Coca tablets in gynecology. Hormonal contraception. Secrets of choosing a combined oral contraceptive. Disadvantages of combined oral contraceptives

Combined oral contraceptives(COCs) are the most popular and effective type of drugs to prevent unwanted pregnancy. As a result of numerous studies, it was found that birth control pills have a beneficial effect on the female body.

To better understand the effect of birth control pills, it is necessary to understand the processes that occur in a woman’s body. All phenomena are cyclical and repeat themselves after a certain period.

The pill, vaginal ring and hormonal patch are contraceptive methods that are reliable. Combination hormonal methods may have benefits that go beyond contraception. They can improve some menstrual problems or symptoms and usually lead to a regular cycle. If necessary, menstrual bleeding can usually be delayed with these contraceptives.

Disadvantages - be considered

In general, the tablets, vaginal ring and hormonal patches are well tolerated. However, the benefits must be carefully weighed against the potential risks, especially thrombosis and pulmonary embolism. Possible side effects of one medicine can be found in the relevant leaflet.

As a rule, the menstrual cycle includes 28 days, but it can decrease or increase, which is quite natural. In the middle of this period, the process of ovulation occurs. If the egg meets the sperm, the process of conception begins. All these phenomena are controlled and controlled by hormones such as estrogen and progesterone.

These are serious events. Thrombosis or pulmonary embolism are rare. The clot obstructs the blood flow and can lead to deep venous thrombosis or pulmonary embolism in the veins or a stroke or heart attack in the arteries. Women who use combined hormonal contraceptives have a slightly increased risk of developing a clot in their veins or arteries. The risk is highest in the first year of use, especially in the first three months; regardless of whether contraception is taken for the first time or after a break of at least four weeks.

Types of COCs

Since the improvement of oral contraceptives has reduced the content of hormones, drugs based on dosage are divided into low-dose, high-dose and micro-dose. It is generally accepted that side effects depend on the dose of hormones. However, taking into account many important aspects, such as chronic pathologies and many others, we can say that contraceptives with minimal hormone content are not suitable for all women.

As the duration of use increases, the risk steadily decreases. Compared to pregnancy, the risk of thrombosis with combined hormonal methods is approximately two to three times lower. Before a doctor prescribes combined hormonal contraception, he should be very careful to clarify whether relevant risk factors exist.

Bleeding - may happen sometime

In most cases, clot formation can be treated well and no collateral damage is expected. Only in about one to two percent of cases is the clot fatal. Unexpected bleeding that occurs between the two rules is called intergastric. Sometimes bleeding may occur in the first few months. If they persist after the first three months, your doctor should be contacted. If bleeding does not stop or occurs repeatedly, consult a doctor to rule out possible organic causes.

Contraceptive pills (COCs) contain analogues of the above hormones. They, in turn, are classified according to substances into the following types:

Monophasic. Each drug consists of an equal amount of hormones. These remedies are considered the most optimal for the bulk of the female population.
Two-phase. The content of progesterone is higher than estrogen.
Three-phase. The hormone levels in these drugs are the most accurate.

The process of action of all COC contraceptives is the same and does not depend on the dose of hormones. The choice of one drug or another will depend on many factors; there are often situations when monophasic tablets are ideal for the body, while triphasic tablets, on the contrary, cause a number of unpleasant side effects.
Use during breastfeeding - baby break
Using combined hormonal contraceptives during lactation can affect milk production in terms of quantity and quality. Women who are considering reliable contraception when breastfeeding, should switch to methods that do not contain hormones or estrogens and seek medical advice early on.

Reasons for immediate withdrawal
The earlier serious side effects are detected, the more likely it is that they can be treated. If you experience the following symptoms, consult your doctor immediately. These symptoms may be the result serious problems health problems that may not necessarily be associated with combined hormonal contraception, but require immediate cessation. However, since reliable contraception may be required, it is advisable to consider a suitable method with your doctor.

Oral contraceptives can be used from the moment of the beginning of intimate life until the onset of menopause. Taking these drugs after menopause is carried out for the preventive purpose of changes in calcium content in tissues.

While taking combination oral pills contraceptive effect is achieved in several stages. These drugs affect ovulation and prevent the maturation of the egg. Also, these drugs change the secretion of the uterus, which in a natural process should stimulate the movement of sperm into the uterine cavity. As a result of taking the pills, this secretion thickens, which significantly reduces sperm activity.

