Contraceptive pills: classification, side effect. How to take birth control pills.
Classification of birth control pills
- Combined oral contraceptives (COCs):
- Monophasic (Regulon, Lindineth-30). Contain a constant dose of a gestagenic and estrogenic element in each tablet, differ in the type of progestogens, estrogens, dosage. Provide a high contraceptive level (Pearl index 0.06-0.08), effectively treat genital endometriosis, positively affect the course and duration of the menstrual cycle, leveling the intensity of bleeding. Cases of interseminal bloody discharge are recorded very rarely;
- Two-phase (Adepal, Antotevin). Contain a varying dose of gestagen and a constant estrogen, are shown to women with sensitivity to gestagens, with clinical symptoms of hyperandrogenism;
- Three-phase (Tri-regol, Tri-merci). Characterized by the variable content of steroids in accordance with the phases of the menstrual cycle. They have a pronounced physiological effect on the menstrual cycle, give a minimum of side effects, regulate the cycle. They are shown to women over 35 who are obese, smokers.
- By the amount of the estrogen component:
- Microdosed: 15-20 μg ethynyl etradiol / day (Logest, Lindineth-20);
- Low-dose: 30-35 μg ethynyl etradiol / day (Yarina, Janine, Regulon);
- High-dose: 50 μg ethynyl etradiol / day (Ovidon).
- Gestagennye oral contraceptives ("mini-drank").
Alternatives to the use of COCs are tablets,Containing pure progestins. The contraceptive effect of "mini-pili" is associated with changes in the mucous membrane of the uterine cavity, hampering the probable implantation of a fertilized egg, and an increase in the viscosity of cervical mucus interferes with the penetration of spermatozoa into the uterus. The gestagenic preparations cause oppression of lutropin production, which suppresses ovulation. Minus "mini-drank": in some cases, taking ovulation tablets occurs - this explains the lower in comparison with the COC Pearl index (0.3-0.6).
How COC works
Mechanisms of exposure to OC are carried out at differentSystem levels of the hypothalamus-pituitary-ovary-uterus-fallopian tubes. Synthetic steroids block the release of gonadotrophic pituitary hormones and hypothalamic hormones, which leads to suppression of ovulation, temporary sterilization. In passing, synthetic gestagens and ethinyl estradiol inhibit folliculogenesis, provoking a decrease in the size of the ovaries, a decrease in the secretion of estrogens by a factor of 2. Undergoes deformations and endometrium - there is regression of the cycle and premature secretory transformation, there are atrophic changes that have an anti-implantation effect. Hormonal contraceptives inhibit the peristalsis of the fallopian tubes, slowing the passage of a fertilized egg, thicken the cervical mucus, which worsens the penetration of spermatozoa into the uterine cavity.
How to choose birth control pills
The main principle of selecting a PR is applicationThe minimum possible dose of steroids, which would provide effective protection against unplanned pregnancy. Women estrogenic type are recommended drugs that are characterized by a strong gestagenic component (Ovidon, Rigevidone). Preparations of the first line for women with a predominance of gestagens - Regulon, Logest. When choosing OK, you need to consider the size of the uterus and the quality of menstruation, because these parameters reflect the hormonal background much better than the evaluation of external signs: lean menstruation indicates increased progesterone activity, long and abundant - about the activity of estrogen. Start taking hormonal contraceptives should be from combined drugs with a minimum dosage of incoming elements. Three-phase and low-dose tablets are not opposed to each other - with adequate use it is equally safe and effective. The criterion for the correct choice of OK is the absence of intermenstrual bleeding, bleeding "breakthrough". More information about the selection of OK you can find here.
How to drink birth control pills:
- Oral contraceptives start at 1-5Day after the onset of menstrual bleeding. Monophasic COCs start to drink tablets on the corresponding day of the week, multiphase ones - from the labeled "start-up" tablet;
- PRs are taken daily, at a specific time, for 21 days;
- After taking the last pill from the package follows a one-week break, during which a menstrual reaction is observed. The next package of the drug is started on the 8th day of the break;
- In the absence of a "withdrawal reaction", tablets continue to be administered according to the traditional scheme when pregnancy is excluded. Otherwise, the drug is stopped;
- Questions of concurrent administration of COCs and drugs (anticonvulsants, antibiotics) are addressed individually;
- It is necessary to know that after the cessation of the COC, conception may occur already in the first cancellation cycle.
Use of birth control pills:
- Immediate effect, almost 100% contraceptive reliability;
- Reversibility of the method, thorough study;
- The possibility of self-monitoring of fertility;
- Low frequency of side effects;
- Simplicity of application, impossibility of overdose;
- Reduction of risks for ectopic pregnancy;
- Decrease in episodes of inflammatory diseases of the pelvic organs;
- Preventing the development of benign tumors of the uterus and ovaries;
- Relief of symptoms of dysmenorrhea, PMS;
- Positive effect in endometriosis;
- Therapeutic effect on the skin in seborrhea, vulgar pimples.
- The risk of cervical cancer in women who have used OC for a long time (more than 10 years) is increased.
Contraceptive pills: contraindications
- Malignant neoplasms of genital organs / breast;
- Pregnancy / suspected pregnancy;
- Severe cardiovascular pathology;
- Severe function disorders, acute diseases, liver tumors;
- thrombosis, thrombophlebitis, thromboembolism;
- bleeding of unexplained genesis.
- chronic nicotine intoxication;
- obesity, porphyria, immobilization;
- tuberculosis, upcoming surgical intervention;
- epilepsy, prolonged depression, uterine fibroids;
- jaundice, migraine, hypercalcemia, hyperlipidemia.
Factors that reduce the reliability of OK:
diarrhea, vomiting, simultaneous intake of laxatives, anticonvulsant, antibacterial.
- estrogen-dependent: vomiting, nausea, blood pressure jumps, headaches, dizziness, weight gain, chloasma;
- progestogen-dependent: decreased libido, depression, acne, dryness of the vaginal mucosa, headache, fatigue;
- insufficient estrogenic effect: decrease in breast size, decreased libido, poor menstruation, intermenstrual bleeding;
- Inadequate progestogenic effect: delay in menstruation, intermenstrual secretions in the 2nd half of the cycle, abundant menstruation.
Side effect on oral administrationContraceptives can be caused by individual intolerance or the action of tablets. The side effect may be harmless or dangerous to the body, regardless of the cause of the onset. Cancellation of the drug usually leads to the disappearance of such a reaction under the influence of treatment or independently.
The best birth control pills
With proper reception, the reliability of oralcontraceptive drugs tends to 100%, the ratio of "safety / reliability" hormone tablets outperform condoms. You can learn more about condoms here. COCs of the latest generation contain hormones in low doses, without androgenic effect. Avoid possible adverse reactions is possible with a medical examination, which is recommended before the start of taking the tablets. Hormonal contraception is reversible, the rate of cycle regeneration depends on the duration of the drug intake and the initial hormonal background. The ideal drug does not exist. New - does not mean the best. The main rule: hormonal contraception is selected, controlled by the treating gynecologist in accordance with the individual characteristics of the female body.