Hormonal pills are possible. Rating of the best contraceptives

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);
• Trialen;
• 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, charozetta)

Emergency contraception medications – 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 more widespread, that is, 24 days of admission, a break in administration 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;
• coronary heart disease;
• 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, the 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.

Instructions for choosing contraceptives for women of different ages.

Contraception is a set of procedures aimed at preventing unwanted pregnancy. Now there are many contraceptives, undoubtedly the most popular are condoms. Women often use non-hormonal pills.

How does a doctor select birth control pills?

There are several criteria by which the doctor chooses birth control pills:

• Patient's age
• Was there a birth or not?
• Past diseases
• Woman's weight
• Presence of diabetes mellitus
• Woman's physique
• Presence of gynecological ailments

Incorrectly selected medications can cause gynecological ailments and even infertility.

How to choose birth control pills without a doctor, on your own?

The easiest way is to purchase non-hormonal pills. But the most common are low-dose hormonal pills. They contain minimal hormones, so they do not cause any harm, provided that the woman is absolutely healthy. If you have any chronic ailments, it is better to seek help from a doctor.

It is imperative to evaluate menstruation. If the discharge during menstruation is scanty and lasts only 3-4 days, then gestagens predominate in the body. But if your periods are heavy and last 6-7 days, then estrogens predominate. There is a special table that will allow you to choose the right tablets.

It is worth noting that they are not taken orally, but are inserted into the vagina before sexual intercourse. They are available in the form of suppositories, gels and tablets.

The most common non-hormonal contraceptives:

• Patentex Oval. The drug contains nonoxynol, which simply makes sperm immobile. Accordingly, she will not be able to enter the uterus
• Pharmatex. Used before sex and protects against the most common sexually transmitted infections
• Gynekotex. The active substance is benzalkonium chloride, which makes vaginal lubrication impervious to sperm. Has an antibacterial effect

New generation non-hormonal contraceptive pills

Such drugs contain substances that reduce sperm motility. In addition, they thicken the vaginal secretion, making it impervious to sperm. You don't need to take pills every day. They are used before sex. Suitable for women who do not have a permanent partner.

Names of non-hormonal tablets:

• Traceptin
• Pharmatex
• Ginakotex

Which birth control pills should you take after sexual intercourse, for how many hours?

Such contraceptives are called emergency. They are also called morning after pills. It is necessary to take the drug no later than 72 hours after sexual intercourse. There are two types of drugs: levonorgestrel and mifepristone. These are hormonal pills that inhibit ovulation, make cervical mucus very thick and prevent the production of progesterone. Accordingly, even a fertilized egg will not be able to attach to the uterus due to the structure of the endometrium.

Names of emergency contraceptive pills:

• Postinor
• Escapelle
• Mifepristone
• Eskinor F

Please note that such drugs contain a “horse” dose of hormones, and therefore have a negative effect on health. It is allowed to take no more than 4 times a year.

What is the best birth control pill to choose at age 20?

It is best to use non-hormonal drugs. These are condoms, gels and suppositories with substances that inhibit sperm. Regarding hormonal pills, they should be prescribed by a doctor after carefully studying the medical history. In addition, it is advisable to take hormone tests. Young girls are usually prescribed low-dose drugs.

List of hormones for young girls:

• Yarina
• Novinette
• Janine

These medications are not only prescribed to prevent pregnancy. Microdosed hormonal tablets allow you to regulate your periods and improve the balance of hormones. Often prescribed for irregular periods.

birth control pills at 20

What is the best birth control pill to choose at age 25?

At 25 years old, if you do not have children, it is better to take microdosed COCs. They contain a minimum of hormones, while you can adjust the frequency and regularity of your periods.

Name of COCs for girls 25 years old:

• Lindineth
• Regulon
• Triquilar

birth control pills at 25

What is the best birth control pill to choose at 30?

• At this age, it is worth switching to mini-dose medications. The hormone content in them is slightly higher than in microdosed ones. At the age of 30, women's hormonal levels change slightly. Mini-dose preparations are ideal for women who have given birth
• They prevent pregnancy and have a beneficial effect on the condition of the genital organs. The risk of fibroids, endometriosis and other ailments is much lower than in women who do not take COCs
• It is at this age that you should switch to mini-pills if your periods are long and very heavy. Mini-pills contain only one hormone – progestin. It thickens cervical mucus and helps the endometrium to completely exfoliate during menstruation. Can be taken by nursing mothers

birth control pills at 30

What is the best birth control pill to choose at 35?

