Myth 1: Hormonal drugs are special birth control pills for women.
Not. Hormonal drugs are drugs obtained synthetically. They act like natural hormones produced in our body. In the human body there are many organs that release hormones: female and male genital organs, endocrine glands, central nervous system and others. Accordingly, hormonal drugs can be different, and they are prescribed for a variety of diseases.
Female hormonal preparations (contain female sex hormones) may either have a contraceptive effect or not. Sometimes, on the contrary, they normalize hormones and promote pregnancy. Drugs containing male sex hormones are prescribed to men with a decrease in the quality of the ejaculate (i.e., sperm motility), with hypofunction, a decrease in the level of male sex hormones.
Myth 2: Hormones are prescribed only for very serious diseases.
Not. There are a number of mild diseases in which hormone preparations are also prescribed. For example, a decrease in thyroid function (hypofunction). Doctors often prescribe hormones in this case, for example, thyroxin or eutirox.
Myth 3: If you do not drink a hormonal pill in time, then nothing terrible will happen.
Not. Hormonal drugs should be taken strictly by the hour. For example, hormonal contraceptive pill is valid for 24 hours. Accordingly, it is necessary to drink it once a day. There are drugs that you need to drink 2 times a day. These are some male sex hormones, as well as corticosteroids (for example, dexamethasone). Moreover, taking hormones is recommended at the same time of day. If you drink hormones irregularly, or forget to drink altogether, the level of the required hormone can drop dramatically.
For example, if a woman forgot to take a hormonal contraceptive pill, the next day she should drink the forgotten evening in the morning and the next pill in the evening of the same day. If the interval between doses was more than a day (recall: the hormonal contraceptive pill is valid for 24 hours), then the level of hormones in the blood will decrease very much. In response to this, minor bleeding will certainly occur. In such cases, you can continue to take birth control pills, but to additionally protect themselves during the next week. If more than 3 days have passed, it is necessary to stop taking hormones, use other means of contraception, wait for the arrival of menstruation and consult with your doctor again.
Myth 4: If you take hormones, they accumulate in the body.
Not. When a hormone enters the body, it immediately breaks down into chemical compounds, which are then removed from the body. For example, the contraceptive pill is destroyed and “leaves” from the body during the day: that is why it is necessary to drink it every 24 hours.
Need to know: the mechanism of long-acting hormones is not related to their accumulation in the body. Simply, this is the principle of action of these drugs: “work” through other structures of the body.
However, hormonal drugs continue to "work" after they have stopped taking them. But they affect indirectly. For example, a woman drinks hormonal pills for several months, then stops taking them, and later she has no problems with the cycle.
Why is this happening? Hormonal drugs act on various target organs. For example, female birth control pills affect the ovaries, uterus, mammary glands, and parts of the brain. When the pill is “gone” from the body, the mechanism that it launched continues to work.
Myth 5: hormonal drugs are not prescribed during pregnancy
Write out. If before the pregnancy the woman had hormonal disorders, then during the carrying of the fetus she needs drug support in order for the production of female and male hormones to be normal, and the child would develop normally.
Or another situation. Before the pregnancy, the woman was all right, and with her onset, suddenly something went wrong. For example, she suddenly notices that intense pilosis has begun from the navel down and around the nipples. In this case, it is necessary to consult a doctor, who can prescribe a hormonal examination, and, if necessary, write out hormones. Not necessarily female sex - it can be, for example, adrenal hormones.
Myth 6: Hormones have a lot of side effects, first of all - weight gain.
There are almost no medications without side effects. But you need to distinguish side effects that do not require discontinuation of the drug. For example, swelling of the mammary glands when taking contraceptive hormones is considered normal. Scanty spotting in the first or second months of admission in the intermenstrual period also have the right to be. Headache, dizziness, fluctuations in weight (plus or minus 2 kg) - all this is not a pathology and not a sign of the disease. Hormonal drugs prescribed for a sufficiently long period. The body adapts by the end of the first month, and everything returns to normal.
But so that there are no really serious problems associated with, say, vessels, it is imperative that you take a medical examination and take tests before prescribing a medicine and during its administration. And only a doctor can prescribe you a specific hormonal drug that will not harm your health.
Myth 7: Hormones can always find an alternative.
Not always. There are situations when hormonal drugs are indispensable. Let's say a woman under 50 had ovaries removed. As a result, she very quickly begins to age and lose health. In this case, her body to 55-60 years old must support hormone therapy. Of course, provided that its main disease (due to which the ovaries were removed) has no contraindications for this purpose.
Moreover, for some diseases, even a neuropsychiatrist can strongly recommend female sex hormones. For example, with depression.
Endocrinologists and gynecologists have been using hormonal drugs for a long time to restore hormonal levels and treat many diseases associated with a lack or excess of hormones. But for residents of Russia, especially over 40-45 years old, this is one of the greatest “horror stories”, so the percentage of people taking these drugs is low, although this is a real chance to prolong their youth, restore or preserve their health.
Should I take hormones?
Hormones are involved in almost all processes occurring in a woman’s body, regardless of age. Hormonal failure can occur as a result of any disease or be the result of the onset of menopause in a woman. To restore the background, it is simply impossible to do without special preparations.
After 45 years, about 55% of women take hormone replacement therapy in England, and less than 1% in Russia.
Hormonal drugs are widely used to treat and stabilize conditions caused by an imbalance of hormones.
Are hormonal drugs dangerous?
Drugs containing hormones, entering the body, interact with receptors that are sensitive to these proteins. As a result, low hormones increase. This is called hormone replacement therapy (HRT), which is prescribed to a woman in such cases:
- Thyroid dysfunction. As a result, there is an imbalance of the corresponding hormones, which is especially dangerous during pregnancy.
