We continue the story about the various means contraception. protection from unwanted pregnancy we have already discussed. Today we’ll talk about the most reliable and, according to doctors, the most useful remedy for women’s health - combined oral contraceptives (COCs). How they work, who are contraindicated and how to prepare for a visit to the doctor so that he writes you birth control pills?

COC: what is it?

Hormonal contraception includes:

1. Combined oral contraceptives;
2. Contraceptives containing only gestagens;
3. Partially - other types of intrauterine contraception.

Combined oral contraceptives: COC- my favorite group of contraceptives. And not only mine. Most civilized women in civilized countries of the world prefer combined oral contraceptives. And that's why. Firstly, they are the most physiological - they contain a combination of two hormones and, thus, to the greatest extent "tuned" to the natural hormonal rhythm of the female body. Second, they are very reliable. They have the lowest Pearl Index - 0.1-1. Yes, and that takes place only because women forget to take pills.

The Pearl Index is the number of unwanted pregnancies per hundred women using this method in one year. (For some methods, the value of the Pearl Index varies considerably, mainly due to misuse, and not at all due to the method itself.)

Thirdly, combined oral contraceptives have a lot of favorable "side" effects. For example, they give rest to the ovaries. Cycles against the background of taking COCs are anovulatory. Ovulation does not occur.

COOK have a central and peripheral effect. Central action COC It manifests itself in the fact that estrogens and progestogen coming from outside inhibit the release of luteinizing (LH) and follicle-stimulating (FSH) hormones by the pituitary gland. This prevents the development of follicles in the ovary and, accordingly, the onset of ovulation.

Peripheral action of COCs It is expressed in the development of endometrial atrophy, which prevents the implantation of the embryo, as well as in an increase in the viscosity of the cervical mucus, which inhibits the penetration of spermatozoa into the uterine cavity.

How does hormonal contraception work in a woman's body?

And here in this place one should not faint - but rejoice. Because a couple of years of rested ovaries is their reliable protection from, for example, oncology. Reversible atrophy of the endometrium is the prevention of hyperplastic processes in the uterus - that is, again, the prevention of background precancerous diseases and, consequently, oncology.

Remember those very notorious grandmothers of ours who gave birth under a haystack. Grandmothers gave birth - breastfed - and became pregnant again. Who survived there from those born under the haystacks - few people thought, and no one was particularly worried about this: we will make new workers, we will give birth.

But in a collective woman who gave birth as a result of such a lifestyle: childbirth - feeding - pregnancy - childbirth, it was the ovaries that felt very comfortable, namely the “calm”, not growing-exfoliating monthly epithelium of the inner surface of the uterus. That's why there was less cancer. Yes, more people died - for completely different reasons. But oncological diseases ovaries, endometrium and mammary glands were less.

Combined oral contraceptives allow our ovaries to rest without forcing the rest of the body to constantly plow for pregnancy and childbirth. And stop carrying on the myth that has worked out your own that from combined oral contraceptives a beard grows and obesity happens (did you try to eat less?). Modern drugs— already the fourth generation! - Very low dose. And if you do not smoke two packs a day, if you do not have advanced thrombophlebitis and you do not weigh one hundred and twenty kilograms, combined oral contraceptives are not harmful to you!

In addition, combined oral contraceptives (except for all the advantages I have already listed) are comfortable and purely psychological: menstrual-like bleeding is present (unlike contraceptive preparations containing only progestogen). The ovaries and endometrium are resting - and there is menstrual bleeding. This is very important for women, they are, sorry, imprisoned for this.

Types of oral contraceptives

According to their composition, combined oral contraceptives are divided into monophasic, two-phase and three-phase. Monophasic contraceptives contain standard daily dose estrogens and gestagens. In two- and three-phase tablets, there are two or three types of tablets containing increasing doses of hormones, even more “sharpened” for the natural course of the natural menstrual cycle.

If you are a young healthy woman, then ... at this point I will urgently bite my tongue and will never tell you that I recommend taking monophasic drugs. It has not been proven that two- and three-phase drugs have at least some advantage over monophasic drugs, and the scheme for taking them is a little more complicated than the dumbest-simplest scheme for taking monophasic drugs: for twenty-one days you take it orally by mouth - eat - one tablet from the package, then a seven-day break. On the eighth day - start taking from new packaging. For those who have a completely sieve instead of a head and for very busy women, there are monophasic preparations for a continuous twenty-eight-day intake: they include seven placebo tablets.

