Hormonal tablets are possible. Rating of the best contraceptives

Unplanned pregnancies often end in abortion. This method adversely affects 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 contraceptive pills reaches 100%. In many cases, due to them, a therapeutic effect is also achieved. Oral hormonal contraceptives (OCs) have been used for over 40 years. During this time they have been constantly studied and improved. Combined OCs were created, in which the content of hormones is significantly reduced, and contraceptive effectiveness is preserved.

How does hormonal contraception work?

Birth control pills "turn off" ovulation, while maintaining cyclical 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 effect of oral contraceptives on a woman's body is as follows:

• stabilization of the menstrual cycle, while reducing the amount of blood released. It helps correct the iron deficiency anemia that many women experience;
• reduction of abdominal pain during ovulation with and manifestations;
• increasing the protective properties of the mucus of the cervical canal, which reduces the frequency of infections of the uterus and appendages by half;
• reduction in the frequency and associated curettage;
• reducing the risk of developing mastopathy when taking monophasic oral contraceptives, especially those containing progestogens with low androgenic activity;
• suppression of androgen production in the ovaries, helping to treat acne, seborrhea, hirsutism and other manifestations of the viril syndrome. This is especially true of contraceptive pills containing progestogens with an antiandrogenic effect or with low androgenic activity;
• increase bone density, improve calcium absorption, which prevents the development of osteoporosis.

Composition of oral contraceptives, classification and their names

Combined oral contraceptives contain an estrogen and a progestogen component. Progestogens prevent pregnancy, and estrogen causes endometrial proliferation, mimicking its normal development, while irregular uterine bleeding is excluded. In addition, it replaces the body's own estrogens, which cease to be produced in the ovaries when using oral contraception.

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

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

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

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

Oral contraceptives are divided into monophasic, biphasic and triphasic.

• In monophasic, the content of both components is the same in all tablets.
• Biphasic contains 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 progestogens are less.
• Three-phase contraceptives have a changing ratio of components that mimics the normal menstrual cycle.

List of the most common monophasic contraceptives:

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

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

• Tri-merci (contains desogestrel);
• trialen;
• Trisilest.

Contraceptive pills with an antiandrogenic effect include a progestogenic component with an antiandrogenic effect (Diana-35, Janine) or with a strong progesterone-like effect (Tri-merci, 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 signs 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, minisiston 20 fem, oralcon, rigevidon)
3. Desogestrel + estrogen (Marvelon, Mercilon, Novinet, Regulon)
4. Gestodene + estrogen (gestarella, lindinet, logest, femoden)
5. Norgestimate + estrogen (silest)
6. Drospirenone + estrogen (Vidora, Dailla, Jess, Dimia, Midiana, Modell Pro, Modell Trend, Yarina)
7. Nomegestrol + estrogen (zoel)
8. Dienogest + ethinylestradiol (diecyclene, janine, silhouette)

Progestogens and estrogens in combinations for sequential administration:

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

Progestogens:

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

Emergency contraceptive drugs - levonorgestrel.

Which of the listed means is better to choose for permanent use? It is impossible to answer this question unambiguously. In different situations, different drugs will be more effective.

Selection of hormonal oral contraceptives

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

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

How to choose birth control pills according to age:

1. For women under the age of 35, low-dose or microdose monophasic contraceptives, as well as triphasic contraceptives, including those containing desogestrel or drospirenone, are preferable.
2. Women after 35-40 years of age are more suitable for monophasic drugs with desogestrel or drospirenone, pure progestins or microdose agents.

The names of birth control pills should be checked with a doctor, because the prescription will most likely only list the active ingredients. The doctor now has no right to write the specific name of the drug in the prescription.

How to take birth control pills

For many years, doctors have used the 21 + 7 scheme for constant intake. Now the “24 + 4” mode is becoming more widespread, that is, 24 days of admission, a break in admission of 4 days.

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

There are regimens that allow you to shift 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, such as when traveling to a sporting event or vacation, before surgery, and so on. Modes for long-term use can be prescribed during treatment, anemia, as well as with the peculiarities of a woman's life, including sports and professional activities. In this case, the woman does not have menstruation 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 harm health.

