What are the best contraceptive pills. Genetic disorders when taking oral contraceptives

Hormonal contraception is currently recognized as the most effective method of preventing unwanted pregnancy.

The modern pharmacological industry has developed a large number of its varieties with various combinations of doses and active ingredients. This allows you to choose birth control pills, which will be best suited for a woman, taking into account her age and hormonal cycle.

Classification of hormonal methods of contraception

All hormonal contraceptives are divided into two large groups:

1. Combined, containing in its composition synthetic analogues of estrogen and progesterone.
2. Single-component, containing only progesterone analogues.

Combined hormonal contraceptives

They consist of a synthetic estrogen component - ethinyl estradiol and various progesterone derivatives.

According to the method of application, the drugs are divided:

1. Oral - available in tablets, taken by mouth.
2. Parenteral - forms of drugs with various routes of administration:

• patches (transdermal contraceptive system Evra);
• vaginal rings (NovaRing).

In turn, combined oral contraceptives are divided according to the dosing regimen:

• single-phase (Zhdes, Novinet, Logest, Regulon, Zhanin, Yarina);
• two-phase (anteovin);
• three-phase (tri-regol, trisiston, trinovum).

Depending on the amount of active drug in a tablet, contraceptives are divided into:

• microdosed (contraceptive pills Mercilon, Novinet, Logest);
• low-dose (contraceptive pills Yarina, Janine, Diane-35, Regulon, Marvelon);
• high-dose (contraceptive pills Non-Ovlon, Ovidon).

Single component hormonal contraceptives

Single-component hormonal contraceptives are divided according to the method of administration:

1. Oral (minipil) - hormonal contraceptive pills for oral administration (Microlut, Exluton, Charozettau).
2. Parenteral:

• injections (medroxyprogesterone);
• implants (desogestrel);
• intrauterine hormonal systems (Mirena).

It is impossible to say unequivocally which birth control pills are better and which are worse, since age, hormonal status, the presence of bad habits and chronic diseases, as well as many other factors affect the choice of drug.

Combined oral contraceptives (COCs)

Mechanism of action

The basis of the contraceptive action of COCs is the suppression of ovulation. This effect is realized due to the action of ethinylestradiol, which replaces its own estradiol and blocks the growth and maturation of the follicle.

The synthetic progestins that are part of COCs affect the mucous layer of the uterus, lead to its change and prevent the implantation of a fertilized egg (even if ovulation has occurred).

Thickening of mucus in the cervix is ​​another contraceptive mechanism. In this case, the penetration of spermatozoa into the uterine cavity becomes extremely difficult. Also, in addition to the contraceptive effect, thickening of the cervical mucus prevents the penetration of infections into the uterine cavity.

Side effect

It should immediately be noted that by the presence or absence of side effects it is impossible to say which birth control pills are better and which are worse. Since the same drugs may or may not be suitable at different periods of a woman's life.

COCs are combined drugs, respectively, side effects are represented by the action of each component of the contraceptive.

Side effects of ethinylestradiol

• increased blood pressure;
• headaches;
• dizziness;
• nausea and vomiting;
• pain and heaviness in the chest;
• hyperpigmentation on the face;
• irritability;
• weight gain.
• headache;
• low mood;
• reduction of mammary glands;
• decreased lubrication in the vagina;
• spotting in the middle of the cycle;
• decrease in sexual desire;
• scanty periods.
• headache;
• depressive states;
• reduced performance;
• increased greasiness of the skin;
• acne;
• decrease in sexual desire;
• increased varicose veins;
• dryness of the vagina;
• weight gain.
• delay in menstrual flow;
• blood smearing in the second part of the cycle;
• pronounced menstrual bleeding.

Side effects associated with the suppression of own estrogens

Side effects of synthetic progestins

Side effects associated with an insufficient dose of progestins

In the initial few months, taking birth control pills is associated with the presence of side effects in 11 - 42% of cases. In the future, the incidence of adverse reactions decreases to 4 - 9%. If, after 3-4 months of continuous use, side effects persist or increase, then the drug should be discontinued or replaced.

Also, it is necessary to make a reservation about a rare, but extremely dangerous complication of hormonal contraception - venous thrombosis and embolism. The likelihood of their development directly depends on the presence of risk factors, such as smoking, age over 35 years and obesity.

