Contraceptive pills - pros and cons. What are the disadvantages of this method of contraception worth knowing? Estrogens for oral use

Hormonal contraceptives from their very appearance on the pharmaceutical market in the early 60s of the twentieth century and to this day are positioned by manufacturers, doctors and sellers as absolutely safe for women's health and having minimal side effects.

This is not surprising. Indeed, according to the most conservative estimates, today more than 100 million women in the developed countries of the West are regularly protected from pregnancy in this way. This is a huge market and huge money.

Indeed, third-generation contraceptives (pills, implants and intrauterine devices) that we are dealing with now are fundamentally different from those contraceptives that were in use in the 60s and 70s.

This difference consists in a much lower concentration of synthetic hormones, which, however, is sufficient to suppress the processes of fertilization. Therefore, there is reason to hope for a weaker manifestation of side effects.

After all, our grandmothers and mothers knowingly experienced some prejudice to the contraceptive pills of that time. And the rumors about their side effects (“you will get fat”; “hair will actively begin to grow “in the wrong place”; “interest in intimate life will disappear”, etc.) were not at all groundless.

What are the positive aspects of the use of new generation hormonal contraceptives can be identified at the moment?

Advantages of hormonal contraceptives.

Close to absolute reliability of the contraceptive effect. Modern hormonal contraceptives act in a complex way. Firstly, they completely suppress the reproductive function of the ovaries, preventing the development and release of the egg. Secondly, they inhibit the secretion of gonadotropic hormones by the pituitary gland and inhibit the process of folliculosis.

Thirdly, they change the composition of the endometrium. Even if the egg is released and fertilized, it cannot be fixed inside the uterus. Fourthly, cervical mucus thickens from hormonal contraceptives, creating impassable conditions for spermatozoa. Due to such a complex effect on the body, the contraceptive effect of hormonal contraceptives is estimated at 99.9% - higher than that of condoms.

Normalization of the menstrual cycle. While taking hormonal contraceptives, menstruation becomes regular, shorter and almost painless. Therefore, birth control pills have also become therapeutic for women suffering from painful and prolonged periods, accompanied by heavy bleeding. These drugs made it possible for women to forget about painful periods both during hormone therapy and for many months after it.

Beneficial effect on the psyche of women. While taking hormonal contraceptives, the severity of the notorious PMS noticeably decreases, the overall emotional background improves, the woman becomes calmer, less prone to bouts of anger or depression.

Therapeutic effect in relation to some gynecological diseases. Contraceptive pills and spirals help to seriously and permanently get rid of such female diseases as endometriosis and endometrial hyperplasia, reduce the risk of occurrence and development of any inflammatory processes of the internal genital organs.

Finally, hormonal contraceptives are simply very convenient to use: as they say, eat and order! But you have to pay for everything, including convenience and comfort.

Cons of hormonal contraceptives.

Long-term use of hormonal contraceptives contributes to the development of infertility. The complex inhibition of the reproductive function of the body, which is carried out for a long time (six months or more), cannot pass without a trace. And the longer the period of hormone therapy, the more difficult it will be to conceive a child later. One of the main reasons that in our time there are so many couples who cannot have a child for a long time (in Europe there are even more such couples) is the long-term use of “absolutely harmless” hormonal contraceptives by young nulliparous women.

A decrease in libido (sexual desire) is the second significant minus of hormonal contraceptives, which every woman who has taken them for a long time will inevitably have to face later. The range of manifestation of this side effect can be different: from regularly recurring persistent unwillingness to have sex, loss of pleasant sensations from intimate life, to complete indifference or aversion to sex.

The development of excess weight and cellulite. Of course, there is no question of such a serious weight gain that women who took old-style contraceptives experienced. However, as a result of taking modern hormonal drugs, a few extra pounds will surely settle so firmly at the waist that it will be incredibly difficult to lose them. The fact that hormonal contraceptives contribute to the development of cellulite on the thighs and buttocks is also a scientifically proven fact.

Thus, the use of hormonal contraceptives is most appropriate for a woman who has already given birth, lives with her husband or a permanent partner (hormonal contraceptives protect only from conception, but not from sexually transmitted diseases); as well as in cases where hormone therapy is needed to get rid of gynecological diseases.

The intrauterine device is one of the oldest contraceptives. Older, perhaps, only a condom. However, until now no one knows how it works. A small polyethylene device resembling the letter "T" is inserted into the uterus, although the shape does not matter. In ancient times, gold balls, pebbles and other foreign bodies were used for these purposes. It is believed that a foreign object in the uterus causes an abortive effect, that is, it does not allow the embryo to gain a foothold and begin its development.

In addition, it is assumed that the IUD contributes to local inflammation, and also causes the fallopian tubes to contract faster than usual, which reduces the likelihood of fertilization. Copper or silver is added to modern spirals - they have a detrimental effect on male and female sex cells, as well as progestins - these hormones, as in the composition of COCs, they prevent ovulation. Accordingly, three types of spirals are distinguished: ordinary, with metals or with a hormone. According to official medical recommendations, the most effective and safest coil is with copper. In second place is the hormone-containing intrauterine system, in third place are all the rest (now they are rarely used). In practice, the main difference between all IUDs is the price, and contraceptive protection is approximately the same and corresponds to that of COCs. The cost of copper-containing contraceptives fluctuates at the level of 3,000–6,000 rubles, Mirena, the most expensive pleasure, is about 12,000–14,000 rubles. The intrauterine device is installed for up to 5-6 years.

The advantages of the intrauterine device are obvious:

• it is inserted once for 5-6 years and the need for contraception is forgotten;
• can be used even during breastfeeding;
• hormone-containing contraceptives have a minimal systemic effect on the body, and the use of a spiral without hormones does not affect general well-being at all;
• relatively low price for the entire period of operation.

There are undeniable disadvantages:

• a gynecologist will be needed to install and remove the spiral;
• in rare cases, the spiral can pop up, so its presence must be periodically monitored, although the woman copes with this task on her own;
• when using a spiral, menstruation often becomes more abundant and prolonged.

However, the main complaints about IUDs are related to their impact on gynecological health. During installation, nulliparous women require an artificial expansion of the cervical canal, which can lead to injury, and in the future to problems in carrying a pregnancy. Therefore, the use of spirals in young girls is limited.

With inept gynecological manipulations, trauma to the uterus is possible, up to rupture of the wall, although this, of course, is rare. The presence of a foreign body in the uterus increases the likelihood of inflammatory and infectious diseases of the female genital area, including STDs, so the hostess of the spiral should especially scrupulously monitor her health. After removing the contraceptive, there may be an inferiority of the endometrium - the inner layer of the uterus, which reduces fertility and increases the risk of abortion in the early stages. Although according to official data, fertility is restored in 72-96% of women within 12 months after stopping the use of the spiral.

Contraindications for intrauterine contraception are inflammatory diseases, anatomical defects in the development of the genital organs, problems with the blood coagulation system and various menstrual disorders, severe general diseases that reduce immunity.

Common intrauterine contraceptives: Copper T Ku 380 A, Multiload Ku-375, NOVA T, Goldlily-Exclusive, Vector Ag 400, Juno Bio-T Cu380Ag, Mirena, etc.

Barrier and chemical methods of contraception

All barrier contraceptives are practically harmless to health and can be used at any age, with a variety of common diseases. In addition, all barrier methods protect against sexually transmitted diseases to varying degrees. A common disadvantage of these means of protection against unwanted pregnancy is the need to apply before or during each intimacy, which to some extent violates the naturalness of the process, deprives romance.

The most famous of the barrier and the only male contraceptive is the condom. From the pros:

• High reliability, although lower than that of KOC and VMK.
• Protection against almost all infections that can be caught during sex, except those that are transmitted by contact with the skin of the perineum: some types of human papillomavirus, herpesvirus, pubic louse, etc.
• Accessibility to everyone and everyone: compared to other contraceptives, it costs a penny, it has absolutely no systemic effects on the body and contraindications for use.

Unfortunately, the advantages of a condom lose all meaning if it is used incorrectly. In this case, the condom may break, come off, or simply dissolve. However, there is nothing complicated in the “operating manual” for rubber products, and those who have carefully read the instructions at least once in their life usually have no problems.

The main reasons why couples refuse a condom are:

• dislike for such a "barrier" in principle;
• complaints of decreased sensitivity during intercourse;
• the disappearance of an erection in men when trying to use a contraceptive;
• Allergy to latex is a very rare complication, but it does occur.

Well, the main disadvantage is that a condom is not at hand just when it is really needed. Although self-discipline and thrift solve this problem.

Of course, these disadvantages look trifling compared to those unwanted side effects that hormonal drugs and intrauterine contraceptives can cause. However, with a long "experience" of intimate relationships with a condom, even these little things, sometimes, get bored.

As for the other representatives of the barrier series, they are less common and in demand, as they are less convenient and reliable. The female condom (femid) is essentially the same as the male condom, only larger. It is a transparent bag with elastic rings at the ends. One ring is inserted into the vagina before sex, the other holds the product outside and covers the female crotch. It is made more often from polyurethane, so it can serve as an alternative contraceptive for latex allergies.

