Contraception during a nursing mother. Mini-pills - names of drugs, instructions, prices and reviews

Women who have previously used this method of contraception decide to take birth control pills while breastfeeding. However, not all remedies are suitable for lactation. Features of protection during breastfeeding, effective and safe contraceptives - in the recommendations of obstetrician-gynecologists.

The onset of a new pregnancy within a short time after childbirth is possible, even if the woman is breastfeeding. Lactational aminorrhea, in which menstruation does not occur, does not provide reliable protection against conception. The absence of menstruation and their irregularity do not allow a woman to assume the probable timing of the release of a mature egg. In fact, pregnancy can occur any day. Therefore, gynecologists recommend starting to protect yourself not from the period of menstruation, but from the moment you start having sex, that is, from the sixth to eighth weeks after childbirth.

Demanded means of protection

In 2011, the magazine "My Child" conducted a sociological survey on the topic of contraception after childbirth. Almost two-thirds of the women surveyed answered that they pay high attention to contraception and use special means for this. More than half of them used a condom, just under thirty percent chose the pill. About ten percent of the mothers surveyed used barrier contraceptives (cap, vaginal ring). And almost eight percent trusted the calendar and cervical methods.

This survey showed that postpartum birth control pills and other hormonal contraceptives are not often used by young mothers. The reason for this is the low level of trust due to the danger of reducing lactation, interfering with the hormonal background. In addition, to choose contraceptives, you should consult a doctor, which takes time. It is much easier to use "improvised" means that do not have a pronounced effect on the body.

But doctors warn of the risks of using them.

Condom. The most popular type of contraception, and not only during breastfeeding, but also in everyday life. For a woman during lactation, it is completely safe. Condoms are available, you can buy them at any pharmacy, they do not affect the hormonal balance. Their advantage is also protection against sexually transmitted infections, which is especially important in the postpartum period, until the natural defense mechanisms of the uterus are restored. The disadvantage of a condom is the need for strict adherence to the rules for its use. In addition, there is a psychological barrier associated with an insufficient level of sensations. Not all couples can overcome it.
barrier means. Barrier contraception during lactation is not very popular. At the same time, gynecologists note its relevance for nursing mothers. A contraceptive cap or diaphragm does not interfere with the hormonal background, does not affect lactation and the reproductive system. They are chosen by women who have already used such contraceptives before pregnancy. After giving birth, the first acquaintance with them may be unsuccessful. Only a doctor can choose the right size, insert a diaphragm or a cap, for which you need to contact a antenatal clinic.
Chemical means. These include suppositories, spermicidal ointments, vaginal tablets. These funds can be used as contraceptives during breastfeeding, as they act exclusively within the vagina, inhibiting sperm motility. Their effectiveness is up to 90%, the probability of conception increases if the requirements for use are not met.
natural contraception. It involves the use of three methods of self-control. First calendar. With him, a woman calculates the days of a possible conception by mathematical calculations. The most dangerous period is the middle of the cycle, when the likelihood of pregnancy increases. The second method is cervical, it involves controlling the volume and quality of mucous secretions from the vagina. By increasing their number, it can be assumed that ovulation has occurred. And the third method is symptothermal. A woman daily measures the temperature in the rectum and, if it rises, she can draw a conclusion about dangerous days. The disadvantage of all these methods during lactation is the lack of an established cycle. In addition, self-discipline and experience are important.
lactational aminorrhea. Natural contraception during breastfeeding, due to high levels of the hormone prolactin, which blocks ovulation. Its efficiency reaches 98%, but several conditions form it. It is necessary to feed the child only with breast milk, without supplementing with water, without the use of supplementary feeding. It is not allowed to offer the baby nipples, and breastfeeding should be as frequent as possible. Reduce the protective effect of long breaks in feeding, for example, for a night's sleep. The method stops working if the baby is six months old or the mother starts menstruating.

Natural and barrier methods of protection against pregnancy are the safest for a woman's health. They act "superficially", do not interfere with the processes occurring in the body. But in terms of effectiveness, birth control pills for nursing mothers are more preferable. They provide an increased level of protection against conception.

