Types of female hormonal drugs. Features of indications and contraindications

Prescribing hormonal medications often frightens people. There are many myths surrounding hormones. But most of them are completely wrong.

Myth 1: Hormonal drugs are special birth control pills for women.

No. Hormonal drugs are drugs obtained synthetically. They act similar to natural hormones produced in our body. There are many organs in the human body that secrete hormones: female and male genital organs, glands internal secretion, central nervous system and others. Accordingly, hormonal drugs can be different, and they are prescribed for a wide variety of diseases.

Female hormonal preparations (contain female sex hormones) may or may not have a contraceptive effect. Sometimes, on the contrary, they normalize hormonal background and promote pregnancy. Preparations containing male sex hormones are prescribed to men when the quality of the ejaculate decreases (that is, sperm motility), hypofunction, or a decrease in the level of male sex hormones.

Myth 2: Hormones are prescribed only for very severe illnesses

No. There are a number of mild diseases for which hormonal drugs are also prescribed. For example, decreased function thyroid gland(hypofunction). Doctors often prescribe hormones in this case, for example, thyroxine or euthyrox.

Myth 3: If you don’t take a hormonal pill on time, nothing bad will happen

No. Hormonal medications must be taken strictly according to the clock. For example, a hormonal birth control pill is valid for 24 hours. Accordingly, you must drink it once a day. There are medications that you need to take 2 times a day. These are some male sex hormones, as well as corticosteroids (for example, dexamethasone). Moreover, it is recommended to take hormones at the same time of day. If you take hormones irregularly, or forget to drink them altogether, the level of the necessary hormone can drop sharply.

Let's give an example. If a woman forgot to take a hormonal contraceptive pill, the next day she should take the forgotten evening pill in the morning, and the next pill in the evening of the same day. If the interval between doses is more than a day (remember: a hormonal contraceptive pill is valid for 24 hours), then the level of hormones in the blood will decrease very significantly. In response to this, minor bloody issues. In such cases, you can continue taking birth control pills, but use additional protection for the next week. If more than 3 days have already passed, you need to stop taking hormones, use other contraceptives, wait until your menstruation arrives and additionally consult a doctor.

Myth 4: If you take hormones, they accumulate in the body

No. When a hormone enters the body, it immediately breaks down into chemical compounds, which are then excreted from the body. For example, a birth control pill breaks down and leaves the body within 24 hours: that is why it needs to be taken every 24 hours.

However, hormonal drugs continue to “work” after they are no longer taken. But they influence indirectly. For example, a woman takes hormonal pills for several months, then stops taking them, and in the future she has no problems with her cycle.

Why is this happening? Hormonal medications act on different target organs. For example, women's birth control pills affect the ovaries, uterus, mammary glands, and parts of the brain. When the pill “leaves” from the body, the mechanism that it started continues to work.

Need to know: The mechanism of prolonged action of hormones is not associated with their accumulation in the body. This is simply the principle of action of these drugs: to “work” through other structures of the body.

Myth 5: Hormonal medications are not prescribed during pregnancy

Discharged. If before pregnancy a woman had hormonal disorders, then during gestation she requires medicinal support so that the production of female and male hormones was normal, and the child developed normally.

Or another situation. Before the woman became pregnant, everything was fine, but when she got pregnant, something suddenly went wrong. For example, she suddenly notices that intense hair growth has begun from the navel down and around the nipples. In this case, you should definitely consult a doctor who can prescribe a hormonal examination and, if necessary, prescribe hormones. Not necessarily female sex hormones - these could be, for example, adrenal hormones.

Myth 6: Hormonal drugs have a lot of side effects, primarily weight gain

No medications at all side effects practically never happens. But we need to distinguish side effects, which do not require discontinuation of the drug. For example, swelling of the mammary glands when taking contraceptive hormones is considered a normal phenomenon. Scanty bleeding in the first or second months of use during the intermenstrual period also has the right to occur. Headache, dizziness, weight fluctuations (plus or minus 2 kg) - all this is not a pathology or a sign of a disease. Hormonal drugs are prescribed for a fairly long period. By the end of the first month, the body adapts and everything returns to normal.

