How to choose contraceptive pills based on analysis. How to choose birth control pills

The concept of family planning begins with the woman deciding for herself whether to have children or not, and if so, how many. Therefore, a huge assortment of contraceptives is becoming more and more interesting to women, and they are increasingly wondering how to choose contraceptives?

Fortunately, pharmacists have long come up with ways to avoid unwanted pregnancy. But the awareness of the population still remains at a very low level and not all women know how to choose birth control pills and not cause harm.

Some ladies are still afraid of myths about the terrible side effects of birth control pills and therefore stand in orderly rows to see a gynecologist to have an abortion. But abortion is a very great evil and has a detrimental effect on the physical and psychological state of a woman.

Let's talk about hormones

The female body has a very complex hormonal system. At different phases of the cycle, estrogen, progesterone, and oxytocin rage in it. Hormones determine many development factors: what genital organs a person will have, female or male, what a woman will look like, what kind of hair she will have, how she will relate to others, what profession she will choose in the future.

Therefore, it is important to know what hormones these are, what they do in the body and what they are responsible for.

Firstly, some hormones are produced in the brain, or rather the pituitary gland. They are the main ones and regulate the amount of other hormones that are produced in the ovaries and adrenal glands.

Estrogen

The most important female hormone. Its development determines:

• human development according to the female type;
• stimulates the growth and function of the uterus, fallopian tubes and ovaries;
• hair growth and quality;
• stimulates the functioning of the mammary glands;
• distributes the amount and location of fatty tissue;
• timely rejection of the uterine mucosa during menstruation;
• inhibits bone resorption;
• act as a prevention of atherosclerosis and the formation of blood clots.

Progesterone

The second most important hormone in the female body. It is produced only after the release of the egg and the formation of the corpus luteum. This hubbub prepares a woman for pregnancy. If ovulation does not occur, progesterone remains low, resulting in anovulatory uterine bleeding.

• progesterone causes the endometrium to enter the secretory phase;
• prepares the uterine mucosa for embryo implantation in case of pregnancy;
• during implantation of the embryo into the mucous membrane, progesterone reduces the action of the woman’s immune system so that it does not kill the embryo;
• reduces the contractility of the uterine muscles;
• if fertilization does not occur, a drop in progesterone levels causes menstruation.

Estradiol

Exclusively female hormone. Produced by the ovaries. Normal estradiol values ​​on different days of the cycle indicate normal ovarian function.

Testosterone

Despite the fact that this is a hormone in the male body, women also have it and even increase during pregnancy. Testosterone is synthesized by the adrenal glands and affects such factors as:

• features of muscle tissue formation;
• libido level;
• regulation of follicle maturation;
• the work of the central nervous system, the woman’s level of aggressiveness, her emotional state and determination.

Oxytocin

Female hormone of love and tenderness. Its production in the brain determines a lot, especially in a woman’s behavioral reactions:

• softness;
• tenderness and compassion;
• compassion and care for others.

This type of hormone is produced during orgasm. Without it, a woman feels oppressed, suffers from depression, and is not interested in caring for others.

It is on changes in the concentration of female sex hormones that the action of hormonal contraceptives is based.

Note!

It must be said right away that, despite the large number of myths and prejudices, hormonal drugs do not destroy a woman’s endocrine system and can not only prevent conception, but also cure some hormone-dependent diseases of the endometrium and ovaries.

Types of contraceptive drugs and their effects

Let's talk about the most popular types of contraceptives for women and their effect on the body.

Monophasic drugs

The most studied and frequently prescribed drugs. Despite the fact that monophasic contraceptives are practically pioneers in the line, their reliability and effectiveness have been tested by more than one generation of women.

The action is based on the presence of two hormones, estrogen and progesterone, the levels of which do not change in the tablets throughout the entire cycle.

1. Janine
2. Yarina
3. Diana-35

The simplicity and uncomplicated nature of the dosage regimen and the ability to simply increase the number of tablets if a woman forgets to take a tablet on time have made these drugs popular.

Taking these pills can cure endometriosis, a condition where endometrial glands spread to other organs and parts of a woman's uterus. Monophases can reduce the amount and pain of menstruation.

Mini-pill

This oral contraceptive works based on the action of minimal doses of progestin, which is a synthetic analogue of progesterone. The dose in a hormone tablet is minimal and does not exceed 500 mcg.

They are prescribed to women who, for some reason, are contraindicated in combination drugs with high levels of progesterone and estrogen. Their action is based on changes in the thickness of cervical mucus.

Due to the fact that the mucus has become thicker, it is more difficult for sperm to penetrate the uterine cavity and fertilize the egg. In addition, progestin acts on the egg, preventing its release and movement through the tube. The effectiveness of this drug is slightly lower than that of multiphase tablets.

The most popular types of melon contraceptives are:

1. Microvapor
2. Ovret
3. Microlute
4. Exluton
5. Latinet
6. Charosetta
7. Narkolut

Combined oral contraceptives

These are more modern drugs. They contain three types of hormones. The concentration is close to changes in the female body.

Of course, the dosage regimen is more complicated and depends on the day of the cycle. But their main advantage is that the drug can be used if a woman has a high risk of complications.

Representatives of three-phase combined contraceptives:

1. Tri-regol
2. Triziston
3. Tri-mercy

Which contraceptives should girls who have not given birth choose?

The ideal option for young girls who have not given birth and are sexually active are combined oral contraceptives.

There are three types of COCs based on the amount of hormones they contain:

1. Micro dosing.
2. Low dosage.
3. Highly dosed.

You should choose micro-containing preparations. They are perfect for those who are using this type of contraception for the first time, as they do not carry additional burden on the young body.

Note!

It may happen that micro-dose contraceptives are not suitable, then low-dose drugs should be chosen. Such drugs can not only prevent unwanted pregnancy, but also regulate the menstrual cycle.

The age of a woman who has not yet given birth and is going to take micro-dosed medications can reach twenty years or even 25 years. Until this period, a woman’s hormonal levels remain at the same level.

• Zoely;
• Claira;
• Jess;
• Dimia.

Contraceptives for women 30 years old

At this age, as a rule, there are already one or more children in the family. However, despite a woman’s young age, her hormonal levels change slightly. Therefore, the choice should fall on low-dose hormonal oral contraceptives.

Taking medications serves as a preventive measure for uterine fibroids - a benign neoplasm of the uterus, endometriosis and hormone-dependent dysmenorrhea.

• Yarina;
• ChrinaPlus;
• Median;
• Tri-mercy;
• Femoden;
• Silest.

• Lactinet;
• Charosetta;
• Eskluton;
• Microlute.

What drugs to choose for women after 35 years of age

The most favorable age for the blossoming of female sexuality. The house and life are arranged, there are children. According to statistics, half of pregnancies at this age end in abortion. This means that many ladies are not ready to plunge back into the pleasant troubles of motherhood.

Note!

At this stage, you should be a little more careful about your health. Before choosing this or that drug, you must definitely visit a gynecologist and donate blood for a quantitative analysis of hormones.

Based on these results, the doctor will prescribe drugs containing only progestogen (mini-pills) or with a certain concentration of estrogen in the form of combined contraceptives.

Birth control pills after 40 years

Having a child at this age is quite risky. But it is not convenient to protect yourself with any barrier methods. Therefore, if a woman has not taken birth control pills before, now is the time to start.

Of course, the only way to the pharmacy should be through the gynecologist’s office. There are already chronic pathologies not only of the genital area, but also of somatic organs. Usually the doctor prescribes high-dose hormonal hormone preparations.

• Tri-regol;
• Ovidon;
• Trisiston;
• Non-Ovlon;
• Triquilar.

Contraindications

But birth control pills have their contraindications. You need to know this and strictly follow the rules for taking medications or abandon them completely.

Note!

Considering the high content of active substances in the tablets that can change the processes of ovulation, metabolism and other important events in a woman’s body, this can be harmful to health.

Women with the following diseases should not take hormonal contraceptives:

1. Varicose veins with or without thrombophlebitis.
2. Previous presence of myocardial infarction, cerebral infarction, infarction of other localization associated with the separation and migration of a blood clot, or acute vascular thrombosis.
3. Migraine, established or migraine-like disorders of the nervous system with local symptoms.
4. Women suffering from type 1 or type 2 diabetes.
5. With liver diseases of both chronic origin (hepatitis, cholangitis) and acute stage.
6. Diseases of the pancreas with dysfunction of the organ.
7. Renal failure, both acute and chronic.
8. If a woman has a malignant neoplasm, the growth and development of which is influenced by hormones.
9. With any dishormonal diseases of the mammary gland or internal genital organs.
10. Bleeding from the vagina, especially of unknown etiology.
11. Individual intolerance to one or more components.

Side effects

Side effects are conditions that can occur, but not in one hundred percent of cases and not all at once and not even in everyone. Therefore, you should not be afraid of this type of contraceptives just because of the side effects that even aspirin has.

1. Due to a lack of zinc or iron, a condition may arise in which a woman will experience hair loss.
2. Mood swings, the hormone gestagen affects the production of serotonin, so excessive tearfulness, sentimentality, or, on the contrary, depression of mood may appear. This can be treated with additional vitamin B.
3. The appearance of a rash and increased production of sebum.
4. Headaches, especially in nulliparous women.
5. Weight gain.
6. Soreness of the mammary glands.
7. Painful sensations in muscles and joints. Pharmacists explain this phenomenon by the effect of estrogen on the body.
8. Absence of menstruation or scanty bleeding.
9. Dyspeptic disorders, nausea, perhaps even vomiting.

The packaging of the contraceptive must contain instructions. Plus, the doctor who prescribes the drug for you will tell you about its dosage regimen and features.

But it still makes sense to recall the general principles:

1. Hormone intake is closely related to a woman's menstrual cycle.
2. The first day of the cycle is counted from the first day of normal menstruation.
3. Each package contains 21 pills. The first tablet is taken on the first day of the cycle or on the first day of menstruation.
4. If a woman has had an abortion, then taking the drug should be started on the first day after it.
5. Reception should be carried out at the same time. For example, at dinner at 21.00.
6. Each hour of delay reduces the effectiveness of the medicine.
7. After all the tablets are gone, you need to take a break of 7 days.
8. Most likely, menstruation will appear, this is normal. Also, a variant of the norm will be the appearance of menstruation late.
9. On day 8, start a new package.
10. On break days they will protect themselves in a different way.
11. If you missed your appointment time or day. You need to take a pill when you remember and 12 hours later another one.
12. If you missed two days or more. Take a break for a week and continue taking pills according to the standard regimen.
13. The mini-pill should be taken from the first day of bleeding. And if you didn’t start drinking on this day, take a break of 21 days.
14. In all cases of a break or missed dose, they will be protected in another way.
15. Drink with water.

Table on how to independently select birth control pills by phenotype

Conclusion

Modern women are very different from women of the last century. Responsibilities include not only creating comfort, giving birth and raising children, but also a career, work and an active social life. The standard of living of many people also does not allow modern families to have many children.

Scanpix

What is the effect of hormonal contraceptives, what reviews does this method have among modern women, how to choose hormonal contraceptives that are safe for health - we will talk about this in detail today in this article.

Hormonal contraceptives (HC) are contraceptives that, in their reliability, safety and convenience, are significantly superior to the popular condoms and coitus interruptus. The reliability of protection with the help of the latter does not guarantee the degree of protection that hormonal contraceptives can provide, writes Sympaty.net.

According to statistics, the above methods protect against pregnancy by an average of 75%. Whereas taking hormonal contraceptives, if all recommendations are followed, guarantees 98 - 99% protection.

The popularity of this method of contraception is evidenced by the fact that more than 70 million women in the world use it.

The principle of action of hormonal contraceptives

The action of hormonal contraceptives is based on changing the amount of female sex hormones (estrogen and progesterone) by introducing their analogues into the body - artificial twin brothers. This is necessary in order to create a hormonal background, as during pregnancy, when the egg does not mature in the body, that is, ovulation does not occur.

Also, pregnancy while taking GC is impossible because these drugs make the mucus more viscous and sperm cannot enter the uterus.

In addition, under the influence of hormones, the inner layer of the uterus, to which the egg is attached, changes.

Thus, once in the body, hormonal contraceptives prevent pregnancy from different sides, which makes them highly effective.

How to choose a hormonal drug?

Why don’t our women trust hormonal contraceptives, preferring other methods?

• Firstly, for a long time there was an opinion that hormonal contraceptives were harmful. This reputation was created for them by the first birth control pills, which, indeed, had a large number of side effects, because the content of synthetic hormones in them was huge! Today their number has been reduced by 50 times. Therefore, modern hormonal drugs do not cause discomfort, as was the case with the first contraceptives. Although they also have side effects. We will talk about this in more detail in a separate article.

• Secondly, it is easier to install the spiral. This is the method that is most often recommended at appointments in public clinics. This is indeed more convenient... for the doctor. After all, according to statistics, only 37% of gynecologists understand the mechanism of action of hormonal drugs. Therefore, they cannot tell or advise how to choose the right hormonal contraceptives. Besides, it’s troublesome: tell people, collect tests, select what you need, trace whether it’s suitable?

• Thirdly, many women, unfortunately, experience discomfort when communicating with a gynecologist, and even more so on topics such as intimate life.

• And finally, many are stopped by the fact that in order to select the correct hormonal drugs, it is necessary to undergo an examination, which consists of the following: dinecological examination, ctesting for hormones - 3 times per menstrual cycle, blood tests for clotting, sugar.

Only after passing all the tests can the doctor determine what is right for you.

Hormonal contraception: types

Depending on the method of drug entry into the body, HAs are divided into the following types:

• OK - oral contraception. The drug enters the body through the oral cavity (tablets and pills).

• Parenteral contraception. Drugs enter the body bypassing the intestines (these are injectable drugs, vaginal rings, implants, skin patches, intrauterine devices containing hormones).

Combined and progestin contraceptives

Read more

The most accessible and popular are oral hormonal contraceptives. Reviews say that the use of birth control pills is reliable contraception, but only a doctor should select them after a full examination. Side effects are often observed, such as decreased sexual desire, disruptions in the menstrual cycle, etc.

If pregnancy occurs, it is mainly only due to errors in the use of OCs.

Today there are two types of oral contraceptives:

• combined (COC) - contain 2 hormone analogues - estrogen and progesterone.

• progestational (mini-pills) - contain only 1 synthetic analogue of progesterone.

When selecting oral contraceptives, the doctor also takes into account the level of hormones in the woman’s body. Depending on the test results, monophasic or two- or three-phase OCs are prescribed.

• Taking monophasic drugs - tablets with the same content of estrogen and progesterone (these are all progestin and most COCs), a woman receives the same amount of hormones throughout the entire menstrual cycle.

• If the body needs to regulate hormone levels, the doctor will select two- or three-phase drugs: they have different combinations of estrogen and progesterone. They must be taken strictly according to the schedule, since they create an imitation of hormonal levels in the female body at different phases of the menstrual cycle. It is for this reason that those who are looking for an answer to the question of how to choose hormonal contraceptives, sympaty.net does not advise doing this without consulting a doctor, following the advice of girlfriends, trusting their intuition, the Internet, etc.

COOK

All combined oral contraceptives contain the same amount of progesterone - it is this that blocks the onset of pregnancy, but these drugs are divided into groups depending on the estrogen content. It's not that complicated here:

• microdosed preparations contain a small dose of estrogen;

• low-dose ones are distinguished by their high content;

• high-dose ones contain the highest dose of estrogen.

It would be a mistake to believe that the latest drugs, which contain a large dose of estrogen, will be the most effective. As previously written, this hormone does not play such an important role in contraception as progesterone.

Thus, birth control pills with a microdose of estrogen are more suitable for nulliparous women, as well as for those over 35. This group includes the drugs Novinet, Logest, Jess Plus, Qlaira, Zoely, Lindinet - 20, Mercilon, etc.

For women who have given birth, as well as for those who are not suitable for microdosed drugs (for example, side effects in the form of bleeding appeared after an adaptation period), tablets with a low dose of estrogen are recommended: Yarina, Yarina plus, Midiana, Tri-Mercy, Lindinet-30, Femoden , Janine, Silest, Regulon, Silhouette, Janetten, Diane-35, Marvelon, Bellune-35, Chloe, etc.

In addition to its main purpose - to protect against unwanted pregnancy, the tablets have an antiandrogenic (cosmetic) effect.

This group is most popular among women who prefer hormonal contraceptives. Reviews about these drugs vary, but this type of contraception is suitable for most women.

High-dose birth control pills are used only on the recommendation of a doctor for the treatment of serious hormonal disorders and contraception. This group includes Tri-regol, Triquilar, Milvane, Ovidon, Non-Ovlon, etc.

Mini-pill

Progestin drugs contain only a microdose of a progesterone analogue. Tablets of this group are prescribed to women during breastfeeding, as well as to those who are not suitable for hormonal contraceptives with estrogen. This group of drugs includes Lactinet (specially designed for nursing mothers), Charozetta, Exluton, Norkolut, Microlut, Micronor, etc.

Their effectiveness is slightly lower than COCs. They require strict adherence to the dosage regimen.

Postinor: “fire fuse”

For those who have had accidental unprotected sexual intercourse, the hormonal contraceptive “Postinor” has been developed, which contains a very high dose of a progesterone analogue, which will help prevent pregnancy. After taking one pill no later than 48 hours after sex, and another 12 hours after taking the first, the contraction of the fallopian tubes changes in the body, the structure of the endometrium changes in such a way that the fertilized egg cannot attach.

Taking this drug requires special caution.

The high content of the hormone included in the composition carries a number of side effects that are dangerous to a woman’s health: dizziness, menstrual irregularities, hormonal imbalances, heavy bleeding, which only a doctor can stop. It should be remembered that Postinor is an emergency hormonal contraceptive, it can be taken only in extreme cases and in no case should this drug be abused.

Parenteral hormonal contraceptives

This type of hormonal contraceptives differs from oral contraceptives in the method of administration: hormones enter the body in a large single dose, rather than being taken daily. After which they are gradually absorbed into the blood, creating a contraceptive effect. These hormonal contraceptives are recommended for women who have given birth and who are not planning a pregnancy in the coming years.

Long-acting (long-acting) drugs are more convenient than birth control pills: they do not require daily use.

• Subcutaneous implant - “Norplant”. 6 thin silicone capsules containing progesterone. They are implanted in the forearm area under local anesthesia at the beginning of menstruation. The capsules gradually dissolve and release the hormone into the body. Validity period from 2 to 5 years.

• The principle of action of injectable hormonal contraceptives is similar to the action of “Norplant”: it thickens the uterine mucus, the secretion of the fallopian tubes, suppresses ovulation and changes the structure of the endometrium. We practice administering the drug “Depo-Provera”. Injections protect against pregnancy for 2 to 3 months. It is impossible to prevent side effects (sometimes weight gain and decreased libido) since the injections have already been administered.

• The action of the spiral with hormonal contraceptives “Mirena” has been noted to be highly effective in contraception. After its installation in the uterus, a progesterone analogue begins to be released in microdoses. Thus, the IUD protects against pregnancy as a barrier and hormonal method, which increases the level of protection to 99.7%.

• The use of the Evra contraceptive patch is becoming increasingly popular among women. It is applied once every 7 days, adheres securely to the skin, does not come off under the influence of water or sun, and does not cause changes in the usual rhythm of life. Every day a certain dose of hormones is released from it, necessary to block ovulation and thicken the mucus in the uterus. With proper use and timely replacement, maximum, almost 100% protection against unwanted pregnancy is achieved.

• The Novaring vaginal ring is a new method of hormonal contraception. It is a soft contraceptive ring that is inserted into the vagina. Estrogen and progesterone are released from the ring. The principle of their influence on reproductive function is the same as the principle of action of all parenteral hormonal contraceptives. This method provides 99% protection against pregnancy. The advantage over other hormonal contraceptives is that estrogen and progesterone go directly to the uterus and ovaries. Nuvaring does not affect the functioning of the liver; it can be given to those who are prone to varicose veins.

If hormonal contraceptives are what you decide to choose, then approach this issue with all responsibility. Do not forget that after long-term use of hormonal contraceptives, the likelihood of conceiving a child increases.

Eggs that are well “rested” can get to work with double effort. That's why after taking these drugs, your chances of having twins or even triplets increase!

The birth of a child is an event that most people prefer to take from the sphere of “divine providence” into their own hands. Fortunately, controlling the onset of pregnancy in the modern world is quite simple. One of the most popular means for this has become birth control pills. How to choose them correctly?

How to choose birth control pills

Ideally, the selection of oral contraceptives should be done by a gynecologist. Contraceptive pills are prescribed only based on the results of examinations, including the following procedures:

1. Smear for oncocytology.
2. Ultrasound of the pelvis on days 5-7 of the menstrual cycle.
3. Hormone analysis (taken 3 times during the menstrual cycle).
4. Blood test for clotting and sugar.
5. Consultation with a surgeon to identify varicose veins (if the disease is detected, hormonal contraceptives are not prescribed).
6. Mammological examination.

Before making a decision, the doctor must analyze the following information about the patient:

• age;
• weight and height;
• number of previous births and abortions;
• regularity of the menstrual cycle, its duration, abundance of discharge, general well-being during menstruation;
• the presence of chronic diseases, problems with excess weight or skin;
• phenotype.

Such attentiveness and conscientiousness of a gynecologist is not always found. Many doctors show amazing indifference and, in the absence of complaints from the patient, limit themselves to a very superficial examination, based on the results of which they make a very “professional” conclusion: “Well, try to drink ... (substitute what is necessary).” In the future, if a woman has no complaints about the prescribed (or guessed?) pills, the choice is considered successful. If side effects occur, another drug is selected.
It is very undesirable to see a doctor whose main tool of work is intuition. After all, oral contraceptives themselves are not very safe: many gynecologists claim that any hormonal drug has side effects, they just do not appear immediately. Therefore, if the doctor’s indifference to the problem of choosing birth control pills is initially obvious, then his complete inattention to the most likely “surprises” that will soon await the woman is almost guaranteed.

For example, many patients who were prescribed Yarina later experience thrombosis. The main reason for this is ignorance that when taking these pills it is recommended to regularly undergo blood clotting tests and, in some cases, additionally take medications that reduce the risk of developing thrombosis.
In general, before you start choosing contraceptives, you need to find a good doctor.

Birth control pills: which one is better to choose yourself

Many women decide to independently select pregnancy pills. The main reason for this is distrust of the gynecologist and reluctance to discuss the details of intimate life with him. Prescribing medications to yourself is a lottery, but to increase your chances of winning it, you need to select contraceptives based on your phenotype. How to define it?

Phenotype	Distinctive features	Recommended drugs
Estrogenic	Low or average height.	Microgynon*, Silest, Miniziston-20*, Rigevidon*.
	Deep feminine voice.
	Dry skin and hair.
	Well developed breasts, enlarged before menstruation.
	Female-type pubic hair growth (triangle pointing down).
	Heavy and long periods (more than 5 days).
	PMS is expressed by increased nervousness and tension.
	The menstrual cycle lasts more than 28 days.
	Profuse leucorrhoea.
	Pregnancy proceeds without any particular complications.
Balanced	Average height.	Miniziston*, Tri-mercy, Novinet, Mercilon, Tri-regol*, Triquilar*, Femoden, Lindinet-20, Marvelon, Lindinet-30, Logest, Milvane, Regulon, Triziston*.
	Feminine voice.
	Normal hair and skin.
	Moderately developed mammary glands.
	Female-type pubic hair growth.
	Moderate menstruation lasting 5 days.
	PMS is mild and there are no noticeable mood swings or physical manifestations.
	28-day menstrual cycle.
	Moderate leucorrhoea.
	Normal course of pregnancy.
Progesterone	Medium or tall height.	Belara*, Yarina, Jess, Chloe, Diane-35, Klaira, Janine*.
	Boyish/masculine features predominate in appearance.
	Low voice.
	Underdeveloped breasts.
	Pubic hair grows in a male pattern (triangle pointing up).
	Oily skin and hair, characterized by redness, acne, pimples, dandruff.
	Light menstrual bleeding lasting less than 5 days.
	PMS is expressed by a depressed mood, pain in the muscles of the legs, abdomen, and lumbar region.
	The menstrual cycle lasts less than 28 days.
	Scanty leucorrhoea.
	Pregnancy is accompanied by toxicosis and significant weight gain.

* – the safest drugs

You should take Novinet, Mercilon, Silest, Marvelon, Regulon, Tri-Mercy, Yarina and Jess tablets with extreme caution, as they have a very negative effect on the liver and significantly increase the risk of blood clots.

You should also remember your family history. Particular attention should be paid to thrombosis, varicose veins, diabetes, cancer, migraines, and epilepsy. If a woman has a predisposition to these pathologies, then it is dangerous for her to take hormonal contraceptives without consulting a doctor.

It is recommended to take the tablets for 6 months to fully understand how suitable they are. But if severe headaches occur, legs swell, depression appears, etc., it is necessary to stop taking the drug. Additionally, you should consult with an appropriate specialist regarding the symptoms that have arisen: for example, a headache is a reason to visit a neurologist.

Improper measures to prevent unwanted pregnancy can cause no less harm than terminating it. Therefore, if luck is not your life partner, it is better to select birth control pills under the supervision of a competent doctor. It's more reliable.

Hormonal type, or rather phenotype- this is the structure of the female body depending on the predominance of one or another sex hormone in the body. With this information, you can better understand the characteristics of your body, select hormonal contraception and calculate its side effects.

In total, 3 female phenotypes were previously identified, but I would still say that there are 5 of them.
Etrogen phentype(type 1), balanced phenotype(type 2), progesterone phenotype(type 3) was previously considered progesterone/androgenic, but based on clinical observations I would single out androgen phenotype in a separate form (type 4). Besides hypoestrogen type allocated to a separate group (with etrogen deficiency).

Estrogen phenotype (i.e. hyperestrogen phenotype): scientific fat type, endomorphic. The predominant hormone is estradiol.

These are women with a “pear” figure type, with pronounced development of the hips and mammary glands, which makes them prone to the phenomena of mastopathy and fibroadenomatosis of the breast. Prone to obesity, with the formation of gallstone disease. They are characterized by good skin, without acne, but a little dry, thin, sometimes curly hair on the head.

Hirsutism (hair growth is active on the face, abdomen, back, thighs) and hypertrichosis (hair growth is more active on the forearms and lower legs) are not typical for them - this applies to Russian women, for women of other nationalities - it depends on the severity of hair growth in the family - constitutional hypertrichosis may be present.

Women of this type are of average height, with a high timbre of voice and a “pretty appearance.” With a tendency to PMS (like “hysteria” and tearfulness). The menstrual cycle is often regular or delays do not exceed 60 days (that is, disorders such as progestron deficiency - hypoluteinism), the cycle can be heavy, with a tendency to endometrial hyperplasia in perimenopause - in the presence of obesity.

Taking Duphaston is well tolerated (they have a “classic type of reaction” to it - with the onset of menstruation 3-6 days after stopping the drug).
By nature, they are more “female lovers”, active (more choleric), in need of constant male attention.

Prone to uterine fibroids, the formation of follicular cysts and varicose veins. They get pregnant quickly, but pregnancy can be complicated by a lack of progesterone and threats of miscarriage. COCs with gestodene, desogestrel, levonogestrel (Mikrogynon, Lindinet-20, etc.) are well suited for them. They may have hot flashes for a long time after menopause, sometimes all their lives.

Balanced Phenotype, a kind of “Ideal Woman”. Estradiol/progesterone are balanced according to the phases of the cycle.

The body structure is proportional, the skin is clean, with normal moisture and oil content. The hair is thick and dense. Menstruation is regular, PMS is not typical or is only slightly expressed. Soprano voice. Hirsutism is uncharacteristic, there may be slight hypertrichosis - more constitutional. They get pregnant and carry to term without problems.

The most suitable COCs are three-phase COCs with desogestrel and gestodene. (Tri-Mercy, Marvelon, Lindinet-20, etc.)

Progesterone phenotype. Scientifically also called bone, ectomorphic. Progesterone predominates.

These are women with the following body type: both shoulders and hips are developed evenly, “sports body type”, subcutaneous tissue is distributed evenly, sometimes according to the android (male) type (this is for obesity, that is, the deposition of fat masses in the upper abdomen and back ). Skin prone to oiliness (oily seborrhea) of both the face and scalp. Acne happens, sporadically.

Height is usually above average (more dependent on genetic characteristics), the mammary glands are moderately developed, with a predominance of adipose rather than glandular tissue. Therefore, they are less prone to mastopathy. Menstruation is often scanty or very. short or long, up to 7 days. PMS happens, but with a tendency to melancholy and tearfulness, swelling.

Taking duphaston (according to indications) can increase the manifestations of PMS and swelling. The reaction to Duphaston may be “non-classical” - menstruation does not begin 7 days after the course of the drug (caused by a preliminary lack of estrogen). By nature, they are more sanguine, the type of “woman-mother” - with the need to care for others.

She often shows sexual activity only in the presence of a love object; in her absence, she can be sexually inactive, which distinguishes her from women of the estrogen type. Therefore, the menstrual cycle is often irregular in women of the progesterone type; sometimes there is a tendency that if there is regular sexual intercourse, the menstrual cycle is regular (the production of estrogen is stimulated), if not, the cycle is irregular. Therefore, she does not get pregnant right away - after a certain time of regular sexual relations, she bears without threats (this is, of course, theoretically, based on the activity of the hormone progesterone), but she is prone to large weight gains!

Prone to insulin resistance and weight gain, also after childbirth. COCs with dienogest and drospirenone are good options. (Yarina, Jess, Bonade, etc.)

Androgenic phenotype. Muscular or mesomorphic.
A woman's appearance depends on the predominance of androgens (male hormones) from the ovaries or adrenal glands.

Adrenal hyperandrogenism (17-OH progesterone, androstenedione or DHA-S predominates) is a tall woman, asthenic (thin), “muscular type”, with poorly developed subcutaneous tissue. “Boyish body type”, the mammary glands are poorly developed, the skin tends to be oily, and acne is not pronounced. An example is modern super-models.

Sexually moderately active, does not get pregnant right away, and carries threats of miscarriage. The menstrual cycle is often irregular. The voice is low.

A woman with a predominance of ovarian androgens (or with mixed secretion, a predominance of total/free testosterone) is short in stature, with a pronounced shoulder girdle, oily skin and acne, hirsutism and hypertrichosis. The mammary glands are moderately developed. The voice is low, mezzo-soprano type. They get pregnant with difficulty and carry threats. Sexually very active (testosterone is the basis of the hormone of sexual activity). We are not prone to PMS because of irregular ovulation, which is the “key” to PMS.

If they are obese, often with the phenomenon of hyperinsulenism and impaired carbohydrate metabolism, they can lose weight well with properly selected physical activity, but there is a risk of “pumping up” the muscles. Behavior of women like “their boyfriend”.

An example is women with PCOS syndrome. COCs with cyproterone acetate, drospirenone and dienogest are good options. (Diana-35, Yarina, Klaira... etc.).

Hypoestrogenic phenotype– these are women who are either tall or short (depending genetically), of an infantile structure – small breasts, disproportionately long arms and legs, thin, “parchment” skin, easily tired. PMS is not typical. The menstrual cycle is disrupted up to amenorrhea - delays of up to 6-12 months. Menstruation is painful. Behavior of a “teenage girl”. The voice is high, poor in overtones. Libido is sharply reduced or absent if there is also a lack of androgens. Getting pregnant is problematic. An example is girls with anorexia.

Indicated: hormone replacement therapy, triphasic COCs, COCs with levonogestrel.

A combination of several phenotypes is possible.

By 2011-2015, information appeared that during perimenopause a 6th phenotype can also form: androgen deficiency (according to Apetov S.S.) the level of androgens in the adrenal glands decreases, which also has its consequences - a decrease in muscle strength and endurance, scarcity of axillary and pubic hair , hair loss on the head, gradual disproportionate weight gain in the waist area. A sharp decrease in libido. Correction of these phenomena may require hormone replacement therapy.

According to information obtained from a clinical study that included 300 women, type 1 of women predominates.

*During the writing process, 6 classifications were analyzed.

Important! Message from the site administration about questions on the blog:

Dear readers! By creating this blog, we set ourselves the goal of giving people information on endocrine problems, diagnostic methods and treatment. And also on related issues: nutrition, physical activity, lifestyle. Its main function is educational.

Within the framework of the blog, in answering questions, we cannot provide full-fledged medical consultations; this is due to both the lack of information about the patient and the doctor’s time spent in order to study each case. Only general answers are possible in the blog. But we understand that not everywhere it is possible to consult with an endocrinologist at your place of residence; sometimes it is important to get another medical opinion. For such situations, when a deeper dive and study of medical documents is needed, at our center we have a format for paid correspondence consultations on medical documentation.

How to do it? Our center’s price list includes a correspondence consultation on medical documentation, costing 1,200 rubles. If this amount suits you, you can send scans of medical documents, a video recording, a detailed description, everything that you consider necessary regarding your problem and questions that you want answered to the address patient@site. The doctor will see if the information provided can give a full conclusion and recommendations. If yes, we will send the details, you will pay, and the doctor will send a report. If, based on the documents provided, it is impossible to give an answer that could be considered as a doctor’s consultation, we will send a letter stating that in this case, absentee recommendations or conclusions are impossible, and, of course, we will not take payment.

Sincerely, Administration of the Medical Center "XXI Century"

Hormonal contraception is a highly effective method of preventing pregnancy if used correctly. If we judge the pros and cons of a particular method of contraception, then the advantages of hormonal contraceptives are much greater than the disadvantages. But in addition to following the rules of administration, you should choose the right hormonal pills or their analogues to avoid side effects.

Types of hormonal contraception

There are different types of hormonal contraceptives. There are several types of hormonal contraceptives:

• combined oral contraceptives or COCs;
• progestin drugs:
  • pure progestins or mini-pills;
  • injectable progestins (have a prolonged effect);
  • progestins that are implanted;
  • contraceptive patch;
• drugs for emergency or fire contraception;
• hormonal intrauterine system;
• vaginal rings with hormones.

Combined oral contraceptives (COCs)

These types of hormonal pills include those that contain both estrogens and gestagens. Depending on the content of hormonal components, COCs are divided into:

• monophasic (each tablet contains the same dose of estrogen and progestogen components) - rigevidon, logest, silest;
• two-phase – anteovin, divina;
• triphasic – tri-regol, triziston.

The effect of this type of hormonal contraception is to suppress the production of the ovaries' own hormones, as a result of which ovulation does not occur. In addition, such tablets thicken the mucus in the cervical canal, which makes it impossible for sperm to penetrate into the uterine cavity and change the uterine mucosa (to some extent atrophying it), which prevents egg implantation.

How to choose the best COCs

It should be noted that among any hormonal contraceptives, both pills and other drugs, not a single doctor will say which is better. The female body is a complex system that easily responds to the slightest changes in hormonal levels, and what is ideal for one woman does not necessarily suit another, it all depends on individual characteristics. It is not recommended to choose COCs on your own, as well as any other hormonal contraceptives; your doctor will help you suggest the appropriate option. After passing certain tests, conducting an external examination and a gynecological examination, the doctor will get an idea of ​​the type of female phenotype and, based on this, will recommend the most suitable drug.

Types of female phenotypes:

• Estrogen (feminine) type
  It is characterized by a long menstrual cycle, fairly heavy menstruation, significant vaginal leucorrhoea, and the woman is very feminine in appearance: developed mammary glands, rounded shape with a tendency to be overweight, normal skin (closer to dry) and hair. For women with a predominance of estrogen, COCs are suitable, the dose of the progestogen component in which is higher than the estrogen content (Norinil, Minulet).
• Balanced type
  Characterized by a balance between estrogens and gestagens. All external and clinical signs are expressed to a moderate degree: the mammary glands are of medium size, the body structure is proportional, the skin is of normal oiliness and moisture, the hair is thick and dense, there are no problems with conceiving and carrying a pregnancy. For such women, three-phase (tri-Mercy) or single-phase COCs with a low content of hormones (Lindinet-20, Mercilon, Marvelon) are optimal.
• Progesterone phenotype
  Another name is the bone or ectomorphic phenotype. Characterized by a predominance of progesterone (released in phase 2 of the cycle). Women have the following features: uniform development of shoulders and hips, like a “sports figure”, uniform distribution of subcutaneous fat, closer to the android (male) type, underdeveloped mammary glands, tall stature, oily skin and hair, acne and seborrhea . Hypertrichosis and hirsutism are also characteristic (depending on nationality). Menstruation is scanty and short, the menstrual cycle is short. For women with a progesterone phenotype, COCs with an antiandrogenic component (Zhanine, Yarina, Diane, Jess) are suitable.

New generation hormonal COCs

The list of new generation hormonal contraceptives includes:

Jess
Ideal for young women. The dose of hormones in these tablets is very low, so they are classified as low-dose hormonal contraceptives. Due to the low hormone content, the risk of developing vascular complications (thrombophlebitis, thromboembolism) is reduced. Jess is well tolerated and does not affect the digestive tract (nausea, vomiting). Recommended to eliminate signs of premenstrual syndrome and eliminate acne. Taking Jess does not affect a woman’s weight and has a positive effect on hair and nails.

Novinet
This combined oral contraceptive contains: ethinyl estradiol in an amount of 20 mcg and desogestrel in a dose of 150 mcg.

The drug normalizes the menstrual cycle, reduces the amount of menstrual flow, does not affect a woman’s weight and has a minimum of side effects. After childbirth (in the absence of lactation), taking Novinet is allowed for 21 days.

Janine
Included in the group of monophasic low-dose COCs. Has an antiandrogenic effect: successful fight against acne, seborrhea and oily skin, hirsutism. Has an excellent contraceptive effect.

Lindinet-20
The drug contains ethinyl estradiol in an amount of 20 mcg and gestodene in a dosage of 75 mcg. Refers to COCs with low hormone content. Taking Lindinet-20 does not increase weight, the risk of side effects (nausea, vomiting) is minimal.

Yarina
Yarina belongs to the new generation of COCs and has an antiandrogenic effect. The drug contains ethinyl estradiol 30 mcg and drospirenone at a dose of 3 mg. Successfully eliminates skin problems (excessive oiliness, acne), has a beneficial effect on the condition of the hair and reduces the manifestations of premenstrual syndrome. The development of side effects is minimal.

Pros of taking COCs

The benefits of taking COCs include:

• simplicity and ease of use;
• relief of symptoms of premenstrual tension;
• reduction of menstrual blood loss;
• normalization of the menstrual cycle;
• prevention of mastopathy and the development of benign tumors of the internal genital organs;
• high contraceptive effect.

Disadvantages of taking COCs

Of the negative aspects of taking COCs, the following should be noted:

• not recommended for women 35 years of age or older;
• require discipline (daily intake at the same time);
• spotting is possible when taking hormonal contraceptives (in the middle of the cycle, especially during the first 3 months of use);
• prescribed with extreme caution to women who smoke;
• do not protect against sexually transmitted infections.

Mini-pill

These tablets (exluton, microlut) contain only progestogens, and in very small doses. The mechanism of action of this type of hormonal contraceptives consists of several points. First of all, this is a cervical factor - the volume of cervical mucus decreases, but it becomes thick and viscous, which makes it difficult for sperm to penetrate the uterus. Secondly, this is a uterine factor - progestogens cause premature secretory transformation of the uterine mucosa (normally this occurs in phase 2 of the cycle), which makes implantation impossible. Moreover, with long-term use of the mini-pill, endometrial atrophy occurs. There is also a tubal factor, caused by weakened peristalsis of the tubes, which slows down the movement of the egg through the tube and reduces its chances of fertilization. And in 25–30% of women, such pills suppress ovulation.

• breastfeeding;
• are overweight;
• cannot tolerate estrogens;
• are premenopausal.

Charosetta
The drug contains desogestrel in a dosage of 75 mcg. Excellent for use by nursing mothers and women who have contraindications to the use of estrogens. Does not affect the amount of milk, quickly restores the menstrual cycle after childbirth.

Lactinet
The drug contains 75 mcg of desogestrel. It has a good contraceptive effect, is suitable for lactating women, and does not affect weight. Side effects: spotting may appear during the first three months of use.

Exluton
The tablets contain linestrenol at a dose of 500 mcg. Does not affect weight, does not reduce libido, an excellent choice for contraception for postpartum women who are breastfeeding.

Pros of the mini-pill

The advantages of the mini-pill are:

• low risk of developing cardiovascular and cerebrovascular pathology (heart attacks, strokes) due to the small amount of progestogen and the absence of estrogens;
• do not affect blood clotting;
• do not affect lipid metabolism (do not provoke weight gain);
• relieves premenstrual syndrome well;
• indispensable for the occurrence of regular ovulatory pain and cycle disorders;
• Possibility of use by women who smoke;
• simplicity and ease of use.

Cons of the mini-pill

Among the disadvantages of these tablets, it should be noted:

• the contraceptive effect is less pronounced than that of COCs;
• require strict adherence to the pill regimen;
• the risk of functional ovarian cysts and ectopic pregnancy increases;
• frequent cycle disturbances in the form of acyclic bleeding;
• shortening of the cycle (25 days or less).

Injectable contraceptives - Depo-Provera

Injectable progestins

The mechanism of action of these contraceptives is the same as that of the mini-pill. The most common drugs are Depo-Provera (150 mg) and norethisterate. The positive aspects of such contraceptives are: long-lasting action (one injection once a quarter), easy to use, and high reliability. The disadvantages include: long restoration of fertility (about 5 - 7 months), the drug cannot be quickly removed from the body, frequent occurrence of acyclic bleeding and regular visits to the clinic for repeated injections.

Transdermal therapeutic system

This method of contraception includes the hormonal contraceptive patch Evra. Presented in the form of a square piece of plaster measuring 5 by 5 cm, flesh-colored. Contraceptive effectiveness reaches 99%. The patch contains ethinyl estradiol at a dose of 600 mcg and norelgestromin at a dosage of 6 mg, that is, it belongs to combined hormonal contraceptives. The package contains 3 patches, each of which is glued to a specific area of ​​the skin (in the area of ​​the buttocks or abdomen, on the outer surface of the shoulder or in the scapular area) once a week. The patch should be applied on the first day of menstruation, but it can also be applied on any other day of the week, but in this case additional contraception is required for 7 days. After a week, you need to peel off the patch and attach a new one, but on a different area of ​​the skin. After using 3 patches (21 days), you must take a week's break, during which menstrual-like bleeding will begin. After the break, on the 8th day, a new patch is applied.

Pros of the hormonal patch

The advantages of this hormonal method of contraception include:

• lower dose of hormones (compared to COCs);
• simplicity and ease of use;
• no need for daily monitoring, for example, as with daily hormonal pills;
• resistant to moisture and sun (will not come off in the shower or while sunbathing);
• maintaining the contraceptive effect when performing physical exercises, in a sauna or bathhouse, during tanning;
• normalization of the menstrual cycle, elimination of intermenstrual bleeding;
• no negative effect on the liver (hormonal components bypass the digestive tract);
• reduction of symptoms of premenstrual syndrome.

Cons of the hormonal patch

Among the disadvantages it should be noted:

• itching (possibly, but not necessarily) at the site of attachment of the patch;
• visible on the skin as an aesthetic defect;
• the likelihood of side effects;
• peeling of the patch upon frequent contact with water;
• There is no protection against sexually transmitted infections.

Subcutaneous implants

Subcutaneous implants are also included in long-acting progestogen contraceptives (Norplant, Implanon). The essence of their contraceptive effect, the disadvantages and advantages are the same as those of injectable progestins. The only difference is that they are injected subcutaneously (capsules with levonorgestrel) into the forearm area from the inside. The duration of the contraceptive effect of Norplant is 5 years (6 capsules are implanted at the same time with a special syringe).

Emergency contraceptive pills

Hormonal drug Escapelle for emergency contraception Hormonal contraceptives for emergency (postcoital) contraception are divided into 2 groups. The first group includes tablets with a high content of levonorgestrel - progestin (postinor or escapelle), and the second group includes drugs with mifepristone - an antiestrogen (gynepristone). Hormonal contraception is called emergency or emergency, as it is used after unprotected sexual intercourse (damage to the condom, rape).

The essence of such pills is either to block ovulation or to prevent implantation. If all conditions for taking the medicine are met, the contraceptive effect is quite high. Emergency contraception should be carried out no later than 72 hours after unprotected sex, and the earlier the pill was taken, the higher the effectiveness (you should take 2 pills in total: the first immediately after intercourse, and the second no later than 12 hours after the first).

The disadvantages of this method of contraception include: frequent occurrence of heavy discharge up to massive bleeding, severe side effects, and menstrual irregularities. But it is important to remember that you should not resort to emergency contraception more than three times a year.

Hormonal intrauterine system

This group of hormonal contraceptives includes the intrauterine device (Mirena), which contains levonorgestrel, which begins to be released immediately after installation of the device. The mechanism of action is double - pregnancy prevention, both with the spiral and with levonorgestrel.

Vaginal hormonal contraceptives

A vaginal contraceptive ring that contains hormones (estrogen - ethinyl estradiol and progestogen - etonogestrel components) - NuvaRing. The contraceptive is presented in the form of an elastic ring, which is installed in the vagina for 3 weeks; during the specified time, hormones are released from it, which have a contraceptive effect similar to COCs.

Cancellation of hormonal contraceptives

The abolition of hormonal contraceptives is carried out either at the request of the woman (she is determined to become pregnant or switch to another type of contraception), or for medical reasons. In the absence of emergency indications, you must stop taking hormonal contraceptive pills according to the following rules:

• finish the entire package (stopping taking pills at the beginning or middle of the cycle threatens the development of hormonal imbalances);
• consult a doctor (select a different method of contraception or discuss the stages of pregnancy planning);
• take a biochemical blood test and blood clotting test (hormonal contraceptives affect the metabolism of proteins, fats and carbohydrates, increase blood viscosity).

After abrupt withdrawal of hormonal contraception (suspicion of pregnancy, thrombosis, liver disease, increased blood pressure, etc.), the following side effects are possible:

• depression;
• the appearance of acne;
• increased hair growth;
• weakening of sexual desire;
• the occurrence of breakthrough bleeding;
• the appearance of headaches;
• nausea, vomiting.