Hormonal contraceptive pills. What types of birth control pills are there - brands and descriptions

Thanks to modern medicine and pharmacology, there are many ways that will help protect yourself without suppressing sensations, and at the same time, providing complete protection for the female body. Oral contraceptives have recently become increasingly popular. What are the safest birth control pills out there, and how to choose them?

Types of contraception

The issue of contraception today is very relevant, since the number of unwanted pregnancies is increasing every day. Nowadays, there are many different methods of protection, and they all differ significantly from each other. Main types:

• hormonal pills;
• suppositories;
• spirals;
• barrier agents;
• natural ways.

It is the hormonal group of drugs that has recently become increasingly popular due to the ease of use and the results themselves. If 10 years ago hormonal pills were not so safe, and their range left much to be desired, today pharmacology has made a significant step forward.

In the modern world, birth control medications exist not only in the form of tablets, but also in the form of:

• plasters;
• vaginal rings;
• injections;
• candles.

Oral contraceptives are the most effective; the level of protection against such drugs is about 99%. Moreover, in addition to the function of protection, such drugs are often prescribed for therapeutic purposes. Recently, cases have become more frequent when they are prescribed to restore or normalize the menstrual cycle, to eliminate polycystic ovary syndrome and for a rebound effect.

Interesting fact:

Scientists have proven that such drugs are absolutely safe and harmless to the female body.

How do new generation birth control pills differ from their predecessors:

• lower dosage of hormones while maintaining reliability and effectiveness;
• the use of new analogues of female sex hormones - ethanyl estradiol and levonorgestrel;
• the use of new third-generation progestagents - norgestimate, gestodene, desogestrel;
• a new type has appeared called mini-pills, which do not contain gestagen, and the amount of hormones is at a minimum.

It is worth noting that modern birth control pills are almost all combined. This means that they contain two main components:

1. Synthetic estrogen.
2. A progestogen component, which is usually available in the form of various progestogens.

However, that's not all. Based on the dosage of the main components available in the drug, they can be divided into the following groups:

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

The new mini-pill contraceptive pills belong to the monophasic group, and are excellent not only for protection before the first pregnancy, but also during lactation.

The principle of action of hormonal contraceptives

All combined oral contraceptives (COCs) contain sex hormones (estrogens and gestagens). The main principle of their action is to suppress the ovulation process, as a result, protection from unwanted pregnancy. What causes ovulation suppression?

Firstly, the natural fluid that is secreted in the cervix is ​​thickened and affects the penetration of sperm. Due to compaction and change of flora, it is quite difficult for sperm to penetrate the cervical canal, and sometimes they can even die when they enter the vagina. In this case, their penetration into the uterus is excluded. Secondly, due to the entry of new hormones into the female body, the production of natural ones is blunted, as a result of which the egg does not mature.

In the process of contraception, the endometrium becomes much thinner. Because of this, even if the egg is somehow fertilized, it will not be able to attach. As a result, pregnancy does not occur.

Today, this method of protection is one of the most effective and safe.

Modern contraceptives have no side effects, which is another undoubted advantage. Scientists have noticed that by taking COCs, the condition of the skin improves, hair disappears, hair becomes thicker, the amount of hair loss is significantly reduced, and nails become stronger. Therefore, recently you can often hear that dermatologists prescribe such drugs to combat various dermatological problems.

Video “How to choose the right oral contraceptives?”

Informational video with advice from an obstetrician-gynecologist on the selection of oral contraceptives.

Mini-pills - what they are and the main advantages of the drug

One of the best birth control pills available today are the mini-pill. Their main advantage over various types of hormonal drugs is that the mini-pill contains only progestan. Nevertheless, the effect of taking this type of remedy is no less positive.

The principle of operation is also similar to COCs. To protect against unwanted pregnancy, mini-pills make the mucus from the cervix thicker and the endometrium thinner, which prevents conception.

Despite the small amount of hormones contained in the drug, it is strictly not recommended to prescribe them to yourself. As in the case of COCs, mini-pills can provoke hormonal disorders, unscheduled bleeding, as well as various gynecological pathologies. Therefore, you should not start taking this type of medication without a doctor’s recommendation.

How to choose birth control pills?

In fact, the process of choosing oral contraceptives is quite simple and ideally this should be done by the attending physician. However, in the modern world, women often do not find time for additional examinations and visits to the gynecologist, and prescribe contraceptive drugs on their own.