But so that it doesn't really happen serious problems associated, say, with blood vessels, before prescribing a medicine and while taking it, it is imperative to be examined and tested. And only a doctor can prescribe you a specific hormonal drug that will not harm your health.

Myth 7: There is always an alternative to hormones

Not always. There are situations when hormonal drugs are irreplaceable. Let's say a woman under 50 has had her ovaries removed. As a result, she begins to age and lose health very quickly. In this case, her body must be supported with hormone therapy until she is 55-60 years old. Of course, provided that her underlying disease (due to which the ovaries were removed) has no contraindications to such a prescription.

Moreover, for some diseases, even a neuropsychiatrist can strictly recommend female sex hormones. For example, with depression.

For treatment wide range diseases, various hormonal drugs are very often used, which, in addition to high efficiency, have a number of side effects.

If used incorrectly, they can be very dangerous and can also aggravate the patient's condition.

Harm of hormonal drugs: truth or myth^

Hormones are products of internal secretion that are produced by special glands or individual cells, are released into the blood and spread throughout the body, causing a certain biological effect.

In a healthy person, hormones are continuously produced by the endocrine glands. If a malfunction occurs in the body, synthetic or natural analogues come to the rescue.

Why you shouldn’t be afraid of hormones: benefits and harms

Treatment with hormones has been used in medicine for more than a century, but people still treat it with fear and mistrust. Despite the fact that the use of drugs containing hormones can reverse the course of a serious illness and even save lives, many consider them harmful and dangerous.

Patients of endocrinologists are often panicky afraid of the word “hormones” and unreasonably refuse to take hormonal medications, fearing side effects such as excess weight and hair growth on the face and body. Such side effects actually occurred during treatment with first-generation drugs, since they were of low quality and contained too large doses of hormones.

But all these problems are a thing of the past - pharmacological production does not stand still and is constantly developing and improving. Modern medicines are becoming increasingly better and safer.

Endocrinologists, in accordance with the test results, select the optimal dose and regimen for taking the hormonal drug, which imitates the function of the gland as in a healthy person. This allows you to achieve compensation for the disease, avoid complications and ensure wellness patient.

Today, hormonal preparations are produced, both natural (having a structure similar to natural hormones) and synthetic (having an artificial origin, but having a similar effect). Depending on their origin, they are divided into several types:

• Animals (derived from their glands);
• Vegetable;
• Synthetic (similar in composition to natural ones);
• Synthetic (not similar to natural ones).

Hormonal therapy has three directions:

1. Stimulating - prescribed to activate the glands. Such treatment is always strictly limited in time or applied in intermittent courses.
2. Blocking - necessary when the gland is too active or when unwanted tumors are detected. Most often used in conjunction with radiation or surgery.
3. Replacement - required for diseases that inhibit the production of hormones. This type Treatment is often prescribed for life, since it does not affect the cause of the disease.

The most common misconceptions about hormone therapy

Truths and myths about the dangers of hormones

Myth-1: Hormonal drugs are prescribed only as contraceptives

In fact, these drugs effectively fight many pathologies: diabetes, hypothyroidism, skin diseases, infertility, cancer and other ailments.

Myth-2: If your health improves, you can stop taking hormones

Such a misconception often cancels out the long-term work of doctors and provokes a rapid return of the disease. Any changes to the dosage schedule must be agreed with your doctor.

Myth-3: Hormone therapy is prescribed as a last resort in the treatment of serious illnesses

In modern pharmacology, there are many drugs of similar composition to get rid of diseases that do not pose a threat to the patient’s life, for example, acne in teenagers or erectile dysfunction in men.

Myth-4: During pregnancy, taking any hormones is contraindicated.

In reality, expectant mothers are so medicines are prescribed quite often, and refusing them on your own can lead to serious consequences. For example, when carrying out tocolytic measures or with hypofunction of the thyroid gland (replacement therapy).

Myth-5: When replacement therapy hormones accumulate in tissues

This opinion is also incorrect. A correctly calculated dosage does not allow an excess of these substances in the body. But in any case, they are easily destroyed and cannot remain in the blood for long.

Myth-6: Hormones can be replaced with other medications

If a deficiency of a certain hormone is diagnosed, then it is this hormone that needs to be taken to restore health. Some plant extracts have similar effect, but they cannot fully replace endocrinological drugs. In addition, their long-term exposure is undesirable due to the risk of allergic reactions.