Women have gained greater sexual freedom at terrible cost to their health and well-being. About the author: Sherrill Seliman conducts psychotherapy research privately in Melbourne, lectures on women's hormonal health, and is the best-selling author of The Hormonal Heresy: she has contributed to its publications in Australia, New Zealand, Canada and the United States .

He announced "an age that would free women from unwanted pregnancy, thereby opening the door to greater equality and freedom." Over the past 37 years, approximately 200 million women worldwide have chosen the pill as their preferred method of contraception. The "medical miracle" included about 90 percent of Western women of reproductive age using some form of contraception at some point in their lives. Birth control options for steroid hormones have now expanded to include a combination and low-dose pill made from estrogen and synthetic progesterone, i.e. progestin, or a progestin-only mini-pill, implant or injection. The pill is said to have been one of the most studied medicines in history. we are told that the correct doses are finally known. Far from being safe and risk-free, it is now suggested that these Hormone Theroids are truly harmful and potentially life-threatening medications that cause serious harm to women. The sexual freedom that women fought so hard for was won at a terrible cost. Indeed, in retrospect, it is likely that in the future it will be worth remembering that the widespread prescription of synthetic hormones for women was the biggest medical mess in history. Most women who use birth control pills know very little about the hormones in their bodies and do not understand the possible side effects. The rapid increase in cervical and breast cancer, as well as strokes, cardiovascular diseases, embolisms, decreased immunity, infertility and significant nutritional imbalances are just some of the conditions that are undoubtedly associated with these hormones. Thus began a feverish rush to control populations. Plans to produce sex hormones have already begun and the necessary clinical trials have begun. Laureate Nobel Prize Frederick Robbins expressed the prevailing opinion of the period when he spoke at a meeting of the American Association of Medical Colleges, which stated: "The dangers of overpopulation are so great that we may be forced to use certain methods of birth control which may involve considerable risks to individual women." Five women died during the study, but no effort was made to determine. Because of their deaths, it is not surprising that the initial tests were incorrect and inadequate. The fact that it was obvious that the product was unsafe did not seem to bother the researchers much. Despite what should have been a serious warning, the pill was promoted by all the enthusiasm of the pharmaceutical companies, although it was very clear that the pill caused emboli, and it was not until the mid-70s that the number of deaths of young women from heart attacks and strokes began to attract public attention. Psychological warnings from some doctors - that widespread The use of oral contraceptives would create health risks on a scale never known in medicine - they understood. Statistics have confirmed that the first women who used this pill had an eleven times higher risk of having thrombosis. In fact, around 60 million women around the world are currently “trying” this pill. It is clear that the first assurances from governments and pharmaceutical companies were lies. David Clark, a neuroscientist at the University of Kentucky School of Medicine, revealed the truth when he said, "The pill allows for experimentation in the general population that would never be allowed through planned experiments." How generous women offer their bodies to medical science, even if it never received a consensus based information. Opposition from manufacturers was expected. However, the American Medical Association and the American College of Obstetricians and Gynecologists were not expected to carry out violent attacks. It seemed that if medical workers, who did not want to spread unfounded alarms among patients, did not report After all, women with risks, no one else had to do this. Although they have known about the many side effects of the pill for forty years, there are still very few doctors who adequately inform their patients about the many risks and possible serious problems associated with the use of the pill. John Gilboud, a famous English family planning specialist, wrote: Despite that the benefits of this pill are not without risks, far outweighing its risks. Another way of saying that the pill is safe, but that some women are dangerous. This two-pronged conversational approach lulls both doctors and women into a false sense of security, assuring them that the new generation of oral contraceptives Unfortunately, nothing could be further from the truth. “The pill allows for experimentation on an entire population that would never be allowed through planned experiments.” David Clark, Neurologist, University of Kentucky School of Medicine How the Pill Works Hormones are very powerful substances. You begin to interfere with the beautifully harmonized messengers of Nature regarding the processes of life and go in search of trouble. This is especially true for women. The psyche of a woman is closely related to her monthly hormonal flow. Hormones not only directly determine physiological processes, but also influence emotional and psychological states. In addition to controlling development and sexual function, hormones also help control muscle growth and development, regulate the digestive system, sugar levels in the blood, blood pressure and water