Hormonal drugs

Means that correct the hormonal background of a woman are represented by pills, spirals, implants. Not all of them are suitable for a young mother. Preparations containing the hormone estrogen negatively affect lactation, suppress the production of breast milk. Therefore, the use of traditional oral remedies during lactation is prohibited.

mini pili

Alternative to oral contraceptives. The composition of the preparations includes gestagens, which do not affect the production of breast milk. The principle of action of contraceptives during lactation is to disrupt the possibility of fertilization of the egg.

Gestagens cause the following body reactions.

Change the quality of mucus on the cervix. Its structure becomes denser more dense. The increased density makes it irresistible for spermatozoa.
Reduce the peristalsis of the fallopian tubes. A decrease in the productivity of the movement of the epithelium does not allow a mature, fertilized egg to reach the uterine cavity.
Exclude the fixation of the egg. In the case of fertilization of the egg, it is not fixed on the walls of the uterus, therefore it is rejected by the woman's body.

“Gestagens have a mild effect on a woman’s body,” comments obstetrician-gynecologist Olga Pankova. - They do not change the composition of breast milk, its taste, do not affect lactation. But their effectiveness depends on the woman's self-discipline. It is important to take the tablets daily, at the same time. A break of more than twelve hours reduces the protective effect.

Contraceptives for breastfeeding such as mini-pili are represented by the preparations "Charozetta", "Lactinet", "Femulen", "Exluton".

Disadvantages of drugs:

the penetration of small doses of hormones into breast milk;
change in the menstrual cycle - increased intensity, reduced cycle duration, intermenstrual bleeding;
skin deterioration, acne development;
risk of developing polycystic ovaries.

Despite the mild effect of drugs on the body, side effects of mini-pills do exist. Therefore, they should be prescribed by a doctor, taking into account the state of health of the woman. If adverse reactions occur, a doctor's consultation is required. After discontinuation of drugs within two to three months, the woman's condition usually returns to normal without additional treatment.

Hormonal coils are more convenient than pills. Their action is always kept at the same level. Efficiency reaches 98%, the result is based on the suppression of the egg maturation process.

Doctors do not exclude the use of an intrauterine device as a solution to the issue of how to protect yourself during breastfeeding. But note the following features of its application.

Childbirth without complications. The introduction of a spiral is possible only for women who have not received ruptures and significant damage to the cervix during childbirth. In this case, the use of the IUD is allowed already six or eight weeks after the birth of the baby. If the birth was traumatic, the installation of the IUD will need to be postponed, sometimes for up to six months.
Risk of inflammation. The use of a spiral increases the likelihood of inflammatory diseases of the genital organs. Therefore, a woman should be regularly observed by a gynecologist.
Side effects. Like other hormonal-type drugs, the spiral can affect the frequency and nature of menstruation, and cause ectopic pregnancy.

It is important for a woman who has installed an IUD to consider the period of its validity. It ranges from several months to five years. Even if the spiral works for a long time, regular examinations by a gynecologist are necessary to control your own health.

implant

If a woman is not sure that she will be able to take birth control pills correctly after childbirth and is afraid of inflammation that is possible after the installation of the spiral, she may choose a subcutaneous implant. It is a thin rod 4 cm long. It is implanted subcutaneously, on the inside of the shoulder. The procedure is fast, performed under local anesthesia, takes about three minutes.

The implant contains the hormone progestogen. It does not affect lactation, but blocks ovulation. Its duration is up to three years. A woman can have an implant inserted as early as six weeks after giving birth.

Subcutaneous implants do not bring harm to health. But when using them, spotting in the middle of the cycle is possible. To prevent negative reactions, regular examinations by a gynecologist are required.

emergency contraception

Emergency contraception during breastfeeding is used after unprotected intercourse, when there is a high risk of unwanted conception. Preparations of this group are hormonal, contain high doses of hormones, so they should be used carefully, only in case of urgent need.