In such cases, it is necessary to adhere to some important nuances when choosing a product:

Most often, when choosing a remedy on your own, preference is given to combined contraceptives, since they do an excellent job of preventing unwanted conception, as well as treating gynecological diseases and disorders. It is COCs that are most often prescribed by dermatologists. This is the safest and most effective option on the pharmaceutical market.

If there are contraindications, it is better to stop taking OCs altogether. Contraindications include:

• diabetes;
• phlebeurysm;
• diseases of the cardiovascular system;
• impaired metabolism in the body;
• malignant formations;
• pregnancy and lactation;
• age over 40 years.

These are not all contraindications; a detailed list is in the instructions for each individual drug; before starting to take it, you must read this list.

Non-hormonal contraceptives

Since medicine does not stand still, today you can even find non-hormonal contraceptives. Unlike hormonal OCs, non-hormonal OCs can be used immediately after childbirth, during breastfeeding, and also for those women who have contraindications to taking COCs.

The main principle of their action is the destruction of sperm that penetrate the vagina, as well as the thickening of the mucus secreted by the cervix and the formation of a protective membrane.

Interesting fact:

Non-hormonal contraceptive drugs are based on spermicides, which also help slow down the speed of sperm movement.

It is important that non-hormonal contraceptives are also a kind of protection for women from sexually transmitted infections. This is due to the existing antibacterial, antiseptic and antimicrobial actions.

This method of protection belongs to the barrier chemical type and is a fairly convenient and safe option. These are reliable birth control pills that do not contribute to hormonal imbalances and are an excellent prevention against various sexually transmitted diseases. Even such more or less safe pharmaceutical products should be prescribed only by the attending physician.

Contraceptive creams and suppositories

Also, in addition to the tablet form, there are non-hormonal suppositories and creams to protect against unwanted pregnancy. Unlike hormonal drugs, local remedies are less effective, but recently this form has been gaining particular popularity.

Many pharmacological manufacturers offer the form of suppositories, ointments and creams, the composition of which contains nonoxynol or benzalkonium chloride. Advantages of local non-hormonal contraceptives:

• ease of use;
• the effect of additional lubrication from suppositories, ointments, creams;
• only a small number of side effects;
• protecting women from infections;
• a wide selection of products and the ability to use during breastfeeding, immediately after childbirth.

However, this form of funds also has its disadvantages:

• vaginal creams and suppositories can provoke a change in the vaginal microflora;
• itching and burning, allergic reactions and rashes may occur;
• lower percentage of protection.

As a rule, topical remedies are used immediately before sexual intercourse, about 10 minutes before. The effect of suppositories and creams lasts no more than 4 hours.

Rules for taking hormonal OCs

Any oral contraceptives must be taken, adhering to certain schemes and rules. They are usually indicated in the instructions for the drug. If the rules are not followed, unscheduled bleeding may occur, as well as unwanted pregnancy and hormonal imbalance.

Typically, one package of the drug contains 21 tablets, this amount is designed for one cycle. Basic rules for taking OK:

1. You should start taking it on the first day of your menstrual cycle.
2. It is necessary to take the tablets at approximately the same time, preferably in the evening. To remember, you can set a reminder on your phone.
3. You must take the tablets daily, without breaks, until the tablets in the blister run out. Afterwards, you need to take a break for 7 days, just at this time menstrual bleeding should begin.
4. After a 7-day break, you need to start a new pack, regardless of whether your period has ended or not.
5. If you suddenly forget to take a pill, you need to resume taking it as soon as possible.
6. For the first two weeks, it is also necessary to use a barrier method of protection (condoms).
7. If slight bleeding occurs in the middle of the cycle, do not stop taking the drug. If there is severe bleeding, you should consult a doctor.

Also, you should not stop taking OK in the middle of the cycle, since this is fraught with consequences such as cycle disruption and so on.

Are OK harmful?

When properly selected, OK drugs are absolutely safe for women. However, if selected incorrectly, various side effects may occur, such as excess weight, hair loss, etc. It is also worth paying attention to contraindications, in which case you can be completely confident in the safety of the product. If you have diabetes, diseases of the cardiovascular system, as well as liver and kidney problems, you should stop taking COCs.

You should not give preference to this method of protection even if you have a bad habit - smoking, since OCs place a significant burden on the heart.

Interesting fact:

With regular use of OCs, sexual activity may decrease. This is due to a decrease in testosterone production.

Birth control pills - which are better?

There is a certain rating of the most popular oral contraceptives, which are most often prescribed by gynecologists both for therapeutic purposes and for contraception. Each drug contains different hormones, the dosage of which also differs.