balance. Hormones also hold the key to subjective sensations and changes in chemical composition related to stress. Hormonal imbalances not only create a host of health problems and illnesses, but can also undermine self-esteem, sense of well-being, emotional balance and visual acuity. The two main hormones in a woman's body are estrogen and progesterone. Nature has combined these two hormones to work together with exquisite timing and balance. Estrogen, which is produced in the first half of the cycle, is responsible for female sexual development: breast growth, development of the reproductive system and shape female body . It also stimulates the growth of cells that prepare endometrial tissue for monthly fertilization. The breasts, uterus and ovaries, as well as the skin, are especially sensitive to estrogen. Progesterone stops the effect of estrogen on rapid cell growth. It also develops proliferative tissue of the uterus, allowing implantation of a fertilized egg. Progesterone is known as the mother of all hormones because estrogen and testosterone all flow from it. Progesterone is not only a sex hormone: it is also involved in a complex way of maintaining many other vital physiological functions. more quickly in the first part of the cycle when the ovaries release estrogen. At the same time, it was discovered that the secretions of the yellow cyst in the ovary prevented the release of any other egg after the start of pregnancy. The internal hormones of the body are endogenous, and those externally ingested through food and prescribed as medicines are exogenous. All exogenous hormones tend to create biochemical stress. When a woman is pregnant, estrogen and progesterone levels rise and the production of other eggs stops. Today's oral contraceptives consist of variable doses of estrogen-progestin combinations or progestin-only products. The pill literally stops menstruation. Daily losses occur every month because synthetic hormones are not taken during the seven days of the cycle. should be called, more precisely, “loss of privation,” rather than menstruation. There is actually nothing natural about taking a pill. The pill's action effectively "castrates" a woman, interrupting her natural reproductive cycle, sometimes permanently damaging her ovaries, and also causing sterility. Different combinations of pills signal to the brain in different ways that ovulation has stopped. all pill formulas cause changes in cervical mucus. This may become increasingly common and therefore make it difficult for sperm to pass through the cervix. This presents some obvious difficulties when a woman decides to stop taking the pill in the hope that it will remain. Both progestin and estrogen-progesterone formulas cause changes in uterine tissue, changing the proliferative nature of the endometrium, which receives and nourishes the fertilized egg in the secretory endometrium, which is a thin, nonvascularized tissue that is physiologically unsuitable for receiving and feeding the zygote and also alters the movement of the fallopian tubes, which can alter the time required for the passage of the egg and therefore reduce the likelihood of fertilization of the eggs. Clearly, when it interferes with a woman's hormones, it interferes with the most delicate psychological and physiological processes. By interfering with these vital processes, profound changes begin in a woman’s body. Smoking Depression Diabetes Epilepsy Fibrous tumors of the uterus Bladder disease or gallstones. Heart or kidney disease High blood pressure High cholesterol or triglycerides Liver tumors Recurrent headaches or headaches Multiple sclerosis Obesity Dangerous diseases during pregnancy such as jaundice, herpes, chloasma. Known or suspected pregnancy Recurrent or active hepatitis Vaginal discharge Unusual varicose veins Very irregular menstrual cycles or menarche rash. In Australia there are currently 1 “Every study shows that there is now an increase,” confirms Carol Ann Rinzler, author of the authoritative book Estrogens and Breast Cancer. Rinzler is particularly concerned about those who may be on the pill for four years or more before the birth of their first child. These young women, she said, are at greatest risk of developing cancer from using the pill, as well as a greater risk of contracting sexually transmitted diseases. Teenagers are especially vulnerable to high doses of artificial steroids contained in the pill. The pill is known to be a safe and natural way to correct hormonal imbalances, which has led to its widespread use to correct the menstrual cycles of young girls or to relieve painful periods. Nowadays, puberty is medicalized, although nature often takes several years to balance the teenage cycle, 13-year-old girls who complain of irregularities are often advised or encouraged by pills to "regulate" their periods. Women who used this pill showed a noticeable change in parameters in a dangerous direction, just a few months after starting to use it! In the mid-1970s, a new test that allowed doctors to identify estrogen-dependent tumors found that about a third of breast cancers contained cellular chains that bind to estrogen molecules. Fraumeni's list of possible influences includes anticonceptual and menopausal hormones, the effects of estrogen-like compounds on plants, and chlorinated hydrocarbons that act as estrogens. This leading authority on breast cancer conducted microscopic studies of biopsies from patients who were using oral contraceptives. I have a series of patients who have had two or three breast biopsies. In some cases, the biopsies were done before they started using birth control pills, and the second or third biopsy was done after the patient