Myth-7: Hormones make you fat

Excessive fatness does not arise from hormones, but from hormonal imbalance and metabolic disorders, which result in nutrients begin to be absorbed by the body incorrectly.

Myth-8: In spring, the level of sex hormones increases

Human endocrine functions are subject to both seasonal and daily cycles. Some hormones are activated at night, others during the day, some during the cold season, others during the warm season.

According to scientists, the level of human sex hormones does not have seasonal fluctuations, however, with increasing daylight hours in the body, the production of GnRH, a hormone with an antidepressant effect, increases. It is he who can evoke feelings of love and euphoria.

Myth-9: Young people are not at risk of hormonal imbalance

Violation hormonal balance in the body can occur at any age. The reasons are different: stress and excessive loads, past illnesses, healthy image life, taking the wrong medications, genetic problems and much more.

Myth-10: Adrenaline is a “good” hormone, its sharp release benefits a person

Hormones cannot be good or bad - each is useful in its own time. The release of adrenaline really stimulates the body, allowing it to cope faster. stressful situation. However, the feeling of a surge of energy is replaced by a state nervous exhaustion and weaknesses, because adrenaline directly affects nervous system, sharply bringing it into combat readiness, which necessarily causes a “rollback” later.

The cardiovascular system also suffers: it increases arterial pressure, the pulse quickens, and there is a risk of vascular overload. That is why frequent stress, accompanied by an increase in adrenaline in the blood, can lead to a stroke or cardiac arrest.

What are the types of hormonal drugs?

According to the method of action, hormonal drugs are divided into:

• Steroids: act on sex hormones and substances produced by the adrenal glands;
• Amine: and adrenaline;
• Peptides: insulin and oxytocin.

Steroid drugs are the most widely used in pharmacology: they are used to treat serious diseases and HIV infections. They are also popular among bodybuilders: for example, Oxandrolone and Oxymethalone are most often used to give the body definition and burn subcutaneous fat, and Stanozolol and Methane - for gaining muscle mass.

In both cases healthy people the drugs cause irreparable harm, so it is not recommended to take them without indications. AAS are based on the hormone testosterone, and for women they are most dangerous: with long-term use, they may develop primary male sexual characteristics (virilization), and the most common side effect is infertility.

What side effects can occur from taking hormones?

Most often side effects hormonal drugs appear in the first two weeks after starting treatment in the form of the following ailments:

• Dizziness and nausea;
• Sweating;
• Shortness of breath, lack of air;
• Tides;
• Candidiasis;
• Drowsiness;
• Deterioration of blood composition;
• Virilization (when women take steroids);
• Hypertension;
• Intestinal dysfunction.

In very rare cases, long-term use of “hormones” or their abuse can cause the development of cancer. To avoid this, you need to periodically undergo tests and do liver tests to monitor your health.

Side effects of hormonal drugs in women: what to watch out for ^

Side effects of hormonal contraceptives

When choosing hormonal method contraception, it is important to take into account all the features hormonal status women. Find out which hormone levels predominate in the body: estrogen or progesterone, whether there is hyperandrogenism ( higher level male sex hormones), which are accompanying illnesses etc..

This method of contraception is used by women quite often, because considered one of the most effective. In most cases negative reactions does not occur, however, there are side effects of birth control pills that can occur if taken for a long time or incorrectly in violation of the instructions:

• Arterial hypertension;
• Anemia;
• Acute renal failure;
• Porphyria;
• Hearing loss;
• Thromboembolism.

The most popular birth control pills are: Qlaira, Regulon, Jess, Tri-Regol. On the contrary, Duphaston is most often used to treat infertility.

Microdosed hormone pills

Side effects of hormonal ointments

Most often, such ointments are used to treat skin diseases: dermatitis, vitiligo, psoriasis, lichen, as well as allergies with the manifestation external signs. What side effects may occur due to ointments:

• Striae, acne;
• Atrophy of the skin treated with the product;
• Dilatation of blood vessels;
• The appearance of spider veins;
• Skin discoloration (temporary).

Prednisolone, which is available in the form of tablets or ointments, is considered the safest and most effective.