The best contraceptive pills in terms of minimal risk of thrombosis are microdose COCs (Novinet, Jess, Qlaira). It has been proven that the risk of developing thromboembolic complications when taking them is lower than during pregnancy.

Contraindications

1. The presence of thrombosis of the veins of the legs or thromboembolism of the pulmonary artery. As well as diseases in which there is a high risk of developing thrombosis, for example, major surgical operations, bone fractures (especially the femur) with prolonged wearing of a plaster cast.
2. Coronary artery disease.
3. Stroke.
4. High blood pressure.
5. Diseases of the valves of the heart.
6. Diabetes mellitus for over 20 years.
7. Oncological disease of the breast.
8. Smoking in women over 35 years of age.
9. Pregnancy.
10. Diseases of the liver.
11. Breastfeeding in the first 6 weeks after childbirth.

All of the listed contraindications to taking birth control pills are absolute. That is, it is strictly forbidden to take hormonal contraceptives if there is at least one item from the above list.

How is individual selection carried out?

In order to make it most clear, let's take a step-by-step analysis of which birth control pills are best to take.

For a woman who has never taken contraceptives before, the selection scheme will consist of three stages:

1. Prescribing the drug of first choice.
2. Selection of the drug, taking into account the presence of hormonal disorders and gynecological diseases.
3. Change contraceptive with the development of side effects.

Prescribing a first choice drug

The first, as a rule, is prescribed a micro or low-dose monophasic COC containing estrogen no more than 35 mcg / day and a progestin with a minimal androgenic effect (Novinet, Logest, Mercilon, Jess).

Selection of the drug, taking into account the presence of hormonal disorders and gynecological diseases

Let us consider in more detail the main female diseases and which contraceptive pills are better to take with them.

Change of contraceptive with the development of side effects

In the event of the development of side effects while taking contraceptives, further selection and change of drugs should be carried out by the attending gynecologist. Most often, a transfer is made to three-phase drugs with the selection of the required dose of ethinyl estradiol.

How are they accepted

COCs are available in calendar blisters of 21 or 28 tablets. They start taking COCs, as a rule, on the first day of menstruation. In the case of an irregular cycle or the absence of menstruation, the reception can be started on any day, subject to the exclusion of pregnancy. Tablets are taken one daily:

• pack of 21 tablets - 21 days of taking pills, 7 days off, then a new pack begins;
• pack of 28 tablets (21 + 7) - taken continuously, at the end of the pack, the next one begins.

Also, there is a method of continuous intake, when the drug is taken in the same dose, regardless of the cycle. The main goal of this method is a medical delay in menstruation. Most often, the continuous method of admission is used for medical purposes, for example, for the treatment of endometriosis. But it can also be used for a short-term delay in menstruation at significant events in life, for example, a wedding, honeymoon, vacation.

What to do if a drug is missed?

1. One tablet not taken

• less than 12 hours have passed - take the drug, continue further administration as before;
• more than 12 hours have passed - take a forgotten pill:
• if the reception is missed in the first week of the cycle - use barrier methods of protection for 7 days;
• if an appointment is missed in the second or third week, the use of additional contraception is not required.

2. If 2 or more tablets are missed, take 2 tablets per day until the intake returns to normal. And also within 7 days to use additional methods of protection. If, after the missed pills, menstruation begins, the drug should be stopped and after 7 days a new pack should be started.

Combined parenteral contraceptives

At the moment, there are only two parenteral combined contraceptives:

• transdermal contraceptive system Evra;
• vaginal contraceptive ring NovaRing.

The Evra transdermal contraceptive system is a beige patch containing 0.6 mg ethinyl estradiol and 6 mg norelgestromin. Moreover, the dose that is absorbed per day corresponds to the intake of microdosed COCs.

The patch is glued for 7 days, three transdermal systems are needed for one cycle. As well as when taking birth control pills, after 21 days (3 patches) a break is made for 7 days.

The NovaRing vaginal contraceptive ring is a hormonal combined contraceptive with a vaginal route of administration. Doses absorbed per day are lower than in microdose COCs (0.015 mg ethinylestradiol, 0.12 mg etonogestrel), which allows you to get a good contraceptive effect with fewer adverse reactions.

