Ok hormone pills. How to choose the right birth control pills

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 accurate 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 prevents pregnancy by suppressing ovulation, changing the properties of the cervical secret, due to 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, inflammation of the mammary glands, 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 embolism, 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 that 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 contraceptive 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:

The era of hormonal contraception begins in the middle of the last century, when the first contraceptive pill was invented by the American scientist Gregory Pincus. Since then, millions of women around the world have been using hormonal contraceptives for family planning and effective protection against unwanted pregnancies.

Of course, during this period, more advanced and convenient forms were invented that allow you to choose hormonal contraception for almost any healthy woman.

What is hormonal contraception?

Regardless of the route of administration, hormonal contraceptives consist of synthetic analogues of one or both of the female sex hormones: estrogen and progesterone. Therefore, hormonal contraceptives (HC) can be combined (containing both hormones) or single-component.

Ethinyl estradiol (EE) is used as the estrogen component in most GCs. In recent years, an estrogenic component has been synthesized, which is similar in structure to the natural hormone of a woman - estradiol valeriate. The first contraceptives contained a huge dose of estrogen (about 150 micrograms / day). However, low- and micro-dose preparations have now been developed that contain much lower daily concentrations of estrogen - 30, 20, and even 15 micrograms.

Progesterone analog (synonyms: progestogen, progestin, gestagen) in modern GCs is represented by a large variety of compounds that can be divided into four groups or generations:

• The first is norethinodrel, ethyndiol acetate, norethinodrone acetate.
• The second is norethisterone, norgestrel, levonorgestrel.
• The third is gestodene, desogestrel, norgestimate.
• The fourth is drospirenone.

It is the progestogen component that determines the whole variety of hormonal contraceptives.

How GCs work:

• Suppress the maturation of the egg (ovulation).
• They thicken the cervical mucus, preventing the passage of spermatozoa.
• Modify the structure of the mucous membrane of the uterus (the probability of attaching a fertilized egg decreases).
• Reduce the speed of movement of sperm in the fallopian tubes.

As a rule, hormonal contraceptives simultaneously have all of the above properties that prevent conception and pregnancy. This determines their high contraceptive effectiveness.

Classification

All hormonal contraceptives can be classified according to several criteria. The most popular is their division along the way of introduction into the body of a woman:

• oral
• Injectable.
• Implants.
• Plasters.
• vaginal rings.
• Intrauterine hormonal system with progestin.

According to the species composition of hormones, all GCs are divided into two categories:

• Combined (contain both an estrogen component and a progestogen).
• One-component - progestagenic.

Each type of hormonal contraception has its own indications and contraindications. The selection of the form and composition of the hormonal contraceptive should be carried out exclusively by a gynecologist!

General contraindications to GC

There are conditions in which hormonal contraceptives are contraindicated in any case. These include:

• Suspected or existing pregnancy.
• Hypersensitivity (allergy) to HA components.
• Bleeding from the genital tract of unknown etiology (until the cause is clarified).
• Cancer of the breast or structures of the genital tract (currently or in history).
• Neoplasm or serious impairment of liver function.
• Increased risk of STI infection (additional use of barrier methods of protection is required).

In addition, combined hormonal contraceptives (due to the negative effect of the estrogen component) are contraindicated in this category of women:

• the entire period of lactation.
• Blood clotting disorders, thrombosis (currently or in history).
• Some somatic diseases in which there is an increased risk of thrombosis: complicated course of diabetes mellitus, severe arterial hypertension, hereditary dyslipoproteinemia and some others.
• Migraine, focal neurological symptoms.
• Estrogen-dependent tumors: suspected or confirmed.
• Women over 35 who smoke. Combined GCs should be used with caution.

There are also certain contraindications to the use of a particular type of hormonal contraception, which will be discussed in the relevant sections of this article.

Oral contraceptives

This is the most famous type of hormonal contraception, which has received the greatest distribution. They are used in the form of tablets, which must be consumed in strict sequence.

Oral contraceptives are combined (COC) or progestin-only (PPOC, "mini-drank").

Combined

Traditionally, according to the combination of the estrogen / progesterone component, COCs are divided into three groups:

• Monophasic - the dose of hormones is the same in all active tablets (most modern COCs: Logest, Marvelon, Jess, Janine, Yarina and many others).
• Biphasic - active tablets contain two different combinations of estrogen and progesterone (Anteovin).
• Multiphasic - the content of estrogen and progesterone in active tablets can have three or more combinations (Tri-Regol, Triquilar, Tri-Merci, Qlaira, etc.).

There is also a different mode of taking such contraceptives. The most popular is the 21+7 mode. In this case, the blister contains 21 active tablets, after which a break is taken strictly for 7 days. For ease of use of such COCs, often seven inactive tablets (“dummy” or iron-containing) are added to the blister. In this case (28 tablets in a blister), there is no need to take a break.

There are other schemes for taking pills: 24 + 4, 26 + 2, etc.

Admission rules

The most important requirement is the daily intake of tablets. It is necessary to take one COC tablet every day, preferably at the same time of day. It is also necessary to obtain precise instructions from the doctor regarding the regimen of taking the tablets and strictly adhere to it.

Start of application:

• It is recommended to take the first tablet within five days from the start of the next menstruation. Most doctors recommend starting COCs on the first day of your period.
• After childbirth: in the absence of lactation, it is possible to start taking COCs as early as three weeks after the birth of the child. When breastfeeding, taking COCs is contraindicated.
• After an abortion: it is advisable to start taking COCs on the day of the procedure or within a week after it.

If for some reason the next pill was not taken, then it is urgent to consult a doctor.

COC advantages:

• When used correctly, it is one of the most reliable contraceptive methods.
• Convenience and ease of the method.
• A woman can stop taking COCs on her own.
• Menstruation usually becomes less abundant and shorter, which contributes to the normalization of hemoglobin levels (with its decrease).
• Reduced menstrual pain.
• Reducing the risk of benign tumors and cancer of the ovaries and endometrium.
• Some types of gestagens in COCs have an antiandrogenic effect and can be used with an additional therapeutic effect (in addition to contraception).

Disadvantages and contraindications to COCs:

• The need for strict daily pills.
• Unpleasant side effects are possible in the first few cycles of administration: nausea, dizziness, headache, spotting, etc.
• Decreased effectiveness with simultaneous use with certain medications (anticonvulsants, anti-tuberculosis, antibacterial and other drugs).
• Temporary changes in the psycho-emotional background, decreased libido, etc. are possible.
• Some change in body weight, etc.

You should immediately consult a doctor if there is no menstrual flow during the 7-day break (to exclude pregnancy).

Pure progestin

These pills contain only one type of hormone - progestin. Currently, on the pharmaceutical market, you can find PPOC preparations with the following composition (in one tablet):

• 0.5 mg linestrenol (Exluton).
• 75 micrograms of desogestrel (Lactinet, Charozetta, Desirette, etc.).

The blister usually contains 28 tablets, which must be taken every day at exactly the same time of day. When using such drugs, there is no need to take breaks: at the end of one blister, the tablets begin from the next.

This type of oral GC has much fewer contraindications and can be used by women who are contraindicated in COCs, for example:

• When smoking.
• With lactation.
• With some somatic diseases (diabetes mellitus, hypertension, etc.).

However, these contraceptives also have disadvantages, which include:

• The need to take pills strictly at the same time.
• Changes in the nature of the menstrual cycle (irregularity, spotting).
• They do not have preventive and therapeutic properties of COCs.
• Decreased contraceptive effect when used simultaneously with certain other medications.

It is necessary to start taking POCs in the same way as COCs: within five days from the beginning of menstruation (preferably on the first day). After childbirth, if a woman wishes, you can start taking such a drug already one and a half months after the birth of a child and in the presence of lactation. If a woman is not breastfeeding, then taking PPOC can be started in the very first days after childbirth.