had been using the pill for several years. Studying surgical specimens under these conditions provides "a unique opportunity to observe changes in tissue." As Dr. Coutier feared, the biopsy revealed "increasing cellular activity that reflected the stimulatory effects of estrogen." The evidence we have suggesting a relationship between steroid hormones and the onset of breast cancer suggests that the relationship is related to dose and duration. Even 17 years ago, the United States listened to Dr. Prophet Claire Chilvers published an important study on Lanza. This risk was common among women who used oral contraceptives for at least four years before their first pregnancy. Because a teenager's breast tissue is still developing and is especially sensitive to overstimulation by synthetic estrogens, the earlier a woman uses the pill, the greater the risk of developing not only breast cancer, but also large tumors with a worse prognosis. However, little or nothing is heard about this women's health scam. on the "Pill" to "regulate" the problems of this period, girls would do much better to correct the problem in the origin with the help of a better diet, nutritional supplements, physical exercise and attention to emotional stress. This would spare them the horrors of breast cancer and the high risk of death from the disease. The attack on the health of women's breasts comes not only from the effects of estrogen, but also from progestogens. For women who used it for six years or more, the risk increased significantly by 320 percent. There is no doubt that progestins also stimulate breast growth. Sudden bleeding. Decreased immune system function. Liver disorders. Eye problems, double vision, inflammation. face and body care Fluid retention and swelling Fungal and ringworm infections Hair loss Hay fever, asthma, itching Loss of libido Granular or soft sinuses Migraine Nausea Psychological and emotional disorders, depression, mood changes. With the introduction of the pill, not only did the number of cervical tumors increase, but also the incidence of sexually transmitted diseases. The sexual freedom caused by the pill is also responsible for more sexually transmitted infections or sexually transmitted diseases. Hormones stimulate increased viral replication. The risk for those using this pill is over 50. Many studies around the world have shown an increase in both uterine squamous cell carcinoma and, less commonly, adrenocarcinoma due to long-term use of the pill. In addition, the pill causes the formation of a certain type of cervical mucus, which makes it easier for the cancer agent to enter a woman's body, and vitamin and mineral deficiencies have been linked to cervical cancer. specific deficiency folic acid. These deficiencies are common among hormone users and smokers. Significant increase in opportunity ectopic pregnancy. Strong likelihood of faster development of pre-existing tumors and progression of cancer from abnormal cells. Tumors such as breast cancer cells have been found to have estrogen receptors. All women who had melanoma before the age of 40 took the pill. Valerie Baral described how using the pill for more than five years significantly increased the risk of melanoma if use of the pill began ten years before the cancer was diagnosed. Considering international medical research on the undeniable relationship between the pill and various forms cancer, it is truly disconcerting and quite depressing that a government-approved tablet patient information leaflet can state the following: “There is currently no evidence from human studies to suggest that an increased risk of cancer is associated with oral contraceptives." The reality is the opposite and the evidence cannot be questioned. We are only beginning to understand the price we pay to be part of a culture dominated by fast food, quick fixes and quick sex. Safer, more effective methods of contraception, barrier methods such as the diaphragm and non-toxic spermicides and condoms are available. Women who use her technique are very in tune with their body and not only affirm health, but also avoid or receive the concept safely. Choice and control of reproductive freedom is the right of every woman in our country modern culture: 99.3% reliable computerized fertility indicators that work with sublingual baseline temperature measurements could be used even more simply, but perhaps it's time for women to rethink the whole Pill story: Women do admit that they have been the victims of a highly successful advertising and propaganda campaign which promotes the joys of sexual freedom without procreation. In fact, the hidden goal was to curb female fertility with synthetic hormones in hopes of limiting the problem of "overpopulation." Meanwhile, it has created a multibillion-dollar industry for pharmaceutical companies and medical researchers. One of the most important researchers compared the pill to the Vietnam War: "We went into it with the best intentions, and now we don't know how the hell to get out of it." Changes required for decommissioning women's health for profit, will require women, as well as conscientious health professionals, to make new choices, inform and ensure safety. For whatever reason, the health and well-being of millions of women around the world and the health of future generations no longer need to be sacrificed. Note. Part two will look at the pill's links to heart disease, stroke, embolism, nutritional deficiencies, birth defects and infertility, as well as the pill's effects on women's mental and spiritual health. The lifetime prevalence of depression is known to be twice as high in women as in men, and this figure does not vary across populations.

