Hormonal contraceptive. Hormonal patches and ring. Varieties of hormonal oral contraceptives

The main essence of contraceptive pills is that they are a means of preventing unwanted pregnancy, which saved humanity from numerous abortions and spoiled destinies.

Despite the fact that modern contraceptive pills have the most positive and numerous reviews, disputes about their use continue both among consumers and among specialists. Such disputes are due to a number of side effects that can occur when taking drugs. Often the question arises as to whether it is possible to get pregnant while taking birth control pills. All the problems that have arisen, most often, are explained simply: the questions of how to take birth control pills and which birth control pills should be taken are incorrectly resolved.

The principle of action of hormonal drugs

In general, several conditions are necessary for conception: the maturation and release of the egg (ovulation), its meeting with the sperm in the fallopian tube, the penetration and fixation of the fertilized egg in the uterine cavity. The whole process is controlled by the pituitary gland of the brain, which regulates the production of sex hormones by the ovaries - estrogen and progesterone. It is these hormones, or rather their balance, that provide the necessary conditions for the process of conception.

Hormonal-type contraceptive pills or oral contraceptives prevent the maturation of the egg, interfere with the penetration of sperm into the fallopian tubes and affect the structure of the endometrium of the uterine cavity, preventing the egg from gaining a foothold on it. Thus, these drugs create the maximum obstacle to conception.

The contraceptive effect is achieved by the presence of estrogen and progesterone in the composition of the tablets. This results in the following impact:

1. Estrogens prevent the maturation of the egg in the follicle, inhibiting pituitary functions, disrupt the structure of the endometrium, increase the peristalsis of the fallopian tubes, inhibit the formation of the corpus luteum, and inhibit the production of their own hormone by the ovaries.
2. Progesterone increases the density of mucus in the cervical canal, inhibiting the movement of spermatozoa, disrupts the release of statins, blocking the production of GnRH, which inhibits the process of ovulation.

How non-hormonal drugs help

The second direction of contraceptives is non-hormonal contraceptive pills. Such funds, although they are available in the form of tablets, are not taken orally. They belong to the group of vaginal agents and are inserted into the vagina. The composition of the preparations introduces an active substance that can suppress the activity of spermatozoa, thereby preventing the fertilization of the egg. In addition, the active component of the tablets increases the density of cervical mucus, blocking the passage of sperm through it.

Thus, the principle of action of non-hormonal drugs is based on a decrease in sperm motility and blocking their movement, without changing the hormonal balance. Benzalkonium chloride and nonoxynol are actively used as active substances. Other ingredients may also be used.

Non-hormonal drugs have less effect on the hormonal female mechanism, which reduces the risk of side effects. Moreover, under their influence, a protective film is formed in the cervical canal, preventing the penetration of fungal and other infections. However, it should be noted the lower contraceptive ability of such drugs compared with hormonal contraceptives (82-86% versus 98-99%). To increase efficiency, women sometimes additionally use vaginal diaphragms, cervical caps.

Why do we need funds after the act

Another way to prevent unwanted pregnancy is birth control pills after intercourse or postcoital pills. Such funds belong to the so-called emergency protection group. They are used after unprotected sex or after a condom breaks. Postcoital tablets contain 2 types of active substance: levonorgestrel or mifepristone. The principle of operation of the first group is based on blocking the ovulation process, increasing the density of cervical mucus and, most importantly, preventing the fixation of the egg on the uterine endometrium. By changing the structure of the endometrium, the active substance provides an abortive effect. When using such a remedy, it should be remembered that the drug is considered hormonal and can significantly affect the hormonal balance.

The second type of drug has pronounced antiprogestogenic properties, which prevents the uterine endometrium from preparing to receive the egg, and also increases the contractility of the uterus, which helps to remove the egg from the cavity.

What hormonal drugs are popular

Hormonal contraceptive pills are available in 2 main types:

• combined preparations that include both main hormones;
• mini-pill containing only progesterone.

The group of mini-pill drugs belong to a monophasic composition. Combined funds can be two-phase and three-phase. Mestranol and Ethinylestadiol are commonly used as estrogen substitutes. Progesterone is administered using the following substances: Norethindrone, Norgestrel, Levonorgestrel, Norgestimate, Desogestrel, Drospirenone. When contraceptive pills are chosen, the following names are preferred: Jess, Yarina, Tri-Merci, Mercilon, Logest, Jeanine, Regulon, Lindinet, Novinet, Marvelon, Charozetta, Diana 35.

Among the combined drugs, you can distribute the tablets according to the required dosage:

• microscopic dosing: provide efficiency, no side effects - these are contraceptive pills Jess, Miniziston, Yarina, Lindinet-20, Novinet, Tri-Merci, Logest, Mercilon;
• low dosage: Lindinet-30, Silest, Marvelon, Microgynon, Femoden, Regulon, Regividon, Jeanine, Belara,
• average dosage: Chloe, Diane-35, Demulen, Triquilar, Triziston, Tri-regon, Milvane;
• drugs that require a high dosage and are used with low efficiency of the previous groups: Ovidon, Non-Ovlon.

Common mini-pills include tablets such as Ecluton, Charozetta, Norkolut, Microlut, Micronor.

Special allocation funds

Numerous reviews of women highlight the following as the best birth control pills:

1. Jess was developed by Bayer Schering Pharma. It contains a small amount of estrogen and a progesterone substitute, drospirenone. In addition to contraceptive abilities, it can help with acne, seborrhea, hirsutism. Designed for women of all ages.
2. Yarina contraceptive pills are widely used. The drug is effective for normalizing the menstrual cycle and eliminating painful symptoms during menstruation. The main effect is aimed at blocking ovulation and changing the structure of the uterine endometrium. Serious side effects are practically not observed.
3. Tablets Novinet inhibits ovulation as a result of blocking the production of luteinizing hormone, increases the viscosity of cervical mucus.
4. Janine is a low-dose drug. It affects all 3 main areas of exclusion of conception. The active substances are ethinylestradiol and dienogest.
5. The drug Regulon contains ethinylestradiol and desogestrel. The main action is the inhibition of the ovulation process. A positive effect is noted for menstrual irregularities, treatment of uterine bleeding.

High-quality hormonal contraceptives provide very high efficiency with regular use, and strictly according to the recommendations of the instructions and the doctor. Can you get pregnant while taking birth control pills? This probability is estimated below 1%, and even it is associated with violations of the rules of admission and its regularity.

The choice of non-hormonal agents

Contraceptives of a non-hormonal type have lower protective properties, but they are recommended in a number of cases when hormonal drugs are contraindicated: neglected fibroids, breastfeeding a child, endocrine pathologies, allergic reactions to hormonal drugs. The main advantage of non-hormonal tablets is the absence of contraindications and side effects.

The following non-hormonal agents are noted in the form of vaginal tablets:

• Pharmatex (action up to 3 hours);
• Gynekotex, Erotex, Benatex (action 3-4 hours);
• Countertex (4 hours);
• Nonoxenol, Patentex, Traceptin.

An important property of these tablets is the simultaneous antifungal and antibacterial protection. They are especially effective against trichomonas, chlamydia, staphylococci, gonococci, proteus and other microorganisms. The disadvantages include a fairly short time of action, which requires an accurate calculation of the time of sexual contact.

An important property of these tablets is the simultaneous antifungal and antibacterial protection. They are especially effective against trichomonas, chlamydia, staphylococci, gonococci, proteus and other microorganisms. The disadvantages include a fairly short time of action, which requires an accurate calculation of the time of sexual contact.

Use of drugs after the act

Emergency protection in the implementation of unplanned sex is carried out by hormonal birth control pills after intercourse. Different types of funds allow you to use them at different times after contact. Such a gap can be, when high-quality contraceptives are used, 72 hours. However, most drugs are designed to be administered within 20-50 hours.