Themis can be inserted into the vagina in advance and removed 10 hours after intercourse. However, female condoms have not yet been widely used. They are 5-6 times more expensive than men's. According to reviews, they are less convenient, for example, they make a sound resembling bursting bubbles of an anti-shock film at the most interesting moment. Finally, for our country it is exotic.

The female condom can be dangerous for men's health

In South Africa, in order to combat rape, Rapex femidomes with sharp plastic teeth along the entire length were manufactured and released into the pharmacy network. After the first friction, a man gets "hooked" with all the ensuing consequences for his intimate health. It's hard to say why a "toothy condom" is better than a stun gun or a kitchen rolling pin, but the idea impresses the imagination!

Of the female barrier contraceptives, caps and diaphragms are worth mentioning - these are rubber products that are inserted into the vagina and cover the cervix. In some cases, they require individual selection, as well as the additional use of spermicides - chemicals that deprive sperm of the fertilizing ability. The efficiency is low, to put on and take off you need to seriously sweat, but you can use it repeatedly with one partner - there is a saving!

Chemical contraceptives: gels, suppositories, foams are introduced into the vagina before intercourse, have the effect of lubricants. These funds are able to destroy spermatozoa in 60 seconds. In addition, they also kill the causative agents of sexual infections, though not all and not always, therefore they reduce the likelihood of STDs, but do not prevent them for sure. Chemical protection methods close the range of recommended contraceptives in terms of reliability. They are usually advised to be used as a safety net during condom sex, as well as in the first two weeks of taking COCs. The most common chemical contraceptives: Erotex, Farmateks, Contraceptin-T, etc.

emergency contraception

This is a "fire" method, it is unreasonable to consider it as a regular one. Usually, emergency contraception means the use of high doses of progestins (the same as those found in COCs and mini-miles), less often they use a combination of estrogens and progestins (a large number of COC tablets), and even less often - insert an intrauterine device.

The most common means for emergency contraception are:

• "Postinor" - tablets containing progestin. The first must be taken no later than 48 hours after unprotected intercourse.
• "Escapel" - tablets with progestin. Take no later than 72 hours after sex.
• Eskinor-F is a progestin. The first tablet is taken no later than 72 hours.

Postcoital contraceptives are effective, but they do not protect against STDs, often cause side effects, and huge doses of hormones cause serious disorder in the female cycle. Therefore, emergency contraception should be used only in the most extreme cases, when it is an alternative to abortion.

Hormonal contraception is a highly effective method of contraception, provided it is used correctly. If we judge the pros and cons of a particular method of contraception, then the advantages of hormonal contraceptives are much greater than the disadvantages. But in addition to following the rules of admission, you should also choose the right hormonal pills or their analogues in order to avoid side effects.

Types of hormonal contraception

• combined oral contraceptives or COCs;
• gestagenic preparations:
  • pure progestins or mini-pills;
  • injectable progestins (have a prolonged action);
  • progestins that are implanted;
  • contraceptive patch;
• preparations for emergency or fire contraception;
• hormonal intrauterine system;
• vaginal rings with hormones.

Combined oral contraceptives (COCs)

These types of hormonal pills include those that contain both estrogens and gestagens. Depending on the content of hormonal components, COCs are divided into:

• monophasic (in each tablet the same dose of the estrogen and progestin component) - rigevidon, logest, silest;
• two-phase - anteovin, divin;
• three-phase - three-regol, trisiston.

The action of this type of hormonal contraception is to suppress the production of their own hormones by the ovaries, as a result of which ovulation does not occur. In addition, such tablets thicken the mucus in the cervical canal, which makes it impossible for sperm to enter the uterine cavity and change the uterine mucosa (atrophying it to some extent), which prevents egg implantation.

How to choose the best COCs

Types of female phenotypes:

• Estrogen (feminine) type
  It is characterized by a long menstrual cycle, fairly heavy menstruation, significant vaginal leucorrhoea, and the woman is outwardly very feminine: developed mammary glands, rounded shapes with a tendency to be overweight, normal skin (closer to dry) and hair. For women with a predominance of estrogens, COCs are suitable, the dose of the progestogen component in which is higher than the estrogen content (Norinil, Minulet).
• Balanced type
  It is characterized by a balance between estrogens and gestagens. All external and clinical signs are expressed to a moderate degree: the mammary glands are of medium size, the body structure is proportional, the skin is of normal fat content and moisture, the hair is thick and dense, they have no problems with conception and pregnancy. Three-phase COCs (tri-merci) or single-phase COCs with a low content of hormones (Lindinet-20, Mercilon, Marvelon) are optimal for such women.
• progesterone phenotype
  Another name for the bone or ectomorphic phenotype. It is characterized by the predominance of progesterone (released in the 2nd phase of the cycle). Women have the following features: uniform development of the shoulders and hips, according to the type of "sports figure", uniform distribution of subcutaneous fat, closer to the android (male) type, underdeveloped mammary glands, tall stature, oily skin and hair, acne and seborrhea . Hypertrichosis and hirsutism are also characteristic (depending on nationality). Menstruation is scanty and short, the menstrual cycle is short. Women with a progesterone phenotype are suitable for COCs with an antiandrogenic component (Janine, Yarina, Diana, Jess).