After age 35, about 50% of all pregnancies end in abortion. Not every woman wants to become a mother at that age. At the same time, many representatives of the fair sex have ailments of the endocrine system, excess weight and chronic diseases of internal organs. Tablets should be safe and help cope with ailments. The minimum hormone content is 20 mcg.

Common contraceptives for women 35 years old:

• Silest
• Femoden
• Marvelon

birth control pills at 35

What is the best birth control pill to choose at 40?

Many gynecologists prescribe mini-pills to mature women. This is due to the content of one hormone - progesterone. After all, most women of this age produce a lot of estrogen, which contributes to excessive growth of the endometrium.

Because of this, endometriosis, endometrial hyperplasia, and polyps of the uterine cavity develop. It is progesterone that helps cope with these ailments. The hormone thickens cervical mucus and inhibits ovulation.

Minipili for women 40 years old:

• Continuin
• Exluton
• Charosetta

birth control pills at 40

As you can see, hormonal contraceptives must be prescribed by a doctor. Even if the pills are ideal for your friend, this does not mean that they will not harm you.

VIDEO: Birth control pills

Every woman should pay special attention to her health, starting from a very young age. This article will discuss what good birth control pills can be recommended for girls who have decided to take such an important step for the first time.

About hormonal drugs

First of all, I would like to say that birth control pills are one of the simplest, most convenient and effective methods of female contraception. And if earlier the concept of “hormonal drugs” could cause horror in the eyes of the fair sex, then modern medications of this type have practically no side effects and do not harm the body at all. But this is only if the most important rule is followed: such contraceptives should be prescribed exclusively by a doctor. Self-medication can lead to negative irreversible consequences.

Types of birth control pills

When figuring out which good birth control pills are best to choose from the list of those offered, it must also be said that there are several main types:

1. COCs, i.e. combined oral contraceptives. They are single-, two- and multi-phase.
2. Mini-pills, that is, progestogen contraceptives. They contain a small dose of the hormone, hence the name - minimal pills.
3. Medicines intended for emergency contraception (taken irregularly).

Depending on the situation and need, a woman can be prescribed any of these types of contraceptives.

COOK

So, what are good birth control pills in this group of contraceptives? A doctor can prescribe these drugs to women who have virtually no health problems. After all, there are certain restrictions for taking COCs. They should not be prescribed if the lady has the following problems:

1. Diabetes mellitus.
2. Hypertension or other heart disease.
3. Liver diseases.
4. Migraines.
5. High possibility of blood clots.

In addition, such drugs are contraindicated for women over 35 years of age who actively smoke (taking COCs and smoking can lead to thrombosis, a most dangerous disease).

These drugs perfectly perform their main function: preventing pregnancy. This occurs by suppressing ovulation. In addition, COCs also have additional advantages:

1. Helps cope with acne.
2. Reduce hair growth on the body and face.
3. Reduce menstrual pain.
4. Even out the menstrual cycle.
5. They prevent cancer of the ovaries, uterus, and ovarian cysts.

Action of COC

If a girl decides to take birth control pills, their effect on the body is what else needs to be talked about. So, the main task of these drugs is to block ovulation, that is, to prevent eggs from leaving the ovaries. This makes it impossible for them to be fertilized by sperm, and therefore become pregnant.

Rules for taking COCs

How to take birth control pills correctly? It is worth saying that these drugs can be mono- and multiphase. At the same time, the method of taking them will also differ. However, one thing must be said: you should not skip taking pills, because this may affect the contraceptive properties of the prescribed drug (in this case, you will need to use, for example, condoms during sexual intercourse). COCs are taken continuously for twenty-one days, then a break is taken for a week (in total this is 28 days, i.e. a woman’s ideal menstrual cycle). Your period will begin at this time.

Main representatives

What are the good birth control pills in this group of drugs?

1. For young women who have an irregular sex life and have not yet given birth, it is best to use microdosed preparations. Among them we can highlight such products as “Jess”, “Novinet”, “Mersilon”. These are all monophasic drugs.
2. If a girl has not given birth yet, but has an active, regular sex life, the doctor will most likely prescribe the following drugs to her: “Yarina”, “Zhanine”, “Diana-35” or “Belluna-35”. These are low-dose monophasic drugs.
3. High-dose medications can be prescribed to those ladies for whom, in addition to contraception, these pills also need to resolve certain hormonal problems. Among such drugs may be “Ovidon”, “Triziston”, “Tri-regol”.