NuvaRing is inserted into the vagina by a woman from the 1st to the 5th day of the menstrual cycle for 21 days, then it is removed and a break is made for 7 days.

The advantages of the parenteral method of administration are:

• ease of use;
• lower doses of hormones;
• fewer side effects.

Of course, the advantages of parenteral drugs are undeniable, but there are some disadvantages that somewhat limit their popularity:

• the patch can peel off and go unnoticed;
• not all parts of the body can be glued;
• may develop a local reaction to drugs.

Given all these disadvantages, hormonal birth control pills remain the best solution for preventing unwanted pregnancies.

Gestagen oral contraceptives (minipils)

These preparations contain very low doses of synthetic progestins, approximately 15-30% less than COCs. Accordingly, the contraceptive effect of their intake is much lower.

Indications

Taking the minipill is justified only in women who are breastfeeding (6 weeks after childbirth) and in case of contraindications to other methods of contraception. In other cases, they are not the best birth control pills.

Contraindications

The same as in the appointment of combined contraceptive drugs.

Side effect

• violation of the menstrual cycle;
• headaches and dizziness;
• nausea and vomiting;
• low mood;
• weight gain;
• decreased sex drive.

Parenteral progestogen contraceptives

Parenteral forms of gestagen contraceptives are much wider than combined ones:

• injection - medroxyprogesterone (Depo-provera);
• implants - desogestrel (Implanon);
• intrauterine hormonal coil (Mirena).

The drug is available in tablets, aerosol, suspension.

For injectable contraception, a suspension is used that contains 0.15 g of medroxyprogesterone.

The mechanism of action of the drug is to suppress ovulation, thicken the cervical mucus and change the inner lining of the uterus. The effectiveness of contraception when using injectable medroxyprogesterone is very high (more than 99%).

Side effects are the same as for oral progestins.

The drug is administered intramuscularly once every three months. The first introduction on the 5th day from the onset of menstruation.

The disadvantages of the drug are:

• long-term recovery of the ability to become pregnant;
• it is impossible to stop contraception at will;
• you must regularly contact the medical center for repeated injections.

It should be noted that after the last injection of medroxyprogesterone, it may take up to a year and a half for the restoration of normal ovulation and the menstrual cycle. Therefore, birth control pills are better because they give you the choice to continue contraception or not to continue.

Implants

Implanon is the only contraceptive implant registered in the Russian Federation. The drug is a polymer rod, 4 cm long and 2 mm wide. Using a special needle, it is injected subcutaneously into the inner surface of the shoulder for a period of 3 years.

The mechanism of action, contraceptive efficacy and disadvantages are the same as those of injectable forms.

The drug is an intrauterine device containing levonorgestrel at a very low dose (52 mg).

The main effect of the drug is local, since the released daily dose of levonorgestrel is very small to have a systemic effect on the body. This is the reason for the minimum number of side effects when using Mirena. Levonorgestrel, acting on receptors in the endometrium, leads to its transformation and prevents the implantation of the egg. Just like other progestins, Mirena causes cervical mucus to thicken, preventing sperm from moving into the uterine cavity.

Planned children who appeared in the family by a deliberate and balanced decision are the key to harmony in the house, so this issue should be taken seriously. To avoid unwanted pregnancy, as well as to treat a number of gynecological problems, there are many medications. Before deciding which birth control pills to choose, you should understand the huge range of oral contraceptives that today's pharmaceutical market offers. All products created to prevent conception are divided into two groups:

1. COOK. Combined oral contraceptives with different composition.
2. Mini-drank. The most gentle for the body with one analogue of the hormone progesterone.

   Depending on which hormones are used in the preparation, COCs are divided into:

   • monophasic;
   • two-phase;
   • three-phase.
   Also, based on the number of active components in the composition, the following classification is accepted:
   • microdosed;
   • low-dose;
   • highly dosed
   It should be remembered that at different ages, certain medicines may or may not suit a woman. Therefore, in order to find out which are the best birth control pills after 30, 40 or 45 years, in your case, you must definitely visit a gynecologist, he will be able to give the most correct recommendation.