New generation hormonal COCs

The list of new generation hormonal contraceptives includes:

Jess
Ideal for young women. The dose of hormones in these tablets is very low, so they are classified as low-dose hormonal contraceptives. Due to the low content of hormones, the risk of developing vascular complications (thrombophlebitis, thromboembolism) is reduced. Jess is well tolerated and does not affect the digestive tract (nausea, vomiting). It is recommended to eliminate signs of premenstrual syndrome, eliminate acne. Taking Jess does not affect a woman's weight and has a positive effect on hair and nails.

Novinet
The composition of this combined oral contraceptive includes: ethinylestradiol in the amount of 20 mcg and desogestrel in a dose of 150 mcg.

The drug normalizes the menstrual cycle, reduces the amount of menstrual flow, does not affect the woman's weight and has a minimum of side effects. After childbirth (in the absence of lactation), Novinet is allowed for 21 days.

Janine
Included in the group of monophasic low-dose COCs. It has an antiandrogenic effect: a successful fight against acne, seborrhea and oily skin, hirsutism. It has an excellent contraceptive effect.

Lindinet-20
The composition of the drug includes ethinylestradiol in an amount of 20 mcg and gestodene in a dosage of 75 mcg. Refers to COCs with a low content of hormones. Taking Lindinet-20 does not increase weight, the risk of side effects (nausea, vomiting) is minimal.

Yarina
Yarina belongs to a new generation of COCs and has an antiandrogenic effect. The composition of the drug includes ethinylestradiol 30 mcg and drospirenone at a dose of 3 mg. Successfully eliminates skin problems (increased fat content, acne), has a beneficial effect on the condition of the hair and reduces the manifestations of premenstrual syndrome. The development of side effects is minimal.

Benefits of taking COCs

The benefits of taking COCs include:

• simplicity and ease of use;
• relief of symptoms of premenstrual tension;
• reduction of menstrual blood loss;
• normalization of the menstrual cycle;
• prevention of mastopathy and the development of benign tumors of the internal genital organs;
• high contraceptive effect.

Cons of taking COCs

Of the negative aspects of taking COCs, it should be noted:

• not recommended for women 35 years of age or older;
• require discipline (daily reception at the same time);
• spotting is possible when taking hormonal contraceptives (in the middle of the cycle, especially during the first 3 months of taking);
• with special care are appointed to smoking women;
• do not protect against sexually transmitted infections.

mini pili

The composition of these tablets (exluton, microlut) includes only progestogens, and in very small doses. The mechanism of action of this type of hormonal contraceptives consists of several points. First of all, this is a cervical factor - the volume of cervical mucus decreases, but it becomes thick and viscous, which makes it difficult for sperm to enter the uterus. Secondly, this is the uterine factor - progestogens cause premature secretory transformation of the uterine mucosa (normally this occurs in the 2nd phase of the cycle), which makes implantation impossible. Moreover, with a long intake of mini-pills, endometrial atrophy occurs. There is also a tubal factor, due to weakened peristalsis of the tubes, which slows down the progress of the egg through the tube and reduces its chances of fertilization. And in 25 - 30% of women, such pills suppress ovulation.

• breastfeed;
• are overweight;
• do not tolerate estrogens;
• are in premenopausal age.

Charosetta
The drug contains desogestrel at a dosage of 75 mcg. Great for nursing mothers and women who have contraindications to the use of estrogens. Does not affect the amount of milk, quickly restores the menstrual cycle after childbirth.

Lactinet
The composition of the drug contains 75 micrograms of desogestrel. It has a good contraceptive effect, suitable for lactating women, does not affect weight. Of the side effects: a daub may appear during the first three months of use.

Exluton
The composition of the tablets includes linestrenol at a dose of 500 mcg. Does not affect weight, does not reduce libido, an excellent choice for contraception for women who are breastfeeding after childbirth.

Pros of the mini-pill

The advantages of mini-pills are:

• low risk of developing cardiovascular and cerebrovascular pathology (heart attacks, strokes) due to the small amount of progestogen and the absence of estrogens;
• do not affect blood clotting;
• do not affect lipid metabolism (do not provoke weight gain);
• well stop premenstrual syndrome;
• indispensable in the event of regular ovulatory pain and cycle disorders;
• the possibility of taking women who smoke;
• simplicity and ease of use.