Tablets "Exapel", "Postinor" contain the hormone levonorgestrel. It is able to affect lactation, reduces milk production. However, due to the short-term course of these drugs (2 tablets per day), they are considered conditionally compatible with lactation.

Currently, there are a large number of means of protection against unwanted pregnancy. Many of them can be used as birth control while breastfeeding. It is allowed to use effective hormonal contraceptives in the form of a mini-pill, an IUD, an implant. The doctor will help you choose the right one, taking into account the state of health and the characteristics of the recovery of the body after childbirth.

Breastfeeding protects against pregnancy if the following conditions are met:

Feedings should be frequent, during the day and at night, with intervals between them no more than 3 hours.
You need to apply the baby, do not limit the sucking time.
The baby should not consume anything other than breast milk - water, formula, complementary foods. The use of a pacifier is also not allowed.
should be absent.

A high contraceptive effect is achieved only if the entire list of conditions is met. When the baby begins to sleep more at night, or he has to give, the effectiveness of this method drops sharply. The most effective lactation method of contraception is for mothers of restless, actively sucking babies. And even in this case, you will have to think about additional contraceptives when the child is 6 months old and should normally begin.

The disadvantages of the method are:

the need to control the frequency of breastfeeding, sometimes the child will have to be woken up to give him a breast;
a strong decrease in the contraceptive effect in case of a child’s illness, when you have to give him the medicine in a diluted form or additionally supplement it with saline solutions;
lack of protection against the penetration of infection into the female genital tract, so it should be used only with full confidence in the partner.

With a decrease in the contraceptive effect, pregnancy can occur during the first ovulation, the appearance of menstruation for conception is not required. Gynecologists do not consider breastfeeding a sufficiently reliable method of protection and insist on the use of other methods, especially in cases where repeated pregnancy is contraindicated in the near future.

Ways to protect yourself while breastfeeding

Resume sexual intercourse after childbirth in most cases resolved after 2 months, with a mandatory preliminary examination by a gynecologist. From now on, it is worth thinking about contraceptives.

There are quite a few options for contraception for a nursing mother, adjusted for the preservation of lactation, all the main methods are allowed:

Interrupted intercourse in combination with the calendar method is the most risky contraceptive method. In 73% of cases, pregnancy occurs already in the first year of its use, and in case of insufficient self-control of a man, even earlier. In addition, it negatively affects the sexual function of both the woman and her partner.
Spermicides in the form of vaginal tablets, gels, creams and suppositories are not much more effective, with them the probability of pregnancy is 71%. Also, these drugs can cause allergic reactions.
Condoms as a contraceptive method are especially recommended when changing sexual partners. In addition to sexually transmitted diseases, they will protect against the introduction of new microflora, which can disrupt the balanced system of bacteria in the woman's vagina. When using high-quality products in accordance with the instructions, pregnancy will not occur in 98% of cases. With errors in application, the contraceptive effect is reduced to 85%.
Other barrier methods - uterine caps, condoms for women - are often used in Western countries, but are not widely used in Russia. These are quite effective ways that allow a woman to control the possibility of conception herself, without relying on a man.
The intrauterine device is the best contraceptive for women who do not plan to become pregnant in the next 5 years. Copper coils provide 99.2% protection. The Mirena system, which contains the hormone levonorgestrel, which is allowed for HB, is considered the most effective contraceptive and provides 99.9% protection from pregnancy. Mandatory conditions for their use are the installation only by a gynecologist and the absence of inflammatory diseases in the pelvic organs.
Oral contraceptives have a contraceptive effect in 99.7% of cases. For nursing mothers, not all pills are allowed, but only mini-drank. They contain only the hormone desogestrel, which is safe for breastfeeding. Despite this, they are no less effective than full-fledged birth control pills.

If emergency contraception is needed after intercourse, nursing mothers can use drugs based on levonorgestrel - Postinor and Escapel. The sooner they are taken after unprotected sex, the better the protection will be. Breastfeeding after their use will have to be interrupted for a day. Levonogestrel inhibits fertilization, but is safe for pregnancy that has already begun, it is not an abortifacient.