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

   Contraceptive pills Regulon

   

   
   Monophasic, combined contraceptive, which contains estrogen and progestogen.
   1. Action. The remedy is effective due to its effect on the hypothalamic-pituitary-ovarian system. With its help, the susceptibility of the endometrium to the blastocyst is reduced and the mucous viscosity in the cervix increases, which makes it more difficult for sperm to move.
   2. Application. Assigned to 1 piece per day from the first day of the full menstrual cycle. You need to drink 21 days, preferably at the same time. After that, the course is interrupted for a week and a new package is started. If more than five days have passed since the onset of menstrual bleeding, the start of the intake should be postponed to the next cycle.
   3. Contraindications. It is forbidden for patients with severe arterial hypertension, thromboembolism, ischemia, atherosclerosis, with serious liver problems, heart defects, diabetic angiopathy, otosclerosis, genital herpes, hypersensitivity to components, lupus erythematosus, estrogen-dependent tumors, genital bleeding.
   4. Side effects. Very rarely, stroke, thrombosis, hypertension, heart attack, cholestatic jaundice, Sydenham's chorea, cholelithiasis were noted.
   The price of Regulon in Russia is about 460 rubles, and in Ukraine 130-160 UAH.

   Jess - birth control pills

   

   
   Low-dose contraceptive with antiandrogenic, antimineralocorticoid effect, good cycle control. Contains drospirenone and ethinyl estradiol. It is prescribed for acne vulgaris and for the treatment of premenstrual syndrome in a complex form.
   1. Action. It prevents pregnancy by suppressing ovulation, changing the properties of the cervical secret, due to which it becomes almost impermeable to spermatozoa.
   2. Application. Drink one tablet a day for 28 days without interruption with plenty of water. As soon as the blister is over, move on to the next one.
   3. Contraindications. You can not use patients with diabetes mellitus, with tumors in the liver, mammary glands, renal and adrenal insufficiency. It is forbidden for thrombosis, after heart attacks, ischemic attacks, vaginal bleeding, angina pectoris, pancreatitis, neurological migraine.
   4. Side effects. Mood swings, anxiety, nervousness, headache, candidiasis, breast inflammation, irregular menstruation, nausea, vomiting, diarrhea, skin rashes, fluid retention, weight gain or loss.
   The price of Jess in Russia is 1100-1200 rubles, and in Ukraine 200-250 hryvnias. More detailed we already did earlier.

   Contraceptive Tri-Regol

   

   
   A three-phase agent containing estrogen and progestogen. It is used for contraception, treatment of bleeding disorders, premenstrual syndrome, dysmenorrhea.
   • Action. The release of luteinizing, follicle-stimulating hormone is prevented, due to which ovulation is inhibited, and the viscosity in the cervix also changes and spermatozoa cannot get further into the cavity.
   • Application. One piece is consumed daily for three weeks, then they take a break for 7 days. First they drink six pink, then five white and ten dark yellow tablets.
   • Contraindications. Do not prescribe for hypersensitivity to components, Gilbert, Rotor, Dubin-Johnson syndromes, severe ailments of the liver and kidneys, cholecystitis, colitis, problems with the heart and blood vessels, thromboembolism, diabetes mellitus, tumors, sickle cell anemia, migraine, otosclerosis, herpes, severe skin itching, lipid metabolism disorders.
   • Side effects. Possible nausea and vomiting, tension in the mammary glands, weight changes, discomfort when wearing lenses, headache, intermenstrual bleeding, depression.
   The price of Tri-Regol in Russia is 300 rubles, and in Ukraine 220–300 UAH.

   Birth control pills Novinet

   

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

   Contraceptive Yarina

   

   
   Monophasic agent, with a combination of the two main active ingredients of the estrogen ethinylestradiol and the progestogen drospirenone. It is very useful for patients suffering from hormone-dependent fluid retention, seborrhea, acne.
   • Action. The medicine changes the viscosity of the cervical mucus, inhibits ovulation, and prevents the egg from developing. Also, with its help, the concentration of HDL increases and the lipid profile improves, the drug has antiandrogenic activity.
   • Application. Every day for 21 days at a certain time they drink one dragee, then they stop for seven days and then continue according to the same scheme.
   • Contraindications. You can not be treated with such a medication if the patient has thrombosis, ischemic attacks, severe renal and hepatic pathologies, angina pectoris, tumors, diseases of the mammary glands, genital organs, bleeding, diabetes mellitus, heart attack or stroke.
   • Side effects. Pain in the mammary glands, discharge, intolerance to contact lenses, nausea, pain in the head and abdomen, skin rashes, chloasma, migraine, fluid retention, changes in vaginal secretion.
   The price of Yarina in Russia is 1100 rubles, and in Ukraine 200-250 UAH.