The drugs act on the uterine lining, as a result of which even a fertilized egg cannot attach to it. This effect of COCs serves as a guarantee of their effectiveness. The effect of contraceptives on the uterus reduces the amount of discharge during menstruation. Usage combined contraception prevents the occurrence of many pathologies associated with hormonal imbalance, for example, benign formations.

The names of monophasic tablets are as follows: “Marvelon”, “Novinet”, “Regulon”, “Ovidon”, “Rigevidon”, “Miniziston” and others. These drugs are indicated as the optimal type of birth control pill for patients under 25 years of age who have not yet gone through childbirth.

Side effects depend on the content of ethinyl estradiol: the less it is, the less unpleasant symptoms there will be. For girls who are just starting to take contraceptives, doctors advise using low-dose contraceptives.

Biphasic agents are not so diverse. These are Anteovin tablets. A positive effect is observed in women who are prone to acne and oily skin. This is an intermediate remedy between the first and second types of COCs.

Three-phase tablets regulate menstrual cycle. This category includes “Triziston”, “Trikvilar”, “Trinovum”, “Tri-regol”. The level of hormones in these products varies. Such drugs are most often prescribed for a therapeutic effect.

How to take?

Oral contraceptives are taken every day for 21 or 28 days. For more convenient use, manufacturers indicate arrows for taking the drug. You need to take these medications from the first day of menstruation. It is very important to stick to the same dosing time. When taken correctly, hormones will be better absorbed in the body.

If you need to take contraceptives with 21 tablets in a package, then after 21 days you need to pause for seven days and start all over again. During these seven days, the effect of contraception will be the same, and additional methods of protection should not be used. If your package of the drug consists of 28 tablets, then there is no need to take any breaks. After 12 months of taking the COC, you should stop using it for three months.

Oral contraceptives may be incompatible with certain medications. When combined with these drugs, the contraceptive effect is reduced. When your doctor prescribes certain medications, it is worth informing him that you are taking COCs. You may be prescribed other methods of protection, such as barrier contraception or other pills with higher levels of hormones.

To choose combined oral contraceptives, you should definitely visit your doctor, who, based on the results of the research, will prescribe the most effective remedy.

Principles of individual reception

Drug selection scheme:

Interviewing the patient, establishing her gynecological status, identifying the advisability of using this type of contraception.
Definition of a contraceptive with its properties and therapeutic effect (if necessary).
Observation of the patient for several months, analysis of effectiveness and tolerability. If necessary, another drug is prescribed.
Monitoring the patient throughout the entire period of admission.

When interviewing a woman, probable risks are identified. It must include the following questions:

How do menstruation occur?
Last day of menstruation, whether menstruation was normal.
Regularity of the cycle. If the answer is negative, it is imperative to establish the reasons.
Have you had any pregnancies in the past, and how did they proceed?
Were there any abortions?
Has it been used before? oral contraception and which one exactly.
A general survey including age, body weight, presence of bad habits and chronic pathologies.
What diseases do you have in your family history?

Diagnostic tests that are needed:

Smear collection for microflora and cytological examination.
An ultrasound should be performed before and after menstruation. The growth and maturation of uterine secretions, the process of ovulation, etc. are analyzed.
You need to visit a mammologist to rule out malignant tumors of the mammary glands.
If necessary, the hormone content is determined.

After three months after taking the medications, you need to visit a specialist again to monitor the influence of hormones and to determine your overall health. After this, you need to visit the doctor regularly every six months.

Pros of combined contraceptives

high percentage of efficiency;
fast action;
excellent tolerability;
ease of use;
lack of connection with intimacy;
regulation of menstruation;
after a woman stops taking COCs, reproductive function is completely restored within several months;
harmlessness for healthy patients;
therapeutic and preventive effects;
reducing the risk of pregnancy;
urgent contraceptives.

Cons of COCs

decreased effectiveness when combined with certain drugs;
the need to take pills regularly;
missing a pill increases the chances of unwanted conception;
some side effects are possible;
do not protect against infection and STDs.

If we talk about the disadvantages, it is worth noting that many women would note gaining excess body weight. Weight gain of several kilograms usually occurs at the beginning of taking pills, which is associated with fluid retention in the body. COCs may also increase appetite, leading to weight gain. But each body is individual, and for some women, these drugs, on the contrary, cause a decrease in body weight or have no effect on weight at all.