Hormonal drugs for menopause

Hormonal therapy during menopause helps improve lipid metabolism, soften hot flashes, reduce anxiety, increase libido and prevent the development of atherosclerosis, but should only be done under the supervision of a doctor. Which negative impacts may occur during self-treatment:

• Sudden weight gain;
• Fluid retention in the body, the appearance of edema;
• Breast engorgement;
• Severe headaches;
• Stagnation of bile.

Hormonal drugs for bronchial asthma

Treatment of this disease hormones are prescribed in very rare cases for several reasons:

• Hormonal dependence and withdrawal syndrome may occur when therapy is stopped;
• Immunity is noticeably reduced;
• Increased bone fragility;
• The production of insulin and glucose is destabilized, which is fraught with the development of diabetes mellitus;
• Concerned about hair loss;
• Muscles weaken;
• Intraocular pressure increases;
• Fat metabolism is disrupted.

Of course, such a side effect does not always occur, but to avoid it, it is best to start treatment with weaker medications.

It is worth noting that almost all hormonal agents affect thyroid or adrenal hormones, so their use should be agreed with a specialist. In general, if the dosage regimen is followed, side effects occur very rarely, but such medications are still not prescribed unless absolutely necessary.

The drugs do not cause tumor formation. However, if there is oncological diseases Such drugs can stimulate them further development. Therefore, before you start taking pills, go through the full examination. Please note that hormone therapy requires caution.

As is known, endocrine system each of us is a kind of “hormonal skeleton” of our body, while all the glands that produce hormones, regardless of their location, are in close interconnection, providing everything essential functions, both physical and psycho-emotional.

Our mental capacity, and general well-being, and appearance, and mood, and proper digestion, and sleep, etc.

In the event that for any reason the body experiences hormonal disbalance, in which the production of hormones is disrupted in one direction or another, then the person is prescribed appropriate treatment.

When planning a pregnancy

Lack of hormones poses a particular danger in situations where a woman dreams of motherhood, but, unfortunately, the lack female hormones estrogen may interfere with conception and normal development fetus

For this reason, in the case when the desired pregnancy does not occur, the woman needs to be examined by an endocrinologist, and this must be done even when everyone else physical indicators hers are within normal limits.

In some cases, a woman may be prescribed hormones that serve as a stimulator for egg maturation. Hormone therapy can prevent or minimize the likelihood of miscarriage.

Of course, before using hormonal therapy, you should contact more simple ways, capable of intensifying work endocrine glands, after all, it is likely that the functional failure is insignificant.

Sometimes it is enough to normalize your diet, ensure sufficient physical activity, visit more fresh air etc., that is, lead a healthy lifestyle.

It is also necessary to remain calm, since fatigue and chronic stress reduce the likelihood of conception by half. The fact is that these factors negatively affect the functioning of the adrenal glands, which, in turn, begin to produce hormones that are not necessary for the maturation of the egg.

For contraceptive purposes

One cannot fail to mention the category of women who use hormonal therapy to prevent unwanted pregnancy.

Moreover, oral contraceptives in our pharmacies you can purchase without much difficulty, and low content hormones in them can prevent not only the onset of pregnancy, but also help in solving problems with overweight, liver, blood vessels.

Of course, no one can give an absolute guarantee that pregnancy can occur, but gynecologists still admit that birth control pills are one of the most reliable means.

By the way, such oral hormonal drugs are often prescribed when gynecological problems ah, for example, with ovarian dysfunction, absence of menstruation (amenorrhea) in adolescence and so on.

However, there is one significant “but”: long-term use of drugs this kind can “wean” the body from independent work, as a result of which it will simply stop producing necessary hormones in the required quantity.

Ultimately, this development of events is fraught with ovarian dysfunction, and, as a consequence, premature aging. For this reason important To determine “your” drug, you need to consult a specialist and conduct an examination, which involves performing the necessary tests.

If you start taking one or another oral contraceptive uncontrollably, this can cause serious gynecological problems, including problems with conception.

If at this time it is determined that the body continues to function normally without taking medications, then you can return to their further use.

If you want to prolong youth

During the period of extinction reproductive function, in order to prolong youth, some ladies also resort to hormone replacement therapy.

