The effect of hormonal drugs on men's health. What do hormone pills do

Hormonal contraception has been the main method of family planning in the developed countries of Europe and America since the mid-twentieth century.

Every second woman uses hormonal contraceptives to prevent pregnancy. there are more than two dozen drugs, which allows you to choose the most suitable for this woman.

There are two types of drugs: tablet and parenteral. The most common forms of contraceptives are birth control pills. They are divided into means for planned contraception (mini-pill) and emergency drugs. At the heart of all contraceptives is the suppression of the production of female sex hormones, but each drug has its own characteristics.

It should also be remembered that birth control pills have an ambiguous effect on a woman's body. Everyone is familiar with such phenomena as weight gain or increased hair growth in unwanted areas of the body.

The harm and benefits of hormonal contraceptives are individual and depend on the current state of the woman's health.

Hormonal contraceptives: how do they work?

Contraceptives contain synthetic hormones estrogen and progesterone, which prevent the maturation of the egg and its release into the uterine cavity. On the other hand, contraceptives do everything so that the sperm does not gain a foothold in the uterus: they thicken the mucus in the vagina and change the structure of the endometrium. The effectiveness of hormonal contraceptives is very high - 98%. But in 2 out of 100 cases, pregnancy can still occur.

It is believed that women can take birth control pills all the time, if there is a need for it, without harm to health. Is it so?

Harm of oral contraceptives

Many believe that hormonal contraceptives do not harm the body, since the dosage of hormones is negligible. But you should carefully read the instructions for the drugs to see possible side effects. These include, for example, the following:

1. Milk production, soreness and engorgement of the mammary glands.
2. Violation of the menstrual cycle, bleeding between periods.
3. Change in natural sex drive.
4. Dryness in the vagina.
5. Migraine.
6. Depression, irritability.
7. Vomit.
8. Skin pigmentation, allergies.

Any of these side effects can seriously ruin a woman's life.

The list of contraindications for taking hormonal contraceptives also inspires serious concerns about their safety:

1. Increased blood clotting, as life-threatening thrombosis occurs.
2. Increase in blood pressure.
3. Condition after surgery.

Also, taking hormonal contraceptives is not compatible with smoking.

In addition, not every woman is aware of the existence of blood clots in the vessels, which, even with a special examination, cannot always be detected. Therefore, before taking hormonal contraceptives, you should definitely visit a doctor and pass the tests recommended by him. This will help both to choose the most suitable drug, and to avoid a threat to life. And even more so, you can’t take hormonal contraceptives on your own, unless a specialist recommends doing so.

Benefits of oral contraceptives

Among women's diseases, pathologies associated with a violation of hormonal regulation are common: irregular periods, ovarian cysts, polyps, etc. There are other gynecological problems for which hormonal contraceptives may be prescribed. Acne brings a lot of "grief" to girls, which for many is associated with an excess of male sex hormones, androgens.

As a rule, in the case of using hormonal contraceptives in the treatment of any diseases, they are taken for a short time, in a course. Within a month from the start of treatment, acne disappears, the pores are cleared. The menstrual cycle also normalizes in about 1-3 months.

The effect of birth control pills on the body

The hormonal system is part of the endocrine system. Its work is controlled by the brain (pituitary and hypothalamus). But as a result of taking birth control pills, the work of the endocrine system changes. The connection between the brain centers and the ovaries becomes not so unambiguous. This leads to a change in the work of their own organs, which are associated with female sex hormones. In particular, the production of its own estrogen and progesterone decreases. Therefore, after the abolition of hormonal pills, the body needs at least 3 months to restore the reproductive system.

What is the danger?

The hormones used for contraception are different from those naturally produced by the female body. However, when they are taken, a signal is sent to the brain that there are hormones and there is no need to synthesize them anymore. There comes a “calming down” of the work of the centers that are responsible for the regulation of estrogen production. The ovaries also seem to fall asleep. Their nutrition is disturbed, which leads to tissue degeneration and size reduction. The structure of the endometrium is disturbed, there is a predisposition to oncological diseases. With prolonged use of hormonal contraceptives, a woman, even after cancellation, cannot become pregnant for a long time, sometimes it is necessary to resort to artificial insemination methods. In addition, hormonal contraceptives affect blood viscosity (it becomes more prone to blood clots) and the state of blood vessels (the conductivity of small capillaries worsens). Synthetic hormonal contraceptives can provoke breast cancer.

Another disadvantage of taking hormonal contraceptives is obesity. This is a common side effect of hormonal drugs. Birth control pills increase blood glucose levels, which leads to overproduction of insulin and metabolic disorders.

Contraceptive pills: to take or not to take?

Each woman chooses those methods of contraception that are most suitable for her, according to her lifestyle and state of health.

It is clear that modern hormonal contraceptives are much safer than those used twenty years ago. But they also have contraindications and serious side effects. Therefore, before taking contraceptives, you should visit a gynecologist, take the tests recommended by the doctor, and be honest about chronic diseases. Only then can your doctor tell you if you are allowed to take hormonal pills or if you should use other methods of contraception.

It is important to remember that hormonal contraceptives only protect against conception, but do not protect against sexually transmitted diseases. It is worth thinking about this aspect of contraception when deciding whether or not to take hormonal pills.

And, of course, when taking hormonal contraceptives, care should be taken to minimize their side effects. In particular, taking antioxidants will help neutralize the negative effect of hormonal pills on blood viscosity and blood vessels.

« If there are facts that contradict the theory,

then you need to refute the theory and accept the facts "

Claude Bernard

But not every woman thinks about the mechanism of action of these pills, what effect they have on the body as a whole, and what consequences await you after prolonged use.