Women who are active sex life.
For those who want to have reliable protection against unplanned pregnancy.
Patients who have not yet given birth.
Girls in adolescence who are sexually active.
Patients after an abortion.
Women with painful and irregular menstruation.
Girls with acne.
Suffering from anemia.
For those who have had an ectopic pregnancy.
Mothers during lactation.
Postpartum mothers who do not breastfeed.
Those who have high levels of male hormones.
Women whose relatives had ovarian pathologies, such as cancer and others.

What to do if you forget to take your pill?

With each missed pill, the chances of an unplanned pregnancy increase. But if you forget to take it, there is no need to panic.

Take the remedy as soon as you remember. Further reception is carried out according to the standard scheme. In this case, the risk will be minimal, but if you still forgot to take an oral contraceptive at the time of ovulation, then protect yourself with additional methods, for example, use barrier contraception, etc.

The principle of operation of modern drugs to prevent pregnancy is that skipping one pill for less than twelve hours has absolutely no effect. If you are worried about this, it would be a good idea to contact the doctor who prescribed this contraceptive for you.

If you missed two tablets, it is recommended to use other protective methods until the onset of menstruation. To ensure that the effect of the drug does not decrease, take two tablets as soon as you remember, regardless of the time of day. The next day, take one tablet in the morning and take one in the evening.

Such actions are explained by the fact that COCs can be used as emergency contraception. In this case, the woman may experience bloody discharge, which is due to exposure to a large dose of hormones. However, such manifestations can last no more than three days. If alarming symptoms persist for a longer period, you should definitely visit a doctor.

If you have missed more than three tablets, then you should definitely start using other means of contraception. At the same time, it will be possible to resume standard COC use after menstruation. If you cannot take contraceptives regularly, then it is better to give preference to other methods of contraception that will be more acceptable to you. Irregular or intermittent use can have a negative impact on health.

Recovery after taking

After stopping the use of contraceptives, fast recovery reproductive system. According to research, approximately 90% of patients can become pregnant within a year. The use of COCs before conception does not adversely affect pregnancy, and even early stages Taking pills, which can happen accidentally, does not pose a threat to the child. However, at the first signs of pregnancy, a woman should immediately stop taking the drug.

What are the contraindications for use?

One hundred percent contraindications under which these combined oral contraceptives should not be taken under any circumstances are the following:

pregnancy or symptoms indicating this condition;
period of six months after childbirth;
liver pathologies;
heart disease;
formation of the pituitary gland;
malignant formations of the mammary glands;
diabetes in a severe stage;
mental disorders.

with high blood pressure, excess weight;
with regular smoking over the age of 35;
if it is necessary to perform surgery, stop taking the drug a month before the intervention;
taking certain antibiotics and other drugs, the combination of which with COCs should be discussed with a specialist.

How long can you use COCs?

Regular use of birth control pills without interruption by specialists is still a serious cause for discussion.

Today, there are more and more specialists who allow long-term use of drugs until the woman plans a pregnancy and until she is completely satisfied with this method of contraception.

Many doctors argue that with a reasonable choice of means, the duration of use does not increase the risk of unwanted consequences at all.

Taking breaks from taking these medications, according to many experts, is very dangerous, since in this case the chances of pregnancy increase. Other experts, on the contrary, believe that it is necessary to take breaks for several months. This way the body will have a rest from the usual doses of hormones.

Absolutely all doctors believe that if a woman has chosen this method of contraception, she should regularly visit the doctor during the entire time she is taking the drug. Remember that under no circumstances should you stop using COCs mid-cycle on your own, as this can lead to serious health consequences.

Regarding the effect of alcohol on the body when using COCs in reasonable quantities of alcohol (2 glasses of wine), we can say that the protective effect is not reduced.

Among the variety of drugs, it is very difficult for women who decide to use this type of contraception to choose the most optimal option for themselves. In the absence of contraindications for use, healthy women are most often prescribed low-dose or micro-dose drugs. However, in order to determine the right remedy for yourself, you need to contact a specialist and conduct a series of diagnostic studies.

When choosing contraceptives, you should take into account all contraindications, effectiveness, age factor, and general health. Today there is no such thing contraceptive method, which would guarantee one hundred percent effectiveness without health risks.

Dear friends, hello!

Why are there so many of them? Or rather, WHY? Was it really impossible to release 3-4 drugs and stop there?