Schemes of taking hormonal contraceptives

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 packages that make it easier to count days. If you skip 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 the intake can occur at different times - from a month to a year. It depends on the state of health of the woman, her hormonal levels, ovarian function. Taking oral contraceptives in cycles preceding pregnancy is safe for the unborn child. If pregnancy is suspected, oral contraceptives should be stopped immediately. However, using them in the early stages will also not harm the fetus.

In some cases, short-term use of contraceptives for 3 months is used to stimulate ovulation after they are stopped, which increases the chance of becoming pregnant. This property of hormonal contraceptives is used to treat infertility.

How long can birth control pills be taken?

With regular monitoring by a gynecologist, good tolerance and effectiveness, such drugs have been 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 protection (coitus interruptus). It happens that a condom breaks or violence occurs. Every woman should know the names of emergency contraceptive pills. Most often, such means as Postinor, Escapel, Eskinor-F are used.

They must be taken within the first 72 hours after intercourse. It is not recommended to reuse the same drugs in the current menstrual cycle. Barrier methods of contraception should be used to prevent pregnancy. In case of repeated unprotected intercourse during the cycle, only emergency non-hormonal contraception using Danazol is used. Its effectiveness is much lower than levonorgestrel.

Side effects and contraindications

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

Side effects are most often mild. At the beginning of the reception, 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 violations of the cycle.

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 not excluded. 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 disorders include intermenstrual spotting when taking hormonal contraceptives, as well as the absence of menstruation. If the 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 atrophy of the endometrium, goes away on its own or is treated with estrogens.

Severe consequences after taking contraceptives are rare. These include thrombosis and thromboembolism, including deep vein 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.

Application is contraindicated in the following cases:

• arterial and venous thromboses;
• transferred transient ischemic attack;
• cardiac ischemia;
• diabetes mellitus with vascular complications;
• migraine with focal neurological symptoms;
• a 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 benefits.

If a woman does not want or cannot take hormonal OCs, she can use new generation non-hormonal contraceptive pills to prevent pregnancy. It must be clearly understood that they mean spermicidal agents for topical use, that is, vaginal tablets. They must be inserted into the vagina before 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%. Of this group, the most commonly used vaginal tablets are Pharmatex, Benatex, Gynecotex.

In modern gynecology, hormonal contraception is considered the "gold standard" for preventing unwanted pregnancies. Modern means are effective, well tolerated, have not only a contraceptive, but also a therapeutic effect. Self-selection of birth control pills is difficult. To discuss issues of contraception, 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 illnesses
• Woman's weight
• The presence of diabetes
• Physique of a woman
• The presence of gynecological ailments

Incorrectly selected drugs can cause gynecological ailments and even infertility.

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

The easiest way to buy non-hormonal pills. But the most common are low-dose hormonal pills. The content of hormones in them is minimal, so they do not do any harm, provided that the woman is absolutely healthy. In the presence of any chronic ailments, it is better to seek help from a doctor.

Be sure to evaluate menstruation. If the discharge during menstruation is meager and lasts only 3-4 days, then gestagens predominate in the body. But if menstruation is heavy and lasts 6-7 days, then estrogens predominate. There is a special table that will allow you to choose the right pills.

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

The most common non-hormonal contraceptives:

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

New generation non-hormonal contraceptive pills

The composition of such drugs contains substances that reduce sperm motility. In addition, they thicken the secretion of the vagina, 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

What birth control pills to take after intercourse, for how many hours?

Such contraceptives are called emergency. They are also called next day pills. It is necessary to take the drug no later than 72 hours after sexual intercourse. There are two types of drugs: based on levonorgestrel and mifepristone. These are hormonal pills that inhibit ovulation, make the cervical mucus very thick and interfere with 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 pills for emergency contraception:

• Postinor
• Escapelle
• Mifepristone
• Eskinor F

Please note that such drugs contain a “horse” dose of hormones, therefore, they adversely affect health. It is allowed to take no more than 4 times a year.

What is better to choose birth control pills in 20 years?

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

List of hormones for young girls:

• Yarina
• Novinette
• Janine

These drugs are prescribed not only to prevent pregnancy. Microdosed hormonal pills allow you to adjust your periods and balance your hormones. Often prescribed for irregular periods.

birth control pills at 20

What is better to choose birth control pills at 25?

At 25, if you don't have children, it's best to take microdosed COCs. They contain a minimum of hormones, while you can adjust the frequency and regularity of menstruation.

Name of COCs for girls aged 25:

• Lindinet
• Regulon
• Triquilar

birth control pills at 25

What is better to choose birth control pills in 30 years?

• At this age, it is worth switching to mini-dose drugs. The content of hormones in them is slightly higher than in microdosed ones. At the age of 30, women's hormonal background changes slightly. Mini-dose preparations are ideal for women who have given birth
• They prevent the onset of 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 you have long periods and very plentiful. Mini pills contain only one hormone - progestin. It thickens cervical mucus and helps to completely exfoliate the endometrium during menstruation. Can be taken by breastfeeding mothers

birth control pills at 30

What is better to choose birth control pills at 35?

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

Common contraceptives for women 35 years old:

• Silest
• Femodene
• Marvelon

birth control pills at 35

What is better to choose birth control pills in 40 years?

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

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

Mninipili for women 40 years old:

• Continuin
• Exluton
• Charosetta

birth control pills at 40

As you can see, hormonal contraceptives should be prescribed by a doctor. Even if the pills fit your friend perfectly, this does not mean that they will not harm you.

VIDEO: Birth control pills

Every woman should pay special attention to the state of her health, starting from a very young age. This article will discuss what good contraceptive pills can be advised to take for girls who first decide to take such an important step.

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 direction have practically no side effects and do not harm the body at all. But this is only when the most important rule is fulfilled: such contraceptives should be prescribed exclusively by a doctor. Self-medication can lead to negative irreversible consequences.

Types of birth control pills

Understanding which good contraceptive pills are best to choose from the list of those proposed, it must also be said that there are several main types of them:

1. COCs, i.e. combined oral contraceptives. They are single, double and multi-phase.
2. Mini-drank, that is, progestogenic contraceptives. They contain a small dose of the hormone, hence the name - minimal pills.
3. Preparations 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 practically no health problems. After all, there are certain restrictions for taking COCs. They cannot be prescribed if the lady has the following problems:

1. Diabetes.
2. Hypertension or other heart disease.
3. Diseases of the liver.
4. Migraine.
5. High possibility of blood clots.

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

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

1. Helps deal with acne.
2. Reduce body and facial hair.
3. Reduce menstrual pain.
4. Align the menstrual cycle.
5. They prevent cancer of the ovaries, uterus, and ovarian cysts.

Action COC

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

Rules for taking COCs

How to take birth control pills correctly? It is worth saying that these drugs can be mono- and multi-phase. However, the way they are received will also differ. However, one thing must be said: you should not skip taking the pills, because this can affect the contraceptive property of the prescribed drug (in this case, during sexual intercourse, you will need to use, for example, condoms). COCs are taken continuously for twenty-one days, then a break is made for a week (in total, this is 28 days, i.e., the ideal menstrual cycle of a woman). At this time, menstruation will come.

Main Representatives

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

1. For young ladies who have an irregular sex life and have not yet given birth, it is best to use microdosed drugs. Among them, one can single out such funds as "Jess", "Novinet", "Mersilon". These are all monophasic drugs.
2. If the girl has not yet given birth, but leads an active regular sex life, the doctor will most likely prescribe the following drugs to her: Yarina, Janine, Diana-35 or Belluna-35. These are low-dose monophasic drugs.
3. High-dose drugs can be prescribed to those ladies who, in addition to contraception, these pills must also resolve certain hormonal problems. Among such drugs may be "Ovidon", "Trisiston", "Tri-regol".

mini pili

We understand further which birth control pills are best for women to take. The next group of attention should be paid to ladies who are representatives of special categories. 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, because they are most effective at that age. In addition, they are advised to those women who smoke. Young mothers constitute a special group. Mini-pills are especially effective during breastfeeding (these pills can be taken without fear immediately after childbirth). They are also advised to ladies who are preparing for surgery (in such a situation, taking COCs is contraindicated). However, if we compare the drugs of this group with combined oral contraceptives, then the risk of becoming pregnant is slightly higher. In addition, taking a mini-pill can cause the development of ovarian cysts or an ectopic pregnancy. It is also worth paying special attention to this when choosing.

Action

So, we looked at mini-pills - birth control pills. Their effect on the body of a lady will be as follows: a change in the mucous membrane of the uterine cavity (an increase in the viscosity of mucus). This will make it difficult for the sperm to penetrate and make it nearly impossible for a fertilized egg to implant.

Methods of reception

What should be a good reception? Birth control pills in this case should be taken continuously, without even stopping for the duration of menstruation. If one pill was missed and less than three hours have passed, you need to take it immediately. If more, additional contraceptives should be used for 7 days. As for spotting, when taking a mini-pill, menstruation can come unplanned on any day of the cycle. This is one of the main disadvantages of taking these medications.

Representatives

Which contraceptive pill is better to take from the mini-pill group? The doctor will most likely prescribe the following monophasic drugs: "Charosetta", "Microlut", "Lactinet" (intended 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 that are not taken regularly, but only in case of unprotected intercourse. These may include the following drugs:

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

These drugs should be taken within 5 days of unprotected intercourse. Pregnancy does not occur in 60-90%.

Competent selection

How to choose the right birth control pills? Reviews of doctors suggest that only a specialist should prescribe them. Self-medication often leads to irreversible serious consequences. The correct principle of selecting birth control pills for ladies:

1. Gynecologist's consultation.
2. Mammologist's consultation - breast examination.
3. A smear for oncocytology.
4. Blood chemistry.
5. Ultrasound of the pelvis, performed on the fifth or 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. cycle regularity.
2. abortion or childbirth.
3. Profuse discharge.

All these nuances are needed to determine the phenotype of a woman, on the basis of which 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, with the independent selection of such contraceptives, a lady 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, abundant discharge, menstruation itself lasts more than five days, the cycle is more than 28 days. The main symptom of PMS is nervousness. In this case, you can take the following drugs: Microgenon, Regividon.
2. balanced type. These are ladies of medium height, feminine, breasts are moderately developed. Skin and hair are normal. The discharge is moderate, menstruation lasts five days, and the cycle is 28 days. PMS is practically non-existent. In this case, the doctor may prescribe the following drugs: Novinet, Regulon, Mercilon.
3. progesterone type. These are tall thin girls of a boyish type. The skin and hair are most often oily, the discharge is scanty. Menstruation lasts less than five days, cycle less than 28 days. During PMS, women are prone to depression. In this case, it is best to take funds such as Diane-35, Janine, Jess, Yarina.

How to drink birth control pills, you can read in the instructions. Alternatively, ask your doctor to tell you about it.

What to pay attention to

Is it possible to drink birth control pills if a woman observes certain side effects? It's best not to. With the following symptoms, you should immediately stop taking the prescribed oral contraceptives:

1. Skin itching or rash.
2. Violation of the menstrual cycle (unscheduled menstruation with regular use of COCs).
3. Visual impairment, hearing impairment.
4. Sudden pressure drops.
5. Suspicions of pregnancy.

Adaptation

If a lady is just starting to take oral contraceptives, she must 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 adverse reactions are possible, which should not disturb the lady too much. If they have not passed within three months from the start of taking the pills, you need to consult a 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, the quality of her life will improve to a certain extent.

Many women are afraid to take birth control pills for fear of side effects. Innovative technologies allow the production of contraceptive preparations containing a minimum amount of hormones and affecting only the process of conception.

pharmachologic effect

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 rupture of the follicle is blocked, so pregnancy cannot occur.

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

Third-generation progestogens have a high affinity for progesterone hormonal receptors, so they can bind to them and have a contraceptive effect, blocking ovulation and the release of FSH, LH. At the same time, progestogens have a low affinity with androgen receptors, which reduces the risk of side effects in the form of male-type 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, 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 substances, 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 contain up to 50 mcg / day. ethinylestradiol.
• Low-dose contraceptives include no more than 35 mcg / day. estrogen component.
• Microdosed tablets differ in the smallest amount, not exceeding 20 mcg / day.

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

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 a variable dosage of estrogens. This creates an imitation of fluctuations in the hormonal balance in a woman's body at different phases of the menstrual cycle.

Pills 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 the use of 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 blood loss during menstruation, ovulatory pain, and reducing the frequency of recurrence of inflammatory diseases of the genitourinary system. COCs reduce the risk of endometrial cancer of the uterus, ovaries, rectum, anemia, 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, cancerous tumors;
• rapid contraceptive effect of tablets;
• protection against ectopic pregnancy;
• accidental use of COCs in early pregnancy is not dangerous;
• prevent the appearance of intermenstrual, dysfunctional uterine bleeding;
• contraceptives are suitable for long-term contraception;
• the possibility of canceling pills if you want to get pregnant;
• the condition of the skin improves.

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

The disadvantages of taking birth control pills include the high cost and possible side effects. Undesirable manifestations are rare (10-30%), mainly in the first few months. Later, the condition of women is normalized. Simultaneous use of COCs and anticonvulsants, anti-tuberculosis 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;
• increase in blood pressure.

If the side effects do not go away after 3 months of taking contraceptives, the pills are canceled 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 a regular sex life, suffering from painful, heavy menstruation, endometriosis, and benign tumors of the mammary glands. Perhaps the appointment of birth control pills in the postpartum period, if the mother is not breastfeeding.

Contraindications:

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

When pregnancy occurs, birth control pills should be discontinued immediately. But if a woman drank the medicine after conception, there is no significant risk for the intrauterine development of the child.

COC regimens

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

The doctor advises the patient on the rules for taking COCs, conducts observation for 3-4 months. During this period, an assessment of the tolerability of tablets is carried out, a decision can be made to cancel or replace the contraceptive. Dispensary records are maintained during the entire period of use of contraceptives.

First-line drugs include monophasic COCs containing no more than 35 mcg of estrogen per day. and gestagens with a weak androgenic effect. Three-phase tablets are prescribed for primary or secondary estrogen deficiency, decreased sexual desire, dryness of the mucous membranes of the vagina, and menstrual irregularities.

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

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

If you miss taking another birth control pill, you need to drink 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 means against unwanted pregnancy (condom, suppositories). Do not stop taking COCs.

Admission schemes

Schemes of 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 schemes 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 contraceptive 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

Microdosed low hormone tablets:

• The median is a monophasic estrogen-progestin COC. The drug contains drospirenone, which has an antimineralcorticoid effect, prevents the accumulation of excess body weight, the appearance of edema, acne, oily skin, seborrhea.
• contains ethinylestradiol 20 mcg, dospirinone 3 mg. A contraceptive drug is prescribed for contraception, for the treatment of severe acne, painful menstruation.
• Lindinet 20 tablets include ethinyl estradiol 20 mcg, gestodene - 75 mcg. It is indicated for use in painful menstruation, with an irregular cycle, 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 a mild androgenic activity, does not have mineralcorticoid, estrogenic and glucocorticoid effects.

mini pili

Popular contraceptive pills with a minimum content of hormones - mini-pills are an alternative method of contraception for women who are contraindicated in taking COCs. The composition of the preparations includes microdoses of progestin, an analogue of progesterone. One capsule contains 300–500 mcg/day. The effect 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.

Women 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 clots, do not contribute to thrombosis, increase blood pressure, therefore they are approved for use in cardiovascular pathologies, thrombophlebitis.

Contraceptive progestin pills do not affect ovulation, they thicken the cervical mucus, preventing the penetration of sperm into 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 be implanted in the event of fertilization of the egg. When taking gestagenic drugs, the menstrual cycle and regular bleeding are preserved.

The contraceptive effect is achieved 3-4 hours after taking the pill and persists for a day. Mini-pills provide 95% protection against unplanned pregnancy.

Rules for using the minipill

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

• Taking the pills starts from the first and continues until the 28th day of the menstrual cycle, they are drunk continuously at the same time. Skipping the next intake of contraceptives for more than 3 hours completely eliminates the contraceptive effect.
• During the first few weeks, nausea may bother you, usually this symptom gradually disappears. To reduce discomfort, it is recommended to take the tablet with meals.
• If vomiting occurs after taking the mini-pill, the tablet should be taken again as soon as the patient feels better. 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 need to drink mini-pills immediately after finishing the packaging of combined contraceptives.
• Pregnancy can occur in the first month after the abolition of progestin tablets. Ovulation occurs 7-30 days (on average 17) after the end of the 56-day course.
• Women who are prone to developing age spots (chloasma) after exposure to the sun should avoid prolonged exposure to ultraviolet radiation.
• With the simultaneous administration of mini-pills and barbiturates, activated charcoal, laxatives, anticonvulsants, Rifampicin, the effectiveness of contraceptives becomes less.
• In the postpartum period, progestin contraceptives are prescribed on the first day of the onset of menstruation, but not earlier than 6 months after the birth of the child.
• After an abortion, the pills begin to drink immediately after the operation, additional contraceptives are not required.
• The contraceptive effect of the mini-pill is weakened if the gap between taking the next contraceptive pill is more than 27 hours. In the case when a woman forgot to take the medicine, it is necessary to do this as soon as possible and strictly follow the treatment regimen in the future. Over the next week, you need to use additional means of protection against the onset of 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, steroids, exacerbation of herpes, liver failure. You can not drink pills if ectopic pregnancies have previously occurred, if malignant tumors of the mammary glands are detected or suspected of them. Contraindication is lactose intolerance, glucose-galactose malabsorption.

A decrease in the effectiveness of contraceptives can be observed in violation of the rules of admission, the use of laxatives, barbiturates, anticonvulsants, after vomiting, diarrhea. Against the background of progestogen tablets, irregular menstruation may appear. In such cases, it is necessary to stop taking the mini-pill, exclude a 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 effects 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.

Mini-pills may increase the need for insulin in diabetic patients. Therefore, before taking birth control pills, it is necessary to consult 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 progestogens can provoke the development of thromboembolism. It should be borne in mind that in women over 40 years of age, the risk of developing breast cancer increases during treatment with hormonal drugs. If serious side effects appear, mini-pills are canceled.

If after the onset of pregnancy there was an accidental use of contraceptives, there is no risk to the fetus, but a further course of pills should be canceled. At high dosages of progestogens, masculinization of the female embryo can be observed. During lactation, part of the active substances of the drug penetrates 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 at a dosage of 75 mcg. Tablets do not cause significant disturbances in carbohydrate, lipid metabolism, 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, irritability. The contraceptive effect of the mini-pill is lower than that of COCs, it is 90-97%.

Modern contraceptives contain small doses of hormones, provoke the development of side effects to a lesser extent, and provide reliable protection against unplanned pregnancy. The attending physician prescribes tablets, taking into account the individual indications of the woman. The patient should be registered with the dispensary for the entire period of COC or mini-pill use. Particularly careful monitoring is carried out during the first 3-4 months from the start of the use of oral contraceptives.

Planned children who appeared in the family by a deliberate and balanced decision are the key to harmony in the house, so this issue should be taken 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 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 composition.
2. Mini-drank. The most gentle for the body with one analogue of the hormone progesterone.

   Depending on which hormones are used in the preparation, 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;
   • highly dosed
   It should be remembered that at different ages, certain medicines may or may not suit a woman. Therefore, in order 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 correct recommendation.

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

   Contraceptive pills Regulon

   

   
   Monophasic, combined contraceptive, which contains estrogen and progestogen.
   1. Action. The remedy 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. Assigned to 1 piece per day from the first day of the full menstrual cycle. You need to drink 21 days, preferably at the same time. After that, 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, the start of the intake should be postponed to the next cycle.
   3. Contraindications. It is forbidden for patients with severe arterial hypertension, thromboembolism, ischemia, atherosclerosis, with serious liver problems, heart defects, diabetic angiopathy, otosclerosis, genital herpes, hypersensitivity to components, lupus erythematosus, estrogen-dependent tumors, genital bleeding.
   4. Side effects. Very rarely, stroke, thrombosis, hypertension, heart attack, cholestatic jaundice, Sydenham's chorea, cholelithiasis were noted.
   The price of Regulon in Russia is about 460 rubles, and in Ukraine 130-160 UAH.