Jess is an excellent option for reproductive age

Jess are the best oral contraceptives of the new generation, excellent for women of reproductive years. Very often prescribed by gynecologists to normalize the menstrual cycle, combat polycystic ovary syndrome and hormonal imbalances. As a nice addition, it can be used to combat acne and other skin problems.

Jess contains estrogens and gestagens that block the ovulation process. This affects pain during menstruation and PMS. Reduces anemia and discomfort, shortens the duration of menstruation, and is prescribed for severe PMS symptoms.

The main advantage over other drugs is the low concentration of active components.

Jess Plus - improved version

Jess Plus is a more improved version of Jess, which, in addition to the hormones responsible for inhibiting ovulation, contains calcium leaomefolate. This is a type of folic acid that is essential for women's health.

Despite the low concentration of hormones, Jess Plus provides up to 99% guarantee against unwanted conception. If pregnancy does occur, then thanks to the folic acid present in the composition, the risks of disorders of the baby’s nervous system are reduced. Can be taken from 18 years of age until menopause.

Yarina and Yarina plus - the most popular OK

The first place in the ranking of birth control pills is a drug called Yarina. They help stabilize the cycle, have a minimal number of side effects and perfectly perform their direct function of protection.

Unlike many other COCs, Yarina does not cause weight gain and is excellent at combating acne, other rashes and dermatological problems. However, it has a small drawback - with long-term use, you may notice the occurrence of frequent headaches.

Just like Jess, it has a more improved version - Yarina Plus with folic acid. It is this drug that experts often give their preference, since Yarina Plus is easily tolerated by most patients, does not cause unscheduled bleeding and promotes a rebound effect.

Novinet is a drug with minimal side effects

The main effect of Novinet is to block ovulation and the production of luteinizing hormone, which helps slow down the movement of sperm. The tablets do not cause pain or discomfort during menstruation and have a minimal number of side effects.

The most common symptoms observed during administration were nausea and sometimes vomiting. Partial hair loss and migraines may occur. A feature and an undeniable advantage can be considered the ability to take Novinet already 3 weeks after birth. However, do not forget that this is still a hormonal drug and it can provoke an increase in milk production during breastfeeding.

Janine is a monophasic low-dose remedy

Thanks to the main three actions, the contraceptive effect is ensured: suppression of ovulation, increasing the viscosity of secretions from the cervical canal, reducing the thickness of the endometrium. The drug can be classified as a monophasic low-dose oral contraceptive. Most reviews about Janine are positive.

Regulon - COC, analogue of Janine

Quite often, Regulon is prescribed by gynecologists to normalize the cycle, as well as to eliminate unscheduled uterine bleeding. It is an analogue of Janine, the composition is similar, as are the actions. Many women who use Regulon note its quality and focus on reliability.

Gynecologists often prescribe Regulon to young girls, even teenagers. Does not cause side effects even with long-term use. There are many positive reviews on the Internet about the therapeutic properties of Regulon.

Logest – minimum hormone content

These are the best new generation contraceptives with minimal hormone content. In addition to the main contraceptive function, it has a therapeutic and preventive effect on female cancer. After its cancellation, reproductive functions are immediately restored. This allows as soon as possible.

Klaira – natural OK

Klaira is the first OC of the fifth generation. Thanks to the main active component - estradiolavalerate, it perfectly combats the symptoms of menopause.

The main difference is a change in the order of administration, thanks to a unique dynamic dosing regimen. This is a four-phase hormonal drug, the packaging of which contains:

• 2 placebo tablets without active ingredient;
• 26 tablets with an active component and effect, where the dosage of the substance is different.

During administration, the dosage of estrogen gradually decreases, but the dosage of gestagen, on the contrary, increases. Thanks to this, the effect of taking it is significantly increased. Today, Qlaira is a revolutionary drug with a high degree of protection and the ability to treat female diseases.

Popular questions about birth control pills

Even the best birth control pills have their own characteristics of use, so quite often women who take them have a lot of questions about the effect of the drug on their body.

How long can I take OK?

Previously, hormonal contraceptives were quite strong drugs that could cause serious harm to the female body. In this regard, most of them could not be applied on an ongoing basis. Today, OCs have been invented with a minimal number of side effects that can be taken for a long time.

However, it is still not worth taking birth control regularly. Periodically you need to take breaks and change the medication you are taking. However, in the absence of side effects, OCs can be used for quite a long time under medical supervision.

Is it possible to get pregnant after stopping contraceptives?