Contraceptives for breastfeeding mothers (names)

Contraceptive pills for nursing mothers are allowed to be used 2 months after the birth of a child, that is, they can be protected immediately after the onset of sexual relations. Ordinary tablets are combined, that is, they contain progestogen and estrogen. It is impossible to use them in the first six months of the child, since estrogen suppresses lactation. For nursing mothers, tablets containing only progestogen are suitable.

The characteristics of the most common oral contraceptives allowed during breastfeeding are shown in the table:

Contraceptive (name)	Compound	Description	Monthly price, rub.
Laktinet, Hungary	Desogestrel 75 mcg	Contain gestagen 3 generations, have a maximum contraceptive effect, provide protection when you skip taking a pill for up to 12 hours. They do not affect the quantity and quality of breast milk. They have fewer side effects compared to products that contain estrogen.	800
Charosetta, USA			1380
Modell mam, Hungary			560
Exluton, The Netherlands	Linestrenol 500 mcg	The contraceptive effectiveness of tablets is lower than that of previous drugs, they require strict adherence to the time of admission, the delay is allowed no more than 3 hours. It can be prescribed as a contraceptive with the likelihood of thromboembolism.	2600

The effect of birth control pills

Contraceptive pills, which contain only the gestagen in the smallest amount that provides contraception, are called minimal pills, or mini-pills. They were created for use in cases where estrogen is contraindicated - for women who smoke, with diseases of the cardiovascular system, for mothers who are breastfeeding.

When using these contraceptives there is no risk for the child on breastfeeding. To receive a dose of progestogen, which is contained in just one tablet, an infant must be fed breast milk for 3 years. Mini-pills also do not have a negative effect on the amount of milk and feeding time. Moreover, some studies have noted an increase in lactation with their use.

The action of birth control pills with progestogen is based on a change in the density of the mucus that is on the cervix. It becomes more viscous and the sperm cannot reach the egg. Also, drugs containing desogestrel suppress ovulation, in 99% of the release of the egg does not occur. For linestrenol-based mini-pills, this figure is less (about 50%), which explains their lower contraceptive effect.

With the advent of the baby into the world, the mother has a lot of trouble that can disrupt the emotional state. Keep on hand.

How to take birth control while breastfeeding

Contraceptives are started no earlier than 3 weeks after the birth of the baby. The best time to take the first pill is 6 weeks after giving birth, before resuming sexual activity. In this case, additional protection is not needed. If the reception is started later, it is necessary to make sure that there is no pregnancy and use other contraceptives in the first week.

You need to drink birth control pills during lactation 1 piece per day at the same time. At different times of admission, the contraceptive effect decreases, especially with Exluton. If you miss a dose, you need to use other methods of protection for 7 days and continue to drink mini-pill. A pass is considered to be a break of more than 36 hours (27 for Exluton).

With diarrhea and vomiting due to indigestion, the absorption of the contraceptive may not be complete. In this case, additional protection is needed, as when skipping a pill.

Some antiepileptic, sedative, antifungal agents, part of antibiotics, St. John's wort, activated charcoal reduce the effectiveness of mini-pills. When prescribing these drugs, you should check with your doctor about the possibility of taking them together.

Side effects with HB

The main side effect when taking progestogen-based tablets is a change in the nature of menstrual flow. The endometrium in 40% of women passes into an inactive phase, its thickness decreases. In this regard, the allocation becomes scarce, irregular, may disappear completely, especially after six months of admission. These phenomena are considered the norm and disappear in the first cycle after the abolition of contraceptives.

When taking pills, the follicles in the egg continue to mature, they can be larger than usual in size, in the future they resolve on their own. When conducting an ultrasound, it is necessary to warn the specialist about taking contraceptives in order to exclude incorrect diagnosis.

In the first months of taking mini-pills, they can cause headaches, mood changes, and nausea. With further use of drugs, they disappear or significantly decrease.

Many women who are breastfeeding their baby are interested in - how to protect yourself while breastfeeding. After all, the onset of another pregnancy is not always desirable at a time when a recently born child is very small.

