home Audience 5 Hormones medications. Replacement therapy: contraindications. Why does hormonal imbalance occur?

Hormones medications. Replacement therapy: contraindications. Why does hormonal imbalance occur?

Hormonal contraception all over the world they are considered the most reliable in terms of protection against unwanted pregnancy. They are trusted by millions of women in civilized countries. They give freedom to choose the time of birth of the desired child, emancipation in sexual relationships, and relief from certain diseases and suffering. Subject to the rules of use hormonal contraceptives provide, without a doubt, a high level of reliability. In the last decade, interest in this method of contraception has also increased in our country, but passions about the benefits and harms, advantages and disadvantages of their use do not subside.

How birth control pills work

Modern oral contraceptives may contain one or two hormones: progesterone and estrogen - then they are called combined, or only progesterone - the so-called mini-pills.

Combined contraceptives are divided into drugs:

with microdoses of hormones;
with low doses;
medium dose;
with high doses of hormones.

“Mini-pill” drugs are considered the most gentle of all birth control pills.

How do birth control pills work?

Birth control pills consist of synthetic hormones, which are analogues of female sex hormones produced in a woman’s body constantly during pregnancy. It is estrogen and progesterone that inhibit the production of other hormones that stimulate follicle maturation, due to which ovulation occurs. Therefore, by administering small doses of estrogen and progesterone with the tablet, it becomes possible to suppress or inhibit ovulation (egg maturation). The mechanism of action of all combined hormonal agents is based on this principle.

The action of the “mini-pill” is based on the same principles, but the effective point here is the effect of the tablets on the structure of the uterine mucosa, and on the change in the viscosity of the secretion of the cervical canal. Thickening of the secretion and looseness of the endometrium does not allow sperm to fertilize the egg, and the egg itself does not allow itself to gain a foothold in the uterus.

All these phenomena disappear when you stop taking contraceptives. Reproductive function is restored within two to three months, and the woman can have the desired pregnancy.

Birth control pills are almost 100% effective in preventing pregnancy when used correctly. At the same time, the use of these products regulates the menstrual cycle, relieves women from pain during menstruation and menstrual bleeding. Modern contraceptives eliminate the symptoms of premenstrual and menopausal periods, reduce the risk of cancer, stop unwanted facial hair growth, and the appearance of acne.

Does the effect of birth control pills decrease with alcohol consumption?

Women, especially at a young age, often wonder how alcohol affects the reliability of birth control pills. Is it possible to take them together? Of course, this question is legitimate, because taking contraceptives can be long-term, but life is life, and no one is immune from circumstances when alcohol intake may occur.

I would like to always be confident in the effectiveness of contraceptives, and to know what factors can reduce it. It is unlikely that anyone will be able to completely eliminate alcohol. And the instructions for contraceptive drugs often do not indicate that they cannot be combined with alcohol intake.

What to do if a festive feast is planned? If the celebration is scheduled for the evening, then taking the pill should be shifted three hours earlier or later. As a last resort, you can reschedule taking the pill until the morning, as if you forgot to take it, but then you need to follow the instructions for the drug exactly according to it. It is also necessary to see a gynecologist to rule out pregnancy.

According to WHO, the dose of alcohol should not exceed 20 mg of ethanol per day, if the need arises in combination with birth control pills. Moderation in drinking alcohol plays a big role in maintaining the effectiveness of contraceptives.

Side effects

The main disadvantages of birth control pills are their side effects on the body, which include:

Bloody spotting, especially common when starting to take the pills. After adaptation to the drug, as a rule, they disappear.
Estrogens included in contraceptives can cause bloating, swelling of the lower extremities, fluid retention in the body, increased blood pressure, and migraine-like headaches.
Progestins, on the contrary, cause irritability, nervousness, acne, and some weight gain.
Weight gain may be associated with increased appetite when taking contraceptives. In some cases, this is due to fluid retention in the body.
Sometimes birth control pills can cause dark spots to appear on the face, similar to those characteristic of pregnancy. In this case, it is better to switch to another type of tablet.
Such dangerous vascular diseases as thrombosis can be caused. Their occurrence depends entirely on the dose of hormones in the product. The higher the dose of estrogen, the greater the risk of developing vascular thrombosis.
Smoking is prohibited while taking some contraceptives. Women who smoke are at risk of developing heart attacks and strokes.
Taking combined oral contraceptives can cause attacks of gallstones and cause the formation of new stones in the bile ducts.
Side effects may occur when oral contraceptives are combined with other medications: antibiotics, antifungals, etc.

Which birth control pills help you get better?

Modern contraceptives, which contain microdoses of hormonal components, do not cause weight gain.

But, if the drug is chosen incorrectly for a particular woman or girl, some weight gain is quite possible. Many women experience weight gain in the first two months of taking contraceptives, which is easily explained by the body’s adaptation. If your weight increases in the future, then you need to decide on switching to another type of pill.

The effect of contraceptives on fat metabolism has been well studied. Therefore, it is possible for each woman to choose a remedy that would not cause the above side effects.

Bleeding while taking birth control pills

Bleeding when using birth control pills is a possible side effect. Bleeding can be either spotty or breakthrough.