According to gynecologists, it can happen much faster. Even if it was previously impossible to conceive a child. After discontinuation, the likelihood of pregnancy increases significantly several times. Sometimes doctors use the so-called rebound effect to treat infertility.

Is it possible to get pregnant while taking OK?

Despite the fact that COCs are a fairly reliable method of contraception, pregnancy cannot be ruled out while taking them. However, this occurs quite rarely. Another thing is due to a violation of the dosage regimen. If the interval between taking pills is more than 24 hours, the effect of protection is significantly reduced.

The main function of the OC is also reduced due to the use of other drugs - antibiotics, various herbal infusions, and so on. Doctors recommend using the barrier method for the first 2 weeks from the moment you start taking the drug.

OK or spiral – what to choose?

Many women believe that the intrauterine device is a safer method of birth control. Moreover, it is safer both in terms of unwanted pregnancy and in terms of the effect on the female body. However, according to gynecologists, this is far from the case.

Still, it is worth remembering that the intrauterine device is a foreign body in the uterine cavity, which can cause inflammation. Tablets are a safer and more reliable option. In the event of an unplanned pregnancy, pills are also the best option, since they do not pose any threat to the fetus, unlike the intrauterine device.

Contraceptive drugs. The universal popularity of these products is influenced by ease of use, reliability and a minimum of side effects on the body.

In today's world, there is a huge choice of contraceptives and most women find it very difficult to choose the best birth control pills.

Before purchasing these products, you should carefully read all the proposed options and learn more about their features and advantages.

There are several types of combined oral contraceptives that can provide varying levels of protection against unwanted pregnancy. This, and drugs.

The table below describes some types of contraceptives.

Name	Hormone content and dose	Price, rub.)	Description
	Ethinyl estradiol and desogestrel are present. Low dosage.	From 200 to 1126	Eases premenstrual syndrome
	Contains ethinyl estradiol and drospirenone. Low dosage.	From 800 to 1100	Suitable for nulliparous women
	Contains ethinyl estradiol and drospirenone. Microdosed.	From 800 to 2500	Effective for eliminating acne
	Contains ethinyl estradiol and dienogest. Low dosage.	From 827 to 1780	Suitable for tall women with a slender figure.
	Gestodene and ethinyl estradiol. Microdosed	From 380 to 500	Suitable for women with oily skin and hair.
	Cyproterone and ethinyl estradiol. Low dosage	From 450 to 700	Helps get rid of excess hair growth and acne.
		From 200 to 400	Eliminates painful PMS symptoms.
	Levonorgestrel and ethinyl estradiol. Low dosage.	From 200 to 600	Suitable for women of average height and normal figure.
	Levonorgestrel and ethinyl estradiol. Low dosage.	From 200 to 500	Recommended for women with normal oily hair and skin.
	Levonorgestrel and ethinyl estradiol. Low dosage.	From 150 to 700	Helps prevent gynecological diseases.
	Levonorgestrel and ethinyl estradiol. Medium dose.	From 200 to 450	Suitable for women of short stature and curvy figures.
		From 345 to 600	Suitable for girls with dry hair and very dry skin.
	Levonorgestrel and ethinyl estradiol. Medium dose	From 250 to 680	Effectively normalizes the menstrual cycle.
	Linestrenol	From 1100 to 1500	Suitable for women during lactation.
	Desogestrel	From 980 to 1100	There are no contraindications for migraine.
	Norgestrel	From 700 to 1000	Can be taken for diabetes.

Monophasic drugs

New and improved drugs appear every year, but many women prefer to take contraception previous generations.

Monophasic contraceptive pills differ from other types of drugs in the presence of two important hormones: progestogen and estrogen.

They are present in tablets in equal quantities and allow you to achieve almost complete control over menstruation and the ovulation process.

These tablets are indicated for women of different reproductive ages who have a great need for quality protection against unexpected pregnancy. Monophasic products are suitable for most women.

• If we consider low-dose products, they are suitable for nulliparous and more women older age category, for example, after 35 years.
• Experts recommend medium dosages for women who have already given birth and for those of older reproductive age.
• And high-dose drugs can be prescribed when medium-dose drugs have proven ineffective.

Eat three type of female phenotype.

Monophasic tablets are more often prescribed to women of small and medium height with a curvaceous figure and a long menstrual cycle.

Also, in the presence of an antiandrogenic component, they can be recommended for tall women, thin builds with scanty periods.

Jess

Effective hormonal tablets with antiandrogenic and antimeneralocorticoid properties. It contains drospirenone and ethinyl estradiol. It acts by suppressing ovulation and changing the cervical system. When used correctly, the Pearl index, which is the number of pregnancies per year per 100 women, can be less than 1.

