Hormonal preparations of a new generation. Who should not take hormonal contraceptives

In modern society, more and more girls and women prefer to take birth control pills, since this method of contraception has significant advantages over other methods of preventing unwanted pregnancy.

In the vastness of our homeland reception contraceptives in tablets is not yet as popular as in the West. A in developed European countries, women have been practicing this for a long time.

More women are starting to use birth control pills

For example, according to recent surveys of women living in France, about 75-80% of them have tried or regularly take birth control pills.

At the beginning of the article we will list the most common birth control pills(names) and their approximate cost in Russia, and then you can learn more about the features of drugs, their composition, use, contraindications and other useful information on this topic.

List of birth control pills (names and approximate price)

Tool name	Release form	Approximate price (rub.)
BELARA N21X3	Pills	1990
GINEPRISTONE 0.01 N1	Pills	580
LOGEST N21	Pills	820
MARVELON N21	Pills	1540
MERCILON N21	Pills	1570
MIDIANA 0.003+0.00003 N21	Pills	730
REGULON N21	Pills	470
RIGEVIDON 21+7 N28	Pills	360
THREE-REGOL N21X3	Pills	810
SILUETE 0.002+0.00003 N21	Pills	800
THREE-MERCY N21	Pills	1010
FEMODEN N21	Pills	824
CHLOE N28	Pills	770
CHAROSETTA 75MKG N28X3	Pills	4000
EXLUTON 0.0005 N28	Pills	4000
YARINA N21	Pills	1160
Janine	Pills	800
Lindinet	Pills	350
MICROGYNON	Pills	320
FEMOSTON	Pills	850
POSTINOR	Pills	300
ORGAMETRYL	Pills	1100
Miropriston	Pills	1550
Exinor-F	Pills	210

Types and effects on the body of contraceptives

In the female body, a large number of hormones that influence and control the activity of the reproductive system. That's why V different periods life hormone ratio is different.

Pills act at the hormonal level, and for each category of women should take their own drugs.

Combined oral preparations (COCs)

The basis of the drugs are 2 synthetic hormones: estrogen and progesterone. Any of the groups COC works on the principle of blocking ovulation. Reliability is extremely high due to progesterone. Estrogen controls menstruation and does not affect pregnancy.

Tablets "Klayra"

COC is divided into several groups. The classification is based on the characteristics of women: age, having a child, problems with the balance of hormones.

microdosed tablets. This group of contraceptives is intended for women who have not given birth, but are actively sexual life. Side effects of drugs are minimal. These birth control pills contain in their list such drugs as (abbreviated names): Qlaira, Jace, Dimia.

Klayra's blisters contain several types of tablets, which must be taken strictly according to the instructions. With pills 2 hormones enter the body - estradiol valerate and dienogest. They suppress ovulation. Dienogest has a positive effect on the appearance of a woman. The price of the drug is from 700 rubles.

James is a remedy with main and additional tablets. Main 24, and additional 4. The drug suppresses ovulation. The cost is about 1 thousand rubles.

Dimia is an analogue of James for the same cost. The active substances of the drug are different.

Low dose birth control pills. Used by women who did not fit microdose tablets:

• the presence of discharge with blood;
• after the birth of a child;
• late reproductive period.

The drugs of the group include: Yarina, Janine, Silhouette.

Yarina is taken for 21 days in the order indicated in the instructions. Tablets "Yarina" can not be combined with other drugs, because it reduces reliability and causes bleeding. It costs from 950 rubles.

Jeanine is an expensive drug, the price starts from 1650 rubles, depending on the place of purchase. Produced in Germany.

tablets contain substances that have beneficial effect on the gastric mucosa and the woman's body as a whole.

High dosage tablets. As a contraceptive during hormonal imbalances, it is recommended to take such contraceptive pills (list of abbreviated names): Tri-regol, Triquilar, Triziston.
Tri-Regol costs 200 rubles. There are cheap alternatives.

Triziston is produced in Germany. The action of the drug is aimed at inhibiting the production of gonadotropic hormones.. Price - from 500 rubles. Active substances begin to act on the body after 2 hours.

Note! High-dose drugs should be taken only as directed by a doctor!

Contraceptives with gestagen

Signs for use:

• lactation period;
• recent childbirth or late period reproductive age;
• regular sex life;
• estrogen is contraindicated;
• smoking and age over 35 years.

Preparations with a progestogen are called "mil-drank." The list of popular names for these contraceptive pills is: Desogestrel, Desogestrel.

Tablets without hormones

In the preparations of this group there are no hormones, they are injected directly into the vagina. Non-hormonal pills are sometimes referred to as spermicides.- candles, gels, creams.

Tablets "Escapel"

The active substance is not hormonal drugs- benzalkonium chloride or nonoxynol. Their goal is to destroy the sperm membrane, which prevents pregnancy.

A list of such contraceptives (names in abbreviated form): Gynekotex, Pharmatex, Postinor, Escapel.

The latest generation of contraceptives

Modern contraceptives of a new generation not only have a hormonal effect on reproductive system, but also create an aggressive environment for spermatozoa.

The drug "Jess"

The scheme of action also has an abortive component, in which spermatozoa are exposed to the active substance of the drug and die.

The less synthetic hormones in the preparation that affect the implantation of the embryo, the higher the abortive effect in the preparation.

Doses of the active substance fluctuate - if the drug contains a small amount of a substance that kills spermatozoa, then a large amount of the hormone to affect the embryo.

Unwanted pregnancy is prevented stepwise - in 2 stages.

The new generation of contraceptive pills is represented by such drugs as (abbreviated list of names): Jess and Jess plus, Marvelon, Novaring, Depo-Prover.

Correct use of contraceptives with hormones

The main rules for taking most drugs:

• daily intake;
• it is desirable to take the drug at the same time;
• reception lasts 21 or 28 days (depending on the specific drug);
• on the foil of the package there is a pointer, according to which the pills are taken;
• after 7 or 21 days, a reaction will follow that resembles menstruation.

Features of taking drugs 21 days

Some birth control pills take 21 days. They begin to drink after the first day of menstruation.. After the end of the reception, a break of 7 days is made. Protection during this period is not required.

Contraceptive pills for 21 days are represented by the following list of names: Novinet, Yarina, Lindinet 20, Midiana, Rigevidon.

Contraceptive 28 days

Birth control pills that take 28 days are a popular remedy for Jess.

Before you start taking contraceptive hormonal drugs, you should consult a gynecologist. It's connected with different amount synthetic hormones in preparations and how they will affect a woman's body both when taken and subsequently.

Not all pills are suitable for all women. In addition, there are certain risks that should be discussed with a qualified doctor.

Undesirable effects of drugs on the body and the prohibition of their use

You should carefully consider the possible side effects of taking a particular drug in order to avoid health complications.

Not all drugs can be taken by smokers

Most of the side effects include:

• lack of menstruation;
• depression, including loss of attraction to men as sexual partners;
• vaginal discharge not during menstruation;
• pain in the head and blurred vision;
• unstable blood pressure;
• change in body weight.

If the above symptoms are observed, then you should immediately consult a doctor who prescribed the drug. He will conduct an examination and, if necessary, replace the drug.

Should know! Some side effects observed only during the first 4 months of admission.

You should immediately consult a doctor if:

• poisoning;
• breathing problems;
• pain in the body;
• problems with speech or vision.

All drugs have contraindications to varying degrees:

• current pregnancy;
• liver problems;
• problems with the cardiovascular system;
• smoking;
• age over 35 years;
• diabetes;
• breast cancer;
• liver disease.

Emergency contraception and hormone-free products

Emergency contraception differs from interruption in that the first is carried out at ovulation. That is at the time of the meeting of the sperm and the egg, they are affected special preparations .

Sometimes emergency contraception is needed

Their goal is to prevent the meeting or prevent the fixation of the encountered zygote in the uterus. For the action of such drugs, only 6 days: 3 days the egg moves to the uterus and 3 days the fixation.

If time is lost, then come resort to abortion at an early stage.