The contraceptive effect when taking PPOC occurs already during the first day from the start of taking the drug.

Injectable contraceptives

Means the introduction of the drug by injection (usually - intramuscular). These drugs have a prolonged action and to maintain the contraceptive effect, it is enough to administer the drug once every few months.

Injectable contraceptives can also be combined (CIC) or progestogen (PIC).

Combined

Currently, CECs are represented by two drugs: Cyclofem and Mesigyna, which have not yet found wide distribution in the CIS countries.

These drugs must be administered intramuscularly once every 28 days. Their main advantages and disadvantages are practically the same as those of COCs. In addition, there is a more frequent violation of the menstrual cycle (irregularity, spotting) at the beginning of the intake.

The first injection should be performed within seven days from the start of the next menstruation. The recommended interval between subsequent injections is 28 days (with a tolerance of 1-7 days).

Progestogenic

Among injectable contraceptives containing a monocomponent (progestin), the following drugs are best known:

• Depo-Provera (150 mg depo-medroxyprogesterone acetate).
• Noristerate (200 mg norethindrone enanthate or NET-EN).

Depo-Provera (150 mg) is the most popular among PICs. It is administered intramuscularly once every three months (deviation in terms of injection is allowed up to 2-4 weeks earlier or later than the appointed time).

Noristerate is administered every two months (with a tolerance of 1–2 weeks).

These drugs have most of the advantages and disadvantages of POCs. Undoubtedly, long-term and reversible contraception with high efficiency is a big plus. They can be used by women of almost any age, as well as nursing mothers. Most somatic diseases, in which the use of estrogens is contraindicated, are also not an obstacle to the use of PIC.

• Frequent occurrence of menstrual irregularities (from amenorrhea to bleeding).
• Weight gain (usually temporary).
• Relatively long recovery of the ability to conceive (from 6-12 months or more).
• Increased glucose tolerance (this should be taken into account in women with diabetes).

The first injection of the drug is performed for seven days from the beginning of the next menstruation. After childbirth, it is permissible to use PIK already after three weeks in the absence of lactation or after a month and a half if it is present.

Subsequent injections are performed two (Noristerat) or three months later (Depo-Provera).

Implants

They are one or more progestin capsules that are implanted (“implanted”) under the skin of the forearm. The operation is performed by a doctor under local anesthesia.

This is a prolonged method of contraception (from three to five years).

Currently, the most commonly used types of implants are:

• Norplant - consists of six thin flexible capsules filled with levonorgestrel. The validity period of the implant is 5 years.
• Norplant-2. Represents two capsules with levonorgestrel, which prevent the onset of pregnancy for three years.
• Implanon. Presented as a single capsule filled with etonogestrel (a metabolite of desogestrel), the validity of which is 3 years.

Implants do not contain an estrogen component, which allows them to be used by those women who are contraindicated in estrogen-containing hormonal contraceptives.

The advantage of this contraceptive method is that there is no need to take pills, regular injections, etc. But for the procedure for inserting and removing the implant, the participation of a specially trained medical specialist is required, which is, in general, the main problem.

Among the disadvantages of this method of hormonal contraception, the following should be especially noted:

• Risk of suppuration and bleeding at the implant site.
• Irregularity of the menstrual cycle, spotting during the first 6-12 months of using the method.
• Some women sometimes experience weight gain, discomfort and tension in the mammary glands, unexpressed headaches, and some other unpleasant symptoms that usually disappear with time.

The remaining disadvantages and advantages are the same as for other progestogen-based GCs.

The introduction of the implant is usually carried out in the first seven days from the start of the next menstruation or the abortion procedure. After childbirth, the implant can be inserted already after 3 weeks, and in the case of lactation - after a month and a half.

When the implant expires, it must be removed and, if desired, a new one inserted.

New combination GCs

A kind of analogue of monophasic combined oral contraceptives are the latest developments - the Evra hormonal patch and the NovaRing vaginal ring. The mechanism of action of these contraceptives does not differ significantly from COCs. The only difference is in the route of administration of hormones - transdermal (transdermal) or through the vaginal bloodstream. This somewhat reduces the risk of those side effects that are associated with the metabolism of hormones in the liver. In addition, there is no need for daily pills.

Hormonal patch

The method is based on the gradual release of estrogen and progesterone from a special patch pasted on the skin of a woman (transdermal route of administration).

Hormonal contraceptive Evra (Evra) is a 20 sq. cm, which is attached by a woman on her own to dry, intact skin. The patch releases approximately 150 micrograms of norelgestromin and 20 micrograms of ethinyl estradiol each day. One package contains three transdermal patches designed for one cycle. The package may contain one or three such packages.

The patch is glued on the first day of menstruation with regular replacement every seven days of use. Then they take it off and take a seven-day break. Therefore, a full contraceptive cycle is 28 days. A new cycle with gluing the patch begins the day after the end of such a break.

• Buttocks.
• Stomach.
• The outer surface of the shoulder.
• Upper body.

Do not stick the patch on the skin of the mammary glands, on the mucous membranes.

It is necessary to regularly and carefully inspect the place of attachment of the patch to ensure that it is tightly attached.

If it is partially or completely peeled off, it should be glued again or replaced with a new one. If the adhesive properties of the contraceptive are lost, there is no need to additionally use adhesive tapes and other fixing devices. In such cases, a new patch is applied. If in doubt, you should seek the advice of your doctor.

What you need to know:

• With excessive body weight (90 kg or more), this contraceptive method should not be used due to its reduced effectiveness in such women.
• More than one patch must not be used at the same time.
• If the skin is irritated, you can re-glue the patch to another area.
• Sometimes during the adaptation period, side effects may occur: nausea, vomiting, menstrual irregularities (even before bleeding). If these symptoms are pronounced, you should consult a doctor.

vaginal ring

NuvaRing is a flexible and elastic ring made of hypoallergenic material. During the day, it secretes approximately 15 micrograms of ethinyl estradiol and 120 micrograms of etonogestrel, the secretion of which is activated by body temperature. Then they enter the bloodstream through the vaginal mucosa, which minimizes their systemic effect. One vaginal ring is designed to be used for one cycle.

The contraceptive is inserted by a woman on her own deep into the vagina on the first day of menstruation. A correctly inserted ring does not cause discomfort. After three weeks of use, the ring is removed and, after a seven-day break, a new one is inserted.

If, during stress, defecation, sexual intercourse and other conditions, the ring falls out, it must be washed in running warm water and reintroduced.

The use of the method may be limited to women with existing vaginal prolapse.

The remaining benefits and contraindications for the use of the hormone patch and vaginal ring are the same as for all combination HAs.

intrauterine system

It is a type of intrauterine contraceptive ("spiral") containing a progestin - levonorgestrel (LNG). Currently used under the following trade names:

• Mirena (abroad - Levonova). Contains 52 mg of LNG. Set for five years.
• Jaydes. Contains 13.5 mg of LNG. The recommended period of use is three years.

Each intrauterine system releases approximately 20 micrograms of progestin daily. The longer the period of use of the system, the lower the daily volume of levonorgestrel excretion.

In addition to the contraceptive effect, intrauterine hormonal systems have a pronounced therapeutic effect and can be used in such conditions:

• Some types of uterine leiomyoma.
• Non-atypical endometrial hyperplasia in women of childbearing age.
• Adenomyosis.
• Idiopathic uterine bleeding.
• Hyperpolymenorrhea, algomenorrhea, etc.

You should be aware that when using this method, there is often a significant decrease in the amount of blood released during menstruation, up to its complete absence.

The intrauterine hormonal system is administered by a doctor during the next menstruation or on any day of the cycle if there is no pregnancy. After childbirth, it is possible to use this method after four weeks.

The main contraindications to the use of this method are (in addition to the general ones):

• Infectious and inflammatory pathology of the genital tract (including recurrent).
• cervical dysplasia.
• Anomalies in the structure of the uterus (including fibroids that deform the uterine cavity).
• Increased risk of infection of the genitals (for example, frequent change of sexual partners).

Before the introduction of the intrauterine hormonal system, some preparation and examination of the woman is necessary, the volume of which is determined by the doctor.

In conclusion, it should be noted: there is no need to be afraid of “hormones”. Properly selected hormonal contraceptives by a doctor have a high contraceptive effect and a minimum of side effects.

Any modern girl must take care of her health. Therefore, contraception plays an important role in the prevention of unplanned pregnancy. Today, medicine offers a huge range of various means, and a woman has the right to decide for herself which birth control pills to choose for her body.

Contraceptive pills after 40 years

Many women who have reached the age of forty are interested in the question, contraceptive pills - which ones are better to choose for protection and is it possible to choose such funds on your own? Only a qualified specialist will help determine the choice of drugs, who, having assessed the state of health, will be able to offer contraceptives for women after 40 years.

To prevent pregnancy, it is better to give preference to drugs that do not contain estrogen. This type of birth control is called a mini-pill. Their advantage is the ability to prevent the development of endometrial hyperplasia in its infancy. Other non-hormonal contraceptives in the form of ointments and suppositories are prescribed for women whose sex life is not permanent. The main difference between these drugs and the previous type is that they should not be taken daily, but only before sexual intercourse.

Oral contraceptives after 40 years

The modern pharmaceutical market is represented by a huge number of contraceptives. As a rule, after 40 years, gynecologists try to prescribe oral contraceptives, because. they 100% prevent pregnancy. In this case, the reception should be dosed, any deviations can cause unpleasant consequences. List of the best oral contraceptives after 40 years:

• Depo Provera is a drug sold as an injection.
• Jess - reduces puffiness.
• Marvelon - prevents pregnancy and improves the condition of the skin.
• Regulon is an effective contraceptive that normalizes the menstrual cycle.
• Silest - inhibits the activity of the egg.

Hormonal contraceptives after 40 years

After forty years, hormonal drugs are a real salvation for the fairer sex. As a rule, women who have reached adulthood complain of deterioration in health and failures of various functions in the body. This is due to the onset of menopause. The following hormonal contraceptives after 40 years can come to the rescue:

• Trisequence. Contains estrogen and progesterone, eliminates the painful symptoms of menopause.
• Femoston. Includes Estradiol, it is advised to use the drug to increase bone tone.
• Janine. Changes the state of the uterine mucosa, affects the appearance of ovulation.
• Novinet. Normalizes the menstrual cycle, reduces blood loss.
• Silest. Suppresses ovulation.

Contraceptive pills after 40 years with myoma

In adulthood, many women experience diseases of the genital organs. The most common disease is uterine fibroids. The main danger of the disease is the formation of nodes that can burst and cause bleeding. Therefore, it is important to choose the right contraceptive. Experts advise giving preference to such contraceptive pills after 40 years with myoma:

• Diana 35. It has an estrogenic, antiandrogenic, contraceptive effect.
• Regulon. Reduces blood loss during menstruation.
• Yarina. Blocks ovulation and increases the viscosity of mucus in the uterus.
• Regividon. Oppressive effect on the production of gonadotropic hormones.

Contraceptives for women under 30

Many young women, when choosing contraceptives, are interested in the question, which birth control pills do not get better? Doctors advise, in the absence of contraindications, to take medium and low-dose hormonal contraceptives, which are convenient to use. Barrier and chemical protection methods (condoms, suppositories) at this age should not be used because of the high probability of pregnancy, but birth control pills up to 30 years old can help:

• Charosetta contains desogestrel. The drug is suitable for breastfeeding.
• Femulen. Increases antisperm aggressiveness.
• Yarina. Changes the properties of the secret (mucus) that is in the cervix.
• Logest. Inhibits the maturation of follicles.

Microdosed birth control pills

For nulliparous young women who are sexually regular, microdosed birth control pills are best suited. Preparations of this group do not have side effects and are easily tolerated by the body. Great for those who have never used hormonal contraceptives. List of the most popular microdosed tablets:

• Qlaira. As close as possible to the hormonal natural background of a woman.
• Jess Plus. It has a cosmetic (antiandrogenic) effect.
• Zoely. Monophasic drug that contains hormones similar to natural ones.
• Lindinet-20. Reduces the occurrence of ectopic pregnancies.
• Dimia. Changes the endometrium and increases the viscosity of the secret, which is located in the cervix.

The best birth control pills for giving birth - rating

For women who have already experienced the happiness of motherhood, low-dose preparations are best suited, which, although they contain estrogenic components, are safe to use. From micro and high-dose drugs in mature women, unplanned bleeding may occur during menstruation. List of the best birth control pills for giving birth:

• Silhouette. Inhibits ovulation, eliminates acne.
• Midian. The action of the contraceptive is aimed at reducing the likelihood of ovulation.
• Milisiston. It treats dysmenorrhea, eliminates the functional disorder of the menstrual cycle.
• Silest. Changes the implantation ability of the endometrium.
• Marvelon. Prevents the maturation of the egg.

The best birth control pills without side effects

Many girls refuse to use birth control pills because of the hormone content. But modern pharmaceutical companies have created the latest drugs, in which the content of synthetic hormones is minimized. This helps to reliably protect women from pregnancy and does not harm the body. At the same time, a decrease in the dose of hormones does not reduce the effectiveness of the drug. The list of the best birth control pills without side effects:

• Yarina. Prevents the appearance of edema and weight gain, treats acne.
• Janine. Reduces the intensity of bleeding.
• Regulon. Resolves ovarian cysts, treats dysfunction of uterine bleeding.
• Logest. Prevents the development of many gynecological diseases.

Good non-hormonal birth control pills

Non-hormonal drugs are not taken orally, but are inserted into the vagina. The mechanism of action of such contraceptives lies in the high content of active substances: nonoxynol or benzalkonium chloride. These compounds, damaging the membrane of spermatozoa, destroy them, which leads to the destruction of tadpoles. List of good non-hormonal birth control pills:

• Pharmatex. The activity of the drug lasts for three hours.
• Erotex. In addition to the contraceptive effect, it also has an antimicrobial effect.
• Gynecoteks. The contraceptive effect lasts 4 hours.
• Benatex. The activity of the tablet is maintained for 3 hours.
• Patentex Oval. It has a high contraceptive activity.

Hormonal birth control

The essence of the hormonal contraceptive method is to suppress ovulation. For this, synthetic analogues of female sex hormones are used. Hormonal contraception is represented by two types: oral tablets and prolonged means. List of the most popular hormonal contraceptives:

• Regulon. The main advantage of using pills is that the remedy does not add weight to a woman.
• Lactinet. Does not affect the lipid spectrum of the blood.
• Three-regol. Reduces the chance of sperm entering the uterus.
• Femoden. Reduces the susceptibility of the endometrium to fixation of the blastocyst.

Combined birth control pills

To avoid unwanted pregnancy, you can use a new generation of combined contraceptive pills, which include synthetic substances in small therapeutic doses. Depending on the qualitative composition, the following classification of combined products is distinguished:

1. Monophasic (Cilest, Belara, Logest, Demulen, Chloe, Mercilon, Regulon, Ovidon, Non-Ovlon). They contain gestagen and estrogen in a single dosage, painted in the same color.
2. Biphasic (Anteovin). Consist of two tablets painted in different colors.
3. Three-phase (Three-regol, Tri-merci, Triquilar, Triseston). They contain three groups of tablets, which are considered more adapted to the woman's natural cycle.

Cheap birth control pills - names

Inexpensive oral contraceptives contain only female hormones - gestagens and estrogens, expensive drugs additionally include antiandrogens - they have fewer side effects and a lower chance of getting fat. Moreover, the price of such funds is more than 1000 rubles for 28 tablets. Good cheap birth control pills are:

The price of birth control pills

You can buy contraceptives at a pharmacy. In addition, a suitable medicine can be found, ordered in online catalogs and bought in an online store. The cost of drugs, as a rule, depends on the number of tablets in the package, the manufacturer's company, the region where they are sold. Approximate prices for birth control pills:

Name	Price in rubles
Orgametril, Jess
Charosetta, Janine
Lactinet
Tri Mercy
Postinor
Regvidon

How to choose birth control pills

To choose the right birth control pills with maximum effect and minimal side effects, you need to consult a doctor. Self-selection can cause negative consequences for the body. It is possible to determine the appropriate drug only after analysis. An approximate scheme for the selection of tablets will be as follows:

• consultation of a gynecologist (the specialist must know the height, weight, age of the patient; whether there were abortions / childbirth, the duration and abundance of menstruation);
• analysis for oncocytology;
• contacting a mammologist;
• cluster blood test for biochemistry, including determination of hormone levels;
• OMT ultrasound on the seventh day of the cycle.

Video

Contraceptive pills - reviews

Karina, 29 years old

For a long time I wanted to find a contraceptive from which you can not get fat. A friend advised me to pay attention to Pharmatex. After consulting with a specialist, I bought this drug. This contraceptive medicine should not be drunk, it should be placed inside the vagina before sex. You can't recover from pills.

Olga, 35 years old

My husband and I have been living for 10 years. Became protected only 5 years ago. During this time I tried different methods of contraception. She put a spiral, introduced a special ring. We used a condom, but there are only minuses from it. After consulting with the doctor, I bought inexpensive pills called Regulon. Both are happy with the result.

Elena, 30 years old

Non-hormonal contraceptives have always fascinated me. But I had to pay attention to them during lactation. After studying the reviews on the Internet, after consulting with a doctor, I chose Patentex Oval. The medicine is convenient to use, it is designed for one dose, which protects the body from the load of various medicines.

A long time ago, more than one or even two children were born in Russian families. A family in which there are “seven on benches” and a mother in the process of demolition is a typical example of the way of pre-revolutionary life. A hundred years ago, a woman was in two states for almost the entire reproductive period - pregnancy and breastfeeding, and the latter smoothly flowed into the next interesting position.

Whether it's good or bad, but in modern families there are much fewer heirs. One or two children are considered normal. And in order not to exceed the upper limit, a healthy woman needs to take contraception seriously.

In the contraceptive arsenal today, there are about a dozen methods of preventing unwanted pregnancies. Almost the most popular way is the use of birth control pills.

How effective and safe is contraception using pills? Who shouldn't rely on this method? And in general, what should be understood by the term "contraceptive pills"? Every woman should own these concepts no worse than a local gynecologist - after all, health sometimes depends on this knowledge. Well, let's figure it out together.

Contraceptive pills: both orally and vaginally

The concept of "contraceptive pills" includes two completely different categories of drugs:

- hormonal contraceptives, which are based on synthetic hormones;

- local spermicides in tablets. The action of these contraceptives is based on the spermicidal effect, which is achieved with topical, vaginal application.

Of course, hormonal agents are of greatest interest from the point of view of the pharmacological effect. With them, we will begin our acquaintance with contraceptives.

Hormonal contraception: origins

Already at the end of the 19th century, it became known that the development of follicles and ovulation is completely suppressed during pregnancy, and the reason for this is the high concentration of corpus luteum hormones. In the 1920s, Ludwig Haberlandt proposed the use of such substances as contraceptives. In the next ten years, three estrogens were synthesized: estrone, estriol and estradiol, and at the end of 1929 scientists identified progesterone.

Probably, the first hormonal contraceptive pills would have appeared ten years earlier, if not for the problem with the synthesis of progesterone. It was mastered only in 1941, after which it was the turn of other progesterone drugs - norethisterone and norethindrone. It was then that these substances received the common name progestogens (or progestins), which emphasized progesterone-like properties.

In the early 50s, scientists began experimenting with hormonal drugs. The first pancake came out lumpy: the use of hormonal pills for the treatment of infertility did not give results. But it was found that in women taking these drugs, ovulation was suppressed. It took researchers another 5 years to select the right formula, and in 1957 the first hormonal contraceptive drug was released. As early as 1960, 0.5 million American women were taking these pills. The era of hormonal contraceptives has begun.

Pharmacological effect of hormonal pills

The action of contraceptive hormonal drugs does not depend on the composition and dosage. The contraceptive effect is achieved by influencing a complex reproductive chain, which includes the pituitary gland, hypothalamus, ovaries, uterus, and even fallopian tubes.

First of all, hormonal contraceptives suppress the production of releasing hormones by the hypothalamus, resulting in a decrease in the gonadotropic function of the pituitary gland. Due to this, ovulation is inhibited, and temporary sterility occurs.

Secondly, hormonal pills suppress ovarian function: estrogen synthesis is almost halved, and the ovaries even decrease in size.

Thirdly, under the influence of hormonal drugs, the properties of cervical mucus change, which becomes very difficult for spermatozoa to pass.

Fourth, the peristalsis of the fallopian tubes slows down significantly. A miraculously mature egg is unlikely to be able to get out of the long, inactive fallopian tubes and, most likely, will be doomed to death.

And fifthly, the endometrium changes, which quickly regresses and does not reach the thickness necessary for the implantation of a fertilized egg. This mechanism serves as additional protection - even if conception has occurred, the embryo simply cannot attach to the uterine wall.

The effectiveness of contraceptive drugs is evaluated using a single indicator - the Pearl index. It is equal to the number of pregnancies in one year in 100 women who used a particular method of contraception. The Pearl Index of hormonal contraceptives rarely exceeds 3-4% and fluctuates around 1%.

Hormone Dosage: Then and Now

The first hormonal contraceptives contained simply lethal doses of hormones: 150 micrograms of estrogen and 9.35 mg of progestogen. In 1964, it was possible to reduce the concentration of active substances to 100 micrograms and 2 mg, respectively. However, these dosages were far from perfect.

The next step was the release of hormonal contraceptives containing 50 micrograms of estrogen. Scientists came to the conclusion that lowering the dose of hormones does not affect the effectiveness of the drug, but it greatly reduces side effects.

In the 1970s, the upward trend in the use of hormonal contraceptives stopped. This resulted in pronounced adverse events in the form of thromboembolism (blockage of blood vessels by blood clots), especially in women who smoke. Pharmacists had no choice but to develop new low-dose drugs. And it succeeded.

Birth control pills of the new, latest generation contain less than 35 mcg of estrogen - the component that causes most of the side effects. In addition, highly active progestogens have been synthesized, including drospirenone, desogestrel, gestodene, and others. Due to these advances, low-dose hormonal drugs have a very high safety profile and a low chance of side effects. Nevertheless, when choosing a contraceptive drug, you need to be vigilant, given the many nuances. However, more on that later.

Classification of hormonal contraceptives

All hormonal drugs can be divided into three large groups:

- combined oral contraceptives (COCs).
Such tablets contain both components: both estrogen and progestogen;

- progestin preparations - mini-pill.
Monocomponent means, which include only gestagen.

- emergency contraceptives.
These contraceptives contain extremely high doses of hormones and are intended for urgent, that is, urgent contraception.

Each of the groups of hormonal pills has its own advantages and disadvantages, on the basis of which the conclusion is based on the appointment of a particular remedy.

KOC: positive aspects

Undoubtedly, the most common hormonal pills are combined contraceptives. They have a lot of positive aspects, including:

• high contraceptive effect;
• excellent tolerance;
• ease of use;
• reversibility of action;
• safety;
• therapeutic action;
• preventive action.

To understand all the advantages of contraceptive hormonal drugs, we will consider each criterion in detail.

Efficacy and tolerability of combined contraceptives

The Pearl Index KOC ranges from 0.1-5%. The average statistics state that the probability of pregnancy with the constant use of hormonal pills during the year does not exceed 1%. Thus, the effectiveness of combined contraceptive pills reaches 99%. An indispensable condition for achieving such results, of course, is compliance with the dosing regimen.

Oral combined contraceptives are generally well tolerated. Side effects develop, as a rule, in the first months of taking, and notice that they decrease on their own and completely disappear.

Types of combined hormonal pills

Depending on the qualitative composition, COCs are divided into three groups:

- monophasic drugs.
These drugs contain estrogen and progestogen in the same dosage. Regardless of the phase of the menstrual cycle, the same amount of hormones enters the body. Tablets of monophasic COCs are painted in one color.

These monophasic contraceptive drugs include most of the modern low-dose COCs: Logest, Silest, Janine, Microgynon, Lindinet-20 and Lindinet-30, Regulon, Diana, Yarina, Jess and others;

- biphasic drugs.
Biphasic COC tablets are divided into two groups: the first contains more estrogen, and the second - progestogen. For ease of administration, the tablets are colored in two colors. Biphasic COCs are rarely used;

- triphasic preparations.
A package of a three-phase COC contains three groups of tablets, the level of hormones in which changes approximately in the same way as in a physiological menstrual cycle. Each group of tablets is coated with its own color. Three-phase preparations are considered the most adapted to the natural cycle of a woman. Among the modern representatives of this group, we note Tri-merci, Tri-regol, Triziston.

Rules for taking birth control pills

The first and main rule, on which both the effectiveness and side effects of COCs depend, is the regularity of intake. Forgetfulness is the main enemy of any contraceptives, and hormonal ones in particular.

We list the main postulates that every woman who takes hormonal contraceptives should remember:

1. It is better to start taking contraceptive drugs on the first day of a new cycle, although it is also allowed in the first 5-7 days from the onset of menstruation. Some experts recommend starting treatment on some convenient day for counting, for example, on Sunday. If a woman needs immediate therapy, you can drink the first tablet immediately after the complete exclusion of pregnancy;

2. It is better to take medicine at the same time. Ideally, you should associate the reception with some kind of ritually repetitive action, for example, evening dress or dinner. Although there are no specific recommendations on the best time of day to take the pill, many doctors advise taking COCs at night. This is due to the fact that at the beginning of treatment there is a possibility of mild nausea, which practically does not annoy during sleep;

3. In the first cycle of taking COCs, additional contraceptive measures should be used: according to some reports, the effectiveness of hormonal contraceptive pills reaches a maximum only after 2-4 weeks of continuous use;

4. After a 21-day intake, a 7-day break follows, during which menstrual-like bleeding occurs. On the eighth day of withdrawal, you should start taking the first tablet of a new treatment cycle. If within a week after the abolition of COC menstruation has not occurred, the next package is still not canceled. However, in such a situation, it is better to seek advice from your doctor: you need to exclude pregnancy and gynecological pathologies;

5. If there was vomiting within four hours after taking the pill, the contraceptive effect is reduced. In such cases, it is better to use an additional method of contraception until the end of the cycle. Usually, the barrier method is considered the best "safety" method, which involves the use of a banal, but true condom;

6. If bleeding occurs while taking COCs, treatment should be continued. Some experts recommend that patients who bleed more than 4 days start taking an additional COC tablet (eg, morning). As a rule, 2-3 additional tablets are enough to restore the normal picture. After stopping the bleeding, you should take another 2-4 days for half the additional dose, and then switch to the standard course of treatment. If, despite the measures taken, the bleeding continues, you will have to see a gynecologist;

7. Patients who take COCs for a long time need to undergo periodic examinations by a gynecologist with monitoring of the condition of the mammary glands.

What if memory fails?

Every woman, no doubt, knows about the regularity of taking hormonal contraceptive pills. But the girl's memory is fragile: there are gaps and gaps in it. What to do with forgetful patients? Moaning: “All is lost!”? Or ... Of course, act! Depending on how many birth control pills the patient missed:

- if no more than 12 hours have passed since the last pill was taken, you need to take the next one immediately after memory recovery and calm down. The contraceptive effect will not change;

- if the interval between doses was more than 12 hours, you must take the next pill, regardless of the time of day, and then continue according to the schedule. The scheme does not change, even if you have to drink two tablets a day;

- if two doses were missed, that is, the interval between doses was more than 24 hours, you need to take two tablets at once and drink two more doses the next day. It should be borne in mind that in such cases, bleeding may occur;

- if the memory was lost for a long time, and this led to the skipping of three or more pills, the likelihood of spotting is very high. Of course, you can forget about the contraceptive effect, and it’s even better to remember where the condoms are. However, what to do with COC? Doctors recommend taking two tablets for the first three days, and then switch to the standard regimen. There is a second way out of the situation: to abandon the old packaging altogether and start from scratch, that is, with a new KOC packaging, for example, next Sunday.

If everything is taken and canceled: the reversibility of COC action

Contraception involves deliberate family planning. And someday there comes a time when a woman would gladly start taking germ pills, if such existed. The purchase of new packs of hormonal contraceptives is postponed indefinitely. The only question that worries a woman is when can you get down to business?

The action of combined hormonal contraceptives is reversible, and this, of course, can be attributed to the important advantages of such drugs. In most cases, in the first 1-3 months after the abolition of COCs in healthy women, a full-fledged ovulatory menstrual cycle is completely restored. The maximum recovery period is 12 months.

There is information about the so-called withdrawal syndrome or rebound effect that occurs after stopping the use of hormonal contraceptives. The ovaries, which have been “resting” for quite a long time, begin to work actively and fruitfully immediately after recovery from “hibernation”. The result of such work is the maturation of the follicles and the release of an egg ready for battle, hungry for action. According to the theory based on the COC withdrawal syndrome, the probability of pregnancy in the first 1-2 months after stopping treatment with hormonal pills is much higher than in the standard cycle.

However, some experts believe that normalization of hormonal levels is still needed for a healthy pregnancy. Many gynecologists insist that conception should occur several months after hormone withdrawal.

Therapeutic effects of COCs: birth control pill therapy

In addition to the contraceptive effect, hormonal preparations also have a proven therapeutic effect, and in this capacity, COCs containing both estrogen and progestogen are mainly used. Consider the main indications for the appointment of combined contraceptives.

Dysfunctional uterine bleeding

Intermenstrual uterine bleeding, not associated with pregnancy and organic pathology, is considered to be dysfunctional. Their main cause lies in a hormonal imbalance caused by a malfunction in the complex circuit of the hypothalamus-pituitary gland-ovaries. It has been proven that long-term use of COCs contributes to the normalization of hormonal levels and the cessation of dysfunctional bleeding.

endocrine infertility

As we have already said, in some cases COCs are used for the sake of the rebound effect. Some endocrinologists believe that if endocrine infertility is suspected, it is first necessary to start treatment with combined contraceptives. If pregnancy does not occur after the abolition of COCs, then proceed to ovulation stimulants.

Premenstrual syndrome

For the treatment of PMS, modern low-dose contraceptives are prescribed, including Novinet, Median, Silhouette, Lindinet, Mercilon, Jeanine, Dimia and other drugs. Symptoms characteristic of premenstrual syndrome - irritability, weakness, swelling, pain in the back, chest, headaches - disappear after 1-2 months of treatment.

endometriosis

Endometriosis is a fairly common disease that can be one of the causes of infertility. With this pathology, a tissue similar to the endometrium (the tissue of the inner lining of the uterus) grows in the pelvis. COCs are recognized as one of the treatment options for endometriosis. As a rule, these drugs are prescribed in long courses for a period of at least 12 months.

Among the contraceptives that are most often used for the treatment of endometriosis are Marvelon, Femoden, Regulon, Microgynon, Logest and others.

Hyperandrogenism

A condition that is accompanied by an increased content of testosterone in the blood - hyperandrogenism - is manifested by a number of striking symptoms. These include excessive hair on the face and body in women, acne (acne) and seborrhea.

The drugs of choice for the treatment of mild and moderate forms of hyperandrogenism include COCs with an antiandrogenic effect. This action is inherent in the gestagen, which is part of some combined contraceptives, namely Diana, Zhanin, Yarina and some others.

Separate words deserve a drug with a powerful antiandrogenic and antimineralocorticoid effect - Yarina. As a progestogen, these tablets use drospirenone, which not only helps to reduce testosterone levels, but also reduces swelling. Therefore, the likelihood of weight gain when taking Yarina is minimal.

With acne and seborrhea in adolescents, a three-phase COC Tri-merci is prescribed, which is able to reduce testosterone levels three times.

And the last. The antiandrogenic effect is achieved after three months of constant use of COCs, so contraceptives in order to get rid of acne will have to be taken for a long time.

COC: not only treatment, but also prevention

Combined contraceptives are also an additional prevention of gynecological diseases.

Inflammatory diseases

It has been proven that regular use of COCs reduces the likelihood of developing an inflammatory process in the small pelvis. This effect is achieved through:

1. increase the viscosity of cervical mucus.
   More viscous mucus turns out to be a barrier not only for spermatozoa, but also for some bacteria;
2. decrease in the intensity of menstruation.
   Menstrual blood is an ideal environment for the growth of pathogenic microorganisms. Therefore, a decrease in monthly blood loss also reduces the likelihood of infection;
3. decrease in the strength of uterine contractions during menstruation.
   With uterine contractions, the infection easily penetrates from the uterus into the fallopian tubes, contributing to the development of dangerous diseases - salpingitis (inflammation of the fallopian tubes) and salpingo-oophoritis (simultaneous inflammation of both the ovaries and tubes). It is these processes that occupy an honorable first place among diseases that lead to the formation of adhesions in the pelvis, and as a result, infertility.

According to the recommendations of the WHO - the World Health Organization - combined contraceptive pills are used in a complex treatment regimen for already developed inflammatory processes. In such cases, COCs allow the ovaries to “rest” and recover, and the cervical mucus plug additionally protects the body from reinfection, that is, re-infection.

Functional ovarian cyst

These pathologies include follicular cyst and cyst of the corpus luteum. Monophasic COCs reduce the likelihood of formation of functional cysts by 3-4 times, and also contribute to the resorption of existing formations.

It is worth noting that triphasic birth control pills may, on the contrary, stimulate the development of cysts. This is because "floating" doses of hormones in such preparations are not able to completely suppress ovarian function.

uterine fibroids, endometriosis

Both uterine fibroids and endometriosis are estrogen-dependent diseases. A decrease in estrogen levels significantly reduces the likelihood of developing these pathologies.

Official figures sound more convincing than words: with the constant use of birth control pills for five years, the risk of fibroids decreases by 17%, seven years - by 20%, and 10 years - by 30%.

Birth control pills: simple cancer prevention

The most reliable studies in the medical world have confirmed that the regular use of COCs reduces the risk of gynecological cancer. Continuous use of birth control pills reduces the risk of developing ovarian cancer by as much as 40%, and such prevention lasts for 15 years after the elimination of COCs. In addition, the use of combined contraceptives reduces the likelihood of developing uterine cancer by exactly half, and the protective effect is also enough for 15 years.

The only condition that should not be overlooked: to obtain a serious preventive effect, birth control pills must be taken for at least two years.

Combined contraceptives: side effects

Of course, the other side of the coin cannot be ignored. COCs have both side effects and contraindications.

Let's start with the first one. The most common side effects of hormonal birth control pills include:

• headache;
• nausea, vomiting;
• discomfort in the stomach and intestines;
• irritability and mood changes;
• increased sensitivity of the mammary glands;
• change in libido;
• dryness of the vagina;
• intermenstrual bleeding: both spotting and breakthrough (many women perceive this effect as menstruation when taking contraceptives).

The intensity of COC side effects is greatest in the first 1-3 months of treatment. After this period, as a rule, taking birth control pills is not accompanied by any adverse events.

You should be aware that with prolonged use or cancellation of oral contraceptives, hormonal disorders may occur. The duration and frequency of menstruation is reduced or increased, and the discharge may become too scarce or plentiful, accompanied by pain in the lower abdomen. A complex of biologically active substances has a beneficial effect on the functions of the female reproductive system -
"Time Factor". It contains extracts of medicinal plants, vitamins B9, C, E and PP, minerals Fe, Mg and Zn - reduce muscle spasms, pain during menstruation and are involved in restoring hormonal balance, including during or after the use of contraceptives.

Important: When are COCs banned?

Combined contraceptives are absolutely contraindicated in:

• pregnancy or the slightest suspicion of it;
• breastfeeding;
• vein diseases;
• IHD - coronary heart disease;
• severe diseases of the heart and blood vessels;
• oncological diseases;
• uncontrolled diabetes mellitus;
• severe pathologies of the liver or kidneys;
• uterine bleeding, the cause of which is not established;
• over 40 years of age;
• smoking a large number of cigarettes, especially women over 35 years of age.

In the presence of one of the above contraindications, COCs should be completely forgotten. There is an additional list of diseases in which it is necessary to weigh the risks and benefits by prescribing contraceptive pills.

Such pathologies include diabetes mellitus, fibroids, age over 35, smoking, and others.

Women suffering from migraine should be especially careful when using COCs. Migraine is a relative contraindication to treatment with hormonal pills. Experts recommend prescribing low-dose contraceptive drugs containing less than 35 micrograms of ethinylestradiol, in particular, Janine, Logest, Minisiston, Mercilon, Regividon, Yarina. If severe headaches appear during COC treatment, the tablets should be discontinued, and as soon as possible.

Monocomponent birth control pills: mini pills

The second large group of hormonal contraceptive pills contains only one hormone - progestogen. Due to the low dose of the active substance, these drugs have received the sonorous name of mini-pills. Some of the most popular mini-pill birth control pills include:

• Exkluton containing 500 micrograms of linestrenol;
• Microlut, which includes 3 mg of levonorgestrel;
• Charozetta and Lactinet, which contain 75 micrograms of desogestrel.

It should be noted that Charozetta and Lactinet occupy a special place among mini-pills. The composition of these funds includes a modern gestagen, which has unique properties. In addition to contraception, desogestrel has an antiandrogenic and antimineralocorticoid effect.

The pharmacological action of the mini-pill is similar to that of COCs. By blocking the production of gonadotropic hormones of the pituitary gland, gestagens contribute to an increase in the viscosity of cervical mucus, forming a barrier to spermatozoa. In addition, mini-pills reduce the contractile activity of the fallopian tubes and cause endometrial hypotrophy, which makes implantation of a fertilized egg difficult.

Rules for taking mini-pills

Unlike combined birth control pills, mini-pills are used daily without taking a break.

The elimination half-life of the mini-pill is quite short: it is 12 hours less than that of the combined drugs and is only 22-24 hours. In this regard, monocomponent contraceptives must be taken at the same time in order to prevent a critical drop in the dose of hormones.

Charozetta and Lactinet can be attributed to a pleasant exception to the rule: their half-life occurs 36 hours after administration.

Monocomponent birth control pills: benefits

What distinguishes mini-pills from COCs? What are the advantages of monocomponent contraceptives over traditional combination drugs? The positive aspects of the mini-pill include:

- no side effects associated with the intake of estrogen.
Estrogen is responsible for most of the adverse events associated with COC use. Due to the lack of this hormone in mini-pills, they are better tolerated than combination pills;

- the possibility of appointment during lactation.
Monocomponent contraceptives are considered a means for nursing mothers. It has been proven that the gestagens used in mini-pili do not affect the qualitative composition of breast milk and do not reduce its amount. On the contrary, there is information stating that taking a mini-pill helps to improve lactation and lengthen the duration of breastfeeding. WHO recommends the use of monocomponent contraceptive pills 6 weeks after birth;

- the possibility of using mini-pills in women who are contraindicated in combination pills.
Monocomponent contraceptives are safe in patients with severe diabetes mellitus, migraine, heart and vascular diseases, varicose veins, as well as in smokers. In addition, mini-pills are birth control pills that are indicated for women of older reproductive age, including those after 40 years;

- no side effects after abrupt withdrawal of tablets.
Unlike COCs, you can stop taking monophasic contraceptives at any time during treatment.

Disadvantages of minipill

Along with a significant list of advantages, monocomponent tablets are not without some disadvantages, including:

• high probability of menstrual irregularities while taking drugs: intermenstrual bleeding, shortening of the cycle, etc.;
• relative low efficiency compared to COCs. The Pearl mini-peel index ranges from 0.5 to 3%. The higher probability of conception is due to the fact that low doses of progestogens in mini-pills cannot completely suppress ovulation. The only monocomponent tablets that guarantee this effect by 96% are Charozetta (Lactinet).
• increased risk of ectopic pregnancy If ovulation and conception still occur while taking the mini-pill, the fertilized egg will not be able to implant in the uterus. Therefore, the embryo is attached to the fallopian tubes or ovaries, as a result of which an ectopic pregnancy develops.

In addition, mini-pills also have side effects, including:

• increased appetite;
• decreased libido;
• nausea, rarely - vomiting;
• headache;
• increased sensitivity of the breast.

And the last. After the abolition of the mini-pill, a full menstrual cycle is restored within 1-3 months. At the same time, the rebound effect that combined contraceptives are famous for should not be expected.

Emergency contraception: contraceptives in haste

Along with planned contraception, every woman should remember that there is a second, emergency option of contraceptive pills. They are intended primarily for patients who rarely have sexual intercourse, as well as in unforeseen cases when, for some reason, planned contraceptive measures were not taken.

Preparations for emergency contraception are called postcoital, used already post factum, that is, after. If sexual intercourse occurred before ovulation, high doses of birth control pill hormones ensure that it does not occur. If conception does occur, emergency contraceptives provide endometrial hypotrophy, as a result of which the embryo cannot attach to the walls of the uterus. In addition, a low concentration of progesterone guarantees the impossibility of pregnancy.

To quickly achieve the desired effect, it is necessary to administer the highest possible doses of hormones. Therefore, postcoital contraception preparations are high-dose hormonal agents that are recommended to be used as rarely as possible. The effectiveness of urgent drugs reaches 97-99%.

Medicines for emergency contraception

There are several means of postcoital contraception:

- combined tablets.
Conventional combined COCs at a certain concentration can provide emergency contraception. This method of contraception is called the Yuzpe method. Among the contraceptives used according to the Yuzpe method are Microgynon, Minisiston, Femoden, Regividon, Regulon and others;

gestagens.
This group is represented by the contraceptive Postinor and its analogues - Microlut, Escapel and Eskinor-F;

antigonadotropic drugs.
These include Danazol, which is a treatment for endometriosis;

antiprogesterone agents.
A modern drug that suppresses the synthesis of progesterone - Mifepristone - is used as both an emergency contraceptive and in medical abortion.

Rules for taking postcoital contraceptive pills

There are strict rules for the use of hormonal emergency contraception, and deviation from them can lead to the most disappointing consequences.

Almost all emergency birth control pills must be taken within 72 hours of intercourse. Dosages of drugs depend on the pharmacological group.

Combined hormonal pills

At the same time take 4 tablets of both colors twice a day with an interval of 12 hours.

Gestagens

Postinor and its generics are prescribed one tablet twice a day after 12 hours.

Antigonadotropic and antiprogesterone drugs

Danazol for the purpose of emergency contraception is used at 400-600 mg twice or three times after 12 hours. An alternative regimen involves the appointment of 200 mg per day for five days in a row.

Mifepristone is used once at a dosage of 600 mg. Perhaps the appointment of 200 mg of mifepristone once a day from the 23rd to the 27th day of the cycle.

Note that according to some data, Mifepristone contributes to abortion up to a period of 5 obstetric weeks.

Emergency contraception side effects

The possible consequences of taking high-dose birth control pills cannot be overlooked.

In the vast majority of cases, taking hormonal pills for emergency contraception is accompanied by menstrual irregularities. Therefore, some experts recommend starting taking COCs to restore hormonal levels next to the “emergency” cycle.

In addition, taking high doses of estrogen is associated with nausea and even vomiting. To reduce these side effects, it is best to take the medication with or after meals. If vomiting could not be avoided, it is necessary to drink another, extraordinary dose.

Local contraceptive pills: alternative contraception

The contraceptive effect of local, that is, vaginal, contraceptives is based on the spermicidal action of the components of the drug. Most spermicides come in the form of suppositories, but pharmaceutical companies have mastered the technology for the production of both contraceptive cream and foam and, of course, vaginal tablets.

In Russia, only one spermicidal vaginal tablet is registered - Pharmatex. The active substance of the drug is an antiseptic and spermicide benzalkonium chloride. Pharmatex has a complex effect:

• spermicidal.
  The Pearl Pharmatex Index, when used correctly, is about 1%. Benzalkonium chloride contributes to the destruction of the flagella and the head of the spermatozoon;
• bactericidal.
  Pharmatex also provides protection against sexually transmitted diseases, including chlamydia, gonorrhea, trichomoniasis, HIV infection, herpes simplex virus type 2.

Rules for the use of Pharmatex

To achieve a contraceptive effect, it is necessary to strictly follow the rules for the use of Pharmatex:

• the tablet must be inserted into the vagina 10-15 minutes before sexual intercourse.
  It is this period of time that is needed for a solid tablet to break up and start working. The duration of action is about three hours. Before each subsequent sexual intercourse, it is necessary to use an additional tablet, even if the previous one has not yet expired;
• it is strictly forbidden to use soap and other alkaline detergents for the toilet of the external genitalia two hours before and after the use of birth control pills. This is due to the fact that soap contributes to the rapid and complete destruction of benzalkonium chloride.

As contraindications to the use of Pharmatex, only individual intolerance to the active substance and ulceration of the vaginal mucosa appear. In other cases, benzalkonium chloride preparations are completely safe.

Among all the contraceptive pills on the market, Pharmatex occupies a special place. If you need to consult a doctor to buy a hormonal drug, then Pharmatex tablets can be purchased at any pharmacy in the world without a prescription.

In conclusion, it is worth recognizing that the choice of birth control pills for a modern woman is great. It's a matter of small things: responsibility.

Reading time: 12 min.

Today, any pharmacy can boast the widest range of contraceptives, including combined oral contraceptives. Properly selected pills will help not only to avoid unwanted pregnancy, but also to prevent or cure many gynecological diseases. We offer for consideration the best contraceptive pills in the TOP-15 rating.