Usually hormones (replacing female sex hormones) are prescribed to a large number of women in order to:

• contraception;
• stimulation of ovulation;
• "treatment" of ovarian cysts,
• and recently began to be prescribed to young girls in order to improve the quality of the skin (for acne).

It's time to talk about the essence of the action of these drugs

Oral (those taken by mouth) hormonal contraceptive (preventing conception) drugs are tablets for daily use. Each tablet contains analogues of female sex hormones.

The mechanisms of action of drugs are not fully understood. The contraceptive effect occurs as a result of the sum of changes in the woman's body from the action of hormones:

• violation in the process of egg maturation and, accordingly, ovulation (the release of a mature egg from the ovary into the fallopian tube);
• violation maturation of the endometrium (the mucous layer of the uterus), resulting in implantation, i.e. attachment of a fertilized egg is impossible;

It must be understood that a hormonal drug affects all levels of the female body, from mood to the genitals, in which there are receptors for these hormones (cervix, tubes, ovaries, uterus).

Now, after many years of mass use of these drugs, we can talk about their side effects, which, unfortunately, they forgot to indicate in the instructions for use.

Consequences of long-term use of contraceptives (more than 5 years):

• Common infertility in women. I call this situation "my ovaries retired." When a woman takes hormonal contraceptives, her own ovaries receive the information that it is not necessary to produce hormones and stop doing it forever.

• A large number of complications in childbirth. Discoordination of labor activity, weakness of labor activity, relocation, placental abruption and others. Why do you think?

Yes, because childbirth is a well-coordinated process that is regulated by the timely release of various hormones. From long-term use of synthesized hormones, this delicate connection in the body is disrupted. Harmony broken! Where is there to talk about natural childbirth!

• More frequent birth of children with Down syndrome.

Of course there are more complications that you can read in the annotation to the drug:

• thromboembolism (blockage of blood vessels leading to strokes) occurs due to an increase in blood viscosity;
• liver disease;
• increases the risk of cervical cancer with the use of drugs, in particular in women who smoke.

In conclusion, I want to give you a document:

Statement of the Moscow Society of Orthodox Doctors in connection with the widespread advertising of hormonal contraceptives

Advertising of hormonal contraceptives is based on profit, not medical in nature, and aims to make a profit from their sale. The claim that hormonal contraceptives are safe is not true and is driven by commercial considerations.

We, Orthodox doctors in Moscow, are concerned about the aggressive planting of commercial advertising of hormonal contraceptives in Russia. Guided by our Christian and medical duty, we consider ourselves obliged to warn the population of the country that hormonal contraceptive pills have a negative impact on health, lead to various complications and can cause serious and incurable diseases, including cancer, and infertility. When taking these drugs, there is also a risk of severecomplications in future children.

In addition, when taking any hormonal contraceptives, the death of an already conceived child at an early stage of embryonic development is possible.

Making and selling hormonal contraceptives is big business. All antenatal clinics are "lured" by medical representatives of the companies producing these pills. Doctors are given various gifts, prize promotions are held - all for the mass prescription of their drugs.

In family planning offices, you and very young girls will be taught to take these pills supposedly for a good purpose - "family planning" and the prevention of abortion.

But the deeper meaning of the mass distribution of these drugs is not money.

These are drugs that lead to the undermining of a woman's health. The responsibility of women and men to each other at the beginning of "close" relationships disappears, which, in turn, leads to "free" sexual relationships. And all this in its depths devalues ​​family relationships.

For the article, I used materials from the book "At the reception at the antenatal clinic" by Kirill Anatolyevich Ivanov, Arkady Ivanovich Tanakov, Konstantin Yuryevich Boyarsky.

These are the facts that make us think about our own health. I was prompted to write this article for you by the large number of complications in childbirth in women who have taken hormones. Because later, when you are treated with infertility, placental abruption, and so on, all the damaging effects of hormone therapy cannot be eliminated from the body in an instant.

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The level of development of modern medicine makes it possible to prevent unwanted pregnancies. Proper use of contraceptives guarantees a woman the right to have a child when she is ready for it.

For nulliparous women, a properly selected contraceptive is not dangerous. Analyze the harm and benefit of contraceptive pills is necessary, taking into account the characteristics of a particular drug. These drugs are taken only after consulting a gynecologist-endocrinologist.

Action

Oral contraceptives (OCs) contain the main hormones that regulate the uterine cycle and a woman's ability to conceive a child. The composition is:

• combined (COC) - based on estradiol and progesterone;
• mini-pill - based on progesterone.

According to the concentration of hormones, combined preparations are:

• microdosed;
• low-dose;
• medium dosed;
• highly dosed.

Depending on the content of hormones, OK is divided into:

• on monophasic (the content of estradiol and progesterone in all tablets is the same);
• biphasic (tablets contain a constant amount of estradiol and a varying amount of progesterone depending on the day of the cycle);
• three-phase (the amount of estradiol and progesterone in tablets corresponds to the day of the menstrual cycle).

The advantages of modern drugs in the absence of side effects (weight gain, neoplasms, body hair growth), which were observed with the first oral contraceptives. These drugs appeared in 1960 and contained a large amount of female hormones.

The latest generation of hormonal pills "mini-pill" is recommended for women over 35 who are contraindicated in estrogens. Their reception is allowed even to smoking patients. Bleeding between periods is not an indication for contraceptive withdrawal.

Small doses of hormones contained in OK have a therapeutic and prophylactic effect:

• prevent the development of malignant tumors of the organs of the reproductive system, infertility;
• regulate the uterine cycle;
• relieve premenstrual syndrome;
• relieve pain during menstruation;
• improve skin condition.

Contraceptive hormonal pills are prescribed to a woman in special conditions:

• in mini-pills;
• COCs are included in therapeutic measures after artificial termination of pregnancy or miscarriage;
• OK for violations of the uterine cycle, for the prevention of endometriosis (growth of the inner layer of the uterine wall), in the treatment of mastopathy.