   There are many proven remedies that reliably protect against unwanted pregnancy, but at the same time can cause a number of unpleasant side effects. Therefore, pharmaceutical companies annually try to release new medicines that will not be associated with health risks. Today, there are already a number of non-hormonal products on sale or with an extremely low percentage of them. The TOP-5 of the best birth control pills we have considered consists of drugs that will not only prevent conception, but at the same time affect the health of a woman as carefully as possible.

   Having decided to use oral contraception, you should definitely consult with a specialist, it is he who will help you choose the right medicine based on the condition, age and individual characteristics of the patient's body.

   How to choose birth control pills, see the following video:

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

Types of hormonal contraception

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

Combined oral contraceptives (COCs)

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

• monophasic (in each tablet the same dose of the estrogen and progestin component) - rigevidon, logest, silest;
• two-phase - anteovin, divin;
• three-phase - three-regol, trisiston.

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

How to choose the best COCs

Types of female phenotypes:

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

New generation hormonal COCs

The list of new generation hormonal contraceptives includes:

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

Novinet
The composition of this combined oral contraceptive includes: ethinylestradiol in the amount of 20 mcg and desogestrel in a dose of 150 mcg.

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

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

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

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

Benefits of taking COCs

The benefits of taking COCs include:

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

Cons of taking COCs

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

• not recommended for women 35 years of age or older;
• require discipline (daily reception at the same time);
• spotting is possible when taking hormonal contraceptives (in the middle of the cycle, especially during the first 3 months of taking);
• with special care are appointed to smoking women;
• do not protect against sexually transmitted infections.

mini pili

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

• breastfeed;
• are overweight;
• do not tolerate estrogens;
• are in premenopausal age.

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

Lactinet
The composition of the drug contains 75 micrograms of desogestrel. It has a good contraceptive effect, suitable for lactating women, does not affect weight. Of the side effects: a daub may appear during the first three months of use.

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

Pros of the mini-pill

The advantages of mini-pills are:

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

Cons of mini-pill

Of the shortcomings of these tablets, it should be noted:

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

Injectable progestins

The mechanism of action of these contraceptives is the same as that of the minipill. The most common drugs are depo-prover (150 mg) and norethisterate. The positive aspects of such contraceptives are: long-term action (one injection once a quarter), easy to use, high reliability. Among the shortcomings can be noted: a long restoration of fertility (about 5 - 7 months), it is impossible to quickly remove the drug from the body, the frequent occurrence of acyclic bleeding and regular visits to the clinic for repeated injections.

Transdermal Therapy System

This method of contraception includes the hormonal contraceptive patch Evra. It is presented in the form of a square piece of patch measuring 5 by 5 cm flesh-colored. Contraceptive efficiency reaches 99%. The composition of the patch includes ethinylestradiol at a dose of 600 mcg and norelgestromin at a dosage of 6 mg, that is, it belongs to the combined hormonal contraceptive preparations. The package contains 3 patches, each of which is glued to a specific area of ​​​​the skin (in the buttocks or abdomen, on the outer surface of the shoulder or in the scapular region) once a week. The patch should be attached on the first day of menstruation, but it is possible on any other day of the week, but in this case, additional contraception is required for 7 days. After a week, the patch must be peeled off and a new one attached, but already on a different area of ​​\u200b\u200bthe skin. After using 3 patches (21 days), you need to take a week break, during which menstrual-like bleeding will begin. After a break, on the 8th day, a new patch is glued.

Benefits of a hormone patch

The advantages of this hormonal method of contraception include:

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

Cons of a hormonal patch

Of the shortcomings, it should be noted:

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

Subcutaneous implants

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

emergency contraceptive pills

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

Among the disadvantages of this method of contraception, there are: the frequent occurrence of copious discharge up to massive bleeding, severe side effects, menstrual irregularities. But it is important to remember that emergency contraception should not be used more than three times a year.