Mini-pill

Let's look further at which birth control pills are best for women to take. Ladies who are representatives of special categories should pay attention to the next group. Such drugs can be prescribed to women with certain diseases, including diabetes, hypertension, etc. It is also good to take these birth control pills after 40 years of age, because they are most effective at that age. In addition, they are recommended for those women who smoke. A special group consists of young mothers. Mini-pills are especially effective during breastfeeding (you can safely start taking these pills immediately after birth). They are also recommended for ladies who are preparing for surgery (in such a situation, taking COCs is contraindicated). However, if you compare drugs in this group with combined oral contraceptives, the risk of getting pregnant is slightly higher. In addition, taking a mini-pill can cause the development of ovarian cysts or ectopic pregnancy. You should also pay special attention to this when choosing.

Action

So, we looked at the mini-pill - birth control pills. Their effect on the woman’s body will be as follows: a change in the mucous membrane of the uterine cavity (increased viscosity of mucus). This will make it difficult for sperm to penetrate and make implantation of a fertilized egg almost impossible.

Methods of administration

What should be a competent reception? In this case, birth control pills should be taken continuously, even without stopping during menstruation. If you missed one pill and less than three hours have passed, you need to take it immediately. If it is more, you should use additional contraceptives for 7 days. As for spotting, when taking the mini-pill, menstruation may occur unplanned on any day of the cycle. This is one of the main inconveniences of taking these medications.

Representatives

Which birth control pills are best to take from the mini-pill group? The doctor will most likely prescribe the following monophasic drugs: Charozetta, Microlut, Laktinet (designed specifically for nursing mothers) or Exluton.

Emergency contraception

There is another group of drugs for women who do not want to get pregnant. These are emergency contraceptive pills, which are not taken regularly, but only in case of unprotected sexual intercourse. These may be the following drugs:

1. "Mifepristone."
2. "Ulipristal acetate."
3. Levonorgestrel.

These medications should be taken for 5 days after unprotected intercourse. Pregnancy does not occur in 60-90%.

Competent selection

How to choose the right birth control pills? Reviews from doctors indicate that they should only be prescribed by a specialist. Self-medication often leads to irreversible serious consequences. The correct principle for selecting birth control pills for women:

1. Consultation with a gynecologist.
2. Consultation with a mammologist - breast examination.
3. Smear for oncocytology.
4. Biochemical blood test.
5. Pelvic ultrasound performed on the fifth to seventh day of the menstrual cycle.

In this case, the doctor will need to know the age, height and weight of the patient, as well as the presence of underlying diseases. The doctor will require the following information:

1. Regularity of the cycle.
2. Abortion or childbirth.
3. Abundance of discharge.

All these nuances are needed to determine a woman’s phenotype, on the basis of which the use of certain oral contraceptives can also be prescribed.

About phenotypes

Can women take birth control pills if they are not prescribed by a doctor? Highly not recommended. However, when independently selecting such contraceptives, a woman can try to independently determine her phenotype:

1. Estrogen type of women. These are short, very feminine ladies with large breasts, whose skin and hair are prone to dryness, discharge is abundant, menstruation itself lasts more than five days, the cycle is more than 28 days. The main symptom of PMS: nervousness. In this case, you can take the following drugs: Microgenon, Regividon.
2. Balanced type. These are ladies of average height, feminine, with moderately developed breasts. Skin and hair are normal. The discharge is moderate, menstruation lasts five days, and the cycle is 28 days. PMS is practically absent. In this case, the doctor may prescribe the following drugs: Novinet, Regulon, Mercilon.
3. Progesterone type. These are tall, thin, boyish girls. The skin and hair are most often oily, and the discharge is scanty. Menstruation lasts less than five days, the cycle is less than 28 days. During PMS, women are prone to depression. In this case, it is best to take such products as “Diane-35”, “Janine”, “Jess”, “Yarina”.

You can read the instructions on how to take birth control pills. As an option, ask the doctor himself to tell you about it.

What to pay attention to

Can I take birth control pills if a woman experiences certain side effects? It's best not to do this. If you experience the following symptoms, you should immediately stop taking the prescribed oral contraceptives:

1. Skin itching or rash.
2. Menstrual irregularities (unscheduled menstruation when taking COCs regularly).
3. Visual and hearing impairments.
4. Sudden changes in pressure.
5. Suspicion of pregnancy.

