessary barrier that will not allow sperm to enter the uterus.

The disadvantage of such drugs is their uneven distribution in the vagina, which can affect their effectiveness.

Spray and gel are sold complete with a special dispenser, which makes it possible to achieve a more even distribution of spermicide in the vagina.

The active ingredient in chemical contraceptives paralyzes and kills sperm. You can buy birth control pills and gels without a prescription. Recommended at any age - from 20 to 50 years.

Advantages of chemical contraceptives:

• availability;
• ease of use;
• no side effects, subject to the tolerability of the drug;
• good protection against pregnancy correct use candles (not less than 80%).

Disadvantages of chemical contraceptives:

• must be entered for certain time before intercourse;
• 2 hours before sexual intercourse and within 6 hours after it, soap should not be used in intimate area so as not to disrupt the contraceptive effect of a candle or pill;
• must always be kept on hand or carried in a purse;
• possible allergic reactions to suppositories and tablets in both partners;
• high risk of pregnancy misuse candles - in 50% of cases.

Age-appropriate contraception for women

Contraception up to 30 years

In the absence of contraindications, all young women are advised to take low- and medium-dose hormonal contraceptives, which are easy to use, have anti-inflammatory and high contraceptive effects.

Chemical and barrier methods of protection (candles, condoms) at this age are not recommended, since in practice almost 30% of women become pregnant, despite the use of these funds during intercourse. But at the same time, condoms help protect a woman from genital infections, which is important if she does not have a permanent sexual partner.

An intrauterine device is not placed before the birth of a child, since the body of nulliparous women rejects foreign body. The spiral can cause local inflammation which, if left untreated, can lead to infertility. Therefore, women under the age of 30 are advised to use hormonal contraception and condoms.

Contraception from 30 to 40 years

It is advisable for women over 30 to give up hormonal contraceptives, since at this age the risk of heart and vascular diseases, in particular thrombosis, increases.

In addition, the female body after 30 years reacts more sharply to hormones - estrogens and gestagens, which are part of birth control pills. They provoke heaviness and pain in the chest, migraines, discomfort in the intestines, increased blood pressure and development of depression.

Contraception after 40 years

After the age of 40, a woman's fertility steadily declines. Many have already abandoned oral contraception due to contraindications that have arisen - metabolic disorders, cardiovascular pathologies or high cholesterol in blood.

At this age, women tolerate the IUD worse. Therefore, most of them switch to barrier and chemical contraceptives (candles, condoms).

Every woman should give preference to exactly those contraceptives that suit her for health reasons, degree of protection and age.

Contraceptives cannot be selected independently; only a gynecologist can choose them. A suitable and effective method of contraception will help to avoid unwanted pregnancy and maintain health.

Useful video about contraceptive methods

Answers

First a riddle. Let's say you have a hundred women. Of these, you gave a third of them into sexual slavery in the editorial office of the magazine (thanks, by the way). Moreover, out of this third, another third are blacks. Attention, the question is: what is the Pearl index? Correctly. This is an index of failures, showing how many women out of a hundred, being protected by the chosen remedy for a year, will eventually become pregnant. The lower it is, the better remedy. For example, for condoms, this index is up to 12, which is quite a lot. What does it have to do with black concubines, you ask. Yes, the image is beautiful.

We collected data on the Pearl index in a table, and described the rest of the pros and cons of all known contraceptives (both male and female) in detail.

1. Condoms

Better than anything, protect against infections. Efficiency - 85-90% (less only for mycoplasmosis and herpes).

Safe, even indifferent to health, if you are not allergic to latex.

They need to be bought, kept in your pocket and put on in time (according to a study by Sanders - Graham - Crosby, 50% of women do not have this skill: they put on a partner in protection after the start of the act).