The peculiarity of contraception during lactation is that properly carried out breastfeeding is already a method that helps protect against unwanted pregnancy and is called the “method of lactational amenorrhea”. The remaining contraceptive methods (barrier, intrauterine, progestin, etc.) are used to enhance the contraceptive effect even when the lactational amenorrhea method is no longer effective enough. This article will help you understand what is possible contraception while breastfeeding However, only the attending physician can choose the most appropriate method.

Lactational amenorrhea method (LAM)

Amenorrhea is the absence of menstruation, so the method of lactational amenorrhea is based on the fact that a nursing mother has no periods for some time after the birth of a child. This happens because the hormone prolactin, which is synthesized in the body of a nursing woman, suppresses ovulation. In order for the LAM to work properly, all of the following factors must be met:

The child who is on breastfeeding is not yet 6 months old.
The woman has not yet resumed menstruation after giving birth.
The baby is exclusively on breastfeeding without taking any other food or liquid, and:

The first time the baby took the breast for an hour after birth.
There is frequent attachment to the baby's breast during the day (about 10 times).
Night feedings are a must.

The benefits of LAM are clear: it is free, does not require medical attention, and has no side effects. The disadvantages include a short time of use (only the first six months after childbirth) and the lack of protection against STDs.

With properly established breastfeeding, without the use of nipples and bottles, such contraception during lactation 98% effective.

natural methods

The effectiveness of using natural methods of contraception (such as: the calendar method, the method of monitoring cervical mucus, the method of determining, the symptomatic method) during lactation is very small - only 50%. This is due to the changes taking place in the body of a woman who has recently given birth.

Barrier Methods

The use of barrier methods (condoms, caps, diaphragms) during lactation is acceptable, since this method of protection does not affect breast milk and is safe for the baby.

Depending on the quality of the condom and the presence or absence of spermicidal preparations in it, the effectiveness of its use is 85-98%.

You can use a cervical cap or diaphragm after 6 weeks from the date of birth. The size of the cap or diaphragm should be selected with your doctor, as the size used before delivery may not be appropriate. Their first introduction should also be made by a doctor.

The efficiency of using the cap is 73-92%, and the diaphragm is 82-86%.

Intrauterine device (IUD)

Intrauterine devices (ring, coil, or T-shaped) do not interfere with lactation and can be used during breastfeeding. However, if the coil was inserted immediately after the birth of the child, then there is a high risk of its loss, so it is recommended to use the IUD 1.5 months after birth.

Modern intrauterine hormonal systems (for example, the Mirena coil) contain a container with a synthetic hormone levonorgestrel, which is released in small doses and is an additional contraceptive protection.

The use of intrauterine devices is quite reliable breastfeeding protection, since the effectiveness of this method reaches 99% when using a hormonal spiral and 97-98% when using a conventional spiral.

Chemicals (spermicides)

During lactation, it is permissible to use various spermicides in the form of suppositories (candles), foam, jelly, creams, etc. The spermicide coats the cervix and vagina, and the chemicals in the drug destroy the sperm. Moreover, such contraception while breastfeeding solves the problem of vaginal dryness, which often occurs in women after childbirth. Depending on the correct use of the method, the effectiveness of the method varies from 64 to 98%.

Hormonal contraceptives

Combined hormonal birth control pills for lactation cannot be used (regardless of whether they are monophasic, biphasic or triphasic), since they affect not only the amount of breast milk, but also its quality, which can unpredictably affect the health of the child.

During breastfeeding, you can use purely progestin tablets, the so-called "mini-pill", since they contain only microdoses of progestin. According to experts, these birth control pills while breastfeeding are quite safe and do not affect the milk and the baby. The efficiency of use is quite high - up to 99%, but only if the exact schedule for taking the pills is observed.