The following contraceptive pills of this type are distinguished:

• funds based on levonorgestrel: Postinor, Escapel, Eskinor F;
• tablets containing estrogen and progesterone: Rigevidon, Non-ovlon, Silest, Ovidon;
• preparations based on mifepristone: Ginepristone, Mifolian, Genale, Agesta.

When using such contraceptive pills, it should be remembered that the maximum period is 72 hours after sexual contact, but the greatest degree of protection is achieved when the drug is administered during the day. In this case, the probability of conception after taking the pills does not exceed 5%. In addition, it should be borne in mind that drugs of this type are considered emergency aid, which is not recommended to get carried away. In view of the high content of hormones in them, the risk of serious complications and the occurrence of hormonal imbalance is quite high.

When not to take drugs

There are a number of contraindications for taking birth control pills. They should not be used in the following cases:

• after a heart attack, stroke, angina pectoris, pulmonary embolism, venous thrombosis; in the presence of malignant tumors;
• with hepatic pathologies of a chronic nature;
• with vaginal bleeding of unknown etiology;
• with diseases of the endocrine nature;
• before the planned surgical intervention for any reason;
• after an abortion or miscarriage;
• when breastfeeding a child.

With great care and only after consulting a doctor, tablets can be used in such conditions.

Hormonal contraceptives around the world are considered the most reliable in terms of protection against unwanted pregnancy. They are trusted by millions of women in civilized countries. They give the freedom to choose the time of birth of the desired child, emancipation in sexual relations, deliverance from certain diseases and suffering. Subject to the rules of use hormonal contraceptives provide, without a doubt, a high level of reliability. In the last decade, interest in this method of protection has also increased in our country, but passions about the benefits and harms, advantages and disadvantages in their use do not subside.

How contraceptive pills work

Combined contraceptives are divided into drugs:

• with microdoses of hormones;
• with low doses;
• medium dosed;
• with high doses of hormones.

How do birth control pills work?

The action of the "mini-drank" is based on the same principles, but the effective moment here is the effect of the tablets on the structure of the uterine mucosa, and on the change in the viscosity of the secretion of the cervical canal. The thickening of the secret and the friability of the endometrium does not allow sperm to fertilize the egg, and the egg itself to gain a foothold in the uterus.

All these phenomena disappear together with the termination of reception of contraceptives. Reproductive function is restored within two to three months, and a woman can have a desired pregnancy.

The action of birth control pills prevents pregnancy by almost 100% if they are used correctly. At the same time, the use of these drugs regulates the menstrual cycle, relieves a woman from pain during menstruation, from menstrual bleeding. Modern contraceptives eliminate the symptoms of premenstrual and menopausal periods, reduce the risk of cancer, stop unwanted facial hair growth, acne.

Does the effect of birth control pills decrease with alcohol?

I would like to be always confident in the effectiveness of contraceptives, and to know what factors can reduce it. It is unlikely that anyone will be able to completely eliminate alcohol. And the instructions for contraceptives often do not indicate that they cannot be combined with alcohol intake.

What to do if a festive feast is planned? If the celebration is scheduled for the evening, then the pill should be moved three hours earlier or later. In extreme cases, you can postpone taking the pill in the morning, as if you forgot to take it, but then you need to follow the instructions for the drug exactly according to it. It is also necessary to see a gynecologist to exclude pregnancy.

According to WHO, the dose of alcohol should not exceed 20 mg of ethanol per day, if there is still a need in combination with birth control pills. Moderation in drinking alcohol plays a big role in maintaining the effectiveness of contraceptives.

Side effects

• Bloody spotting, especially common at the beginning of taking the pills. After adaptation to the drug, as a rule, disappear.
• Estrogens, which are part of contraceptives, can cause bloating, swelling of the lower extremities, fluid retention in the body, increased blood pressure, migraine headaches.
• Progestins - on the contrary, cause irritability, nervousness, acne, some weight gain.
• Weight gain may be associated with increased appetite when taking contraceptives. In some cases, this is due to fluid retention in the body.
• Sometimes birth control pills can cause dark patches on the face that resemble pregnancy patches. In this case, it is better to switch to another type of pill.
• Formidable vascular diseases such as thrombosis can be caused. Their occurrence depends entirely on the dose of hormones in the remedy. The higher the dose of estrogens, the greater the risk of developing vascular thrombosis.
• When taking certain contraceptives, smoking is unacceptable. Women who smoke are at risk of developing heart attacks and strokes.
• Taking combined oral contraceptives can cause cholelithiasis attacks, and cause the formation of new stones in the biliary tract.
• Side effects can occur when oral contraceptives are combined with other drugs: antibiotics, antifungals, etc.

What contraceptive pills get better?

But, in case of the wrong choice of drug for a particular woman or girl, some weight gain is quite possible. Many women experience weight gain in the first two months of taking contraceptives, which is easily explained by the adaptation of the body. If in the future the weight increases, then it is necessary to decide on the transition to another type of tablet.

The effect of contraceptives on fat metabolism is well studied. Therefore, it is possible for each woman to choose a remedy that would not cause the above side effects.

Bleeding while taking birth control pills

Spotting bleeding occurs in the first months of taking contraceptives. More often they are observed when using drugs with a low content of hormones than when combined. The reason is as follows: microdoses of hormones in a tablet do not have time to accumulate in the body, and they are not enough to delay menstruation. This is normal, and it is not advisable to stop taking the pills due to the appearance of spotting. The body will adapt, and all functions will be restored.

In the event of breakthrough bleeding, you need to sound the alarm. It is better to immediately seek advice from a doctor who will conduct an examination to exclude ectopic pregnancy, inflammatory diseases, uterine fibroids, endometriosis.

What to do if bleeding occurs:

• Continue taking contraceptives as usual, or stop taking them within seven days.
• Appeal to the doctor. Your doctor may prescribe additional high progestin pills.
• If bleeding continues, then a blood test should be taken to rule out anemia. Anemia is treated with iron supplements.

Vaginal discharge

By the way, vaginal discharge is found in every woman, but normally they are odorless, transparent in appearance and insignificant.

In case of violation of the menstrual cycle, you need to consult a doctor who will tell you what to do. Establishing a cycle duration of 21-36 days is considered the norm.

With changes in mood, herbal collection with common prune helps well, which affects the level of testosterone in the body.

Skin problems in the form of acne, oily hair, their greasiness? talk about the imbalance of hormones in the female body. In this case, combined oral contraceptives with antiandrogenic action are selected.

Doctors believe that it is better to cancel the pills two to three months before the planned conception. However, it should be borne in mind that the likelihood of conception increases already in the first month after the abolition of the contraceptive.

How to take birth control pills correctly?

In the absence of lactation, it is better to start taking it 21 days after birth. When breastfeeding, taking oral contraceptives should be postponed for six months.

After an abortion, it is necessary to start using birth control pills on the day of its implementation.

Standard regimen of hormonal contraceptives
The drug is taken daily for 21 days, followed by a seven-day break, then continues to be taken from a new package. Menstrual-like bleeding passes during the rest from taking the pills.

Special Modes
The 24 + 4 mode is typical for the contraceptive Jess, the package of which contains 24 hormonal and 4 inactive tablets. Tablets are taken daily, without interruption.

Extended mode
It consists in taking a product containing only "active" tablets (continuously, more than one package). A common is a three-cycle regimen - taking 63 tablets of monophasic drugs followed by a 7-day break.

Thus, the number of menstrual-like bleeding per year is reduced to four.

What should I do if I forgot to take a pill?

If one or two tablets are missed, or a new pack is not started within one to two days
Take a pill. There is a risk of pregnancy.

Missing three or more tablets in the first 2 weeks of taking, or not starting a new pack within three days
Take a pill. Use barrier methods of contraception for 7 days. If intercourse has taken place within 5 days, use emergency contraception.