Hormonal intrauterine system

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

Vaginal hormonal contraceptives

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

Cancellation of hormonal contraceptives

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

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

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

• depressive state;
• the appearance of acne;
• increase in hair growth;
• weakening of sexual desire;
• the occurrence of breakthrough bleeding;
• the appearance of headaches;
• nausea, vomiting.

Means for the prevention of pregnancy can rightly be attributed to the oldest. After all, they were used in ancient times. For example, women of the indigenous population of America for this purpose used douching with a remedy made from lemon and a decoction of mahogany bark. In ancient Egypt, tampons soaked in honey and decoction of acacia were used. Even condoms are not a modern method of protection against unexpected pregnancy.

Of course, the effectiveness of all these tools was extremely low, and there was no need to talk about ease of use at all. Everything changed around the second half of the 20th century, when doctors first started talking about combined oral contraceptives (COCs). The first drug created for the purpose of protection was Enovid, which appeared on the pharmacy market in 1960. It was with him that the development of hormonal contraception began.

What is hormonal contraception?

The mechanism of action of contraceptive pills is based on the ability of substances that are synthetic analogues of sex hormones produced by the female body to influence the hormonal background. In this case, the brain receives a signal that there are enough hormones in the blood and the command to the ovaries to produce their own does not pass.

The hormones that enter the body, depending on the type, trigger several mechanisms at once. All of them lead to the fact that pregnancy, even with the occurrence of ovulation and fertilization of the egg, does not occur.

Estrogens help:

• The next egg does not mature in the ovaries and ovulation does not occur.
• In the uterus, there is a violation of secretory processes, due to which the development of edema of the mucous membrane - the endometrium occurs, which, in turn, makes it impossible to implant a fertilized egg.
• A process called luteolysis is launched - that is, the reverse development of the corpus luteum, which normally forms after ovulation and serves to synthesize the hormone progesterone, which prepares the body for a possible pregnancy.

• Stimulate the compaction of cervical mucus, which clogs the cervix and makes it impermeable to sperm.
• They inhibit the activity of enzymes that help the sperm enter the egg.
• They reduce the contractile activity of the fallopian tubes and the uterus itself and prevent the egg from moving along them.
• They thin the endometrium, making it unsuitable for egg implantation.
• Block the release of hormones that are responsible for ovulation in the middle of the cycle.

Regardless of the type of components and composition, all hormonal contraceptives have almost the same mechanism of action.

Application features

Any hormonal pills should be taken strictly according to the scheme, preferably at the same time of the day. You can't miss another appointment. Depending on the composition and type of the drug, in case of omission, the contraceptive effect will last on average only up to 12 hours. After this time, the effectiveness of the drug decreases.

The start of taking most COCs coincides with the first day of the cycle. At the same time, you can choose the most convenient time for you. Most women prefer to take birth control pills in the evening, before bed. In this case, negative effects such as nausea, headache or mood changes are not so pronounced.

All hormonal birth control pills are prescription drugs and are used only on prescription. Before you start drinking the drug, carefully read the instructions and rules for taking.

Advantages

Of course, the main advantage of COC contraception using both monophasic and multiphasic drugs is the simplicity of the method itself. Agree, taking a pill is much easier than, for example, using a vaginal ring. And with such means as injectable contraception or intrauterine devices, which can not be used without a doctor, there is no comparison at all.

However, this is far from the only plus, the undoubted advantages of hormonal contraception are:

• High efficiency, even for three-phase preparations, the reliability index does not exceed 0.6%. In other words, out of one thousand women using this method of protection for one year, pregnancy occurred in only one case.
• Security. Despite the fact that all birth control pills interfere with the hormonal background, their effect is much more harmless than the consequences that abortion is dangerous for.
• Normalization of the menstrual cycle, which becomes regular while taking the pills, and the menstruation itself is not so painful, long and plentiful.
• Due to the improvement of the barrier properties of cervical mucus, the incidence of inflammatory diseases or exacerbation of chronic pathologies is almost halved.
• The use of hormonal contraceptives during the year reduces the risk of endometrial cancer by 50%, ovarian cancer by 30%, and the risk of developing mastopathy is reduced by 70%.

disadvantages

Despite the many positive aspects, hormonal contraceptive pills also have disadvantages. The main one, of course, is the side effects, which sometimes make taking the drug simply impossible. In addition, birth control pills:

• They do not protect against sexually transmitted infections, including dangerous ones such as HIV or cytomegalovirus.
• They affect the blood coagulation system and can increase the risk of blood clots and the development of thromboembolism.
• They can aggravate the course of chronic diseases of the liver and gallbladder or provoke the occurrence of cardiovascular pathologies, disorders in the circulatory system, as well as severe headaches and migraines.