With regular intake of monophasic drugs, maximum contraceptive reliability is ensured and favorable “side” effects are most pronounced. Getting your monophasic medications on a regular basis is as easy as shelling pears: put them in the bathroom near your toothbrush; or in the kitchen, near the coffee maker - in general, where you go every morning. Toilets and showers are fine too.

How the doctor selects pills

To select the drug, contact your obstetrician-gynecologist. It is he who will select the most suitable drug for you! He and no one else! Not a girlfriend. And not a drugstore pharmacist. The pharmacist does not know everything about female body- especially your particular one! Not to mention the fact that not every salesperson in a pharmacy is now a pharmacist (did they even stay there, pharmacists in pharmacies?).

By the way, if you really decide to ask a pharmacy or a girlfriend which one is best for you to take a combined oral contraceptive, then do not be lazy, spend a month of time (waking up five minutes earlier - it's all business!) And build the notorious curve of your personal. Put it in your bag.

We ran into a pharmacy or to a girlfriend to ask which COC would be better for you to take? Take out your personal basal temperature curve from your purse (preferably also the levels of LH and FSH, natural estrogens, progesterone and androgens - well, this is for the especially advanced) - and show it to the pharmacist in the window or to a friend. If they hatch their eyes at you, then they are clearly not obstetrician-gynecologists. And, therefore, for advice on combined oral contraceptives, you are not to them.

Those birth control pills that contained "horse" doses of hormones (not horse, of course!), Are not currently used as contraceptives. Now they are used only in clinical practice (“clinical practice” means only for patients, only by prescription and only under medical laboratory control) - for the treatment of a number of conditions associated with endocrine disruption and oncology.

Contraindications to hormonal contraception

Alas and ah, in our dear country there is still a high distrust of the combined oral contraception. But I am glad that, compared with the nineties of the twentieth century (just then, civilized hormonal contraceptives), the rate of consumption of hormonal contraception has increased significantly (tens of times!).

And, having praised (quite deservedly!) Combined oral contraception to the skies, I cannot but note that it also has disadvantages. No, the word "disadvantages" is incorrect here. The word "contraindications" is more appropriate. And these very contraindications are already directly related to your shortcomings. More precisely, of course, - conditions and diseases. And these contraindications are divided into absolute(“You can’t at all!”) and relative("it is possible, but...").

Absolute contraindications(impossible!) to the use of combined oral contraceptives:

1. Thrombophlebitis in the past, present or history of thromboembolic complications;
2. Violations of cerebral or coronary circulation;
3. Coronary artery disease;
4. Severe hypertension;
5. malignant tumors;
6. Local migraine;
7. Pregnancy and suspected pregnancy;
8. Bleeding from the genital tract of unknown origin;
9. Acute liver diseases;
10. Estrogen-dependent tumors, especially breast cancer.

Relative contraindications(possible, just be careful!) to the use of combined oral contraceptives:

1. Generalized migraine;
2. Prolonged immobilization (long immobility - due to an increased tendency to thrombosis and embolism);
3. Irregular menstruation (oligomenorrhea or amenorrhea in nulliparous women - and there is no time for sex, then urgently see a gynecologist-endocrinologist!);
4. Smoking more than two packs of cigarettes per day over the age of thirty-five and significantly overweight;
5. Transient disorders blood pressure(until the cause is clarified and stabilization-correction);
6. Severe varicose veins (no, that “one blue wreath” is not it);
7. History of familial thrombosis;
8. Epilepsy;
9. Diabetes;
10. Frequent seizures in history (go to a psychiatrist already!);
11. Chronic cholecystitis and hepatitis.

Relative contraindications are more related to two- and three-phase drugs, not at all to monophasic ones.

To whom - what

And I will not write the names of combined oral contraceptives. Firstly, although they are sold without a prescription - but I have already said (and I will not be too lazy to repeat!): It is better to check with an obstetrician-gynecologist what exactly is right for you. Now there are a lot of family planning clinics where you will be provided with advice.

Secondly - a lot of proprietary and generic names, just a sea. Current specialists are watching them much more closely than me. Go to the doctor. Then, at least, you will have someone to appeal to if three-phase COCs start your mood to “jump”. And bribes from girlfriends and sellers are completely smooth!

What should a competent obstetrician-gynecologist do, to whom you turn for advice on contraception?

Now I will list everything in detail: find out in detail your family history and the diseases you have had; measure blood pressure; conduct a general objective (examine, listen) and gynecological examination (yes, look at the chair too). If, in general, everything is in order with you and there are no frightening details-details that are in your stories that the doctor did not find during the examination, then he will immediately prescribe you a drug based on your phenotype (appearance, so to speak).

Young slender normosthenic women prefer to prescribe low-dose types of marvelon, femoden, microgynon, regulon. And, perhaps, three-phase (which I don’t like too much, but who cares) tri-regol, trisiston, triquilar ... (Oh horror, it seems that I still write and list the names! But you know what? .. Knowing the names does not free reasonable women from a visit to the doctor!)

Women with signs of androgenization - such, somewhat "male type": short, stocky, tightly knocked down, with a light mustache - are prescribed, as a rule, COCs with an antiandrogenic component: Diane-35, janine. Smokers older than thirty-five, women with uterine fibroids older than forty are prescribed mainly microdose COCs: Mercilon, Novinet, Logest.

Another doctor should explain to you in detail the essence of the method of combined oral contraception; tell you how to use the prescribed drug specifically for you; explain what to expect, what to look for and what to do if the pill is not taken on time. After three months of taking it (if you are taking COC for the first time), it is advisable (mandatory!) to see an obstetrician-gynecologist. Thereafter, once every six months.

Tatyana Solomatina

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Discussion

Pluuuda, I wonder how this can be detected by analyzes?

The article is good, but it is not indicated that now you can do an analysis and find out how much you can generally take oral contraceptives, whether there are risks of developing thrombosis as a result of taking them.

I have a negative attitude to any OK, Mirena, IUD and other methods of protection. It can lead, for example, to an ectopic pregnancy and a bunch of other side effects.

The doctor picked up contraception for me, we stopped at Zhanina. I know that strong drug and there are side effects, so I drink them together with Lavit's vitamins. I have been taking OK for six months and everything is super!

In vain you are so talking about the author, the article is written awesomely)) And yes, I absolutely agree with everything - only a consultation with a specialist and only she, no one else will direct you and advise the right remedy. It's all very individual, you can not take it negligently! I regularly see a gynecologist, he picked up OK for me, so I haven’t been sitting with the same ones for almost a year now and I don’t complain about anything) And together with OK, as they told me, it’s good to periodically drink courses of vitamins. Recently, I drank the Lavita vitamin-mineral complex, it just combines with OK and is designed for a month. The effect of them is gorgeous, I'm still not overjoyed)) Hair and skin have never looked so good. In general, you should not sin on OK - a regular dose of vitamins, and you are a beauty, and besides, you are also healthy!))

I have been taking hormonal contraceptives for a very long time. I have nothing bad in a feminine way, everything is normal, but you need to protect yourself somehow. Spiral is not an option at all. I lost weight from hormones, it's good) I was 54 - I became 47)) I'm small, petite, so I'm ok. My husband is happy too. In principle, everything is in order with my health, I regularly - twice a year drink another complex of vitamins "Lavita". Therefore, everything is in order with my hair, nails and skin)) Yes, and vitamins are always in abundance.

Comment on the article "Hormonal contraception: how a doctor selects birth control pills"

Hormonal contraception: how a doctor selects birth control pills. Combined oral contraceptives: how they work.

Discussion

I have been using Jess for several years, absolutely satisfied!

I take Qlaira tablets, here you can read about them [link-1] . Almost all of my friends who take OK sit on them. So far, no one has had zaletov, and problems with hormones too. We usually invite everyone together via the Internet, from the site to which I gave a link. So it’s more profitable - they deliver it home for free.

Section: Contraception (I understand that in any case I need to see a doctor, but I don’t have my own doctor, I’ll go to the paid one). Choose contraceptives.

Discussion

Recently picked:
1. donated blood for hormones (which are not thyroid glands, I don’t remember exactly how the analysis is called there from 3 chtoli or 4). On the 5th day of the cycle, they are given strictly, so you look when you apply. There is also some kind of analysis that is given at the end of the cycle, but this time I was not prescribed it ..
2. donated blood for coagulation (clotting) and something else called by the doctor "how the liver copes" (I drank charosetta before)
3. They also did ultrasound and took all sorts of smears, as they say if there is some kind of infection, then it is better to treat it before you start taking OK, but if you are regularly examined (I rarely: () you may not be touched about this :)

The most important thing is to keep track general condition organism! I drank for 6 years, everything is super!!! And then the bells began, somehow you can’t immediately connect with the priming of the drug: eczema of the hands (never had any dermatitis), the liver began to hurt, they examined, they said steroid hormones thicken bile, that’s pain, periodontitis - already the gums glowed and again pointed to them. As a result, the endocrinologist said that this was not from a "bad COC", but from a long-term use, it is necessary to give the body 6-9 months to recover. And gynecologists all this time kept repeating "everything is super-duper!"

Moreover, today users of hormonal contraceptives have the opportunity to choose a contraceptive not only according to the well-known criteria listed above.

Discussion

It is impossible to consider this question so one-sidedly!!! Those are hormones! And any hormonal intervention in the body can lead to unpredictable consequences. Our medicine is not so developed as to speak so categorically about the benefits of hormonal drugs. For example, I managed with "little blood" only recovered by 10 kg. 3 months of medication.
And even more so to say that it is not required medical examination... Young people also visit the site, read a lot, and then they will pay for it all their lives. I believe that condoms are a safer contraception (and also protection against diseases)

The pharmaceutical company paid the administration of the site to promote their pharmaceuticals .... :-))

Hormonal contraception: how a doctor selects birth control pills. Combined oral contraceptives (COCs): how do women work in the body ...

Discussion

Of course, drop it and pick up new ones, but not by yourself, but by the doctor !!!

I also had a problem with the cycle. I started drinking contraceptives - 2 years (the cycle was established, as if by notes - 28 days), then I didn’t drink them for a year (I cleansed the body before pregnancy) - the cycle began to dance again. Then I gave birth, after consulting with a gynecologist, the better to continue to be protected, I decided to stop again on pills. BUT I decided to buy more modern ones. And then all the horrors that you describe began, moreover, I felt sick every day. I finished the course-cycle, and the next month I bought those that I drank before pregnancy. Everything settled down. I drank them for 8 years. I don’t drink them for a year - of course, my cycle is not by the hour, but regularly 30 days + - 2 days. I like.
Try and you just change the contraceptive, maybe it just doesn't suit you.

How to choose the right birth control pills so that they benefit, and not harm the body? And to have fewer side effects. Is it possible and under what conditions to choose birth control pills without a doctor?

In fact, the main role here is not what kind of drug a woman will take, but whether she can even use oral contraceptives. After all, there are a lot of contraindications for their reception.

So a woman who decides to protect herself hormonally you need to visit a doctor. He must confirm the absence of severe lesions of the cervix, indicating a possible oncological process. This may be indicated by a poor result of colposcopy and a Pap test (a smear for cytology). In addition, it is desirable to do an ultrasound of the mammary glands and uterus, again to exclude oncology. After all, it is she who is the main contraindication to hormonal contraception.

Also, the doctor can send for blood tests, check its coagulability. For women who have had vein problems, oral contraceptives are prescribed with caution.

Giving birth is quite simple. If the woman is healthy, then any low-dose oral contraceptive will do. Your doctor may give you several medications to choose from. Usually start with preparations containing minimum concentration estrogen. But in some cases, they look not at this, but at other properties of the drug. For example, women with heavy menstruation, most likely, they will appoint "Janine". And for those who already have repeated unsuccessful experience of using hormonal drugs due to some of their side effects, three-phase drugs are those in which the pills contain different concentrations of hormones.

Those who care about how to choose should remember that the safest drugs are those that contain the least hormones. And at this point in time, these are not even oral contraceptives, but vaginal ring Nuvaring. Perhaps it is suitable for a woman with a tendency to rapid weight gain.

There is also a way to choose oral contraceptives by phenotype without a doctor, this will help to make a table on our website. By the way, about the same analysis, including visual, is carried out by doctors when a patient comes to them with a request to advise pills. When choosing, its appearance is evaluated (features of the figure, skin, hair, etc.), anamnesis (what are the abundance of menstruation and how long they last).

Table of how to independently choose birth control pills by phenotype:

Oral contraceptives are considered the best option for reliable protection against pregnancy. They are suitable for women who have regular sex life with one partner. The potential harm from OK is much lower than the actual preventive effect of many diseases.

How to choose OK?

Slender, tall women with a boyish figure, with a deep voice and scanty menstruation, have elevated progesterone levels. Weakly developed mammary glands, oily skin prone to acne, problems during pregnancy also speak in favor of the progesterone type. Such women are shown drugs with an antiandrogenic effect.

For women of a balanced type with normal growth, feminine physique, without signs of elevated progesterone levels, micro and low-dose preparations are suitable.

It is important that these features should be assessed together. Often, women who outwardly belong to the estrogen type have elevated level progesterone: oily skin, problems during pregnancy, male pattern hair.
In some cases, the doctor may prescribe a drug without laboratory diagnostics when the hormonal type is beyond doubt, the woman was examined earlier and no violations were found.

Trial and error method

Mistakes and misconceptions

Bloody discharge in the first three months after the start of taking OK is the norm. Other pills should be selected if the discharge bothers you for more than 3 months.

The safest contraceptive

Special cases

If you decide to purchase contraceptives without a doctor's prescription, select them according to your hormonal type and read the contraindications.

Tip 2: How to choose modern contraceptives

The issue of convenience and effective contraception always relevant. And although medicine is developing, and contraceptives are constantly being improved, the number of abortions is not decreasing. In addition to hormonal pills, intrauterine devices and condoms, there is a whole group of topical agents that every woman who wants to protect herself from unwanted pregnancy needs to know about.

Instruction

The principle of operation of vaginal contraceptives is very simple - the chemical contained in them destroys spermatozoa. There are several types of spermicides: non-oxylon-9, octoxylon and benzalkonium chloride. Similar funds can be used when breastfeeding, which is important for young mothers.

Contraceptives do not need to be used constantly, it is enough to insert a candle into the vagina once before sexual intercourse. The substance nonoxylol has both antibacterial, antifungal and antiviral action. Thus, apart from contraceptive effect protection against many sexually transmitted diseases is also achieved. Candles "Patentex Oval" have just such an effect.

The most famous topical drug is Pharmatex. In terms of the effectiveness of protection against unwanted pregnancy, it can even be compared with an intrauterine device and hormonal pills. Also, the chemical contained in the preparation protects the woman from dangerous diseases. It inhibits pathogenic flora (gonococci, chlamydia,

Hormonal birth control is modern facilities contraceptives, in terms of their reliability and ease of use, as well as relative safety, have long surpassed such methods of protection as condoms or vaginal suppositories.

With proper observance of the instructions for the use of birth control pills, the degree of protection against unwanted pregnancy is 99%. More than 70 million women around the world choose hormonal contraception as a method of protection.

The mechanism of action of contraceptives

The action of hormonal pills is based on changing the amount and ratio of estrogen and progesterone in a woman's body by introducing artificial analogues of these hormones into it.

This is necessary in order to create in the patient hormonal background, are characteristic of the state of pregnancy, i.e. in which ovulation is completely absent and, accordingly, the possibility of conception.

Pregnancy while taking hormonal contraceptives is also unlikely due to the fact that they make a woman's cervical mucus very viscous and thick, which prevents sperm from entering the uterus.

Moreover, under the influence of artificial hormones, the endometrium lining the inner layer of the uterus also changes and makes it impossible for an egg to attach to it.

Types of contraceptives

Depending on the route of entry into the body, birth control pills are divided into two kinds:

- oral contraceptives (OC), which are available in the form of tablets and pills and are taken orally;

- parenteral contraceptives (PC) that do not enter the body through the intestines (vaginal ring, patches, injections, intrauterine device)

Let's look at each of them in detail.

Oral contraceptives

Oral contraceptives are by far the most popular means of protection against unwanted pregnancies. There are two of them varieties:

- combined oral contraceptives(contains both estrogen and progesterone)

- progestogen oral contraceptives(contains only one synthetic analogue of progesterone)

The composition of any combined OK includes the same amount of progesterone, which blocks ovulation. The division of drugs into groups occurs depending on the content of estrogen in them, namely:

• microdosed OK contain a very small dose of estrogen;
• low-dose OK have a slightly higher dose of the hormone;
• high-dose OK contain the highest dose of estrogen

But do not think that the higher the dose of estrogen in the drug, the more effective they are, it is not. A contraceptive is selected for each woman individually, taking into account her age, hormonal levels, the presence or absence of children, and lifestyle.

Microdosed COCs mostly prescribed to nulliparous women, a girl in her teens, or those over 35 years old. The constant dose of ethinylestradiol in them is 20 mcg, and progestin (75-150 mcg).

These are drugs such as Lindinet-20, Novinet, Mercilon, Logest, Jess Plus etc. This type of pills, in addition to protection, has a pronounced cosmetic effect and has virtually no side effects.

For those who have a spotting discharge on a microdose of hormones, as well as women who have given birth, contraceptive pills with a low dose of estrogen are recommended, namely: Yarina, Marvelon, Diane-35, Janine, Regulon, Silhouette, Tri-merci and etc.

The drugs in this category contain a dose of ethinyl estradiol equal to 30 mcg, a dose of progestins - 150-300 mcg. According to research low-dose COCs contribute to the reduction of unwanted vegetation and seborrhea, as well as the disappearance of skin problems in the form of increased fat content and acne.

High-dose oral contraceptives usually prescribed as a treatment for diseases such as endometriosis, or during the treatment of hormonal disorders. These include: Tri-regol, Ovidon, Non-ovlon etc. These drugs are also prescribed to women as a means of contraception, if they use drugs that weaken the contraceptive effect during the treatment of COCs.

To progestogen oral contraceptives include mini-pills containing only a microdose of a progesterone analogue. This type of contraception is recommended for those who are breastfeeding, or for those who are not suitable for estrogen contraception. Often progestin OCs are prescribed to women with hormonal diseases genital area, such as,.

Mini-pills include the following drugs: Norkolut, Charosetta, Microlut etc. The effectiveness of mini-pills is lower than that of combined OK, therefore, when using them, you must strictly follow the instructions and adhere to the recommended scheme. Only half of the women who use this type of contraception completely block ovulation.

When choosing contraceptives, the hormonal background of a woman is necessarily examined and, depending on the predominance of certain hormones, the doctor prescribes to the patient monophasic, biphasic, or triphasic oral contraceptives.

Monophasic OK contain the same amount of estrogen and progesterone that a woman receives throughout her menstrual cycle. If a woman has hormonal disorders, the doctor will select her two or three-phase OK, having different combinations of estrogen and progesterone content.

It is imperative to take such drugs without gaps and strictly according to the scheme, since they will mimic the different phases of your menstrual cycle.

parenteral contraceptives

Parenteral contraceptives differ from oral contraceptives in the way they are used. They are not taken orally every day, they are introduced into the body once in a large dose, being absorbed into the blood gradually, providing a prolonged contraceptive effect.

This method of protection is suitable for women who have given birth and who do not plan a second pregnancy in the near future. These include:

1)Vaginal ring "Novaring"

Nuvaring - Enough effective method hormonal contraception. It is a small soft ring that releases the hormones estrogen and progesterone when it is in the vagina, which go directly to the uterus and ovaries. This method of protection provides 99% protection against unwanted pregnancy.

Nuvaring does not provide negative impact on the liver, contraindicated in persons prone to thrombosis, suffering from severe diabetes and others. The price of the Novaring ring ranges from 1300-1500 rubles.

2) Subcutaneous implant - "Norplant"

Norplant is one of the latest ways protection from unwanted pregnancy. It is an implant system consisting of 6 capsules with progestogen, which are sutured to a woman subcutaneously in the armpit area under local anesthesia. These ampoules provide a contraceptive effect for up to 5 years, gradually saturating the woman's blood with the necessary dose of hormones.

You can remove it earlier. After the expiration of the Norplant, you can immediately enter a new one in its place. With this method of contraception, hormones do not pass through the liver, which eliminates the adverse effect on it. The price for installing Norplant is on average 13,000-16,000 rubles.

3) Spiral "Mirena"

A very effective and popular method of hormonal contraception is the Mirena intrauterine device. The spiral does not affect the quality of sexual intercourse, it is installed for a long time and practically does not require any control.

But she has a significant disadvantage: after the installation of the spiral, a large number of patients have frequent bleeding or spotting, and therefore they have to abandon this method of protection.

Installation of the Mirena spiral is contraindicated in women with inflammatory processes in the small pelvis. The cost of installing the Mirena Navy is approximately 13,000-15,000 rubles.

4) Contraceptive patch "Evra"

The Evra contraceptive patch is also convenient to use, which is glued to the skin once a week and provides almost 100% protection against unwanted pregnancy.

It is able to stay on the skin despite exposure to moisture or the sun. Every day, a certain dose of the hormone is released into the blood from it, which is necessary to block ovulation. The price for the Evra patch is about 1000 rubles.

How to choose the right birth control pills

The question of how to choose the right birth control pill is very popular among women. Many of them prefer to choose hormonal contraception for themselves, or on the advice of friends or a pharmacist in a pharmacy, which is sometimes fraught with consequences. After all, not everyone knows about side effects hormonal pills, about contraindications to their use and that hormonal agents cannot be taken for a long time.

Only a competent gynecologist can choose the right method of hormonal contraception after a carefully collected anamnesis of the patient, which includes: face-to-face consultation, taking a smear from the cervix for cytology, biochemical analysis blood (liver tests, glucose), coagulogram (blood clotting test), blood test for hormones, ultrasound of the small pelvis, ultrasound of the mammary glands and consultation with a mammologist.

The doctor also needs to take into account the age, height, weight, type of hair growth of the patient, the presence of bad habits (alcohol, smoking), problematic skin, a tendency to be overweight, chronic diseases, the duration of the menstrual cycle and the characteristics of the course of critical days (abundance of discharge, number of days of menstruation, soreness ). We will not be superfluous to visit an ophthalmologist, since long-term use of OK can provoke the development of glaucoma and other eye diseases.

After analyzing the results, the specialist will be able to determine the phenotype of a woman ( estrogenic, progesterone or balanced) and on the basis of this, choose the appropriate hormonal contraception for her. Women with an estrogen phenotype tend to be short, feminine, with dry, irritated skin. Their menstruation proceeds with significant blood loss and lasts quite a long time. Such patients are mainly prescribed high-dose or medium-dose COCs, such as Triziston, Milvane, etc.

In women with a predominance of gestagens in the body, there is an external similarity with the male sex, high growth, small breasts, increased greasiness of the skin and hair. Menstruation in patients with this phenotype is painful and scanty, the cycle itself is short. In this case, it is recommended to take Zhanin, Jess, Yarina, since these drugs have an antiandrogenic component.

A balanced phenotype is characterized by a combination of the following features: average height, development of the mammary glands, normal fat content skin and hair, lack of PMS (premenstrual syndrome), menstruation of medium duration. For women with this phenotype, 2nd generation drugs are suitable: Femoden, Lindinet-30, Marvelon, etc.

In any case, the selection of birth control pills should be done by a doctor in order to take into account all your individual characteristics and get the maximum benefit from taking COCs with minimal consequences for the body.

How to take birth control pills

Standard packages of COCs have 21 tablets, but there are also preparations with 24 (for example, Jess) or 28 (Klaira) tablets in a blister. You need to take birth control every day, preferably at the same time of day. It is necessary to start taking it from the 1st day of menstruation, taking a week break after the end of the package, during which the woman begins her period. After 7 days, the woman should resume taking COCs, regardless of whether menstruation has stopped.

In the first 2 weeks of taking COCs (the very first pack), you need to additionally protect yourself, since the contraceptive effect begins to act only after 14 days from the start of taking the drug. Blocking ovulation begins immediately, but you can guarantee maximum protection against unwanted pregnancy after monthly intake tablets.

It is better to put the packaging with pills in a conspicuous place so as not to forget to take them. If you miss a birth control pill, you should take it as soon as possible. In this case, during the day it is better to protect yourself with condoms. In case of vomiting, you will need to take another pill out of turn in order to avoid reducing the effectiveness of contraception and it is also better to protect yourself from unprotected contacts.

Intermenstrual bleeding is not a reason to stop taking oral contraceptives. It takes place to be the first 2-3 months of taking COCs and is a consequence of the body's addiction to hormones from the outside. If necessary, take medicines that reduce the effect of contraception, for the entire period of their consumption must be protected. COCs after an abortion are taken either on the same day or a month later, when the first menstruation begins.

Even if the doctor selected the contraceptive pills for a woman, focusing on the results of her tests, those who take oral contraceptives periodically need to be examined for the presence or absence of side effects from taking the pills. The preventive reception includes measurement of blood pressure, urinalysis, biochemical blood test, examination of the mammary glands, gynecological examination.

Contraindications to taking birth control pills

Birth control pills are absolutely contraindicated for women with the following diseases:

• bronchial asthma;
• rheumatoid;
• multiple sclerosis(autoimmune disease);
• hyperthyroidism (enlargement of the thyroid gland);
• thyrotoxicosis (excessive intake of thyroid hormones into the blood);
• nalassemia (violation of the synthesis of any chain of hemoglobin);
• myasthenia gravis (pathological muscle fatigue);
• kidney dialysis;
• retinitis pigmentosa (eye disease);
• sarcoidosis (systemic connective tissue disease);
• lymphogranulomatosis ( malignant disease lymphoid tissue)
• Gilbert's syndrome (congenital hyperbilirubinemia)

Benefits of taking oral contraceptives

The criterion for correctly selected birth control pills is the cessation of intermenstrual bleeding after 3 months of the adaptation period, good health women, the disappearance of health problems (, oily skin). If the pills are chosen well, they can be drunk for a long time, not forgetting to undergo an examination at least once every 6 months to exclude the negative effect of COCs on the body.

Regular intake of oral contraceptives is an excellent prevention of the development of benign, cysts, cancer of the uterus and ovaries. With the help of birth control pills, the condition of the hair and skin improves, disappears increased hairiness, the frequency decreases inflammatory processes in the pelvic organs. COC helps fight such women's ailments as endometriosis and uterine fibroids.

Premenstrual syndrome and painful menstruation disappear, blood loss during critical days decreases, menstruation becomes regular. The advantages of birth control pills are also the convenience and ease of use, minimal side effects, low cost, the ability to delay or accelerate the onset of menstruation, and most importantly, almost 100% protection against unwanted pregnancy. Fertility usually returns within 2-6 menstrual cycles after stopping OCs.

Cons of birth control pills

But, despite the large number of advantages from taking COCs, in practice there are many negative aspects associated with them. Probably everyone heard about the danger hormonal contraception, about the terrible consequences in the form of obesity, hair growth, ovarian dysfunction. All this took place, but in the distant past, when the doses of hormones in the preparations were huge. Now they are reduced by 50 times, but the cons of taking contraceptives still exist.

In the modern world, pharmaceutical companies make a good profit on the sale of drugs that a woman needs on a monthly basis, so, of course, to publish truthful studies and reviews about them potential harm for the body no one will. However, it is reliably known that long-term use of oral contraceptives provokes the occurrence of migraine in the future, depression, hair loss, impaired body pigmentation, increased blood sugar, the development of osteoporosis, vascular thrombosis.

The ovaries of a woman clearly interact with all organs. The uterus expects a fertilized egg every month, and even a small dose of hormones from the outside disrupt this fragile and such an important interaction, which affects the entire body. With a very long-term use of OK, the function of the female genital organs changes.

The amount of sex hormones produced is reduced, the proper functioning of the ovaries is suppressed, the structure of the endometrium of the uterus, its mucous layer changes, because its rejection occurs unevenly, in the future this may negatively affect the reproductive health of a woman, therefore it is recommended to take breaks when taking contraceptives.

In women taking OK for more than 3 years, the risk of developing increases. Those who drink contraceptives for more than 5 years often develop Crohn's disease (chronic inflammatory disease gastrointestinal tract). COCs provoke the formation of blood clots in any vessels, including the vessels of the brain, heart, pulmonary artery, which in the future increases the risk of pulmonary thromboembolism.

Of course, everything is individual, but the risk increases depending on the dose of hormones received and the so-called additional risk factors - smoking, especially in women over 35 years old, high blood pressure, genetic predisposition.

The use of oral contraceptives leads to the formation of spider veins on the body, the appearance of venous insufficiency and related complications. A serious disease that can also be triggered by taking COCs is multiple sclerosis (the risk increases by 35%).

For many, taking birth control reduces libido. In addition, COCs do not protect against sexual infections, so it is not advisable to use them for women who have a large number of sexual partners. Particularly at risk of all these pathologies are young nulliparous girls who, from their youth, begin to drink birth control pills.

And at the beginning of taking hormones and after the end of the OK, the body experiences a strong shake-up, so some women take months or even years to recover after taking birth control. Prices for birth control pills are quite high and fluctuate on average from 500 to 2000 per pack.

For many women, a big disadvantage in taking OCs is a thorough examination that must be completed before taking birth control pills. But, unfortunately, regardless of whether a woman chose OK for herself or started taking them after taking tests and consulting a doctor, it happens that the drug may not be suitable.

So which birth control is best? This question can only be answered this way: everything is individual and depends on the immune, hormonal system of a woman and the health of her body as a whole. Reviews about taking birth control pills are very contradictory, one drug is suitable for someone, another for someone else.

It is important to realize that there are no good or bad birth control pills, there are drugs that are suitable or not suitable for a particular person. But it is in your power to minimize the risks by taking birth control correctly.

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