Affects regular periods, which become less painful and intense. Severe symptoms of PMS disappear, such as headaches, swelling and pain in the mammary glands and characteristic pain in the joints and muscles. This drug also reduces the risk of various tumors and anemia.

Yarina

This is a combined universal estrogen-progestin contraceptive drug. Its effect is achieved by increasing the viscosity of mucus in the pelvic organs and suppressing ovulation.

Yarina is especially useful for women with acne and noticeable fluid retention due to hormonal reasons.

Has a positive effect on the passage of menstruation. May also help relieve painful symptoms during menstruation. Reduces oily hair and skin.

Regulon

This is a combined drug that contains an estrogen component (ethinyl estradiol) and a gestagen component (desogestrel). It acts by inhibiting the ability to produce pituitary gonadotropins and complicates ovulation. At the same time, the density of the church mucus decreases and sperm cannot penetrate into the uterus. At the same time, it has a positive effect on lipid metabolism. It has a good effect on the skin and perfectly helps get rid of acne. Also normalizes the menstrual cycle and prevents the development of gynecological diseases

Janine

It is an estrogen-progestin agent with an antiandrogenic effect. The composition contains hormones: dienogest and ethinyl estradiol. This effective remedy inhibits ovulation. In this case, the cycle becomes constant and regular, and the intensity of bleeding decreases. The risk of iron deficiency anemia is also reduced. Among other things, Janine improves the characteristics of the blood lipid profile.

Lindineth

These are tablets that have an estrogen-progestin effect. Suppresses the pituitary gland's secretion of certain hormones. Does not have a noticeable effect on carbohydrate and lipid metabolic processes in the body. Prevents the maturation of an egg capable of fertilization. Increases the level of viscosity of the substance located in the cervix. It has a healing effect, preventing the development of many gynecological diseases.

Chloe

Combined low-dose contraceptive with antiandrogenic activity. Affects the reduction of activity of the sebaceous glands and promotes the disappearance of acne. Effectively inhibits ovulation and prevents egg maturation. Affects the normalization of menstruation and reduces the intensity of bleeding. It is not recommended to use this drug with normal androgen levels.

In biphasic medications, the dose of estrogen contained is the same in all tablets, and the dosage of gestagen changes for the 1st and 2nd half of the menstrual cycle. The package contains 2 types of tablets.

In addition to the main use, two-phase products help to cure acne.

Suitable for women of average height, with normal skin and hair, who have a normal menstrual cycle.

It contains hormones such as levonorgestrel and ethinyl estradiol. It has a slowing effect on ovulation and follicle maturation. They are used not only as contraception, but also to restore the menstrual cycle and to eliminate painful symptoms.

This is an effective contraceptive combination drug. It contains ethinyl estradiol and levonorgestrel. It blocks the release of certain substances from the hypothalamus and suppresses the secretion of the pituitary gland, thereby inhibiting ovulation. Prevents the occurrence of many gynecological diseases.

It is a low-dose oral contraceptive drug. Also contains levonorgestrel and ethinyl estradiol. At the level of hypothalamic-pituitary regulation, it suppresses ovulation. Changes the properties of cervical secretion. Affects changes in the substance of the endometrium, which makes implantation of the egg after fertilization almost impossible. Reduces the risk of iron deficiency anemia and reduces bleeding during menstruation.

It is a contraceptive that regulates the passage of menstruation and contributes to the timely prevention of dangerous gynecological diseases. For example, various tumors. It contains hormonal substances such as levonorgestrel and ethinyl estradiol. When taken orally correctly, it has a depressing effect on the pituitary secretion of hormones, which inhibits the release of an egg ready for maturation.

Triphasic contraceptives

Experts say:

• That young girls are best suited for monophasic tablets, which do not cause noticeable changes in the hormonal system.
• And for women over 30 years of age and those who have given birth, drugs “that do not contradict nature” are recommended, that is, two- and three-phase contraceptives.

Before choosing a specific product, consultation with a specialist is necessary.

Three-phase drugs can simulate the menstrual cycle, since they contain hormones in quantities as close as possible to physiological characteristics. Such tablets contain two types of hormones, but the package contains three types of tablets.

First, tablets of one specific color are used, and then the other two colors are drunk sequentially.

Modern high-quality tablets have a general regulatory effect on the female body and do not make changes to the endocrine structure.