Types of COCs

The whole variety of birth control pills can be divided into two main groups. The first includes drugs containing only gestagens, their other name is mini-pills. The second group is combined contraceptives, which contain several hormones.

Usually these are synthetic analogues of estrogens and progesterone. It is this group that is most popular and is prescribed by doctors most often. Combined drugs are also divided into three types.

Monophasic

They are the first generation of drugs intended for hormonal contraception. They contain two hormones: estrogen and progesterone, which are contained in each tablet in the same amount. The most famous of this group are Janine, Yarina or Diane-35.

Despite the fact that this generation of drugs is not new and has been around for a long time, in terms of their effectiveness they are practically in no way inferior to multi-phase drugs.

The advantage of monophasic contraceptives can be considered ease of use and the possibility of doubling the dose in case you forget to take another pill. But with multi-phase agents, this is not always possible, and their use requires more caution and attention.

In addition, monophasic drugs can help treat endometriosis, normalize the menstrual cycle, reduce its duration and pain. Also, in monophasic drugs, cases of intermenstrual bleeding are less common than in other groups.

Monophasic contraceptives are by far the most studied and frequently prescribed group of drugs by doctors.

Two-phase

The second generation of hormonal contraceptives is different in that each tablet contains a constant dose of estrogen, and the concentration of the second component, gestagen, varies depending on the day of the cycle. Of the drugs in this group, for example, Anteovin is currently used.

Two-phase contraceptives are prescribed mainly only for women with abnormal sensitivity to progestogens. Another indication for such drugs is hyperandrogenism. This is a pathology in which a woman's body begins to produce a large amount of male sex hormones.

Three-phase

This group of drugs differs in that the tablets intended for different days of the cycle contain their own, specific dose of hormones. Such a change in the concentration of estrogens and gestagens is as close as possible to those hormonal fluctuations that occur in a woman's body. Due to this, three-phase contraceptives are considered the most physiological.

Typically, this group of drugs is prescribed to women over 35 or under 18, as well as smokers or obese. Such drugs include, for example, Tri-regol, Triziston or Tri-merci.

The main positive quality of this group of drugs is to reduce the risk of side effects from progestins. The main disadvantage is higher, compared with monophasic drugs, the incidence of bleeding between periods. A more complex regimen and not always possible to double the dose in case of missing the next pill.

Studies have shown that triphasic contraceptives are inferior to monophasic contraceptives in terms of reliability of protection against unplanned pregnancy.

The Pearl index for monophasic preparations is 0.15–0.18, while for three-phase preparations, depending on the characteristics of the composition, the values ​​can range from 0.19 to 0.68.

Criterias of choice

If before this experience of taking hormonal contraceptives a woman did not have, then usually the doctor prefers monophasic preparations containing minimal doses of hormones. But only after receiving the results of all necessary tests. Such as: smear for cytology, hormone analysis, general and biochemical blood tests, ultrasound of the pelvic organs. In some cases, an additional consultation with a mammologist may be necessary. In addition, the doctor must take into account the peculiarities of the menstrual cycle and the phenotype of the woman.

It is simply impossible to choose the right drug without consulting specialists and a series of tests. You should not buy hormonal contraceptives on your own, this can harm your health.

To date, combined oral contraceptives are considered one of the most reliable methods of protection against pregnancy. However, from a woman they require a careful attitude to their condition and strict adherence to the regimen.

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

About hormonal drugs

First of all, I would like to say that birth control pills are one of the simplest, most convenient and effective methods of female contraception. And if earlier the concept of "hormonal drugs" could cause horror in the eyes of the fair sex, then modern medications of this direction have practically no side effects and do not harm the body at all. But this is only when the most important rule is fulfilled: such contraceptives should be prescribed exclusively by a doctor. Self-medication can lead to negative irreversible consequences.

