Monophasic low-dose contraceptives. Video: Oral contraceptives

Most people, due to a lack of knowledge in the field of medicine, consider hormonal drugs to be something terrible that bring a huge amount (from weight gain to significant hair growth). Such fears are unfounded. An example is hormonal pills for women. These drugs are widespread and effective in their use. What hormones are, why they are taken, and which of them are the best is discussed in the article.

Hormonal medications include synthetic hormones or hormonoids (substances that have similar properties). Hormones are produced by glands of the endocrine system. Entering the blood, they spread throughout the body and reach target cells, on which they have a direct effect. Specific reactions occur there that control the vital functions of the body.

All hormonal medications can be divided into the following types:

• pituitary gland preparations - representatives are and, which is known to every woman;
• – used in the treatment of insufficient or excessive synthesis of hormonally active substances;
• pancreatic agents (based on);
• parathyroid preparations;
• hormones of the adrenal cortex - glucocorticosteroids, which are used in most areas of medicine to relieve insufficiency, inflammatory and allergic processes;
• preparations of sex hormones (progestins, androgens);
• anabolic steroids

What are hormonal drugs used for?

Hormonal drugs are used to treat and prevent a number of pathological conditions, namely:

• as contraception;
• for replacement treatment during menopause and menopause, this also includes men with androgen deficiency;
• treatment of inflammatory and allergic diseases;
• replacement therapy for deficiency of certain hormones;
• as part of the complex treatment of tumor processes.

Female hormonal drugs are used for the following purposes:

• menstrual irregularities;
• prevention and treatment of anemia;
• period after ectopic pregnancy;
• postpartum contraception (3 weeks after the end of lactation);
• therapy of gynecological pathologies;
• condition after abortion.

Features of oral contraception

The history of contraception goes back to ancient times. Everything was not used until the structure of steroidal hormonally active substances was studied and the suppressive effect of high doses of sex hormones on ovulation was discovered. This included interrupted sexual intercourse, various cases soaked in infusions and decoctions of herbs, fish bladders, and prolonged breastfeeding.

The use of hormones began in 1921, when the Austrian professor Haberlandt confirmed the possibility of inhibiting the ovulation process by introducing an extract from the ovaries themselves. It was first synthesized in the USA in 1942, and used in 1954. The negative point was that the hormones in the tablets contained at that time a significant dose of the active substance (tens of times higher than what a woman now takes), and therefore caused weight loss. side effects.

Modern agents that are well tolerated were synthesized in the 90s of the 20th century. How effective a drug is is assessed by the Pearl Index. This indicator clarifies the possibility of pregnancy within 12 months of regular use of the drug. The index of modern hormonal drugs ranges from 0.3% to 3%.

Hormone-based contraceptives:

• combined;
• mini-pills (non-combined);
• drugs for urgent contraception.

Combined hormonal agents

COCs are a group of the most popular modern contraceptives. They contain estrogen (ethinyl estradiol) and gestagen (norgestrel, levonorgestrel, desogestrel) - hormonoids similar in their action to female sex hormones.

Depending on the dosage, as well as the ratio of gestagens and estrogens, several groups of hormonal tablets are distinguished:

1. Monophasic - have the same dosage of active substances in each tablet of the package.
2. Biphasic - the amount of estrogen is constant, and the dose of gestagen varies depending on the phase of the cycle.
3. Three-phase - variable content of hormones in the composition.

The last group is considered the most physiological. It contains three types of tablets. The amount of hormones in each type depends on the phase of the menstrual cycle. The first 5 tablets correspond to the follicular phase, the next 6 tablets imitate the periovulatory phase, the remaining 10 - the luteal phase. The amount of estrogen in each of the tablets is maximum, and the level of progestogen gradually increases, reaching its highest levels by the third phase of the cycle.

Mechanism of action

All hormone-based contraceptives are aimed at preventing the production and release of active substances, the action of which is associated with ovulation and implantation of the fertilized egg into the uterine cavity. The gonads decrease in size, as if “falling asleep.”

The drugs have the property of making cervical mucus thicker, which prevents a significant number of sperm from penetrating into the uterus. In addition, there is a change in the functional state of the endometrium, it becomes thinner, and its ability to attach the fertilized egg to itself decreases, if conception does occur.

Reviews from women who use products from this group confirm the effectiveness of use under the age of 35. The package contains 21 tablets of the same color. There may be a strict usage pattern, but it is of little value since all tablets have the same composition. The following is a list of the most popular and effective remedies.

The drug contains 30 mcg and 2 mg of dienogest. Regular intake has the following features:

• Pearl index does not exceed 1%;
• has androgenic activity - taken by women with elevated levels of male hormones;
• normalizes blood cholesterol levels.

A good product made in Germany. Gestagen is represented by gestodene (75 mcg). Available in the form of dragees. It is not advisable to use with other medications, as the risk of uterine bleeding increases.

The product is the most popular representative of the group. Drospirenone acts as a gestagen. Properties are similar to the drug Janine. In addition to lowering cholesterol and anti-adrogenic effects, Yarina has a positive effect on the condition of the skin. This explains why dermatologists prescribe tablets in the treatment of acne and acne.

It is an analogue of Logest. Significant differences are the country of manufacture, the color of the tablet shell and the slightly higher estrogen content in the composition.

The name of this representative is also constantly heard. Contains ethinyl estradiol and cyproterone acetate. The product is the drug of choice for those women who have an increased level of hair growth, since the gestagen included in the composition has a powerful antiandrogenic effect.

One of the well-tolerated drugs, eliminating the formation of edema, weight gain, and increased appetite. Drospirenone, which is part of the composition, has the following features:

• softens the effect of estrogen;
• relieves manifestations of premenstrual syndrome;
• reduces blood cholesterol levels.

Monophasic drugs do not end with this list. There are also a significant number of representatives:

• Miniziston;
• Mercilon;
• Silest;
• Regividon;
• Dimia;
• Midiana.

Two-phase and three-phase agents

Experts prefer monophasic drugs to representatives of these groups due to fewer side effects. Biphasic ones are rarely used, which is why among them there are tablets whose names are not familiar even to pharmacists: Femoston, Anteovin, Binovum, Neo-Eunomin, Nuvelle.

Three-phase drugs, due to their physiological composition, are more popular, however, side effects and complications when taking them are no less pronounced. The representative of the group will be called as follows: the name begins with the prefix “three”. For example, Tri-regol, Tri-mercy, Trister, Triziston.

The tablets are colored differently depending on the phase of administration. Such drugs must be taken strictly according to the regimen that comes with the package.

Advantages and disadvantages

Modern contraceptives have a lot of positive qualities, which makes them widely used:

• fast effect and high reliability;
• the ability of the woman herself to control the state of her fertility;
• knowledge of the means;
• low incidence of side effects;
• ease of use;
• lack of influence on the partner;
• reducing the possibility of developing an ectopic pregnancy;
• positive effect in the presence of benign tumor processes of the mammary gland;
• prevention of tumor processes of the female reproductive system;
• relief of manifestations of dysmenorrhea;
• positive effect on the condition of the skin, gastrointestinal tract, and musculoskeletal system.

The negative aspects of COCs include the need for regular use according to a specific regimen, as well as the possibility of delaying subsequent ovulation cycles after discontinuation of the drug.