Postcoital (emergency) contraception. Postinor while breastfeeding

Emergency contraception is used in very rare cases after sexual intercourse, when conventional contraceptive methods did not work (for example, a condom broke). In the question is it possible to use such hormonal pills as Postinor while breastfeeding expert opinions differ. Some believe that it is definitely impossible, some that it is possible, but with caution. This is explained by the fact that the effect of the drug on lactation and the child is not well understood. If a woman nevertheless took an “emergency” pill, then you can feed the baby only after 36 hours. The effectiveness of postcoital contraception is about 97%.

Sterilization

Female (tubal occlusion) or male (vasectomy) sterilization are very radical methods of contraception. This method, of course, is almost 100% effective, but it is absolutely irreversible, so its application is possible after long and careful consideration: the decision not to have more children should not be made under the influence of stress or any circumstances.

The list of contraceptives that can be used during lactation is quite large, so each couple can choose the best option for themselves. However, one should once again pay attention to the fact that combined hormonal contraceptives while breastfeeding cannot be used. When using combined oral contraceptives, there is a risk of various types of unplanned bleeding: from spotting to profuse breakthrough bleeding, when contacting a doctor cannot be delayed. The hormones contained in contraceptives, of course, pass into breast milk, and, accordingly, into the body of the child. This can lead to a violation of the hormonal background of the baby and adversely affect his health: for example, there are cases when girls reached precocious puberty at the age of 5-7 years, instead of the usual 12-13 years.

Preparations that contain the minimum dose of the hormone progestin are called mini pili. This is one of the varieties of contraceptives, which is a good substitute for combined oral contraceptives (or COC). "Minimum pills", as mini-pills are also called, differ from combined oral contraceptives in their composition: they contain progestin, which was created as a synthetic substitute for progesterone ( a hormone produced in the ovaries).

The content of progestin in the "minimal pills" - from 300 to 500 micrograms. Combined products contain synthetic substitutes for progesterone and estrogen, the dosages of which are higher. Progestin preparations are inferior in their effectiveness to combined ones, however, they also act on the woman's body much softer, which makes it possible to use them for those women who have contraindications to COCs.

When are progestin contraceptives the drug of choice?

during lactation ( do not affect the quality and taste of milk).
When smoking in older women ( nicotine in combination with COCs contributes to thrombosis due to a violation of blood clotting).
With cardiac pathologies.

Names of drugs included in the group

Mini-pill preparations constituting a separate group contraceptives:

Charosetta,
Ovret,
Exluton,
Primoliut-Nor,
Micronor,
Continuin.

Mechanism of action

Progestin drugs do not suppress ovulation like combined oral contraceptives. The contraceptive effect of this group of contraceptives is based on the process of changing the quality of the mucus that covers the cervix. The mucus becomes thicker and this is an obstacle to the passage of sperm to the egg. If the sperm nevertheless reaches the egg, then the second contraceptive factor mini-pili comes into force: if the uterine mucosa changes, it is impossible to attach the embryo to it.

In addition, the peristalsis of the fallopian tubes slows down ( The ovum travels through the tubes into the uterine cavity).

The effectiveness of progestin drugs - 95%; combined oral contraceptives - 99%.

Instructions for use

The effectiveness of progestin agents largely depends on the accuracy of their application. They need to be taken every day without skipping!), and preferably at the same time. Regardless of whether there was bleeding ( menstrual, spotting postmenstrual) or did not appear, the tablets should be taken 365 times a year. The optimal time of reception is 18 - 20 hours. 4 hours after application, the tablets produce the maximum contraceptive effect, so it is better to take them in the evening, not in the afternoon. Although, of course, this does not mean that during the day during sexual intercourse this type of contraception will already be ineffective. But the optimal effect is preserved precisely when the above recommendations are observed.

When breastfeeding in lactating women, ovulation is suppressed and physiological infertility develops - the so-called lactational amenorrhea. This is because when ovulation is suppressed, the egg does not mature and does not come out of the ovary. But even in this period, before the onset of menstruation, the follicle can mature and then ovulation will occur. In this case, pregnancy occurs without the start of the menstrual cycle after childbirth. That is why it is very important to use contraceptives during lactation.