There is nothing to add to what has been said. Just to get a little bored. According to science, to achieve an impressive 95% effectiveness of a condom, you need to:
● inspect the condom packaging for damage;
● don't wear it inside out...
● …and an erect penis, to the end (fun, Beavis, we said "end"!);
● always leave a spout at the end to collect sperm (you will be surprised, but this really somehow increases the effectiveness of a latex friend);
● use exclusively water-based lubricants ( butter leave the Tango in Paris to the heroes).

2. Barrier contraception

In our editorial office, full of hypocrites, and even Old Believers, there was no person who could without hesitation write down all the words of an expert on female contraception Tatyana Kaznacheeva, Ph.D., associate professor of the department reproductive medicine and surgery FPDO MGMSU. Therefore, warn your woman: it is better to draw information about candles and sponges not from a men's magazine, and not even from a women's one, but from a conversation with a personal gynecologist. However, we have learned something. The diaphragm and the female condom, according to Tatyana, have not really taken root in our country, despite the fact that “this rare condom, due to its larger surface, is able to protect against STIs to a greater extent than the male one.” Well, as for spermicidal agents (creams, vaginal tablets and candles), their only advantage is their availability. There are at least three cons.

Spermicides can cause irritation and allergies not only in her, but also in you.

They are so ineffective that young anemones are generally not recommended to use them due to frequent misfires.

Most of the funds need to be entered 20-30 minutes before the act and updated with each next one, and this is not always convenient.

3. Vasectomy

This method, with a stretch, can also be classified as a barrier method, only the obstacle in the way of spermatozoa is not foam pills and latex, but your bandaged ones ( surgically) vas deferens. Vasectomy does not affect the amount of sperm, which lovers of the amount of sperm cannot help but appreciate.

Contraception is always with you, it does not require you to download a new firmware and generally take care of maintaining it in any way.

A vasectomy is only good if you've already had some children. Because it might not work anymore...

- ...because a reconstructive operation is a procedure several orders of magnitude more complicated than basic knotting. Its result is unpredictable. It often happens that it is completely impossible.

4. Female sterilization

Nearly 100% efficient.

One operation for life.

Regulated by law and even in our liberal (ha ha) country is prohibited nulliparous women up to 35 years old.

A real operation - with preparation, hospitalization, anesthesia.

Conditionally irreversible. Reconstructive surgery is possible, but there are a lot of reservations.

There is, however, a method of reversible sterilization, when the mouth fallopian tubes spiral devices are introduced that make it impossible for the egg and sperm to rendezvous. But this method in our country is widespread, to put it mildly, not everywhere.

5. COC tablets

Few side effects. At permanent reception for two years or more reduce the likelihood of developing various female diseases. New ones are not added.

Long history of observation and quality control: tablets have been used in the civilized world for 50 years.

They require daily intake and, as a result, the presence of a certain amount of gray matter in the head of a woman. If the regimen is broken, COCs lose their effectiveness.

They are not amenable to severe male control: it is impossible to understand by the type of pills what your woman is drinking - contraceptives or glycine, which means that deceptions and intrigues are likely (well, all of a sudden).

Bad reputation: if your woman decided that she would not “take hormones”, then it would be logically impossible to convince her. Especially since side effects like weight gain and headaches really happen even with the most modern wheels. True, much less frequently than the "classic" drugs.

If your woman's prejudice only applies to the form of release of combined contraceptives, you can offer her a skin patch or a vaginal ring. You don’t even have to blatantly lie that these products are more gentle and less hormonal. Often it is. Oh yes, there are still mini-pills! These do not contain estrogens at all, and besides, they are more harmless purely visually - because of their size.

Gynecologist, PhD, Medical Adviser, MSD Pharmaceuticals LLC

COOK
Pills containing the female hormones estrogen and progesterone should be taken daily for three weeks, followed by a week-long break during which menstruation occurs. The main mechanism of action is the suppression of egg maturation. There are pills that do not contain estrogens, they contain analogues of progesterone (one of the female hormones) and are just as reliable as combination pills. Such drugs may be recommended for lactating women or those who are contraindicated in estrogens. Tablets are often packaged in a blister pack with flowers on them, but this is not required. It looks like any other small tablets.