Why fool women, obstetricians-gynecologists, and pharmacists who are forced to answer the eternal question of their customers, “which is better?”

Moreover, often they, in the sense of buyers, want to know everything “here and now”, and categorically do not want to go to the doctor to get a prescription for a remedy for women’s “”.

But you will have to... You know better than me how many contraindications are indicated in the instructions for hormonal contraception, and how many side effects they can cause.

Let's try to understand the abundance of hormonal pills that leave the stork almost no chance to bring a human baby to the couple in its beak.

But this article is not intended for you to choose a hormone on your own!

Always, when I start talking about prescription drugs, I am afraid that you will use this information in your own way and will recommend them left and right, as, unfortunately, happens.

As I begin this conversation, I set myself four goals:

To structure information about hormonal contraceptives for you.
Show their differences from each other.
Analyze the principles by which doctors recommend this or that remedy.
To scare you, as well as those who will read these lines. Because I believe that in this matter it is better to be over-safe than under-safe. :-)

And again about the menstrual cycle

We have already talked about the female reproductive system and the menstrual cycle.

Before we start analyzing hormonal contraceptives, I will remind you of the story that happens in a woman’s body every month.

The hypothalamus and pituitary gland control the menstrual cycle.

It all starts with the hypothalamus instructing the pituitary gland to release follicle-stimulating hormone into the blood.

Under his strict guidance, several follicles with eggs inside begin to grow and mature in the ovaries, synthesizing estrogens, which are necessary for their maturation. After some time, one of the follicles breaks forward in its development, while the others resolve.

Meanwhile, in the uterus, under the influence of estrogens, the preparation of a “pillow” for the fertilized egg begins, so that it feels warm, cozy and nourishing there. The uterine mucosa thickens.

On average, after 2 weeks from the beginning of the cycle, the level of estrogen reaches its maximum, and the egg reaches its “coming of age.” The “signal signal” for its exit from its native nest is the release of luteinizing hormone by the pituitary gland (in response to an increase in estrogen levels). The follicle bursts, the egg is released (this is called ovulation), enters the fallopian tube and makes its way into the uterine cavity.

And in place of the burst follicle, a corpus luteum is formed, which produces progesterone.

Progesterone is eagerly involved in the process of preparing the uterus to welcome a fertilized egg. It loosens the endometrium, one might say, “fluffs the feather bed” for newlyweds (if a fateful meeting takes place), reduces the tone of the uterus in order to preserve, changes the properties of cervical mucus to prevent infection, and prepares the mammary glands for a possible pregnancy.

If fertilization does not occur, the level of progesterone drops, and the overgrown functional layer of the endometrium is rejected as unnecessary. This is menstruation.

The maximum level of estrogen occurs during the period of ovulation, and progesterone - approximately on the 22-23rd day of the cycle.

Hormonal contraception for different target audiences

I divided all hormonal contraceptive drugs into 3 groups:

For those in charge.
For busy or “happy” people.
For the irresponsible. :-)

The first two groups are intended for those who have regular sex life with one partner, since they do not protect against sexually transmitted infections, which casual relationships are famous for. True, life with one partner does not always save you from them, but we will assume that everyone is faithful to each other, like swans, and none of the couple walks either to the left or to the right, or diagonally, or in a circle.

To the group "for those in charge"(according to my classification) includes drugs that need to be taken every day and preferably at the same time.

These include:

Combined oral contraceptives. They contain a COMBINATION of estrogen and gestagen, simulating the menstrual cycle. Hence the name.
Mini-drinks. This is the name for products containing only gestagen.

Agree, not every woman (due to girlish memory) will be able to swallow pills every day, and even at the same time, often for several years.

In a group “for busy or “happy” there are medications that do not need to be used every day, so there is a risk of missing a dose birth control pill decreases.

“Happy” because, as the classic said, “ Happy Hours They’re not watching.”

Those who are very busy, overwhelmed with their problems beyond the roof, can remember about the pills after a few days, or even only in the absence of red days on the calendar. Therefore, the optimal thing for them is something that they stick on, insert, inject, and forget about for a few days/months/years.

Drugs of this group are especially convenient for conductors, flight attendants, for those who constantly travel on business trips, tours, competitions, and at the same time, as I said, manage to have a regular sex life.

It has 5 subgroups:

Transdermal therapeutic system Evra.
Vaginal ring NuvaRing.
Intrauterine devices.
Contraceptive implants.
Contraceptive injections.