Contraindications

Absolute contraindications for prescribing COCs include pregnancy, malignant tumors of the reproductive system and mammary glands, pathology of the liver, heart and blood vessels, acute thrombosis or thrombophlebitis, as well as uterine bleeding of unknown etiology.

Pathological conditions that create problems during the period of drug use include:

• arterial hypertension;
• epileptic condition;
• migraine;
• depression, psychosis;
• diabetes mellitus of any type;
• chronic liver pathologies;
• bronchial asthma;
• tuberculosis;
• porphyrin disease is a pathology of pigment metabolism, accompanied by a high level of porphyrins in the blood and their massive excretion in urine and feces;
• benign tumors of the uterus;
• upcoming immobilization or surgery.

There are a number of factors that reduce the effectiveness of the products used. These include dyspeptic symptoms in the form of vomiting and diarrhea, taking laxatives, antibiotics, and anticonvulsants. If vomiting and diarrhea occur within 3 hours of taking the last tablet, you need to take an additional one.

What are progestin oral contraceptives?

These are alternative drugs (mini-pills) that contain exclusively gestagens. Hormones from this group are needed in the following cases:

• older women;
• during lactation;
• those who smoke;
• those for whom COCs are contraindicated;
• patients with hypertension.

Progestin contraceptives have a higher Pearl index. It can reach 4%, which is a negative point for the contraceptive process. Representatives: Levonorgestrel, Charozetta, Ovret, Micronor.

Reception scheme

The tablets must be taken once a day at the same time. If a woman misses a dose, then she should take hormones as soon as she remembers, even if she has to take two tablets at the same time.

If a woman remembers the pill no later than 12 hours from the time she needed to take it, the contraceptive effect remains, but after 12 hours, additional methods of protection should be used.

Urgent remedies

Emergency contraception is represented by drugs used in times of emergency. These drugs contain significant doses of hormones that prevent the ovulation process or change the functional state of the endometrium of the uterus. The most famous are Postinor, Escapelle, Ginepriston. Cases when there is a need to take such drugs should be as rare as possible, since they cause a huge hormonal surge in the body.

How to choose an oral contraceptive

The specialist assesses the hormonal balance of the patient’s body and determines what minimum dose of the drug will be able to show the desired effect. The dose of estrogen should not be higher than 35 mg, and the dose of gestagen (in terms of levonorgestrel) - 150 mcg. The doctor also pays attention to the woman’s constitutional type. There are three main types:

• with a predominance of estrogen;
• balance;
• with a predominance of gestagens.

Representatives of the first type are suitable for those products that have an increased dose of gestagens, the third - with an increased level of the estrogen component. If a woman has signs of an increased amount of male sex hormones, the ideal option would be to use drugs with an enhanced antiandrogenic effect.

The gynecologist also evaluates the condition of the patient’s reproductive organs. Heavy menstruation over a long period, increased size of the uterus are factors in increased estrogen levels in the body. Scanty menstruation in combination with uterine hypoplasia indicates high levels of gestagen.

Currently, the most used are combined mono- and triphasic oral contraceptives, which have a low dose of hormonally active substances included in the composition. These products have the same effectiveness and safety if you follow the rules for their use. The choice between specific representatives is made on the basis of each individual clinical case. Confirmation that the contraceptive has been chosen correctly is the absence of uterine bleeding or bloody discharge between menstruation.

Bibliography

1. Obstetrics: course of lectures. UMO stamp for medical education. Strizhakov A.N., Davydov A.I., Budanov P.V., Baev O.R. 2009 Publisher: Geotar-Media.
2. Obstetrics. National leadership. UMO stamp for medical education. Ailamazyan E.K., Radzinsky V.E., Kulakov V.I., Savelyeva G.M. 2009 Publisher: Geotar-Media.
3. Preeclampsia: theory and practice. Ailamazyan E.K., Mozgovaya E.V. 2008 Publisher: MEDpress-inform.
4. Intrauterine infection: Management of pregnancy, childbirth and the postpartum period. UMO stamp for medical education. Sidorova I.S., Makarov I.O., Matvienko N.A. 2008 Publisher: MEDpress.
5. Clinical recommendations. Obstetrics and gynecology. Savelyeva G.M., Serov V.N., Sukhikh G.T. 2009 Publisher: Geotar-Media.

Today, every couple can plan to have children and control their sex life thanks to the pharmaceutical industry. A huge selection of contraceptives allows you to choose the appropriate method of protection against pregnancy and/or sexually transmitted infections.

Review of some contraceptives

The list of means and methods of protection includes a dozen items or more. This includes the calendar method, the use of spermicides (the so-called non-hormonal tablets and suppositories), and common condoms, and hormonal patches, rings, and the intrauterine device, and injections, and patches, and oral contraceptives. Read more about each method, especially birth control pills, below.

Coitus interruptus

The most unreliable options for preventing pregnancy are interrupted sexual intercourse and the calendar method. In general, PPA can hardly be called a method of contraception. The essence of the method is to remove the penis before ejaculation begins.

In 60% of couples who use PPA protection, pregnancy occurs in the first year of using the method. And according to statistics, 80% of women who became pregnant “accidentally” were protected by interrupted sexual intercourse. The problem is that not all men feel the onset of ejaculation. One “wrong” move, and the likelihood of getting pregnant increases significantly.

Calendar method

The method is slightly more effective than the previous one - 65%. For every hundred women who take the risk of using this method, there are 10-15 pregnancies per year. This method becomes more relevant after 30 than for young girls. Only girls and women with a regular menstrual cycle can afford to protect themselves in this way.

The essence of the method is to calculate the so-called dangerous days on the calendar and not have sex during this period. In general, from the 16th day until the expected start of the next period, the probability of conception is greatest. The most dangerous days fall in the middle of the cycle - from the 12th to the 18th day of the cycle (with a 28-day cycle).

Cons: errors, irregular cycle, in which it is almost impossible to accurately calculate the day of ovulation, hormonal imbalances. There are other nuances - if sexual intercourse occurred several days before the expected ovulation, sperm can live in the genital tract for several days and fertilize the egg even after such a seemingly long time. To increase the reliability of this method of contraception, you need to learn how to correctly calculate dangerous days. In addition to the calendar method, you can use ovulation test strips or monitor basal temperature charts.

Spermicides and non-hormonal tablets

Another not very effective method (70% reliability) is spermicides. These are special substances that are introduced into the vagina and negatively affect sperm, after which they can no longer fertilize a woman’s egg. Products with a similar mechanism of action are sold in pharmacies in the form of suppositories, creams, capsules or tablets, which are administered directly orally before sex.

Such non-hormonal ones (which ones are better to choose, reviews of different types - below) are used by many women who, for one reason or another, are afraid to take conventional OCs (oral contraceptives). Such non-hormonal tablets are recommended for use in premenopausal women, patients with impaired functioning of the endocrine system, individual sensitivity and adverse reactions to conventional OCs. What is important, these can be used during breastfeeding (breastfeeding).

How to choose non-hormonal contraceptives? The ranking of the best is presented by the following tablets:

1. "Pharmatex". Available in the form of tablets, cream and suppositories. The average price of a package of 12 tablets is 250 rubles.
2. "Gynekotex". The same release form, price - 100 rubles for the same 12 tablets.
3. "Benatex". The cost of 10 tablets is 250-300 rubles.
4. "Erotex". Price 5 pcs. - 110 rubles.
5. "Contratex".

How to choose tablets? It is advisable to consult a doctor; otherwise, you should rely on your personal feelings when using it. Some pills, for example, cause itching in some women, which goes away when they switch to a different brand of medication.

Barrier contraception

Barrier methods protect not only from conception and unwanted pregnancy, but also from infections transmitted through sexual contact. But the reliability of such means is not 100% (moreover, no contraceptive means is 100% reliable, except complete abstinence from any sexual intercourse), but is only about 85%. Barrier methods include the use of condoms, but they can also break, and then all efforts will go in vain and blur the sensations of sexual intercourse.

Hormonal patches and ring

Other non-invasive methods include patches and hormonal rings. The effectiveness of such products reaches 92%. The patch adheres to the skin, but it is noticeable, requires regular replacement and is not suitable for use by women weighing more than 90 kg. The ring is inserted into the vagina, but also has disadvantages: in some cases it can cause a change in the nature of menstrual bleeding and disrupt the regularity of menstruation. These methods do not have additional contraceptive effects, such as treating acne, relieving PMS symptoms or preventing seborrhea.

Implants and injections

Hormonal implants and injections are essentially the same oral contraceptives, i.e. birth control pills, only with a different mechanism of action. If substances from tablets are absorbed through the digestive tract, then injectable contraceptives are administered intramuscularly. The frequency of injections is once a month or every three months. Implants are inserted into the shoulder and require replacement only once every five years. The effectiveness of the methods is 90-99%.

Such contraception, however, can cause migraines, changes in the menstrual cycle, hormonal imbalances, decreased sex drive or weight gain. Injections and implants, as a rule, are not used by young women who have not yet given birth; this method of contraception is more suitable for women between thirty and forty years old who do not plan to have a child in the near future.

Intrauterine device

The second most effective method of contraception after birth control pills is the intrauterine device. The method also refers to the barrier method, only the spiral is installed in the uterine cavity, preventing the embryo from fixing. But installing an IUD can cause changes in the nature of menstruation, sometimes causes pain, and increases the risk of developing various inflammations and the occurrence of an ectopic pregnancy.

Oral contraceptives

Oral contraceptives protect against unwanted pregnancy, but not against diseases transmitted through sexual contact. The newest birth control pills also have an additional effect: many drugs contain the active form of folic acid, so they relieve PMS symptoms, have an antidepressant effect, help fight acne, and improve the condition of the skin and hair. The reliability of OCs is 99.7%, but this method of contraception requires prior consultation with a gynecologist and the woman’s attentiveness and organization when taking it. It is this method of planned contraception that will be discussed further.

Classification of OK according to hormone content

All are divided into 2 large groups: combined oral contraceptives (COCs) and mini-pills. COCs contain an estrogen analogue and a progestogen. The mechanism of action of such tablets is that they block the onset of ovulation (the maturation of the egg and its readiness for conception), make implantation of the egg into the uterine cavity impossible due to “glandular regression” and thicken the mucus, which disrupts the movement of sperm to the female reproductive cell.

COCs are divided into groups according to the variation of hormones and their content. Thus, there are monophasic, two- and three-phase tablets (more about them below), as well as micro-dose, low-dose and high-dose COCs. Microdosed OCs are suitable for young girls, since the content of active substances in the tablets is minimal. The rating of birth control pills of this type is presented as follows:

1. "Jess."
2. "Marvelon".
3. "Klayra" (the only three-phase tablets in the list of microdosed ones).
4. "Dimia."
5. "Zoeli."
6. "Logest".
7. "Mersilon".
8. "Lindynet."
9. "Novinet."

Low-dose OCs are suitable for both young and more mature women; they can be used by those patients who experience intermenstrual bleeding when using microdosed tablets. These birth control pills are suitable for women who have given birth. In addition, low-dose OCs prevent hair growth in unwanted places, eliminate oily skin and acne, and reduce the manifestations of seborrhea.

1. "Yarina.
2. Tablets "Janine".
3. "Silhouette".
4. "Diana."
5. Femoden tablets.
6. "Tri-mercy."
7. "Lindynet."
8. Tablets "Silest".
9. "Miniziston" and others.

High-dose OCs can be taken only on the recommendation of a gynecologist. Such drugs are generally used for therapeutic purposes (for the treatment of endometriosis, hormonal disorders and other diseases). In the rating of birth control pills with a high concentration of hormones, the following are OK:

1. "Non-Ovlon."
2. "Trikivlar."
3. "Ovidon".
4. "Triseston".
5. "Tri-Regol."

Another type of contraceptives - mini-pills - contains only progestogen. The mini-pill affects the reproductive system only at the local level:

• increase the viscosity and amount of cervical mucus, which interferes with the free movement of sperm;
• change the biochemical and morphological structure of the uterine endometrium, which makes it impossible for the embryo to attach even in the case of fertilization.

Mini-pills completely block ovulation in only half of women, but this does not affect the reliability of the pills as a method of birth control.

1. "Charozetta" (800 rubles per package).
2. "Laktinet" (530 rub.).
3. "Orgametril" (1100 rub.).
4. "Exluton" (1250 rub.).

There is also emergency contraception, which is used if unprotected sex occurs, which can lead to pregnancy. These birth control pills are taken within 72 hours after sex. A common example of this type of OC is Postinor. You need to take birth control pills within 72 hours after sexual intercourse, otherwise emergency contraception will not have any effect. Such drugs cannot be used constantly.

Monophasic, two- and three-phase drugs

COCs also differ in variations in hormone content, being divided into monophasic, biphasic and triphasic. In monophasic tablets, the percentages of substances do not change in each tablet; in biphasic tablets, the ratio of active components changes in the first and second halves of the cycle; in three-phase tablets, the percentage of substances changes three times per package.

Monophasic birth control pills:

• "Regulon";
• "Rigevidon";
• "Janine";
• "Silhouette";
• "Lindynet";
• "Logest";
• "Femoden";
• "Mikrogynon" and others.

Two-phase OK:

• "Femoston";
• "Binovum";
• "Bifazil";
• "Adepal";
• "Anteovin" and others.

Three-phase are represented by the drugs "Tri-Mercy", "Triziston", "Tri-Regol" and others.

How to choose the right birth control pills

You cannot choose birth control pills on your own or even with the help of a pharmacist at a pharmacy. To find the right contraceptive, you should definitely see a doctor. The gynecologist will interview the patient, find out if there are any diseases (whether they were in the past) and which ones, and conduct an examination. During the examination, the gynecologist will measure the patient’s weight, blood pressure, assess the condition of the skin, palpate the breasts and prescribe tests. You may also need to visit an ophthalmologist, since long-term use of OCs increases the risk of various eye diseases.

The doctor chooses the tablets that are best suited for the patient depending on the phenotype. The phenotype takes into account the woman’s height and appearance, mammary glands, degree of hair growth, condition of the skin, hair, existing chronic diseases, the nature and frequency of menstruation, the presence and severity of PMS, and so on.

There are three main phenotypes:

1. Women of short or medium height whose skin and hair are prone to dryness. Menstruation is heavy and prolonged, the cycle is more than 28 days. Medium- and high-dose COCs are suitable for such patients, for example, Milvane, Triziston, Femoden and others.
2. Women of average height, with hair and skin of normal oil content, with medium-sized breasts. This type of woman does not have PMS symptoms or they do not cause negative, painful feelings. The menstrual cycle is standard - 5 days, every 28 days. Suitable tablets are Marvelon, Regulon, Tri-Mercy, Silest, Logest, Tri-Regol and others (most COCs on the market).
3. Women who are tall, have underdeveloped mammary glands, oily hair and skin. Menstruation is frequent and painful, but scanty, and PMS symptoms are often severe. Tablets "Yarina", "Jess", "Zoeli", "Dimia" are suitable.

Rating of oral contraceptives

Oral contraceptives are too diverse to form an overall rating. But still, the recommendations of gynecologists and reviews of patients allow us to identify several of the best COCs of the new generation. The rating of birth control pills is represented by the following drugs:

1. "Jess." Not only do they perform a direct function, that is, they protect against unwanted pregnancy, but they also treat a number of gynecological diseases, hormone dependence, improve the condition of the skin and hair, reduce the symptoms of PMS and ease painful periods. How to take birth control pills "Jess"? According to the instructions, you need to start taking it on the first day of your period, you need to take pink pills every day, and on the 28th day you need to take white pills (placebo). After the end of the cycle, start the next package.
2. "Jess Plus". The same “Jess”, only it also contains an active form of folic acid, which normalizes the psycho-emotional state and allows you to avoid unpleasant consequences if pregnancy does occur: the body will be ready to bear a child, despite taking the pills. If the patient decides to stop taking OCs in order to become pregnant, planning can begin already in the next cycle after discontinuation. In addition, "Jess Plus" is a birth control pill that does not make you fat. The latter is confirmed by patient reviews.
3. Tablets "Janine". According to girls and women who took "Zhanine", this drug somewhat reduces libido, but is reliable. In addition, "Janine" is a birth control pill that does not make you fat, as proven by many reviews.
4. "Marvelon". OCs are recommended for use by women over 25-35 years of age who are of childbearing age but have already given birth. The hormone content is minimal, but the tablets are suitable for patients who are sexually active. Like other OCs, Marvelon improves the appearance, condition of the skin and hair, normalizes hormonal balance and reduces hair growth in unwanted places.
5. "Regulon", instructions for use, price, reviews of which are of interest to many women, costs about 1,150 rubles (63 tables). You need to take the pills daily, from the first to the twenty-first day of the cycle. This is followed by a seven-day break. After the break, you need to start taking Regulon again, even if your periods have not stopped yet. Instructions for use, price, reviews must be studied before purchasing. The opinions of patients are contradictory: some women became irritable and gained weight, noted a significant deterioration in their health and disruption of the menstrual cycle, others were completely satisfied with the drug, while other OCs were not suitable for them.
6. "Depo-Provera". The tablets are recommended for women over forty years of age and can be used in the treatment of various gynecological diseases. There are injections - doctors say that Depo-Provera is much more effective this way than in tablet form.
7. "Pharmatex". This is a non-hormonal contraceptive that is inserted directly into the vagina in the form of suppositories. It is recommended to use Pharmatex for women over 45 years of age who are sexually active.
8. "Yarina". The drug is low-dose and has an antiadrogenic effect. Some patients claim that they managed to get pregnant while taking Yarina strictly according to the instructions. How to take birth control pills "Yarina"? You need to drink OK every day, starting from the 1st day of the cycle, in the order indicated on the blister.
9. "Lactinet" is not a combination drug, but a mini-pill, which has a number of contraindications, so before you start taking it, you should definitely consult a doctor. The tablets are suitable for women over 45 years of age, patients with diabetes mellitus, varicose veins, smokers, and breastfeeding patients.
10. Birth control pills "Silhouette". Many patients note a visible improvement in the appearance of their skin and hair, stabilization of the menstrual cycle, and a decrease in pain during menstruation and PMS symptoms. But Silhouette birth control pills can cause weight gain - about half of women complain about this side effect.

Side effects of taking contraception

A reliable, safe (if you consult a gynecologist before taking it) and convenient method of contraception is birth control pills. There are, however, side effects too. Among them:

• nausea;
• absence of menstruation;
• lack of appetite;
• weight gain;
• uncharacteristic discharge between periods;
• dizziness, headaches;
• decreased libido;
• swelling of the legs;
• painful sensations in the chest.

If side effects occur, contraceptive pills are discontinued.

Contraindications for use

Contraindications to taking OCs include:

• hypertension;
• kidney pathologies;
• pregnancy;
• serious diseases of the cardiovascular system;
• migraine of unknown origin;
• preparation for surgical intervention;
• overweight (more than 30%);
• smoking after 35 years (for some tablets this fact is not a contraindication - a mandatory consultation with a doctor is required);
• diabetes mellitus (you can use some OCs) and so on.

Whether to take birth control pills is a personal choice for each woman. This is a reliable means of contraception that is convenient to use for those who are sexually active. At the same time, there are a number of side effects that occur if you choose the wrong remedy. So, the main thing to be guided by when choosing and taking birth control pills is the recommendations of a gynecologist.

Contraceptive methods for women are considered. The names of the most common contraceptives sold in pharmacies are presented.

Contraceptives are means that protect a woman from unwanted pregnancy. There are a lot of myths around hormonal pills. Many people believe that taking them is accompanied by weight gain and the inability to become pregnant in the future. We will try to dispel or confirm dubious information regarding female contraceptives.

Why should women use contraceptives?

If you ask about the most popular contraceptive, most will answer that these are condoms. But this method is inconvenient and quite expensive if you have a regular sexual partner whom you trust.

Accordingly, contraceptives are used by women to protect against pregnancy and to obtain more vivid sensations during sex. Oral contraceptives are used for medicinal purposes and help get rid of skin problems and female ailments.

What types of contraceptives are there for women?

Types of female contraceptives:

• Spermicides– ointments or gels containing substances that slow down the movement of sperm. These drugs thicken cervical mucus and prevent male cells from entering the uterus.
• Spiral– a small plastic or metal product. Placed by a doctor inside the uterus
• Oral contraceptives– pills based on female hormones. They may block ovulation or thicken cervical mucus
• Patch- hormonal contraceptive. Hormones enter the body through the skin
• Vaginal ring– a silicone or plastic ring that contains a small dose of hormones. Set for 21 days. You can do this yourself without the help of a doctor.
• The natural way– calendar method. Used based on calculating periods of pregnancylessness and fertility
• Method of interrupting sexual intercourse– before ejaculation, the partner removes the penis from the vagina

Barrier contraceptives for women. Pros and cons

Barrier contraception is a method of preventing pregnancy by using mechanical barriers to prevent sperm from entering the uterine cavity. Barrier contraception includes local chemical agents that inhibit sperm activity. Barrier contraceptives include: sponge, diaphragm, cap, female condom, suppositories, ointments, gels.

Advantages:

• Can be used immediately before sexual intercourse
• Protects against most sexually transmitted diseases (spermicides)
• High reliability
• Can be used by parous and nulliparous women
• Low price
• Rapid restoration of reproductive function

Flaws:

• Less reliable compared to hormonal contraceptives
• Often cause allergies and itching
• Reduce sensitivity

Chemical contraceptives for women

This is a barrier contraception based on reducing sperm activity using chemicals. Often cause allergies and burning. High degree of protection and low price. Below is a list of popular spermicides.

Non-hormonal contraceptives for women, list

These substances are barrier contraceptives. Their effectiveness is due to a decrease in sperm activity. Some of the products even kill sperm.

List of chemical non-hormonal contraceptives:

• Pharmatex– a drug produced in the form of suppositories, sponges, cream and gel. This is a regular spermicide that contains benzalkonium chloride, an antiseptic. Accordingly, the drug can be used when having sex with casual partners. Effective period: 3 hours after insertion into the vagina
• Benatex– Available in the form of vaginal tablets and gel. Contains spermicide and antiseptic. The drug contains no hormones, so the substance does not affect the menstrual cycle
• Pantex Oval- spermicide based on nonoxynol. Has antimicrobial and antiviral properties. Inserted into the vagina 15 minutes before sexual intercourse
• Conceptrol– available in the form of suppositories and contains nonoxynol
• Gynekotex– spermicide based on benzalkonium chloride. This is a combined substance that kills viruses and bacteria, and also reduces the motor activity of sperm.

Local contraceptives for women

These are chemical and mechanical means that either reduce sperm motility or simply prevent them from penetrating into the uterus.

Mechanical local contraceptives:

• Female condom- analogue of the male one, inserted into the vagina. One edge is fixed on the cervix, and the second will remain outside. Accordingly, it protects not only from pregnancy, but also from contracting diseases transmitted during sex
• Diaphragm- This is a dome-shaped cap made of latex or rubber. It is placed on the cervix and simply prevents sperm from entering the uterus. Can be used several times. The doctor selects this method of contraception, since the sizes of the diaphragm are different. After childbirth or due to weight gain, it is necessary to purchase a larger diaphragm
• Cervical cap- a product made of soft rubber. It is placed on the cervix using a suction cup principle. Negative pressure is created due to the compression of the cap, and it is securely fixed. Low degree of protection due to the possibility of the cap being skewed during sexual intercourse.

Hormonal contraceptives for women

• Preparations containing the hormones estrogen and progestin. They change the composition and viscosity of cervical mucus, which makes it impossible for sperm to penetrate the vagina. Some combined contraceptives inhibit ovulation. Accordingly, the egg does not mature, so pregnancy is impossible
• Mechanical products with low progestin content: patch, injections and subdermal implants. The patch can be considered the most convenient - it is a relatively new contraceptive. It contains ethinyl estradiol and norelgestromin - synthetic analogues of female hormones. Hormones enter the bloodstream through the skin. Small amounts of hormones are released every day. The action of the patch is based on reducing the thickness of the uterine mucosa, to which the embryo cannot attach. In addition, the patch inhibits the functioning of the ovaries and prevents the dominant follicle containing the egg from growing

Contraceptive injections for women. Pros and cons

In our country, this method of contraception is unpopular. This is due to the high price of the drug and the mistrust of women. The injection is given intramuscularly once every 3 months. It is necessary that the injection be administered on the 5th day of the menstrual cycle.

The essence of using the drug is that it contains progesterone, which thickens the uterine mucosa and thickens cervical mucus.

In addition, ovulation is suppressed. The injections can be used by women who have given birth and those who have not given birth. There have not been any cases of infertility reported in the world after discontinuation of the drug. Although reproductive function is restored within 6-12 months.

Advantages:

• Efficiency is 99%
• There is no need to constantly calculate the days of the menstrual cycle
• Suitable for women who smoke
• Has medicinal properties and promotes the disappearance of endometriosis, endometrial hyperplasia

Oral contraceptives for women, video

Oral contraceptives are well-known contraceptive pills with a combined hormonal composition. In the video you can watch a speech by a gynecologist regarding COCs.

Video: Oral contraceptives

Contraception for women after childbirth

Please note that combined contraceptives cannot be taken during breastfeeding. They affect the amount of breast milk.

• Mini-pill
• Hormonal injections
• Intrauterine device
• Remember, after giving birth you can’t have sex for a month, so after the discharge stops you can resume sexual activity
• If you have a regular sexual partner, then it makes sense to get an IUD or take hormonal contraceptives based on gestagens. These are synthetic hormones similar in their effect to progesterone. It does not suppress lactation and does not harm the baby’s health, since a very small amount of the drug penetrates into the milk.
• Previously, it was believed that it was possible to protect yourself after the birth of a child using a natural method. That is, due to the development of lactational amenorrhea, when there is no menstruation, it is safe to have sex. But now many doctors note the ineffectiveness of the method. Some women experience spontaneous ovulation, which will lead to an unplanned pregnancy

Contraception for nulliparous women

Many young girls are wary of taking hormonal oral contraceptives. they believe that they will gain a lot of weight and become unattractive. This is not true, since most women experience no weight gain at all or a slight weight gain of 2-3 kg.

There are rumors about numerous cases of infertility after stopping COCs. This is also a myth, since reproductive function is restored after 3-8 months. Some girls managed to conceive a child in the first month after stopping contraceptives.

But if you decide to take COCs, then seek help from a doctor, he will prescribe a drug with minimal doses of progestins and estrogens. Most often, young girls are prescribed Novinet, Jazz, Yarina.

They improve the condition of the skin and make periods less painful. COCs are not used for cystic changes in the ovaries and endometriosis.

The following methods are ideal for nulliparous women who have a regular sexual partner:

• Barrier contraceptives
• Condoms

An intrauterine device is not installed in nulliparous girls due to the possibility of developing pain and uterine bleeding after the device is removed.

Emergency contraception is used in the following cases:

• Rape
• Skipping a COC dose
• Damage to the condom
• Unprotected sexual intercourse

These are drugs that cause detachment of the endometrium from the uterus. Thus, menstruation begins and sperm is simply carried away from the uterus along with the blood. It is recommended to take no later than 24-72 hours after sexual intercourse. Here are the names of some emergency contraceptives: Postinor, Escapel, Mifegin, Miropriston.

The best contraceptives for women over 30 years old. Video

• Typically, by the age of 30, a woman already has a child and a regular sexual partner. In this case, an intrauterine device is considered the ideal option.
• An IUD containing progesterone is often prescribed. Such contraceptives are indicated for women with endometriosis and other estrogen-dependent diseases. The most popular hormonal IUD is Mirena. Its cost is high, but its validity is 3-5 years
• For women over 30 who have given birth, medium-dose combined oral contraceptives are used. They contain more hormones, this is due to the physiological characteristics of the body at this age. Among such drugs are Diana, Chloe, Dimulen

VIDEO: Contraceptives for women

Contraceptives for women after 45 years. Which ones to choose?

• At this age, many women have chronic illnesses and are overweight. This is why classic COCs are not prescribed
• For such women, three-phase drugs have been developed with minimal androgenic effect. Often before menopause, mini-pills - progestin contraceptives - are prescribed. Since many women who have given birth experience endometrial hyperplasia and endometriosis
• It is best to install the Mirena hormonal IUD after 45 years. It will help not only prevent pregnancy, but also restore the uterine mucosa. This device significantly reduces the risk of developing uterine cancer.
• After the birth of her second or third child, a woman can undergo sterilization. This is a tubal ligation operation. Now this operation is performed without the use of scalpels, using laparoscopy.

Contraceptives for nursing women. Features of the choice of contraceptives for breastfeeding women

• The ideal option is mini-pills or Depo-Provera (progestin) injections. They do not affect lactation and do not affect the baby’s health in any way. But in most cases, women do not want to take any medications during lactation, so they use barrier methods of contraception
• Absence of menstruation during lactation should not be used for contraception. This method only works if you have never missed a feeding, that is, the break between feedings was no more than 3 hours

Female contraceptive pills. Which ones to choose?

• Low dose drugs. Prescribed to nulliparous girls, they contain a minimum of hormones (Jazz, Novinet)
• Medium dosed drugs prescribed to women over 30 years of age (Diana)
• Progestin drugs should be taken if you have endometriosis, endometrial hyperplasia (Norkolut, Mini-pill)

Do not buy birth control pills on your own based on a recommendation from a friend or pharmacist.

The doctor must assess your health condition and only then prescribe a specific drug. What suits your friend may not suit you. If you have endometrial hyperplasia and adenomyosis, you should not take medications with a high content of estrogen. This makes the mucous membrane thicken and the problem worsens.

Folk means of contraception. Recipes

• Douching with a slightly acidic solution. Usually a tablespoon of acetic acid or lemon juice is added to a glass of water.
• Calendar method. The periods of pregnancylessness before and after menstruation are calculated. 5 days before and after menstruation are considered safe
• Rowan flower remedy. To prepare the substance, pour 200 ml of boiling water over a tablespoon of flowers. Leave for an hour and strain. Take 100 ml before each meal.
• Coitus interruptus method
• Douching with a weak solution of potassium permanganate

Traditional medicine offers many methods of emergency contraception that cause rejection of the fertilized egg during pregnancy. Almost after using each of these remedies, a woman is taken away by ambulance for uterine bleeding. Cleaning is carried out in the hospital. There are known cases of death due to blood poisoning due to rotting of the fetus inside the uterus.

The importance of contraceptives in preserving a woman’s reproductive health

Combined oral contraceptives, when used correctly and prescribed by a doctor, prolong a woman’s youth. Oddly enough, after stopping the drugs, even women aged 45-55 years can become pregnant. This is due to the fact that at birth, every girl’s ovaries contain the rudiments of future dominant follicles.

When taking COCs, there is no ovulation, which means that this potential dominant follicle remains until the next time. In medicine, this phenomenon is called Anti-Mullerian hormone. If its content is high, a woman can become pregnant. With a very low concentration of this hormone, a woman will not be able to get pregnant even with IVF, since the supply of eggs has been exhausted.

The effect of contraceptives on a woman’s body

If you take the medications correctly and as prescribed by the doctor, the effect of the medications will be positive. Many of the COCs are created to treat ailments of the reproductive function of women. Try to change your contraceptive once a year, as the body often gets used to it and spontaneous pregnancy may occur.

How to protect yourself without pills and IUDs?

Despite their ineffectiveness, the following methods are still popular:

• Calendar
• Coitus interruptus method
• Douching with potassium permanganate or vinegar solution after sex
• To be sure, use barrier methods of contraception
• The easiest way is to use a condom
• With a regular sexual partner you can use spermicidal gels and suppositories

You can find a lot of positive and negative reviews about hormonal contraceptives. In most cases, negative experiences are associated with the use of a drug that was not prescribed by a doctor, but was recommended by a friend or pharmacist.

• Often, after miscarriages, low-dose COCs are prescribed to restore the menstrual cycle. After their abolition, many women managed to get pregnant
• In young girls who have not given birth, their skin condition improves, acne disappears, and menstruation becomes less painful
• In general, taking hormonal contraceptives has a positive effect on a woman’s health. It's much safer than recovering from an abortion or miscarriage

The final decision on the use of contraceptives is made by the woman. Remember, no amount of persuasion from your partner and the pleasure of sexual intercourse without a condom or contraceptives is worth your health. Therefore, always use protection and consult good gynecologists. Good health to you.

VIDEO: Consequences of hormone therapy

Unplanned pregnancies often end in abortion. This method has a negative impact on health, so it is necessary to use effective methods of contraception. One of the best ways to prevent pregnancy today is the use of oral contraceptives, which contain synthetic analogues of female sex hormones.

The effectiveness of modern birth control pills reaches 100%. In many cases, thanks to them, a therapeutic effect is achieved. Oral hormonal contraceptives (OCs) have been used for more than 40 years. During this time they were constantly studied and improved. Combined OCs have been created in which the hormone content is significantly reduced, while contraceptive effectiveness is maintained.

How does hormonal contraception work?

Birth control pills “turn off” ovulation, while maintaining cyclic bleeding reminiscent of menstruation. The follicle does not grow, the egg does not mature in it, it does not leave the ovaries, so pregnancy is impossible. In addition, the mucus in the cervix thickens, and the endometrium also changes, which prevents the attachment of a fertilized egg in case of pregnancy.

The beneficial effects of oral contraceptives on a woman’s body are as follows:

• stabilization of the menstrual cycle, while the amount of blood released decreases. This helps correct iron deficiency anemia, which occurs in many women;
• reduction of abdominal pain during ovulation and manifestations;
• increasing the protective properties of the mucus of the cervical canal, which halves the frequency of infections of the uterus and appendages;
• reduction in the frequency and associated curettages;
• reducing the risk of developing mastopathy when taking monophasic oral contraceptives, especially those containing progestogens with low androgenic activity;
• suppressing the production of androgens in the ovaries, helping to treat acne, seborrhea, hirsutism and other manifestations of virile syndrome. This is especially true for birth control pills containing progestogens with an antiandrogenic effect or with low androgenic activity;
• increasing bone density, improving calcium absorption, which prevents the development of osteoporosis.

Composition of oral contraceptives, classification and their names

Combined oral contraceptives contain an estrogen and progestogen component. Progestogens prevent pregnancy, and estrogen causes proliferation of the endometrium, simulating its normal development, while eliminating irregular uterine bleeding. In addition, it replaces the body's own estrogens, which are no longer produced in the ovaries when using oral contraception.

The active estrogen found in most birth control medications is ethinyl estradiol. The progestogenic component is represented by derivatives of 19-nortestosterone: Norethisterone, Levonorgestrel, Norgestrel. Modern progestogens have been created: Dienogest, Drospirenone, Desostrel, Norgestimate, Gestodene. They have a minimal androgenic effect, do not cause weight gain, and do not affect fat metabolism in the body.

After childbirth, while breastfeeding, it is recommended to take medications only with a progestogen component (Mini-pill), since estrogens suppress milk secretion. Purely gestagenic drugs are also indicated for women who need to limit the intake of estrogens (patients with hypertension, diabetes, obesity). These include Microlut, Excluton, Charozetta (contains desogestrel).

If oral contraceptives contain less than 35 mcg of estrogen, they are called “low-dose”. In microdosed birth control pills, the concentration of estrogen is reduced to 20-30 mcg. High-dose drugs containing 50 mcg ethinyl estradiol are used primarily for medicinal purposes.

What is the difference between monophasic, biphasic and triphasic drugs?

Oral contraceptives are divided into monophasic, biphasic and triphasic.

• In monophasic tablets, the content of both components is the same in all tablets.
• Biphasic ones contain a constant dose of estrogens and a varying concentration of progestogens, which increases in the second phase of the cycle. At the same time, the total dose of estrogens is slightly higher than in monophasic preparations, and less of progestogens.
• Three-phase contraceptives have a varying ratio of components that simulate the normal menstrual cycle.

List of the most common monophasic contraceptives:

• low-dose: Femoden containing desogestrel - Marvelon and Regulon;
• microdosed: Logest containing desogestrel - Mercilon and Novinet.

List of new generation hormonal contraceptives with a three-phase structure:

• Tri-Mercy (contains desogestrel);
• Trialene;
• Trisileste.

Contraceptive pills with an antiandrogenic effect contain a progestogen component with an antiandrogenic effect (Diane-35, Zhanine) or with a strong progesterone-like effect (Tri-Mercy, Regulon, Novinet). Preparations containing desogestrel are often used to treat hyperandrogenism in adolescents.

Drospirenone is a fourth-generation progestogen component with significant antiestrogenic, antiandrogenic, and antigonadotropic effects. It does not cause any serious side effects. Drospirenone, in particular, is part of such a microdosed monophasic drug as Dimia. It is especially indicated for patients with unstable blood pressure. This drug is very effective in relieving symptoms of premenstrual syndrome.

Classification of oral contraceptives depending on the composition and phase of action:

Fixed combinations of estrogens and progestogens:

1. Norgestrel + estrogen (cyclo-progynova)
2. Levonorgestrel + estrogen (microgynon, miniziston 20 fem, oralcon, rigevidon)
3. Desogestrel + estrogen (Marvelon, Mercilon, Novinet, Regulon)
4. Gestoden + estrogen (Gestarella, Lindinet, Logest, Femoden)
5. Norgestimate + estrogen (silest)
6. Drospirenone + estrogen (Vidora, Dayla, Jess, Dimia, Midiana, Modell Pro, Modell Trend, Yarina)
7. Nomegestrol + estrogen (zoely)
8. Dienogest + ethinyl estradiol (diecyclen, janine, silhouette)

Progestogens and estrogens in combinations for sequential use:

1. Levonorgestrel + estrogen (tri-regol, trigestrel, triquilar)
2. Desogestrel + estrogen (tri-mercy)

Progestogens:

1. Linestrenol (exluton)
2. Levonorgestrel (postinor, escapelle, eskinor-f)
3. Desogestrel (lactinet, modell mam, charozette)

Medicines for emergency contraception - levonorgestrel.

Which of the following remedies is better to choose for regular use? It is impossible to answer this question unequivocally. Different drugs will be more effective in different situations.

Selection of hormonal oral contraceptives

The prescription of hormonal contraceptives is carried out by a gynecologist after examination and taking into account many factors: the patient’s age, type of contraceptive, dosage and type of progestogen component, dose of estrogen.

The best new generation birth control pills contain progestogens such as gestodene, desogestrel, norgestimate, drospirenone.

How to choose birth control pills depending on age:

1. For women under 35 years of age, low-dose or micro-dose monophasic contraceptives are preferable, as well as triphasic ones, including those containing desogestrel or drospirenone.
2. For women over 35-40 years of age, monophasic drugs with desogestrel or drospirenone, pure progestins or microdoses are more suitable.

The names of birth control pills should be checked with your doctor, because the prescription will most likely only list the active ingredients. The doctor currently does not have the right to write the specific name of the drug in the prescription.

How to take birth control pills

For continuous use, doctors used the “21 + 7” scheme for many years. Nowadays, the “24 + 4” regimen is becoming increasingly widespread, that is, 24 days of admission, a break of 4 days.

During the break, bleeding usually occurs, reminiscent of menstruation. It may begin 2-3 days after stopping use and continue during the first days of taking a new package.

There are regimens that allow you to delay the onset of this bleeding or reduce the number of such cycles during the year. These modes can be used for short periods of time, for example, when traveling to sports competitions or on vacation, before surgery, and so on. Regimens for long-term use can be prescribed during treatment, anemia, as well as for the characteristics of a woman’s life, including sports and professional activities. In this case, the woman does not have her period for many weeks.

Long-term use of oral contraceptives without interruption is used for diseases of the genital organs, for example. In addition, it increases the reliability of contraception and does not cause harm to health.

Hormonal contraceptive regimens

The tablets are taken orally, once a day, at the same time, with a small amount of water. For convenience, many modern contraceptives are available in special packaging that makes it easier to count days. If you miss taking the drug, you must follow the clear rules specified in the instructions. Most often it is recommended to take the next pill as soon as possible and use barrier methods of contraception during this cycle.

Pregnancy after stopping treatment can occur at different times - from a month to a year. This depends on the woman’s health, her hormonal levels, and ovarian function. Taking oral contraceptives in cycles preceding pregnancy is safe for the unborn child. If pregnancy is suspected, immediate discontinuation of oral contraceptives is necessary. However, using them in the early stages will also not cause harm to the fetus.

In some cases, short-term use of birth control for 3 months is used to stimulate ovulation after stopping it, which increases the chance of getting pregnant. This property of hormonal contraceptives is used to treat infertility.

How long can you take birth control pills?

With regular monitoring by a gynecologist, good tolerability and effectiveness, such drugs are used for several years. If necessary, the medicine can be changed, but the method of hormonal contraception itself has proven itself very well for the treatment and prevention of female diseases.

Emergency contraception

Cases of its use are not uncommon, especially if a woman uses primitive methods of contraception (coitus interruptus). It happens that a condom breaks or violence occurs. Every woman should know the names of emergency contraceptive pills. The most commonly used products are Postinor, Escapelle, Eskinor-F.

They should be taken within the first 72 hours after sexual intercourse. Repeated use of the same drugs in the current menstrual cycle is not recommended. To protect against pregnancy, barrier methods of contraception should be used. In case of repeated unprotected sexual intercourse during the cycle, only emergency non-hormonal contraception using the drug Danazol is used. Its effectiveness is significantly lower than levonorgestrel.

Side effects and contraindications

One of the main myths about birth control pills is that they can cause cancer. Modern oral contraceptives do not cause cancer. On the contrary, in women who use this method of contraception for 3 years, the incidence of endometrial cancer is reduced by half, and the incidence of ovarian or intestinal cancer is reduced by a third.

Side effects are most often mild. At the beginning of treatment, they occur in a third of patients, then these phenomena are observed in every tenth woman.

Side effects of oral contraceptives:

1. Clinical:

• A) general;
• B) causing cycle disorders.

2. Dependent on the action of hormones.

Common side effects include headache and dizziness, depression, breast tightness, weight gain, irritability, stomach pain, thrombophlebitis, decreased glucose tolerance, skin rash and other symptoms. An allergy to the components of the drug is also possible. Hair loss when taking such drugs is rare; it is associated with insufficient antiandrogenic activity of the drug and requires changing the drug to a more effective one.

Menstrual irregularities include intermenstrual spotting when taking hormonal contraceptives, as well as absence of menstruation. If side effects do not go away within 3 months, you need to replace the drug with another one.

Amenorrhea after taking hormonal contraceptives occurs due to endometrial atrophy, goes away on its own or is treated with estrogens.