The substances in three-phase tablets affect the activity of the corpus luteum of the ovaries and significantly reduce the thickness and activity of the endometrium, which prevents implantation.

Important advantages of these drugs include their ability to reduce the risks of cysts, ectopic pregnancies and various tumors.

This drug contains hormones in different ratios. These are the progestin hormones levonorgestrel and ethinyl estradiol. Triziston normalizes the menstrual cycle and relieves pain during menstruation.

This is an effective three-phase contraceptive that mimics the physiological fluctuations in the level of certain hormones in the blood during the menstrual cycle and promotes excellent tolerability of the drug. This drug increases the viscosity of mucus in the cervix and suppresses the secretion of gonadotropic hormones by the pituitary gland, which affects the inhibition of ovulation.

Provides high contraceptive effectiveness due to the ingestion of progestin with estrogen, released in different phases of the cycle and in such a ratio to the corresponding physiological processes. It not only prevents pregnancy, but also regulates the menstrual cycle.

Mini-pill

These high-quality drugs contain only one progestogen. Their action is based on local action on the peripheral areas of the reproductive system. They affect the amount and structure of the cervical mucous substance, and also make changes in the biochemical processes of the endometrium. These drugs are inferior in effectiveness to their combined analogues, but can be successfully used in the presence of some contraindications.

• The undoubted advantage of this drug is that it can be taken by women for whom combination drugs are not recommended. For example, with diabetes, high blood pressure, migraines.
• It is also indicated for women over 35 years of age, especially those who smoke.
• May be effective in women who are breastfeeding.
• This drug is recommended for women over 40 years of age.

The advantage of these contraceptives is that they have fewer side effects than when taking combination drugs.

It is a synthetic progestogen. Prevents the introduction of a fertilized egg into the uterus, due to changes in the composition of cervical mucus and transformation of endometrial secretion. Contains linestrenol. Exluton is recommended for nursing mothers. With long-term use, it prevents inflammatory processes in the pelvic organs and reduces the risk of fibrocystic mastopathy.

It is a contraceptive product that contains only a progestogen (desogestrel). The effect of preventing pregnancy is achieved by inhibiting ovulation, which is achieved by thickening the cervical mucus. Taking this medication leads to a significant decrease in the amount of estradiol to those characteristic of the early follicular phase.

It contains a hormonal substance – norgestrel. This is a gestagenic drug that has a contraceptive effect. Affects a decrease in contractility and muscle activity of the fallopian tubes and uterus. It affects the secretion of hypothalamic factors and blocks the formation of gonadotropic hormones. Has an efficiency of about 97%.

There are simply no ideal recommendations on the topic of the best birth control pills, which ones to choose. In any case, it would be a good idea to consult with a doctor who will prescribe the best option. It is important to remember a simple rule: if you haven’t had your period for 3 months after taking birth control, then most likely this drug is right for you. It is also necessary to take into account that any drug should not be taken for a long time.

Means for preventing pregnancy can rightfully be considered one of the oldest. After all, they were used in ancient times. For example, women of the indigenous population of America used douching for this purpose with a remedy prepared from lemon and a decoction of red tree bark. In Ancient Egypt, tampons soaked in honey and acacia decoction were used. Even condoms are not a modern method of protection against unexpected pregnancy.

Of course, the effectiveness of all these tools was extremely low, and there was no need to talk about ease of use at all. Everything changed around the second half of the 20th century, when doctors first started talking about combined oral contraceptives (COCs). The first drug created for the purpose of protection was Enovid, which appeared on the pharmacy market in 1960. It was with him that the development of hormonal contraception began.

What is hormonal contraception?

The mechanism of action of birth control pills is based on the ability of substances that are synthetic analogues of sex hormones produced by the female body to influence hormonal levels. At the same time, the brain receives a signal that there are enough hormones in the blood and the command to the ovaries to produce their own does not go through.

Hormones entering the body, depending on the type, trigger several mechanisms at once. All of them lead to the fact that pregnancy, even if ovulation has occurred and the egg has been fertilized, does not occur.

Estrogens contribute to:

• The next egg does not mature in the ovaries and ovulation does not occur.
• In the uterus, a disruption of secretory processes occurs, which causes the development of swelling of the mucous membrane - the endometrium, which, in turn, makes implantation of a fertilized egg impossible.
• A process called luteolysis is launched - that is, the reverse development of the corpus luteum, which is normally formed after ovulation and serves to synthesize the hormone progesterone, which prepares the body for a possible pregnancy.