Cons of mini-pill

Of the shortcomings of these tablets, it should be noted:

• the contraceptive effect is less pronounced than that of COCs;
• require strict adherence to the regimen of taking pills;
• increases the risk of functional ovarian cysts and ectopic pregnancy;
• frequent violations of the cycle in the form of acyclic bleeding;
• shortening the cycle (25 or less days).

Injectable progestins

The mechanism of action of these contraceptives is the same as that of the minipill. The most common drugs are depo-prover (150 mg) and norethisterate. The positive aspects of such contraceptives are: long-term action (one injection once a quarter), easy to use, high reliability. Among the shortcomings can be noted: a long restoration of fertility (about 5 - 7 months), it is impossible to quickly remove the drug from the body, the frequent occurrence of acyclic bleeding and regular visits to the clinic for re-injection.

Transdermal Therapy System

This method of contraception includes the hormonal contraceptive patch Evra. It is presented in the form of a square piece of patch measuring 5 by 5 cm flesh-colored. Contraceptive efficiency reaches 99%. The composition of the patch includes ethinylestradiol at a dose of 600 mcg and norelgestromin at a dosage of 6 mg, that is, it belongs to the combined hormonal contraceptive preparations. The package contains 3 patches, each of which is glued to a specific area of ​​​​the skin (in the buttocks or abdomen, on the outer surface of the shoulder or in the scapular region) once a week. The patch should be attached on the first day of menstruation, but it is possible on any other day of the week, but in this case, additional contraception is required for 7 days. After a week, the patch must be peeled off and a new one attached, but already on a different area of ​​\u200b\u200bthe skin. After using 3 patches (21 days), you need to take a week break, during which menstrual-like bleeding will begin. After a break, on the 8th day, a new patch is glued.

Benefits of a hormone patch

The advantages of this hormonal method of contraception include:

• lower dose of hormones (compared to COCs);
• simplicity and ease of use;
• no need for daily monitoring, for example, as with daily hormonal pills;
• resistant to moisture and sun (will not peel off in the shower or when sunbathing);
• preservation of the contraceptive effect during exercise, in the sauna or in the bath, during the tanning procedure;
• normalization of the menstrual cycle, elimination of intermenstrual bleeding;
• no negative effect on the liver (hormonal components bypass the digestive tract);
• reduction of symptoms of premenstrual syndrome.

Cons of a hormonal patch

Of the shortcomings, it should be noted:

• itching (possibly, but not necessarily) at the patch site;
• visibility on the skin, as an aesthetic defect;
• the likelihood of side effects;
• peeling off the patch with frequent contact with water;
• there is no protection against sexually transmitted infections.

Subcutaneous implants

Subcutaneous implants are also included in long-acting progestogen contraceptives (norplant, implanon). The essence of their contraceptive effect, the disadvantages and advantages are the same as those of injectable progestins. The only difference is that they are injected subcutaneously (capsules with levonorgestrel) into the forearm from the inside. The duration of the contraceptive action of Norplant is 5 years (at the same time, 6 capsules are implanted with a special syringe).

emergency contraceptive pills

The essence of such pills is either blocking ovulation or preventing implantation. If all the conditions for taking the medicine are met, then the contraceptive effect is quite high. Emergency contraception should be carried out no later than 72 hours after unprotected sex, and the earlier the pill was taken, the effectiveness is higher (in total, it is supposed to drink 2 pills: the first immediately after intercourse, and the second no later than 12 hours after the first).

Among the disadvantages of this method of contraception, there are: the frequent occurrence of copious discharge up to massive bleeding, severe side effects, menstrual irregularities. But it is important to remember that emergency contraception should not be used more than three times a year.

Hormonal intrauterine system

This group of hormonal contraceptives includes the intrauterine device ("Mirena"), which contains levonorgestrel, which begins to be released immediately after the installation of the device. The mechanism of action is dual - prevention of pregnancy, both with a spiral and with levonorgestrel.

Vaginal hormonal contraceptives

A vaginal contraceptive ring that contains hormones (estrogen - ethinyl estradiol and progestogen - etonogestrel components) - NovaRing. The contraceptive is presented in the form of an elastic ring, which is installed in the vagina for 3 weeks, during the specified time, hormones are released from it that have a contraceptive effect like COCs.