Missing 3 or more pills during the third week of taking
Take the pill as soon as possible. If the package contains 28 tablets, do not take the last seven tablets. Do not take a break. Use barrier methods of contraception for 7 days. If intercourse has taken place within 5 days, use emergency contraception.

When do birth control pills start working?

How to choose the right drug for nulliparous and giving birth women?

Women who have given birth are suitable for low-dose and medium-dose hormonal preparations. These include: Yarina, Marvelon, Lindinet-30, Regulon, Silest, Jeanine, Minisiston, Diana-35 and Chloe.

Features of contraception depending on the age of the woman

Undoubtedly, the choice of contraceptive drug depends on age characteristics.

At what age can birth control pills be taken?

It is desirable to start contraception in adolescence, unless, of course, there is a need for it. In recent years, there has been a decrease in the age of first pregnancy and childbirth, and the frequency of abortions at a young age is increasing.

The most effective for adolescents, according to WHO, are recognized as combined oral contraceptives containing low doses of steroids, and third-generation drugs containing progestogens. Three-phase drugs are best suited for adolescents: Triziston, Triquilar, Tri-regol, as well as single-phase drugs: Femoden, Mercilon, Silest, Marvelon, which regulate the course of the menstrual cycle.

Birth control pills for young girls

In addition to oral contraceptives, other methods are also popular in our country: the introduction of an intrauterine device, the use of a condom, the use of injectable methods of contraception.

It has been proven that birth control pills are used not only for contraception, but also for therapeutic and prophylactic purposes for diseases such as infertility, inflammatory and oncological diseases, and menstrual irregularities. The only drawback to be aware of is that hormonal contraceptives do not protect women from sexually transmitted infections.

The most common remedies at this age are Janine, Yarina, Regulon.

What contraceptive pills are better to take after 35 years?

A woman may suffer from diseases of the cervix, endometriosis, endocrinological diseases - diabetes, thyrotoxicosis, obesity. Many women smoke. These factors complicate the selection of hormonal contraceptives.

Steroids are prescribed only with a guaranteed absence of contraindications. The latest generation combined contraceptive pills and three-phase drugs are preferred: Femoden, Triziston, Silest, Triquilar, Marvelon, Tri-regol.

For this group of women, products with a low content of hormones, as well as "mini-drink" preparations, are excellent. Hormonal contraception is combined with the therapeutic effect of new generation drugs. The most popular of them is Femulen. It can be used if a woman has diseases such as thrombophlebitis, a previous heart attack and stroke, hypertension, severe headaches such as migraine, and some gynecological diseases.

What birth control pills are suitable for women over 45?

Undoubtedly, a woman is able to become pregnant and give birth to a child, but at the same time, pregnancy often proceeds with complications, since at this age there is a rather large bouquet of various diseases. Usually there are diseases of the cardiovascular system, liver and kidneys, chronic disorders of the reproductive system. All factors can serve as contraindications for the appointment of hormonal contraceptives. Smoking and the presence of other bad habits also complicate the use of birth control pills.

Very often, by the age of 40, women no longer plan pregnancy, and unwanted pregnancies are artificially interrupted. Abortion, especially during this period, has consequences that threaten the woman's health. Frequent complications of abortion are the development of uterine fibroids, cancer, severe manifestations of menopause. The possibility of developing diseases indicates the need for contraception in this period.

Also, birth control pills are prescribed for many gynecological diseases, osteoporosis, to prevent the development of ovarian and uterine cancer.

At the age of over 45, it is promising to use low-dose hormonal drugs, mini-pill tablets, injectables and implants that are implanted under the skin (for example, Norplant).

Combined action contraceptive pills are contraindicated in women over 45 years of age in the following cases:

• if a woman smokes;
• if a woman suffers from diseases of the heart and blood vessels - heart attack, stroke, thrombosis;
• with type 2 diabetes;
• in severe liver diseases with the development of liver failure;
• with obesity.

The effect of birth control pills

For pregnancy

Taking hormonal drugs in the first three weeks of pregnancy does not adversely affect the condition of the fetus and the health of the woman.

Overall for the body

For the development of mastopathy

Experts say that with the right choice of birth control pills and the correct mode of their use, mastopathy cannot develop. Another thing is when a woman has a hormonal imbalance, there are chronic gynecological diseases, diseases of the liver, kidneys, adrenal glands. Hormonal imbalance, stress, depression, abortion, breast trauma can lead to mastopathy.

Contraceptives should be selected only by a doctor. The doctor must take into account all the characteristics of a particular woman, her state of health, age, heredity, phenotype, bad habits, lifestyle, sexual activity. With the wrong selection of the drug, no doubt, the risk of developing mastopathy increases.

It is important to start taking hormonal drugs only after consultation and examination by a specialist - in this case, you will avoid undesirable consequences and possible complications.

Do birth control pills help with menopause and androgenetic alopecia?

Is it possible to leave without a doctor's prescription?

Therefore, it is not surprising that more than 70 million women worldwide use hormonal contraceptives.

The mechanism of action of any hormonal drug is as follows:

• suppress ovulation (maturation and release of the egg);
• contributes to the thickening of mucus in the cervix, making it impassable for sperm.

Choice of hormonal contraceptives

Before you start taking hormonal contraceptives, it is advisable to undergo a gynecological examination and consult with your doctor. It is also necessary to warn the doctor about the use of hormonal contraception when prescribing any other medications.

When choosing a contraceptive, lifestyle also plays an important role. If you don't have sex regularly, or if you have many partners, birth control pills may not be the best option. A method that you can use as needed, or a method that will provide protection against sexually transmitted diseases - AIDS, syphilis, chlomidia, herpes and others (barrier method: condoms), is preferable. If you do choose hormonal contraceptives, you should use condoms to protect against sexually transmitted diseases. But if you are married and do not want to have children for a while, then oral contraceptives are just what you need. But still, the choice is yours.

Types of hormonal contraceptives

1. Combined estrogen-gestagen preparations.
2. Mini-drank.
3. Injectable drugs.
4. subcutaneous implants.
5. Hormone ring for vaginal use.
6. Contraceptive patch.
7. Postcoital drugs.

Combined drugs

Combined drugs- These are birth control pills containing substances similar to female hormones that are produced by the ovaries - estrogens and gestagens (progestins). Depending on the proportion of these substances are:

• monophasic: contain 21 tablets with the same amount of estrogen and progestogen.
• biphasic: contain 21 tablets with two different combinations of estrogen and progestogen.
• triphasic: contain 21 tablets with three different combinations of estrogen and progestogen and differ in color. Their intake completely mimics the secretion of female hormones during a woman's normal menstrual cycle.

Tablets should be taken daily, preferably at the same time for 21 or 28 days (depending on the drug).

Side effects:

• amenorrhea (absence of menstrual-like bleeding at the end of the cycle);
• intermenstrual bleeding and spotting;
• depression (mood changes or loss of sex drive);
• headaches (possible in combination with visual impairment);
• increased blood pressure;
• soreness of the mammary glands;
• weight gain;
• decreased sex drive.

Combined contraceptives are not recommended for women over 35 who smoke, hypertensive patients (high blood pressure), women with cardiovascular disease, liver disease, breast cancer and lactation.

mini pili

mini pili contain only microdoses of progestogens (300 - 500 mcg), which is 15-30% of the progestogen dose in combined estrogen-progestogen preparations.

Changes in the liver when taking a mini-pill are extremely minor. Based on the characteristics of mini-pills, they can be recommended as a method of contraception for women with extragenital diseases (liver diseases, hypertension, thrombophlebitis, obesity).

• women who complain of frequent headaches or increased blood pressure when using combined oral contraceptives;
• during lactation 6-8 weeks after birth;
• with diabetes;
• with varicose veins;
• with liver diseases;
• women over 35 years of age.

Mini-pills are taken continuously, starting from the 1st day of the cycle daily, for 6-12 months. As a rule, at the beginning of the use of the mini-pill, spotting is noted, the frequency of which gradually decreases and completely stops by the 3rd month of use.