Arguments for and against birth control pills

Every issue has its positives and negative sides. With protection from unwanted pregnancy is similar. The arguments for the use of birth control pills are as follows:

• almost one hundred percent efficiency;
• the possibility of application in any age category;
• comfort during intercourse;
• stabilization of hormonal balance in a woman's body.

However, there is also Arguments AGAINST using birth control pills:

• in the presence of contraindications or the manifestation of side effects, taking pills is prohibited;
• possible complications after taking, up to the occurrence of oncological diseases;
• pills remove some vitamins from the body;
• the risk of glaucoma;
• the risk of developing diseases of the genital organs;
• risk of hormonal failure, weight and mood changes.

If we weigh the pros and cons, the advice of experts and the opinions of women, it is worth noting that taking birth control pills on a regular basis is recommended only after childbirth. Since in this case the possible negative impact on female body and future pregnancy.

According to doctors and psychotherapists, abortion is a serious step that a woman should take only in extreme circumstances.

It is easier to prevent unwanted egg fertilization by creating unacceptable conditions for sperm inside the vagina than to regularly take birth control pills with the possible risk of worsening women's health.

And of course, regardless of age and state of health, every representative of the beautiful half of humanity, be sure to consult a doctor before taking any medications, even if they are claimed to be safe.

This video will tell you about the dangers of birth control pills:

The following video will tell you about oral pills and the rules for taking them:

You can learn about the effect of birth control pills from this video:

by the most effective method preventing unwanted pregnancy in this moment recognized as hormonal contraception.

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

Classification of hormonal methods of contraception

All hormonal contraceptives are divided into two large groups:

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

Combined hormonal contraceptives

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

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

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

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

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

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

Depending on quantity active drug in a tablet, contraceptives are divided:

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

Single component hormonal contraceptives

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

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

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

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

Combined oral contraceptives (COCs)

Mechanism of action

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

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

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

Side effect

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

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

Side effects of ethinylestradiol

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

Side effects associated with the suppression of own estrogens

Side effects of synthetic progestins

Side effects associated with an insufficient dose of progestins

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

Also, one should make a reservation about the rare, but extremely dangerous complication hormonal contraception – venous thromboses and embolism. The likelihood of their development directly depends on the presence of risk factors, such as smoking, age over 35 years and obesity.

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

Contraindications

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

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

How is individual selection carried out?

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

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

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

Prescribing a first choice drug

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

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

Let's take a closer look at the main female diseases And what contraceptive pills are better to take with them.

Disease
Acne, facial hair growth, greasy skin	Contraceptive pills Jess, Yarina, Diane-35, Jeanine.
Violations menstrual cycle	Marvelon, Microgenon, Femoden, Jeanine.
endometriosis	Jeanine, Marvelon, Regulon, Ovidon.
	microdosed drugs. At the age of over 35 COCs are contraindicated.
Previous contraceptive use has been associated with chest pain, swelling, weight gain
Diabetes	Microdosed COCs.

Change of contraceptive with the development of side effects

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

How are they accepted

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

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

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

What to do if a drug is missed?

1. One tablet not taken

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

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

Combined parenteral contraceptives

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

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

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

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

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

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

The advantages of the parenteral method of administration are:

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

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

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

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

Gestagen oral contraceptives (minipils)

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

Indications

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

Contraindications

The same as in the appointment of combined contraceptive drugs.

Side effect

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

Parenteral progestogen contraceptives

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

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

The drug is available in tablets, aerosol, suspension.

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

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

Side effects are the same as for oral progestins.

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

The disadvantages of the drug are:

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

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

Implants

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

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

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

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

A long time ago, more than one or even two children were born in Russian families. A family in which there are “seven on benches” and a mother in the process of demolition is a typical example of the way of pre-revolutionary life. A hundred years ago, a woman was in two states for almost the entire reproductive period - pregnancy and breastfeeding, and the latter smoothly flowed into the next interesting position.

Whether it's good or bad, but in modern families there are much fewer heirs. One or two children are considered normal. And in order not to exceed the upper limit, a healthy woman needs to take contraception seriously.

In the contraceptive arsenal today, there are about a dozen methods of preventing unwanted pregnancies. Almost the most popular way is the use of birth control pills.

How effective and safe is contraception using pills? Who shouldn't rely on this method? And in general, what should be understood by the term "contraceptive pills"? Every woman should own these concepts no worse than a local gynecologist - after all, health sometimes depends on this knowledge. Well, let's figure it out together.

Contraceptive pills: both orally and vaginally

The concept of "contraceptive pills" includes two completely different categories. medicines:

- hormonal contraceptives, which are based on synthetic hormones;

- local spermicides in tablets. The action of these contraceptives is based on the spermicidal effect, which is achieved with topical, vaginal application.

Of course, the greatest interest from the point of view pharmacological effect constitute hormonal agents. With them, we will begin our acquaintance with contraceptives.

Hormonal contraception: origins

Already at the end of the 19th century, it became known that the development of follicles and ovulation is completely suppressed during pregnancy, and the reason for this is high concentration hormones corpus luteum. In the 1920s, Ludwig Haberlandt proposed the use of such substances as contraceptives. In the next ten years, three estrogens were synthesized: estrone, estriol and estradiol, and at the end of 1929 scientists identified progesterone.

Probably, the first hormonal contraceptive pills would have appeared ten years earlier, if not for the problem with the synthesis of progesterone. It was mastered only in 1941, after which it was the turn of other progesterone drugs - norethisterone and norethindrone. That's when these substances got common name progestogens (or progestins), which emphasized progesterone-like properties.

In the early 50s, scientists began experimenting with hormonal drugs. The first pancake came out lumpy: application hormonal pills for the treatment of infertility has not yielded results. But it was found that in women taking these drugs, ovulation was suppressed. It took researchers another 5 years to select the right formula, and in 1957 the first hormonal contraceptive drug was released. As early as 1960, 0.5 million American women were taking these pills. The era of hormonal contraceptives has begun.

Pharmacological effect of hormonal pills

The action of contraceptive hormonal drugs does not depend on the composition and dosage. The contraceptive effect is achieved by influencing a complex reproductive chain, which includes the pituitary gland, hypothalamus, ovaries, uterus, and even fallopian tubes.

First of all, hormonal contraceptives suppress the production of releasing hormones by the hypothalamus, resulting in a decrease in the gonadotropic function of the pituitary gland. Due to this, ovulation is inhibited, and temporary sterility occurs.

Secondly, hormonal pills suppress ovarian function: estrogen synthesis is almost halved, and the ovaries even decrease in size.

Thirdly, under the influence of hormonal drugs, the properties of cervical mucus change, which becomes very difficult for spermatozoa to pass.

Fourth, the peristalsis of the fallopian tubes slows down significantly. A miraculously mature egg is unlikely to be able to get out of the long, inactive fallopian tubes and, most likely, will be doomed to death.

And fifthly, the endometrium changes, which quickly regresses and does not reach the thickness necessary for the implantation of a fertilized egg. This mechanism serves as additional protection - even if conception has occurred, the embryo simply cannot attach to the uterine wall.

The effectiveness of contraceptive drugs is evaluated using a single indicator - the Pearl index. It is equal to the number of pregnancies in one year in 100 women who used a particular method of contraception. The Pearl Index of hormonal contraceptives rarely exceeds 3-4% and fluctuates around 1%.

Hormone Dosage: Then and Now

The first hormonal contraceptives contained simply lethal doses of hormones: 150 micrograms of estrogen and 9.35 mg of progestogen. In 1964, it was possible to reduce the concentration of active substances to 100 micrograms and 2 mg, respectively. However, these dosages were far from perfect.

The next step was the release of hormonal contraceptives containing 50 micrograms of estrogen. Scientists came to the conclusion that lowering the dose of hormones does not affect the effectiveness of the drug, but it greatly reduces side effects.

In the 1970s, the upward trend in the use of hormonal contraceptives stopped. This resulted in the expressed adverse events in the form of thromboembolism (blockage of blood vessels by blood clots), especially in smoking women. Pharmacists had no choice but to develop new low-dose drugs. And it succeeded.