Cancellation of hormonal contraceptives

Cancellation of hormonal contraceptives is carried out either at the request of a woman (she is determined to become pregnant or switch to another type of contraception), or for medical reasons. In the absence of emergency indications, it is necessary to stop taking hormonal contraceptive pills according to the following rules:

• drink the entire package to the end (stopping taking the pills at the beginning or middle of the cycle threatens the development of hormonal disruptions);
• consult a doctor (choose another method of contraception or discuss the stages of pregnancy planning);
• take a biochemical blood test and blood clotting (hormonal contraceptives affect the metabolism of proteins, fats and carbohydrates, increase blood viscosity).

After abrupt cancellation of hormonal contraception (suspected pregnancy, thrombosis, liver disease, increased blood pressure, etc.), the following side effects are possible:

• depressive state;
• the appearance of acne;
• increase in hair growth;
• weakening of sexual desire;
• the occurrence of breakthrough bleeding;
• the appearance of headaches;
• nausea, vomiting.

Hormonal contraceptives include contraceptive pills containing artificially synthesized hormones, which in their composition and properties are very close to the hormones produced in - estrogen and gestagen. Modern oral contraceptives may contain either one type of hormone (progesterone) or two (and estrogen). In the first case they are called "mini-drank"("Microlut", "Exluton"), in the second - combination drugs("Lugest", "Felyudin", "Mikroginon", etc.). In addition, monophasic, two- and three-phase preparations are distinguished. Monophasic preparations consist of a set of tablets, i.e. all tablets contain the same dose of hormones. When taking biphasic drugs, the dose of hormones changes twice per course, when taking three-phase drugs - three times (such tablets, as a rule, differ in color). Tablets "mini-drank" are only monophasic.

Mini-pills contain only progestin. It also changes the lining of the uterus and increases the viscosity of the mucus in the cervix. Mini-pills can also prevent the release of an egg from the ovary. To maintain the contraceptive effect, mini-pills must be taken daily at the same time, plus or minus 2 hours.

Pills and minipills are considered very reliable contraceptives and are therefore the most commonly used. However, like any potent drugs, they have contraindications and side effects, and therefore must be prescribed by a doctor.

"Mini-drank" take once a day, starting from the first day of menstruation, regularly at the same time. Most convenient - at night. If you miss the next dose by more than three hours, the contraceptive effect is lost for 48 hours. During this time, it is necessary to use additional contraceptives, while continuing to take the drug. The simultaneous use of antibiotics, except for, does not reduce the contraceptive effect.

Combined oral contraceptives also taken once a day at the same time, starting from the first day of the menstrual cycle. You can delay taking the pill for no more than 12 hours. If this period is exceeded, the pill must still be taken, and regardless of this, the next pill is taken at the right time, and for the next 7 days additional contraceptives, such as barrier ones, must be used. Nausea or vomiting may occur at the start of taking combination drugs. In this case, the pills should be continued and at the same time additional contraceptives should be used, which are used for another 7 days after the disappearance of these symptoms. If it is necessary to use antibiotics, the combined pills are continued, additional contraceptives are used all the time while they are used, plus another 7 days. If you are going to have surgery while taking the combination medication, you should stop taking the pills four weeks before.

Pregnancy may occur as early as one month after discontinuation of the drug. On average, a woman's ability to give birth to a child is restored after three months.

Birth control pills can reduce the risk of developing benign breast tumors, uterine and ovarian cancer, ovarian cysts, uterine fibroids, pelvic inflammatory disease, eliminate acne and prevent hair loss. Combination birth control pills can be used for emergency contraception.

The contraceptive effect occurs from the first day of taking the pills if a woman adheres to the regimen established for the drug. The disadvantages of hormonal contraceptives include the need to take the drug daily, an increased risk of pregnancy if you skip taking the pill.

In addition, one should not forget that hormonal contraceptives do not protect against STDs. Therefore, the use of a condom by a man is considered necessary in combination with this method.

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 combining hormonal drugs with drugs such as rifampicin, carbamazepine, barbiturates, the contraceptive pill regimen should be adjusted.

Modern contraceptive drugs differ in the active substances that make up their composition. All modern drugs consist of two components: progestogen and estrogen. The progestogen component can be represented by two substances: levonorgestrel and desogestrel. Preparations with levonorgestrel (Demulen, Diane-35, etc.) are the most optimal. Desogestrel tablets (Marvelon, Mercilon, Femoden) should not be used in women with varicose veins, as they contribute to blood clots. However, these drugs may be suitable for women who have experienced acne, headache, depression, weight gain, and intermenstrual bleeding with other drugs.

Video about birth control pills and the myths associated with taking them

The estrogen component is always represented by one substance, estrogen, but in different dosages. Preparations containing 20 micrograms of estrogen (Mersilon) are recommended for women after 35-40 years of age, with obesity. Preparations containing 30-40 micrograms of estrogen can be taken in all age groups. Preparations containing estrogen 50 mcg are taken in special cases, for example, when taking certain medications and for therapeutic purposes.