What are the consequences of canceling

Earlier hormonal contraceptives required a mandatory break of several months every 3 years of use. Modern OK can be taken for a long time, their cancellation affects the body in different ways.

Positive

Already in the first months after the cancellation of OK, a woman has the opportunity to become pregnant. During the time of taking hormonal drugs in the body, favorable conditions are created for the conception of a child: the ovaries are rested, the uterus is prepared for bearing the fetus. Birth control pills do not pose a threat to the life of the unborn child. But if pregnancy occurs while taking a contraceptive, it must be immediately canceled.

Negative

In some episodes, with the abolition of hormonal pills, women cannot become pregnant. Gynecologists in this case recommend that the patient undergo an examination to exclude the presence of inflammation of infectious diseases, malignant neoplasms in the uterus. In the absence of pathologies, a woman can plan a pregnancy.

Sometimes, after the abolition of OK, women begin to have skin problems, mood swings, depression occur, and the uterine cycle fails. They associate these phenomena with the development of dependence on the intake of steroid hormones. Negative reactions develop only in the case of an incorrectly selected contraceptive, so the doctor makes his choice and regularly monitors the patient's condition. Dependence in the course of taking OK does not develop.

Contraindications

The benefits and harms of birth control pills can only be determined by a specialist. The doctor will choose the best state of health, regularity of sexual activity and other factors. Definitely OK will be harmful in the following pathologies:

• diseases of the liver, kidneys;
• hypertension;
• diabetes;
• thrombosis;
• ischemia of the heart;
• arthritis;
• lupus erythematosus.

With depressive disorders, migraines, varicose veins, PMS, birth control pills can be taken under medical supervision.

Oral hormonal contraceptives are a reliable and safe method. They should be selected only by the attending physician. This will help to avoid negative consequences and provide reliable protection against unwanted pregnancy. OK are used as therapeutic and prophylactic agents.

Hormonal drugs are a group of drugs used for hormone therapy and containing hormones or their synthesized analogues.

The effect of hormonal drugs on the body is well studied, and most of the studies are freely available to a wide range of readers.

There are hormonal agents containing hormones of natural origin (they are made from the glands of slaughtered cattle, urine and blood of various animals and humans), including both plant and synthetic hormones and their analogues, which naturally differ from natural ones in their chemical composition. , however, produce the same physiological effect on the body.

Hormonal agents are prepared in the form of oily and aqueous formulations for intramuscular or subcutaneous administration, as well as in the form of tablets and ointments (creams).

Effect

Traditional medicine uses hormonal drugs for diseases that are associated with a lack of production of certain hormones by the human body, for example, insulin deficiency in diabetes, sex hormones - with reduced ovarian function, triiodothyronine - with myxedema. This therapy is called replacement therapy and is carried out over a very long period of the patient's life, and sometimes for the rest of his life. Also, hormonal preparations, in particular, containing glucocorticoids, are prescribed as anti-allergic or anti-inflammatory drugs, and mineralocorticoids are prescribed for myasthenia gravis.

Important female hormones

In the female body, a very large number of hormones “work”. Their well-coordinated work allows a woman to feel like a woman.

Estrogens

These are “female” hormones that stimulate the growth and function of the female genital organs and the growth of the mammary glands. In addition, they are responsible for the appearance of female secondary sexual characteristics, i.e., breast enlargement, fat deposition and the formation of muscles according to the female type. In addition, these hormones are responsible for the cyclical nature of menstruation. They are produced by the ovaries in women, the testicles in men, and the adrenal cortex in both sexes. These hormones affect bone growth and water-salt balance. After menopause, women experience less estrogen. This can lead to hot flashes, sleep disturbance and atrophy of the organs of the genitourinary system. Also, a lack of estrogen can be the cause of osteoporosis that develops in postmenopause.

Androgens

Produced by the ovaries in women, the testes in men, and the adrenal cortex in both sexes. These hormones can be called "male". In certain concentrations, they cause the development of male secondary sexual characteristics in women (coarseness of the voice, facial hair growth, baldness, muscle growth “in the wrong places”). Androgens increase libido in both sexes.

A large amount of androgens in the female body can lead to partial atrophy of the mammary glands, uterus and ovaries and infertility. During pregnancy, under the influence of an excessive amount of these substances, a miscarriage can occur. Androgens can reduce the secretion of vaginal lubrication, while sexual intercourse becomes painful for a woman.

Progesterone

Progesterone is called the "pregnancy" hormone. It is produced by the corpus luteum of the ovaries, and during pregnancy also by the placenta. Progesterone helps to maintain pregnancy, stimulates the development of the mammary glands and "prepares" the uterus for bearing the fetus. During pregnancy, its level increases by 15 times. This hormone helps us get the most out of what we eat and increases our appetite. During pregnancy, these are very useful qualities, but if its formation rises at another time, this contributes to the appearance of extra pounds.

luteinizing hormone

Produced by the pituitary gland. It regulates the secretion of estrogen by the ovaries in women, and is also responsible for ovulation and the development of the corpus luteum.

Follicle-stimulating hubbub

Synthesized by the pituitary gland. Stimulates the growth and maturation of ovarian follicles, estrogen secretion and ovulation. Gonadotropic hormones (FSH - follicle-stimulating hormone, LH - luteinizing hormone and prolactin), produced in the adenohypophysis, determine the sequence of maturation of follicles in the ovary, ovulation (egg release), development and functioning of the corpus luteum.

Prolactin

This hormone is also produced by the pituitary gland. In addition, the mammary gland, placenta, central nervous system and immune system are involved in its secretion. Prolactin stimulates the growth and development of the mammary glands and is involved in the formation of the maternal instinct. It is necessary for lactation, increases milk secretion and converts colostrum into milk.