Patch
It also contains analogues of two female sex hormones. A patch measuring 4.5 by 4.5 cm is independently glued by a woman to a clean, dry ass. I mean, sorry, skin. The mechanism of action is the suppression of ovulation. Color - beige, does not peel off by itself.

Flexible vaginal ring
Arranged on the principle of a multilayer membrane. It continuously releases minimal (due to localization they should not be large) doses of estrogen and progestogen, which are absorbed into the blood through the mucous membrane, you know what. It couldn't be simpler: a flexible ring with a diameter of 5.4 cm is inserted independently by a woman, you know where (following the example of a tampon). The location of the ring does not affect its effectiveness. The ring stays inside for three weeks, and it's better not to forget to change it, like a cat's tray. Between the removal of the old and the introduction of the new - a week break. The ring effectively inhibits the release of the egg. By the way, as private surveys show, some people really like it when a partner himself understands where (none of our articles has this bashful euphemism repeated such a terrifying number of times. - Approx. ed.) has such a pretty ring. It supposedly improves the feel.

6. Injections and implants

The relentless need to take pills every day often leads to truly zen riddles like “I forgot to take them for three days. Can I now take three pills at once? In order not to answer the endless questions of endless forum visitors, doctors came up with long-term solutions.

Long-term effect: 3 months for injections and up to 5 years for implants.

Do not require feats of self-discipline. Injections need to be done quite rarely, which the organizer or secretary will always remind you of - after all, she is also interested in this.

All procedures are invasive and require a visit to the doctor. You could theoretically handle an intramuscular injection, but not a subcutaneous implant.

No matter how few side effects modern drugs cause, in this case they are irreversible: if an injection is made and something goes wrong, then the entire duration of the drug will go.

7. Intrauterine devices

The efficiency of some "spiral" solutions is up to 99%.

It is very convenient to use: set it and forget it. Moreover, not for himself, but for her. And you have nothing to do with it. Although not, periodically monitor the position, sorry for the details, of the "antennae" of the intrauterine device and you will have to monitor the service life. However, this mission is also unlikely to be entrusted to you.

Can be used as early as six weeks after birth. You are such a paranoid.

There are no draconian age and smoking restrictions specific to COCs.

Any foreign object in the body reduces the local resistance to infection and gladly exacerbates and aggravates its course, if it has already appeared. This also applies to spirals.

It is no longer possible for your partner to catch an STI. That is, you and all her other men are now required to use condoms. Therefore, give them all this magazine - let them know that these are not jokes, and generally xerify the article.

Ordinary copper intrauterine devices can, especially at first, cause discomfort, pain and all sorts of bleeding. Expensive hormonal systems like Mirena are almost devoid of such effects, their main disadvantage is the price, that is, the only IUD parameter that concerns you for once.

One more thing to remember important point. This hellish remedy is famous for one unpleasant fact: pregnancy when using it is still possible. The sperm connects with the egg - life is actually born, but it does not go beyond this. The resulting zygote cannot stick to the wall of the uterus due to local effects created by the spiral, therefore, in some cases, it spits on the health of the mother and nests where it wants. This is called an ectopic pregnancy and is no joke. Urgently to the hospital!

8. Natural Methods

They are always with you, you do not need to buy them in a pharmacy. That is, you pay with them only for sex!

Most of the so-called natural methods of contraception do not work at all and are based on myths. Even for coitus interruptus, the Pearl index is very high, and for other tricks and subterfuges it is even higher.

Again, there are studies proving the harm of coitus interruptus for prostate health. They are not supported by the proper apparatus of evidence, but still somehow disturbing.