Spotting bleeding occurs in the first months of taking contraceptives. They are more often observed when using drugs with low hormone content than when using combined drugs. The reason is this: microdoses of hormones in the pill do not have time to accumulate in the body, and they are not enough to delay menstruation. This is a normal phenomenon, and it is not advisable to stop taking pills due to the appearance of spotting. The body will adapt and all functions will be restored.

If breakthrough bleeding occurs, the alarm should be sounded. It is better to immediately consult a doctor who will conduct an examination to exclude ectopic pregnancy, inflammatory diseases, uterine fibroids, and endometriosis.

What to do if bleeding occurs:

Continue taking birth control as usual, or stop taking it within seven days.
Contact the doctor. Your doctor may prescribe additional high-progestin pills.
If bleeding continues, a blood test must be taken to rule out anemia. For anemia, iron supplements are prescribed.

Vaginal discharge

Are women often concerned about an increase in vaginal discharge? and associate them with the use of birth control pills.

By the way, vaginal discharge is found in every woman, but normally it is odorless, transparent in appearance and insignificant.

If your menstrual cycle is irregular, you should consult a doctor who will tell you what to do. Establishing a cycle duration of 21-36 days is considered the norm.

With changes in mood, a herbal mixture with common twig helps well, which affects the level of testosterone in the body.

Skin problems such as acne, oily hair, greasiness? talk about an imbalance of hormones in the female body. In this case, combined oral contraceptives with antiandrogenic action are selected.

Doctors believe that it is better to stop taking the pills two to three months before the planned conception. However, it should be borne in mind that the likelihood of conception increases already in the first month after discontinuation of the contraceptive.

How to take birth control pills correctly?

It is better to start taking contraceptives on the first day of your period - only then the pills take effect immediately. If taken on the fifth day of menstruation, additional precautions should be taken. Women with irregular periods can start taking contraceptives on the first day of their cycle, confident that they are not pregnant.

In the absence of lactation, it is better to start taking it 21 days after birth. If breastfeeding, taking oral contraceptives should be postponed for six months.

After an abortion, it is necessary to start using birth control pills on the day of the abortion.

Standard regimen for hormonal contraceptives
The drug is taken daily for 21 days, followed by a seven-day break, then continues to be taken from a new package. Menstrual-like bleeding goes away during a break from taking the pills.

Special Modes
The 24+4 mode is typical for the contraceptive Jess, the package of which contains 24 hormonal and 4 inactive tablets. The tablets are used daily, without breaks.

Extended mode
It consists of taking a product containing only “active” tablets (continuously, more than one package). A three-cycle regimen is common - taking 63 tablets of monophasic drugs followed by a 7-day break.

Thus, the number of menstrual bleeding per year is reduced to four.

What to do if you forgot to take your pill?

The basic rule in case of missing a pill:
1. Take the missed pill as soon as possible!
2. Take the remaining tablets at your usual time.

If one or two tablets are missed, or a new pack is not started within one or two days
Take a pill. There is a risk of pregnancy.

Missing three or more tablets in the first 2 weeks of use, or not starting a new pack within three days
Take a pill. Use barrier methods of contraception for 7 days. If sexual intercourse has taken place within 5 days, use emergency contraception.

Skipping 3 or more tablets during the third week of use
Take the pill as soon as possible. If the package contains 28 tablets, do not take the last seven tablets. Don't take a break. Use barrier methods of contraception for 7 days. If sexual intercourse has taken place within 5 days, use emergency contraception.

When do birth control pills start working?

When taken correctly, the tablets begin to act immediately after the start of the course.

How to choose the right drug for nulliparous and parous women?

Young, nulliparous women are more often prescribed microdosed birth control pills. Such drugs as Lindinet -20, Jess, Logest, Mercilon, Qlaira, Novinet are ideal for them.

Low-dose and medium-dose hormonal drugs are suitable for women who have given birth. These include: Yarina, Marvelon, Lindinet-30, Regulon, Silest, Janine, Miniziston, Diane-35 and Chloe.

Features of contraception depending on the woman’s age

Selecting birth control pills is a difficult task that can be solved together with your doctor. The goal of the task is reliable protection against the occurrence of unwanted pregnancy. The criteria may be effectiveness, absence of side effects, ease of use of the pills and speed of restoration of fertility after discontinuation of the contraceptive.

Undoubtedly, the choice of contraceptive drug depends on age characteristics.

At what age can you take birth control pills?

The periods of a woman’s life are divided into adolescence - from 10 to 18 years, early reproductive - up to 35 years, late reproductive - up to 45 years, and perimenopausal - lasting 1-2 years from the last menstruation.

It is advisable to start contraception in adolescence, if, of course, there is a need for it. In recent years, there has been a decrease in the age of first pregnancy and childbirth, and the frequency of abortions at a young age is increasing.

According to WHO, combined oral contraceptives containing small doses of steroids and third-generation drugs containing progestogens are recognized as the most effective for adolescents. Three-phase drugs are best suited for adolescents: Triziston, Triquilar, Tri-Regol, as well as single-phase drugs: Femoden, Mercilon, Silest, Marvelon, which regulate the course of the menstrual cycle.

Birth control pills for young girls

Between the ages of 19 and 35, women can use all known methods of contraception. However, it should be borne in mind that the use of combined oral contraceptives is more reliable and effective.

In addition to oral contraceptives, other methods are also popular in our country: insertion of an intrauterine device, use of a condom, and use of injection methods of contraception.

It has been proven that birth control pills are used not only for contraception, but also for therapeutic and preventive purposes for diseases such as infertility, inflammatory and oncological diseases, and menstrual irregularities. The only drawback that you need to be aware of is that hormonal contraceptives do not protect a woman from sexually transmitted infections.

The most common remedies at this age are Janine, Yarina, Regulon.

Which birth control pills are best to take after 35 years of age?

Doctors say that at this age women should protect themselves from unwanted pregnancy by using intrauterine devices, because At this age, steroids, due to the presence of diseases acquired by the woman, are contraindicated.

A woman may suffer from cervical diseases, endometriosis, endocrinological diseases - diabetes mellitus, thyrotoxicosis, obesity. Many women smoke. These factors complicate the selection of hormonal contraceptives.

Steroids are prescribed only if there are no contraindications. The latest generation combined contraceptive pills and three-phase drugs are preferred: Femoden, Triziston, Silest, Triquilar, Marvelon, Tri-regol.

For this group of women, products with a low content of hormones, as well as “mini-pill” preparations, are excellent. Hormonal contraception is combined with the therapeutic effect of new generation drugs. The most popular of them is Femulen. It can be used if a woman has diseases such as thrombophlebitis, previous heart attack and stroke, hypertension, severe migraine-type headaches, and some gynecological diseases.

Which birth control pills are suitable for women over 45?

After 45 years, ovarian function gradually decreases, the likelihood of pregnancy decreases, but is still possible. Many women at this age are still ovulating, and fertilization of the egg can occur.

Undoubtedly, a woman is able to become pregnant and give birth to a child, but pregnancy often occurs with complications, since at this age there is a fairly large bouquet of various diseases. Usually there are diseases of the cardiovascular system, liver and kidneys, chronic dysfunctions of the reproductive system. All factors can serve as contraindications for the prescription of hormonal contraceptives. Smoking and other bad habits also complicate the use of birth control pills.

Very often, by the age of 40, women no longer plan a pregnancy, and unwanted pregnancies are artificially terminated. Abortion, especially during this period, has consequences that threaten a woman’s health. Frequent complications of abortion are the development of uterine fibroids, cancer, and severe manifestations of menopause. The possibility of developing diseases indicates the need for contraception during this period.

Birth control pills are also prescribed for many gynecological diseases, osteoporosis, and to prevent the development of ovarian and uterine cancer.

At the age of over 45 years, it is promising to use low-dose hormonal drugs, mini-pills, injections and implants that are implanted under the skin (for example, Norplant).

Combined-action contraceptive pills are contraindicated in women over 45 years of age in the following cases:

if a woman smokes;
if a woman suffers from heart and vascular diseases - heart attack, stroke, thrombosis;
with type 2 diabetes mellitus;
in case of severe liver diseases with the development of liver failure;
for obesity.

At this age, the modern drug Femulen is often used, which has virtually no side effects.

Effect of birth control pills

For pregnancy

When taking hormonal contraceptives, pregnancy is quite possible if a woman takes the pills incorrectly or the regimen for taking them is disrupted. If pregnancy is suspected or established, the drug must be discontinued immediately.

Taking hormonal drugs in the first three weeks of pregnancy does not have a negative effect on the condition of the fetus and the health of the woman.

Overall for the body

Hormonal contraceptives have different effects on a woman’s body. In order to promptly identify side effects of contraceptives, a woman taking these drugs is required to consult with her doctor twice a year. Contraceptives can affect the vaginal microflora. This influence manifests itself in various symptoms. Some people develop signs of thrush (bacterial vaginitis) because taking medications containing gestagens leads to a decrease in the level of lactobacilli in the vagina. In this case, it is possible to discontinue the pills until the estrogen level is restored and the symptoms disappear.

For the development of mastopathy

Women often ask the question: can birth control pills cause mastopathy?

Experts say that with the correct choice of birth control pills and the correct regimen for their use, mastopathy cannot develop. Another thing is when a woman has hormonal imbalances, there are chronic gynecological diseases, diseases of the liver, kidneys, and adrenal glands. Hormonal imbalance, stress, depression, abortion, breast injury can lead to mastopathy.

Contraception should only be selected by a doctor. The doctor must take into account all the characteristics of a particular woman, her state of health, age, heredity, phenotype, bad habits, lifestyle, sexual activity. If the drug is selected incorrectly, without a doubt, the risk of developing mastopathy increases.

It is important to start taking hormonal medications only after consultation and examination by a specialist - in this case, you will avoid unwanted consequences and possible complications.

Do birth control pills help with menopause and androgenetic alopecia?

An effective treatment for women during menopause and with androgenetic alopecia can be tablets and creams containing estrogen and progesterone.

Is it possible to leave without a doctor's prescription?

Birth control pills are prescription drugs and can only be prescribed by a doctor. The law does not prohibit the sale of hormonal contraceptives without a prescription. But only a doctor can help you choose the right method and means of contraception.

Today, contraception using hormones occupies a leading position in effectiveness among all methods of preventing unwanted pregnancy. These drugs contain estrogens and progestins - synthetically created female sex hormones.

Medicines produced in tablet form, the main active ingredients of which are hormones used to prevent pregnancy, are called combined oral contraceptives.

Classification

Based on the amount of estrogen and progestin content, contraceptives are:

Single-phase or monophasic - tablets containing the same amount of hormones are used daily throughout the menstrual cycle. The main drugs of the group have the following names: Regulon, Diane-35, Novinet, Logest. Such drugs are more often used by young, nulliparous women under 24–26 years of age.
Two-phase. Preparations with different contents of these hormones. A representative of this group is the drug Anteovin.
Three-phase. Thanks to the variable amount of hormones, the drugs imitate their quantitative changes in the female body. Among the representatives of this group are: Triziston, Triquilar, Tri-regol.

Throughout the menstrual cycle, there are natural fluctuations in the levels of different hormones in a woman's body. By imitating them, three-phase contraceptives are the most physiological; monophasic drugs have this ability to the least extent. But this fact does not indicate the advantage of triphasic hormonal drugs over others. All contraceptives are selected personally.

According to experts, in most cases, monophasic tablets are more suitable for young girls. Women over 27 years of age are predominantly prescribed three-phase contraceptives.

One package of single-phase drugs most often contains 21 tablets, much less often there will be 28. And three-phase drugs, on the contrary, always contain 28 tablets of three different colors.

Based on the quantitative content of estrogen calculated per daily intake, drugs are divided into:

Highly dosed.
Low dosage.
Microdosed.

Operating principle

The progestogen component of the drugs has the main effect of birth control pills.

Any contraceptive contains exogenous estrogen. Its main purpose is to compensate for its deficiency that occurs when taking medications. The predominant formation of estrogen in a woman’s body occurs in the ovaries. Combined oral contraceptives block its synthesis by stopping the growth and maturation of follicles. The fundamental principle of estrogen's action is to control the course of the menstrual cycle and the physiological reproduction of cells in the uterine mucosa, which is clinically manifested by the absence of intermenstrual bleeding.

The principle of action of birth control pills is the same, regardless of the quantitative value of hormones:

The development and release of the egg from the follicle is stopped.
They impede the movement of sperm due to the strong viscosity of cervical secretions.
They act on the mucous layer of the uterus, preventing the fixation of the embryo.
Slow down the movement of sperm through the fallopian tubes.

All these mechanisms of influence on conception and the further development of the fertilized egg elevate combined oral contraceptives to the rank of the most effective drugs for preventing pregnancy.

Help doctor

Different groups of drugs contain different doses of hormones, which determines their specific drug effects and side effects. Therefore, personal selection of contraceptives is the task of a gynecologist.

You cannot buy or use combined oral contraceptives on your own without a doctor’s prescription and consultation!

To select a specific drug, the doctor prescribes the necessary list of examinations to assess risk factors and identify contraindications to taking different groups of contraceptives:

Examination by an obstetrician-gynecologist. Study of the cellular and microbial components of smears taken from the walls of the vagina and cervix. Examination for tumor and infectious diseases.
Instrumental examination of the pelvic organs using ultrasound (ultrasound). The examination is performed twice after menstruation and before the next one during one cycle. When performing it, the doctor monitors the growth and differentiation of cells in the mucous wall of the uterus, the processes of follicle growth and ovulation. At the same time, concomitant anatomical and functional pathology of the pelvic organs is excluded.
Examination of the mammary glands. It can be performed by a gynecologist and mammologist.
Examination of the mammary glands using ultrasound (ultrasound) to exclude tumor formations. According to indications, mammography is prescribed.
According to indications, it is possible to prescribe laboratory tests to monitor the levels of hormones in the blood.

Only after conducting strictly individual studies can a doctor select a specific combination oral contraceptive drug for a woman.

Drug selection scheme:

Survey about previous and chronic diseases. Collection of information about family diseases. Gynecologist examination data. Using the World Health Organization's universal eligibility criteria, to determine whether a given woman is eligible for different types of contraception.
Selection of a drug from a certain group of combined oral contraceptives, based on their properties and required therapeutic effects.
Within a period of three to four months, monitoring the woman’s health and determining her general condition. Monitoring the effect of hormonal contraceptives. Determination of drug tolerability.
If side effects or individual intolerance to drug components occur, replace or discontinue the contraceptive.
Registration of a woman during the period of use of combined oral contraceptives. Scheduled gynecological appointment once every six months.

Symptoms that should alert a woman:

Heaviness and intense pain in the legs.
Unbearable pain in the abdomen and chest.
The appearance of weakness and malaise for one month or more.
Hearing loss.
Speech and vision impairment.

If you experience these symptoms, seek medical advice immediately. They may be a manifestation of individual intolerance to drug components or symptoms of a disease, the occurrence of which could be provoked by the use of combined oral contraceptives.

How to take contraceptives?

Oral contraceptives are available in packages of 21 and 28 tablets. Using arrows or indicating the days of the week on the blister, manufacturers determine the order in which they should be taken. Birth control pills begin to work from the first week of taking them.

How to properly take birth control pills containing 21 capsules? To achieve the contraceptive effect of the drugs, they must be used one tablet daily. You need to start taking birth control pills from the first day of your menstrual cycle. At the end of their intake, a pause is made for seven days. After this, they begin a newly purchased pack of contraceptives. During this week, a reaction similar to menstruation appears. During the break, the contraceptive effect of the drugs is maintained, so additional precautions are not required.

It is imperative to start taking birth control pills containing 28 tablets from the first day of the cycle, but they are used without a seven-day interval. After finishing one package, immediately start a new one. A menstrual-like reaction occurs between days 21 and 28 of the cycle.

At the end of a year of taking oral contraceptives, it is necessary to pause their use for three to four months to resume the hormone-producing function of the ovaries. During this period, in order to protect against unplanned pregnancy, it is necessary to use other contraceptive measures.

Remember that combined oral contraceptives are incompatible with a number of other groups of drugs.

These are not compatible with:

Anticonvulsants.
Antibacterial drugs.
Medicines needed to treat lung diseases.

The combined use of these groups of drugs initiates the appearance of side effects and leads to a decrease in contraceptive properties. This is the time when you will need to find additional protective measures.

Every time doctors prescribe medications for the treatment of extragenital pathologies, it is necessary to warn about taking combined oral contraceptives.

Studies have proven the absence of harmful effects on the course of pregnancy and the fetus when using drugs before conception. At the first suspicion of pregnancy, it is necessary to interrupt the use of contraceptives. Occasional use of drugs in the early stages of pregnancy is also not scary. Also, taking them is not a reason to interrupt it.

After finishing taking oral contraceptives, adequate functioning of the endocrine-reproductive system is resumed in a short time. Short-term use of drugs leads to stimulation of the growth and maturation of eggs by increasing the sensitivity of receptors of the hypothalamic-pituitary-ovarian system. Within a year of stopping the use of oral contraceptives, more than 80% of women become pregnant. This fact corresponds to the level of fertility in the population.

Menstruation appears after stopping the use of oral contraceptives in a period equal to the time of restoration of the uterine mucosa. A small number of women develop amenorrhea (lack of menstruation) lasting up to six months. If such a situation occurs, you should consult a doctor.

What to do if you miss an appointment?

If you forget to take one pill, you must take it immediately. The next dose of contraceptives should be taken at its normal time, even if you need to take two tablets per day. If you are less than 12 hours late in taking the drug, there is no need to use other contraceptive measures. If the time is exceeded, it is possible to use another type of birth control before the start of the next menstruation.

How to take birth control pills if you miss two pills? It is necessary to immediately take them as soon as you remember. The next day you need to take the next two tablets. Due to the excessive intake of hormones in the blood, spotting may occur. The contraceptive effect of the drugs decreases, which requires the use of other methods of birth control.

If you miss more pills, you should think about abandoning this method of contraception. This is the time when they begin to select and use other methods of birth control.

Hormonal contraception is a modern type of protection against unwanted pregnancy, widespread throughout the world. Millions of women trust this method, making no mistakes in their choice.

The principle of action of hormonal contraceptives is the complex effect of analogues of natural female sex hormones on the body: suppression of ovulation, thickening of cervical mucus and changes in the structure of the endometrium. Suppression of ovulation prevents the maturation and release of the egg, which prevents fertilization. Changes in mucus prevent sperm from entering the uterine cavity. Even if fertilization has occurred, the fertilized egg will not be able to attach itself due to the special structure of the endometrium.

These 3 mechanisms provide reliable protection against pregnancy - according to WHO (World Health Association), when used correctly, the effectiveness is close to 100%, however, irregularities in taking (skipping pills, taking other medications, violating the regimen) can lead to conception, which reflected in statistical data.

There are also male hormonal contraceptives, but their use has not yet become widespread. The “universal pill” is at the development stage, and existing hormone regimens cause serious harm to health.

Any drug must be selected individually, since there is no universal method without drawbacks. Many of the pros and cons of hormonal contraceptives are similar, since they all contain similar active ingredients.

Pros of hormonal contraception:

high reliability;
independence from the time of sexual intercourse;
reversibility of the method;
low incidence of side effects.

In addition, there are non-contraceptive benefits:

reducing the risk of developing ovarian and endometrial tumors;
weakening of premenstrual syndrome;
treatment of dysmenorrhea;
reducing the abundance of menstruation (prevention and treatment of iron deficiency anemia);
treatment of acne, hirsutism, seborrhea (when using COCs with an antiandrogenic effect);
treatment of endometriosis.

Minuses:

does not protect against sexually transmitted diseases;
the need for regular use;
the possibility of serious complications;
many contraindications;
incompatibility with some medications.

Classification by shape

Based on the method of delivering the hormone to the body, we can distinguish:

pills;
injections;
subcutaneous implants;
skin patches;
vaginal rings;
hormone-containing intrauterine devices (IUDs).

Classification by hormonal composition

Here is a classification of hormonal contraceptives according to the hormones used:

Combined means. Contains estrogen and progestogen components. Typically these are combined oral contraceptives (COCs), patches, vaginal rings or injections (CIC).
Non-combined drugs. They do not contain estrogens - mini-pills, implants, spirals, single-component injections.

Pills (oral contraceptives)

One pack of tablets is designed for 1 cycle, most often containing 21 or 28 tablets. Should be taken from the 1st day of the cycle. If there are 21 tablets, then a seven-day break is needed before a new pack; if there are 28, a break is not required. Combined tablets are mono- and polyphasic, depending on the dosage of hormones by day of the cycle. Depending on the amount of estrogens, high-, micro- and low-dose hormonal contraceptives (COCs) are distinguished.

These drugs are often used in gynecology for the treatment of endometriosis, functional ovarian cysts, dysmenorrhea, and infertility. New generation hormonal contraceptives are indicated for hirsutism, acne, seborrhea and can be prescribed even to girls who are not sexually active.

Combination medications must be taken daily. Efficiency is high - more than 99%. If you miss a pill, you should refer to the instructions for use and strictly follow the instructions - this will eliminate the possibility of pregnancy.

Unfortunately, if more than 2 tablets are missed on dangerous days, the likelihood of pregnancy is quite high. When taking other medications, you need to carefully study the instructions - they may reduce the contraceptive effect.

Contraindications for hormonal contraception with combined pills:

lactation period;
age over 35 years, especially in combination with smoking;
vascular diseases, migraines;
thrombosis, diseases of the blood coagulation system;
malignant breast tumors;
liver diseases.

Another type of tablet - "mini-drink". They contain only a gestagenic component, which significantly reduces the number of contraindications and side effects. The peculiarity of taking pills is strictly at the same time of day, otherwise the contraceptive effect may be reduced.

Reliability is somewhat lower than that of COCs, but the lack of systemic effects of estrogens on a woman’s body makes them safer and expands the range of patients to whom oral contraception can be recommended. When prescribing hormonal contraception after 40 years, during breastfeeding, with a risk of thrombosis, attention is often paid to progestin drugs.

Contraindications:

mammary cancer;
migraine;
functional cysts.

A special type of oral contraception - postcoital drugs. This is one or two tablets with a high content of a progestogen analogue. Taken in emergency cases within 72 hours after sexual intercourse.

Contraindications:

age up to 16 years;
severe liver disease;
pregnancy.

Injection contraception

Injections are one of the long-acting methods of hormonal contraception. Combination drugs (CICs) and progestogens are used. A CIC (for example, Cyclofem, Mesigina) is administered by a medical professional once a month from days 1 to 7 of the cycle, the effect develops after 24 hours and lasts 30 days. After discontinuation of the drug, pregnancy is possible in the first month. Contraindications for use: breastfeeding, diseases of the veins and cardiovascular system, liver.

Progestin drugs (Depo-Provera) are well tolerated and have a high degree of protection (0-1 pregnancy per year per 100 women). Administered intramuscularly once every 3 months. The disadvantage of the drug is that the ability to fertilize is restored about 9 months after discontinuation of hormonal contraceptives.

Intrauterine device

The hormonal IUD is a small plastic T-shaped tube coated with copper. It is inserted into the uterine cavity through the cervix, securely fastening inside. It is recommended for use by women who have already given birth, since any intervention in the uterine cavity in nulliparous women can lead to secondary infertility.

Spirals are designed to last for several years. They are installed and removed by a gynecologist without anesthesia. Reliability is close to 100%, since the local effect of the spiral is combined with the general hormonal effect.

Contraindications:

deformation of the cervix and uterine cavity;
history of ectopic pregnancy;
mammary cancer;
functional cysts.

How hormonal contraception is selected

The use of hormonal contraception is contraindicated without consulting a gynecologist! Very often the question is asked how to choose hormonal contraceptives on your own. There is a clear answer to this: you shouldn’t do this. All hormonal drugs have a wide list of indications and contraindications, so the doctor should select the drug after a thorough medical history and (at a minimum) examination on the chair.

After consultation, the specialist will decide whether additional examination is necessary (blood for hormones, ultrasound, coagulogram) and will prescribe the best hormonal contraceptives for a particular case.

The table for selecting hormonal contraceptives based on phenotype will help you guess which product is right for you.

Characteristic	Estrogen type	Balanced	Progesterone
Appearance	Very feminine	Feminine	Boyish, teenage
Leather	Dry	Normal	Acne, seborrhea
Menses	Abundant, long lasting	normal	Scanty, up to 3–5 days
Premenstrual syndrome	Breast engorgement and tenderness, nervous mood	Practical none	Pain in the lower back, muscles, lower abdomen, low mood
Cycle duration	More than 28 days	28 days	Less than 28 days
Beli	Abundant	Moderate	Scarce
Recommendations	Mini-pills and COCs with an enhanced gestagen component are indicated: Rigevidon, Bisekurin, Miniziston	Tri-Mercy, Lindinet, Triziston, Regulon, etc. are suitable.	Drugs with an antiandrogenic effect are needed: Yarina, Jess, Janine, Chloe, Diane-35, etc.

Hormonal contraceptives during breastfeeding: mini-pills, subcutaneous implants, intrauterine devices and progestin injections. The same products are recommended for women over 40 or smoking women over 35.

Possible reactions and side effects of hormonal contraception

Side effects of hormonal contraceptives in healthy women are extremely rare, but you need to be aware of the symptoms, which should promptly consult a doctor and stop taking the medications:

There are a number of side effects that may occur normally. They usually go away within 2–3 months from the start of therapy. These include:

spotting when taking hormonal contraceptives;
absence of menstruation;
decreased libido;
distortion of tastes and smells;
the appearance of skin problems (for example, acne);
mild headaches.

Long-term side effects that occur in a small number of women:

amenorrhea after taking hormonal contraceptives;
long-term restoration of fertility;
irregular cycle;
if antiandrogen drugs were taken, a resumption of acne and hirsutism is possible.

General principles of withdrawal of hormonal contraception and the body's reaction

Most contraception can be canceled on your own - stop taking the pills, stop using the patch or ring at the end of the cycle. Only a doctor can remove the spiral and implant. It is recommended to take a break from taking hormonal contraceptives every five years. In some cases, the doctor may recommend a different treatment regimen, and then you need to follow the instructions.

The ability to get pregnant is restored in different ways: after stopping the pills, vaginal ring and patch, fertility returns almost immediately, when using injections, implants, IUDs - within 9 months.

During pregnancy, hormonal contraceptives are canceled immediately, but even if pregnancy is diagnosed late, most drugs do not harm the fetus. The main thing to remember is that many methods of contraception increase the risk of ectopic pregnancy.

Thus, hormonal contraception is a modern, highly effective way of protecting against unwanted pregnancy. It is suitable for women who have a regular sexual partner as the only method of protection, as well as for those who want one hundred percent protection in combination with a condom. What are the dangers of hormonal contraceptives? Like any medicine, they have their contraindications, and if you do not forget about them, the danger of hormonal contraception tends to zero.

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This is a group of drugs that are used for hormone therapy. The effect of such drugs on the body has been studied well enough that it does not cause concern.

Such a broad group as hormonal drugs includes the following categories of drugs:

Contraceptives.
Medicinal (drugs whose action is aimed at curing a disease caused by a deficiency of the hormone).
Regulating (for example, to normalize the menstrual cycle).
Maintenance (insulin for diabetics).

All drugs affect the body and women differently. It all depends on the general condition of the body, the presence of serious diseases and the state of the immune system.

Treatment drugs

This group is used for hormonal therapy and is available in the form of tablets and ointments. Tablets treat serious diseases caused by hormonal imbalances, and ointments have a local effect.

In girls experiencing a lack of hormone production, the skin suffers from cracks and wounds in the winter, as the synthesis of new cells is disrupted. To deal with such trouble. The doctor prescribes creams, ointments and lotions containing hormones. Typically, ointments contain corticosteroids, which are absorbed into the blood within a few hours.

Such drugs can seriously affect the body. Therefore, it is important to maintain the dosage and, when prescribing, immediately determine the duration of the course, since one wrong step can lead to complications of existing problems.

Regulatory drugs

Due to the lifestyle of a modern woman, deteriorating nutrition and a polluted environment, many representatives of the fair sex experience menstrual irregularities. This can affect not only the sexual sphere of the body, but also the general condition of the body. Hormonal imbalances can lead to the development of breast cancer, as well as infertility. The action of hormonal drugs can help solve problems.

However, before taking it, examination and tests are necessary. First, a blood test is performed for certain substances. He will be able to identify either their excess. Such tests are quite expensive, but to solve problems it is necessary to start treatment in a timely manner. After identifying a deficiency or excess of hormones, regulation of their content begins. For this, courses of injections or tablets are prescribed. Properly selected oral contraceptives will help normalize the cycle without harm to health.

Any product containing hormones requires scrupulousness in determining the dosage, since it is quite easy to cross the line of the required dose. For example, exceeding the norm can lead to hair loss, swelling and pain in the mammary glands.

Hormonal preparations can be made from naturally occurring hormones or they can be synthetically produced substances. A course of hormonal therapy is aimed at normalizing hormonal levels and normalizing metabolic processes. Depending on the functional state of a particular gland, hormone therapy is conventionally divided into replacement, stimulating and blocking.

Negative effects of hormones

For the body of both men and women, the use of hormonal drugs can cause such unpleasant consequences as:

osteoporosis and ulcers of the mucous membrane of the duodenum and the stomach itself when taking glucocorticoids;
weight loss and cardiac arrhythmia when taking thyroid hormones;
too sharp a decrease in blood sugar when taking insulin.

The effect of hormonal ointments on the body

Preparations containing topical hormones can vary greatly in the degree of effect on the body. Ointments and creams are considered the most powerful; gels and lotions contain lower concentrations. Hormonal ointments are used to treat skin diseases and allergic manifestations. Their action is aimed at eliminating the causes of inflammation and irritation on the skin.

However, if you compare ointments with tablets or injections, then their harm is minimal, since absorption into the blood occurs in small doses. In some cases, the use of ointments can lead to a decrease in the productivity of the adrenal glands, but after the end of the course of treatment, their functionality is restored on its own.

The effect of hormonal contraceptives on a woman’s body

The peculiarities of the influence of hormonal drugs on the human body are that many factors are perceived purely individually. The use of such drugs is not only an intervention in natural physiological processes, but also an impact on the functioning of body systems throughout the day. Therefore, the decision to prescribe hormonal drugs can only be made by an experienced doctor based on the results of a comprehensive examination and tests.

Hormonal contraceptives can be produced in various forms and dosages:

Combination medications contain substances similar to female hormones produced by the ovaries. To be able to choose the optimal medicine, all groups of drugs can be monophasic, biphasic and triphasic. They differ in the proportions of hormones.

Knowing about the properties of gestagens and estrogens, we can identify certain mechanisms of action of oral contraceptives:

reduction in the secretion of gonadotropic hormones due to the effects of gestagen;
increased vaginal acidity due to the influence of estrogens;
increased viscosity of cervical mucus;
Each instruction contains the phrase “ovum implantation,” which represents a veiled abortifacient effect of the drugs.

Since the advent of the first oral contraceptives, debates about the safety of the drugs have not subsided, and research in this area continues.

What hormones are included in contraceptives?

Typically, hormonal contraceptives use progestogens, also called progestins or progestogens. These are hormones that are produced by the corpus luteum of the ovaries, in small quantities by the adrenal cortex and during pregnancy by the placenta. The main gestagen is progesterone, which helps prepare the uterus in a state favorable for the development of a fertilized egg.

Another component of oral contraceptives is. Estrogens are produced by ovarian follicles and the adrenal cortex. Estrogens include three main hormones: , estriol and estrogen. These hormones are necessary in contraceptives to normalize the menstrual cycle, but not to protect against unwanted conception.

Side effects of hormonal drugs

Each drug has a number of side effects that may occur; when these occur, a decision is made to immediately discontinue the drug.

The most frequently reported cases of side effects of hormonal drugs are:

Hemolytic-uremic syndrome. It manifests itself with disorders such as anemia, thrombocytopenia and acute renal failure.
Porphyria, which is a disorder of hemoglobin synthesis.
Hearing loss due to otosclerosis.

All manufacturers of hormonal drugs indicate thromboembolism as a side effect, which is extremely rare. This condition is a blockage of a blood vessel by a blood clot. If the side effects outweigh the benefits of the medication, it should be discontinued.

Side effects of oral contraceptives are:

Studies on side effects of oral contraceptives

In foreign countries, studies are constantly being conducted on the side effects of hormonal drugs on a woman’s body, which have revealed the following facts:

Hormonal contraceptives are used by more than 100 million women in different countries.
The number of deaths from venous and arterial diseases is recorded at 2 to 6 per million per year.
The risk of venous thrombosis is important in young women
Arterial thrombosis is relevant for older women.
Among women who smoke and take OCs, the number of deaths is about 100 per million per year.

The influence of hormones on the male body

The male body is also seriously dependent on hormones. A man's body also contains female hormones. Violation of the optimal balance of hormones leads to various diseases.

Either estrogen leads to a decrease in testosterone production. This can cause problems:

in the cardiovascular system;
with memory;
age ;
decreased immunity.

If the balance of hormones is disturbed, a course of hormonal therapy is necessary to help avoid further deterioration of health.

Progesterone has a calming effect on the male nervous system and helps men suffering from premature ejaculation solve sexual problems.

The normal content of estrogen in the male body has a number of beneficial properties:

maintaining optimal levels of “good cholesterol”;
pronounced muscle growth;
regulation of the nervous system;
improvement of libido.

When noted:

Any of the symptoms is extremely unpleasant, so do not hesitate to visit a doctor. A competent specialist will be able to conduct a full examination and prescribe a course of medications that will significantly improve the condition of the body.

Bibliography

Sudakov K.V., Normal physiology. - M.: Medical Information Agency LLC, 2006. – 920 p.;
Kolman Y., Rem K. - G., Visual biochemistry // Hormones. Hormonal system. - 2000. - pp. 358-359, 368-375.
Berezov T.T., Korovkin B.F., Biological chemistry // Nomenclature and classification of hormones. - 1998. - p.250-251, 271-272.
Grebenshchikov Yu.B., Moshkovsky Yu.Sh., Bioorganic chemistry // Physico-chemical properties, structure and functional activity of insulin. - 1986. - p.296.
Orlov R. S., Normal physiology: textbook, 2nd ed., revised. and additional – M.: GEOTAR-Media, 2010. – 832 p.;
Tepperman J., Tepperman H., Physiology of metabolism and the endocrine system. Introductory course. - Per. from English - M.: Mir, 1989. – 656 p.; Physiology.