In addition to hormonal contraceptives in tablets, drugs are also used in the form injections and implants implanted under the skin. Implants implanted under the skin Norplant is a classic drug of this group. Small capsules 35 mm long and 2.5 mm in diameter. secrete the active hormonal substance. A single injection is sufficient to provide a contraceptive effect for 5 years. Only one small skin incision is needed for insertion.

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). Moreover, implantable contraception can be used by women with diseases in which taking pills is contraindicated (migraine, heart defects, diabetes mellitus without vascular complications, high blood pressure, severe obesity), as well as women who smoke over 35 years of age. Injectable contraceptives (the only drug registered in Russia - Depo Provera) are administered every three months.

Contraindications for taking hormonal contraceptives
All women who have no contraindications can take pills. Many drugs (especially triphasic tablets) can be successfully taken by teenage girls.

Absolute contraindications- malignant tumors of the mammary glands; malignant tumors of the genital organs; venous thromboembolism; vascular disorders of the brain; unrecognized acyclic vaginal bleeding; ; hereditary hyperlipidemia.

Relative contraindications- age over 40 years; smoking; arterial hypertension or hypertension during pregnancy (toxicosis); epilepsy; diabetes; bouts of depression; diseases of the gallbladder and liver; oligomenorrhea or in nulliparous women.

Side effects when using birth control pills
If the tablets are well tolerated, all side effects disappear within three months, if adverse symptoms persist, this drug should be changed.

All side effects are divided into two groups:
Side effects associated with taking drugs in which estrogen predominates. First of all, the “false pregnancy effect”. It includes: nausea, bloating, vaginal discharge, irritability, increased sensitivity of the mammary glands.

The second group of symptoms is associated with drugs in which the progestogen predominates. These are depression, decreased libido (sex drive), decreased vaginal lubrication, acne, and weight gain.

If allergic reactions occur, the drug should be discontinued.

When should you immediately stop taking birth control pills and consult a doctor? This should be done if:

• Strong headache.
• Sudden loss of hearing and vision.
• Pain in the legs, swelling in the legs.
• Feelings of pain or tightness in the chest.
• Acute pain when breathing, severe cough of unknown origin.
• Plaster cast on the lower body and legs.
• Jaundice.
• Violent itching and profuse rash.
• epileptic fit.
• A sharp rise in pressure. Signs of a possible pregnancy (lack of menstruation).

What factors weaken the contraceptive effect of pills?

• Smoking.
• The use of large doses of alcohol.
• Vomit.
• Taking tranquilizers, antibiotics, painkillers and some other medications.

Smoking and birth control pills
The combination of taking birth control pills with smoking increases the risk of thromboembolic complications and is generally harmful to health. Nicotine is a powerful factor that increases the risk of cardiovascular disease.

Benefits of this type of contraception
The most important thing is high efficiency. Taking contraceptives reduces the risk of ectopic pregnancy, prevents the development of inflammatory diseases, prevents the development of benign and malignant tumors, normalizes the menstrual cycle, reduces back pain that occurs in the middle of the menstrual period. Hormonal birth control pills do not interfere with the reproductive capacity of the body. The ability to fully conceive is restored 1-2 months after the end of taking the pills. Birth control pills are widely available, easy and convenient to use, and can be successfully used for 5 years without interruption under medical supervision.

Disadvantages of hormonal contraception
There are medical contraindications. With prolonged use or overdose, birth control pills can adversely affect the cardiovascular system, increasing the body's predisposition to hypertension, blockage of blood vessels. Sometimes there are situations when you have to refuse to take pills: trauma, depression.

Birth control pills- one of the most reliable methods of contraception. Its efficiency is 98%. Every year, hormonal contraceptives are becoming more and more advanced. However, women are still afraid to take them, fearing side effects. I WANT to talk about all the pros and cons of birth control pills.

All hormonal contraceptives are based on synthetic substitutes for estrogen and progesterone. The main function of these drugs is to prevent fertilization in several ways due to the addition of hormones.

The most important thing for a woman who wants to use contraceptive pills as the main form of contraception is to undergo an examination and consultation with a gynecologist. The fact is that all birth control pills have a number of contraindications. But taking hormonal contraceptives can be absolutely safe for health if the pills are chosen correctly, taking into account the individual characteristics of each woman. Therefore, you cannot start taking them on your own.

Another conclusion follows from this: there are no "best" birth control pills. There are those that are most suitable for a particular woman.