Mini-drinks are allowed to be taken by lactating women. However, after the cessation of feeding and the appearance of menstruation, it is better to switch to combined oral contraceptives. However, if desired, a woman can continue to use progestin drugs if she is satisfied with the schedule for taking the pills.

For the best choice of contraceptives, you need a consultation with a gynecologist, who will prescribe a diagnosis and, in accordance with its results, recommend the most suitable drug for a woman. Before prescribing progestin drugs, a gynecological examination is performed, swabs are taken from the cervix and vagina ( to exclude oncology and determine the microflora); ultrasound of the pelvic organs ( to absolutely exclude pregnancy and confirm the fact of lactational amenorrhea).

When should you start taking?

Mini-pills need to start taking:

On the first day of menstruation.
Right after the abortion.
Six weeks after giving birth.

Advantages

Soft effect on the female body.
Unlike the estrogen found in combination oral products, minipills do not reduce lactation or impair the taste of breast milk.
They have a quick effect - in 4 hours the contraceptive effect reaches a maximum.
Do not cause headache or nausea even at the beginning of application.
Reception is not directly related to sexual intercourse.
No risk of thrombosis.
Does not increase the pressure in those who suffer from hypertension.
They do not affect emotionality, unlike COCs.
Do not affect libido.
Approved for use during preparation for surgical procedures ( COCs, on the contrary, are not recommended for use in such situations.).
Reduce pain during menstruation.
The ability to conceive is restored quickly - within a month after the abolition of the mini-pill.

Flaws

The regularity of the use of tablets - this requires a high organization from a woman.
Lower efficiency than COC.
Small changes in a woman's weight ( plus or minus a few kilos).
Lack of protection against genital infections.
The contraceptive effect is reduced when phenytoin and phenobarbital are taken simultaneously ( anticonvulsants), Rifampicin ( anti-tuberculosis agent).

Side effects

Short-term changes in the menstrual cycle: the appearance of unplanned bleeding, increased duration of bleeding or their absence. Cancellation of the drug is not required.
Development of ovarian cysts after the abolition of the mini-pill, the cysts resolve spontaneously after 1-2 months).
Exacerbation of thrush in the chronic course of the disease.
Nausea and weakness in diabetes mellitus are short-term effects that do not require discontinuation of the drug.
Change in oily skin temporarily).
Increased sensitivity of the mammary glands ( no cancellation required).
Sensitivity to ultraviolet rays ( it is undesirable to sunbathe).
Increased body hair growth rarely).
Swelling of the legs.

Contraindications

Bleeding from the genitals of unknown etiology.
Severe lesions of the vessels of the heart and brain.
Malignant tumor of the breast.
Tumor-like diseases of the liver, cirrhosis.
Serious pathologies of the kidneys.
Hepatitis in the active phase.
Simultaneous use of anticonvulsants.

Who can use?

Women of any age: in the reproductive period and in postmenopause.
Lactating women.
Parents but not breastfeeding.
Smokers.
Women after an abortion.
Women who have contraindications to taking combined oral contraceptives.

If a woman wants to switch from mini-pill to combination oral medications, she should start using COCs on the first or second day of her period ( if possible, before the end of the last package of the progestin drug). If menstruation does not occur, then immediately after taking the last progestin pill, you can take a combined oral contraceptive.

If a woman wants to switch from COCs to progestin drugs, then the mini-pill tablet can be taken immediately after taking the last COC tablet. Two weeks later, a full contraceptive effect occurs.

If a woman wants to switch to barrier methods of contraception, it is advisable to take another additional package of progestin preparation in combination with the barrier method to be sure.

What to do if you forget to take a pill?

It is highly undesirable to skip taking the pills, moreover, they must be taken strictly at the same time. If no more than three hours have passed after the time of admission, then you need to urgently take a pill and use barrier methods of protection for another week. If vomiting begins within 2 hours after the appointed time, which makes it impossible to take a new pill, then the next two to three days should be additionally protected. The same applies to a case of diarrhea occurring within 12 hours of taking the tablet.

When do you need an urgent consultation with a gynecologist?