Types of birth control pills

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

1. COCs, i.e. combined oral contraceptives. They are single, double and multi-phase.
2. Mini-drank, that is, progestogenic contraceptives. They contain a small dose of the hormone, hence the name - minimal pills.
3. Preparations intended for emergency contraception (taken irregularly).

Depending on the situation and need, any of these types of contraceptives can be prescribed to a woman.

COOK

So, what are good birth control pills in this group of contraceptives? A doctor can prescribe these drugs to women who have practically no health problems. After all, there are certain restrictions for taking COCs. They cannot be prescribed if the lady has the following problems:

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

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

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

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

Action COC

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

Rules for taking COCs

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

Main Representatives

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

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

mini pili

We understand further which birth control pills are best for women to take. The next group of attention should be paid to ladies who are representatives of special categories. Such drugs can be prescribed to women with certain diseases, including diabetes, hypertension, etc. It is also good to take these birth control pills after 40 years, because they are most effective at that age. In addition, they are advised to those women who smoke. Young mothers constitute a special group. Mini-pills are especially effective during breastfeeding (these pills can be taken without fear immediately after childbirth). They are also advised to ladies who are preparing for surgery (in such a situation, taking COCs is contraindicated). However, if we compare the drugs of this group with combined oral contraceptives, then the risk of becoming pregnant is slightly higher. In addition, taking a mini-pill can cause the development of ovarian cysts or an ectopic pregnancy. It is also worth paying special attention to this when choosing.

Action

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

Methods of reception

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

Representatives

Which contraceptive pill is better to take from the mini-pill group? The doctor will most likely prescribe the following monophasic drugs: "Charosetta", "Microlut", "Lactinet" (intended specifically for nursing mothers) or "Exluton".

emergency contraception

There is another group of drugs for women who do not want to get pregnant. These are emergency contraceptive pills that are not taken regularly, but only in case of unprotected intercourse. These may include the following drugs:

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

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

Competent selection

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

1. Gynecologist's consultation.
2. Mammologist's consultation - breast examination.
3. A smear for oncocytology.
4. Blood chemistry.
5. Ultrasound of the pelvis, performed on the fifth or seventh day of the menstrual cycle.

In this case, the doctor will need to know the age, height and weight of the patient, as well as the presence of underlying diseases. The doctor will require the following information:

1. cycle regularity.
2. abortion or childbirth.
3. Profuse discharge.

All these nuances are needed to determine the phenotype of a woman, on the basis of which certain oral contraceptives can also be prescribed.

About phenotypes

Can women take birth control pills if they are not prescribed by a doctor? Highly not recommended. However, with the independent selection of such contraceptives, a lady can try to independently determine her phenotype:

1. Estrogen type of women. These are short, very feminine ladies with large breasts, whose skin and hair are prone to dryness, the discharge is plentiful, the menstruation itself lasts more than five days, the cycle is more than 28 days. The main symptom of PMS is nervousness. In this case, you can take the following drugs: Microgenon, Regividon.
2. balanced type. These are ladies of medium height, feminine, breasts are moderately developed. Skin and hair are normal. The discharge is moderate, menstruation lasts five days, and the cycle is 28 days. PMS is practically non-existent. In this case, the doctor may prescribe the following drugs: Novinet, Regulon, Mercilon.
3. progesterone type. These are tall thin girls of a boyish type. The skin and hair are most often oily, the discharge is scanty. Menstruation lasts less than five days, cycle less than 28 days. During PMS, women are prone to depression. In this case, it is best to take funds such as Diane-35, Janine, Jess, Yarina.

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

What to pay attention to

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

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

Adaptation

If a lady is just starting to take oral contraceptives, she must understand that the body must get used to them. After all, although this is a small dose of the hormone, it is not planned by the body. Therefore, at first, minor adverse reactions are possible, which should not disturb the lady too much. If they have not passed within three months from the start of taking the pills, you need to consult a doctor with a request to change the drug. If birth control pills are completely suitable for a woman, she should not feel any discomfort after taking them. Moreover, the quality of her life will improve to a certain extent.