- Diabetes. Without insulin-containing (hormone) drugs, there is a threat to life for a woman.
- Infertility. Often the reason for this is a high level of prolactin, the suppression of which with appropriate drugs will help solve the problem.
- Climax, including artificial. Occurs as a result of the extinction of ovarian function or their removal. They produce estrogen and progesterone, responsible for reproductive function, youthful skin, severity of symptoms such as hot flashes, cardiovascular diseases, osteoporosis.
All of these cases are a direct indication for the appointment of HRT, without which the quality of life of a woman is reduced, there is a risk of serious diseases.
Myths about HRT
Many do not know reliably why hormonal drugs cannot be taken, they have no reason for this, but there is a great fear. It is caused by the following myths:
- They are only contraceptives. This is not so, because the effect on the body depends on the type of active hormone, its concentration. HRT successfully fights with a large number of different diseases.
- This is a treatment for severe dysfunctions. In fact, even a small deviation from the norm can cause health problems that are easily resolved by taking hormonal drugs.
- When pregnancy can not take hormones. This is a categorical misconception that leads to the independent refusal of patients from taking the prescribed drugs. This, in turn, leads to the appearance of a threat to the life of the child and mother (thyroid dysfunction causes underdevelopment, including mental, in children).
- Hormones accumulate in tissues. These substances can not persist for a long time, therefore, in the absence of a reaction with receptors, they are rapidly destroyed.
- HRT provokes weight gain. This is possible only with improperly selected dosage (self-treatment), as a result of which hormonal imbalance develops. It leads to improper absorption of nutrients.
- HRT can be replaced by non-hormonal drugs. An alternative can serve as a means of phytoestrogens. But they are not able to fully replace hormones, and long-term use causes allergic reactions.
- Young people are not threatened with hormonal failure. Imbalance can be caused by any factor, including stressful situations. Therefore, age is not a contraindication to receive replacement therapy.
Russian women have an absolutely unreasonable fear of HRT, which is based on myths and not real facts.
Pros and cons of hormonal drugs
Women are afraid of hormones that are natural for their body, while they safely take foreign substances - antibiotics. Estrogen and progesterone are most important for women's health. Maintaining their normal balance will not allow the development of such diseases as type 2 diabetes, coronary disease, uterine fibroids, atherosclerosis and osteoporosis. Also, they will significantly reduce the manifestations of menopausal syndrome, will allow to establish the menstrual cycle.
Decide on the appointment of a particular drug and its doses can only the attending physician who conducted the necessary examinations.
Modern drugs are microdoses that are as safe as possible for a woman’s health, with virtually no side effects. But sometimes such side effects as dizziness, nausea, indigestion, candidiasis, feeling of lack of air can occur. If you notice any deterioration in health, consult a doctor so that he can adjust the therapy.
What are dangerous hormonal drugs for women?
The danger of taking hormonal drugs occurs only in the case of self-treatment. There are a number of contraindications for prescribing HRT, and a detailed examination is required in advance.
Replacement therapy is contraindicated if available:
- Malignant tumors of the breast or uterus. This is a 100% contraindication, while benign tumors do not belong to the prohibition of the appointment of hormone therapy. Recent studies show that modern drugs can prevent the development of any tumor processes.
- Ovarian cyst. But the ban applies only to diseases caused by an imbalance of sex hormones. If the cause is pituitary hormones, the therapy is indicated for use.
- High thrombosis. In this case, the use of HRT may trigger the emergence of new blood clots.
- Myocardial infarction as a result of coronary artery disease. This suggests that taking hormones is too late.
- Fibroadenoma. Increased risk of rebirth of benign education in malignant.
Other cancers are not contraindicated for HRT.
thank
general information
Hormones are active substances that are involved in all physiological processes. They are produced by the endocrine glands and coordinate various processes: growth, reproduction, metabolism, and so on.Hormone therapy in children
This type of treatment requires a special qualification from doctors, since the use of even the “lightest” hormonal drug necessarily reduces the activity of the gland that secretes it. It should be understood that finally the endocrine glands develop only by the age of twenty five. Therefore, the inept use of hormones can disrupt the natural process of the formation of the endocrine system.Children are prescribed hormonal drugs only in special cases and those that are quickly destroyed in the body ( prednisone, hydrocortisone). It is better to give a medicine containing hormones to a baby during ( or before) breakfast.
Insulin preparations are very carefully prescribed to babies. The presence of glucose in the urine does not necessarily indicate diabetes. There are many diseases that are similar in their manifestations to diabetes, but not all of them are associated with a lack of insulin. Usually, in the treatment of such diseases in hospitals do not use hormonal agents.
After infectious diseases and in violation of the work of the endocrine glands, in some cases, anabolic steroids are prescribed to babies, but they cannot be used with infectious-allergic diseases ( for example, collagenosis, glomerulonephritis).
Any hormonal means babies can be given only after consulting an endocrinologist and in strict accordance with the prescribed dosage.
During the course of treatment, it is necessary to carefully monitor the condition of the baby, the weight of his body, the work of the digestive system.
If prednisone is prescribed, it is necessary to periodically check the amount of calcium and sugar in the blood, to ensure that the child does not increase body hair, pressure does not rise, there are no signs of a decrease in adrenal function.