This hormone prevents a new pregnancy from occurring while the baby is breastfeeding. It is also involved in providing orgasm and has an analgesic effect. Prolactin is called the stress hormone. Its production increases during stressful conditions, anxiety, depression, severe pain, psychosis, and the action of adverse external factors.

All these hormones are very important for the proper functioning of the body of a woman. They allow the female body to function normally.

Features of hormonal drugs

Such a broad concept as "hormonal drugs" includes various drugs:

1. Contraceptives.
2. Treating (drugs whose action cures diseases, for example, somatotropin in childhood treats dwarfism caused by its deficiency).
3. Regulatory (various pills to normalize the menstrual cycle or hormonal levels).
4. Supportive (insulin for diabetics).

All of them have a different effect on the body of a woman.

Contraceptives

Without contraceptives, avoiding an unwanted pregnancy is difficult, and constantly using condoms or other mechanical methods of contraception can be uncomfortable. Therefore, for the representatives of the weaker sex, many drugs have been developed that, when taken, pregnancy does not occur.

Most often, the action of contraceptives is that they do not allow the egg to attach to the walls of the uterus, so the development of the fetus becomes impossible. The use of contraceptives in the form of tablets is popular today, but along with positive qualities, there are also negative consequences for a woman's body:

• violation of the menstrual cycle (with the wrong selection of the drug);
• swelling and weight gain (due to the body not taking medication);
• hair loss, brittle nails and dry skin (due to improper selection);
• lethargy, feeling unwell, decreased libido.

But all these qualities in 90% of cases are manifested in the wrong or self-selection of contraceptives. Such serious drugs can only be selected by a gynecologist, because for this it is necessary to analyze the data of the hormonal background of a woman. In no case do not prescribe oral contraceptives on your own, because if one girl did not feel bad from some contraceptives, this does not mean that they will suit others.

But not everyone can use this method of protection.

There are several contraindications for the use of hormonal contraceptives:

• having problems with the background;
• taking antibiotics;
• pregnancy;
• problems with the cardiovascular system;
• age less than 17 years;
• overweight and allergic reactions.

During the period of such protection, chronic diseases can worsen. Discuss all the details with your doctor or gynecologist before you start taking contraceptives.

Side effects

In instructions for hormonal contraceptives, mental disorders are sometimes indicated as side effects. Usually it is depression and anxiety disorders. Fear attacks or panic attacks are not always listed separately, because they are often reduced to just anxiety disorders. Although they deserve special attention and can greatly ruin the life of a woman who uses contraceptives. According to studies conducted by the Royal Society of General Practitioners, women taking hormonal contraception have an increased risk of mental illness, neurotic depression (10-40%), the development of psychosis, and suicide. Aggressiveness increases, changes in mood and behavior are noted. It is possible that this factor has a significant impact on the life of the family and society.

Considering that even the normally observed fluctuations in the levels of endogenous hormones during the menstrual cycle affect the mood in women (for example, according to data from France and England, 85% of the crimes committed by women occur during their premenstrual period), it becomes clear why when taking GC aggressiveness and depression increase by 10-40%.

Under the influence of contraception, the level of the hormone testosterone, which is responsible for sexuality, is significantly reduced. Women taking hormonal contraceptives often complain of a lack of desire, libido, and difficulty getting an orgasm. It is known that long-term use of hormonal contraceptives can cause irreversible changes in sexuality and libido. Due to the blocking of testosterone in very young girls using contraceptives, there is sexual coldness, often anorgasmia.

Particular attention when taking hormonal contraceptives should be paid to the following recommendations:

• pills designed to prevent unwanted pregnancy do not protect the female body from sexually transmitted diseases;
• women over 35 years of age when taking combined contraceptive pills should stop smoking, since in this case the risk of blockage of blood vessels increases significantly;
• during feeding, it is undesirable to use tablets of a combined composition, since the estrogen in their composition affects the quality and composition of milk. In this case, tablets are prescribed containing only the hormone of the corpus luteum;
• with the appearance of nausea, dizziness, indigestion, you should seek the advice of a specialist;
• if you are prescribed drugs, you must inform your doctor that you are taking hormonal contraceptives;
• if there was a pass in taking the pills, then there is a need to use additional contraceptives, for example, condoms;
• for women with severe forms of endocrine diseases, such as diabetes mellitus, as well as those with pathology of the heart and blood vessels, neoplasms, taking oral contraceptives is undesirable.

treating

This group heals the body from diseases and disorders. Such hormonal preparations can be in the form of a tablet or topical application. The former are used to treat serious diseases caused by abnormalities in the hormonal background. The latter affect more locally, in places of use.

Often, girls synthesize few hormones responsible for the synthesis of new cells, so cracks or bleeding wounds appear on the skin, especially in winter, which do not heal. For their treatment, a dermatologist may prescribe a cream, ointment, lotion with certain hormones.

Often, ointments contain corticosteroids, which, when applied to the skin, are absorbed into the blood within a few hours and begin to act. How does this group affect the body? This issue should be approached seriously, because the medications most require attention when prescribing, determining the dosage and duration of the course, because the wrong step will cause complications of existing disorders.

Regulatory

Due to the crazy pace of life, daily poor nutrition, bad habits, sedentary lifestyle and newfangled diets, women often suffer from menstrual irregularities. This negatively affects the development of the reproductive system, the general condition of the body, increases the risk of developing breast cancer, and can also cause infertility. But there is a solution to this problem, because most often the cycle goes astray due to changes in the hormonal background.

Therefore, a detailed blood test for these substances is taken. Such procedures are not cheap, because it is very difficult to work with hormones, but remember: the treatment of the consequences of violations will cost much more, so take care of your body in a timely manner.