“I have safe days”, “She is breastfeeding. Somewhere I read that it is possible”, “I went to the sauna, and spermatozoa remain alive only at temperatures below 36 degrees” - what phrases do not respond with joy in the hearts of irresponsible partners! Some even still believe in a lemon, you know where you put it (everything, everything, this phrase will not be used again), and that you can’t get pregnant in the rider’s position. Ha! Still not to believe! Cash outlay is zero. Zero hassle. Guarantees - well, let's say, not zero, but they are rather absent, if the word "guarantee" is understood correctly.

All in all, natural methods- one of the most unreliable. Indeed, overheating of the scrotum sometimes prevents conception. And while breastfeeding or severe stress in some women, the mechanism of ovulation is confused and even completely disappears. However, relying on these vagaries of nature is not worth it. Cunning spermatozoa are contained not only in semen, but also in lubricants, they live in communication routes, sometimes for ten days in a row (that is, they can hold out and meet the dawn of a “dangerous” day with a whoop). Do not consider all these dances with tambourines as serious methods of contraception and turn your attention, for example, to the most reliable method, according to experts. Of course, we saved it for last.

Just so you know, our consultants tried not to use the word "contraception" at all. Allegedly, it has a shade of undesirability, and you need to say "family planning." Because here, after all, the thing is this: today you don’t plan it, and tomorrow amniotic fluid may well hit your head.

Therefore, in most cases, especially with unfamiliar partners with whom you still don’t even plan to have breakfast, doctors recommend using the “double Dutch method”. This is when a woman drinks COCs, and a man uses a condom. Even in the case of the most hectic lifestyle, such a tandem brings not only the likelihood of pregnancy to zero, but also the risk of catching an STI.

Well, if you both understand that children are exactly the reason that you lack to take another consumer loan from a bank, you can always refuse the Dutch method.

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

• 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 potential risk the development of long-term effects of taking such drugs even by a healthy woman.

By doing this, we want to draw the attention of women to a longer-term prognosis of their health and reflect on the fact that any intervention in 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 contraceptives, presented in the pharmacy, hormonal contraceptive pills occupy a leading position today (and bring their manufacturers billions of dollars a year). 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 taking 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 microdose drugs, experience intermenstrual bleeding. According to research by manufacturers, 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 hold 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:

• growth, 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 rub)	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, look "boyish", mammary glands are underdeveloped, skin and hair are oily, depression on the eve of menstruation and abdominal pain, in 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, to 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 breast milk. 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 the appearance of serious, as well as with constant small side effects, contraceptives are discontinued.

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 in many developing countries regular check-ups are unlikely, and there are programs (in some countries) to distribute OCs to women who do not have access to medical care. This points to high probability that OK will be used by groups of women high risk. Consequently, it will be more difficult for such women to obtain medical care 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 a risk of developing pulmonary thromboembolism, the development of oncology, is extremely high.

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 taking pills are violated (missing, irregular, in different time intake past the expiration date of the drug).
• It should also be taken into account possible vomiting in case of poisoning or joint use 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 if they have cardiovascular pathology coupled with smoking, a high risk of cancer. 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 for emergency cases(rape, condom damage), 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 further reproductive function. female body.

• Non-hormonal contraception

They are spermicides that are used topically to prevent unwanted pregnancy. Active ingredient 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 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. Positive points use of 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 the reception contraceptive pills the menstrual cycle acquires regularity, the disappearance of pain during menstruation is possible (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 cyst (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 condition health, availability chronic diseases. According to the results of many studies, the use of oral contraceptives (long-term), has a long-term Negative consequences for the health of a woman, especially those who smoke and have any chronic diseases.

Arguments AGAINST oral contraceptives

AT 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.

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 every cycle for a fertilized egg, 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). gradually changing slime layer and uterine tissue, which in the future (more often during menopause) threatens with oncological degeneration.

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

• women who have the contraindications listed above should in no case 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 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 an age of oncological tension and unimproved early diagnosis of the initial asymptomatic stages of oncology, a woman taking OCs may not be aware that she has early stages 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 factors risk - high blood pressure, smoking (especially over 35 years old), see genetic disposition;
• 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;
• an increased risk of developing inflammatory diseases cervical, 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 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 hormonal patch and then spiral.

After reports of harm to OK, several deaths and litigation, in some countries (USA, Germany, France) the drug Diane-35 is prohibited, and surveys of Europeans showed that 67% of people aged 15-63 try to protect themselves with condoms, these are married couples and free women, 17% prefer the patch, 6% use the coil, the remaining 5-10% continue to use OC.

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.

Many women prefer protection with oral contraceptives, which is due to several factors: preventing unexpected pregnancy, improving the appearance of the skin, hair and nails, and normalizing hormonal levels. Among the shortcomings are bloody issues between periods, lack of protection against sexually transmitted diseases, the difficulty of selection in accordance with individual characteristics. The latter factor is decisive in the successful prevention and hormone replacement therapy.

Classification and types

Which one is best for reliable contraception? The pharmaceutical industry produces enough new generation oral contraceptives. Contrary to popular beliefs about the dangers of hormones for the female body, modern drugs do not increase weight (in some cases even reduce body weight), do not increase hair growth in unwanted places, do not affect libido and women's health. Ease of use and benefits for the beauty of the body and face often become a defining condition for this particular type of contraception. Before choosing birth control pills, need to know existing species tablets.

Single-phase (otherwise, monophasic) tablets

A characteristic feature of such tablets is the same ratio of estrogenic and progestin hormones. The main drugs of the group are the following tablets:

The doctor selects single-phase oral contraceptives to correct the hormonal background after abortion, in case of menstrual irregularities.

Biphasic contraceptives

One tablet of biphasic drugs includes a certain constant concentration of estrogen and a variable dose of progestogen, which changes in the I and II periods of the menstrual cycle. There are the following types of tablets:

This group of drugs is prescribed for women with particular sensitivity to gestagens, as well as with a history of hyperandrogenism. Treatment is carried out in accordance with the indications of the drug.

Contraception in three phases

Three-phase preparations contain a dose of hormones that changes three times during the menstrual cycle. The main drugs in this group are:

Tablets with a three-phase effect are prescribed for women over 35 years old and girls under 18 years old. Considering that the main contraindication to the use of tablets is smoking, then three-phase hormones can be taken smoking women. The advantage is high efficiency in obesity at any stage of development. The main disadvantage is the complex scheme of application and the frequency of bleeding between periods.

Mini pills

The active ingredient in mini-pill tablets is only progestogen. The substance affects the local areas of the female reproductive system, normalizes the cervical mucus and its biochemical composition. The volume of mucus under natural conditions decreases in the middle of the cycle, but against the background of the use of the drug, the viscosity remains stably high and prevents the movement of spermatozoa. Usually the choice falls on such effective pills:

Lactinet, Charozetta (based on the drug desogestrel);

Microlut, Exluton, Orgametril (based on linestrenol).

Changes against the background of taking a mini-pill occur at the level of biochemical processes, as well as in the endometrial layer. Implantation of a fertilized egg is difficult. In many women, ovulation is completely blocked. Even such pills without a doctor are extremely difficult to pick up.

The basic principle of action of combined oral contraceptives is to completely block ovulation and implantation. gestational sac to the wall of the uterus. Oral contraception provides a kind of glandular regression in the mucous structures of the uterus. Mucous components in cervical canal thicken, which prevents the penetration of spermatozoa. These changes are due to the contraceptive effect of the use of tablets.