Severe consequences after taking contraceptives are rare. These include thrombosis and thromboembolism, including deep veins or pulmonary artery. The risk of these complications is lower than during pregnancy. However, oral contraceptives are relatively contraindicated if there is at least one risk factor for thrombosis: smoking, obesity, arterial hypertension.

Use is contraindicated in the following cases:

• arterial and venous thrombosis;
• previous transient ischemic attack;
• cardiac ischemia;
• diabetes mellitus with vascular complications;
• migraine with focal neurological symptoms;
• combination of risk factors for thrombosis;
• severe diseases of the liver and pancreas;
• tumors of the liver, genital organs, mammary glands;
• uterine bleeding of unknown cause;
• pregnancy;
• for combined drugs – lactation.

If you avoid using birth control pills with such contraindications, then the likely harm from hormonal contraceptives is much less than their real benefit.

If a woman does not want or cannot take hormonal OCs, she can use new generation non-hormonal birth control pills to prevent pregnancy. It must be clearly understood that they mean spermicidal agents for topical use, that is, vaginal tablets. They need to be inserted into the vagina before sexual intercourse. These drugs not only kill sperm, but also have an anti-inflammatory effect. Unfortunately, the contraceptive effectiveness of such drugs is less; the chance of getting pregnant when using them is 20-25%. From this group, vaginal tablets Pharmatex, Benatex, Ginekotex are most often used.

In modern gynecology, hormonal contraception is considered the “gold standard” for protecting against unwanted pregnancy. Modern drugs are effective, well tolerated, and have not only a contraceptive, but also a therapeutic effect. Choosing birth control pills on your own is difficult. To discuss issues of birth control, you should consult a doctor.

Today, there are two main types of birth control pills:

1. Combined oral contraceptives (COCs)
   These drugs contain 2 synthetic analogs of female hormones: estrogen (ethinyl estradiol) and progesterone. Combined oral contraceptives are either monophasic (the level of hormonal substances in the tablets remains unchanged throughout the entire administration) or triphasic (the tablets contain three combinations of hormones that change during the menstrual cycle).
2. Progestin-based birth control pills (“mini-pills”)
   These drugs contain only synthetic progestogen and are intended specifically for nursing mothers, or in case of contraindications to the use of combined oral contraceptives (estrogens).

1. Combined contraceptive pills (COCs)

Combined contraceptive pills can be divided into several groups, each of which is suitable for a specific category of women. This takes into account age, whether the woman has given birth or not, and whether she suffers from any hormonal or other disorders of the body.

ATTENTION!!!
All groups of COCs equally reliably block ovulation, which means they equally protect against pregnancy. Ovulation is blocked by progestogen, and its dose is the same in all combination drugs. The difference between microdosed and low-dose is only in the content of the estrogen dose. Estrogens are added not to protect against unwanted pregnancy, but to control the menstrual cycle.

1.1. Microdosed birth control pills

Contraception for young, nulliparous women who have regular sex life. Drugs in this group are easily tolerated and have minimal side effects. Great for those who have never used hormonal contraceptives. As well as contraception for mature women over 35 years of age (up to the onset of menopause).

Name	Compound	Notes
	Nomegestrol acetate 2.50 mg; Estradiol hemihydrate 1.55 mg.	A new monophasic drug containing hormones similar to natural ones.
	Estradiol valerate 2 mg; Dienogest 3 mg.	New three-phase drug. Best suited to a woman’s natural hormonal background.
Jess	Ethinyl estradiol 20 mcg; drospirenone 3 mg.
Jess Plus	Ethinyl estradiol 20 mcg; drospirenone 3 mg; calcium levomefolate 451 mcg.	New monophasic drug + vitamins (folates). Has an anti-androgenic (cosmetic) effect.
Dimia	Ethinyl estradiol 20 mcg; drospirenone 3 mg.	Monophasic drug. Similar to Jess.
Miniziston 20 fem	Ethinyl estradiol 20 mcg; levonorgestrel 100 mcg.	New monophasic drug.
Lindinet-20	Ethinyl estradiol 20 mcg; gestodene 75 mcg.	Monophasic drug.
Logest	Ethinyl estradiol 20 mcg; gestodene 75 mcg.	Monophasic drug.
Novinet	Ethinyl estradiol 20 mcg; desogestrel 150 mg.	Monophasic drug.
Mercilon	Ethinyl estradiol 20 mcg; desogestrel 150 mcg.	Monophasic drug.

1.2. Low-dose birth control pills

Contraception for young, nulliparous women who have regular sex life (in the event that microdosed drugs are not suitable - the presence of spotting on the days of taking active pills after the end of the period of adaptation to the drug). As well as contraception for women who have given birth, or women of late reproductive age.

Name	Compound	Notes
Yarina	Ethinyl estradiol 30 mcg; drospirenone 3 mg.	Monophasic drug of the latest generation. Has an anti-androgenic (cosmetic) effect.
Yarina Plus	Ethinyl estradiol 30 mcg; drospirenone 3 mg; calcium levomefolate - 451 mcg.	A monophasic drug of the latest generation containing vitamins (folates). Has an anti-androgenic (cosmetic) effect.
Midiana	Ethinyl estradiol 30 mcg; drospirenone 3 mg.	Yarina.
Tri-Mercy	Ethinyl estradiol 30 mcg; desogestrel 125 mcg.	Three-phase drug of the latest generation.
Lindinet-30	Ethinyl estradiol 30 mcg; gestodene 75 mcg.	Monophasic drug.
Femoden	Ethinyl estradiol 30 mcg; gestodene 75 mcg.	Monophasic drug.
Silest	Ethinyl estradiol 30 mcg; norgestimate 250 mcg.	Monophasic drug.
Janine	Ethinyl estradiol 30 mcg; dienogest 2 mg.	Monophasic drug. Has an anti-androgenic (cosmetic) effect.
Silhouette	Ethinyl estradiol 30 mcg; dienogest 2 mg.	New monophasic drug. Analogue of Janine.
Janetten	Ethinyl estradiol 30 mcg; dienogest 2 mg.	New monophasic drug. Analogue of Janine.
Miniziston	Ethinyl estradiol 30 mcg; levonorgestrel 125 mcg.	Monophasic drug.
Regulon	Ethinyl estradiol 30 mcg; desogestrel 150 mcg.	Monophasic drug.
Marvelon	Ethinyl estradiol 30 mcg; desogestrel 150 mcg.	Monophasic drug.
Microgynon	Ethinyl estradiol 30 mcg; levonorgestrel 150 mcg.	Monophasic drug.
Rigevidon	Ethinyl estradiol 30 mcg; levonorgestrel 150 mcg.	Monophasic drug.
Belara	Ethinyl estradiol 30 mcg; chlormadinone acetate 2 mg.	New monophasic drug. Has an anti-androgenic (cosmetic) effect.
Diana-35	Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg.	Monophasic drug with anti-androgenic (cosmetic) effect.
Chloe	Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg.	Monophasic drug. Analogous to Diana-35.
Bellune-35	Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg.	New monophasic drug. Analogous to Diana-35.
Desmoulins	Ethinyl estradiol 35 mcg; ethynodiol diacetate 1 mg.	Monophasic drug.

1.3. High dose tablets

They are used to treat various hormonal diseases, as well as for contraception during the treatment of hormonal disorders. Ovidon