Benefits of birth control pills

Helps deal with acne. One of the causes of acne is increased production of sebum. The intensity of sebum production is controlled mainly by the balance of male and female sex hormones. It is known that the increased production of male hormones in a woman's body leads to increased secretion of sebum, and preparations containing estrogens have the opposite effect, therefore they are often used in

They have a therapeutic effect in polycystic ovaries. NMC (menstrual irregularities of all kinds) is one of the first manifestations of polycystic ovary syndrome. The danger of this disease lies in the increased risk of developing diabetes and infertility, although in general, with early access to a gynecologist, polycystic disease proceeds favorably and can be treated with hormonal contraceptive pills.

Favorably affect the body during menopause. Also, hormonal contraceptives are used for replacement therapy in menopause and the postmenopausal period, which is characterized by a decrease in the level of hormone secretion by the ovaries. In the pathological course of menopause, which occurs in 50% of women and is accompanied by disorders of the nervous, endocrine, cardiovascular systems, hormone therapy is necessary.

An effective means of contraception. Hormonal contraceptives are monophasic and multiphasic, depending on the dose of estrogen and progestogen. In monophasic preparations, it is constant throughout the cycle, while polyphasic ones imitate fluctuations in the levels of their own hormones produced by the ovaries during the cycle. That is why multiphasic oral contraceptives are considered more natural and less effective in terms of contraception, which means they are used mainly to correct hormonal status. Monophasic drugs are the best contraceptive for young women.

Birth control pills may offer you some protection against:

• Osteoporosis.
• Iron deficiency anemia (which may be the result of heavy periods).
• Ovarian cysts.
• Acne.
• Vaginal dryness and pain during intercourse.
• Non-malignant neoplasms of the breast.
• Excess body hair.
• Menstrual migraines.
• Symptoms of premenstrual dysphoric disorder.

Cancer protection and birth control pills

Studies show that women who use birth control pills are three times less likely to develop cancer of the ovaries or lining of the uterus (endometrial cancer) than those who do not.

The protective effect can last up to 30 years after you stop taking the combined birth control pill. In addition, protection increases with each year of use. Thus, if you take the combination pill for 6 years, using the pill can reduce your risk of developing ovarian or endometrial cancer by 60%.

Recent studies show that the pill has little to no effect on the risk of developing breast cancer. But the risk of developing colorectal cancer among women who use the pill is reduced by 18 percent.

Cons of birth control pills

If you are using birth control pills, then you may experience unwanted side effects. The good news is that most of these will disappear by the second or third month of use, after your body has adjusted to the progestin and/or estrogen in the pill. The cons include the following:

• Headache.
• Soreness of the mammary glands.
• Nausea (sometimes with vomiting).
• Bleeding between periods.

In addition, combined birth control pills may:

• Induce depression.
• Change in sexual desire.
• Progestin-only birth control pills can lead to irregular periods and bleeding (at least more often than with combination pills).

It is worth noting that birth control pills do not provide a 100% guarantee of protection against unwanted pregnancy. It should be borne in mind that the way the drug is used plays a big role here: a missed tablet, for example, jeopardizes the safety of the entire cycle. Thus, the high degree of responsibility of a woman can be attributed to the disadvantages of the application.

Side effects

Before use, it is very important to read the information leaflet that comes with the drug in order to get more detailed information about the use and risks of your birth control pills. In addition, the insert should also explain when to take birth control pills (and what to do if you miss a pill or two).

You can take birth control pills with dinner or before bed to reduce nausea and/or vomiting. Try not to stop taking your pills, even if you don't feel well at first.

Be sure to talk to your doctor if you experience side effects after three months of taking birth control pills - this may mean that a particular brand of pill is not right for you.

Possible risks and complications

Serious problems are extremely rare. Women who use combination medications may be slightly more likely to develop certain medical problems than those who do not use them. The risk increases:

• If a woman smokes
• At the age of 35 years and older.
• There are conditions associated with a heart attack (such as high cholesterol, high blood pressure, diabetes, and conditions that increase the risk of blood clotting).

The most serious complication of combined birth control pills is blood clots in the heart, lungs, brain, or legs. Women using combination pills who are required to stay in bed or wear a cast are more likely to develop a blood clot. If you are about to have major surgery, you should tell your surgeon that you are using combined birth control pills.

Additional risks associated with the use of birth control pills to be aware of:

• There is a link between birth control pills and weight. This means that the effectiveness of the pill may be compromised if you are overweight.
• You should also pay attention to the medications you are taking. Some medicines may reduce the effectiveness of the tablets. Medicines containing drospirenone can suppress hormones that regulate water and electrolyte levels in your body, so these pills may interact with medicines that increase potassium.
• When you visit any doctor, it is very important to make them aware of the contraceptive medications you are taking.