Classification by volume of hormonal components

Differences in tableted contraceptives are also due to the total concentration of hormones in one tablet. The information is presented in the following table:

Features of the choice of contraceptive pills

It is very difficult to choose pills on your own, so doctors recommend not practicing on your own health. In some cases, even after examinations and consultations of specialists pick up the right drug perfect the first time. Women are tormented by constant spotting between menstruation, there is no effectiveness of the therapeutic effect and an increase in the symptoms of gynecological diseases. When prescribing the drug, a number of diagnostic criteria are taken into account:

general clinical history;

the number of births and abortions;

living conditions (nutrition, the presence of bad habits, sexual contacts, the nature of menstruation);

analysis indicators (sampling with cervical canal, urine, blood tests);

ultrasound of the organs of the peritoneum and small pelvis;

mammological examination;

assessment of the type of woman on the hormonal background.

All this data can not be obtained at home. Self-administration leads not only to a decrease in contraceptive function, but also to a number of side effects.

Before Appointment need to consult an endocrinologist, ophthalmologist. The choice of oral contraceptives is also based on other criteria for assessing general physiological parameters:

type of mammary glands;

the nature of the course of menstruation;

the presence of chronic diseases of organs and systems, including gynecological pathologies;

general state skin and hair;

type of hair growth of the pubic area.

According to all clinical data, the phenotype of the woman is compiled, which is the main selection criterion suitable tablets for contraception and treatment of gynecological diseases, including infertility.

Women of this type are of medium or short stature, hair and skin are dry. Femininity is defined. Menstruation is accompanied severe blood loss, lengthy. The duration of the menstrual cycle is more than 4 weeks. Such women are prescribed high-dose and normal-dose contraceptives. The main drugs are Milvane, Femoden, Triregol, Rigevidon, Lindinet, Microgynon, Logest, Triziston. Such funds are not assigned to oneself.

Balanced estrogen levels

The type of woman is characterized by average height, medium-sized breasts, normal state skin and hair. Signs of PMS are usually absent or mild. The duration of menstruation does not exceed 5 days, and total duration menstrual cycle is normal. Women can choose the following drugs:

Tri-merci;

• Lindinet-30;

  Triquilar;

• Marvelon;

• Microgynon.

A balanced content of female hormones is accompanied by moderate femininity, normal hair growth of the pubic area and other parts of the body.

The predominance of progestogens (otherwise, androgens)

Women, predominantly tall with a boyish appearance. The mammary glands are poorly developed, there is an increased oiliness of the hair and skin. Androgenic manifestations are expressed in excessive hair growth armpits, pubis. PMS is accompanied by depression, pain in the abdomen. The duration of the menstrual cycle is short, less than 28 days. Menstruation itself lasts no more than 3-4 days. The following tablets are prescribed:

Yarina, Jess, Dimia, Jazz containing drospirenone and ethinyl estradiol;

Erica-35, Chloe and Diana-35 with ethinyl estradiol, cyproterones in the composition;

Siluet and Jeanine, which are dominated by dienogest and ethinyl estradiol;

Zoely with estradiol and nomegestrol.

Each phenotype is distinguished by features, individual characteristics in clinical and life terms.

Contraceptives by age

It is impossible to independently assess age-related changes in the body without consequences for the body and ensuring normal contraceptive function. The benefits and harms of certain pills can only be assessed after adequate diagnosis. The selection of oral contraceptives is the task of professional gynecologists. The main goal is to prevent unwanted pregnancy and additional therapeutic effect if necessary. Age features women are an important aspect of successful and effective prescribing. Biochemical parameters of the female body change with age and are divided into several main periods:

teenage girl (from 11 to 18 years old);

early reproductive (from 19 to 33 years);

late reproductive (from 34 to 45 years);

postmenopausal (2-3 years after the cessation of menstruation).

The initiation of adequate contraception should be started as early as adolescence if necessary. According to statistics, the age of the woman in labor is noticeably decreasing, and the frequency of abortions is increasing. Combined contraceptives are predominant in adolescence with low doses of hormones. The following drugs are shown to young girls: Tri-regol, Trikvilar, Triziston, Mercilon, Marvelon, Silest, Femoden. These drugs not only protect against unwanted pregnancy, but improve the appearance of the skin with juvenile acne, normalize the menstrual cycle, and prevent the development of gynecological diseases.