   Jess - birth control pills

   

   
   Low-dose contraceptive with antiandrogenic, antimineralocorticoid effect, good cycle control. Contains drospirenone and ethinyl estradiol. It is prescribed for acne vulgaris and for the treatment of premenstrual syndrome in a complex form.
   1. Action. It does not allow you to get pregnant, suppressing ovulation, changing the properties of the cervical secret, because of which it becomes almost impermeable to spermatozoa.
   2. Application. Drink one tablet a day for 28 days without interruption with plenty of water. As soon as the blister is over, move on to the next one.
   3. Contraindications. You can not use patients with diabetes mellitus, with tumors in the liver, mammary glands, renal and adrenal insufficiency. It is forbidden 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 hryvnias. More detailed we already did earlier.

   Contraceptive Tri-Regol

   

   
   A three-phase agent containing estrogen and progestogen. It is used for contraception, treatment of bleeding disorders, premenstrual syndrome, dysmenorrhea.
   • Action. The release of luteinizing, follicle-stimulating hormone is prevented, due to which ovulation is inhibited, and the viscosity in the cervix also changes and spermatozoa cannot get further into the cavity.
   • Application. One piece is consumed daily for three weeks, then they take a break for 7 days. First they drink six pink, then five white and ten dark yellow tablets.
   • Contraindications. Do not prescribe for hypersensitivity to components, Gilbert, Rotor, Dubin-Johnson syndromes, severe ailments of the liver and kidneys, cholecystitis, colitis, problems with the heart and blood vessels, thromboembolism, diabetes mellitus, 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-Regol in Russia is 300 rubles, and in Ukraine 220–300 UAH.

   Birth control pills Novinet

   

   
   Single-phase drug, with ethinyl estradiol and desogestrel. A reliable method of contraception that reduces the amount of bleeding and the duration of menstruation, removes pain, minimizes the possibility of infections in the pelvis, anemia, ectopic pregnancy, the development of diseases in the uterus, ovaries.
   • Action. It inhibits the maturation of the egg due to the influence of luteal and follicular synthetic hormones.
   • Application. A three-week period is drunk 1 tablet, after which they are interrupted for 7 days and start a new package. If it is required to delay menstruation, a break is not made.
   • Contraindications. Cannot be used for malignant tumors in the uterus and mammary glands, thrombosis, pulmonary thromboembolism, stroke, heart attack, hypertension, severe diabetes mellitus, lipid metabolism disorders, ailments in the liver and kidneys, jaundice, hearing loss during a previous pregnancy, autoimmune diseases, skin rashes.
   • Side effects. Gagging, nausea, allergic rash, intermenstrual bleeding, pain in the head and breasts, weight changes, cancer of the cervix and glands, liver problems, thromboembolism, jaundice, sudden pain in the abdomen.
   The price of Novinet in Russia is 500 rubles, and in Ukraine 135–170 hryvnias.

   Contraceptive Yarina

   

   
   Monophasic agent, with a combination of the two main active ingredients of the estrogen ethinylestradiol and the progestogen drospirenone. It is very useful for patients suffering from hormone-dependent fluid retention, seborrhea, acne.
   • Action. The medicine changes the viscosity of the cervical mucus, inhibits ovulation, and prevents the egg from developing. 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 dragee, then they stop for seven days and then continue according to the same scheme.
   • Contraindications. You can not be treated with such a 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 vaginal secretion.
   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 can cause a number of unpleasant side effects. Therefore, pharmaceutical companies annually try to release new medicines, the use of which will not be associated with health risks. Today, there are already a number of non-hormonal products on sale or with an extremely low percentage of them. The TOP-5 of the best birth control pills we have considered consists of drugs that will not only prevent conception, but at the same time affect the health of a woman as carefully as possible.

   Having decided to use oral contraception, you should definitely consult with a specialist, it is he who 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: