The safest contraceptive pills. How to choose the right hormonal birth control pills

After 35 years of age, birth control pills will become an excellent contraceptive option that can be controlled by the woman herself. If you choose the right pills and follow the rules, you can even improve women's health and overall well-being.

But only the attending physician can prescribe pills. By choosing on your own or on the recommendations of a pharmacist, you risk becoming a victim of side effects. It is always worth remembering that birth control pills are based on hormones, and such therapy has a complex effect on the body.

By the age of thirty-five, most women have already given birth. In modern conditions, it is at this age that women have recently acquired offspring. And here the problem of contraception is acute - after all, now they rarely give birth to a second child until the first one goes to school.

After 35, many women still plan to become a mother, or want to give birth to a second child. Therefore, they treat their own reproduction very carefully. I don’t want to put my women’s health at risk.

Another point is the importance of a healthy sex life at this age. According to modern research, it is at 30-35, and especially after childbirth, that a woman’s sexual desire blossoms. And you don’t want to disrupt sexual intercourse either by preparation or by barriers between the partners’ bodies.

Due to the increasing incidence of cancer, it is worth thinking about their prevention. Some birth control pills, which we will talk about today, help strengthen the female body in the face of such diseases.

The main rule when choosing female contraceptive pills is to listen to the recommendations of the treating gynecologist. He knows your condition and will be able to determine what dangers there are in the case of certain contraceptives. With the help of his advice and knowledge, you can not only competently approach the issue of contraception after 35 years, but also strengthen your women's health.

The most important indicator when choosing contraceptives is hormonal levels.

So, if the body produces enough of its own estrogen, combined oral contraceptives (COCs) will be harmful. In such cases, mini-pills are recommended - tablets with a reduced content of hormones, devoid of estrogen. And vice versa, if there are not enough female sex hormones, male sex hormones are produced - COCs will be an ideal option. By choosing birth control pills according to this scheme, you can even bring tangible benefits to your health.

It is worth considering the general condition of the body. Thus, problems with the digestive system or a tendency to increased blood clotting will be a clear contraindication to taking birth control pills.

Benefits of tablets

Birth control pills are more than just a form of contraception. This is a complex effect on the body, which can result in both good and bad. Only a doctor can choose the right drug and generally determine the possibility of such contraception. To do this, he must familiarize himself with the results of studies - blood tests, gynecological examination.

In this case, the tablets will be chosen correctly, and with their help:

Monthly cycles will return to normal;
The risk of malignant diseases will decrease;
Your daily mood will improve;
Increased desire in the sexual sphere;
Female organs will receive protection from inflammation;
They will serve as good prevention and treatment for fibroids.

In addition, birth control after 35 years will also become a good cosmetic product. If the type of hormones and their dosage are selected correctly, testosterone production will be reduced. This means that the skin on your face and scalp will become less oily. The hair will be less greasy, and the skin will get rid of unpleasant acne rashes.

Combined oral contraceptives

Most often, when talking about birth control pills, doctors and women who use them mean COCs. These drugs are based on two substances - estrogen and artificial gestagens. Together they provide a comprehensive effect that provides maximum reliability. COCs are divided into several subtypes depending on the order in which the hormones act:

Single-phase (Yarina, Logest) - substances are mixed in all tablets of the cycle;
Biphasic (Anteovin) - throughout the entire course, the estrogen content does not change, unlike gestagenic substances;
Three-phase (Triquilaz, Tri-Mercy) - the ratio of estrogen and gestagen in tablets changes three times per month course.

Operating principle

Combined contraceptive pills act according to the following scheme:

They do not allow ovulation to occur normally. The body mistakenly reads hormonal indicators, and the female cell does not leave the ovarian follicle;
There is too much mucus inside the uterus and its cervix. Sperm cannot break through this barrier, and their journey to the egg ends in the vaginal environment;
The level of endometrial density increases. The chance of fertilization of the egg is already minimal, but if this happens, the zygote will not be able to gain a foothold in the uterus and will die.

Each of these factors is already a powerful barrier to pregnancy. Together, these three points reduce the possibility of pregnancy to almost zero.

Contraindications

Combined contraceptive pills should not be used if a woman is over 35 years of age:

Already bearing fruit;
Experiencing cardiac pathologies;
Has a platelet count in the blood that is higher than normal;
Is a smoker;
Has kidney failure;
Prone to cancer;
Has malignant neoplasms;
Is in the period of lactation and feeding.

If, despite such contraindications, a woman still decides to take COCs, there is a high probability that as a result:

Your head will hurt;
Excretion of blood outside of menstruation;
Appetite will disappear;
Menstruation will disappear;
You will feel dizzy;
Unwanted hairiness will increase;
Sexual desire will decrease;
Intestinal bloating will begin.

But these are just minor side effects. More serious negative consequences may include:

Thrombosis and bleeding disorders;
Diseases of the liver and digestive system;
The appearance of excess kilograms;
Skin rashes and acne;
Difficulty speaking;
Unexpected hypertensive attacks;
Phlegm in the throat;
Chest pain;
Severe persistent migraines;
Swelling of the lower extremities.

Mini-pill

These birth control pills contain only artificial progestogen and no estrogen. They are also called single-component birth control pills. Here we can mention Microlute, Charozetta.

Most often, mini-pills are prescribed after the age of 35, especially if a woman has already given birth. In such cases, the woman’s own estrogen is usually sufficient. Excess estrogen can cause harm in two ways.

Firstly, by increasing the risk of cancer and inflammation - because the uterine tissue will become denser. Secondly, and these effects are very common - in response to excess estrogen, the body will start producing testosterone. And then the negative consequences will be excess hair, oily skin and hair, and a purulent rash. That is why the effect of gestagen is sufficient. It operates in generally the same way as in COCs. Ovulation does not occur, and the passage of sperm through the genital tract is extremely difficult. A fertilized egg (which is extremely unlikely) will not be able to implant in the uterus.

Menstruation does not occur when taking mini-pill birth control pills. Instead, bloody discharge occurs, which can be attributed to false menstruation. Contraindications and side effects are the same as for combined contraceptives.

Microdosed and low dosed

Microdosed birth control pills contain the least amount of hormones. Suitable if a woman’s hormonal levels at 35 years old are completely normal and have not changed compared to her younger age. This includes Zoely, Jess, Lindinet.

Low-dose birth control pills, like mini-pills, are suitable if you have enough estrogen. The advantage over the mini-pill is that it has a weaker effect on the menstrual cycle. After taking microdose tablets and mini-pills, if severe discomfort is caused by “false menstruation”, low-dose ones are prescribed. These include Silest, Microgynon, Demoulin.

How are contraceptives selected?

The question of which pills to take as a contraceptive cannot be figured out on the Internet or from the advice of girlfriends. You should always remember that any hormonal therapy has a powerful and complex effect on the body. Changes in the functioning of the endocrine system will affect the functioning of all organs and structures of the female body.

Therefore, only a gynecologist can specifically resolve the issue. To do this, he will need to collect data through the following studies:

Dermatological tests;
Checks for bacteria and infections;
Body weight surveys;
Blood pressure measurements;
Palpation of the chest;
Tests for liver function;
Gynecological examination and smears.

Before using birth control pills, it is wise to visit an eye doctor. After all, long-term use of such drugs often leads to dysfunction of the eyeballs, especially glaucoma.

Another necessary examination to avoid the development of side effects is a blood test for coagulation and ultrasound examination of the veins. Thrombosis is one of the very common and most dangerous side effects.

More than 55 years have passed since the appearance of the first hormonal contraceptive - Enovida. Today, drugs have become lower-dose, safer and more varied in form.

Combined oral contraceptives (COCs)

Most drugs use the estrogen ethinyl estradiol at a dosage of 20 mcg. The following is used as a gestagen:

norethindrone;
levonorgestrel;
norgestrel;
norethindrone acetate;
norgestimate;
desogestrel;
Drospirenone is the most modern progestin.

A new trend in the production of COCs is the release of drugs that increase the level of folate in the blood. These COCs contain drospirenone, ethinyl estradiol and calcium levomefolate (a metabolite of folic acid) and are indicated for women planning a pregnancy in the near future.

Monophasic COC contraceptives have a constant dose of estrogen and progestin. Biphasic COCs contain two, three-phase - three, and four-phase - four combinations of estrogen and gestagen. Multiphasic drugs have no advantages over monophasic combined oral contraceptives in terms of effectiveness and side effects.

About three dozen COCs are available on the pharmaceutical market, the vast majority of which are monophasic. They are available in the form of 21+7:21 hormonally active tablets and 7 placebo tablets. This facilitates consistent daily monitoring of regular COC use.

Combined oral contraceptives (COCs) list: types and names

Mechanism of action

The main principle of operation of COCs is to inhibit ovulation. The drugs reduce the synthesis of FSH and LH. The combination of estrogen and progestin gives a synergistic effect and increases their antigonadotropic and antiovulatory properties. In addition, COC contraceptives change the consistency of cervical mucus, cause endometrial hypoplasia and reduce contractility of the fallopian tubes.

Efficiency largely depends on compliance. The pregnancy rate during the year ranges from 0.1% with correct use to 5% with violations of the dosage regimen.

Advantages

Combined hormonal contraceptives are widely used to treat menstrual irregularities and reduce or eliminate ovulatory syndrome. Taking COCs reduces blood loss, so it is advisable to prescribe them for menorrhagia. COCs can be used to adjust the menstrual cycle — if necessary, delay the onset of the next menstruation.

COCs reduce the risk of developing benign breast formations, inflammatory diseases of the pelvic organs, and functional cysts. Taking COCs for existing functional cysts helps to significantly reduce them or completely resolve them. The use of COCs helps reduce the risk of malignant ovarian diseases by 40 %, endometrial adenocarcinoma by 50 %. The protective effect lasts up to 15 years after discontinuation of the drug.

Flaws

Side effects: nausea, breast tenderness, breakthrough bleeding, amenorrhea, headache.

Estrogen, which is part of COCs, can activate the blood clotting mechanism, which can lead to the development of thromboembolism. The risk group for developing such complications while taking COCs includes women with high levels of LDL and low levels of HDL in the blood, severe diabetes accompanied by arterial damage, uncontrolled arterial hypertension, and obesity. In addition, the likelihood of developing blood clotting disorders increases in women who smoke.

Contraindications for the use of combined oral contraceptives

thrombosis, thromboembolism;
angina pectoris, transient ischemic attacks;
migraine;
diabetes mellitus with vascular complications;
pancreatitis with severe triglyceridemia;
liver diseases;
hormone-dependent malignant diseases;
bleeding from the vagina of unknown etiology;
lactation.

COCs and breast cancer

The most comprehensive analysis of cases of breast cancer development while taking COCs was presented in 1996 by the Collaborative Group on Hormonal Factors in Breast Cancer. The study assessed epidemiological data from more than 20 countries. The study results showed that women who are currently taking COCs, as well as those who have taken them in the past 1–4 years, have a slightly increased risk of developing breast cancer. The study highlighted that women participating in the experiment were much more likely to undergo breast examinations than women not taking COCs.

Today it is assumed that the use of COCs may act as a cofactor that only interacts with the underlying cause of breast cancer and possibly potentiates it.

Transdermal Therapeutic System (TTS)

The transdermal therapeutic system patch is applied for 7 days. The used patch is removed and immediately replaced with a new one on the same day of the week, on the 8th and 15th days of the menstrual cycle.

TTS appeared on the market in 2001 (“Evra”). Each patch contains a week's supply of norelgestromin and ethinyl estradiol. TTC is applied to dry, clean skin of the buttocks, abdomen, outer surface of the upper arm or torso with minimal hair growth. It is important to monitor the density of TTC attachment every day and not apply cosmetics nearby. Daily release of sex steroids (203 mcg norelgestromin + 33.9 mcg ethinyl estradiol) is comparable to that of low-dose COCs. On the 22nd day of the menstrual cycle, the TTS is removed and a new patch is applied 7 days later (on the 29th day).

The mechanism of action, effectiveness, disadvantages and advantages are the same as those of COCs.

Vaginal ring

The hormonal vaginal ring (NovaRing) contains etonogestrel and ethinyl estradiol (daily release 15 mcg + 120 mcg, respectively). The ring is installed for three weeks, after which it is removed and a week-long break is maintained. On day 29 of the cycle, a new ring is inserted.

The dosage of ethinyl estradiol in the vaginal ring is lower than that of COCs, due to the fact that absorption occurs directly through the vaginal mucosa, bypassing the gastrointestinal tract. Due to complete suppression of ovulation and regular release independent of the patient, the effectiveness is higher than that of COCs (0.3–6 %). Another advantage of the ring is the low likelihood of dyspeptic side effects. Some patients experience vaginal irritation and discharge. In addition, the ring may accidentally slip out.

The effect of hormonal contraceptives on libido has not been sufficiently studied; research data are contradictory and depend on the average age in the sample and gynecological diseases, the drugs used, and methods for assessing the quality of sexual life. In general, 10-20 percent of women may experience a decrease in libido while taking medications. In most patients, the use of GC does not affect libido.

Acne and hirsutism usually have low levels of sex hormone binding globulin (SHBG). COCs increase the concentration of this globulin, having a beneficial effect on the condition of the skin.

Subtleties of application

Estrogen in COCs helps eliminate LDL and increase HDL and triglyceride levels. Progestins counteract estrogen-induced changes in lipid levels in the body.

For acne, medications containing cyproterone acetate, drospirenone or desogestrel are prescribed as a progestin. COCs containing cyproterone acetate and ethinyl estradiol are more effective for acne than the combination of ethinyl estradiol and levonorgestrel.
For hirsutism, medications containing progestogens with antiadrogenic properties are recommended: cyproterone acetate or drospirenone.
Combinations of estradiol valerate and dienogest are more effective in reducing menstrual blood loss than ethinyl estradiol and levonorgestrel. In addition, the intrauterine system is indicated for the treatment of menorrhagia.
Preparations containing drospirenone 3 mg and ethinyl estradiol 20 mcg are recognized as the most effective combination for correcting PMS symptoms, including those of a psychogenic nature.
Taking oral contraceptives increases systolic blood pressure (BP) by 8 mmHg. Art., and diastolic by 6 mm Hg. Art. . There is evidence of an increased risk of cardiovascular events in women taking COCs. Due to the increased likelihood of developing myocardial infarction and stroke in patients with arterial hypertension, when prescribing COCs, the benefit/risk ratio must be carefully weighed.
In non-smoking women under 35 years of age with compensated hypertension, COCs can be prescribed with careful monitoring of blood pressure during the first months of use.
In case of increased blood pressure while taking COCs or in women with severe hypertension, an intrauterine system or DMPA is indicated.
The selection of a contraceptive for patients with dyslipidemia must be carried out taking into account the effect of the drugs on lipid levels (see Table 5).
Because the absolute risk of cardiovascular events in women with controlled dyslipidemia is low, COCs containing 35 mcg or less of estrogen can be used in most cases. For patients with LDL levels above 4.14 mmol/L, alternative means of contraception are indicated.
The use of COCs in women with diabetes mellitus accompanied by vascular complications is not recommended. A suitable option for hormonal contraception for diabetes mellitus is the intrauterine levonorgestrel-releasing system, and, as a rule, no dose adjustment of hypoglycemic drugs is required.
The results of epidemiological studies examining the risk of myocardial infarction when oral contraceptives are prescribed to women who smoke are contradictory. Due to limited convincing data, COCs are recommended to be prescribed with caution to all women over 35 years of age who smoke.
Obesity with a body mass index of 30 kg/m2 or higher reduces the effectiveness of COCs and transdermal GCs. In addition, the use of COCs in obesity is a risk factor for venous thromboembolism. Therefore, the method of choice for such patients is mini-pills (gestagen-containing tablet contraceptives) and intrauterine contraceptives (levonorgesterel-releasing system).
Use of COCs containing less than 50 mcg estrogen in nonsmoking, healthy women over 35 years of age may have beneficial effects on bone density and vasomotor symptoms during perimenopause. This benefit must be considered in light of the risk of venous thromboembolism and cardiovascular factors. Therefore, women of the late reproductive period are prescribed COCs individually.

List of sources

Van Vliet H. A. A. M. et al. Biphasic versus triphasic oral contraceptives for contraception //The Cochrane Library. - 2006.
Omnia M Samra-Latif. Contraception. Available from http://emedicine.medscape.com
Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies. Lancet 1996; 347(9017):1713–1727.
Carlborg L. Cyproterone acetate versus levonorgestrel combined with ethinyl estradiol in the treatment of acne. Results of a multicenter study. Acta Obstetricia et Gynecologica Scandinavica 1986;65:29–32.
Batukan C et al. Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism. Gynecol Endocrinol 2007;23:38–44.
Fruzzetti F, Tremollieres F, Bitzer J. An overview of the development of combined oral contraceptives containing estradiol: focus on estradiol valerate/dienogest. Gynecol Endocrinol 2012;28:400–8.
Lopez LM, Kaptein AA, Helmerhorst FM. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev 2012.
Armstrong C, Coughlin L. ACOG releases guidelines on hormonal contraceptives in women with coexisting medical conditions. - 2007.
Carr BR, Ory H. Estrogen and progestin components of oral contraceptives: relationship to vascular disease. Contraception 1997; 55:267–272.
Burrows LJ, Basha M, Goldstein AT. The effects of hormonal contraceptives on female sexuality: a review. The journal of sexual medicine 2012; 9:2213–23.

Today, every couple can plan to have children and control their sex life thanks to the pharmaceutical industry. A huge selection of contraceptives allows you to choose the appropriate method of protection against pregnancy and/or sexually transmitted infections.

Review of some contraceptives

The list of means and methods of protection includes a dozen items or more. This includes the calendar method, the use of spermicides (the so-called non-hormonal tablets and suppositories), and common condoms, and hormonal patches, rings, and the intrauterine device, and injections, and patches, and oral contraceptives. Read more about each method, especially birth control pills, below.

Coitus interruptus

The most unreliable options for preventing pregnancy are interrupted sexual intercourse and the calendar method. In general, PPA can hardly be called a method of contraception. The essence of the method is to remove the penis before ejaculation begins.

In 60% of couples who use PPA protection, pregnancy occurs in the first year of using the method. And according to statistics, 80% of women who became pregnant “accidentally” were protected by interrupted sexual intercourse. The problem is that not all men feel the onset of ejaculation. One “wrong” move, and the likelihood of getting pregnant increases significantly.

Calendar method

The method is slightly more effective than the previous one - 65%. For every hundred women who take the risk of using this method, there are 10-15 pregnancies per year. This method becomes more relevant after 30 than for young girls. Only girls and women with a regular menstrual cycle can afford to protect themselves in this way.

The essence of the method is to calculate the so-called dangerous days on the calendar and not have sex during this period. In general, from the 16th day until the expected start of the next period, the probability of conception is greatest. The most dangerous days fall in the middle of the cycle - from the 12th to the 18th day of the cycle (with a 28-day cycle).

Cons: errors, irregular cycle, in which it is almost impossible to accurately calculate the day of ovulation, hormonal imbalances. There are other nuances - if sexual intercourse occurred several days before the expected ovulation, sperm can live in the genital tract for several days and fertilize the egg even after such a seemingly long time. To increase the reliability of this method of contraception, you need to learn how to correctly calculate dangerous days. In addition to the calendar method, you can use ovulation test strips or monitor basal temperature charts.

Spermicides and non-hormonal tablets

Another not very effective method (70% reliability) is spermicides. These are special substances that are introduced into the vagina and negatively affect sperm, after which they can no longer fertilize a woman’s egg. Products with a similar mechanism of action are sold in pharmacies in the form of suppositories, creams, capsules or tablets, which are administered directly orally before sex.

Such non-hormonal ones (which ones are better to choose, reviews of different types - below) are used by many women who, for one reason or another, are afraid to take conventional OCs (oral contraceptives). Such non-hormonal tablets are recommended for use in premenopausal women, patients with impaired functioning of the endocrine system, individual sensitivity and adverse reactions to conventional OCs. What is important, these can be used during breastfeeding (breastfeeding).

How to choose non-hormonal contraceptives? The ranking of the best is presented by the following tablets:

"Pharmatex". Available in the form of tablets, cream and suppositories. The average price of a package of 12 tablets is 250 rubles.
"Gynekotex". The same release form, price - 100 rubles for the same 12 tablets.
"Benatex". The cost of 10 tablets is 250-300 rubles.
"Erotex". Price 5 pcs. - 110 rubles.
"Contratex".

How to choose tablets? It is advisable to consult a doctor; otherwise, you should rely on your personal feelings when using it. Some pills, for example, cause itching in some women, which goes away when they switch to a different brand of medication.

Barrier contraception

Barrier methods protect not only from conception and unwanted pregnancy, but also from infections transmitted through sexual contact. But the reliability of such means is not 100% (moreover, no contraceptive means is 100% reliable, except complete abstinence from any sexual intercourse), but is only about 85%. Barrier methods include the use of condoms, but they can also break, and then all efforts will go in vain and blur the sensations of sexual intercourse.

Hormonal patches and ring

Other non-invasive methods include patches and hormonal rings. The effectiveness of such products reaches 92%. The patch adheres to the skin, but it is noticeable, requires regular replacement and is not suitable for use by women weighing more than 90 kg. The ring is inserted into the vagina, but also has disadvantages: in some cases it can cause a change in the nature of menstrual bleeding and disrupt the regularity of menstruation. These methods do not have additional contraceptive effects, such as treating acne, relieving PMS symptoms or preventing seborrhea.

Implants and injections

Hormonal implants and injections are essentially the same oral contraceptives, i.e. birth control pills, only with a different mechanism of action. If substances from tablets are absorbed through the digestive tract, then injectable contraceptives are administered intramuscularly. The frequency of injections is once a month or every three months. Implants are inserted into the shoulder and require replacement only once every five years. The effectiveness of the methods is 90-99%.

Such contraception, however, can cause migraines, changes in the menstrual cycle, hormonal imbalances, decreased sex drive or weight gain. Injections and implants, as a rule, are not used by young women who have not yet given birth; this method of contraception is more suitable for women between thirty and forty years old who do not plan to have a child in the near future.

Intrauterine device

The second most effective method of contraception after birth control pills is the intrauterine device. The method also refers to the barrier method, only the spiral is installed in the uterine cavity, preventing the embryo from fixing. But installing an IUD can cause changes in the nature of menstruation, sometimes causes pain, and increases the risk of developing various inflammations and the occurrence of an ectopic pregnancy.

Oral contraceptives

Oral contraceptives protect against unwanted pregnancy, but not against diseases transmitted through sexual contact. The newest birth control pills also have an additional effect: many drugs contain the active form of folic acid, so they relieve PMS symptoms, have an antidepressant effect, help fight acne, and improve the condition of the skin and hair. The reliability of OCs is 99.7%, but this method of contraception requires prior consultation with a gynecologist and the woman’s attentiveness and organization when taking it. It is this method of planned contraception that will be discussed further.

Classification of OK according to hormone content

All are divided into 2 large groups: combined oral contraceptives (COCs) and mini-pills. COCs contain an estrogen analogue and a progestogen. The mechanism of action of such tablets is that they block the onset of ovulation (the maturation of the egg and its readiness for conception), make implantation of the egg into the uterine cavity impossible due to “glandular regression” and thicken the mucus, which disrupts the movement of sperm to the female reproductive cell.

COCs are divided into groups according to the variation of hormones and their content. Thus, there are monophasic, two- and three-phase tablets (more about them below), as well as micro-dose, low-dose and high-dose COCs. Microdosed OCs are suitable for young girls, since the content of active substances in the tablets is minimal. The rating of birth control pills of this type is presented as follows:

"Jess."
"Marvelon".
"Klaira" (the only three-phase tablets in the list of microdosed ones).
"Dimia."
"Zoeli."
"Logest".
"Mersilon".
"Lindynet."
"Novinet."

Low-dose OCs are suitable for both young and more mature women; they can be used by those patients who experience intermenstrual bleeding when using microdosed tablets. These birth control pills are suitable for women who have given birth. In addition, low-dose OCs prevent hair growth in unwanted places, eliminate oily skin and acne, and reduce the manifestations of seborrhea.

"Yarina.
Tablets "Janine".
"Silhouette".
"Diana."
Femoden tablets.
"Tri-mercy."
"Lindynet."
Tablets "Silest".
"Miniziston" and others.

High-dose OCs can be taken only on the recommendation of a gynecologist. Such drugs are generally used for therapeutic purposes (for the treatment of endometriosis, hormonal disorders and other diseases). In the rating of birth control pills with a high concentration of hormones, the following are OK:

"Non-Ovlon."
"Trikivlar."
"Ovidon".
"Triseston".
"Tri-Regol."

Another type of contraceptives - mini-pills - contains only progestogen. The mini-pill affects the reproductive system only at the local level:

increase the viscosity and amount of cervical mucus, which interferes with the free movement of sperm;
change the biochemical and morphological structure of the uterine endometrium, which makes it impossible for the embryo to attach even in the event of fertilization.

Mini-pills completely block ovulation in only half of women, but this does not affect the reliability of the pills as a method of birth control.

"Charozetta" (800 rubles per package).
"Laktinet" (530 rub.).
"Orgametril" (1100 rub.).
"Exluton" (1250 rub.).

There is also emergency contraception, which is used if unprotected sex occurs, which can lead to pregnancy. These birth control pills are taken within 72 hours after sex. A common example of this type of OC is Postinor. You need to take birth control pills within 72 hours after sexual intercourse, otherwise emergency contraception will not have any effect. Such drugs cannot be used constantly.

Monophasic, two- and three-phase drugs

COCs also differ in variations in hormone content, being divided into monophasic, biphasic and triphasic. In monophasic tablets, the percentages of substances do not change in each tablet; in biphasic tablets, the ratio of active components changes in the first and second halves of the cycle; in three-phase tablets, the percentage of substances changes three times per package.

Monophasic birth control pills:

"Regulon";
"Rigevidon";
"Janine";
"Silhouette";
"Lindynet";
"Logest";
"Femoden";
"Mikrogynon" and others.

Two-phase OK:

"Femoston";
"Binovum";
"Bifazil";
"Adepal";
"Anteovin" and others.

Three-phase are represented by the drugs "Tri-Mercy", "Triziston", "Tri-Regol" and others.

How to choose the right birth control pills

You cannot choose birth control pills on your own or even with the help of a pharmacist at a pharmacy. To find the right contraceptive, you should definitely see a doctor. The gynecologist will interview the patient, find out if there are any diseases (were there in the past) and which ones, and conduct an examination. During the examination, the gynecologist will measure the patient’s weight, blood pressure, assess the condition of the skin, palpate the breasts and prescribe tests. You may also need to visit an ophthalmologist, since long-term use of OCs increases the risk of various eye diseases.

The doctor chooses the tablets that are best suited for the patient depending on the phenotype. The phenotype takes into account the woman’s height and appearance, mammary glands, degree of hair growth, condition of the skin, hair, existing chronic diseases, the nature and frequency of menstruation, the presence and severity of PMS, and so on.

There are three main phenotypes:

Women of short or medium height whose skin and hair are prone to dryness. Menstruation is heavy and prolonged, the cycle is more than 28 days. Medium- and high-dose COCs are suitable for such patients, for example, Milvane, Triziston, Femoden and others.
Women of average height, with hair and skin of normal oil content, with medium-sized breasts. This type of woman does not have PMS symptoms or they do not cause negative, painful feelings. The menstrual cycle is standard - 5 days, every 28 days. Suitable tablets are Marvelon, Regulon, Tri-Mercy, Silest, Logest, Tri-Regol and others (most COCs on the market).
Women who are tall, have underdeveloped mammary glands, oily hair and skin. Menstruation is frequent and painful, but scanty, and PMS symptoms are often severe. Tablets "Yarina", "Jess", "Zoeli", "Dimia" are suitable.

Rating of oral contraceptives

Oral contraceptives are too diverse to form an overall rating. But still, the recommendations of gynecologists and reviews of patients allow us to identify several of the best COCs of the new generation. The rating of birth control pills is represented by the following drugs:

"Jess." Not only do they perform a direct function, that is, they protect against unwanted pregnancy, but they also treat a number of gynecological diseases, hormone dependence, improve the condition of the skin and hair, reduce the symptoms of PMS and ease painful periods. How to take birth control pills "Jess"? According to the instructions, you need to start taking it on the first day of your period, you need to take pink pills every day, and on the 28th day you need to take white pills (placebo). After the end of the cycle, start the next package.
"Jess Plus". The same “Jess”, only it also contains an active form of folic acid, which normalizes the psycho-emotional state and allows you to avoid unpleasant consequences if pregnancy does occur: the body will be ready to bear a child, despite taking the pills. If the patient decides to stop taking OCs in order to become pregnant, planning can begin already in the next cycle after discontinuation. In addition, "Jess Plus" is a birth control pill that does not make you fat. The latter is confirmed by patient reviews.
Tablets "Janine". According to girls and women who took "Zhanine", this drug somewhat reduces libido, but is reliable. In addition, "Janine" is a birth control pill that does not make you fat, as proven by many reviews.
"Marvelon". OCs are recommended for use by women over 25-35 years of age who are of childbearing age but have already given birth. The hormone content is minimal, but the tablets are suitable for patients who are sexually active. Like other OCs, Marvelon improves the appearance, condition of the skin and hair, normalizes hormonal balance and reduces hair growth in unwanted places.
"Regulon", instructions for use, price, reviews of which are of interest to many women, costs about 1,150 rubles (63 tables). You need to take the pills daily, from the first to the twenty-first day of the cycle. This is followed by a seven-day break. After the break, you need to start taking Regulon again, even if your periods have not stopped yet. Instructions for use, price, reviews must be studied before purchasing. The opinions of patients are contradictory: some women became irritable and gained weight, noted a significant deterioration in their health and disruption of the menstrual cycle, others were completely satisfied with the drug, while other OCs were not suitable for them.
"Depo-Provera". The tablets are recommended for women over forty years of age and can be used in the treatment of various gynecological diseases. There are injections - doctors say that Depo-Provera is much more effective this way than in tablet form.
"Pharmatex". This is a non-hormonal contraceptive that is inserted directly into the vagina in the form of suppositories. It is recommended to use Pharmatex for women over 45 years of age who are sexually active.
"Yarina". The drug is low-dose and has an antiadrogenic effect. Some patients claim that they managed to get pregnant while taking Yarina strictly according to the instructions. How to take birth control pills "Yarina"? You need to drink OK every day, starting from the 1st day of the cycle, in the order indicated on the blister.
"Lactinet" is not a combination drug, but a mini-pill, which has a number of contraindications, so before you start taking it, you should definitely consult a doctor. The tablets are suitable for women over 45 years of age, patients with diabetes mellitus, varicose veins, smokers, and breastfeeding patients.
Birth control pills "Silhouette". Many patients note a visible improvement in the appearance of their skin and hair, stabilization of the menstrual cycle, and a decrease in pain during menstruation and PMS symptoms. But Silhouette birth control pills can cause weight gain - about half of women complain about this side effect.

Side effects of taking contraception

A reliable, safe (if you consult a gynecologist before taking it) and convenient method of contraception is birth control pills. There are, however, side effects too. Among them:

nausea;
absence of menstruation;
lack of appetite;
weight gain;
uncharacteristic discharge between periods;
dizziness, headaches;
decreased libido;
swelling of the legs;
painful sensations in the chest.

If side effects occur, contraceptive pills are discontinued.

Contraindications for use

Contraindications to taking OCs include:

hypertension;
kidney pathologies;
pregnancy;
serious diseases of the cardiovascular system;
migraine of unknown origin;
preparation for surgical intervention;
overweight (more than 30%);
smoking after 35 years (for some tablets this fact is not a contraindication - a mandatory consultation with a doctor is required);
diabetes mellitus (you can use some OCs) and so on.

Whether to take birth control pills is a personal choice for each woman. This is a reliable means of contraception that is convenient to use for those who are sexually active. At the same time, there are a number of side effects that occur if you choose the wrong remedy. So, the main thing to be guided by when choosing and taking birth control pills is the recommendations of a gynecologist.

There are a lot of contraceptives. To navigate their choice, it is necessary to consider in detail the types of this assortment.

Main groups of contraceptives:

hormonal contraceptives;
spirals;
candles;
barrier agents;
natural methods.

Hormonal drugs are considered the most effective.

Hormonal contraceptives are divided into the following types:

vaginal ring;
patch;
injections;
pills.

All hormonal preparations contain sex hormones: estrogens and gestagens. These hormones suppress the ovulation process and thicken the natural fluid that the cervix secretes. As a result, it is difficult for sperm to penetrate into the uterine cavity.

In addition, the entry of new sex hormones into the body slows down the production of its own. Because of this, the egg does not mature, which means pregnancy will not occur.

Under no circumstances should you take these medications on your own. Hormonal drugs contain many contraindications. Only after a medical examination will the doctor prescribe this or that remedy.

The Nova Ring vaginal ring is a modern contraceptive for women. It is a transparent elastic ring that is inserted into the vagina.

You should start using the ring from the first day of your menstrual cycle. The contraceptive releases a certain amount of hormones for 3 weeks. After this, the woman must remove the contraceptive without the help of a gynecologist. After 7 days, the ring is reinstalled as intended.

Side effects: migraines, nausea, vaginal discharge. If such manifestations become frequent, you should consult a doctor.

This product looks like a regular patch. It is glued to any area of the skin except the chest. The principle of its action is that the patch actively releases hormones that are absorbed through the skin.

Hormones inhibit the maturation of the egg and increase the viscosity of the fluid that accumulates at the cervix.

The first patch should be applied from the beginning of the menstrual cycle. The effect of one patch is 1 week. Therefore, in one menstrual cycle it is necessary to use 3 patches, and then take a break for 7 days.

The IUD is an intrauterine device that has proven itself to be a highly effective contraceptive. It is not recommended to use this method for girls under 23 years of age. Despite its effectiveness (99%), the IUD can cause complications, including infertility.

The spiral is inserted into the uterus itself. This is done by a gynecologist after a thorough medical examination. The validity period of this device is up to 5 years.

There is a hormonal device (Mirena) and a non-hormonal device - made of plastic and copper. The copper spiral is an effective remedy and has far fewer contraindications. It can be used even during lactation. However, a copper IUD cannot be used in the presence of chronic diseases of the reproductive system and inflammation.

The hormonal uterine device is the most popular among women. This drug releases certain doses of the hormone levonorgesterol into the uterine cavity, which prevents pregnancy.

Benefits of the hormonal IUD:

reduces discharge during menstruation;
long-term effect – up to 5 years;
efficiency 99%.

Disadvantages of the spiral:

age limit (from 25 years);
menstruation disorders;
contraindications for liver and heart diseases.

Contraceptive injections

This method involves injecting a woman intramuscularly with a special substance that stops the ovulation process and also changes the composition of the mucus in the uterus. As a result, it is almost impossible to get pregnant. The duration of the injection is 3 months.

However, not all so simple. This contraceptive can cause bleeding, headaches, and decreased libido. Long-term use of this method can negatively affect the integrity of bone tissue.

So, hormonal contraceptives are quite effective, but they have a number of side effects on the body. How to be? If a woman has health problems and the doctor does not recommend taking hormonal medications, then you can use non-hormonal contraceptives in the form of suppositories.

Birth control suppositories are chemical preparations of spermicide. The candle is inserted into the vagina before sexual intercourse and, under the influence of body temperature, melts there, creating a protective membrane inside. Thus, sperm are retained by this substance and do not penetrate into the uterus.

The candle is valid for up to 5 hours. This remedy protects not only from pregnancy, but also from the penetration of infections and sexually transmitted viruses. The main disadvantage of suppositories is their regular administration before each sexual intercourse. Long-term use of suppositories is also undesirable, since spermicide can disrupt the internal microflora of the vagina.

After sexual intercourse using a candle, you should not wash with soap, as the alkali will neutralize the chemical substance that makes up the candle. Therefore, it is better to wash with just warm water.

Safe contraceptives

Thus, having studied the listed contraceptive methods, we can conclude that they have side effects because they contain hormones or chemicals. Are there really no other methods that are safer for health? This issue is especially relevant for young girls who have not given birth, who find it difficult to get pregnant after taking contraceptives.

Alternative methods of contraception:

interrupted sexual intercourse;
condom;
calendar method;
temperature method;
douching.

Alternative methods are not harmful to health, but their effectiveness is low.

Coitus interruptus- A fairly popular method among married couples. However, its effectiveness is 70-75%. It involves the man removing the penis from the vagina before ejaculation. The effectiveness of the method is reduced by the fact that during sexual intercourse a small amount of sperm is still released along with natural lubrication. And not every man can control himself during sex.

Condom– the most reliable remedy not only for unwanted pregnancy, but also for sexually transmitted diseases. This is especially true for those who do not have a permanent partner.

Calendar method- simplest. It involves calculating the ovulation phase according to the calendar. To do this, you need to know the length of a woman’s cycle and the first and mark the first day of menstruation on the calendar. Count 10-11 days from this day - the beginning of ovulation. Ovulation lasts approximately 7-9 days. During this period, you should abstain from sexual relations, since it is at this time that the risk of becoming pregnant is greatest.

Temperature method involves measuring basal temperature in women on different days of the cycle. After ovulation, it rises by 0.2°C, which indicates that it is safe to get pregnant. This method is quite painstaking - it requires daily recording of the temperature.

Douching consists of washing the vagina with various solutions immediately after sexual intercourse. To do this, you can prepare a weak solution of sea salt or a decoction of herbs. But this method is also very questionable - after all, there will always be “active” sperm that will “have time” to penetrate the uterine cavity.

Which birth control pills are best to choose?

Oral contraceptives are divided into two groups:

Combined, containing estrogen and gestagen.
Mini-pills that contain only one hormone - gestagen.

How to take contraceptives? There is no single regimen for taking oral contraceptives, since each of them contains a different dose of hormones and is prescribed individually.

Want something interesting?

Contraindications to taking oral contraceptives:

diabetes;
varicose veins;
hypertension;
heart diseases;
migraine;
metabolic disease;
excess weight;
malignant tumors;
high cholesterol;
pregnancy and breastfeeding;
age over 40 years.

Types of birth control pills

One of the most popular contraceptives of our time is Yarina birth control pills. They stabilize the cycle well, do not cause weight gain, and perfectly fulfill their intended purpose - to protect against pregnancy.

But this drug has a side effect: long-term use causes frequent headaches.

If such diseases are present, then these tablets should not be taken. In addition, “Yarina” gives a number of other complications: vegetative-vascular dystonia and headaches.

Birth control pills Jess is a combined drug with antiandrogenic effects. This drug has a good contraceptive effect, treats acne and eliminates premenstrual syndrome.

The package contains 28 tablets, which should be taken 1 per day. In addition, the pack contains a special calendar in which it is convenient to mark the days of taking the pills.

Side effects of the drug:

nausea;
vomit;
bleeding;
headache.

The drug is contraindicated during breastfeeding.

Contraceptive Regulon has several areas of application:

protects against unwanted pregnancy;
treats dysfunction of uterine bleeding;
stabilizes the cycle;
treats dimenorrhea;
eliminates pain during menstruation;
treats uterine fibroids;
resolves ovarian cysts.

Thus, Regulon is an excellent cure for female diseases. Unlike previous drugs, Regulon is usually prescribed to women over 40. It helps prevent abortion and its negative consequences.

Birth control Lindinet is a hormonal pill that helps prevent pregnancy and also stabilizes the menstrual cycle. The tablets also prevent the occurrence of ectopic pregnancies and reduce the risk of tumors in the mammary glands. Lindinet perfectly treats acne on the skin.

Contraindications:

hepatitis;
pancreatitis;
otosclerosis;
smoking;
pregnancy and lactation;
thrombosis;
tumors of the genital organs.

There are post-coital birth control pills that are emergency contraception. This method is an “ambulance” for unprotected sexual intercourse. They are hormonal and should be taken immediately after sex.

The most popular drugs in this series: Miniziston, Femoden, Marvelon. These contraceptives are widely available and are available in pharmacies without prescriptions.

Oral contraceptives are available in monophasic, biphasic and triphasic forms. The doses of hormones in each drug are different. However, the rules for taking pills are, in most cases, the same.

Rules for taking birth control pills:

Before you start taking pills, you must consult your doctor.
You should take the tablets at the same time every day (preferably at night or with meals).
As a rule, 1 pack contains 21 tablets, which should be taken every day from the beginning of the cycle, and then take a break for 1 week.
After the end of the break, on the 8th day you should resume taking the pills with a new package, if pregnancy is not planned.
If one tablet was missed in weeks 1 and 2, then it should be taken immediately, and then the next one after 12 hours. The next day - according to the usual schedule.
If 1-3 tablets were missed in the third week, it is better to stop taking it before your period. And after menstruation - resume the course.

When to stop taking the pills:

Onset of pregnancy.
Frequent headaches.
A sharp increase in body weight.
Increased pressure.
Visual impairment.
Voice change.
The occurrence of gynecological diseases.
3 weeks before surgery.

Pregnancy after birth control

Many women are concerned about the question: is it possible to get pregnant after taking birth control pills for a long time?

The answer is simple: you can! Any instructions for contraceptives indicate that pregnancy can occur in the next cycle after discontinuation of the contraceptive.

But is everything so clear?

After all, if a woman took contraceptives for a long time, then all functions of the reproductive system were suppressed. After stopping the pills, the female organs gradually begin to return to their previous function, sometimes even with enhanced effect. It is this fact that gynecologists often use in the treatment of infertility. A woman who cannot get pregnant is prescribed contraceptives for 2-4 months, and then discontinued in order to “stimulate” the reproductive system to work twice as well. In most cases, this method helps. But sometimes you have to undergo 2-3 courses of such therapy.

Menstruation when taking birth control pills is quite scanty. This is explained by the fact that hormonal drugs suppress the biological processes of the female body. However, this case has its advantages. Firstly: menstruation passes very quickly while taking contraceptives and they are practically painless. Secondly, a clear monthly cycle is established - 28 days.

There are times when a woman wants to artificially “delay” her period. For example, when traveling to the sea. In this case, she does not take a week's break from taking the pills, but continues to take them. Then your period does not come. But this cannot be abused! After all, the menstrual cycle may be disrupted or intermenstrual bleeding may appear.

Good contraceptives are those that suit a woman individually. This means that a contraceptive should be selected by a gynecologist, taking into account all the characteristics of the individual’s body. And whether or not to take contraceptives is a personal matter for everyone.

The main thing to remember: Children should be wanted and born on time. After all, there is nothing worse than an unloved and abandoned child.