To the group "For the irresponsible" I placed emergency contraception. Sorry if I offended anyone. :-)

As a rule, they are taken by those who are in search of unearthly happiness, who like to “relax” on holidays and weekends, who lose the remnants of their sanity when heard in their ears with a breath: “Honey, having sex with a condom is like smelling a rose in a gas mask,” and hopes for “maybe.”

Total turned out total 8 subgroups, which we will analyze in order.

Combined oral contraceptives

Combined oral contraceptives (COCs) were invented by men in the 1960s. These were chemist Carl Djerassi, pharmacologists Gregory Pincus and John Rock. And the first oral contraceptive was called Enovid.

What prompted them to this invention, history, of course, is silent. Perhaps they were driven by the desire to save their loved ones from frequent “headaches.”

The first contraceptive contained just horse doses of estrogen and gestagen, so against the background of their use, women began to grow in the wrong places, acne appeared on the body, and some even died from a heart attack or stroke.

All subsequent research was aimed at increasing the safety of oral contraceptives and reducing the number of side effects. Doses of estrogen and gestagen were gradually reduced. But it was important not to cross the line when the contraceptive effect was at risk.

This process continues to this day, since the ideal COC has not yet been invented, although colossal progress has been achieved in this direction.

You may have heard of the Pearl Index. This is the failure rate, which shows the number of pregnancies per 100 women using a particular method of contraception.

So that you understand: for modern COCs it is less than one, while for condoms it is 10, for spermicides and lovers of coitus interruptus - 20.

How do combined oral contraceptives work?

Since there are estrogens in the body (which come from outside), the hypothalamus understands that “everything is calm in Baghdad” and does not give the command to the pituitary gland to produce follicle-stimulating hormone.
Since follicle-stimulating hormone is not produced, the follicles in the ovaries are in a half-asleep state, they do not produce estrogen, and if they grow, they grow very sluggishly and reluctantly. Therefore, the egg does not mature.
If the egg cannot reach the age of majority, it is deprived of the opportunity to leave its parental home and go in search of a spouse. There is no ovulation.
Since estrogen levels do not increase, luteinizing hormone is not released, the corpus luteum is not formed, and progesterone is not produced. Why is it needed? After all, it comes from outside.
This same “foreign” progesterone thickens the mucus produced by the glands of the cervix, and no matter how fast the sperm are, they cannot penetrate the uterus.
There is another level of protection: since in a woman’s reproductive system, while taking COCs, what should be happening is not happening, the uterus cannot prepare a “cushion” to receive a fertilized egg. The functional layer of the endometrium grows quite a bit. Then it will come out in the form of menstrual-like bleeding. And even if by some miracle the egg matures in spite of all its enemies, comes out of the follicle, and the sperm overcomes all obstacles, and they merge in a fit of passion, then the fertilized egg will not be able to settle on the lining of the uterus.

So what happens?

It turns out that when a COC enters the body, the estrogen and gestagen that come in their composition signal the hypothalamus that everything is OK in the body, there are enough necessary hormones, everyone is happy and calm, in general, EVERYONE SLEEP!

And a sleepy kingdom begins in the female reproductive system...

So COC is a deep anesthesia for the hypothalamus, pituitary gland, and ovaries. Deception of nature. Everyone sleeps quietly, snoring and making timid attempts to rehabilitate themselves only on the rare days of a hormone-free interval.

Hormonal contraception: secrets of medical prescriptions

To be honest, until I delved into this topic, I thought that in order to select a contraceptive, a woman needs to be carefully examined for hormonal status, the presence of malignant tumors, condition, coagulation system, etc.

It turns out there is nothing like that!

The obstetrician-gynecologist questions the woman in detail to determine her health problems, lifestyle, readiness and ability to take pills daily.

The doctor finds out:

Is the woman breastfeeding her baby?
How long has it been since your last birth?
Is there a mass in the mammary gland of unknown origin?
Is there any damage to the heart valves?
Do migraines happen? With or without aura?
Is there? If so, is it compensated or not?
Have you had a heart attack or stroke in the past, or is there any ischemic heart disease?
Are there any serious problems with the liver and biliary tract?
Have you had thrombophlebitis or pulmonary embolism in the past?
Are you planning a major surgical operation in the near future, which in itself dramatically increases the risk of thrombosis and pulmonary embolism?

With love to you, Marina Kuznetsova