Appointment for women from 20 to 35 years

At this age, all methods of protection against unwanted pregnancy are usually widely used. The use of combined oral tablets is especially effective with constant sexual contact. The main disadvantage of drugs is the lack of full protection against sexually transmitted diseases. Women of this age group usually prescribe drugs with a minimum dosage of hormones or low-dose agents that ensure the stabilization of the hormonal background. These products do no harm. reproductive health women, normalize the menstrual cycle. The main drugs are Yarina, Regulon, Janine.

Women over 35

Women over 30 should be given adequate contraception against unwanted pregnancies due to high perinatal risks. Usually at this age they do not think about children, many women smoke, build a career. Often there are diseases of the female genital organs, endocrine disorders, varicose veins. Hormones are prescribed here only after a thorough diagnosis and medical consultation.

Preferred agents are Triziston, Silest, Marvelon, Tri-regol, Triquilar. Contraceptives from the mini-pill group with a low content of the hormonal component are suitable for women. After 35 years, it is important to prescribe drugs with a clear healing effect, for example Femulen. Medicine suitable for many female diseases, chronic lesion liver and kidneys of any genesis. Smoking and systemic chronic diseases greatly complicate the selection of oral contraception for women at any age.

Appointment after 45 years

After 40 years, the reproductive function of a woman is significantly reduced, the activity of the ovaries decreases. Many women have menopause and some continue to ovulate. The probability of pregnancy is greatly reduced, but protection is still necessary. The risk of pregnancy may occur, but full bearing is already problematic: existing diseases, aging of the tissues of the pelvic organs affect, possible pathologies fetus. Other important aspect is raising a child - many women after 45 have their own grandchildren. When pregnancy occurs, abortion is resorted to in 90% of cases, which has a particularly negative effect on the health of a woman, up to the development of endometriosis and uterine cancer.

The presence of chronic diseases of organs and systems, sexual dysfunction, bad habits- all this can become a contraindication to the appointment of oral contraceptives. After 45 years, the use of hormonal pills, injectable implants, mini-drinks is considered promising contraception. At this age, oral contraception is contraindicated in obesity, severe forms hepatic or renal insufficiency, diabetes mellitus. Femulen, with a low chance of side effects, may be ideal.

Basic rules for taking birth control pills

traditional birth control pills taken on the first day of the offensive active phase menstrual cycle, only then the tablets begin their active action. With irregular periods, you can start taking the drug from the first day of the cycle with the absolute exclusion of pregnancy. After childbirth, tablets should be taken after 3 weeks (on day 21), provided there is no lactation. If you continue breastfeeding, taking oral contraceptives should be postponed for six months. After an abortion of any complexity, you should start taking contraceptives on the day of the operation.

Dosing regimen

Classic mode suggests duration of the course is 21 days, after which they take a break of 7 days. Further, continuous reception is continued new packaging. The appearance of smearing discharge between menstruation occurs in the interval between taking.

A complex scheme involves special treatment when they drink pills for 24 days, taking a 4-day break (scheme 24 + 4).

The prolonged regimen consists in the continuous use of tablets with active hormones. So, 63 days of monophasic tablets with a 7-day break. With this scheme, the discharge between menstruation is reduced up to 4 times.

Adequate contraception is of interest to girls from the moment of the first menstruation. The correct selection of hormonal pills not only protects against unplanned pregnancy, but also significantly improves the appearance of a woman. At the same time, with the normalization of the hormonal background, the condition of the hair, nails, skin of the face and body improves. Modern drugs have practically no effect on a woman's weight, and in some cases hormonal treatment allows you to even reduce it.

Understand hormonal background on your own is a difficult task, so you need to trust specialists for comfortable contraception without consequences for health and life.