This method was especially popular in the USA and Great Britain in the sixties of the last century. But, at present, experts are skeptical about this method of prolonging youth, since, in their opinion, the use of hormonal drugs can provoke the development of breast and ovarian cancer, and also promotes the process of blood clots.

At the same time, some researchers are inclined to believe that the intake of additional amounts of estrogen into the female body is a good prevention of the development of osteoporosis, because this hormone prevents the leaching of calcium from the body. These arguments are put in opposition to those who argue that hormone therapy can cause more harm than good.

Nevertheless, if you, for whatever reason, decide to use hormonal therapy, first of all, clearly understand for yourself for what purpose you need it. So, for example, in the case of a complex course of menopause, accompanied by hot flashes, excessive sweating, emotional swings, taking medications of this kind is completely justified.

But if the motives are only to postpone impending old age indefinitely, then in this case it will be more effective and safer to visit a psychologist and conduct a course of psychotherapy.

And if, for one reason or another, you have to take hormonal drugs for a long time, then you must first undergo a full examination, which in the future must be repeated every six months. The total duration of hormone replacement therapy should not exceed three to five years.

So you should still be careful when using hormonal treatment. Some gynecologists advise giving preference not to tablets, but to patches, suppositories, and gels, since these products contain fewer hormones.

The word “hormones” causes fear in 60% modern women. This fact is not surprising: hormone therapy is indeed quite serious and often not harmless therapeutic event. The dangers of hormonal drugs are often talked about a lot, while their benefits are rarely remembered. But few people think that hormonal therapy can significantly improve a person’s quality of life, and sometimes even support this very life (with diabetes mellitus, thyroid diseases, bronchial asthma etc.).

Are hormonal pills harmful?

Just as hormones differ from hormones, hormonal agents differ in the degree of positive and negative influence on the body. The balance of harm and benefit of hormonal drugs is determined by the type of hormone, its concentration, frequency, duration and method of application.

Yes, of course, hormonal drugs bring certain harm body. But, as a rule, they do not cause more harm to health than the disease for which this drug is used. Today there are diseases that cannot be treated without hormones.

Why are hormonal drugs harmful?

It is necessary to clearly understand that hormonal drugs of the 21st century cannot be compared with hormonal agents XX century. If our mothers associated the phrase “hormonal treatment” with excess weight, swelling, unnatural hair growth, then in our time such side effects are minimized. But it is important to understand that the harm from using a hormonal drug will be minimal only if it is correct selection.

So, why are hormonal drugs harmful? To answer this question, you just need to read the instructions for use for a specific product. In the “Side Effects” section, as a rule, the entire range of possible (but not obligatory) side effects is indicated, among them the classic ones: metabolic disorders, weight gain, excessive hair growth, skin rashes, disruption of the gastrointestinal tract and more.

Harm and benefits of hormonal contraceptives

Hormonal therapy in women most often involves treatment with oral contraceptives (OCs), the main purpose of which is contraception, and therapeutic effect achieved as a positive side effect. Discussions about the benefits and harms of hormonal contraceptives have been ongoing for many years.

Some theorists and practitioners of medicine, including alternative medicine, are categorically against the use of medical practice hormonal contraceptives, as they cause irreparable harm female body in the form of: suppression of ovarian function, changes in the natural background of a woman, dangerous side effects.

Another part of the experts claims, and numerous Scientific research confirm that everything written above has nothing to do with modern OK. Huge doses of hormones contained in the first generations of hormonal preparations caused serious harm to the female body. Improved new generation OKs are different soft action due to maximum purification and minimal quantitative hormone content. While taking OK:

The benefit-risk ratio when taking hormonal contraceptive pills is clearly positive.

And on frequently asked question women: “Why are hormonal pills harmful?” the following answer can be given: in the absence of contraindications, provided correct setting diagnosis and correct selection of the drug - practically nothing. During the first three months of use (the period of adaptation to the drug), side effects are possible: nausea, headaches and dizziness, engorgement of the mammary glands, mood swings, decreased sexual desire.

Hormonal contraception is modern look protection against unwanted pregnancy, widespread throughout the world. Millions of women trust this method, making no mistake in their choice.