Replacement therapy for menopause
During menopause, a woman's body produces not only less female sex hormone - estrogen, but also a weaker form - estrone. Due to the introduction of replacement therapy, the level of the female sex hormone is normalized in the body, which has a beneficial effect on the state of the body.Pros:
- Brain activity is activated,
- Normal sleep
- Normalized blood pressure
- Normal heart rate,
- Collagen fibers are strengthened in vessels, cartilage, skin,
- Warn atherosclerosis ( high density lipoprotein increases - good cholesterol),
- The probability of a heart attack, heart attacks decreases, the probability of death from coronary diseases decreases by half,
- Reduced chance of stroke by 50%
- The chance of fractures due to osteoporosis is reduced by 50%,
- Such climacteric symptoms as vaginal dryness, vulvar itching, vaginal mucosal atrophy, urination disorders, are eliminated.
- The thyroid gland is regulated,
- Not increased body weight under the influence of testosterone.
- Severe diabetes mellitus,
- Disruption of the liver,
- Vaginal bleeding of obscure nature.
Before prescribing the medication, the doctor will send you for an examination that identifies common diseases, which can be aggravated by taking hormones. It will be necessary to go to a gynecologist's reception, to make an ultrasound examination of the pelvic organs, to undergo an analysis for oncocytology, to examine the state of the breast, to check the pressure, the body weight, to donate blood for cholesterol and a general analysis, for sugar, and also for urine analysis.
During the course of substitution therapy, it is necessary to undergo an annual examination by a doctor and an ultrasound test.
Gynecology replacement therapy
Indications:- Menopause,
- Earlier ovarian depletion,
- Hypogonadotropic amenorrhea,
- Gonadal dysgenesis,
- Normalization of the state of the endometrium after surgery or in the chronic form of endometritis,
- Drug menopause.
Steroid hormones are used in treatment because they affect many internal organs. Their shortage adversely affects the state of adipose tissue, liver, dermis, bones, digestive system, organs of reproduction, blood vessels, brain.
Hormonal drugs of the latest generations, practically, imitate natural, their concentration in the blood in one to one. The treatment uses small dosages of sex hormones that do not interfere with ovulation and do not have contraceptive action.
The use of hormones in the treatment of infertility is reduced to the fact that with a natural shortage of hormones in the patient's body, with the help of their artificial analogues, conditions are created that are as close to normal as possible. Due to this, fertilization and gestation are carried out. When prescribing dosages of drugs one of the most important indicators is the state of the endometrium.
With amenorrhea and early menopause, hormonal drugs are administered in cycles. Treatment continues up to the age of onset of normal menopause. If a woman wants children, hormone intake is not interrupted, as it helps to normalize the condition of the endometrium.
Tumors are divided into three groups:
- Hormonoactive,
- Hormone-related,
- Hormone-dependent.
The appearance of such a tumor does not in all cases indicate the expediency of treatment with hormones.
Hormonoactive - These are tumors that secrete hormones. Such tumors have a double damaging effect on the body. These include cancer of the adrenal glands or pituitary, pancreas, thyroid. They can appear on other organs that do not produce hormones in a healthy state ( for example, the intestines or lungs).
Hormone-dependent - These are neoplasms, the existence of which is impossible without the presence of certain hormones. Changes in the hormonal background of the body, stopping the production of the hormone necessary for a tumor, leads to inhibition of tumor development. Some tumors of the breast, testicles, ovaries, prostate gland, kidneys, thyroid gland, uterus can be considered in this category. Here for the treatment of such tumors and need hormone therapy.
Usually used hormone therapy for metastasis ( the occurrence of secondary tumors). The effect depends on how sensitive the tumor is to hormones. Sometimes this method is assigned in the early stages in combination with other methods.
The most significant results have been achieved with hormone treatment for breast and prostate cancer.
Breast Cancer Therapy
The female sex hormone estrogen in many cases is an activator of the appearance of malignant breast tumors. Estrogens interact with proteins in the upper layers of the neoplasm and accelerate the division of malignant cells.The use of hormones in breast cancer leads to:
- Decreased ovarian estrogen levels
- Inhibition of the activity of mammary gland receptors to progesterone and estrogen,
- Reduced estrogen production by the adrenal glands,
- Inhibition of the activity of the hormone itself by increasing the level of male sex hormones.
If the tumor is sensitive to this type of therapy, then it can be completely removed along with metastases. Often, it is because of this type of treatment that patients live longer for several decades.
Ovarian Removal Therapy
After removal of the ovaries, young patients begin to experience sensations that are observed in women of menopause. Already after 15 to 20 days, symptoms of malaise appear, which begin to annoy seriously 8 to 12 weeks after surgery. This is due to the fact that estrogen residues are gradually removed from the body and early menopause develops.A woman begins to experience fever, increased sweat gland performance, tachycardia, she is unstable with pressure and mood, often has a headache, poor sleep and no interest in the opposite sex.
After some time, these unpleasant signs will disappear, but other, more dangerous ones will take their place: dysfunction of the vessels, urinary organs, external genital organs.
Some of the hormones are produced by the adrenal glands. However, their work is not enough. Therefore, women are prescribed hormone replacement therapy. Hormonal drugs can be drunk until the end of life, which will prevent the development of early menopause and allow a woman to feel good for a long time.
In the event that removal of the ovaries was due to a malignant tumor, hormonal treatment is usually prohibited. Then homeopathic remedies are prescribed instead.
With psoriatic arthritis
In severe cases of joint damage with psoriasis, the following drugs are prescribed that contain glucocorticoids:- Kenalog ,
- Flosteron ,
- Diprospan ,
- Hydrocortisone ,
- Metipred .
The patient's condition is quickly relieved: pain in the affected joints is relieved, their mobility increases, and fever and lethargy disappear.
Negative effect of treatment:
- Immunity is suppressed, which provokes ulcers on the body,
- Drugs are addictive,
- Side effects: hypertension, obesity, diabetes, edema,
- Drugs are prohibited to use constantly and for a long time.