Birth control pills new, latest generation contain less than 35 micrograms of estrogen - the component that causes most side effects. In addition, highly active progestogens have been synthesized, including drospirenone, desogestrel, gestodene, and others. Due to these advances, low-dose hormonal drugs have a very high safety profile and a low chance of side effects. Nevertheless, when choosing a contraceptive drug, you need to be vigilant, given the many nuances. However, more on that later.

Classification of hormonal contraceptives

All hormonal drugs can be divided into three large groups:

- combined oral contraceptives (COCs).
Such tablets contain both components: both estrogen and progestogen;

- progestin preparations - mini-pill.
Monocomponent means, which include only gestagen.

- emergency contraceptives.
These contraceptives contain extremely high doses of hormones and are intended for urgent, that is, urgent contraception.

Each of the groups of hormonal pills has its own advantages and disadvantages, on the basis of which the conclusion is based on the appointment of a particular remedy.

KOC: positive aspects

Undoubtedly, the most common hormonal pills are combined contraceptives. They have a lot of positive aspects, including:

• high contraceptive effect;
• excellent tolerance;
• ease of use;
• reversibility of action;
• safety;
• therapeutic action;
• preventive action.

To understand all the advantages of contraceptive hormonal drugs, we will consider each criterion in detail.

Efficacy and tolerability of combined contraceptives

The Pearl Index KOC ranges from 0.1-5%. The average statistics state that the probability of pregnancy with the constant use of hormonal pills during the year does not exceed 1%. Thus, the effectiveness of combined contraceptive pills reaches 99%. An indispensable condition for achieving such results, of course, is compliance with the dosing regimen.

Oral combined contraceptives are generally well tolerated. Side effects develop, as a rule, in the first months of taking, and notice that they decrease on their own and completely disappear.

Types of combined hormonal pills

Depending on the qualitative composition, COCs are divided into three groups:

- monophasic drugs.
These drugs contain estrogen and progestogen in the same dosage. Regardless of the phase of the menstrual cycle, the same amount of hormones enters the body. Tablets of monophasic COCs are painted in one color.

These monophasic contraceptive drugs include most of the modern low-dose COCs: Logest, Silest, Janine, Microgynon, Lindinet-20 and Lindinet-30, Regulon, Diana, Yarina, Jess and others;

- biphasic drugs.
Biphasic COC tablets are divided into two groups: the first contains more estrogen, and the second - progestogen. For ease of administration, the tablets are colored in two colors. Biphasic COCs are rarely used;

- triphasic preparations.
A package of a three-phase COC contains three groups of tablets, the level of hormones in which changes approximately in the same way as in a physiological menstrual cycle. Each group of tablets is coated with its own color. Three-phase preparations are considered the most adapted to the natural cycle of a woman. Among the modern representatives of this group, we note Tri-merci, Tri-regol, Triziston.

Rules for taking birth control pills

The first and main rule, on which both the effectiveness and side effects of COCs depend, is the regularity of intake. Forgetfulness is the main enemy of any contraceptives, and hormonal ones in particular.

We list the main postulates that every woman who takes hormonal contraceptives should remember:

1. It is better to start taking contraceptive drugs on the first day of a new cycle, although it is also allowed in the first 5-7 days from the onset of menstruation. Some experts recommend starting treatment on some convenient day for counting, for example, on Sunday. If a woman needs immediate therapy, you can drink the first tablet immediately after the complete exclusion of pregnancy;

2. It is better to take medicine at the same time. Ideally, you should associate the reception with some kind of ritually repetitive action, for example, evening dress or dinner. Although there are no specific recommendations on the best time of day to take the pill, many doctors advise taking COCs at night. This is due to the fact that at the beginning of treatment there is a possibility of mild nausea, which practically does not annoy during sleep;

3. In the first cycle of taking COCs, it is worth using additional measures contraception: according to some reports, the effectiveness of hormonal contraceptive pills reaches a maximum only after 2-4 weeks of continuous use;

4. After a 21-day intake, a 7-day break follows, during which menstrual-like bleeding occurs. On the eighth day of withdrawal, you should start taking the first tablet of a new treatment cycle. If within a week after the abolition of COC menstruation has not occurred, the next package is still not canceled. However, in such a situation, it is better to seek advice from your doctor: you need to exclude pregnancy and gynecological pathologies;

5. If there was vomiting within four hours after taking the pill, the contraceptive effect is reduced. In such cases, it is better to use an additional method of contraception until the end of the cycle. Usually, the barrier method is considered the best "safety" method, which involves the use of a banal, but true condom;

6. If bleeding occurs while taking COCs, treatment should be continued. Some experts recommend that patients who bleed more than 4 days start taking an additional COC tablet (eg, morning). Usually for recovery normal picture 2-3 extra tablets are enough. After stopping the bleeding, you should take another 2-4 days for half the additional dose, and then switch to the standard course of treatment. If, despite the measures taken, the bleeding continues, you will have to see a gynecologist;

7. Patients who long time take COCs, you need to undergo periodic examinations by a gynecologist with monitoring of the condition of the mammary glands.

What if memory fails?

Every woman, no doubt, knows about the regularity of taking hormonal contraceptive pills. But the girl's memory is fragile: there are gaps and gaps in it. What to do with forgetful patients? Moaning: “All is lost!”? Or ... Of course, act! Depending on how many birth control pills the patient missed:

- if from the time of admission last pill no more than 12 hours have passed, you need to take the next one immediately after the restoration of memory and calm down. The contraceptive effect will not change;

- if the interval between doses was more than 12 hours, you must take the next pill, regardless of the time of day, and then continue according to the schedule. The scheme does not change, even if you have to drink two tablets a day;

- if two doses were missed, that is, the interval between doses was more than 24 hours, you need to take two tablets at once and drink two more doses the next day. It should be borne in mind that in such cases there may be spotting;

- if the memory was lost for a long time, and this led to the skipping of three or more pills, the likelihood of spotting is very high. Of course, you can forget about the contraceptive effect, and it’s even better to remember where the condoms are. However, what to do with COC? Doctors recommend taking two tablets for the first three days, then switch to standard scheme. There is a second way out of the situation: to abandon the old packaging altogether and start from scratch, that is, with a new KOC packaging, for example, next Sunday.

If everything is taken and canceled: the reversibility of COC action

Contraception involves deliberate family planning. And someday there comes a time when a woman would gladly start taking germ pills, if such existed. The purchase of new packs of hormonal contraceptives is postponed indefinitely. The only question that worries a woman is when can you get down to business?

The action of combined hormonal contraceptives is reversible, and this, of course, can be attributed to important advantages. similar drugs. In most cases, in the first 1-3 months after the abolition of COCs in healthy women, a full-fledged ovulatory menstrual cycle is completely restored. The maximum recovery period is 12 months.

There is information about the so-called withdrawal syndrome or rebound effect that occurs after stopping the use of hormonal contraceptives. The ovaries, which have been “resting” for quite a long time, begin to work actively and fruitfully immediately after recovery from “hibernation”. The result of such work is the maturation of the follicles and the release of an egg ready for battle, hungry for action. According to the theory based on the COC withdrawal syndrome, the probability of pregnancy in the first 1-2 months after stopping treatment with hormonal pills is much higher than in the standard cycle.

However, some experts believe that healthy pregnancy still needs normalization hormonal background. Many gynecologists insist that conception should occur several months after hormone withdrawal.

Therapeutic effects of COCs: birth control pill therapy

In addition to the contraceptive effect, hormonal drugs also have a proven therapeutic effect, and in this capacity, mainly COCs containing both estrogen and progestogen are used. Consider the main indications for the appointment of combined contraceptives.

Dysfunctional uterine bleeding

Intermenstrual uterine bleeding, not associated with pregnancy and organic pathology, is considered to be dysfunctional. Their main cause lies in a hormonal imbalance caused by a malfunction in the complex circuit of the hypothalamus-pituitary gland-ovaries. It has been proven that long-term use of COCs contributes to the normalization of hormonal levels and the cessation of dysfunctional bleeding.

endocrine infertility

As we have already said, in some cases COCs are used for the sake of the rebound effect. Some endocrinologists believe that if endocrine infertility is suspected, treatment should first be started. combined contraceptives. If pregnancy does not occur after the abolition of COCs, then proceed to ovulation stimulants.