After identifying specific hormones that are not enough, or they are in excess, a course of drugs is prescribed to regulate their level. It can be tablets or injections. Often gynecologists prescribe oral contraceptives to normalize the menstrual cycle. Don't be afraid, they are not trying to cheat or make things worse. Depending on the results of the tests, some hormonal remedies actually improve menstruation without causing negative consequences. The influence of regulatory agents depends on the correctness of their selection and dosage, because active substances are required by the body in the smallest doses, so it is very easy to cross the line of the norm. For example, if you overdo it with injections of progesterone with its deficiency, then swelling, nausea, hair loss and pain in the mammary glands may appear.

Supportive

These pills or injections keep the body back to normal if diseases or disorders can no longer be cured. This may be due to chronic diseases, constant failures, poor functioning of the endocrine organs, and others. For example, without insulin injections, a diabetic can die within a few days, even if he does not eat sweets.

Thyroxine tablets can stop the development of myxedema in people with thyroid dysfunction.

These drugs can often be harmful:

• loading the gastrointestinal tract;
• irritating the mucous membranes of the stomach or intestines;
• causing hair loss or other unpleasant symptoms.

But it is impossible to refuse them, because it is these drugs that support the life of the patient.

Hormonal drugs fundamentally affect a woman's body, especially if they are oral contraceptives or regulatory agents. Therefore, remember that only a specialist after detailed analyzes can prescribe them. Pills, injections, ointments and other drugs with hormones often disrupt the digestive system, excretory system, and can cause weakness, so consult your doctor if you experience such symptoms.

Common myths

1. Hormonal drugs are very harmful to health, they should not be used in any case. An erroneous opinion. Hormonal drugs have a diverse systemic effect on the body, and, like any other medicine, they can cause side effects. However, abortion, from which these drugs protect almost 100 percent, is much more dangerous for a woman's health.
2. I will take those hormonal drugs that helped my friend (sister, acquaintance). You should not self-prescribe hormones (as well as any other drugs). These drugs are prescription drugs, they should be prescribed only by a doctor after an examination, taking into account all the characteristics of your body (which, by the way, may be completely opposite to the characteristics of the body of your girlfriend or even a relative).
3. Hormonal drugs should not be used for nulliparous and girls under 20 years old. A completely erroneous opinion. Hormonal contraceptives can be used even by adolescents, especially if you need to achieve a certain therapeutic effect.
4. After using hormones for a long time, you can not be afraid to get pregnant. Not at all. Already a month after the end of taking the drugs, it becomes possible to become pregnant, and even give birth to twins or triplets, since 2-3 eggs mature in the ovary. Some forms of infertility are treated by prescribing contraceptives for 3-4 months.
5. After a certain time (half a year, a year, etc.), you should take a break in taking hormonal drugs. This opinion is erroneous, since interruptions in taking the drug do not affect either the appearance (or not the appearance) of complications, or the ability to bear children at the end taking medications. If there is a need and, according to the doctor, there are no contraindications for continuous use, hormonal preparations can be used continuously and for as long as you like.
6. Nursing mothers should not take hormones. This statement is true only in relation to some pills that affect lactation. However, there are pills containing only a small amount of the hormone that do not affect lactation. It should only be remembered that these tablets must be used strictly after 24 hours in continuous mode. Even a minimal deviation from the hours of admission completely destroys the contraceptive effect of this drug.
7. Hormonal pills can make a big difference. Hormonal pills do have an effect on appetite, but for some it increases and for others it decreases. It is impossible to predict exactly how the drug will affect you. If a woman is inclined to be overweight or with an increase in body weight while taking it, the doctor prescribes drugs with a low content of progestogens responsible for increasing body weight.
8. Hormonal drugs are created only to prevent pregnancy in women, there are no drugs of this kind for men. This is not true. Hormonal drugs are synthetic drugs that act like natural hormones produced in our body. Such drugs do not necessarily have a contraceptive effect, and can be prescribed to both women and men (depending on the type of drugs) to normalize the function of the reproductive system, normalize hormonal levels, etc.
9. Only very severe diseases are treated with hormonal drugs. Not necessary. In the treatment of some non-severe diseases, hormonal drugs are also prescribed. For example, with a decrease in thyroid function, thyroxine or euthyrox is used.
10. Hormones accumulate in the body. Wrong opinion. Once in the body, hormones almost immediately break down into chemical compounds, which are then excreted from the body. For example, a birth control pill breaks down and “leaves” the body during the day: that is why it needs to be taken every 24 hours. After the end of taking hormonal drugs, the effect of their impact is maintained not due to the accumulation of drugs in the body, but due to the fact that hormones affect various organs (ovaries, uterus, mammary glands, parts of the brain), normalizing their work.
11. Pregnant women are not prescribed hormonal drugs. If a woman had hormonal disorders before pregnancy, then during the bearing of the fetus she needs drug support so that the production of female and male hormones is normal and the child develops normally. Also, hormones (for example, adrenal hormones) are used if during pregnancy the hormonal background of a woman's body is disturbed.
12. In any case, hormonal drugs can be replaced with other drugs. Unfortunately, this is not the case. In some situations, hormonal drugs are indispensable (for example, if a woman under 50 has her ovaries removed). And sometimes hormonal treatment is prescribed by a psychoneurologist (for example, for depression).

From previous publications, we know about the abortive effect of hormonal contraceptives (GC, OK). Recently, in the media, you can find reviews of affected women from the side effects of OK, we will give a couple of them at the end of the article. To highlight this issue, we turned to the doctor, who prepared this information for the ABC of Health, and also translated for us fragments of articles with foreign studies on the side effects of HA.