- May contribute to the development of gastric ulcers,
- The drug can not be canceled immediately, as the patient's condition deteriorates sharply.
Against acne
Hormonal treatments can sometimes help those who suffer from acne on their face and body. The use of hormonal drugs reduces the production of sebum by the skin glands, so the skin is actually cleansed.But many people notice that after the end of the intake of the drug, acne appears again. In order for the effect to last, hormones should be combined with skin treatment with special antibacterial agents. Means should be selected on the basis of natural ingredients that do not contain antibiotics and chemistry.
Side effects observed when taking hormonal preparations for cleansing the skin from acne:
- Headache,
- Weight gain
- Depressed mood
- Edema,
- Individual intolerance to the drug.
Shemale and Hormonotherapy
Estrogens are used to suppress the production of testosterone and make the body more feminine. In addition, progestogens are used, under the action of which the mammary glands are enlarged.Antiandrogens inhibit the production of male sex hormones. The use of these hormones makes it possible to reduce the dosage of estrogen drugs and reduce the sensitivity of the internal organs to the action of testosterone.
In order to suppress the production of estrogen, testosterone preparations are taken.
Hormone therapy when changing sex is divided into two phases:
1.
The first months of treatment ( half a yeara) hormonal preparations are taken in large dosages, which allows to achieve the desired result in a shorter time. As soon as the desired result is obtained or if the maximum dosage of hormonal drugs is taken, the doses should be slowly reduced. Twenty to 30 days before surgery, hormone preparations should be completely abolished to reduce the likelihood of thrombus development. This phase of treatment suppresses the work of the sex glands and helps the appearance of signs of the desired sex. Also, treatment helps prevent a serious complication of the operation — a post-construction syndrome characterized by lethargy, weakness, and a burden to sleep.
2. The second phase begins after the operation. After removal of the testes, antiandrogens are discontinued. After the uterus and ovaries are removed, the dosage of drugs to suppress the production of female sex hormones is reduced. However, in order for the hormonal background to match the selected sex, therapy is carried out throughout life.
Acceptance of hormonal therapy allows you to achieve a change in the appearance of a transsexual by the desired sex type.
Most often, hormones are taken orally in pill form. But there are drugs in the form of patches, gels, liquids for injections.
Since the use of hormone therapy increases blood density, thrombosis, stroke, heart attack can develop as a side effect. The likelihood of developing heart and vascular diseases, breast cancer, osteoporosis and Alzheimer's disease increases.
To minimize the likelihood of side effects, you need to give up nicotine, balance the menu, lead a healthy lifestyle and from time to time conduct a general diagnosis. In no case should not cancel or prescribe a hormonal drugs themselves.
It should be understood that the effect of taking hormonal drugs occurs gradually and slowly enough. Only 24 months after the start of treatment can you achieve maximum results.
The effect of the action of drugs may be stronger or less, depending on age, genetic characteristics. The strongest effect is observed in persons aged 18 to 21 years. But if the patient is over 30 years old, the magic will not happen.
But there are indicators that even hormones can not affect.
It:
- Hair growth of the face. The hair will not be so coarse, but they will not disappear completely,
- Breast may increase quite a bit,
- The width, height and size of the legs and arms,
- The voice will not change either.
The effects of therapy in men
Hormone therapy of female sex hormones causes:- Reduced attraction to the opposite sex,
- Flush to the cheeks and upper body,
- Osteoporosis and bone fractures,
- The increase and tension of the mammary glands,
- Reducing the level of red blood cells
- Reduced memorizing function
- Decreased muscle mass, increased body weight due to fat,
- Lethargy and fatigue,
- Increasing the amount of cholesterol in the blood,
- Depressed mood.
Before use, you should consult with a specialist.
Hello Anna.
Why do hormonal disorders occur and how are they diagnosed?
At the beginning of your question, you write about the diagnosis, but what diagnosis you still do not specify. Irregular menstruation, which is not the disease itself, but only its consequence, leads to a huge number of violations in the reproductive system of women. Moreover, violations can be both congenital, genetically determined, and acquired - as a result of the development of some problems.
Malfunctions of the immune system, surgery, abnormalities of the genital organs, inflammation, genital infections, STDs, tumors, cysts and neoplasms - this is not a complete list of possible disorders, the development of which leads to disruption of the menstrual cycle and hormonal background. Even frequent colds or infectious diseases in childhood can lead to the fact that already in an adult woman there are chronic problems with hormonal disturbances.
Unfortunately, you do not specify a diagnosis, or any other important details, because the diagnosis of hormone imbalance itself does not exist. The clarity could have a significant effect on the accuracy of the recommendations provided.
Diagnosis of the female body in these disorders is the first and most important stage. The doctor advised to donate blood for hormone levels - this is correct. The results of the analysis will help identify violations in the thyroid gland, pituitary, adrenal glands - all organs that are involved in the production of hormones, because failures can occur at any stage of this complex process. If you have been taking OK for a long time (for therapeutic purposes), but problems with the menstrual cycle have not returned to normal, the problem with overweight has joined, then a blood test for hormones is extremely necessary for you.
However, a blood test as a method for diagnosing hormonal disorders is not the only way to identify problems. Ultrasound, laparoscopy, hysteroscopy are other methods of diagnosing hormonal problems that can be used both individually and in combination (depending on the situation).
How to treat hormonal disorders?
The fact remains: today hormone therapy is the most applicable treatment method for the problems described by you. Depending on the situation and the specifics of the diagnosed disorders, hormone therapy may be temporary (for the correction of the work of those organs in which doctors find the "focus" of problems), and maybe even for life.
Modern hormonal drugs woman without fear can take a lifetime, if her body can not for normal life to provide her with a sufficient level of a hormone. There is nothing wrong with that, but the drug must be chosen perfectly. If you have problems with weight, the doctor may reconsider the choice of the drug. You can take the same drug for years, but then you need to cancel it and then select another OK.
Again, perhaps your problems are solved not only through hormone therapy, but also surgery. A huge amount of hormonal disorders is eliminated through surgical treatment, fixing the result of hormone therapy only at the stage of the woman’s rehabilitation after the operation.
However, to assert something certainly does not make any sense, because the whole process should be monitored only by the attending physician. Perhaps your situation is not so hopeless, and the need for hormone therapy is eliminated after proper treatment using other methods.
Sincerely, Natalia.
Elena Berezovskaya
As it is impossible to imagine the modern world without a computer and the Internet, it is impossible to imagine the life of a modern woman without protection from pregnancy with hormonal contraceptives. Hormonal contraceptives have appeared on the market long since the creation of the pill form of synthetic progesterone - ethisterone in 1938 by German chemists, although World War II prevented the widespread use of the first hormonal contraceptive. Nevertheless, we can safely say that for almost 60 years, women in the world use hormonal contraception. Is it possible to draw conclusions about its safety, taking into account the side effects that occur during the administration of hormones and after a certain period of time after the completion of their administration? This question is also relevant because the talk about the growth of malignant tumors, which is popularly called cancer, can be heard everywhere. Are the levels of various cancers growing or diagnostic technologies make it possible to detect many types of cancer in the early stages, which were previously missed and not treated?
There are many supporters of hormonal contraception, but there are many opponents - and all are allegedly convincingly arguing about the benefits and harms of this type of birth control. As a doctor who does not want to be held hostage to myths and rumors, I must provide my patients with accurate and truthful information about everything related to human health, including hormonal contraception, often leaving their personal views and preferences to the side. But when in the thousandth since the question is how long hormonal contraceptives can be taken and whether it does not harm women's health, I decided that it was time to express my point of view, which would be a mixture of the point of view of the doctor and the woman.
We often make false conclusions only because we don’t know much about what we draw conclusions. Therefore, to answer the question of how long you can take OK without harm to the body, let's discuss a few important facts.
Another 100-150 years ago, the average life expectancy of women was 35-40 years. Many married in adolescence (14-18 years) and fell into a recurring cycle of pregnancies, childbirth, breastfeeding, giving birth to 7-12 children. Such women did not need contraception — their purpose was predetermined by Nature herself: a woman was created to be a mother. For many, even menstruation was uncommon due to repeated pregnancies and lactation periods (milk production). Termination of menstrual cycles, most occurred in 35-37 years, and many do not live to climacteric age.
With the increase in life expectancy, women began not only to menstruate earlier (from 12-13 years old), but also longer (to 50-55 years old). This means that the reproductive age of a modern woman, when there is an opportunity to become pregnant, has increased significantly and is about 40 years. If the level of conception of offspring is not high in adolescence (up to 18–19 years old) and premenopausal (after 37–38 years old) ages, almost 20 reproductive years of life remain. Most women in Europe, North America, Australia do not want to give birth to more than 1-3 children, which takes from 1 to 6 years of their life when reliable contraception is not so important. Many postpone fertility to a later age — the average age of first birth women in developed countries is 29-32 years. And before and after that they try to use the best methods of protection from pregnancy.
Before the advent of hormonal contraception at an affordable price in many countries, especially in those where there were no other contraceptives, artificial abortions of pregnancy flourished - abortions, both legal and criminal. The leader in the world in the number of abortions since 1964 (possibly earlier) was the USSR, right up to its collapse - up to 80% of all conceived pregnancies were interrupted. These figures did not include the level of criminal abortions, which were also common in the Soviet republics, as far as not all women advertised unwanted pregnancies.
Until now, in many post-Soviet countries, up to 65-70% of unplanned pregnancies are interrupted, despite the fact that there are several types of hormonal and other contraceptives in almost every pharmacy, and the younger generation of women constantly abuse emergency hormonal contraception. Why so many abortions? The still unchanged mentality of society, that protection from pregnancy and getting rid of accidental “flying” is the prerogative of a woman, not a man, amid the high cost of hormonal contraceptives (many of our women still cannot afford these drugs).
If you look at the data of the UN report on the use of contraception in different countries of the world, published in 2011, about 67% of Ukrainian women aged 15-49 use different methods of contraception, of which only 4.8% use hormonal contraceptives (2007 figures). The most popular type of birth control is intrauterine devices (17.7%) and male condoms (23.8%).
Hormonal contraception was created to prevent pregnancy. and nothing more. The fact that it is used for other purposes, and quite often unreasonably, without any evidence, is a different matter.
In all hormonal contraceptives, the main contraceptive role is played by the synthetic progestin. In fact, the main purpose of obtaining progesterone in the past and making it on a production basis was the creation of a contraceptive “medicine”, because progesterone is an excellent contraceptive (that's right, I did not make a reservation).
Estrogens can also be used as contraceptives, because in large doses they suppress the maturation of the germ cells in the ovaries, however, they have a more pronounced negative effect on a number of hormone-dependent organs and tissues, therefore they have not been used as contraceptives. They were added to progestin to better imitate the natural menstrual cycle and getting better withdrawal bleeding (artificial menstruation), especially with the advent of the 28 day hormone regimen (hormones and 7 days pills are taken for 21 days with dummies or a 7-day break without hormones). Such a regime in the early 50s allowed to calm the nerves of most women, who, against the background of continuous hormonal pills, did not have menstruations, and therefore were worried whether the pills worked or not. He also allowed hormonal contraceptives to be taken by the Catholic and other churches without serious opposition and criticism. And the hormonal contraceptive boom began!
There are many supporters and opponents of different modes of taking hormonal contraceptives, but clinical studies have shown that none of the methods has any advantages.
There are a lot of progestins on which the action of oral contraceptives (OC) is based, and they determine the additional effect of OC, which is based on how the drug is absorbed and which cell receptors it binds to. For example, some OK can suppress the level of male sex hormones, others, on the contrary, increase, etc. This additional function of hormonal contraceptives is used for therapeutic purposes in a number of diseases.
It is important to know that there are four generations of progestins, which is the basis of the classification of hormonal contraceptives. And naturally, the younger (newer) the generation of drugs, the better it should be. In fact, improvement has occurred in lowering the doses of synthetic hormones that are part of the OC, while maintaining the effectiveness of contraceptive action. Therefore, the negative effect of hormones on the woman's body with a decrease in dose decreased. Scientists around the world are in constant search for such progestins, which could be taken less frequently, but the side effects, including the distant ones, were smaller, and the contraceptive effect did not decrease.
Now let's talk about the safety of hormonal contraceptives.
It is extremely important to understand that hormonal contraceptives are drugsand not candies, chocolates, vitaminchiki. These are medicines! And this says a lot. So, like any drugs, hormonal contraceptives have their indications and contraindications for use, method and forms of use, side effects. Also, drugs can interact with other substances, including medicines. The most important thing is that familiarization with the instructions for use of the drug is somehow overlooked. The answer to the question of what “is waiting for me in the future if I start to take hormonal contraceptives” is presented in the rubric of side effects in the instructions. How many women read this rubric? How many women read the instructions for use of the drug?
The most interesting thing is that the side effects rubric includes a description of the negative effect of hormonal contraceptives only on the period of taking the drug. But after all, there are long-term effects of any drugs. However, most often they are not mentioned, because it can significantly reduce the level of sales and administration of medicines. Hormonal contraceptives also have long-term side effects, which we will discuss further.
So, the fact that hormonal contraceptives (any) - drugs, of course. But many do not pay attention to the word "hormonal". When a person is told: “You need to take hormones,” it often causes a negative reaction and fear. “Hormones? Isn't it dangerous? It's still hormones! ”It doesn't matter what hormones are for treating diabetes, diseases of the joints, thyroid gland, etc.“ They put me on hormones ”often sounds like a sentence. But when it comes to hormonal contraception, the perception of the word “hormone” is changing dramatically. “I have pimples on my skin. What advice do you have from hormones? ”“ What hormonal contraceptives I should choose, and then the doctor said, choose which ones you want, so I think those that are cheaper will fit? ”“ My one friend took “” and the other “”, and my doctor says that it is better to insert “Mirena” into the uterus, but I have not yet given birth. What do you think, what to prefer? "
Hormonal contraceptives are hormonal medicines, and in most countries of the world they are not prescribed in absentia without a woman’s examination, and they also require a prescription for their purchase.
All hormones, unlike other drugs, in a small amount can affect, including negatively, cells, tissues, organs and organ systems that have special sensors - receptors, through which hormones manifest their action. Hormonal contraceptives are not an exception, therefore they have contraindications. How many women, looking at the instructions, thought that if the list of contraindications is so impressive (impressive for different organ systems, and not for one group of diseases), then these are really not vitamins, and not tablets for headaches or for lowering body temperature. Even the majority of antibiotics, which are prescribed to the right and left by many doctors, have far fewer contraindications and side effects than hormonal contraceptives (for the sake of interest, open the instructions for use and compare).
The traditional phrase “Millions of women have been taking hormonal contraceptives for years and nothing terrible is happening to them” can come up as a “bouncing agent” if the doctor does not want to answer the woman’s question, “What is the risk of taking OK for my health?”. A more professional answer: “Read the instructions” (and understand yourself). But, after reading the instructions, the woman will again ask how then millions of other women are taking these hormones, whether she will be included in the percentage of those who have side effects, whether hormone therapy will increase the risk of developing some kind of cancer in the future ...
What is important in such cases to know? The assimilation of hormonal contraceptives and their impact with the development of side effects for each woman is individual and not predictable in most cases. The only guaranteed action OK, which works in 99% of cases when they are properly taken, will be a contraceptive effect - for this they are created. Everything else as an additional or side effect, sometimes even positive (improved skin condition, for example), appears as an individual response to OK.
And now we will talk about the remote actions of hormonal contraceptives. As mentioned above, modern women have long periods of life when conceiving children is not planned, but sex is available. And regardless of the frequency of these sexual relations, regardless of age and chances of getting pregnant, they want to be sure that there will be no pregnancy.
To answer the question, what threatens the long-term use of hormonal drugs, it is necessary to weigh many factors.
1.What kind of OK or other types of hormonal contraceptives does a woman take? Very often, women in the post-Soviet space give preference to the old high-dose OK, many of which have ceased to be used in developed countries. They are cheaper OK new generations, so they are more profitable to buy and sell. For a long time, the countries of the “second and third worlds” have become a convenient ground for the fusion of all that the “first world” refuses.
Thus, the higher the dose of hormonal components OK and the longer they take, the higher the risk of side effects and long-term effects.
Also, different types of progestins can have side effects in different ways - this must also be taken into account by both doctors and women.
2. Woman's age plays an important role in the selection of OK. The older the woman, the more urgent becomes the question of the optimal dose of estrogen and progestin, as well as the feasibility of taking hormonal contraception. After all, many women do not really need such a form of contraception, but live on false beliefs imposed by doctors that the ovaries are “resting” while taking OK, that hormonal contraceptives “preserve the ovarian reserve”, “prolong youth”, “rejuvenate the ovaries and the body "," Increase the sexuality of women, "etc. No, hormonal contraceptives only protect against pregnancy, but do not prevent aging of the ovaries, and of the whole organism, and even less, they do not rejuvenate.
3.The aging of the body with age is accompanied by the appearance of various diseases, especially if the woman does not lead a healthy lifestyle. Some diseases can be aggravated by taking hormonal contraceptives. For the digestion and manifestation of the action, OC require good work of the gastrointestinal tract (hormones enter the bloodstream through it, and their metabolic products are removed with feces), the liver (here they partially disintegrate and partially bind to special proteins) and kidneys (through their metabolic products are excreted from the body). Adipose tissue plays an important role in the exchange of hormones and is often the role of a warehouse (depot), where they can accumulate in the form of metabolism substances (metabolites) and stored for many months and years. It is the cumulative effect of adipose metabolism of hormones that plays a negative role in the development of some serious diseases, including a number of cancers.
4. Although the woman at the time of reception of the OC may not have diseases and conditions that are included in the list of contraindications, but there is such a thing as genetic predisposition to the development of the disease. This does not mean that a person will necessarily become ill with what his close relatives suffer from. A healthy lifestyle, which includes a healthy diet, physical activity and a healthy psycho-emotional state, can prevent the emergence of most diseases, even if there are cases of such diseases in the genus. Hereditary predisposition was found in diabetes mellitus, increased blood pressure (hypertension), migraine, blood clotting and blood vessel diseases, some liver and kidney diseases. The list of diseases can be expanded, and most of them will be in the list of contraindications to the use of OK. It is rational to undergo periodic screening while receiving hormonal contraceptives for the timely detection of abnormalities that can lead to the development of diseases.
It is also important to remember that hormonal contraceptives can interact with drugs and other drugs, worsening the condition of the woman and the course of the disease.
5. Having bad habitsfirst of all smoking. In itself, smoking is a risk factor for the development of many diseases, primarily such dangerous ones as lung cancer and cardiovascular diseases. Smoking is also a risk factor for the development of 13 other types of cancer: throat, esophagus, stomach, mouth and lips, pharynx, nasal cavity, bladder, pancreas, kidneys, liver, intestines, ovaries, cervix, certain types of blood cancer ( leukemia). There is evidence of an increase in breast cancer in women who smoke.
Probably, many people do not know that the first publications about the connection between smoking and lung cancer appeared in the 1930s, and tobacco companies conducted a thorough check of these data through their own research. The data was confirmed, but instead of presenting the results to the public, maximum efforts were made to conceal and falsify them.
Today, the warning on cigarette packs that smoking increases the risk of lung cancer will surprise no one. But the appearance of this warning took more than fifty years of struggle of brave scientists, doctors, public figures, many of whom lost their jobs, positions, position, reputation, family, and even life. It took about thirty years to adopt a law banning smoking in public places.
Of course, doctors often warn that smoking while taking OC is not desirable (to put it mildly, not compatible). But many women "play pranks" periodically, smoking and ignoring the warnings of doctors.
In addition to smoking, the use of alcohol and drugs also increases the risk of developing serious diseases, especially in combination with OK.
Interestingly, the fact that alcohol is a teratogen, that is, is involved in the appearance of fetal malformations, is known to many women, especially those who are planning to become pregnant. Not everyone knows that the link between taking alcohol and the risk of developing neck and head cancer (throat, larynx, oral cavity, lips), esophagus, liver, mammary glands, and large intestine is proven. For example, a daily intake of 2 bottles of beer (350 ml each), or 2 glasses of wine (300 ml), or about 100 ml of a strong alcoholic beverage increases the risk of developing breast cancer two times compared with those who do not take alcohol (data from the National Institute of Cancer, USA. However, such warnings on the labels of alcoholic beverages you will not find.
And here I would like to draw your attention to such a thing as carcinogens. Many people know that carcinogens are substances that are directly or indirectly involved in the development of malignant processes. The fact that smoking (more precisely, a number of substances contained in smoke) and alcohol are classified as carcinogenic is no surprise to anyone - they write and say a lot about it. Natural estrogens and progesterone can also cause the growth of certain malignant tumors in a woman’s body (however, in men as well), which we often call hormone-dependent tumors. Therefore, estrogens and progesterone are classified as carcinogens.
It's hard to believe, isn't it? If the carcinogenic effect of estrogens (both natural and synthetic forms) and the risk of developing breast and uterus cancer, doctors have known for a long time and try not to prescribe them without strict indications, especially in older age, quite a few doctors have developed from progesterone and its synthetic forms from all female diseases.
WHO, in its monograph on human carcinogenic risk studies together with the International Agency for Research on Cancer (IARC), claimed in 1999 that both hormones, estrogen and progesterone, are considered carcinogenic to humans for good reason. This statement has been supported by the US Department of Health and Human Services Toxicology Program in carcinogen reports for nearly 15 years. In the last report of this program (13th edition), progesterone is still on the list of carcinogens - it has not gone anywhere.
Synthetic hormones that are part of the OC and replace the effect of estrogen and progesterone, do not differ in any cardinal from the action of natural hormones. They are also carcinogenic, which means they can be put on a par with smoking and alcohol.
Moreover, manufacturers of hormones, including progestins and progesterone, have long been no secret about the fact that they are carcinogenic. For example, in the information about the products of Sigma-Aldrich Corporation, one of the world's largest manufacturers of progesterone, which has offices in 40 countries, the description of the biochemical and physiological properties of progesterone says that the hormone “causes maturation and secretory activity of the endometrium of the uterus, inhibits ovulation. Progesterone is involved in the etiology (occurrence) of breast cancer. " The same company, like many others, conducts its research, the results of which are not hidden, as was done before.
Numerous clinical studies have proven the link between increased levels of breast, cervical, and liver cancer and OK. A positive effect is observed in reducing ovarian and endometrial cancers in women taking hormonal contraceptives. At the same time, hormone replacement therapy, which contains a lower dose of the same synthetic estrogens and progestins, on the contrary, increases the level of endometrial and ovarian cancer in women of premenopausal and climacteric age.
How long can you take OK to avoid serious side effects and increase the risk of developing a number of malignant tumors? There is no exact answer, because everything depends on the individual characteristics of the organism and all the factors listed above. But data from a number of studies have shown that, for example, taking OK for more than 5 years increases the risk of developing precancerous conditions and cervical cancer (the level drops to the average 10 years after the termination of hormonal contraceptives).
There are different types of risk in assessing the effect of something on something in medical statistics, but most often they use relative and individual risks. The risk of developing a disease under the influence of a risk factor is the ratio of cases in two groups of people - with and without a risk factor. This risk can be calculated taking into account other risk factors for a group of people or for a particular person taking into account his risk factors (individual risk).
Over the past fifteen years in the medical literature, there has been an enormous amount of publications on the association of breast cancer and hormonal contraceptives, with some data indicating the existing risk for the period of taking hormonal contraceptives (not just pill forms) and a short period after the end of reception, others for a long period after the completion of hormones. Independent from pharmacological companies and medical institutions, organizations also conduct their own research, and the data from such research is not encouraging.
In general, the risk of developing cancer increases by 50% after one year (12 months) of hormonal contraceptives, and slowly decreases over the next 10 years after discontinuation of hormones to the level of risk for those who did not take hormones. Such data relate primarily to OK containing high doses of estrogen (the old generation of hormonal contraceptives). Also, some types of progestins (ethynodiol diacetate) may double the risk. Three-phase hormonal contraceptives, especially those containing norethindrone, which are rarely used in developed countries, but are still widely prescribed (because of cheapness) in post-Soviet countries, increase the risk of developing breast cancer three times (already within a year of taking the drug). Modern low-dose drugs have a lower level of risk. Since low-dose OC appeared on the market not so long ago, and breast cancer occurs in older women (premenopausal and menopausal), the study of the effect of these types of contraceptives on the occurrence of cancer takes more time.
Also, controversy is increasingly heard, especially in medical circles, how safe it is to take hormonal contraceptives for women over 40 who lead an active sex life and therefore can become pregnant, despite the low level of conceptions in this age group. Some doctors suggest using more alternative methods of contraception. Others, on the contrary, argue that there is nothing to worry about if a woman takes OK before the onset of menopause (which can be overlooked while taking hormones). I believe that if a woman still wants to take OK, then it is best to switch to low-dose hormonal drugs with regular monitoring of the condition of those organs for which the risk of cancer is increasing.
These data can cause a certain shock to readers, especially women. There are also quite a few opponents, especially among supporters of hormonal contraceptives and those who prescribe and take hormones (estrogens and progesterone) for other reasons that would be outraged by such a review of hormonal contraception. But even if you do not take into account the risk of developing cancer, hiding behind the phrase “is, but minimal”, I would like to ask every reader a question: you would take a substance (any, including a drug), if you knew that it was a carcinogen, then is involved in cancer development? Would you buy a product with the designation, as on the packaging of cigarettes, that using it increases the risk of developing cancer (anyone)? Of course, many people who smoke do not pay attention to such warnings - this is their personal choice. Many carcinogenic substances are constantly present in our lives. Some drugs can also cause cancer, but, fortunately, their dose and dose are limited, and people do not take them for months and years more often. But hormonal contraceptives are taken by women for years ...
Why do millions of women around the world take hormones for so many years? Because it is profitable
(1) Manufacturers of hormonal contraceptives,
(2) Sellers of hormonal contraceptives,
(3) Men, because they do not need to take responsibility or share with women the responsibility for the consequences of unprotected sex,
(4) Women, because they have gained some independence from men and can now control their own reproductive function.
The most outraged readers will say: “Well, if hormonal contraceptives are so bad, then what remains for women? To return again to the era of abortion or to abandon sex life altogether? ”
Indeed, abstinence or rejection of sexual activity is the most reliable means of protection against unplanned pregnancy, but it will not work for most married couples. It can also undermine and break the relationship of many men and women. Of the reliable methods of protection from pregnancy are still the same male condoms, but they require the active participation of men in this type of protection. In developed countries (USA, Canada, some European countries) and Latin American countries, male and female sterilization began to grow rapidly (20-25% of contraceptive cases), which also has its pros and cons and is not suitable for all people (most often who completed the childbearing function and no longer plans children). The popularity of intrauterine devices (IUD, but without hormones) is also increasing worldwide. Other methods of protection from pregnancy have a different level of efficiency, require certain skills from sexual partners, and therefore also can not be used by all people.
The decision is always for the woman (this is her personal decision), however, if the doctors provided true information about what they are prescribing (this applies not only to hormonal contraception), then many diseases and complications of directly treating and taking medications can be avoided.
Thus, my answer as a doctor to the question of how long hormonal contraceptives can be taken in a safe mode for health will be the following: hormonal contraceptives are hormone medications, therefore their safety will be determined by the type of components, dose, mode, method and duration reception, compliance with indications and contraindications, individual tolerance, the presence of other diseases, harmful habits and the timely detection of side effects.
Like a woman, in the depths of my soul, the hope is shaking that modern men will not only enjoy sex with women, but will increase their level of responsibility, taking a more active part in protecting their loved and dear women (sexual partners) from unplanned pregnancies.
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