Adaptation

If a woman is just starting to take oral contraceptives, she should understand that the body must get used to them. After all, although this is a small dose of the hormone, it is not planned by the body. Therefore, at first, minor side reactions are possible, which should not worry the lady too much. If they do not go away within three months from the start of taking the pills, you need to contact your doctor with a request to change the drug. If birth control pills are completely suitable for a woman, she should not feel any discomfort after taking them. Moreover, her quality of life will improve to a certain extent.

Many women are afraid to take birth control pills for fear of side effects. Innovative technologies make it possible to produce contraceptive drugs that contain a minimal amount of hormones and only affect the process of conception.

Pharmacological action

New generation birth control pills contain a complex of progestogens and estrogens. These sex hormones inhibit the synthesis of gonadotropins (follicle-stimulating and luteinizing hormone) in the pituitary gland of the brain. As a result, the process of egg maturation and follicle rupture is blocked, so pregnancy cannot occur.

Oral contraceptives help thicken the cervical mucus, making it difficult for sperm to move and penetrate the uterus. After taking birth control pills, a secretory transformation of the endometrial layer occurs; even if spontaneous ovulation occurs, fertilization of the egg occurs, the embryo cannot be implanted into the uterine wall.

Third-generation progestogens have a high affinity for the hormonal receptors of progesterone, so they can bind to them and have a contraceptive effect, blocking ovulation and the release of FSH and LH. At the same time, progestogens have a low affinity for androgen receptors, which reduces the risk of side effects such as male-pattern hair growth, acne, excess weight, hair loss, irritability, etc.

The contraceptive effect of the pills is mainly provided by progestogens; estrogens support the proliferation of the inner layer of the uterus, control the course of the menstrual cycle, and replace the lack of estradiol, the synthesis of which is blocked along with ovulation. Thanks to synthetic estrogens, intermenstrual bleeding does not occur while taking modern birth control pills.

Depending on the composition of the active ingredients, COCs are distinguished - combined oral contraceptives containing progestogens + estrogens, and purely progestogen contraceptive pills (mini-pills).

Taking into account the daily dosage of synthetic estrogens, COCs are classified:

• High-dose ones contain up to 50 mcg/day. ethinyl estradiol.
• Low-dose contraceptives include no more than 35 mcg/day. estrogenic component.
• Microdosed tablets are characterized by the smallest amount, not exceeding 20 mcg/day.

High-dose hormonal contraceptives are used only for medicinal purposes and for emergency protection after unprotected sexual intercourse. Currently, preference is given to low and micro-dose contraceptives for the prevention of unwanted pregnancy.

Depending on the combination of progestogens and estrogens, COCs are divided into:

• Monophasic tablets are characterized by a constant daily dose of both sex hormones.
• Multiphasic contraceptives are characterized by variable dosages of estrogen. This creates an imitation of fluctuations in hormonal balance in a woman’s body during different phases of the menstrual cycle.

Tablets with a low content of hormones provide reliable protection against unplanned pregnancy (99%), are well tolerated, and allow you to control the menstrual cycle. After stopping taking COCs, reproductive function is restored within 1–12 months.

In addition to the contraceptive effect, oral contraceptives are prescribed for the treatment of dysmenorrhea, reducing the volume of blood loss during menstruation, ovulatory pain, and reducing the frequency of relapses of inflammatory diseases of the genitourinary system. COCs reduce the risk of developing endometrial cancer of the uterus, ovaries, rectum, anemia, and ectopic pregnancy.

Pros and cons of taking COCs

The main benefits of taking combined birth control pills include:

• high level of reliability – 99%;
• additional therapeutic effect;
• prevention of chronic diseases, cancer;
• rapid contraceptive effect of pills;
• protection against ectopic pregnancy;
• accidental use of COCs in early pregnancy is not dangerous;
• prevent the occurrence of intermenstrual, dysfunctional uterine bleeding;
• contraceptives are suitable for long-term contraception;
• the ability to stop taking the pill if you want to get pregnant;
• the condition of the skin improves.

After short-term use of combined oral contraceptives (3 months), the sensitivity of hormonal receptors in the ovaries increases, therefore, after discontinuation of COCs, increased stimulation of ovulation and the release of gonadotropins occurs - a rebound effect. This method of therapy helps women suffering from anovulation to become pregnant.

The disadvantages of taking birth control pills include high cost and possible side effects. Undesirable manifestations are rare (10–30%), mainly in the first few months. Later, the women's condition returns to normal. Simultaneous use of COCs and anticonvulsants, antituberculosis drugs, tetracyclines, antidepressants reduces the therapeutic effect of contraceptives.