Side effects of hormonal contraceptives.

The actions of hormonal contraceptives, like those of other drugs, are determined by the properties of their constituent substances. Most contraceptive pills prescribed for planned contraception contain 2 types of hormones: one gestagen and one estrogen.

Gestagens

Gestagens = progestogens = progestins- hormones that are produced by the corpus luteum of the ovaries (a formation on the surface of the ovaries that appears after ovulation - the release of the egg), in a small amount - by the adrenal cortex, and during pregnancy - by the placenta. The main progestogen is progesterone.

The name of the hormones reflects their main function - "pro gestation" = "to [preserve] pregnancy" by restructuring the uterine endothelium into a state necessary for the development of a fertilized egg. The physiological effects of gestagens are combined into three main groups.

1. vegetative effect. It is expressed in the suppression of the proliferation of the endometrium, caused by the action of estrogens, and its secretory transformation, which is very important for a normal menstrual cycle. When pregnancy occurs, gestagens suppress ovulation, lower the tone of the uterus, reducing its excitability and contractility ("protector" of pregnancy). Progestins are responsible for the "maturation" of the mammary glands.
2. generative action. In small doses, progestins increase the secretion of follicle-stimulating hormone (FSH), which is responsible for the maturation of ovarian follicles and ovulation. In large doses, gestagens block both FSH and LH (luteinizing hormone, which is involved in the synthesis of androgens, and together with FSH provides ovulation and progesterone synthesis). Gestagens affect the center of thermoregulation, which is manifested by an increase in temperature.
3. General action. Under the influence of gestagens, amine nitrogen in the blood plasma decreases, the excretion of amino acids increases, the separation of gastric juice increases, and the separation of bile slows down.

The composition of oral contraceptives includes various gestagens. For a while it was believed that there was no difference between progestins, but now it is known for sure that the difference in molecular structure provides a variety of effects. In other words, progestogens differ in spectrum and in the severity of additional properties, but the 3 groups of physiological effects described above are inherent in all of them. The characteristics of modern progestins are shown in the table.

Pronounced or very pronounced gestagenic effect common to all progestogens. The gestagenic effect refers to those main groups of properties that were mentioned earlier.

Androgenic activity is not characteristic of many drugs, its result is a decrease in the amount of "good" cholesterol (HDL cholesterol) and an increase in the concentration of "bad" cholesterol (LDL cholesterol). As a result, the risk of atherosclerosis increases. In addition, there are symptoms of virilization (male secondary sexual characteristics).

Explicit antiandrogenic effect available for only three drugs. This effect has a positive meaning - an improvement in the condition of the skin (cosmetic side of the issue).

Antimineralocorticoid activity associated with an increase in diuresis, sodium excretion, and a decrease in blood pressure.

Glucocorticoid effect affects metabolism: there is a decrease in the body's sensitivity to insulin (risk of diabetes), increased synthesis of fatty acids and triglycerides (risk of obesity).

Estrogens

The other ingredient in birth control pills is estrogen.

Estrogens- female sex hormones, which are produced by the ovarian follicles and the adrenal cortex (and in men also by the testicles). There are three main estrogens: estradiol, estriol, and estrone.

Physiological effects of estrogens:

- proliferation (growth) of the endometrium and myometrium according to the type of their hyperplasia and hypertrophy;

- development of genital organs and secondary sexual characteristics (feminization);

- suppression of lactation;

- inhibition of resorption (destruction, resorption) of bone tissue;

- procoagulant action (increased blood clotting);

- an increase in the content of HDL ("good" cholesterol) and triglycerides, a decrease in the amount of LDL ("bad" cholesterol);

- retention of sodium and water in the body (and, as a result, an increase in blood pressure);

- ensuring the acidic environment of the vagina (normally pH 3.8-4.5) and the growth of lactobacilli;

- increased production of antibodies and activity of phagocytes, increased resistance of the body to infections.

Estrogens in oral contraceptives are needed to control the menstrual cycle, they do not take part in protection against unwanted pregnancy. Most often, the composition of the tablets includes ethinylestradiol (EE).

Mechanisms of action of oral contraceptives

So, given the basic properties of gestagens and estrogens, the following mechanisms of action of oral contraceptives can be distinguished:

1) inhibition of the secretion of gonadotropic hormones (due to gestagens);

2) a change in the pH of the vagina to a more acidic side (the effect of estrogens);

3) increased viscosity of cervical mucus (gestagens);

4) the phrase “ovum implantation” used in instructions and manuals, which hides the abortive effect of HA from women.

Gynecologist's commentary on the abortive mechanism of action of hormonal contraceptives

When implanted in the wall of the uterus, the embryo is a multicellular organism (blastocyst). An egg (even a fertilized one) is never implanted. Implantation occurs 5-7 days after fertilization. Therefore, what is called an egg in the instructions is actually not an egg at all, but an embryo.

Unwanted estrogen...

In the course of a thorough study of hormonal contraceptives and their effect on the body, it was concluded that undesirable effects are associated to a greater extent with the influence of estrogens. Therefore, the smaller the amount of estrogens in a tablet, the fewer side effects, but it is not possible to completely eliminate them. It was these conclusions that prompted scientists to invent new, more advanced drugs, and oral contraceptives, in which the amount of the estrogen component was measured in milligrams, were replaced by tablets containing estrogen in micrograms ( 1 milligram [ mg] = 1000 micrograms [ mcg]). There are currently 3 generations of birth control pills. The division into generations is due to both a change in the amount of estrogen in the preparations and the introduction of newer progesterone analogues into the composition of the tablets.

The first generation of contraceptives include "Enovid", "Infekundin", "Bisekurin". These drugs have been widely used since their discovery, but later their androgenic effect was noticed, manifested in the coarsening of the voice, the growth of facial hair (virilization).

Second-generation drugs include Microgenon, Rigevidon, Triregol, Triziston and others.

The most commonly used and widespread are third-generation drugs: Logest, Merisilon, Regulon, Novinet, Diane-35, Zhanin, Yarina and others. A significant advantage of these drugs is their antiandrogenic activity, which is most pronounced in Diane-35.

The study of the properties of estrogens and the conclusion that they are the main source of side effects from the use of hormonal contraceptives led scientists to the idea of ​​​​creating drugs with an optimal reduction in the dose of estrogen in them. It is impossible to completely remove estrogens from the composition, since they play an important role in maintaining a normal menstrual cycle.

In this regard, the division of hormonal contraceptives into high-, low- and microdosed preparations has appeared.

High-dose (EE = 40-50 mcg per tablet).

• "Non-ovlon"
• Ovidon and others
• Not used for contraception.

Low-dose (EE = 30-35 mcg per tablet).

• "Marvelon"
• "Janine"
• "Yarina"
• "Femoden"
• "Diana-35" and others

Microdosed (EE = 20 mcg per tablet)

• "Logest"
• Mercilon
• "Novinet"
• "Minisiston 20 Fem" "Jess" and others

Side effects of hormonal contraceptives

Side effects from the use of oral contraceptives are always described in detail in the instructions for use.

Since the side effects from the use of various contraceptive pills are approximately the same, it makes sense to consider them, highlighting the main (severe) and less severe ones.

Some manufacturers list conditions that should stop taking immediately. These states include the following:

1. Arterial hypertension.
2. Hemolytic-uremic syndrome, manifested by a triad of signs: acute renal failure, hemolytic anemia and thrombocytopenia (decrease in the number of platelets).
3. Porphyria is a disease in which the synthesis of hemoglobin is impaired.
4. Hearing loss due to otosclerosis (fixation of the auditory ossicles, which should normally be mobile).

Almost all manufacturers designate thromboembolism as rare or very rare side effects. But this grave condition deserves special attention.

Thromboembolism is the blockage of a blood vessel by a thrombus. This is an acute condition that requires qualified help. Thromboembolism cannot occur out of the blue, it needs special “conditions” - risk factors or existing vascular diseases.

Risk factors for thrombosis (formation of blood clots inside the vessels - thrombi - interfering with the free, laminar blood flow):

- age over 35 years;

- smoking (!);

- high levels of estrogen in the blood (which occurs when taking oral contraceptives);

- increased blood clotting, which is observed with a deficiency of antithrombin III, proteins C and S, dysfibrinogenemia, Marchiafava-Michelli disease;

- trauma and extensive operations in the past;

- venous congestion with a sedentary lifestyle;

- obesity;

- varicose veins of the legs;

- damage to the valvular apparatus of the heart;

- atrial fibrillation, angina pectoris;

- diseases of the cerebral vessels (including transient ischemic attack) or coronary vessels;

- arterial hypertension of moderate or severe degree;

- connective tissue diseases (collagenoses), and primarily systemic lupus erythematosus;

- hereditary predisposition to thrombosis (thrombosis, myocardial infarction, cerebrovascular accident in the closest blood relatives).

If these risk factors are present, a woman taking hormonal contraceptive pills has a significantly increased risk of developing thromboembolism. The risk of thromboembolism increases with thrombosis of any localization, both present and past; with myocardial infarction and stroke.

Thromboembolism, whatever its localization, is a severe complication.

In addition to thromboembolism, there are other, less severe, but still uncomfortable side effects. For example, candidiasis (thrush). Hormonal contraceptives increase the acidity of the vagina, and in an acidic environment, fungi multiply well, in particular Candidaalbicans, which is an opportunistic pathogen.

A significant side effect is the retention of sodium, and with it water, in the body. This may lead to edema and weight gain. Decreased tolerance to carbohydrates, as a side effect of the use of hormonal pills, increases the risk of diabetes mellitus.

Other side effects, such as: mood swings, mood swings, increased appetite, nausea, stool disorders, satiety, swelling and soreness of the mammary glands, and some others - although they are not severe, however, affect the quality of life of a woman.

In the instructions for the use of hormonal contraceptives, in addition to side effects, contraindications are listed.

Contraceptives without estrogen

Exist gestagen-containing contraceptives ("mini-drank"). In their composition, judging by the name, only gestagen. But this group of drugs has its indications:

- contraception for lactating women (they should not be prescribed estrogen-progestin drugs, because estrogen suppresses lactation);

- prescribed for women who have given birth (because the main mechanism of action of "mini-drank" is the suppression of ovulation, which is undesirable for nulliparous women);

- in late reproductive age;

- in the presence of contraindications to the use of estrogen.

In addition, these drugs also have side effects and contraindications.

Particular attention should be paid to emergency contraception". The composition of such drugs includes either a progestogen (levonorgestrel) or an antiprogestin (mifepristone) in a large dose. The main mechanisms of action of these drugs are inhibition of ovulation, thickening of cervical mucus, acceleration of desquamation (desquamation) of the functional layer of the endometrium in order to prevent the attachment of a fertilized egg. And Mifepristone has an additional effect - an increase in the tone of the uterus. Therefore, a single use of a large dose of these drugs has a very strong simultaneous effect on the ovaries, after taking emergency contraceptive pills, there can be serious and prolonged menstrual irregularities. Women who regularly use these drugs are at great risk to their health.