Oral contraceptive "Belara" reduces the secretion of follicle-stimulating hormone, inhibits ovulation, transforms the secretory ball and reduces the risk of sperm entering the uterus. In addition to the contraceptive effect, "Belara" also helps to normalize the menstrual cycle and reduce the risk of gynecological diseases, has a positive cosmetic and health-improving effect on the female body. The drug has established itself as a high-quality and reliable contraceptive, but it has a fairly extensive list of contraindications.

The combined drug Silest has a contraceptive effect on the female body, inhibiting ovulation in the ovaries and immobilizing spermatozoa in the cervix. In addition to contraceptive properties, Silest has the ability to normalize the menstrual cycle, reduce pain and reduce blood loss during menstruation. The drug is very reliable, but, unfortunately, not suitable for everyone. With the correct appointment and observance of the regimen, Silest does not cause side effects.

The contraceptive drug "Femoden" suppresses ovulation and increases the density of cervical mucus. Doctors usually prescribe this drug to women with an unstable menstrual cycle or heavy menstrual blood loss. During the period of taking the medication, the regularity of menstruation is observed, their pain decreases, the discharge is reduced, which significantly reduces the risk of iron deficiency anemia.

The popular contraceptive drug "Mikroginon" is equally effective for mature and nulliparous women aged 15 to 45 years. The contraceptive effect of the drug is based on the suppression of ovulation and the thickening of cervical mucus, which makes it difficult for sperm to enter the uterine cavity. "Microgynon" helps to improve skin condition, stabilize the menstrual cycle, reduce blood loss during menstruation, and eliminate pain. With prolonged use of the drug, the risk of ectopic pregnancy, oncological pathologies of the ovaries and endometrium, inflammation of the pelvic organs, and benign neoplasms of the mammary gland is reduced.

The contraceptive effect of "Jess" is achieved by inhibiting ovulation and immobilizing spermatozoa in the cervix. The drug also helps to normalize the menstrual cycle, minimize pain and blood loss during menstruation, and alleviate the symptoms of PMS. According to statistics, "Jess" reduces the risk of oncological pathologies of the female reproductive organs. In taking the drug, the skin becomes healthier, the hair becomes less greasy, the number of acne rashes is significantly reduced. Due to the minimum content of hormones, side effects from the use of the drug appear only in exceptional cases. "Jess" is easily tolerated, does not harm the gastrointestinal tract, does not block the removal of fluid from the body.

At the heart of the contraceptive effect of the drug "Trikvilar" is the work of complementary mechanisms, consisting of the suppression of ovulation and the increase in the density of cervical mucus. The drug has a positive effect on the stabilization of the menstrual cycle, reduces the intensity of bleeding and reduces pain, prevents the symptoms of iron deficiency anemia, reduces the risk of developing oncological pathologies of the ovaries and endometrium. "Trikvilar" is ideal for women who are used to planning their lives, does not fail, but requires strict adherence to the admission schedule.

The effective contraceptive drug "Regulon" acts by inhibiting the work of the pituitary gland, hindering ovulation and increasing the density of cervical mucus. Since the influence of Regulon is softer than that of most other similar drugs, doctors often recommend it to young girls as their first oral contraceptive. It is reliable and does not lead to weight gain with prolonged use. The drug is prescribed for contraception or the treatment of menstrual disorders: dysmenorrhea, PMS, dysfunctional uterine bleeding. In women taking Regulon, the appearance of the skin, hair and nails improves.

The result of the action of the drug "Novinet" is the blocking of ovulation, changes in the endometrium and thickening of the cervical mucus, preventing fertilization. The drug has other medicinal properties, among which it should be noted: stabilization of the menstrual cycle, reduction of blood loss during menstruation, prevention of inflammatory processes in the pelvic organs, reduction of the risk of ectopic pregnancy, counteraction to the occurrence of neoplasms in the ovaries, endometrium and mammary glands. Long-term use of the drug "Novinet" has a positive effect on the general condition of the skin of a woman.

"Klaira" is a multi-phase contraceptive drug, whose effectiveness is achieved through the inhibition of ovulation, the increase in the density of cervical mucus and the creation of obstacles to the implantation of a fertilized egg. Refers to natural oral contraceptives. In addition to the contraceptive effect, the drug has the properties to reduce the intensity and duration of menstrual flow, to alleviate the manifestations of PMS and pain during menstruation. Taking "Klaira" reduces the risk of developing certain gynecological diseases, reduces excessive vegetation in hypertrichosis, and helps to endure the manifestations of menopause.

The contraceptive drug "Yarina" prevents unwanted pregnancy by putting pressure on the process of ovulation, inhibiting the maturation of follicles and making it difficult for sperm to enter the uterus. Thanks to the regular use of contraceptives, women develop a clear and regular menstrual cycle, pain is reduced and the amount of menstrual flow is noticeably reduced. Since the contraceptive has a significant cosmetic effect, it is often prescribed to women with acne or seborrhea. Taking "Yarina" does not affect the weight of a woman, but it improves mood and increases libido.

An effective contraceptive "Marvelon", due to the low content of hormones, is suitable for women of any reproductive age. The high level of guarantee of protection (99%) makes the drug indispensable for the fair sex, who live an active sexual life. "Marvelon" eliminates menstrual problems, helps to cope with PMS, has a positive effect on the skin of the face, reduces vegetation in unwanted places and normalizes the level of hormones in the body. Long-term use of the drug contributes to the prevention of gynecological diseases.

The effective action of the contraceptive is based on three important mechanisms: the suppression of ovulation at the level of the pituitary gland, an increase in the viscosity of mucus in the cervical canal, and a change in the endometrium that prevents the implantation of a fertilized egg. In women taking "Janine", there is an adjustment of the menstrual cycle, less painful menstruation, a decrease in the intensity of bleeding, and a decrease in the risk of iron deficiency anemia. With prolonged use of "Janine", the condition of the skin and hair improves markedly. The active substances of the drug help to reduce the number and volume of the sebaceous glands, which allows the use of "Janine" for the treatment of acne.

The contraceptive effect of the drug "Logest" is achieved by changing the cervical mucus and suppressing ovulation. The amount of hormones in the preparation is minimized, which allows you to achieve a good result without tangible harm to the body. With prolonged use, the drug is able to: normalize the menstrual cycle, reduce pain, reduce spotting, prevent iron deficiency anemia, minimize the likelihood of developing ovarian cancer and benign breast diseases, prevent inflammation of the organs of the reproductive system, prevent ectopic pregnancy and the formation of ovarian cysts.

A very effective contraceptive drug with good tolerance. The drug is one of the few suitable for use by adolescents. "Three-regol" not only prevents unwanted pregnancy, but also has a beneficial effect on the health and appearance of a woman. Long-term use of "Three-Regol" will help bring a woman's health in order if she has problems in the form of: an irregular menstrual cycle, greasy, acne-prone skin and spotting caused by menopause. The drug will help the formation of the cycle, cleanse the skin, reduce the risk of inflammatory processes and diseases in the pelvic organs, help prevent the formation and development of oncological formations in the uterus and ovaries. The drug is often prescribed for certain gynecological problems and diseases. They can be: dysmenorrhea, oligomenorrhea, non-systematic menstruation, profuse blood loss during menstruation, hormonal dysfunction.

Microdosed hormonal contraceptive with an almost 100% guarantee of effectiveness. Mercilion prevents unwanted pregnancy by inhibiting ovulation and increasing the viscosity of the cervical mucosa. In addition to preventing fertilization, the drug also helps to improve the condition and appearance of the skin, removes acne and acne, stabilizes the menstrual cycle, reduces the risk of anemia, prevents certain types of gynecological diseases, and prevents the development of malignant and benign formations of the female reproductive organs.