Common side effects include:

• irritability, aggressiveness, tendency to depression;
• migraine;
• swelling of the mammary glands;
• impaired glucose tolerance;
• weight gain;
• chloasma - the appearance of age spots on the skin;
• acne, seborrhea;
• breakthrough bleeding;
• intermenstrual bleeding;
• thrombophlebitis;
• decreased libido;
• amenorrhea due to endometrial atrophy;
• increased blood pressure.

If side effects do not go away after 3 months of taking contraceptives, the pills are discontinued or replaced with other drugs. A complication such as thromboembolism is extremely rare.

Indications and contraindications for taking COCs

Combined oral contraceptives are suitable for women who have regular sex life, suffer from painful, heavy menstruation, endometriosis, and benign tumors of the mammary glands. It is possible to prescribe birth control pills in the postpartum period if the mother does not breastfeed.

Contraindications:

• thrombophlebitis;
• diseases of the cardiovascular system;
• diabetes mellitus;
• pregnancy or suspicion of possible conception;
• pancreatitis;
• inflammatory diseases, liver tumors;
• renal failure;
• lactation;
• uterine bleeding of unknown etiology;
• migraine;
• individual intolerance to the active ingredients.

If pregnancy occurs, birth control pills should be stopped immediately. But if a woman takes the medicine after conception, there is no significant risk to the intrauterine development of the child.

COC dosage regimens

Contraceptives are selected individually for each woman. This takes into account the presence of gynecological diseases, concomitant systemic ailments, and possible contraindications.

The doctor advises the patient about the rules for taking COCs and monitors them for 3–4 months. During this period, the tolerability of the pills is assessed, and a decision may be made to cancel or replace the contraceptive. Dispensary records are maintained throughout the entire period of contraceptive use.

First-line drugs include monophasic COCs containing estrogen no more than 35 mcg/day. and gestagens with weak androgenic effects. Three-phase tablets are prescribed for primary or secondary estrogen deficiency, decreased libido, dry vaginal mucosa, and menstrual irregularities.

After starting to take birth control pills, side effects may occur in the form of spotting, intermenstrual bleeding, breakthrough uterine bleeding caused by changes in hormonal levels. After 3 months, all symptoms should go away. If the discomfort persists, the drug is replaced taking into account the problems that have arisen.

Birth control pills are taken at the same time every day. For convenience, serial numbers are indicated on the blister. COCs are started on the first day of the menstrual cycle and continued for 21 days. Then they take a break for 1 week, during this period withdrawal bleeding is observed, which ends after the start of a new package.

If you miss taking another contraceptive pill, you should take it no later than 12 hours later. If more time has passed, the contraceptive effect of the drug will be lower. Therefore, over the next 7 days it is necessary to use additional barrier agents against unwanted pregnancy (condom, suppositories). You cannot stop taking COCs.

Dosage regimens

Schemes for prolonged use of combined oral contraceptives for menstrual irregularities:

• Short dosing of birth control pills allows you to increase the interval between periods by 1-4 weeks. Such regimens are used to delay spontaneous menstruation, prevent bleeding, and cancel after a course of oral contraceptives.
• Long-term dosing is prescribed to delay menstruation from 7 weeks to several months. Treatment with birth control pills is prescribed for anemia, endometriosis, premenstrual syndrome, hyperpolymenorrhea.

Some women prefer cyclic use of COCs with a seven-day break due to fear of pregnancy and infertility. Some patients believe that menstruation is a physiological process.

Popular combined oral contraceptives

Low Hormone Microdose Pills:

• Median is a monophasic estrogen-progestogen COC. The drug contains drospirenone, which has an antimineralkorticoid effect, prevents excess body weight gain, the appearance of edema, acne, oily skin, and seborrhea.
• contains ethinyl estradiol 20 mcg, dospirinone 3 mg. The contraceptive drug is prescribed for contraception purposes, for the treatment of severe acne, painful menstruation.
• Lindinet 20 tablets include ethinyl estradiol 20 mcg, gestodene - 75 mcg. Indicated for use in painful menstruation, irregular cycles, and for contraception.
• Zoely. Active ingredients: estradiol hemihydrate – 1.55 mg, nomegestrol acetate – 2.5 mg. Nomegestrol acetate is a highly selective progestogen with a similar structure to progesterone. The active component has mild androgenic activity and does not have mineralocorticoid, estrogenic or glucocorticoid effects.

Mini-pill

Popular contraceptive pills with minimal hormone content - mini-pills - are an alternative means of contraception for women who are contraindicated in taking COCs. The drugs contain microdoses of progestin, an analogue of progesterone. One capsule contains 300–500 mcg/day. The action of mini-pills is inferior to COCs, but they have a milder effect; they are recommended for women who experience side effects after taking combined contraceptive pills.

Representatives of the fairer sex can take low-dose progestin preparations during lactation; the active substance does not affect the taste of breast milk and does not reduce its volume. Unlike COCs, mini-pills do not cause blood thickening, do not contribute to thrombosis, or increase blood pressure, therefore they are approved for use in cardiovascular pathologies and thrombophlebitis.

Progestin-only birth control pills do not affect ovulation; they thicken cervical mucus, preventing sperm from entering the uterine cavity and ovaries. In addition, the peristalsis of the fallopian tubes slows down, proliferative changes in the endometrium occur, which does not allow the embryo to implant in the event of fertilization of the egg. When taking gestagen drugs, the menstrual cycle and regular bleeding are maintained.

The contraceptive effect is achieved 3–4 hours after taking the tablet and lasts for 24 hours. Mini-pills provide 95% protection against unplanned pregnancy.

Rules for using the mini-pill

Before starting to use contraceptives, women must be examined by a gynecologist to rule out pregnancy and chronic diseases of the reproductive system. To get the desired result, you must strictly follow the rules for using the mini-pill:

• Taking pills starts from the first and continues until the 28th day of the menstrual cycle, drinking them continuously at the same time. Missing the next dose of contraceptives for more than 3 hours completely eliminates the contraceptive effect.
• Nausea may occur during the first few weeks, but this symptom usually goes away gradually. To reduce discomfort, it is recommended to take the tablet with food.
• If you vomit after taking the mini-pill, you should take the pill again as soon as you feel normal. This recommendation also applies to diarrhea. In the next 7 days, you must use additional contraception (condom) to protect against unwanted pregnancy.
• When switching from COCs, you should take mini-pills immediately after finishing the package of combined contraceptives.
• Pregnancy can occur in the first month after stopping progestogen pills. Ovulation occurs 7–30 days (average 17) after the end of the 56-day course.
• Women who are prone to the appearance of age spots (chloasma) after exposure to the sun should avoid prolonged exposure to ultraviolet radiation.
• When taking mini-pills and barbiturates, activated carbon, laxatives, anticonvulsants, and Rifampicin at the same time, the effectiveness of contraceptives becomes less.
• In the postpartum period, progestin contraceptives are prescribed on the first day of menstruation, but not earlier than 6 months after the birth of the child.
• After an abortion, you start taking pills immediately after the operation; no additional contraception is required.
• The contraceptive effect of the mini-pill is weakened if the gap between taking the next contraceptive pill is more than 27 hours. If a woman forgets to take the medicine, it is necessary to do so as soon as possible and then strictly follow the treatment regimen. Over the next week, it is necessary to use additional means of protection against pregnancy.

Contraindications

It is contraindicated to take oral contraceptives with a low dose of hormones during pregnancy, with uterine bleeding of unknown etiology, liver disease, taking steroids, exacerbation of herpes, liver failure. You should not take the pills if you have previously had an ectopic pregnancy, or if you have detected or suspected malignant tumors of the mammary glands. Contraindications include lactose intolerance and glucose-galactose malabsorption.

A decrease in the effectiveness of contraceptives can be observed if the rules of administration are violated, the use of laxatives, barbiturates, anticonvulsants, after vomiting, diarrhea. Irregular menstruation may occur against the background of gestagen pills. In such cases, it is necessary to stop taking the mini-pill, rule out possible pregnancy (including ectopic) and only then resume the course.

Side effects of birth control pills

Mini-pills have fewer side effects than COCs. The negative consequences of taking birth control pills include:

• vaginal candidiasis (thrush);
• nausea, vomiting;
• intermenstrual bleeding;
• intolerance to contact lenses;
• swelling of the mammary glands, discharge from the nipples;

• contraceptives cause weight gain;
• the appearance of chloasma;
• urticaria, erythema nodosum;
• headache;
• acne;
• breakthrough bleeding while taking drugs that affect liver function;
• decreased libido;
• follicular ovarian cyst;
• amenorrhea, dysmenorrhea.

Minipills may increase insulin requirements in patients with diabetes. Therefore, before taking birth control pills, it is necessary to consult with an endocrinologist and, if necessary, adjust the dosage of hypoglycemic agents. Women should constantly monitor their blood sugar levels during the first month of taking the mini-pill.

In rare cases, the use of progestin agents can provoke the development of thromboembolism. It should be taken into account that in women over 40 years of age, the risk of developing breast cancer increases during treatment with hormonal drugs. If serious side effects occur, the mini-pill should be discontinued.

If, after pregnancy, there is an accidental use of contraceptives, there is no risk to the fetus, but the further course of pills should be discontinued. At high dosages of progestogens, masculinization of the female embryo can be observed. During lactation, some of the active substances of the drug penetrate into breast milk, but its taste does not change.

Popular mini-pills

• Femulen (ethinodiol).
• Exluton (linestrenol 0.5 mg).
• Charosetta. The active substance is desogestrel in a dosage of 75 mcg. The tablets do not cause significant disturbances in carbohydrate, lipid metabolism, or hemostasis.
• Microlut (levonorgestrel 0.03 mg).
• Continuin (ethinodiol acetate 0.5 mg).

The disadvantages of using progestin contraceptive pills include the possible formation of follicular ovarian cysts, menstrual irregularities, edema, weight gain, and irritability. The contraceptive effect of the mini-pill is lower than that of COCs, 90–97%.

Modern contraceptive drugs contain small doses of hormones, provoke the development of side effects to a lesser extent, and provide reliable protection against unplanned pregnancy. The pills are prescribed by the attending physician, taking into account the woman’s individual indications. The patient must be registered with a dispensary for the entire period of use of COCs or mini-pills. Particularly careful monitoring is carried out during the first 3–4 months from the start of using oral contraceptives.

Planned children born into a family based on a thoughtful and balanced decision are the key to harmony in the home, so this issue should be approached seriously. To avoid unwanted pregnancy, as well as to treat a number of gynecological problems, there are many medications. Before deciding which birth control pills are best to choose, you should understand the huge range of oral contraceptives that today's pharmaceutical market offers. All products created to prevent conception are divided into two groups:

1. COOK. Combined oral contraceptives with different compositions.
2. Mini-drinks. The most gentle for the body with one analogue of the hormone progesterone.

   Depending on what hormones are used in the drug, COCs are divided into:

   • monophasic;
   • two-phase;
   • three-phase.
   Also, based on the number of active components in the composition, the following classification is accepted:
   • microdosed;
   • low-dose;
   • high-dose
   It should be remembered that at different ages, certain medications may or may not be suitable for a woman. Therefore, to find out which are the best birth control pills after 30, 40 or 45 years, in your case, you must definitely visit a gynecologist, he will be able to give the most accurate recommendation.

   Let's take a closer look at the most popular anti-conception medications today.

   Regulon birth control pills

   

   
   Monophasic, combined contraceptive containing estrogen and gestagen.
   1. Action. The drug is effective due to its effect on the hypothalamic-pituitary-ovarian system. With its help, the susceptibility of the endometrium to the blastocyst is reduced and the mucous viscosity in the cervix increases, which makes it more difficult for sperm to move.
   2. Application. Prescribed 1 piece per day from the first day of the full menstrual cycle. You need to drink it for 21 days, preferably at the same time. After this, the course is interrupted for a week and a new package is started. If more than five days have passed since the onset of menstrual bleeding, you should postpone the start of use to the next cycle.
   3. Contraindications. Prohibited for patients with severe arterial hypertension, thromboembolism, ischemia, atherosclerosis, serious liver problems, heart defects, diabetic angiopathy, otosclerosis, genital herpes, hypersensitivity to components, lupus erythematosus, estrogen-dependent tumors, genital bleeding.
   4. Side effects. Stroke, thrombosis, hypertension, heart attack, cholestatic jaundice, Sydenham chorea, and cholelithiasis were observed extremely rarely.
   The price of Regulon in Russia is about 460 rubles, and in Ukraine 130–160 UAH.

   Jess - anti-conception pills

   

   
   Low-dose contraceptive with antiandrogenic, antimineralocorticoid effect, good cycle control. Contains drospirenone and ethinyl estradiol. Prescribed for acne vulgaris and for the treatment of complex premenstrual syndrome.
   1. Action. It prevents you from getting pregnant by suppressing ovulation, changing the properties of cervical secretion, which is why it becomes almost impenetrable to sperm.
   2. Application. Drink one tablet a day for 28 days without breaks, drinking plenty of water. As soon as the blister is finished, move on to the next one.
   3. Contraindications. It should not be used by patients with diabetes mellitus, tumors in the liver, mammary glands, kidney or adrenal insufficiency. Prohibited for thrombosis, after heart attacks, ischemic attacks, vaginal bleeding, angina pectoris, pancreatitis, neurological migraine.
   4. Side effects. Mood swings, anxiety, nervousness, headache, candidiasis, breast inflammation, irregular menstruation, nausea, vomiting, diarrhea, skin rashes, fluid retention, weight gain or loss.
   The price of Jess in Russia is 1100–1200 rubles, and in Ukraine 200–250 hryvnia. We have already done a more detailed one earlier.