Foreign studies of side effects of GC

Interesting studies on the side effects of hormonal contraceptives have been carried out in foreign countries. Below are excerpts from several reviews (translation by the author of the article of fragments of foreign articles)

Oral contraceptives and the risk of venous thrombosis

May, 2001

FINDINGS

Hormonal contraception is used by more than 100 million women worldwide. The number of deaths from cardiovascular diseases (venous and arterial) among young, low-risk patients - non-smoking women from 20 to 24 years old - is observed worldwide in the range of 2 to 6 per year per million, depending on the region of residence, the estimated cardiovascular - vascular risk and the volume of screening studies that were carried out before the appointment of contraceptives. While the risk of venous thrombosis is more important in younger patients, the risk of arterial thrombosis is more relevant in older patients. Among older women who smoke and use oral contraceptives, the number of deaths is from 100 to just over 200 per million every year.

Reducing the dose of estrogen reduced the risk of venous thrombosis. Third-generation progestins in combined oral contraceptives have increased the incidence of adverse hemolytic changes and the risk of thrombosis, so they should not be given as first choice in hormonal contraceptive beginners.

Reasonable use of hormonal contraceptives, including the avoidance of their use by women who have risk factors, is absent in most cases. In New Zealand, a series of deaths from PE were investigated, and often the cause was an unaccounted for risk by doctors.

Reasonable prescription can prevent arterial thrombosis. Almost all women who had a myocardial infarction while using oral contraceptives were either of an older age group, or smoked, or had other risk factors for arterial disease - in particular, arterial hypertension. Avoiding the use of oral contraceptives in these women may lead to a decrease in the incidence of arterial thrombosis, as reported by recent studies in industrialized countries. The beneficial effect that third-generation oral contraceptives have on the lipid profile and their role in reducing the number of heart attacks and strokes has not yet been confirmed by control studies.

To avoid venous thrombosis, the doctor asks if the patient has ever had a venous thrombosis in the past, to determine if there are contraindications to prescribing oral contraceptives, and what is the risk of thrombosis while taking hormonal drugs.

Nixodosed progestogen oral contraceptives (first or second generation) caused a lower risk of venous thrombosis than combination drugs; however, the risk in women with a history of thrombosis is not known.

Obesity is considered a risk factor for venous thrombosis, but it is not known whether this risk is increased with oral contraceptive use; thrombosis is uncommon among obese people. Obesity, however, is not considered a contraindication to oral contraceptive use. Superficial varicose veins are not a consequence of pre-existing venous thrombosis or a risk factor for deep venous thrombosis.

Heredity may play a role in the development of venous thrombosis, but its tangibility as a high risk factor remains unclear. Superficial thrombophlebitis in history can also be considered as a risk factor for thrombosis, especially if it is combined with aggravated heredity.

Venous thromboembolism and hormonal contraception

Royal College of Obstetricians and Gynecologists, UK

July, 2010

Do combined hormonal contraceptive methods (pills, patch, vaginal ring) increase the risk of venous thromboembolism?

The relative risk of venous thromboembolism increases with the use of any combined hormonal contraceptive (pills, patch and vaginal ring). However, the rarity of venous thromboembolism in women of reproductive age means that the absolute risk remains low.

The relative risk of venous thromboembolism increases in the first few months after starting combined hormonal contraception. As the duration of taking hormonal contraceptives increases, the risk decreases, but as a background it remains until the cessation of the use of hormonal drugs.

In this table, the researchers compared the incidence of venous thromboembolism per year in different groups of women (in terms of 100,000 women). From the table it is clear that in non-pregnant women and women not using hormonal contraceptives (non-pregnantnon-users), an average of 44 (with a range of 24 to 73) cases of thromboembolism per 100,000 women are registered per year.

Drospirenone-containingCOCusers - users of drospirenone-containing COCs.

Levonorgestrel-containingCOCusers - using levonorgestrel-containing COCs.

Other COCs not specified - other COCs.

Pregnantnon-users are pregnant women.

Strokes and heart attacks while using hormonal contraception

"New England Journal of Medicine"

Medical Society of Massachusetts, USA

June, 2012

FINDINGS

Although the absolute risks of stroke and heart attack associated with hormonal contraceptives are low, the risk was increased from 0.9 to 1.7 with drugs containing ethinylestradiol at a dose of 20 mcg and from 1.2 to 2.3 with the use of drugs containing ethinyl estradiol at a dose of 30-40 mcg, with a relatively small risk difference depending on the type of gestagen included.

Risk of thrombosis of oral contraception

WoltersKluwerHealth is a leading provider of qualified health information.

HenneloreRott - German doctor

August, 2012

FINDINGS

Different combined oral contraceptives (COCs) are characterized by a different risk of venous thromboembolism, but the same unsafe use.

COCs with levonorgestrel or norethisterone (the so-called second generation) should be the drugs of choice, as recommended by national contraceptive guidelines in the Netherlands, Belgium, Denmark, Norway and the UK. Other European countries do not have such guidelines, but they are essential.

In women with a history of venous thromboembolism and/or known coagulation defects, the use of COCs and other contraceptives containing ethinyl estradiol is contraindicated. On the other hand, the risk of venous thromboembolism during pregnancy and the postpartum period is much higher. For this reason, such women should be offered adequate contraception.

There is no reason to abstain from hormonal contraception in young patients with thrombophilia. Progesterone-only preparations are safe in relation to the risk of venous thromboembolism.

Risk of venous thromboembolism among users of drospirenone-containing oral contraceptives

American College of Obstetricians and Gynecologists

November 2012

FINDINGS
The risk of venous thromboembolism is increased among users of oral contraceptives (3-9/10,000 women per year) compared with non-pregnant and non-users of these drugs (1-5/10,000 women per year). There is evidence that drospirenone-containing oral contraceptives have a higher risk (10.22/10,000) than drugs containing other progestins. However, the risk is still low and much lower than during pregnancy (approximately 5–20/10,000 women/year) and postpartum (40–65/10,000 women/year) (see table).

Tab. risk of thromboembolism.