• They stimulate the thickening of cervical mucus, which clogs the cervix and makes it impenetrable to sperm.
• They inhibit the activity of enzymes that help sperm penetrate the egg.
• They reduce the contractile activity of the fallopian tubes and the uterus itself and prevent the movement of the egg through them.
• They thin the endometrium, making it unsuitable for egg implantation.
• Block the release of hormones that are responsible for ovulation in the middle of the cycle.

Regardless of the type of components and composition, all hormonal contraceptives have almost the same mechanism of action.

Features of application

Any hormonal pills should be taken strictly according to the schedule, preferably at the same time of day. You cannot skip the next appointment. Depending on the composition and type of drug, if missed, the contraceptive effect will last on average only up to 12 hours. After this time, the effectiveness of the drug decreases.

The start of taking most COCs coincides with the first day of the cycle. At the same time, you can independently choose the most convenient time for you. Most women prefer to take birth control pills in the evening, before bed. In this case, negative effects such as nausea, headache or changes in mood are not as pronounced.

All hormonal birth control pills are prescription drugs and are used only as prescribed by a doctor. Before you start taking the drug, carefully read the instructions and rules of administration.

Advantages

Of course, the main advantage of COC contraception using both monophasic and multiphasic drugs is the simplicity of the method itself. Agree, taking a pill is much easier than, for example, using a vaginal ring. And with such means as injection contraception or intrauterine devices, which cannot be used without a doctor, there is no comparison at all.

However, this is far from the only advantage; the undoubted advantages of hormonal contraception are:

• High efficiency, even for three-phase drugs the reliability indicator does not exceed 0.6%. In other words, out of one thousand women using this method of protection for one year, pregnancy occurred in only one case.
• Safety. Despite the fact that all birth control pills interfere with hormonal levels, their effects are much less harmful than the consequences of abortion.
• Normalization of the menstrual cycle, which becomes regular while taking the pills, and the menstruation itself is not so painful, long and heavy.
• By improving the barrier properties of cervical mucus, the incidence of inflammatory diseases or exacerbation of chronic pathologies is almost halved.
• The use of hormonal contraceptives for a year reduces the risk of endometrial cancer by 50%, ovarian cancer by 30%, and the risk of developing mastopathy becomes less by 70%.

Flaws

Despite many positive aspects, hormonal birth control pills also have disadvantages. The main one, of course, is side effects, which sometimes make taking the drug simply impossible. In addition, birth control pills:

• They do not protect against sexually transmitted infections, including such dangerous ones as HIV or cytomegalovirus.
• They affect the blood coagulation system and can increase the risk of blood clots and thromboembolism.
• They can aggravate the course of chronic diseases of the liver and gallbladder or provoke the occurrence of cardiovascular pathologies, disorders in the circulatory system, as well as severe headaches and migraines.

Types of COCs

The whole variety of birth control pills can be divided into two main groups. The first includes drugs containing only gestagens, another name for them is mini-pills. The second group is combined contraceptives, which contain several hormones.

Usually these are synthetic analogues of estrogens and progesterone. It is this group that is most popular and is most often prescribed by doctors. Combination drugs are also divided into three types.

Monophasic

They are the first generation of drugs intended for hormonal contraception. They contain two hormones: estrogen and progesterone, which are contained in the same amount in each tablet. The most famous of this group are Janine, Yarina or Diane-35.

Despite the fact that this generation of drugs is not new and has existed for quite a long time, in terms of their effectiveness they are practically in no way inferior to multiphase drugs.

The advantage of monophasic contraceptives is their ease of administration and the possibility of doubling the dose in case you forget to take another pill. But with multiphase agents this is not always possible, and their use requires more caution and attention.

In addition, monophasic drugs can help treat endometriosis, normalize the menstrual cycle, reduce its duration and pain. Also, with monophasic drugs, cases of intermenstrual bleeding are less common than with other groups.

Monophasic contraceptives are by far the most studied and frequently prescribed group of drugs by doctors.

Two-phase

The second generation of hormonal contraceptives differs in that each tablet contains a constant dose of estrogen, and the concentration of the second component, gestagen, varies depending on the day of the cycle. Among the drugs in this group, Anteovin is used today, for example.

Biphasic contraceptives are prescribed mainly only to women with abnormal sensitivity to gestagens. Another indication for such drugs is hyperandrogenism. This is a pathology in which a woman’s body begins to produce a large amount of male sex hormones.

Three-phase

This group of drugs differs in that the tablets intended for different days of the cycle contain their own specific dose of hormones. Such a change in the concentration of estrogens and gestagens is as close as possible to the hormonal fluctuations that occur in a woman’s body. Thanks to this, three-phase contraceptives are considered the most physiological.

Typically, this group of drugs is prescribed to women over 35 years of age or under 18, as well as those who smoke or are obese. Such drugs include, for example, Tri-regol, Triziston or Tri-Mercy.

The main positive quality of this group of drugs is the reduction in the risk of side effects from progestins. The main disadvantage is the higher frequency of bleeding between menstruation compared to monophasic drugs. A more complex dosage regimen and not always possible to double the dose if you miss another pill.

Studies have shown that triphasic contraceptive drugs are inferior to monophasic ones in terms of reliability of protection against unplanned pregnancy.

The Pearl index for monophasic drugs is 0.15–0.18, while for three-phase drugs, depending on the composition, the values ​​can range from 0.19 to 0.68.

Criterias of choice

If a woman has no previous experience of taking hormonal contraceptives, then the doctor usually gives preference to monophasic drugs containing minimal doses of hormones. But only after receiving the results of all the necessary tests. Such as: cytology smear, hormone test, general and biochemical blood test, ultrasound of the pelvic organs. In some cases, an additional consultation with a mammologist may be necessary. In addition, the doctor must take into account the characteristics of the menstrual cycle and the woman’s phenotype.

It is simply impossible to choose the right drug without consulting specialists and a series of tests. You should not buy hormonal contraceptives yourself, as this can harm your health.

Today, combined oral contraceptives are considered one of the most reliable methods of protection against pregnancy. However, they require a woman to pay close attention to her condition and strictly follow the dosage regimen.

Oral contraceptives are considered the best option for reliable pregnancy protection. They are suitable for women who have regular sex life with one partner. The potential harm from OCs is much lower than the actual preventive effect of many diseases.

How to select OK?

First, the obstetrician is the type of woman. A woman can independently determine her type by looking in the mirror. Women of the estrogen type are usually short with a very feminine figure, female-type hair - no hair above the upper lip, hair in the pubic area does not extend beyond the bikini area. Menstruation is usually abundant, PMS is well expressed, occurring with nervousness and engorgement of the mammary glands. Skin and hair are often dry. Pregnancy proceeds without complications. Progestogen drugs are optimal for such women.

Thin, tall women with a boyish figure who have a low menstruation voice have elevated progesterone levels. Poorly developed mammary glands, oily skin prone to acne, problems during pregnancy also speak in favor of the progesterone type. Such women are shown drugs with antiandrogenic effects.

For women of a balanced type with normal height, feminine physique, and no signs of increased progesterone levels, micro and low-dose drugs are suitable.

It is important that these signs should be assessed together. Often women who appear to be of the estogen type have increased levels of progesterone: oily skin, problems during pregnancy, male-pattern hair growth.
In some cases, a doctor may prescribe a drug without laboratory diagnostics, when the hormonal type is beyond doubt, the woman has been examined previously and no violations have been identified.

Trial and error method

Unfortunately, tests and other objective data do not always allow you to select a drug the first time. Women complain that for about six months now the doctor has not been able to prescribe “good” pills and turn to a friend for help. In the antenatal clinic, the selection of OCs is carried out under supervision, the doctor prescribes additional ultrasounds and hormone tests. This allows you to find out the body's reaction to the drug. The absence of weight gain and a visible antiandrogenic effect is an important factor, but not a determining one.

Errors and misconceptions

Women who self-prescribe OK often take an annual break so that the body can “rest.” This increases the risk of side effects. A properly selected drug can be taken for a long time without risk to health.

Bloody discharge in the first three months after starting to take OK is normal. You should choose other tablets if the discharge has been bothering you for more than 3 months.

The safest contraceptive

Not long ago, new, microdosed OCs appeared; they contain an extremely small amount of hormones and can be used by women of all ages. The risk of side effects and discomfort is minimized, and the contraceptive effect is quite high.

Special cases

For women with diseases of the reproductive system, OCs can be a salvation, blocking the functioning of the ovaries, they prevent the appearance of endometriosis, and reduce the risk of tumor diseases. During lactation, you can also use OCs, which belong to the category of mini-pills and contain gestagen.

If you decide to purchase contraceptives without a doctor's prescription, select them according to your hormonal type and read the contraindications.

Related article

We all dislike doctors and often let even the most serious issues take their course, without thinking at all about how many problems we will bring to our loved ones.

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. Analogous to Janine.
Janetten	Ethinyl estradiol 30 mcg; dienogest 2 mg.	New monophasic drug. Analogous to 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