The principle of action of hormonal contraceptives is the complex effect of analogues of natural female sex hormones on the body: suppression of ovulation, thickening of cervical mucus and changes in the structure of the endometrium. Suppression of ovulation prevents the maturation and release of the egg, which prevents fertilization. Changes in mucus prevent sperm from entering the uterine cavity. Even if fertilization has occurred, then ovum will not be able to gain a foothold due to the special structure of the endometrium.

These 3 mechanisms provide reliable protection against pregnancy - according to WHO (World Health Association), with correct use the effectiveness is close to 100%, however, irregularities in taking (skipping pills, taking other medications, violating the regimen) can lead to conception, which is reflected in the statistical data.

There are also men's hormonal contraceptives, but their use has not yet entered into widespread practice. The “universal tablet” is at the development stage, and existing schemes Taking hormones causes serious harm to health.

Any drug must be selected individually, since there is no universal method no flaws. Many of the pros and cons of hormonal contraceptives are similar, since they all contain similar active ingredients.

pros hormonal contraception:

• high reliability;
• independence from the time of sexual intercourse;
• reversibility of the method;
• low incidence of side effects.

In addition, there are non-contraceptive benefits:

• reducing the risk of developing ovarian and endometrial tumors;
• weakening of premenstrual syndrome;
• treatment of dysmenorrhea;
• reducing the abundance of menstruation (prevention and treatment of iron deficiency anemia);
• treatment of acne, hirsutism, seborrhea (when using COCs with an antiandrogenic effect);
• treatment of endometriosis.

Minuses:

• does not protect against sexually transmitted diseases;
• the need for regular use;
• the possibility of serious complications;
• many contraindications;
• incompatibility with some medications.

Classification by shape

Based on the method of delivering the hormone to the body, we can distinguish:

• pills;
• injections;
• subcutaneous implants;
• skin patches;
• vaginal rings;
• hormone-containing intrauterine devices(Navy).

Classification by hormonal composition

Here is a classification of hormonal contraceptives according to the hormones used:

• Combined means. Contains estrogen and progestogen components. Typically these are combined oral contraceptives (COCs), patches, vaginal rings or injections (CIC).
• Not combination drugs. They do not contain estrogens - mini-pills, implants, spirals, single-component injections.

Pills (oral contraceptives)

One pack of tablets is designed for 1 cycle, most often containing 21 or 28 tablets. Should be taken from the 1st day of the cycle. If there are 21 tablets, then a seven-day break is needed before a new pack; if there are 28, a break is not required. Combined tablets are mono- and polyphasic, depending on the dosage of hormones by day of the cycle. Depending on the amount of estrogens, high-, micro- and low-dose hormonal contraceptives (COCs) are distinguished.

These drugs are often used in gynecology to treat endometriosis, functional cysts ovaries, dysmenorrhea, infertility. New generation hormonal contraceptives are indicated for hirsutism, acne, seborrhea and can be prescribed even to girls who are not sexually active.

Combination medications must be taken daily. Efficiency is high - more than 99%. If you miss a pill, you should refer to the instructions for use and strictly follow the instructions - this will eliminate the possibility of pregnancy.

Unfortunately, if more than 2 tablets are missed dangerous days, the probability of pregnancy is quite high. When taking other medications, you need to carefully study the instructions - they may reduce the contraceptive effect.

Contraindications for hormonal contraception with combined pills:

• lactation period;
• age over 35 years, especially in combination with smoking;
• vascular diseases, migraines;
• thrombosis, diseases of the blood coagulation system;
• malignant breast tumors;
• liver diseases.

Another type of tablet - "mini-drink". They contain only a gestagenic component, which significantly reduces the number of contraindications and side effects. The peculiarity of taking pills is strictly at the same time of day, otherwise the contraceptive effect may be reduced.

Reliability is somewhat lower than that of COCs, but the lack of systemic effects of estrogens on a woman’s body makes them safer and expands the range of patients to whom oral contraception can be recommended. When prescribing hormonal contraception after 40 years, during breastfeeding, with a risk of thrombosis, attention is often paid to progestin drugs.

Contraindications:

• mammary cancer;
• migraine;
• functional cysts.

A special type of oral contraception - postcoital drugs. This is one or two tablets with high content gestagen analogue. Taken in emergency cases within 72 hours after sexual intercourse.

Contraindications:

• age up to 16 years;
• severe liver disease;
• pregnancy.