Injectable drugs

Hormonal injectable contraceptives is a highly effective long-acting method containing one hormone - progestogen. It is administered intramuscularly with a syringe. One injection provides contraception for 3 months.

The question of the use of hormonal injectable contraceptives must be decided with the doctor.

• if there are malignant diseases of the female genital organs or mammary glands;
• earlier than six weeks after childbirth;
• with liver diseases;
• with diabetes.

In our country, this type of contraception is not widely used.

Subdermal implants

Subdermal implants are silicone capsules containing hormones - gestagens. Six capsules are injected under the skin of the inner surface of the forearm through a small incision under local anesthesia. Capsules secrete a small amount of the hormone every day, and it, gradually absorbed into the blood, creates a reliable contraceptive effect for 5 years.

The implant can be inserted:

in the first 7 days of the menstrual cycle;

immediately after an abortion;

after childbirth after 4 weeks, if the woman is not going to breastfeed;

after 6 weeks for nursing mothers.

The subcutaneous implant may be removed at any time and before the expiration of the five year period.

The advantages of this method include high efficiency (comparable to sterilization, but reversible) and great convenience (the drug does not require any attention, it is only necessary to visit a gynecologist 2 times a year).

In addition, implantable contraception can be used by women with diseases in which taking pills is contraindicated (migraine, varicose veins, heart defects, diabetes mellitus without vascular complications, high blood pressure, severe obesity), as well as smoking women over 35 years old.

This method of contraception, like injection contraception, has not received proper distribution in our country.

Hormone ring for vaginal use

Hormone ring for vaginal use(elastic ring) is a flexible contraceptive ring made of hypoallergenic material that contains microscopic doses of hormones and is applied topically, taking the shape of a woman's body and comfortably placed in the vagina.

One ring is designed for one menstrual cycle: a woman inserts it into the vagina from the 1st to the 5th day of the menstrual cycle. NuvaRing fits comfortably inside and stays in the vagina for three weeks, releasing the microscopic dose of hormones needed to protect against unwanted pregnancies.

There are contraindications, so you can start using the ring only after consulting a doctor.

Due to the fact that the hormonal ring is applied topically, it has a number of advantages. First, the ring contains the bare minimum of hormones - just 15 micrograms of estrogen - less than any other drug. Secondly, there is no unnecessary burden on the liver and gastrointestinal tract. Thus, the effect of NovaRing on the body is minimal.

Contraceptive patch

Contraceptive patch - transdermal contraceptive, the most advanced and one of the most effective methods of hormonal contraception. Refers to microdosed contraceptives, combining efficiency and maximum safety in use. Reliably attached to the skin, does not peel off either during water procedures or under the influence of the sun.

The transdermal patch is very simple and comfortable to use. The patch is glued to dry, clean skin (in the buttocks, abdomen, outer surface of the upper shoulder or upper torso) once a week for 3 weeks (21 days), with a week break. Contraception with the Evra contraceptive patch begins on the first day of menstruation. The patch is applied and removed on the same day of the week. During the 4th week, from the 22nd to the 28th day of the cycle, the patch is not used. A new contraceptive cycle begins the next day after the end of the 4th week; the next patch should be pasted, even if there was no menstruation or it did not end.

It is unacceptable to use a contraceptive patch on the area of ​​​​the mammary glands, as well as on hyperemic, irritated or damaged areas of the skin.

There are contraindications, so you can start using a contraceptive patch only after consulting your doctor.

Postcoital drugs

Postcoital drugs- this is contraception that cannot be used constantly, but only in emergency cases, within 72 hours after sexual intercourse. These are, as a rule, combined hormonal preparations or gestagens. But the main thing for emergency contraception is the high content of hormones to achieve the desired effect.

The era of hormonal contraception begins in the middle of the last century, when the first contraceptive pill was invented by the American scientist Gregory Pincus. Since then, millions of women around the world have been using hormonal contraceptives for family planning and effective protection against unwanted pregnancies.

Of course, during this period, more advanced and convenient forms were invented that allow you to choose hormonal contraception for almost any healthy woman.

What is hormonal contraception?

Regardless of the route of administration, hormonal contraceptives consist of synthetic analogues of one or both of the female sex hormones: estrogen and progesterone. Therefore, hormonal contraceptives (HC) can be combined (containing both hormones) or single-component.

Ethinyl estradiol (EE) is used as the estrogen component in most GCs. In recent years, an estrogenic component has been synthesized, which is similar in structure to the natural hormone of a woman - estradiol valeriate. The first contraceptives contained a huge dose of estrogen (about 150 micrograms / day). However, low- and micro-dose preparations have now been developed that contain much lower daily concentrations of estrogen - 30, 20, and even 15 micrograms.

Progesterone analog (synonyms: progestogen, progestin, gestagen) in modern GCs is represented by a large variety of compounds that can be divided into four groups or generations:

• The first is norethinodrel, ethyndiol acetate, norethinodrone acetate.
• The second is norethisterone, norgestrel, levonorgestrel.
• The third is gestodene, desogestrel, norgestimate.
• The fourth is drospirenone.

It is the progestogen component that determines the whole variety of hormonal contraceptives.

How GCs work:

• Suppress the maturation of the egg (ovulation).
• They thicken the cervical mucus, preventing the passage of spermatozoa.
• Modify the structure of the mucous membrane of the uterus (the probability of attaching a fertilized egg decreases).
• Reduce the speed of movement of sperm in the fallopian tubes.

As a rule, hormonal contraceptives simultaneously have all of the above properties that prevent conception and pregnancy. This determines their high contraceptive effectiveness.

Classification

All hormonal contraceptives can be classified according to several criteria. The most popular is their division along the way of introduction into the body of a woman:

• oral
• Injectable.
• Implants.
• Plasters.
• vaginal rings.
• Intrauterine hormonal system with progestin.

According to the species composition of hormones, all GCs are divided into two categories:

• Combined (contain both an estrogen component and a progestogen).
• One-component - progestagenic.

Each type of hormonal contraception has its own indications and contraindications. The selection of the form and composition of the hormonal contraceptive should be carried out exclusively by a gynecologist!

General contraindications to GC

There are conditions in which hormonal contraceptives are contraindicated in any case. These include:

• Suspected or existing pregnancy.
• Hypersensitivity (allergy) to HA components.
• Bleeding from the genital tract of unknown etiology (until the cause is clarified).
• Cancer of the breast or structures of the genital tract (currently or in history).
• Neoplasm or serious impairment of liver function.
• Increased risk of STI infection (additional use of barrier methods of protection is required).

In addition, combined hormonal contraceptives (due to the negative effect of the estrogen component) are contraindicated in this category of women:

• the entire period of lactation.
• Blood clotting disorders, thrombosis (currently or in history).
• Some somatic diseases in which there is an increased risk of thrombosis: complicated course of diabetes mellitus, severe arterial hypertension, hereditary dyslipoproteinemia and some others.
• Migraine, focal neurological symptoms.
• Estrogen-dependent tumors: suspected or confirmed.
• Women over 35 who smoke. Combined GCs should be used with caution.

There are also certain contraindications to the use of a particular type of hormonal contraception, which will be discussed in the relevant sections of this article.

Oral contraceptives

This is the most famous type of hormonal contraception, which has received the greatest distribution. They are used in the form of tablets, which must be consumed in strict sequence.

Oral contraceptives are combined (COC) or progestin-only (PPOC, "mini-drank").

Combined

Traditionally, according to the combination of the estrogen / progesterone component, COCs are divided into three groups:

• Monophasic - the dose of hormones is the same in all active tablets (most modern COCs: Logest, Marvelon, Jess, Janine, Yarina and many others).
• Biphasic - active tablets contain two different combinations of estrogen and progesterone (Anteovin).
• Multiphasic - the content of estrogen and progesterone in active tablets can have three or more combinations (Tri-Regol, Triquilar, Tri-Merci, Qlaira, etc.).

There is also a different mode of taking such contraceptives. The most popular is the 21+7 mode. In this case, the blister contains 21 active tablets, after which a break is taken strictly for 7 days. For ease of use of such COCs, often seven inactive tablets (“dummy” or iron-containing) are added to the blister. In this case (28 tablets in a blister), there is no need to take a break.

There are other schemes for taking pills: 24 + 4, 26 + 2, etc.

Admission rules

The most important requirement is the daily intake of tablets. It is necessary to take one COC tablet every day, preferably at the same time of day. It is also necessary to obtain precise instructions from the doctor regarding the regimen of taking the tablets and strictly adhere to it.

Start of application:

• It is recommended to take the first tablet within five days from the start of the next menstruation. Most doctors recommend starting COCs on the first day of your period.
• After childbirth: in the absence of lactation, it is possible to start taking COCs as early as three weeks after the birth of the child. When breastfeeding, taking COCs is contraindicated.
• After an abortion: it is advisable to start taking COCs on the day of the procedure or within a week after it.

If for some reason the next pill was not taken, then it is urgent to consult a doctor.

COC advantages:

• When used correctly, it is one of the most reliable contraceptive methods.
• Convenience and ease of the method.
• A woman can stop taking COCs on her own.
• Menstruation usually becomes less abundant and shorter, which contributes to the normalization of hemoglobin levels (with its decrease).
• Reduced menstrual pain.
• Reducing the risk of benign tumors and cancer of the ovaries and endometrium.
• Some types of gestagens in COCs have an antiandrogenic effect and can be used with an additional therapeutic effect (in addition to contraception).

Disadvantages and contraindications to COCs:

• The need for strict daily pills.
• Unpleasant side effects are possible in the first few cycles of administration: nausea, dizziness, headache, spotting, etc.
• Decreased effectiveness with simultaneous use with certain medications (anticonvulsants, anti-tuberculosis, antibacterial and other drugs).
• Temporary changes in the psycho-emotional background, decreased libido, etc. are possible.
• Some change in body weight, etc.

You should immediately consult a doctor if there is no menstrual flow during the 7-day break (to exclude pregnancy).

Pure progestin

These pills contain only one type of hormone - progestin. Currently, on the pharmaceutical market, you can find PPOC preparations with the following composition (in one tablet):

• 0.5 mg linestrenol (Exluton).
• 75 micrograms of desogestrel (Lactinet, Charozetta, Desirette, etc.).

The blister usually contains 28 tablets, which must be taken every day at exactly the same time of day. When using such drugs, there is no need to take breaks: at the end of one blister, the tablets begin from the next.

This type of oral GC has much fewer contraindications and can be used by women who are contraindicated in COCs, for example:

• When smoking.
• With lactation.
• With some somatic diseases (diabetes mellitus, hypertension, etc.).

However, these contraceptives also have disadvantages, which include:

• The need to take pills strictly at the same time.
• Changes in the nature of the menstrual cycle (irregularity, spotting).
• They do not have preventive and therapeutic properties of COCs.
• Decreased contraceptive effect when used simultaneously with certain other medications.

It is necessary to start taking POCs in the same way as COCs: within five days from the beginning of menstruation (preferably on the first day). After childbirth, if a woman wishes, you can start taking such a drug already one and a half months after the birth of a child and in the presence of lactation. If a woman is not breastfeeding, then taking PPOC can be started in the very first days after childbirth.

The contraceptive effect when taking PPOC occurs already during the first day from the start of taking the drug.

Injectable contraceptives

Means the introduction of the drug by injection (usually - intramuscular). These drugs have a prolonged action and to maintain the contraceptive effect, it is enough to administer the drug once every few months.

Injectable contraceptives can also be combined (CIC) or progestogen (PIC).

Combined

Currently, CECs are represented by two drugs: Cyclofem and Mesigyna, which have not yet found wide distribution in the CIS countries.

These drugs must be administered intramuscularly once every 28 days. Their main advantages and disadvantages are practically the same as those of COCs. In addition, there is a more frequent violation of the menstrual cycle (irregularity, spotting) at the beginning of the intake.

The first injection should be performed within seven days from the start of the next menstruation. The recommended interval between subsequent injections is 28 days (with a tolerance of 1-7 days).

Progestogenic

Among injectable contraceptives containing a monocomponent (progestin), the following drugs are best known:

• Depo-Provera (150 mg depo-medroxyprogesterone acetate).
• Noristerate (200 mg norethindrone enanthate or NET-EN).

Depo-Provera (150 mg) is the most popular among PICs. It is administered intramuscularly once every three months (deviation in terms of injection is allowed up to 2-4 weeks earlier or later than the appointed time).

Noristerate is administered every two months (with a tolerance of 1–2 weeks).

These drugs have most of the advantages and disadvantages of POCs. Undoubtedly, long-term and reversible contraception with high efficiency is a big plus. They can be used by women of almost any age, as well as nursing mothers. Most somatic diseases, in which the use of estrogens is contraindicated, are also not an obstacle to the use of PIC.

• Frequent occurrence of menstrual irregularities (from amenorrhea to bleeding).
• Weight gain (usually temporary).
• Relatively long recovery of the ability to conceive (from 6-12 months or more).
• Increased glucose tolerance (this should be taken into account in women with diabetes).

The first injection of the drug is performed for seven days from the beginning of the next menstruation. After childbirth, it is permissible to use PIK already after three weeks in the absence of lactation or after a month and a half if it is present.

Subsequent injections are performed two (Noristerat) or three months later (Depo-Provera).

Implants

They are one or more progestin capsules that are implanted (“implanted”) under the skin of the forearm. The operation is performed by a doctor under local anesthesia.

This is a prolonged method of contraception (from three to five years).

Currently, the most commonly used types of implants are:

• Norplant - consists of six thin flexible capsules filled with levonorgestrel. The validity period of the implant is 5 years.
• Norplant-2. Represents two capsules with levonorgestrel, which prevent the onset of pregnancy for three years.
• Implanon. Presented as a single capsule filled with etonogestrel (a metabolite of desogestrel), the validity of which is 3 years.

Implants do not contain an estrogen component, which allows them to be used by those women who are contraindicated in estrogen-containing hormonal contraceptives.

The advantage of this contraceptive method is that there is no need to take pills, regular injections, etc. But for the procedure for inserting and removing the implant, the participation of a specially trained medical specialist is required, which is, in general, the main problem.

Among the disadvantages of this method of hormonal contraception, the following should be especially noted:

• Risk of suppuration and bleeding at the implant site.
• Irregularity of the menstrual cycle, spotting during the first 6-12 months of using the method.
• Some women sometimes experience weight gain, discomfort and tension in the mammary glands, unexpressed headaches, and some other unpleasant symptoms that usually disappear with time.

The remaining disadvantages and advantages are the same as for other progestogen-based GCs.

The introduction of the implant is usually carried out in the first seven days from the start of the next menstruation or the abortion procedure. After childbirth, the implant can be inserted already after 3 weeks, and in the case of lactation - after a month and a half.

When the implant expires, it must be removed and, if desired, a new one inserted.

New combination GCs

A kind of analogue of monophasic combined oral contraceptives are the latest developments - the Evra hormonal patch and the NovaRing vaginal ring. The mechanism of action of these contraceptives does not differ significantly from COCs. The only difference is in the route of administration of hormones - transdermal (transdermal) or through the vaginal bloodstream. This somewhat reduces the risk of those side effects that are associated with the metabolism of hormones in the liver. In addition, there is no need for daily pills.

Hormonal patch

The method is based on the gradual release of estrogen and progesterone from a special patch pasted on the skin of a woman (transdermal route of administration).

Hormonal contraceptive Evra (Evra) is a 20 sq. cm, which is attached by a woman on her own to dry, intact skin. The patch releases approximately 150 micrograms of norelgestromin and 20 micrograms of ethinyl estradiol each day. One package contains three transdermal patches designed for one cycle. The package may contain one or three such packages.

The patch is glued on the first day of menstruation with regular replacement every seven days of use. Then they take it off and take a seven-day break. Therefore, a full contraceptive cycle is 28 days. A new cycle with gluing the patch begins the day after the end of such a break.

• Buttocks.
• Stomach.
• The outer surface of the shoulder.
• Upper body.

Do not stick the patch on the skin of the mammary glands, on the mucous membranes.

It is necessary to regularly and carefully inspect the place of attachment of the patch to ensure that it is tightly attached.

If it is partially or completely peeled off, it should be glued again or replaced with a new one. If the adhesive properties of the contraceptive are lost, there is no need to additionally use adhesive tapes and other fixing devices. In such cases, a new patch is applied. If in doubt, you should seek the advice of your doctor.

What you need to know:

• With excessive body weight (90 kg or more), this contraceptive method should not be used due to its reduced effectiveness in such women.
• More than one patch must not be used at the same time.
• If the skin is irritated, you can re-glue the patch to another area.
• Sometimes during the adaptation period, side effects may occur: nausea, vomiting, menstrual irregularities (even before bleeding). If these symptoms are pronounced, you should consult a doctor.

vaginal ring

NuvaRing is a flexible and elastic ring made of hypoallergenic material. During the day, it secretes approximately 15 micrograms of ethinyl estradiol and 120 micrograms of etonogestrel, the secretion of which is activated by body temperature. Then they enter the bloodstream through the vaginal mucosa, which minimizes their systemic effect. One vaginal ring is designed to be used for one cycle.

The contraceptive is inserted by a woman on her own deep into the vagina on the first day of menstruation. A correctly inserted ring does not cause discomfort. After three weeks of use, the ring is removed and, after a seven-day break, a new one is inserted.

If, during stress, defecation, sexual intercourse and other conditions, the ring falls out, it must be washed in running warm water and reintroduced.

The use of the method may be limited to women with existing vaginal prolapse.

The remaining benefits and contraindications for the use of the hormone patch and vaginal ring are the same as for all combination HAs.

intrauterine system

It is a type of intrauterine contraceptive ("spiral") containing a progestin - levonorgestrel (LNG). Currently used under the following trade names:

• Mirena (abroad - Levonova). Contains 52 mg of LNG. Set for five years.
• Jaydes. Contains 13.5 mg of LNG. The recommended period of use is three years.

Each intrauterine system releases approximately 20 micrograms of progestin daily. The longer the period of use of the system, the lower the daily volume of levonorgestrel excretion.

In addition to the contraceptive effect, intrauterine hormonal systems have a pronounced therapeutic effect and can be used in such conditions:

• Some types of uterine leiomyoma.
• Non-atypical endometrial hyperplasia in women of childbearing age.
• Adenomyosis.
• Idiopathic uterine bleeding.
• Hyperpolymenorrhea, algomenorrhea, etc.

You should be aware that when using this method, there is often a significant decrease in the amount of blood released during menstruation, up to its complete absence.

The intrauterine hormonal system is administered by a doctor during the next menstruation or on any day of the cycle if there is no pregnancy. After childbirth, it is possible to use this method after four weeks.

The main contraindications to the use of this method are (in addition to the general ones):

• Infectious and inflammatory pathology of the genital tract (including recurrent).
• cervical dysplasia.
• Anomalies in the structure of the uterus (including fibroids that deform the uterine cavity).
• Increased risk of infection of the genitals (for example, frequent change of sexual partners).

Before the introduction of the intrauterine hormonal system, some preparation and examination of the woman is necessary, the volume of which is determined by the doctor.

In conclusion, it should be noted: there is no need to be afraid of “hormones”. Properly selected hormonal contraceptives by a doctor have a high contraceptive effect and a minimum of side effects.

The latest birth control pills: freedom of choice. Hormonal and non-hormonal, used after the act. Which of them is better to use?

Thanks

The main priorities of modern medicine are caring for the preservation of a woman's reproductive health, protection and ensuring safe motherhood. It is no secret that Russia is in one of the first places in terms of the number of abortions. Abortion is a real operation that often results in infertility, menstrual irregularities, miscarriages, and even maternal death. The following conclusion can be drawn - measures to prevent abortions can help maintain a woman's health and give birth to a healthy child.

No wonder they say that children are the flowers of life. But each flower opens only at a certain time by nature. A woman has the right to give birth to a child whenever she wants, at any time in her life, so that the child is desired and happy. This fact is confirmed by law.

For the prevention of unwanted pregnancy and the prevention of abortions at a certain stage in a woman's life, an important role is played by contraception.

Contraception has been used by women since ancient times. So, even in ancient Africa, intravaginal herbal remedies were used in the form of a cocoon, and in America they used douching with decoctions of herbs, lemon juice, decoction of mahogany bark after sexual intercourse.

The number of contraceptives increased over time, but effective methods and reliable drugs appeared only in the 20th century.

New contraceptives appear almost every day. Science does not stand still. They are easy to use, reliable, safe for health, moreover, they have a therapeutic effect in certain diseases.

Currently, medicine offers various contraceptives, and a woman can always choose which methods and drugs to use. In our country, freedom of choice of contraceptives is ensured, but a woman cannot always decide on her own what is best for her. In deciding on the choice of a contraceptive, consultation with the attending physician will help - only a qualified specialist can assess the state of a woman's health, determine the indications for prescribing a particular method of contraception, and offer the best drug for the patient.

Hormonal oral contraceptives

The effectiveness of contraceptives is estimated by specialists by counting the number of unplanned pregnancies per 100 women during the year. This index is called the Pearl Index.

Types and composition of birth control pills

• New contraceptive pills began to contain small doses of hormones, while at the same time their effectiveness and reliability were maintained.
• New analogues of female sex hormones were obtained: ethanyl estradiol and levonorgestrel.
• Third-generation progestogens appeared - norgestimate, desogestrel, gestodene.
• The latest contraceptives have been developed - mini-pills that do not contain progestogen.

Combined contraceptives contain two components in their composition:
1. Synthetic estrogen ethinyl estradiol, which is the estrogenic component of the drugs.
2. Progestogen component in the form of various progestogens.

All contraceptive pills, depending on the dosage of hormones, are divided into the following types:

• monophasic;
• two-phase;
• three-phase.

Biphasic drugs involve changing doses of hormones twice per course, triphasic drugs - three times. Usually such tablets for one course have a different color. Biphasic contraceptives include Anteovin, three-phase contraceptives include Tri-merci, Triquilar, Tri-regol, Triziston.

Contraceptives "mini-drank" are monophasic, and are intended for the period of breastfeeding and lactation. These include: Lactinet, Exluton, Charozetta.

The action of combined oral contraceptives (COCs) is based on blocking ovulation. This way they protect against unplanned pregnancy. Only progestogen has the ability to block the ovulation process, the dose of which is the same in all combined birth control pills. The difference between micro-dose and low-dose drugs is only in the dosage of estrogen. Estrogens affect a woman's menstrual cycle.

Depending on the dosage of the active ingredients, contraceptive pills are divided into four types:

Microdosed birth control pills
As a rule, these drugs contain minimal doses of the hormone ethinyl estradiol. Side effects when using them are minimal. In some cases, they have the ability to eliminate hormonal disorders: acne (especially in adolescence), painful menstruation. These pills are best suited for young girls under 25 who have not given birth and are sexually active on a regular basis. They can also be used by mature women over 35 and women who have never used hormonal contraception. The most popular are: Tri-Merci, Jess, Mercilon, Lindinet -20, Klaira, Novinet.

Low dose birth control pills
The preparations contain the same ethinylestradiol, but in combination with various hormones: desogestrel, gestodene, norgestimate, dienogest or levonorgestrel. These birth control pills are recommended for young women who have given birth. In addition to the contraceptive effect, these funds have a pronounced antiandrogenic effect: they help eliminate unwanted facial hair growth, prevent the appearance of acne and hair loss due to hormonal imbalance. Popular tablets: Regulon, Belara, Marvelon, Yarina, Janine, Midiana, Femoden.

Medium dose birth control pills
As a rule, they contain two hormones: ethinylestradiol and levonorgestrel. Less commonly, they may contain other combinations of hormones. Medium-dose birth control pills are intended for women who have given birth, especially over 30 years of age. They also have an antiandrogenic effect, which is important for women who have not recovered from pregnancy and childbirth. However, when choosing a drug, one condition must be observed - these drugs are not suitable for nursing. Popular tablets: Diana 35, Demulen, Tri-regol, Chloe.

High dose birth control pills
They contain ethinylestradiol and levonorgestrel, but only in higher doses. Such funds are primarily used to treat and prevent hormonal diseases. Contraceptives of this type can be taken by women over 35 years of age, with the ineffectiveness of drugs with a low dosage of hormones. These include: Triquilar, Tri-regol, Ovidon, Milvane, Non-Ovlon.

The latest birth control pills: how to choose?

The choice of contraceptive is difficult, it should be approached seriously.

Ideally, a specialist should deal with the selection of contraceptives, but sometimes a woman herself decides which pills to take. In these cases, it is necessary to scrupulously collect information about the remedy. Where to start?
1. Familiarize yourself with the different types of contraceptives.
2. Compare all the pros and cons.
3. Define your goal - decide what you want to get as a result of using oral contraceptives.

What do you need to know to make the right choice? Let's figure it out.

A woman should find information about drugs and their effects on the body. It should be borne in mind that birth control pills differ in parameters, degree of reliability and side effects.

Combined contraceptives usually contain two analogues of female sex hormones, so they are in the first place in terms of reliability. Combined oral agents are used both for protection against pregnancy and for the treatment of diseases and hormonal disorders. Women who opt for hormonal birth control pills are still advised to consult with their doctor and undergo a hormonal study.

New contraceptives are the so-called "mini-pill". They contain only one hormone - in this regard, the reliability of drugs is 90%. Their advantage is the possibility of use during lactation, as well as by women who have estrogen intolerance (which are part of COCs).

The next type of contraceptive pill is represented by means for emergency contraception. These tablets are not intended for long-term use, but are used immediately after sexual intercourse. The content of hormones in them is very high, so these funds can be used only once a month.

Currently, contraceptives of the second - fifth generations have appeared on the market. These newer drugs contain a small dose of hormones, have mild side effects. It should be understood that there are no good or bad contraceptives. There are remedies that are suitable or not suitable for a woman. Therefore, for the selection of contraceptives, the individual characteristics of the body of a particular woman should be taken into account.

With self-selection, it is necessary, first of all, to determine the phenotype - the body type of a woman.

There are the following types of female phenotype:
1. With a predominance of estrogen - estrogenic type.
2. With a balance of estrogens and progestogens - a balanced type.
3. With a predominance of gestagens and androgens - progestogen type.

The phenotype is determined by the following features: general appearance, volume and condition of the mammary glands, skin type, the nature of menstruation, the duration of the menstrual cycle, the presence of toxicosis during a previous pregnancy, the woman's body weight and a tendency to be overweight.

A balanced phenotype is characterized by average values ​​of these traits. In this case, it is recommended to take Marvelon, Triquilar, Microgynon, Triziston, Mercilon, Tri-merci, Regulon.

With the predominance of the estrogen phenotype, a very feminine appearance is characteristic, a very long menstrual cycle, very abundant menstruation and vaginal discharge, and moderate fullness. It is advisable to take drugs such as Anteovin, Minulet, Norinil, Rigevidon, Minisiston.

With the predominance of the gestagenic phenotype, all signs are less pronounced: unfeminine appearance, small volume of the mammary glands, scanty menstruation, a short duration of the menstrual cycle, oily skin. The following remedies are effective Bisecurin, Chloe, Non-ovlon, Yarina, Ovidon, Jess, Jeanine, Claira, Diana, Midian, Belara.

No matter how carefully the choice is made, it still happens that the drug is not suitable. The ideal selection method has not yet been invented. Often you have to act by "trial and error", but sometimes this is inevitable, because the body of each woman is unique.

It has been proven that the criterion for a successful choice of a contraceptive is the absence of menstruation for three months - i.e. period of adaptation. Then this drug can be taken for a long time.

Non-hormonal contraceptive pills

The fact is that the use of non-hormonal birth control pills is not contraindicated for women immediately after childbirth, nursing mothers, as well as women who cannot take hormones. And another important detail: non-hormonal means to prevent pregnancy not only have the ability to destroy spermatozoa, but also contribute to the formation of a protective film on the vaginal mucosa, and thickening of mucus in the cervical canal. Moreover, active substances - spermicides - reduce the speed of spermatozoa, and the resulting mucus is a barrier to their penetration into the uterus. This is a good protection against unwanted pregnancy. Non-hormonal contraceptive pills, which is important in our time, protect a woman from sexually transmitted infections, as they have both antiseptic and antimicrobial effects.

It follows from this that non-hormonal contraceptives can be used by many women at different periods of life. The use of tablets refers to the barrier chemical method of contraception. They are easy to use, do not disrupt the hormonal background, can be used at any reproductive age of a woman, and are the prevention of sexually transmitted diseases.

Contraceptive pills Pharmatex

In addition to the contraceptive effect, Pharmatex birth control pills prevent the transmission of sexual infections, reduce the risk of their consequences: infertility, miscarriage, cervical disease, tumors caused by HIV infection.

A huge advantage of using Pharmatex is that it in no way affects either the hormonal background or the vaginal microflora.

Pharmatex, like other non-hormonal tablets, affects such types of microorganisms as Trichomonas, gonococci, chlamydia, Candida fungi, herpes virus. Pharmatex acts locally, which does not give side effects on the organs and systems of the whole organism.

The use of vaginal tablets is more suitable for women in the postpartum period, during lactation and breastfeeding, after an abortion, with irregular sexual activity, when there is no permanent partner.

Mode of application
The manufacturer of funds, as a rule, attaches instructions for use. Basically, non-hormonal vaginal tablets are inserted into the vagina to a sufficient depth 10 minutes before sexual intercourse. For more convenient administration of tablets and other dosage forms, a special applicator is included in the package of the drug.

It is necessary to know that before each subsequent sexual intercourse, and in the case of sexual intercourse that occurred later than two hours after the administration of the pill, it is necessary to introduce a new tablet. Of course, this is inconvenient to a certain extent, since a woman cannot afford to re-administer the pill after casual or unexpected sex. She needs to plan the time of intercourse, which is unnatural.

It is believed that the effect of the drug lasts from 40 minutes to several hours. But it must be remembered that the use of vaginal tablets is not combined with water procedures before and after sexual contact using intimate hygiene products.

In some women, the drug may cause a burning sensation in the vagina. In this case, you should consult with your doctor about continuing or canceling Pharmatex. The reliability of Pharmatex is 80-82%.

Contraceptive suppositories and creams

In addition to tablets, manufacturers suggest using other dosage forms: suppositories, creams, ointments. The active substance in the suppositories is either nonoxynol or benzalkonium chloride.

Pharmatex is also available in various forms: in the form of vaginal suppositories, tampons, creams, capsules.

Benefits of using contraceptive suppositories
Contraceptive suppositories are easy to use, easy to insert into the vagina, and have minor side effects. Another advantage in the use of non-hormonal vaginal suppositories is the effect of additional lubrication. They are especially suitable for partners who have problems with natural lubrication and dryness in the genitals.

Vaginal suppositories protect a woman from sexually transmitted infections, are indispensable for casual sexual intercourse, with infrequent sexual intercourse, in the absence of a permanent partner.
Disadvantages in the use of contraceptive suppositories
Vaginal contraceptive suppositories can affect the microflora of the vagina, since in their composition, in addition to the active substance, they have acids. Burning and itching, allergic rashes that occur when using candles, are an indication for their cancellation.

Dosing
Candles are vaginal. The candle is inserted into the vagina 10 minutes before sexual intercourse. The drug works for 4 hours.

Tampon vaginal. The tampon is taken out of the package, with the help of a finger, it is inserted into the vagina, up to the cervix. The protection effect is immediate and lasts 24 hours. The tampon does not need to be changed during this period, which is very convenient. The tampon does not change even if there are several sexual intercourses that follow each other during the day. The tampon is removed no earlier than 2 hours after the last sexual intercourse, but no later than 24 hours after its first insertion into the vagina.

Cream vaginal. It is inserted into the vagina with a special syringe. The device should be filled to the mark without the formation of air bubbles. Then slowly insert into the vagina before intercourse. The introduction is made lying down. The action of the remedy begins immediately, and lasts about 10 hours. Before repeated sexual contact, it is necessary to introduce a portion of the cream again.

Popular drugs: Pharmatex, Nonoxynol, Patentex Oval, Contraceptin T.

Birth control pills after intercourse

Sometimes this method is simply called: emergency, fire, emergency contraception, contraception the next morning after. But still, it is correct to call it emergency, since this method is used in emergency situations.

Emergency contraception aims to prevent pregnancy at the following stages: ovulation, fertilization and fixation of a fertilized egg in the endometrium (the inner layer of the uterine lining).

• in emergencies associated with violent actions by a partner, as well as in violation of the integrity of the condom or skipping the birth control pill for a woman;
• with rare sexual contact;
• during unprotected sex, when no methods of contraception were used.

• thrombosis and thromboembolism (even in history);
• liver disease with a high degree of insufficiency;
• kidney disease;
• oncological diseases.

Estrogens for emergency contraception have not been used as often recently, because they contain high doses of hormones, which leads to side effects - nausea and vomiting.

Combined birth control pills are used within 72 hours after sexual intercourse, twice, with a break of 12 hours. You can use any drug from this group.

The most well-known drug for emergency contraception in Russia is Postinor. It is recommended to take it twice, one tablet at a time. The first tablet is taken no later than 72 hours after sexual intercourse, the second - 12 hours after the first.

The second drug for emergency contraception - Escapelle - is taken once within 96 hours after sexual intercourse.

Combined oral contraceptives are taken daily for 21 days. Then a break of 7 days is taken, and the next package of the drug begins. The course begins with an active tablet.

"Mini-drank" are taken without interruption. Immediately after the end of the package, the reception of the next one begins.

Reception break

Menstruation while taking

If the intake of contraceptives was regular, without gaps and breaks, but the menstruation stopped, then it is necessary to continue taking them.

But if the reception was irregular, it is worth suspecting the onset of pregnancy, urgently stop using the contraceptive and contact a gynecologist to identify it.

Menstruation after cancellation

Bleeding on admission

If you experience heavy bleeding, you should consult your doctor.

Can you get pregnant while taking birth control pills?

Another situation is that a woman vomits when taking it. Then you need to take the next pill, because the first one has not been absorbed. With repeated vomiting, it is better to switch to another type of drug. The same actions should be taken with loose stools.

The reliability of contraceptive contraceptives may decrease when taking other drugs - for example, antibiotics, St. John's wort, etc. In this case, the use of an additional method of contraception is recommended.

How long can the tablets be taken?

According to scientists, fifth-generation contraceptives have already appeared in Russia, which have minor side effects. But the number of questions is not decreasing.

Is it possible to take birth control pills constantly, for more than a year?

Pregnancy after stopping birth control pills

Can you stop taking birth control pills?

Which is better: birth control pills or a spiral?

The best birth control pills

Jess

This tool belongs to the fourth generation of contraceptives.

It is recommended to use the drug for a long time. The package contains 28 tablets. Take the tablets daily, preferably at the same time. They begin to take Jess on the first day of menstrual bleeding, then drink continuously.

Jess is a novelty in medicine. The popularity of the drug is growing. Jess provides reliable protection, controls the menstrual cycle, is used to treat symptoms of premenstrual syndrome, acne, and has a beneficial effect on hair and nails. At the same time, the weight of women using Jess remains stable. The period of adaptation to the contraceptive is 1-2 months.

No wonder the drug Jess is called the contraceptive of the twenty-first century.

Novinet

The drug has minimal side effects, does not cause pain during menstruation, does not affect the weight gain of a woman.

When taking Novinet, nausea, rarely vomiting, partial hair loss, headaches may occur.

Novinet take 1 tablet daily for 21 days. Break - 7 days, on the eighth day they start a new package.

Breastfeeding women can start taking the drug three weeks after giving birth. It should be remembered that Novinet dramatically increases the amount of breast milk.

Reviews about Novinet are mostly positive.

Janine

The active substances are dienogest and ethinylestradiol.

Janine take 1 tablet daily for three weeks. Then they take a break for a week, after which the course is repeated.

Reviews of Janine prove a really pronounced contraceptive effect.

Regulon

Regulon helps with menstrual disorders, uterine bleeding.

Reviews about Regulon
Women who took this drug note the quality of the drug and its reliability. Regulon acts much softer than other drugs. It was often recommended by doctors for use by teenagers and young girls. With prolonged use, it does not cause side effects, reliably protects against unwanted pregnancy and does not contribute to weight gain.

Women who used it for medicinal purposes speak positively about Regulon. The drug helps with uterine bleeding, abundant vaginal discharge, improves the quality and appearance of hair, nails and skin.

Yarina

The drug is well tolerated and has few side effects. During the reception, the woman's weight remains unchanged, there is no nausea and vomiting, a therapeutic effect is expressed - a decrease in premenstrual symptoms, symptoms of seborrhea, acne.

Women taking Yarina noted the high reliability of the drug, as well as an improvement in mood, restoration of libido, and normalization of the menstrual cycle.

The minimum cost of a monthly drug intake in Russia ranges from 600 rubles.

Logest

The action of the drug is based on the inhibition of ovulation, an increase in the viscosity of the secret, which makes it difficult for the movement of sperm and prevents the implantation of the egg in the uterus.

The tablets are taken on the first day of the menstrual cycle. Take 1 tablet daily for 21 days. Then they take a week break, after which the course is repeated.

With the abolition of the drug, the body's ability to conceive is fully restored.

The price of the drug ranges from 330 to 450 rubles per pack.

claira

Qlaira refers to natural oral contraceptives. For the first time, ethinylestradiol as an active substance was not included in the combined hormonal preparation for contraception. It has been successfully replaced by the milder and safer hormone estradiolavalerate, which is a hormone with a natural formula. This hormone is well studied, and is used mainly to treat the symptoms of menopause.

To enhance contraceptive functions, scientists added the active substance dienogest to estradiol valeriate, which also solved the problem of intermenstrual bleeding.

The procedure for taking the drug has also been changed. It has a unique dynamic dosing mode. Qlaira is a four-phase hormonal drug. The package contains two placebo tablets, that is, they do not contain the active ingredient, and 26 active tablets with different doses of the active substance. The doses of estrogen when taken are gradually reduced, and the doses of progestogen are increased. This dosing regimen increases the effectiveness of the drug several times.

At the present stage of development of contraception, Qlaira is revolutionary, providing a high degree of protection and treatment of women's diseases.

Despite a very large selection of birth control pills, the abortion rate remains high in our country. Women do not have sufficient information about drugs, they experience a panic fear of using hormonal drugs, not allowing the idea that safe and reliable contraceptives have appeared at the present stage. New generation contraceptive pills containing lower doses of active substances can help women plan pregnancy without being at risk of complications and abortions.