   Contraceptive Tri-Regol

   

   
   A three-phase product containing estrogen and gestagen. Used for contraception, treatment of bleeding disorders, premenstrual syndrome, dysmenorrhea.
   • Action. The release of luteinizing hormone and follicle-stimulating hormone is prevented, which inhibits ovulation, and the viscosity in the cervix changes and sperm cannot get further into the cavity.
   • Application. One piece is consumed daily for three weeks, then take a break for 7 days. First, drink six pink ones, then five white and ten dark yellow tablets.
   • Contraindications. Not prescribed for hypersensitivity to components, Gilbert, Rotor, Dubin-Johnson syndromes, severe liver and kidney diseases, cholecystitis, colitis, problems with the heart and blood vessels, thromboembolism, diabetes, tumors, sickle cell anemia, migraine, otosclerosis, herpes, severe skin itching, lipid metabolism disorders.
   • Side effects. Possible nausea and vomiting, tension in the mammary glands, weight changes, discomfort when wearing lenses, headache, intermenstrual bleeding, depression.
   The price of Tri-Regola in Russia is 300 rubles, and in Ukraine 220–300 UAH.

   Birth control pills Novinet

   

   
   Single-phase medicine, with ethinyl estradiol and desogestrel. A reliable method of contraception that reduces the amount of bleeding and the duration of menstruation, relieves pain, minimizes the possibility of infections in the pelvis, anemia, ectopic pregnancy, and the development of diseases in the uterus and ovaries.
   • Action. Inhibits the maturation of the egg due to the influence of luteal and follicular synthetic hormones.
   • Application. For a three-week period, take 1 tablet, then stop for 7 days and start a new package. If it is necessary to delay menstruation, there is no break.
   • Contraindications. Do not use if you have malignant tumors in the uterus and mammary glands, thrombosis, pulmonary embolism, stroke, heart attack, hypertension, severe diabetes mellitus, lipid metabolism disorders, liver and kidney diseases, jaundice, hearing impairment during a previous pregnancy, autoimmune diseases, skin rashes.
   • Side effects. Vomiting, nausea, allergic rash, intermenstrual bleeding, pain in the head and mammary glands, weight changes, cervical and glandular cancer, liver problems, thromboembolism, jaundice, sudden abdominal pain.
   The price of Novinet in Russia is 500 rubles, and in Ukraine 135–170 hryvnia.

   Contraceptive Yarina

   

   
   Monophasic drug, with a combination of two main active components of estrogen ethinyl estradiol and the gestagen drospirenone. It is very useful for patients suffering from hormone-dependent fluid retention, seborrhea, and acne.
   • Action. The medicine changes the viscosity of the cervical mucus, inhibits ovulation, and prevents the development of the egg. Also, with its help, the concentration of HDL increases and the lipid profile improves; the drug has antiandrogenic activity.
   • Application. Every day for 21 days at a certain time they drink one tablet, then stop for seven days and then continue according to the same scheme.
   • Contraindications. You cannot be treated with this medication if the patient has thrombosis, ischemic attacks, severe renal and hepatic pathologies, angina pectoris, tumors, diseases of the mammary glands, genital organs, bleeding, diabetes mellitus, heart attack or stroke.
   • Side effects. Pain in the mammary glands, discharge, intolerance to contact lenses, nausea, pain in the head and abdomen, skin rashes, chloasma, migraine, fluid retention, changes in secretion in the vagina.
   The price of Yarina in Russia is 1100 rubles, and in Ukraine 200–250 UAH.

   There are many proven remedies that reliably protect against unwanted pregnancy, but at the same time they can cause a number of unpleasant side effects. Therefore, pharmaceutical companies annually try to release new medications, the use of which will not pose a health risk. Today there are already a number of non-hormonal products on sale or with extremely low percentages of them. The TOP 5 best birth control pills we reviewed consist of drugs that will not only prevent conception, but will also affect the woman’s health as carefully as possible.

   If you decide to use oral contraception, you should definitely consult with a specialist; he will help you choose the right medicine based on the condition, age and individual characteristics of the patient’s body.

   How to choose birth control pills, see the following video: