There are a lot of contraceptives. To navigate their choice, it is necessary to consider in detail the types of this assortment.
Main groups of contraceptives:
- hormonal contraceptives;
- spirals;
- candles;
- barrier agents;
- natural methods.
Hormonal drugs are considered the most effective.
Hormonal contraceptives are divided into the following types:
- vaginal ring;
- patch;
- injections;
- pills.
All hormonal preparations contain sex hormones: estrogens and gestagens. These hormones suppress the ovulation process and thicken the natural fluid that the cervix secretes. As a result, it is difficult for sperm to penetrate into the uterine cavity.
In addition, the entry of new sex hormones into the body slows down the production of its own. Because of this, the egg does not mature, which means pregnancy will not occur.
Under no circumstances should you take these medications on your own. Hormonal drugs contain many contraindications. Only after medical examination, the doctor will prescribe this or that remedy.
The Nova Ring vaginal ring is a modern contraceptive for women. It is a transparent elastic ring that is inserted into the vagina.
You need to start using the ring from day one menstrual cycle. The contraceptive releases a certain amount of hormones for 3 weeks. After this, the woman must remove the contraceptive without the help of a gynecologist. After 7 days, the ring is reinstalled as intended.
Side effects: migraines, nausea, vaginal discharge. If such manifestations become frequent, you should consult a doctor.
This product looks like a regular patch. It is glued to any area of the skin except the chest. The principle of its action is that the patch actively releases hormones that are absorbed through the skin.
Hormones inhibit the maturation of the egg and increase the viscosity of the fluid that accumulates at the cervix.
The first patch should be applied from the beginning of the menstrual cycle. The effect of one patch is 1 week. Therefore, in one menstrual cycle it is necessary to use 3 patches, and then take a break for 7 days.
The IUD is an intrauterine device that has proven itself to be a highly effective contraceptive. It is not recommended to use this method for girls under 23 years of age. Despite its effectiveness (99%), the IUD can cause complications, including infertility.
The spiral is inserted into the uterus itself. This is done by a gynecologist after a thorough medical examination. The validity period of this device is up to 5 years.
Happens hormonal IUD(Mirena) and non-hormonal - made of plastic and copper. The copper spiral is an effective remedy and has much fewer contraindications. It can be used even during lactation. However, a copper IUD cannot be used in the presence of chronic diseases of the reproductive system and inflammation.
The hormonal uterine device is the most popular among women. This drug releases certain doses of the hormone levonorgesterol into the uterine cavity, which prevents pregnancy.
Benefits of the hormonal IUD:
- reduces discharge during menstruation;
- long-term effect – up to 5 years;
- efficiency 99%.
Disadvantages of the spiral:
- age limit (from 25 years);
- menstruation disorders;
- contraindications for liver and heart diseases.
Contraceptive injections
This method involves injecting a woman intramuscularly with a special substance that stops the ovulation process and also changes the composition of the mucus in the uterus. As a result, it is almost impossible to get pregnant. The duration of the injection is 3 months.
However, not everything is so simple. This contraceptive can cause bleeding, headaches, and decreased libido. Long-term use of this method can negatively affect the integrity of bone tissue.
So, hormonal contraceptives are quite effective, but they have a number of side effects on the body. How can this be? If a woman has health problems and the doctor does not recommend taking hormonal medications, then you can use non-hormonal contraceptives in the form of suppositories.
Contraceptive suppositories are chemicals from spermicide. The candle is inserted into the vagina before sexual intercourse and, under the influence of body temperature, melts there, creating a protective membrane inside. Thus, sperm are retained by this substance and do not penetrate into the uterus.
The candle is valid for up to 5 hours. This remedy protects not only from pregnancy, but also from the penetration of infections and sexually transmitted viruses. The main disadvantage of suppositories is their regular administration before each sexual intercourse. Also undesirable long-term use suppositories, since spermicide can disrupt the internal microflora of the vagina.
After sexual intercourse using a candle, you should not wash with soap, as the alkali will neutralize the chemical substance that makes up the candle. Therefore, it is better to wash with just warm water.
Safe contraceptives
Thus, having studied the listed methods of contraception, we can conclude that they have side effects because they contain hormones or chemicals. Are there really no other methods that are safer for health? This issue is especially relevant for young girls who have not given birth, who find it difficult to get pregnant after taking contraceptives.
Alternative methods of contraception:
- interrupted sexual intercourse;
- condom;
- calendar method;
- temperature method;
- douching.
Alternative methods are not harmful to health, but their effectiveness is low.
Coitus interruptus- A fairly popular method among married couples. However, its effectiveness is 70-75%. It involves the man removing the penis from the vagina before ejaculation. The effectiveness of the method is reduced by the fact that during sexual intercourse a small amount of sperm is still released along with natural lubrication. And not every man can control himself during sex.
Condom– the most reliable means not only from unwanted pregnancy, but also from sexually transmitted diseases. This is especially true for those who do not have a permanent partner.
Calendar method- the simplest. It involves calculating the ovulation phase according to the calendar. To do this, you need to know the length of a woman’s cycle and the first and mark the first day of menstruation on the calendar. Count 10-11 days from this day - the beginning of ovulation. Ovulation lasts approximately 7-9 days. During this period, you should abstain from sexual relations, since it is at this time that the risk of becoming pregnant is greatest.
Temperature method involves measuring basal temperature in women different days cycle. After ovulation, it rises by 0.2°C, which indicates that it is safe to get pregnant. This method is quite painstaking - it requires daily recording of the temperature.
Douching consists of washing the vagina various solutions immediately after intercourse. To do this, you can prepare a weak solution of sea salt or a decoction of herbs. But this method is also very doubtful - after all, there will always “be” active sperm that will “have time” to penetrate the uterine cavity.
Which birth control pills are best to choose?
Oral contraceptives are divided into two groups:
- Combined, containing estrogen and gestagen.
- Mini-pills that contain only one hormone - gestagen.
How to take contraceptives? There is no single dosage regimen oral contraceptives, since each of them contains a different dose of hormones and is prescribed individually.
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Contraindications to taking oral contraceptives:
- diabetes;
- varicose veins;
- hypertension;
- heart disease;
- migraines;
- metabolic disorders;
- excess weight;
- malignant tumors;
- high cholesterol;
- pregnancy and breastfeeding;
- age over 40 years.
Types of birth control pills
One of the most popular contraceptives of our time is Yarina birth control pills. They stabilize the cycle well, do not cause weight gain, and perfectly fulfill their intended purpose - to protect against pregnancy.
But this drug has a side effect: long-term use causes frequent headaches.
If such diseases are present, then these tablets should not be taken. In addition, “Yarina” gives a number of other complications: vegetative-vascular dystonia and headaches.
Birth control pills Jess is a combination drug with antiandrogenic effects. This drug has a good contraceptive effect, treats acne and eliminates premenstrual syndrome.
The package contains 28 tablets, which should be taken 1 per day. In addition, the pack contains a special calendar in which it is convenient to mark the days of taking the pills.
Side effects of the drug:
- nausea;
- vomit;
- bleeding;
- headaches.
The drug is contraindicated during breastfeeding.
Contraceptive Regulon has several areas of application:
- protects against unwanted pregnancy;
- treats dysfunction of uterine bleeding;
- stabilizes the cycle;
- treats dimenorrhea;
- eliminates pain during menstruation;
- treats uterine fibroids;
- resolves ovarian cysts.
Thus, Regulon - excellent medicine from women's diseases. Unlike previous drugs, Regulon is usually prescribed to women over 40. It helps prevent abortion and its negative consequences.
Birth control Lindinet is a hormonal pill that helps prevent pregnancy and also stabilizes the menstrual cycle. The tablets also prevent the occurrence of ectopic pregnancies and reduce the risk of tumors in the mammary glands. Lindinet perfectly treats acne on the skin.
Contraindications:
- hepatitis;
- pancreatitis;
- otosclerosis;
- smoking;
- pregnancy and lactation;
- thrombosis;
- tumors of the genital organs.
There are post-coital birth control pills that are emergency contraception. This method is an “ambulance” for unprotected sexual intercourse. They are hormonal and should be taken immediately after sex.
The most popular drugs in this series: Miniziston, Femoden, Marvelon. These contraceptives are widely available and are available in pharmacies without prescriptions.
Oral contraceptives are available in monophasic, biphasic and triphasic forms. The doses of hormones in each drug are different. However, the rules for taking pills are, in most cases, the same.
Rules for taking birth control pills:
- Before you start taking pills, you must consult your doctor.
- You should take the tablets at the same time every day (preferably at night or with meals).
- As a rule, 1 pack contains 21 tablets, which should be taken every day from the beginning of the cycle, and then take a break for 1 week.
- After the end of the break, on the 8th day you should resume taking the pills with a new package, if pregnancy is not planned.
- If one tablet was missed in weeks 1 and 2, then it should be taken immediately, and then the next one after 12 hours. The next day - according to the usual schedule.
- If 1-3 tablets were missed in the third week, it is better to stop taking it before your period. And after menstruation - resume the course.
When to stop taking the pills:
- Onset of pregnancy.
- Frequent headaches.
- A sharp increase in body weight.
- Increased pressure.
- Visual impairment.
- Voice change.
- The occurrence of gynecological diseases.
- 3 weeks before surgery.
Pregnancy after birth control
Many women are concerned about the question: is it possible to get pregnant after long-term use? contraceptive drugs?
The answer is simple: you can! In any instructions contraception it is indicated that pregnancy can occur in the next cycle after discontinuation of the contraceptive.
But is everything so clear?
After all, if a woman took contraceptives for a long time, then all functions of the reproductive system were suppressed. After stopping the pills, female organs are gradually starting to return to old job, sometimes even with enhanced effect. It is this fact that gynecologists often use in the treatment of infertility. A woman who cannot get pregnant is prescribed contraceptives for 2-4 months, and then discontinued to “spur up” reproductive system perform twice as well. In most cases, this method helps. But sometimes you have to undergo 2-3 courses of such therapy.
Menstruation when taking birth control pills is quite scanty. This is explained by the fact that hormonal drugs suppress the biological processes of the female body. However, this case has its advantages. Firstly: menstruation passes very quickly while taking contraceptives and they are practically painless. Secondly, a clear monthly cycle— 28 days.
There are times when a woman wants to artificially “delay” her period. For example, when traveling to the sea. In this case, she does not take a week's break from taking the pills, but continues to take them. Then your period does not come. But this cannot be abused! After all, the menstrual cycle may be disrupted or intermenstrual bleeding may appear.
Good contraceptives are those that suit a woman individually. This means that a contraceptive should be selected by a gynecologist, taking into account all the characteristics of the individual’s body. And whether or not to take contraceptives is a personal matter for everyone.
The main thing to remember: Children should be wanted and born on time. After all, there is nothing worse than an unloved and abandoned child.
Exists large number contraceptives, but the leading position among the whole variety is occupied by birth control pills, which are characterized by a high degree of prevention of unwanted pregnancy. Let's look at each of the groups of drugs in order to know which birth control pills are best to choose, find out the names and read reviews about them.
Microdosed hormonal drugs
The drugs in this group of tablets are characterized by minimal side effects.
Suitable for both girls over 18 years old and women over 35 years old who are constantly sex life.
Zoely
A drug that contains nomegestrol acetate and estradiol hemihydrate. These compounds are similar in structure to natural female hormones. The drug is aimed at suppressing ovulation. It also acts on cervical mucus, changing its secretion.
Claira
Highly effective combined oral contraceptive. Reduces the risk of cancer in women, minimally affects the liver. Its composition is close to the natural hormonal background of women, where the main active substance– estradiol valerate. Indicated for any age. The tablets should not be taken during breastfeeding or early pregnancy.
A monophasic drug that is aimed at suppressing ovulation and changes in cervical secretions, which leads to a decrease in permeability to sperm. Improves the regularity of menstruation, reduces painful sensations. When using contraception, the risk of cancer is reduced. The main active ingredient is ethinyl estradiol, the auxiliary ingredient is drospirenone. You can use the tablets after 40 years.
A new drug that, in addition to contraception, contains vitamins. Unlike Jess tablets, it contains calcium levomefolate. The drug is aimed at suppressing ovulation and minimizing sperm permeability. When taken, there is an effect of reducing pain during menstruation.
Dimia
Microdosed oral contraceptive is combined agent, which contains ethinyl estradiol and drospirenone. The action is based on inhibition of ovulation and changes in cervical secretions.
A drug aimed at contraception as a result of inhibition of ovulation and changes in the properties of uterine mucus. The main active ingredients are ethinyl estradiol and levonorgestrel. Positively affects the regularity of menstruation, suppresses painful sensations. Thanks to its composition, it reduces the risk of developing iron deficiency anemia.
Lindinet-20
Monophasic tablets, which are aimed at inhibiting the secretion of gonadotropic hormones of the pituitary gland. The active ingredients are ethinyl estradiol and gestodene. Prevents the development of a viable egg, has positive impact on the regularity of the menstrual cycle, reduces the risk of tumors in women.
Contraceptive drug, release form - pills. It interferes with the ovulation process and increases the viscosity of the uterine mucus. Before starting to use the drug, you should undergo a thorough gynecological examination. The active ingredients are ethinyl estradiol and gestodene.
Novinet
A drug based on a combination of estrogen and gestagen that suppresses ovulation and slows down the movement of sperm. The active ingredients of the tablets are synthetic estrogen, the progestogen desogestrel. When taken, blood loss during menstruation is noticeably reduced, so it is indicated for women with heavy discharge.
Mercilon
The main active ingredients in the drug are ethinyl estradiol and desogestrel. Duration of treatment – 21 days, then a break – 7 days and resumption of treatment.
Low-dose drugs
Drugs that belong to this group are suitable not only for women who have given birth, but also for girls over 18 years of age.
They are prescribed by gynecologists if microdosed hormonal pills are not suitable.
Yarina
New generation tablets containing ethinyl estradiol and drospirenone. It is a multiphase drug. Besides contraceptive action, has a cosmetic effect, reducing acne.
Midiana
Birth control pills, which are characterized by low content hormones. The active ingredients of the drug are ethinyl estradiol and drospirenone. It is also prescribed for cosmetic purposes in the fight against acne.
A contraceptive drug with a small hormone content. The main active ingredients are desogestrel and ethinyl estradiol. Reduces pain during menstruation, improves skin condition with acne. It is advisable to take one tablet at the same time for 21 days with a break of 7 days. Especially suitable for girls over 18 years old and women over 40 years old.
Lindinet-30
Monophasic contraceptive, which is characterized by suppression of the secretion of gonadotropic hormones of the pituitary gland, while preventing unwanted pregnancy. The main active ingredients are ethinyl estradiol and gestodene. Release form: film-coated tablets are quickly absorbed into the gastrointestinal tract.
Femoden
A drug used regularly to prevent unwanted pregnancy, as well as to normalize the menstrual cycle and regulate the intensity of discharge during menstruation. Refers to drugs with low hormone content. The main active ingredients are ethinyl estradiol and gestodene. Indicated for scheduled use.
Silest
A combined drug whose action is aimed at regulating the gonads in order to prevent unwanted pregnancy. The main active ingredients are norgestimate and ethinyl estradiol. Used for 21 days with a break of 7 days. Apply orally.
Janine
Low-dose monophasic contraceptive. The main active ingredients are ethinyl estradiol and dienogest. It affects the body through three mechanisms: suppression of ovulation, increased mucus impermeability, and changes in the endometrium. As a result of use, an improvement in the regularity of menstruation is observed. Prescribed to women for regular use to prevent unwanted pregnancy.
Silhouette
The main active ingredients of the drug are ethinyl estradiol and levonorgestrel. Release form: pills. The drug is quickly absorbed in the intestines. Doctors prescribe it to treat acne, normalize the menstrual cycle and prevent unwanted pregnancy. The drug is intended for regular use.
Combined drug for contraception in women. Prevents sperm from entering the egg. The main active ingredients are ethinyl estradiol and desogestrel. Prescribed by a gynecologist to normalize the menstrual cycle and PMS as well. Characterized by regular use.
Marvelon
The main active ingredients are ethinyl estradiol and desogestrel. Characterized by oral use daily for 21 days with a break. Contains a small amount of hormones. Aimed at suppressing ovulation and controlling the regularity of the menstrual cycle.
High dose tablets
Drugs that belong to the group of high-dose hormonal pills, can only be taken with a doctor's prescription.
Prescribed for treatment purposes hormonal diseases and for contraception during their treatment.
Three-phase medicinal drug, which is aimed at contraception, is characterized high content hormone. The main active ingredients are ethinyl estradiol and levonorgestrel. The drug blocks the maturation of a viable egg. It is prescribed by a doctor, and examinations are required every 6 months.
Triquilar
Combined contraceptive, which is characterized by high dosage. The main active ingredients are ethinyl estradiol and levonorgestrel. It is used in three phases for 21 days with a break. Women applying this remedy, observe stabilization of the menstrual cycle and high contraceptive results.
A highly effective drug containing progestin and estrogen. Indications for use: prevention of unwanted pregnancy. It is characterized by good tolerability.
A contraceptive containing estrogen and gestagen. These components have a high degree of activity compared to natural hormones and under their influence ovulation stops. The effect of application is 100%.
Non-ovlon
The hormonal drug is available in the form of green dragees, in a package of 21 tablets. Characterized by a high level of hormone content. The main active ingredients are ethinyl estradiol and norethisterone. Indicated for use to prevent pregnancy, regulate cycle duration, and treat psychological infertility.
Mini-pill
Mini-pills refer to medicines that prevent pregnancy. Distinctive feature– this is a gentle effect on the woman’s body.
With regular use, the effect of the mini-pill is 99%.
They are an oral contraceptive.
A contraceptive based on the active ingredient desogestrel. Affects the condition of the uterine mucus, making it thicker and less permeable to sperm. Approved for use by nursing women.
Charosetta
A drug that prevents unwanted pregnancy by reducing the possibility of ovulation and increasing the viscosity of uterine mucus. Does not affect lipid processes in the human body. Normalizes the menstrual cycle in women. The main active ingredient is desogestrel.
Exluton
It is a contraceptive that can be used after childbirth. The main active ingredient is desogestrel. It is prescribed orally. The drug is for daily systematic use. In case of irregular use, the result is not guaranteed.
Microlute
A contraceptive that contains gestagen, which makes it well tolerated by women. The main active ingredient is levonorgetrel. Can be used during breastfeeding. Its use in conjunction with non-hormonal contraceptives is also recommended.
Non-hormonal tablets
A distinctive feature of non-hormonal pills is that they are inserted into the vagina rather than taken orally.
They act due to the active substance in the composition, which affects sperm, destroying them.
The main active ingredient is benzalkonium chloride. The drug does not affect the natural microflora of the vagina. It is prescribed if it is not possible to use stronger (hormonal) contraceptives.
Gynekotex
Vaginal tablets that have a contraceptive and antiseptic effect. The main active ingredient is benzalkonium chloride. Can be used during pregnancy and breastfeeding. Inserted into the vagina 5-10 minutes before sexual intercourse. Do not affect the natural microflora of the vagina.
Benatex
A product that prevents unwanted pregnancy and has the property of getting rid of unwanted microbes and fungi in the vagina. The main active ingredient is benzalkonium chloride. There are no contraindications for use during pregnancy and breastfeeding.
A contraceptive containing active substance– benzalkonium chloride. It destroys the structure of the sperm and thereby prevents unwanted pregnancy. It must be inserted into the vagina before sexual intercourse. Also serves as an antiseptic.
Contratex
Non-hormonal pills that are aimed at destroying the sperm membrane during sexual intercourse. The main active ingredient is benzalkonium chloride. They are inserted into the vagina and tend to thicken the uterine mucus. Can be used while breastfeeding.
Nonoxynol
Contraceptive pills, which, in addition to their main properties, have antifungal properties. The main active ingredient is nonoxynol. Prescribed by a doctor, including during lactation and pregnancy.
Traceptin
A vaginal product that is necessary for contraception. Introduction is recommended into the vagina 5-10 minutes before sexual intercourse. The main active ingredient is potassium hydrogen tartrate. A non-hormonal drug that can be used during pregnancy and breastfeeding.
All contraceptive medications must be prescribed by doctors with preliminary diagnosis on an individual basis.
And it should be remembered that the contraceptives in question have a much better effect on a woman’s body than birth control pills after sexual intercourse.
In this article we will look at 2 “sides of the coin” - positive aspects taking oral contraceptives and potential health hazards:
- at the beginning of the article we will look at the classification, contraindications, side effects and all the positive aspects of taking hormonal contraceptives
- then about the potential risk of developing long-term consequences of taking such drugs even by a healthy woman.
With this we want to draw the attention of women to a longer-term prognosis of their health and think about the fact that any intervention in natural processes in female body is fraught with consequences - for some insignificant, barely noticeable, for others much more serious, even tragic.
In no case do we encourage you to refuse medications prescribed by your doctor; the article is for informational purposes and the decision to take oral contraceptives is made by a woman after consultation and examination with a gynecologist. But, every woman should be aware of the possible risks she is exposed to when taking oral contraception for a long time.
Groups of birth control pills, names and their effects
Despite the fairly rich assortment of contraceptives available in pharmacies, hormonal birth control pills occupy a leading position today (and bring their manufacturers billions of dollars a year). Unfortunately, not everyone knows about contraindications to their use, side effects, rules for taking pills, that their use should not be long and the choice of oral contraceptives should be made only by a doctor after a thorough diagnosis and collection of the patient’s medical history.
All contraceptive hormonal pills are divided into two “companies”: combined oral contraceptives (COCs) and mini-pills.
Monophasic tabletsIn these tablets, the percentage of estrogen and progestogen components does not change in each tablet. |
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Desogestrel and ethinyl estradiol:
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 Ethinyl estradiol and dienogest:
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 Gestodene and ethinyl estradiol:
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Biphasic drugsIn them, the dose of estrogen is the same in all tablets, and the dose of gestagen changes in the 1st and 2nd periods of the menstrual cycle. |
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Triphasic tabletsIn the OK data, the doses of hormones change three times in one package, which is associated with changing periods of the menstrual process. |
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The main point in the mechanism of action of COCs is the blocking of ovulation, caused by inhibition of the formation of FSH and LH in the pituitary gland. At the same time, ovarian function and a local obstruction to ovulation are blocked. In addition, “glandular regression” occurs in the structure of the uterine mucosa, which makes implantation of a fertilized egg impossible. Changes also occur in the mucus of the cervical canal; it thickens, which disrupts the movement of sperm deeper into the uterus.
COCs are also divided into 3 groups based on the quantitative content of active components:
Microdosed OK
The dose of hormones in these pills is minimal, so they are ideal for young women under 25 years of age, and, in addition, for those who are faced with the need to take birth control pills for the first time. Examples of drugs: Zoeli (monophasic), Qlaira (3-phase) and other monophasic drugs - Jess, Dimia, Logest, Mercilon, Miniziston, Lindinet, Novinet.
Low-dose OK
Such tablets are recommended for young and mature representatives of the fairer sex, including those who have gone through childbirth, or are prescribed to those patients who experience intermenstrual spotting when using microdosed drugs. According to manufacturers' research, a group of low-dose tablets has an antiandrogenic effect (hair growth in uncharacteristic places decreases, acne and increased skin greasiness disappear, decreases). The list of birth control pills includes: Diane, Yarina (Midiana), Femoden, Siluet, Janine, Tri-mercy, Lindinet, Silest, Miniziston, Regulon, Marvelon, Microgynon, Rigevidon, Belara, Chloe, Demoulen.
High-dose OK
The dose of hormones in these contraceptive pills is quite high, so they are prescribed either for the purpose of treatment (for example, endometriosis) or at the stage of treatment of hormonal disorders (Non-ovlon, Triquilar, Ovidon, Trizeston, Tri-regol) only as prescribed by a doctor.
We can say about mini-pills that they contain only progestogen. The mechanism of their action lies in the local effect on the peripheral areas of the reproductive system. Firstly, mini-pills affect the composition of cervical mucus and its quantity. So, in the middle of the cycle, its volume decreases, but the viscosity of the mucus remains high in any phase of the menstrual cycle, which interferes with the free movement of sperm. Changes also occur in the morphological and biochemical structures of the endometrium, which create “poor” conditions for implantation. In about half of women, ovulation is blocked. Mini-pills include: linestrenol (Exluton, Microlut, Orgametril), desogestrel (Lactinet, Charozetta).
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How to choose good birth control pills
Which birth control pills are good, the best, you can’t figure this out on your own, much less buy them at the pharmacy on the recommendation of friends or a pharmacist. To find the best birth control pills, you need to visit your doctor. The gynecologist will collect an anamnesis, focusing specifically on family history, existing diseases or those suffered in the past, since all of the above may be a contraindication to the use of hormonal contraceptives.
After this, the doctor will conduct an examination, during which he will evaluate:
- skin (telangioexaia, petechiae, signs of hyperandrogenism, presence/absence of hypertrichosis, etc.)
- measures weight and blood pressure
- palpates the mammary glands
- will prescribe tests for liver enzymes, blood sugar, blood coagulation system, tests hormonal levels, Ultrasound of the mammary glands, ultrasound of the pelvic organs, mammography if necessary
- then conduct a gynecological examination with taking smears
- A woman should also visit an ophthalmologist, since long-term use of OCs increases the risk of developing other eye diseases.
To prescribe tablets that are most favorable for a given patient, her constitutional and biological type is taken into account, which takes into account:
- height, appearance
- mammary glands
- pubic hair
- skin, hair
- menstruation and premenstrual symptoms
- cycle irregularities or absence of menstruation
- as well as existing chronic diseases
There are 3 phenotypes:
Prevalence of estrogens
Women of short or medium height, very feminine in appearance, skin and hair tend to be dry, menstruation with significant blood loss and long, and the cycle is more than four weeks. Medium and high-dose COCs are suitable for patients with this phenotype: Rigevidon, Milvane, Triziston and others.
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Milvane (ethinyl estradiol and gestodene):
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Balanced type
Women are of average height, feminine, medium-sized and developed mammary glands, normal oily skin and hair, no premenstrual signs, menstruation 5 days every 4 weeks. For such women, second-generation drugs are recommended: Marvelon, Silest, Lindinet-30, Microgynon, Femoden and others.
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Ethinyl estradiol and desogestrel:
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Ethinyl estradiol and Norgestimate:
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Eethinyl estradiol and gestodene (Milvane):
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Ethinyl estradiol and levonorgestrel:
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Prevalence of gestagens/androgens
Women are tall, have a “boyish” appearance, underdeveloped mammary glands, oily skin and hair, depression on the eve of menstruation and abdominal pain, lumbar region, menstruation is scanty, less than 5 days, cycle is short, less than 28 days. In this case, the doctor will recommend hormonal drugs with an antiandrogenic component: Diane-35, Janine, Yarina, Jess.
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Ethinyl estradiol and drospirenone:
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Ethinyl estradiol and drospirenone:
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Nomegestrol and Estradiol
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Ethinyl estradiol and dienogest:
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Ethinyl estradiol and cyproterone:
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How to take hormonal oral contraceptives correctly
Standard blisters with COCs contain 21 tablets. There are only a few exceptions, for example, Jess - a new generation of birth control pills, which contain 24 tablets and are often prescribed by gynecologists to young women. For women over 35 years of age, the doctor may recommend Qlaira tablets, a new generation of oral contraceptives containing 28 tablets.
How to take birth control pills:
- You should take the pills every day, at approximately the same hour, starting on the first day of menstruation.
- In order not to forget about taking the next pill, it is better to put them in a place where a woman looks every day (in her cosmetic bag, to her toothbrush, or attach it to the refrigerator with a magnet).
- Take one tablet every day until the blister runs out.
- Then you need to take a break for a week.
- During this time period, menstrual-like bleeding will begin.
- At the end of 7 days, start taking COCs again, regardless of whether menstruation has ended or not.
- In case of vomiting, you must take an extra pill.
- If you miss taking a pill, you need to take it as quickly as possible.
- In these two cases, you need to take additional protection during the day.
- At the very beginning of taking COCs, if they have not been used before, you should additionally use protection for the first 14 days.
- Intermenstrual bleeding is not considered a reason to stop taking pills (see)
- They are usually observed in the first 2–3 months, and indicate a reconfiguration of the body from hormones that are synthesized in the ovaries and pituitary gland to hormones coming from outside.
Taking hormonal combination drugs after a medical termination of pregnancy, it should begin either on the day ) or a month later, when the first menstruation begins.
The contraceptive effect of hormonal drugs may decrease with simultaneous use with a number of drugs, for example, rifampicin (it stimulates the activity of liver enzymes). Therefore, when prescribing treatment for any disease, inform your doctor about taking oral contraceptives, and carefully study the instructions for use of the drugs prescribed to you. In case of appointment medicines that reduce the effect of COCs, additionally use other methods of protection (condoms).
A standard mini-pill blister contains 28 tablets. These tablets are taken without a break for 7 days, just like COCs, at the same hour. Mini-pills are suitable for women who are breastfeeding breast milk. If a woman does not lactate or prefers artificial feeding, then low-dose COCs (Belara, Miniziston, Regulon and others) are recommended for her. You can start taking COCs as early as 21–28 days after delivery.
It is worth knowing that the contraceptive effect begins to manifest itself after 2 weeks of taking the pills, and 100% effect and reliability of such a contraceptive method as OK occurs in the second month of taking the drugs. Ovarian blockade begins as soon as hormones begin to flow from outside, but the maximum guarantee comes after a month’s course of their use.
Side effects of birth control drugs
Side effects are signs or conditions that develop when using contraceptives, but do not threaten women’s health. They are divided into 2 groups:
Minor side effects:
|
Serious side effects:
|
In case of serious, as well as persistent minor side effects, contraception is discontinued.
Regardless of the chosen OC, a woman needs periodic assessment of her health in connection with possible side effects from taking them, namely:
- Blood pressure: measure once every 6 months
- Physical examination (breast, liver palpation, gynecological examination), urine test: 1 r/year
- Monthly breast self-examination.
It is no secret that in many developing countries, regular screening is unlikely, and there are programs (in some countries) to distribute OCs to women who do not have access to medical care. This indicates a high likelihood that OCs will be used by groups of women high risk. Consequently, it will be more difficult for such women to obtain medical help in the event of dangerous side effects.
Absolute contraindications to oral contraceptives
Diseases for which the use of oral contraceptives is not advisable: (congenital hyperbilirubinemia), bronchial asthma, rheumatoid arthritis, multiple sclerosis, thyrotoxicosis, ), myasthenia gravis, sarcoidosis, retinitis pigmentosa, thalassemia, renal dialysis.
Absolute contraindications to combined OCs:
|
Absolute contraindications to taking pure progestins:
|
At the end of the article there is a video of a TV show detailing the dangers of using OCs by any woman, since even in the absence of the contraindications listed above (the woman and the doctor may not be aware of them), it would seem healthy woman the risk of developing pulmonary thromboembolism and cancer is extremely high.
Hormonal contraceptives and possible pregnancy
Can you get pregnant while taking birth control?
This question worries many women. Of course, pregnancy while using hormonal oral contraceptives is not excluded, but its likelihood is too low.
- First of all, an unwanted pregnancy occurs when the rules for taking pills are violated (missing, irregular, different times intake, the expiration date of the drug has expired).
- It should also be taken into account possible vomiting in case of poisoning or combined use with drugs that reduce the contraceptive effect of hormonal pills.
Is it possible to take contraceptives when pregnancy has already occurred or is suspected?
The answer to this question is negative. If pregnancy occurs after taking contraceptive drugs, it is desired, then there are no indications for its termination (interruption). You just need to stop taking the pills right away.
Taking hormonal pills in late childbearing years
Currently, in economically developed countries, about half of married couples after 40 years of age prefer sterilization. Hormonal medications include COCs or mini-pills. Women who are over the age of 35 should stop using hormones if they have cardiovascular pathology coupled with smoking and a high risk of cancer. A good alternative for women after 40-45 years of age are mini-pills. These drugs are indicated for uterine fibroids, endometriotic inclusions and endometrial hyperplasia.
Emergency and non-hormonal contraception
- Emergency contraception
If sexual intercourse occurs without the use of means that protect against pregnancy, emergency (fire) contraception is performed. One of the well-known and widely used drugs is Postinor, Escapelle. You can take Postinor no later than 72 hours after coitus without using contraceptives.
First you need to take one tablet, and after 12 hours the second one is taken. But you can also use COCs for fire contraception. The only condition is that one tablet must contain at least 50 mcg of ethinyl estradiol and 0.25 mg of levonorgestrel. First, you should take 2 tablets as soon as possible after coitus, and repeat another 2 tablets after 12 hours.
These drugs can only be used in emergency cases (rape, damage to the condom), WHO does not recommend their use more than 4 times a year, but in Russia they are popular and used by women much more often (see). In fact, they have an abortifacient effect; of course, this is not a surgical manipulation like a medical abortion, but it is no less harmful from the point of view of the further reproductive function of the female body.
- Non-hormonal contraception
They are spermicides that are used topically to prevent unwanted pregnancy. Active ingredient Such tablets inactivate sperm and “prevent” them from entering the uterine cavity. Moreover, non-hormonal tablets have anti-inflammatory and antimicrobial effect. These tablets are used intravaginally, that is, they are inserted deep into the vagina before intercourse. Examples of non-hormonal tablets: Pharmatex, Benatex, Patentex Oval and others.
Arguments FOR taking hormonal birth control pills
Contraceptive pills, especially new birth control pills (new generation) have advantages over barrier contraceptives. Positive points the use of OCs, which are promoted by gynecologists:
- one of the most reliable and high-quality methods of contraception (effectiveness reaches 100%);
- can be used at almost any age;
- while taking contraceptive pills, the menstrual cycle becomes regular, and pain during menstruation may disappear (see);
- good cosmetic effect (disappearance of acne, oily or dry hair and skin disappear, reduction of pathological hair growth);
- peace of mind (no fear of getting pregnant);
- the possibility of accelerating the onset of menstruation or delaying it;
- therapeutic effect - endometriosis, uterine fibroids, ovarian cyst (do OK healing effect- still remains a highly controversial issue, since most studies are carried out by manufacturers of hormonal contraceptives);
- after stopping taking the pills, fertility is usually restored within 2-6 menstrual cycles (with rare exceptions, up to a year).
But despite all the advantages, negative consequences there is much more benefit from taking hormonal contraceptives and they outweigh the arguments FOR. Therefore, the decision whether to take birth control pills is made by the doctor and the woman herself, based on the presence of contraindications, possible side effects of these drugs, general condition health, availability chronic diseases. According to the results of many studies, taking oral contraceptives (long-term) has long-term negative consequences for the health of women, especially those who smoke and have any chronic diseases.
Arguments AGAINST oral contraceptives
In the modern world, the pharmaceutical industry is a business like any other sector of the economy, and the material benefits from the sale of drugs that a woman needs every month are fabulous. Over the past decades, independent American experts have conducted several studies, the results of which suggest that taking hormonal contraceptives by a woman before the birth of 1 child increases the risk of cervical cancer. In addition, OCs cause depression, contribute to the development of osteoporosis, hair loss, and the appearance of pigmentation on the body.
Hormones produced by the body perform certain functions in the body, controlled in the higher hormonal centers - the pituitary gland and hypothalamus, which are associated with the adrenal glands, thyroid gland and ovaries ( peripheral organs). The ovaries have a clear hormonal interaction with the entire body, the uterus waits for a fertilized egg every cycle, and even small doses of hormones coming from outside disrupt this fragile interaction.
With long-term use of hormonal contraceptives, the functions of the genital organs completely change. Every day, taking the pill suppresses ovulation, the release of an egg does not occur, the functions of the ovaries are suppressed, and this, in turn, inhibits the regulatory centers. With prolonged use of pills (for years), a woman’s uterus undergoes a change in the inner layer, as it is rejected unevenly (hence bleeding and). The mucous layer and tissue of the uterus gradually changes, which in the future (usually during menopause) threatens with oncological degeneration.
With long-term use of oral contraceptives, the amount of sex hormones is reduced, the ovaries decrease in size, and their nutrition is disrupted - this is a powerful blow to the reproductive function of the body. Both at the beginning of taking OCs and after stopping them, a disruption occurs in the hormonal system, so in some women, restoration of reproductive function occurs within a year, and in some cases it may not be restored at all. So:
- Women who have the contraindications listed above should never take oral contraceptives, as they may develop serious complications, up to death (development of vascular thrombosis), oncology;
- with long-term use of OCs, the excretion of vitamin B6 from the body is accelerated, which can lead to hypovitaminosis B6, as well as vitamin B2 (see), which negatively affects nervous system(weakness, insomnia, irritability, skin diseases etc. see);
- also OK interfere with the absorption of something very important for the body folic acid, which is very necessary 3 months before conception and during a future desired pregnancy and (see), the addition of which to some hormonal contraceptives is only a marketing ploy;
- Long-term use (over 3 years) doubles the risk of developing glaucoma. A study by scientists at the University of California showed that (3,500 women over 40 years of age took contraceptives from 2005 to 2008) when taking oral contraception for 3 years without interruption, women were more likely to be diagnosed with glaucoma.
- oral contraceptives significantly increase the risk of developing osteoporosis in women in the future (after 40 years, see);
- Taking OCs for 5 or more years increases the risk 3 times (see). Researchers associate the growth of this disease with the “Era of Hormonal Contraception”;
Today - in the age of oncological tension and unimproved early diagnosis initial asymptomatic stages of oncology, a woman taking OCs may not be aware of the presence of early stages of oncology, in which contraceptives are contraindicated and contribute to aggressive tumor growth;
- studies by Danish scientists show that long-term use in women is 1.5-3 times;
- oral contraceptives promote thrombus formation in any vessels, incl. and vessels of the brain, heart, pulmonary artery, which increases the risk of stroke and death from pulmonary thromboembolism. The risk increases depending on the dose of hormones, as well as additional risk factors - high blood pressure, smoking (especially over 35 years), genetic predisposition, see;
- taking oral contraceptives increases the risk of the appearance and development of chronic venous insufficiency- pain in the legs, night cramps, a feeling of heaviness in the legs, transient swelling, trophic ulcers;
- the risk of developing inflammatory diseases cervical, breast cancer
- in some cases, the return of fertility is delayed (1 - 2%), that is, the body gets used to the supply of hormones from the outside and in the future some women may have difficulties conceiving;
- do not provide protection against sexually transmitted infections, so their use is not advisable in the presence of many partners, for women who are promiscuous (only condoms protect against sexually transmitted infections and viruses, including), syphilis, etc.);
- taking oral contraceptives can provoke the appearance of a woman’s body;
- According to American studies, women taking oral contraceptives have a risk of early development multiple sclerosis increases by 35% (see, which today can occur in both a 20-year-old and a 50-year-old woman);
- one of them may be taking oral contraceptives;
- the risks of transient development increase;
- women taking OCs are more likely to develop depression;
- some women experience a significant decrease in libido;
- the need for self-monitoring and daily intake;
- errors cannot be excluded when using contraceptive pills;
- the need to consult a gynecologist before the appointment;
- the price is quite high
According to WHO, about 100 million women use oral contraception, which brings fabulous profits to the pharmaceutical cartels. Manufacturers of hormonal contraceptives are extremely uninterested in disseminating truthful information about the dangers of products that bring them huge profits.
Today, all over the world there is powerful public opposition aimed at banning the sale of dangerous drugs, and information about their potential harm is publicly available. The result of this is that European and American gynecologists strongly recommend protection with condoms, which protect not only from unwanted pregnancy, but also from sexually transmitted infections. Next in popularity is the hormonal patch and then the IUD.
After reports of harm from OK, several deaths and trials, in some countries (USA, Germany, France) the drug Diane-35 is prohibited, and surveys of Europeans showed that 67% of people aged 15-63 years try to protect themselves with condoms, this is married couples And free women, 17% prefer a patch, 6% use a spiral, the remaining 5-10% continue to use OK.
Russian doctors actively continue to offer (advertise) oral contraception to women; moreover, they prescribe them to girls from 14-18 years of age, without informing about the potential and completely real threat their health.
Today, there are two main types of birth control pills:
- Combined oral contraceptives (COCs)
These drugs contain 2 synthetic analogue female hormones estrogen (ethinyl estradiol) and progesterone. Combined oral contraceptives are either monophasic (the level of hormonal substances in the tablets remains unchanged throughout the entire administration) or triphasic (the tablets contain three combinations of hormones that change during the menstrual cycle). - Progestin-based birth control pills (“mini-pills”)
These drugs contain only synthetic progestogen and are intended specifically for nursing mothers, or in case of contraindications to the use of combined oral contraceptives (estrogens).
1. Combined contraceptive pills (COCs)
Combined contraceptive pills can be divided into several groups, each of which is suitable for a specific category of women. This takes into account age, whether the woman has given birth or not, and whether she suffers from any hormonal or other disorders of the body.
ATTENTION!!!
All groups of COCs equally reliably block ovulation, which means they equally protect against pregnancy. Ovulation is blocked by progestogen, and its dose is the same in all combination drugs. The difference between microdosed and low-dose is only in the content of the estrogen dose. Estrogens are added not to protect against unwanted pregnancy, but to control the menstrual cycle.
1.1. Microdosed birth control pills
Contraception for young people, nulliparous women leading regular sex life. Drugs in this group are easily tolerated and have minimal side effects. Great for those who have never used hormonal contraceptives. As well as contraception for mature women over 35 years of age (up to the onset of menopause).
| Name | Compound | Notes |
| Nomegestrol acetate 2.50 mg; Estradiol hemihydrate 1.55 mg. |
A new monophasic drug containing hormones similar to natural ones. | |
| Estradiol valerate 2 mg; Dienogest 3 mg. |
New triphasic drug. Best suits the natural hormonal background of a woman. | |
| Jess | Ethinyl estradiol 20 mcg; drospirenone 3 mg. |
|
| Jess Plus | Ethinyl estradiol 20 mcg; drospirenone 3 mg; calcium levomefolate 451 mcg. |
New monophasic drug + vitamins (folates). Has an anti-androgenic (cosmetic) effect. |
| Dimia | Ethinyl estradiol 20 mcg; drospirenone 3 mg. |
Monophasic drug. Similar to Jess. |
| Miniziston 20 fem | Ethinyl estradiol 20 mcg; levonorgestrel 100 mcg. |
New monophasic drug. |
| Lindinet-20 | Ethinyl estradiol 20 mcg; gestodene 75 mcg. |
Monophasic drug. |
| Logest | Ethinyl estradiol 20 mcg; gestodene 75 mcg. |
Monophasic drug. |
| Novinet | Ethinyl estradiol 20 mcg; desogestrel 150 mg. |
Monophasic drug. |
| Mercilon | Ethinyl estradiol 20 mcg; desogestrel 150 mcg. |
Monophasic drug. |
1.2. Low-dose birth control pills
Contraception for young, nulliparous women who have regular sex life (in the event that microdosed drugs are not suitable - the presence of spotting on the days of taking active pills after the end of the period of adaptation to the drug). As well as contraception for women who have given birth, or women of late reproductive age.
| Name | Compound | Notes |
| Yarina | Ethinyl estradiol 30 mcg; drospirenone 3 mg. |
Monophasic drug latest generation. Has an anti-androgenic (cosmetic) effect. |
| Yarina Plus | Ethinyl estradiol 30 mcg; drospirenone 3 mg; calcium levomefolate - 451 mcg. |
A monophasic drug of the latest generation containing vitamins (folates). Has an anti-androgenic (cosmetic) effect. |
| Midiana | Ethinyl estradiol 30 mcg; drospirenone 3 mg. |
Yarina. |
| Tri-Mercy | Ethinyl estradiol 30 mcg; desogestrel 125 mcg. |
Three-phase drug of the latest generation. |
| Lindinet-30 | Ethinyl estradiol 30 mcg; gestodene 75 mcg. |
Monophasic drug. |
| Femoden | Ethinyl estradiol 30 mcg; gestodene 75 mcg. |
Monophasic drug. |
| Silest | Ethinyl estradiol 30 mcg; norgestimate 250 mcg. |
Monophasic drug. |
| Janine | Ethinyl estradiol 30 mcg; dienogest 2 mg. |
Monophasic drug. Has an anti-androgenic (cosmetic) effect. |
| Silhouette | Ethinyl estradiol 30 mcg; dienogest 2 mg. |
New monophasic drug. Analogue of Janine. |
| Jeanetten | Ethinyl estradiol 30 mcg; dienogest 2 mg. |
New monophasic drug. Analogue of Janine. |
| Miniziston | Ethinyl estradiol 30 mcg; levonorgestrel 125 mcg. |
Monophasic drug. |
| Regulon | Ethinyl estradiol 30 mcg; desogestrel 150 mcg. |
Monophasic drug. |
| Marvelon | Ethinyl estradiol 30 mcg; desogestrel 150 mcg. |
Monophasic drug. |
| Microgynon | Ethinyl estradiol 30 mcg; levonorgestrel 150 mcg. |
Monophasic drug. |
| Rigevidon | Ethinyl estradiol 30 mcg; levonorgestrel 150 mcg. |
Monophasic drug. |
| Belara | Ethinyl estradiol 30 mcg; chlormadinone acetate 2 mg. |
New monophasic drug. Has an anti-androgenic (cosmetic) effect. |
| Diana-35 | Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg. |
Monophasic drug with anti-androgenic (cosmetic) effect. |
| Chloe | Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg. |
Monophasic drug. Analogous to Diana-35. |
| Bellune-35 | Ethinyl estradiol 35 mcg; cyproterone acetate 2 mg. |
New monophasic drug. Analogous to Diana-35. |
| Desmoulins | Ethinyl estradiol 35 mcg; ethynodiol diacetate 1 mg. |
Monophasic drug. |
1.3. High dose tablets
They are used to treat various hormonal diseases, as well as for contraception during the treatment of hormonal disorders. Ovidon
levonorgestrel 250 mcg.
norethisterone acetate 1 mg.
2. Progestin-based birth control pills (“mini-pills”)
Contraception for women during lactation (breastfeeding). Contraception for women who have given birth or women in late reproductive age who have regular sex life, in case of contraindications to the use of estrogens. Contraception for smoking women over 35 years of age.
| Name | Compound | Notes |
| Lactinet | Desogestrel 75 mcg. | Monophasic drug of the latest generation. Especially for nursing mothers. |
| Charosetta | Desogestrel 75 mcg. | New monophasic drug. |
| Exluton | Linestrenol 500 mcg. | Monophasic drug of the latest generation. |
| Microlute | Levonorgestrel 30 mcg. | Monophasic drug. |
My article
There are many ways to protect yourself from unwanted pregnancy. The most popular today is the use of oral contraceptives (OCs). For several decades now, women all over the world have been using this method, which significantly reduces the number of abortions and, as a consequence, complications after them.
Hormonal contraception is designed not only to protect a woman from unwanted pregnancy, but also to improve the quality of life. The fact is that now women rarely turn to a gynecologist with only one purpose - to choose a contraceptive. According to statistics, more than 60% of women have one or another gynecological problems and need to be corrected. OCs are one of the methods for treating pathology of the pelvic organs, be it rehabilitation after abortion, PMS treatment or endometriosis, as well as mammary glands - mastopathy.
Very often, patients complain of many side effects from taking OCs: swelling, increased blood pressure, weight gain, severe PMS symptoms, headache, stress. And the main complaints are related precisely to this. This leads to the question: how to choose hormonal contraception, is it possible to change the drug and how to avoid side effects?
It is worth noting that OK is selected by the doctor taking into account your gynecological history and concomitant pathology. You can’t choose OK for yourself based on the experience of friends or colleagues - what suited them may absolutely not suit you.
Why do side effects occur?
All side effects are caused by an increased level of estrogen in the blood, which is most often caused by an incorrectly selected drug that contains a high dose of estrogen. But there is one “but” that gynecologists often do not take into account when selecting OK. The level of estrogen in the blood can be increased without the use of OCs, and this may be associated with smoking, obesity, disease gastrointestinal tract, chronic stress, thyrotoxicosis and chronic alcohol intoxication, taking certain medications (diuretics, cardiac glycosides, narcotic analgesics, non-steroidal anti-inflammatory drugs (nurofen, ibuprofen), antibiotics, anticoagulants, hypoglycemic drugs). All of the above factors contribute to an increase in estrogen levels in the blood. So when smoking woman experiencing chronic stress, comes to the gynecologist for OK and does not talk about her lifestyle to the doctor, then a situation may occur when the doctor prescribes not the lowest dosage drug, but layering on the already existing hyperestrogenism leads to the fact that when taking OK, all known symptoms appear side effects.
In connection with the above, attention should be paid to the woman’s behavior at the gynecologist:
When visiting a doctor, be sure to tell the doctor about your bad habits.
Tell us about your activities, focus on the stress factor of your work (whether you have frequent stress or not).
If your mother and/or grandmother had heart attacks, thrombosis, strokes or varicose veins veins, then you need to inform your doctor about this, the prescription of the drug will depend on this.
If you are taking antibiotics, painkillers, or other medications long time, then also tell your doctor.
Don't tell your doctor that you have varicose veins. Women often mistake visible veins on their legs for varicose veins. Remember that the diagnosis of “varicose veins” can be made either by a surgeon or a phlebologist based on certain examinations (ultrasound of veins lower limbs, blood tests, certain physiological tests). If you make such a diagnosis, then back it up with certificates from the surgeon or ask additional examination at the gynecologist.
Do not hide from the gynecologist the number of abortions performed and how long ago the last operation was performed - this information is no less important when choosing an OC.
Inform your doctor about the degree of PMS, the length of the cycle, the duration, pain of menstruation and the volume of discharge.
It is important for your doctor to know when you are planning a pregnancy. The regimen for prescribing OK - prolonged or regular - depends on this.
It is important to note that normalizing lifestyle, avoiding stress and bad habits helps reduce estrogen levels in the blood. But it is unlikely that there will be women who will change their lifestyle specifically for OK. Moreover, all OKs were created with the goal of improving a woman’s life, which is why dozens of the most different drugs. And not a single pharmaceutical company will miss its economic benefit and will not force a woman to change her usual lifestyle. Rather, pharmaceutical companies will release a dozen more OCs in order to satisfy the need for contraception and improve the quality of life of every woman.
If the drug is not suitable for you.
First, let’s figure out what “not suitable” means. Everyone has an OK certain period, during which it must “integrate” into the woman’s body. This means that the drug, firstly, is a good contraceptive, secondly, it relieves a woman of concomitant pathologies (endometriosis, PMS, etc.) and, thirdly, it no longer produces side effects. This should take from three (on average) to six months. In these three months you should have completed everything side effects from OK and you just shouldn’t notice the drug. If nothing has changed during these three months, and side effects remain, then there are 2 ways to solve the problem: 1. start leading a healthy and calm lifestyle and 2. replace OK. In the first case, normalizing your lifestyle will reduce the level of estrogen in the blood, thereby mitigating side effects. And in the second case, the drug is replaced with one where the dose of estrogen is lower.
Replacement takes place as follows: you finish a pack of OK, take a week break and start drinking new drug. Of course, before this you should visit a gynecologist.
But even here, not everything is so simple. There are OCs that are very similar in estrogen content: 20 and 30 mcg. The gynecologist will choose a lower dosage if you are at high risk of thrombotic complications, if your close blood relatives have had heart attacks, strokes or thrombosis. Therefore, it is imperative to explain everything in detail to the doctor, especially with regard to medical aspects.
You should not immediately buy a large package of OK, where the tablets last for three months, since the drug may not be suitable.
The doctor's view on the prescription is OK.
When selecting an OC, the gynecologist takes into account the presence of general and gynecological pathology in a woman. A general blood test is done and, if necessary, hormone tests. But it is very difficult to study the level of estrogen in the blood - the production of this hormone does not occur linearly, and one analysis is not enough. Therefore, the doctor most often limits himself to standard examinations, such as examination, ultrasound of the pelvic organs, general tests blood and urine, questioning the patient (history taking). Additionally, the gynecologist may prescribe a study of hormonal levels, including thyroid hormones, examination of the veins, gastrointestinal tract, and so on. Your task is to state your complaints as clearly as possible, focusing on the main thing.
Currently, OKs are divided into several types:
According to hormone dosage:
1. Monophasic, containing the same dose of estrogen and gestagen
2. multiphase (two- and three-phase). These OCs contain a variable (non-constant) dose of hormones, which is similar to the production of hormones in natural cycle women (without taking OK). Currently, three-phase OKs are the most popular.
Important! Action of three-phase OK:
the ovaries decrease in size
temporary sterility occurs, i.e., there is no ovulation
many atretic “non-functioning” follicles
atrophic phenomena occur in the endometrium, so the fertilized egg does not attach (if ovulation does occur)
peristalsis of the fallopian tubes slows down, so if ovulation occurs, the egg does not pass through the fallopian tubes.
Cervical mucus becomes viscous, making it very difficult for sperm to penetrate the uterus
Hormone dosage:
1. high dose
2. low dosage
3. microdosed
To monophasic high-dose OCs include: Non-ovlon, Ovidon. They are used for contraception rarely, for short periods of time and only for medicinal purposes.
To monophasic microdosed OCs include:
Logest 
Lindinet (generic Logesta). Can be used by nulliparous girls from 15 years of age. They have a beneficial effect on PMS, painful menstruation, mastopathy and menstrual irregularities. They prevent fluid retention in the body and have an antiandrogenic effect.
Novinet (generic Mercilon), Mercilon. Can be used by nulliparous girls from 15 years of age. They have an antiandrogenic effect. 
Miniziston 20 fem. Can be used by nulliparous girls from 15 years of age. Has a beneficial effect on painful menstruation. 
To monophasic low-dose applies:
Marvelon 
Regulon 
- both have weak antiandrogenic properties
Microgynon, Rigevidon, Miniziston - traditional OK
Silest, Femoden, Lindinet 30 - have weak antiandrogenic properties 
Janine - first choice OK with a therapeutic effect for endometriosis, acne, seborrhea
Diane-35 - used for polycystic ovary syndrome, with increased testosterone levels. Has a pronounced antiandrogenic effect, exhibits maximum therapeutic effect for seborrhea and acne 
Belara - has a slight antiandrogenic effect - improves the condition of the skin and hair (reduces the secretion sebaceous glands) (compared to Diane-35 antiandrogenic activity - 15%),
Yarina 
- prevents fluid retention in the body, helps stabilize weight, improves the condition of the skin and hair (compared to Diane-35, antiandrogenic activity is 30%), eliminates PMS.
Midiana 
Three-phase OK:
Triquilar 
Triziston, Tri-regol, Qlaira. Simulates the menstrual cycle. Indicated for adolescents with delayed sexual development. Often cause weight gain. The side effects of estrogen are the most pronounced. 
Single-component progestin preparations:
Microlut, Exluton, Charozetta - can be used during lactation. Can be used if COCs are contraindicated. Contraceptive effect lower than that of COCs. Amenorrhea may develop while taking medications. 
Norkolut - has androgenic activity, used mainly with therapeutic purpose to normalize the condition of the endometrium.
Postinor, Zhenale - emergency contraception. Often calls uterine bleeding. It is not recommended to use more than 4 times a year. 
Escapelle - causes inhibition of ovulation, prevents implantation of a fertilized egg, changes the properties of the endometrium, increases the viscosity of cervical mucus. When taken, menstrual irregularities and uterine bleeding often develop. 
It is clear that only for contraception it is best to use microdosed preparations, since they contain a minimal amount of estrogens. Accordingly, when taking these OCs, side effects will be minimized. Please note that in each group of drugs, for example, in monophasic low-dose drugs, many drugs are similar to each other. The question arises: what exactly is the difference? For example, Marvelon, Regulon, Microgynon, Rigevidoe have the same amount of estrogen (30 mcg) and progestogen (150 mcg). It's simple: firstly, these may be different manufacturing companies, and, secondly, there may be generics and original drugs. It is believed that original drugs are better than generics because they are better purified and have high bioavailability and better absorption. They are considered to have fewer side effects. Although, generics have existed for decades and are also produced with decent quality, like the original drugs.
At abundant and long periods It is likely that drugs with an enhanced gestagen component are better tolerated - Microgynon, Miniziston, Femoden, Lindinet 30, Rigevidon, Diane-35, Belara, Zhanin, Yarina. For short and scanty periods - with an enhanced estrogen component (Sileste)
Women with hypersensitivity to estrogen(nausea, vomiting, abdominal pain, tension in the mammary glands, increased vaginal mucus formation, heavy menstruation, cholestasis, varicose veins) it is advisable to prescribe combined OCs with a pronounced progestin component.
In women up to 18 years and after 40 preference should be given to drugs with a minimal content of estrogens and gestagens (Logest, Lindinet 20, Miniziston 20 fem, Novinet, Mercilon)
For teenagers You should not use long-acting medications (Depo-Provera, Mirena IUD), as they contain high doses steroid hormones(estrogens and gestagens) and are poorly tolerated.
Alternative to OK - intrauterine devices, Nuvaring ring and barrier methods