Injection contraception

Injections are one of the long-acting methods of hormonal contraception. Combination drugs (CICs) and progestogens are used. CIC (for example, Cyclofem, Mesigina) is administered medical worker Once a month from 1 to 7 days of the cycle, the effect develops after 24 hours and lasts 30 days. After discontinuation of the drug, pregnancy is possible in the first month. Contraindications for use: breastfeeding, venous diseases and of cardio-vascular system, liver.

Progestin drugs (Depo-Provera) are well tolerated and have high degree protection (0–1 pregnancy per year per 100 women). Administered intramuscularly once every 3 months. The disadvantage of the drug is that the ability to fertilize is restored about 9 months after discontinuation of hormonal contraceptives.

Intrauterine device

The hormonal IUD is a small plastic T-shaped tube coated with copper. It is inserted into the uterine cavity through the cervix, securely fastening inside. It is recommended for use by women who have already given birth, since any intervention in the uterine cavity in nulliparous women can lead to secondary infertility.

Spirals are designed to last for several years. They are installed and removed by a gynecologist without anesthesia. Reliability is close to 100%, since the local effect of the spiral is combined with the general hormonal effect.

Contraindications:

• deformation of the cervix and uterine cavity;
• history of ectopic pregnancy;
• mammary cancer;
• functional cysts.

How hormonal contraception is selected

The use of hormonal contraception is contraindicated without consulting a gynecologist! Very often the question is asked how to choose hormonal contraceptives on your own. There is a clear answer to this: you shouldn’t do this. All hormonal drugs have wide list indications and contraindications, therefore the doctor should select the remedy after a thorough history taking and (at a minimum) examination on the chair.

After consultation, the specialist will decide whether it is necessary additional examination(blood for hormones, ultrasound, coagulogram) and will prescribe the best hormonal contraceptives for a specific case.

The table for selecting hormonal contraceptives based on phenotype will help you guess which product is right for you.

Hormonal contraceptives for breastfeeding: mini-pills, subcutaneous implants, intrauterine devices and progestin injections. The same products are recommended for women over 40 years of age or smoking women after 35.

Possible reactions and side effects of hormonal contraception

Side effects of hormonal contraceptives in healthy women are observed extremely rarely, but you need to be aware of the symptoms, if they appear, you should urgently consult a doctor and stop taking the medications:

• the onset of pregnancy;
• sudden visual disturbances;
• the need for surgical interventions;
• jaundice;
• the appearance of thrombosis;
• severe migraine;
• breakthrough bleeding;
• sudden weight gain;
• the appearance of tumors in the breast;
• increase in fibroids.

There are a number side effects, which may appear normally. They usually go away within 2–3 months from the start of therapy. These include:

• spotting when taking hormonal contraceptives;
• absence of menstruation;
• decreased libido;
• distortion of tastes and smells;
• the appearance of skin problems (for example, acne);
• mild headaches.

Remote side properties appearing in a small number of women:

• amenorrhea after taking hormonal contraceptives;
• long-term restoration of fertility;
• irregular cycle;
• if antiandrogen drugs were taken, resumption of acne, hirsutism.

General principles of withdrawal of hormonal contraception and the body's reaction

Most contraception can be canceled on your own - stop taking the pills, stop using the patch or ring at the end of the cycle. Only a doctor can remove the spiral and implant. It is recommended to take a break from taking hormonal contraceptives every five years. In some cases, the doctor may recommend a different treatment regimen, and then you need to follow the instructions.

The ability to get pregnant is restored in different ways: after stopping the pills, vaginal ring and patch, fertility returns almost immediately, when using injections, implants, IUDs - within 9 months.

During pregnancy, hormonal contraceptives are canceled immediately, but even if pregnancy is diagnosed late, most drugs do not harm the fetus. The main thing to remember is that many methods of contraception increase the risk of ectopic pregnancy.

Thus, hormonal contraception is a modern, highly effective way of protecting against unwanted pregnancy. It is suitable for women who have a regular sexual partner as the only method protection, as well as for those who want 100% protection in combination with a condom. What are the dangers of hormonal contraceptives? Like any medicine, they have their contraindications, and if you do not forget about them, the danger of hormonal contraception tends to zero.

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