Premenstrual syndrome

For PMS treatment prescribe modern low-dose contraceptives, including Novinet, Median, Silhouette, Lindinet, Mercilon, Jeanine, Dimia and other drugs. Symptoms characteristic of premenstrual syndrome - irritability, weakness, swelling, pain in the back, chest, headaches - disappear after 1-2 months of treatment.

endometriosis

Endometriosis is a fairly common disease that can be one of the causes of infertility. With this pathology, a tissue similar to the endometrium (the tissue of the inner lining of the uterus) grows in the pelvis. COCs are recognized as one of the treatment options for endometriosis. As a rule, these drugs are prescribed in long courses for a period of at least 12 months.

Among the contraceptives that are most often used for the treatment of endometriosis are Marvelon, Femoden, Regulon, Microgynon, Logest and others.

Hyperandrogenism

A condition that is accompanied by an increased content of testosterone in the blood - hyperandrogenism - is manifested by a number of striking symptoms. These include excessive hair on the face and body in women, acne (acne) and seborrhea.

The drugs of choice for the treatment of mild and moderate forms of hyperandrogenism include COCs with an antiandrogenic effect. This action is inherent in the gestagen, which is part of some combined contraceptives, namely Diana, Zhanin, Yarina and some others.

Separate words deserve a drug with a powerful antiandrogenic and antimineralocorticoid effect - Yarina. As a progestogen, these tablets use drospirenone, which not only helps to reduce testosterone levels, but also reduces swelling. Therefore, the likelihood of weight gain when taking Yarina is minimal.

With acne and seborrhea in adolescents, a three-phase COC Tri-merci is prescribed, which is able to reduce testosterone levels three times.

And the last. The antiandrogenic effect is achieved after three months of constant use of COCs, so contraceptives in order to get rid of acne will have to be taken for a long time.

COC: not only treatment, but also prevention

Combined contraceptives are also an additional prevention of gynecological diseases.

Inflammatory diseases

It has been proven that regular use of COCs reduces the likelihood of developing an inflammatory process in the small pelvis. This effect is achieved through:

1. increase the viscosity of cervical mucus.
   More viscous mucus turns out to be a barrier not only for spermatozoa, but also for some bacteria;
2. decrease in the intensity of menstruation.
   Menstrual blood is the ideal environment for growth pathogenic microorganisms. Therefore, a decrease in monthly blood loss also reduces the likelihood of infection;
3. decrease in the strength of uterine contractions during menstruation.
   With contractions of the uterus, the infection easily penetrates from the uterus into the fallopian tubes, contributing to the development dangerous diseases- salpingitis (inflammation of the fallopian tubes) and salpingoophoritis (simultaneous inflammation of both the ovaries and tubes). It is these processes that occupy an honorable first place among diseases that lead to the formation of adhesions in the pelvis, and as a result, infertility.

According to the recommendations of the WHO - the World Health Organization - combined contraceptive pills are used in a complex treatment regimen for already developed inflammatory processes. In such cases, COCs allow the ovaries to “rest” and recover, and the cervical mucus plug additionally protects the body from reinfection, that is, re-infection.

Functional ovarian cyst

These pathologies include follicular cyst and a corpus luteum cyst. Monophasic COCs reduce the likelihood of formation functional cysts 3-4 times, and also contribute to the resorption of existing formations.

It is worth noting that triphasic birth control pills may, on the contrary, stimulate the development of cysts. This is because "floating" doses of hormones in such preparations are not able to completely suppress ovarian function.

uterine fibroids, endometriosis

Both uterine fibroids and endometriosis are estrogen-dependent diseases. A decrease in estrogen levels significantly reduces the likelihood of developing these pathologies.

Official figures sound more convincing than words: with the constant use of birth control pills for five years, the risk of fibroids decreases by 17%, seven years - by 20%, and 10 years - by 30%.

Birth control pills: simple cancer prevention

The most reliable studies in the medical world have confirmed that the regular use of COCs reduces the risk of gynecological cancer. Continuous use of birth control pills reduces the risk of developing ovarian cancer by as much as 40%, and such prevention lasts for 15 years after the elimination of COCs. In addition, the use of combined contraceptives reduces the likelihood of developing uterine cancer by exactly half, and the protective effect is also enough for 15 years.

The only condition that should not be overlooked: to obtain a serious preventive effect, birth control pills must be taken for at least two years.

Combined contraceptives: side effects

Of course, the other side of the coin cannot be ignored. COCs have both side effects and contraindications.

Let's start with the first one. The most common side effects of hormonal birth control pills include:

• headache;
• nausea, vomiting;
• discomfort in the stomach and intestines;
• irritability and mood changes;
• increased sensitivity of the mammary glands;
• change in libido;
• dryness of the vagina;
• intermenstrual bleeding: both spotting and breakthrough (many women perceive this effect as menstruation when taking contraceptives).

The intensity of COC side effects is greatest in the first 1-3 months of treatment. After this period, as a rule, taking birth control pills is not accompanied by any adverse events.

You should be aware that with prolonged use or cancellation oral contraceptives hormonal imbalances may occur. The duration and frequency of menstruation is reduced or increased, and the discharge may become too scarce or plentiful, accompanied by pain in the lower abdomen. The complex has a beneficial effect on the functions of the female reproductive system active substances —
"Time Factor". It contains extracts medicinal plants, vitamins B9, C, E and PP, minerals Fe, Mg and Zn - reduce muscle spasms, pain during menstruation and are involved in restoring hormonal balance, including during or after the use of contraceptives.

Important: When are COCs banned?

Combined contraceptives are absolutely contraindicated in:

• pregnancy or the slightest suspicion of it;
• breastfeeding;
• vein diseases;
• IHD - coronary heart disease;
• severe diseases of the heart and blood vessels;
• oncological diseases;
• uncontrolled diabetes mellitus;
• severe pathologies of the liver or kidneys;
• uterine bleeding, the cause of which is not established;
• over 40 years of age;
• smoking a large number cigarettes, especially women over 35.

In the presence of one of the above contraindications, COCs should be completely forgotten. There is an additional list of diseases in which it is necessary to weigh the risks and benefits by prescribing contraceptive pills.

Such pathologies include diabetes mellitus, fibroids, age over 35, smoking, and others.

Women suffering from migraine should be especially careful when using COCs. Migraine is a relative contraindication to treatment with hormonal pills. Experts recommend prescribing low-dose contraceptive drugs containing less than 35 micrograms of ethinylestradiol, in particular, Janine, Logest, Minisiston, Mercilon, Regividon, Yarina. If severe headaches appear during COC treatment, the tablets should be discontinued, and as soon as possible.

Monocomponent birth control pills: mini pills

The second large group of hormonal contraceptive pills contains only one hormone - progestogen. due to low dose active ingredient these drugs have received the sonorous name of mini-pills. Some of the most popular mini-pill birth control pills include:

• Exkluton containing 500 micrograms of linestrenol;
• Microlut, which includes 3 mg of levonorgestrel;
• Charozetta and Lactinet, which contain 75 micrograms of desogestrel.

It should be noted that Charozetta and Lactinet occupy a special place among mini-pills. The composition of these funds includes a modern gestagen, which has unique properties. In addition to contraception, desogestrel has an antiandrogenic and antimineralocorticoid effect.

The pharmacological action of the mini-pill is similar to that of COCs. By blocking the production of gonadotropic hormones of the pituitary gland, gestagens contribute to an increase in the viscosity of cervical mucus, forming a barrier to spermatozoa. In addition, minipills reduce contractile activity fallopian tubes and cause endometrial hypotrophy, which makes implantation of a fertilized egg difficult.

Rules for taking mini-pills

Unlike combined birth control pills, mini-pills are used daily without taking a break.

The elimination half-life of the mini-pill is quite short: it is 12 hours less than that of the combined drugs and is only 22-24 hours. In this regard, monocomponent contraceptives must be taken at the same time in order to prevent a critical drop in the dose of hormones.

Charozetta and Lactinet can be attributed to a pleasant exception to the rule: their half-life occurs 36 hours after administration.

Monocomponent birth control pills: benefits

What distinguishes mini-pills from COCs? What are the advantages of monocomponent contraceptives over traditional combination drugs? The positive aspects of the mini-pill include:

- no side effects associated with the intake of estrogen.
Estrogen is responsible for most of the adverse events associated with COC use. Due to the lack of this hormone in mini-pills, they are better tolerated than combination pills;

- the possibility of appointment during lactation.
Monocomponent contraceptives are considered a means for nursing mothers. It has been proven that the gestagens used in mini-pili do not affect the qualitative composition of breast milk and do not reduce its amount. On the contrary, there is information stating that taking a mini-pill helps to improve lactation and lengthen the duration of breastfeeding. WHO recommends the use of monocomponent contraceptive pills 6 weeks after birth;

- the possibility of using mini-pills in women who are contraindicated in combination pills.
Monocomponent contraceptives are safe in patients with severe diabetes, migraine, diseases of the heart and blood vessels, varicose disease as well as in smokers. In addition, mini-pills are birth control pills that are indicated for women of older reproductive age, including those after 40 years;

- no side effects after abrupt withdrawal of tablets.
Unlike COCs, you can stop taking monophasic contraceptives at any time during treatment.

Disadvantages of minipill

Along with a significant list of advantages, monocomponent tablets are not without some disadvantages, including:

• high probability of menstrual irregularities while taking drugs: intermenstrual bleeding, shortening of the cycle, etc.;
• relative low efficiency compared to COCs. The Pearl mini-peel index ranges from 0.5 to 3%. The higher probability of conception is due to the fact that low doses of progestogens in mini-pills cannot completely suppress ovulation. The only monocomponent tablets that guarantee this effect by 96% are Charozetta (Lactinet).
• increased risk of ectopic pregnancy If ovulation and conception still occur while taking the mini-pill, the fertilized egg will not be able to implant in the uterus. Therefore, the embryo is attached to fallopian tubes or ovaries, resulting in an ectopic pregnancy.

In addition, mini-pills also have side effects, including:

• increased appetite;
• decreased libido;
• nausea, rarely - vomiting;
• headache;
• increased sensitivity of the breast.

And the last. After the abolition of the mini-pill, a full menstrual cycle is restored within 1-3 months. At the same time, the rebound effect that combined contraceptives are famous for should not be expected.

Emergency contraception: contraceptives in haste

Along with planned contraception, every woman should remember that there is a second, emergency option of contraceptive pills. They are intended primarily for patients who rarely have sexual intercourse, as well as in unforeseen cases when, for some reason, planned contraceptive measures were not taken.

Preparations for emergency contraception are called postcoital, used already post factum, that is, after. If sexual intercourse occurred before ovulation, high doses of birth control pill hormones ensure that it does not occur. If conception does occur, emergency contraceptives provide endometrial hypotrophy, as a result of which the embryo cannot attach to the walls of the uterus. In addition, a low concentration of progesterone guarantees the impossibility of pregnancy.

To quickly achieve the desired effect, it is necessary to introduce as much as possible high doses hormones. Therefore, postcoital contraception preparations are high-dose hormonal agents that are recommended to be used as rarely as possible. The effectiveness of urgent drugs reaches 97-99%.

Medicines for emergency contraception

There are several means of postcoital contraception:

- combined tablets.
Conventional combined COCs at a certain concentration can provide emergency contraception. This method of contraception is called the Yuzpe method. Among the contraceptives used according to the Yuzpe method are Microgynon, Minisiston, Femoden, Regividon, Regulon and others;

gestagens.
This group is represented by the contraceptive Postinor and its analogues - Microlut, Escapel and Eskinor-F;

antigonadotropic drugs.
These include Danazol, which is a treatment for endometriosis;

antiprogesterone agents.
A modern drug that suppresses the synthesis of progesterone - Mifepristone - is used as both an emergency contraceptive and in medical abortion.

Rules for taking postcoital contraceptive pills

There are strict rules for the use of hormonal emergency contraception, and deviation from them can lead to the most disappointing consequences.

Almost all emergency birth control pills must be taken within 72 hours of intercourse. Dosages of drugs depend on the pharmacological group.

Combined hormonal pills

At the same time take 4 tablets of both colors twice a day with an interval of 12 hours.

Gestagens

Postinor and its generics are prescribed one tablet twice a day after 12 hours.

Antigonadotropic and antiprogesterone drugs

Danazol for the purpose of emergency contraception is used at 400-600 mg twice or three times after 12 hours. An alternative regimen involves the appointment of 200 mg per day for five days in a row.

Mifepristone is used once at a dosage of 600 mg. Perhaps the appointment of 200 mg of mifepristone once a day from the 23rd to the 27th day of the cycle.

Note that according to some data, Mifepristone contributes to abortion up to a period of 5 obstetric weeks.

Emergency contraception side effects

Can't be overlooked possible consequences taking high-dose birth control pills.

In the vast majority of cases, taking hormonal pills for emergency contraception is accompanied by menstrual irregularities. Therefore, some experts recommend starting taking COCs to restore hormonal levels next to the “emergency” cycle.

In addition, taking high doses of estrogen is associated with nausea and even vomiting. To reduce these side effects, it is best to take the medication with or after meals. If vomiting could not be avoided, it is necessary to drink another, extraordinary dose.

Local contraceptive pills: alternative contraception

The contraceptive effect of local, that is, vaginal, contraceptives is based on the spermicidal action of the components of the drug. Most spermicides come in the form of suppositories, but pharmaceutical companies have mastered the technology for the production of both contraceptive cream and foam and, of course, vaginal tablets.

In Russia, only one spermicidal vaginal tablet is registered - Pharmatex. The active substance of the drug is an antiseptic and spermicide benzalkonium chloride. Pharmatex has a complex effect:

• spermicidal.
  Pearl Pharmatex index at correct application is about 1%. Benzalkonium chloride contributes to the destruction of the flagella and the head of the spermatozoon;
• bactericidal.
  Pharmatex also provides protection against sexually transmitted diseases, including chlamydia, gonorrhea, trichomoniasis, HIV infection, herpes simplex virus type 2.

Rules for the use of Pharmatex

To achieve a contraceptive effect, it is necessary to strictly follow the rules for the use of Pharmatex:

• the tablet must be inserted into the vagina 10-15 minutes before sexual intercourse.
  It is this period of time that is needed for a solid tablet to break up and start working. The duration of action is about three hours. Before each subsequent sexual intercourse, it is necessary to use an additional tablet, even if the previous one has not yet expired;
• It is strictly forbidden to use soap and other alkaline detergents for the toilet of the external genital organs two hours before and after the use of birth control pills. This is due to the fact that soap contributes to the rapid and total destruction benzalkonium chloride.

As contraindications to the use of Pharmatex, only individual intolerance to the active substance and ulceration of the vaginal mucosa appear. In other cases, benzalkonium chloride preparations are completely safe.

Among all the contraceptive pills on the market, Pharmatex occupies a special place. If you need to consult a doctor to buy a hormonal drug, then Pharmatex tablets can be purchased at any pharmacy in the world without a prescription.

In conclusion, it is worth recognizing that the choice of contraceptive pills in modern woman great. It's a matter of small things: responsibility.

In this article, we will look at 2 "sides of the coin" - the positive aspects of taking oral contraceptives and the potential health hazards:

• at the beginning of the article, we will consider 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 for a healthy woman.

By doing 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 the natural processes in the female body is fraught with consequences - for someone insignificant, subtle, for someone much more serious, even tragic.

In no case do we call for abandoning the drugs prescribed by the doctor, the article is for informational purposes and the decision to take oral contraceptives is made by a woman after consultation and examination by a gynecologist. But, every woman should know about possible risks to which she is exposed during long-term use of oral contraception.

Groups of contraceptive pills, names and their action

Despite the rather rich assortment of contraceptives presented in the pharmacy, hormonal contraceptive pills today occupy a leading position (and bring billions of dollars a year to their manufacturers). Unfortunately, not everyone knows about contraindications to taking them, side effects, rules for taking pills, that they should not be taken for a long time and the choice of oral contraceptives should be made only by a doctor after a thorough diagnosis and collection of the patient's history.

All contraceptive hormonal pills are divided into two "companies": combined oral contraceptives (COCs) and mini-pills.

Monophasic tablets In these tablets, the percentage of estrogenic and progestogen components does not change in each tablet.
Desogestrel and ethinylestradiol: Regulon (400-1100 rubles) prices 2018.	Ethinylestradiol and dienogest: Jeanine (price 1000 rubles) Silhouette (price about 680 rubles)	Gestodene and ethinylestradiol: Lindinet (380-500 rub.), Logest (800 rubles), Femoden (950 rubles)
Rigevidon (price 280 rubles)	Microgynon (380 rubles)	Minisiston (450 rubles)
Biphasic drugs In them, the dose of estrogen is the same in all tablets, and the dose of progestogen changes in the 1st and 2nd periods of the menstrual cycle.
Femoston Dydrogesterone + Estradiol (900 rubles).	(Ethinylestradiol + Levonorgestrel): Anteovin, Binordiol, Sekvularum, Adepal, Sequilar, Bifazil	Binovum (Ethinylestradiol + Norethisterone) Neo-Eunomine (Ethinylestradiol + Chlormadinone Acetate)
Triphasic Tablets In the OK data, the doses of hormones are changed three times in one package, which is associated with a change in the periods of the menstrual process.
Tri-Regol (280 rubles)	Three merci (120 rubles)	Triziston

The main point in the mechanism of action of COCs is the blocking of ovulation, due to inhibition of the formation of FSH and LH in the pituitary gland. In parallel, ovarian function and local obstruction of 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 spermatozoa deep into the uterus.

COCs are also divided into 3 groups according to the quantitative content of active components:

Microdosed OK

The dose of hormones in these pills is minimal, so they are ideal for young women up to 25 years old, 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 ones - Jess, Dimia, Logest, Mercilon, Minisiston, Lindinet, Novinet.

Low-dose OK

Such tablets are recommended for young and mature representatives of the weaker sex, including those who have gone through childbirth, or are prescribed to those patients who, when using microdosed drugs, experience intermenstrual bleeding. According to manufacturers' studies, 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 contraceptive pills includes: Diana, Yarina (Midiana), Femoden, Siluet, Jeanine, Trimerci, Lindinet, Silest, Minisiston, Regulon, Marvelon, Microgynon, Rigevidon, Belara, Chloe, Demulen.

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 therapy for hormonal disorders (Non-ovlon, Triquilar, Ovidon, Triseston, Triregol) only as directed by a doctor.

It can be said about mini-pills that they contain only progestogen. The mechanism of their action lies in the local influence on the peripheral parts 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 of the phases of the menstrual cycle, which prevents the free movement of spermatozoa. There are also changes in the morphological and biochemical structures of the endometrium, which create "bad" conditions for implantation. About half of women are blocked from ovulation. Mini-pills include: linestrenol (Exluton, Microlut, Orgametril), desogestrel (Lactinet, Charozetta).

Charozetta (1300 rubles) desogestrel	Lactinet (600 -700 rubles) desogestrel	Orgametril (3300 rub.) linestrenol	Exluton (3300 rubles) linestrenol

How to choose good birth control pills

Which contraceptive pills are good, the best, you can’t deal with this issue on your own, especially buying them at a pharmacy on the recommendation of friends or a pharmacist. To find the best birth control pills, you need to visit a doctor. The gynecologist will collect an anamnesis, dwell separately on a family history, existing diseases or past ones, since all of the above may be a contraindication to the use of hormonal contraceptives.

After that, the doctor will conduct an examination, during which he will evaluate:

• skin (telangiosis, petechiae, signs of hyperandrogenism, presence / absence of hypertrichosis, etc.)
• measure weight and blood pressure
• palpates the mammary glands
• prescribe tests for liver enzymes, blood sugar, blood coagulation, hormonal levels, ultrasound of the mammary glands, ultrasound of the pelvic organs, if necessary, mammography
• then hold gynecological examination with swabs
• also a woman should visit an ophthalmologist, because long-term use OK increases the risk of developing other eye diseases.

For the appointment of tablets that are most favorable for this patient, her constitutional and biological type is taken into account, which takes into account:

• height, appearance
• mammary gland
• pubic hair
• skin, hair
• menstruation and premenstrual symptoms
• cycle irregularities or lack of menstruation
• as well as existing chronic diseases

There are 3 phenotypes:

The prevalence of estrogens

Women of short or medium height, very feminine in appearance, skin and hair are prone to dryness, 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.

Milvane (ethinylestradiol and gestodene): Logest (720 rubles) Femoden (600-650 rubles) Lindinet ( average price 320 rub)	Rigevidon (price 180 rubles), Microgynon (320 rubles), Minisiston (370 rubles) Tri-regol (200 rubles), Triquilar (530 rubles), Triziston

Balanced type

Women of average height, feminine, mammary glands of medium size and developed, skin and hair of normal oiliness, no premenstrual signs, menstruation 5 days after 4 weeks. Such women are recommended second-generation drugs: Marvelon, Silest, Lindinet-30, Microgynon, Femoden and others.

Ethinylestradiol and desogestrel: Marvelon (630 rubles), Novinet (330 rubles), Regulon (280-320), Tri-merci (650r) Mercilon (630 rubles)	Ethinylestradiol and Norgestimate: Silest	Eethinylestradiol and Gestodene (Milvane): Lindinet (280-350 rub.), Logest (720 rubles), Femoden (600-650 rubles)	Ethinylestradiol and levonorgestrel: Rigevidon (180r), Tri-regol (200r) Microgynon (320r), Minisiston (370r) Triquilar (530r), Triziston

The prevalence of gestagens / androgens

Women are tall, “boyish” in appearance, underdeveloped mammary glands, skin and hair with increased fat content, depression on the eve of menstruation and pain in the abdomen, in the lumbar region, menstruation is scanty, less than 5 days, the cycle is short, less than 28 days. In this case, the doctor will advise hormonal preparations with an antiandrogenic component: Diane-35, Janine, Yarina, Jess.

Yarina (price 800 rubles)	Ethinylestradiol and drospirenone: Jess (820 rubles)	Ethinylestradiol and drospirenone: Dimia (550 rubles)	nomegestrol and estradiol Zoely (1000 rubles)

Ethinylestradiol and dienogest: Janine (800 rubles), Silhouette (400 rubles)		Ethinylestradiol and cyproterone: Diana 35 (820 rubles), Chloe 35 (450 rubles), Erica 35 (360 rubles)

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, in which there are 24 pills and which are often prescribed by gynecologists to young women. For women after 35 years, the doctor may recommend Qlaira tablets, a new generation of oral contraceptives containing 28 tablets.

How to take birth control pills:

• Tablets should be taken every day, at about 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 the place where a woman looks every day (in a cosmetic bag, on a toothbrush or attach a magnet to the refrigerator).
• Every day one tablet is drunk until the blister is over.
• 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 COC again, regardless of whether the period has ended or not.
• In case of vomiting, it is necessary to take an extraordinary tablet.
• If you miss taking a pill, you need to drink it as soon as possible.
• In these two cases, during the day you need to additionally protect yourself.
• At the very beginning of taking COCs, if they have not been used before, additional protection should be taken during the first 14 days.
• Intermenstrual bleeding is not considered a reason to stop taking pills (see)
• Usually they are noted 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 that come from outside.

Taking hormonal combination drugs after medical termination of pregnancy should be started either on the day) or a month later, when the first menstruation begins.

The contraceptive effect of hormonal drugs may decrease when used simultaneously 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, carefully study the instructions for using the drugs prescribed to you. In case of appointment medicines that reduce the effect of COCs, additionally use other methods of protection (condoms).

The standard mini-pill blister contains 28 tablets. These tablets are drunk 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 is not lactating or prefers artificial feeding, then low-dose COCs (Belara, Miniziston, Regulon and others) are recommended to 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 the 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 the outside, but the maximum guarantee comes after a month's course of their use.

Side effects of birth control pills

Side effects are signs or conditions that develop when using contraceptives, but do not threaten the health of women. They are divided into 2 groups:

Minor side effects: pain in the head; bleeding between periods; soreness and swelling of the mammary glands; nausea; lack of appetite; lack of menstruation; dizziness, weight gain, increased gas formation, skin rashes, chloasma; increased hair growth; decreased sex drive

Serious side effects: pain and swelling calf muscle On the one side; acute pain behind the sternum; migraine, hemicrania; difficulty breathing moist cough mucus streaked with sputum; tendency to faint; loss of visual fields; speech problems (difficulty); sudden jumps in blood pressure; urticaria as an allergic reaction to the drug (see)

In the event of the appearance of serious, as well as with constant small side effects, contraceptives are discontinued.

Regardless of the chosen OK, a woman needs a periodic assessment of her health in connection with possible side effects from their use, namely:

• Blood pressure: measure every 6 months
• Physical examination (breast, liver palpation, gynecological examination), urinalysis: 1 r / year
• Monthly breast self-examination.

It is no secret that regular checkups are unlikely in many developing countries, 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 high-risk groups of women. Consequently, it will be more difficult for such women to obtain medical care in case of dangerous side effects.

Absolute contraindications to oral contraceptives

Diseases in which the appointment of oral contraceptives is not desirable: (congenital hyperbilirubinemia), bronchial asthma, rheumatoid arthritis, multiple sclerosis, thyrotoxicosis, ), myasthenia gravis, sarcoidosis, retinitis pigmentosa, thalassemia, renal dialysis.

Absolute contraindications to combined OK: the period of breastfeeding; less than 1.5 months after delivery; existing and possible pregnancy; pathology of the cardiovascular system; pathological changes in the vessels of the brain; pathology of the liver and tumors of this organ; migraines of unknown origin; bleeding from the genital tract of unknown nature; hypertension 2A - 3 degrees, kidney pathology; gestational herpes; cancer of the genital organs and endocrine glands; prolonged immobility; 4 weeks before surgery; overweight (from 30%); smoking at age 35 and beyond; long-term or progressive diabetes mellitus diseases that predispose to thrombosis.

Absolute contraindications to taking pure progestins: present or suspected pregnancy; malignant neoplasms of the mammary glands; acute liver disease; bleeding from the genital tract of unknown origin; problems of the cardiovascular system; the presence of an ectopic pregnancy in the past; genital cancer.

At the end of the article there is a video of a TV show detailing the dangers of using OCs by any woman, because even in the absence of the above contraindications (the woman and the doctor may not know about them), a seemingly healthy woman has a risk of developing pulmonary thromboembolism, the development of oncology, is extremely high.

Hormonal contraceptives and possible pregnancy

Can you get pregnant while taking birth control?

This question worries many women. Of course, pregnancy against the background of the use of hormonal oral contraceptives is not excluded, but its probability is too small.

• First of all, an unwanted pregnancy occurs when the rules for taking pills are violated (missing, irregular, in different time intake past the expiration date of the drug).
• You should also take into account the possible vomiting in case of poisoning or co-administration 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 after taking contraceptives has happened, it is desirable, then there is no indication for its termination (interruption). You just have to stop taking the pills right away.

Taking hormonal pills in late childbearing age

Currently, in economically developed countries, about half of married couples after 40 years of age prefer sterilization. Of the hormonal drugs, COCs or mini-pills are used. Women who are over the age of 35 should stop using hormones with existing cardiovascular pathology, coupled with smoking, a high risk of oncology. A good alternative for women after 40 - 45 years old are mini-pills. These drugs are indicated for uterine fibroids, endometrioid inclusions and endometrial hyperplasia.

Emergency and non-hormonal contraception

• emergency contraception

If sexual intercourse has occurred without the use of means that protect against pregnancy, emergency (fire) contraception is carried out. One of the well-known and widely used drugs is Postinor, Escapel. You can take Postinor no later than 72 hours after coition without the use of contraceptives.

First you need to drink one tablet, and after 12 hours, the second is taken. But COCs can also be used for fire contraception. The only condition is that one tablet must contain at least 50 micrograms of ethinylestradiol and 0.25 mg of levonorgestrel. First, you should drink 2 tablets as soon as possible after intercourse, and repeat the intake of 2 more after 12 hours.

These drugs can only be used in emergency cases (rape, condom breakage), 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 abortive effect, of course, this is not a surgical manipulation like a medical abortion, but no less harmful from the point of view of further reproductive function female body.

• Non-hormonal contraception

They are spermicides that are used topically to prevent unwanted pregnancy. The active component of such tablets inactivates spermatozoa and “does not let” them into the uterine cavity. Moreover, non-hormonal tablets have anti-inflammatory and antimicrobial effects. 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. The positive aspects of using OK, which are promoted by gynecologists:

• one of the most reliable and high-quality methods of contraception (efficiency reaches 100%);
• can be used at almost any age;
• against the background of taking contraceptive pills, the menstrual cycle becomes regular, pain may disappear during menstruation (see);
• good cosmetic effect (disappearance of acne, oiliness or dryness of 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 its delay;
• therapeutic effect - endometriosis, uterine fibroids, ovarian cyst (do OK healing effect- while it remains very controversial issue, since most of the research is done by manufacturers of hormonal contraceptives);
• after refusing to take pills, fertility is usually restored within 2-6 menstrual cycles (with rare exceptions up to a year).

But despite all the advantages, there are much more negative consequences from taking hormonal contraceptives and they outweigh the arguments FOR. Therefore, the decision to drink birth control pills is made by the doctor and the woman herself, based on the presence of contraindications, possible side effects these drugs, general health, chronic diseases. According to the results of many studies, the use of oral contraceptives (long-term), has a long-term Negative consequences for the health of a woman, especially those who smoke and have any chronic diseases.

Arguments AGAINST oral contraceptives

In the modern world, the pharmaceutical industry is the same business as any other sector of the economy, and the material benefit from the sale of drugs that a woman needs every month is fabulous. Over the past decades, several studies have been conducted by independent American experts, the results of which suggest that taking hormonal contraceptives by a woman before the birth of 1 child increases the risk, and increases the cervix. In addition, OK 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 and hypothalamus, which are associated with the adrenal glands, thyroid gland and ovaries (peripheral organs). The ovaries have a clear hormonal interaction with the whole body, the uterus waits for a fertilized egg each cycle, and even small doses of hormones coming from outside disrupt this fragile interaction.

With prolonged use of hormonal contraceptives, the functions of the genital organs completely change. Every day, taking a pill suppresses ovulation, the release of an egg does not occur, ovarian function is suppressed, which in turn depresses the regulatory centers. With prolonged use of tablets (for years), a woman in the uterus changes the inner layer, since it is rejected unevenly (hence bleeding and). The mucous layer and tissue of the uterus gradually change, which in the future (more often during menopause) threatens with oncological degeneration.

With prolonged use of oral contraceptives, the amount of sex hormones is reduced, the ovaries are reduced in size, their nutrition is disturbed - this is a powerful blow to the reproductive function of the body. And at the beginning of the reception and after stopping the reception of OK, a failure occurs in hormonal system, therefore, in some women, the restoration of reproductive function occurs within a year, and in some cases it may not be restored at all. So:

• women with the above contraindications should never take oral contraceptives, since serious complications may develop, up to lethal outcome(development of vascular thrombosis), oncology;
• with prolonged use of OK, the excretion of vitamin B6 from the body is accelerated, which can lead to hypovitaminosis B6, as well as vitamin B2 (see), which adversely affects nervous system(weakness, insomnia, irritability, skin diseases, etc., see);
• also OK disrupt the absorption of a very important for the body folic acid, which is very necessary 3 months before conception and with a future desired pregnancy and (see), the addition of which to some hormonal contraceptives is only a marketing ploy;
• With prolonged use (over 3 years), the risk of developing glaucoma increases by 2 times. Studies by scientists at the University of California showed that (3500 women over 40 years old, from 2005 to 2008 took contraceptives) when taken for 3 years without interruption of oral contraception, women are 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 OK for 5 years or more increases the risk by 3 times (see). Researchers attribute the growth of this disease to the "Era of hormonal contraception";

Today - in the age of oncological tension and unimproved early diagnosis the initial asymptomatic stages of oncology, a woman taking OCs may not be aware that she has early stages 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 contribute to thrombosis 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 old), genetic disposition, see;
• taking oral contraceptives increases the risk of developing chronic venous insufficiency - pain in the legs, night cramps, feeling of heaviness in the legs, transient edema, trophic ulcers;
• an increased 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 intake of hormones from the outside and in the future, some women may have difficulty conceiving;
• do not provide protection against genital infections, so their use is not advisable if there are many partners, women who have a promiscuous sex life (only condoms protect against genital infections and viruses, including), syphilis, etc.);
• taking oral contraceptives can provoke the appearance of a woman's body;
• according to American studies in women taking oral contraceptives, the risk early development multiple sclerosis increases by 35% (see, which today can be in both a 20-year-old and a 50-year-old woman);
• one of them may be taking oral contraceptives;
• the risks of developing transient increase;
• women taking OCs are more likely to develop depression;
• some women have significantly reduced libido;
• the need for self-monitoring and daily intake;
• errors are not excluded when using contraceptive pills;
• the need to consult a gynecologist before taking;
• the price is quite high

According to WHO, about 100 million women use oral contraception, which brings pharmacartels fabulous profits. 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 a powerful public opposition aimed at banning the sale of dangerous drugs, and information about them potential harm publicly available. The result of this is that European and American gynecologists strongly recommend condoms, which protect not only from unwanted pregnancy, but also from genital infections. Next in popularity is the hormonal patch and then the spiral.

After reports of the dangers of OK, several deaths and lawsuits, Diane-35 is banned in some countries (USA, Germany, France), and surveys of Europeans showed that 67% of people aged 15-63 try to protect themselves with condoms, this is married couples and single women, 17% prefer the patch, 6% use the 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 the age of 14-18, without reporting a potential and very real threat to their health.

Hormonal contraceptives are today considered the most effective and highly reliable in preventing unwanted pregnancy. This group Contraceptives allow not only to plan the birth of the desired baby, but also liberate in relations between partners in terms of sex, besides, they simultaneously cure some diseases of the female genital area.

Hormonal contraception is contraceptive method, based on hormonal suppression of ovulation, in which synthetic analogues of female sex hormones are used. Hormonal contraceptives are divided into oral (OC or hormonal birth control pills) and prolonged (implants and injections). Around the world, including in Russia, over the past few years, interest in this method protection against unplanned pregnancy.

The level of efficiency and reliability of these contraceptives is ensured directly by strict observance of the rules for their use. In practice, often the necessary rules are not always followed, which is why pregnancy still happens when using hormonal contraception. Moreover, the reasons for this can be very different - this is skipping the pill, confidence in the long-term preservation of the contraceptive effect, interaction with certain medications.

Classification of hormonal contraceptives.
Along the path of hormone penetration into the blood, hormonal contraceptives exist in the form of tablets, ampoules (injections are made every 45-70 days) and implants that are implanted under the skin (capsules gradually release hormones, maintaining the required level of their content in the blood).

Hormonal contraceptives differ in the type and content of hormones. They are divided into combined (estrogens and progestogens are present in the composition) and non-combined (contains only progestogens, hence the second name is progestogen contraceptives).

Combined contraceptives that enter the body of a woman with birth control pills or injections during the entire menstrual cycle interfere with the regulation of the functions of the reproductive system, imitating natural changes in the content of hormones in the blood. Hormones coming from outside suppress ovulation, as a result of which the release of the egg does not occur, and, therefore, the onset of pregnancy cannot be in principle, even if hundreds of spermatozoa have entered the fallopian tubes.

Combined hormonal contraceptive pills can be single-phase (monophasic), biphasic and triphasic.

Single-phase (or monophasic) birth control pills. These first generation oral contraceptives contained a huge dose of the hormone. During the twenty-one days of the menstrual cycle, a constant amount of estrogens and progestogens is "thrown" into the body, and meanwhile, the level of natural hormones in the blood during the cycle is subject to significant fluctuations. The tablets of this group of contraceptives have one color.

Biphasic oral contraceptives, unlike single-phase drugs, contain tablets of two colors in one package. Tablets of one color are taken in the first half of the cycle, and the other - in the second, and in the latter the level of gestagens is much higher, which is necessary to "copy" the natural changes in the content of hormones in the woman's blood.

Three-phase preparations in the package contain tablets already three colors, while tablets of the same color are taken during the first few days of the cycle, then tablets of the second and third colors are taken in sequence. Due to the different content of hormones, the secretion of sex hormones during the entire cycle is successfully imitated. When purchasing funds from this group, you should carefully read the composition. The content of estrogens (ethinyl estradiol) in the preparation is very important, the optimal level is 30-35 mcg per tablet.

Non-combined contraceptives consist only of gestagens (mini-pills). Typically, drugs in this group are prescribed to women who have had side effects when using combined contraceptives. This type of contraception can also be used during lactation. Drugs in this group are also prescribed for the treatment of fibroids, endometriosis and some other diseases of the female genital area.

Hormonal contraceptives are also divided into micro-dose, low-dose, medium-dose and high-dose.

Microdosed preparations are suitable as contraception for young nulliparous women who have regular sex life (once a week or more), as well as for those who have not yet used hormonal contraceptives.

Low-dose hormones are also ideal for young people. nulliparous women leading an active sexual life, as well as if microdosed drugs could not block ovulation. Also this species suitable for women who have given birth and women in late reproductive period.

Medium-dose hormonal preparations are ideal for women who have given birth or women in the late reproductive period who have regular sex life).

High-dose hormonal drugs are prescribed for the treatment of hormonal diseases, but are also used as contraception by women who have given birth or women in the late reproductive period who have regular sex life (once a week or more) if low- and medium-dose drugs have not prevented ovulation.

Indications for use:

• preventing an unplanned pregnancy,
• insufficient synthesis of sex hormones in a woman's body,
• menstrual irregularities.

Mechanism of action of hormonal contraceptives.
Hormonal agents prevent pregnancy by suppressing ovulation and thickening the mucus secreted by the cervix, which further prevents the penetration of sperm into the uterus and, accordingly, the fertilization process.

When using hormonal drugs, the female body does not synthesize its own sex hormones, but with even a short interruption of the drug (missing a pill), a strong release of hormones occurs, which can cause ovulation in a few hours.

Modern hormonal contraceptives are produced in the form of tablets (oral contraceptives), contraceptive patches, hormonal implants, vaginal rings, as well as special injections.

With long-term use, as well as with a sharp abolition of oral contraceptives, cases of hormonal failures are not uncommon. This is expressed in violation of the frequency of menstruation and their duration, as well as the amount of discharge. Menstruation becomes excessively scarce or, on the contrary, abundant. Some women experience pain in the lower abdomen. The complex of biologically active substances "Time Factor" has a beneficial effect on the functioning of the reproductive system. Reducing the pain of menstruation is achieved due to the unique composition of the drug, which includes extracts from medicinal herbs, vitamins C, E, B9 and PP, minerals (magnesium, iron, zinc). The components help relieve muscle spasms, restore the balance of hormones, which is quite common during the use of contraceptives or after refusing them.

It is important to remember that hormonal contraceptives cannot protect against STDs, therefore, in the absence of confidence in a sexual partner or in case of casual relationships, barrier methods of contraception (condom) should be used.

Only a gynecologist together with a woman can choose one or another hormonal contraceptive, taking into account many factors and the results of an analysis for hormones (FSH, estradiol and testosterone), which is carried out in the middle of the menstrual cycle.