You should immediately consult a gynecologist if you observe one of the following symptoms:

Profuse and prolonged bleeding.
Delayed menstruation in the absence of pregnancy.
Pain in the pelvic region it could be a sign of an ectopic pregnancy).

If you have broken the continuity of taking the pills, and pregnancy has occurred, you need to stop taking the mini-pill. At the same time, it is not worth terminating a pregnancy due to hormonal influence - there is no negative effect on the fetus, and the pregnancy will proceed normally.

drug interaction

The effectiveness of progestin drugs is affected by the same drugs as COCs. However, when taking antibiotics such as Doxycycline, Amoxicillin, Tetracycline, Ampicillin, Phenoxymethylpenicillin, the effectiveness of the mini-pill does not decrease.

Storage method

Do not store in damp rooms or in rooms with high air temperature. Tablets should be out of the reach of children.

Where to buy and what is the price?

You can buy drugs from the mini-pill group at ordinary pharmacies, pharmacies at antenatal clinics and family planning centers, at social pharmacies. The cost of drugs varies and can be, for example: Charozetta - from $ 25 for a pack of 28 tablets; Exluton - $100 for a pack of 84 tablets and $40 for a pack of 28 tablets.

The question of choosing a method of protection in the postpartum period is relevant, since the newborn is still too small, and the woman's body did not have time to recover. When choosing suitable contraceptives, consider their effect on lactation and all sorts of side effects. Otherwise, there is a risk of disruption of milk production, an allergic reaction is possible, an improperly selected product can harm the baby.

There are many methods of protection, the most natural of them is lactational amenorrhea. In addition, lactating women use barrier, intrauterine, hormonal and other methods of contraception. The gynecologist will select the appropriate method of preventing unwanted pregnancy for a woman who is breastfeeding.

Woman in the postpartum period

The body of a lactating woman requires restoration: weakened immunity, hormonal changes, energy consumption for lactation. Not all mothers are in perfect health and can become pregnant 3-5 months after giving birth. It is possible, but dangerous to health. For a woman to fully recover during lactation, she needs at least 2 years.

The balance of hormones during fetal development was adjusted for 9 months. After the birth of a child, the woman's body is rebuilt again, the hormonal background changes. As a result, a woman becomes impressionable, distracted, quick-tempered. Approximately 3 months the body needs to regulate the production of the necessary hormones. A new pregnancy will only aggravate the already unstable condition of the woman.

After unprotected intimacy, an emergency contraceptive drug is used, for example, Postinor. This hormonal remedy should be taken with caution if a woman is breastfeeding. The drug has not undergone medical research, and therefore its effect on lactation and the newborn is not fully known. Breastfeeding is allowed only 36 hours after taking Postinor. The degree of protection of the drug is not higher than 98%.

Spermicidal contraception

Spermicidal preparations (Patentex Oval, Pharmatex, etc.) have a low level of reliability. Spermicides are available in the form of suppositories (vaginal suppositories), foams, jelly, creams, etc. The drug envelops the vagina and uterine cavity, and the chemical components that make up its composition destroy spermatozoa.

Spermicidal drugs help fight atrophic vaginitis (drying of the vaginal mucosa), this problem is typical for women in the postpartum period. Gynecologists recommend using them in combination with barrier agents. The effectiveness of spermicidal contraception is from 59% to 96%.

Sterilization

Voluntary surgical sterilization is a cardinal method of protection against unwanted pregnancy. This is an operation, as a result of which an artificial obstruction of the fallopian tubes is created, and the woman loses her reproductive function. The effectiveness of this method is 99%, but the consequences of surgical intervention are irreversible, and therefore, before making a decision, weigh the pros and cons. Entrust the operation to a professional, otherwise pregnancy is possible.

There are many more methods of contraception, among which you can choose the most suitable option. However, it should be remembered that hormonal drugs during breastfeeding are not recommended. Otherwise, there are side effects in the form of bleeding of varying intensity. In addition, hormonal agents adversely affect lactation and the body of the newborn. The gynecologist is engaged in the choice and appointment of a contraceptive.