Means for the prevention of pregnancy can rightly be attributed to the oldest. After all, they were used in ancient times. For example, women of the indigenous population of America for this purpose used douching with a remedy made from lemon and a decoction of mahogany bark. In ancient Egypt, tampons soaked in honey and decoction of acacia were used. Even condoms are not a modern method of protection against unexpected pregnancy.

Of course, the effectiveness of all these tools was extremely low, and there was no need to talk about ease of use at all. Everything changed around the second half of the 20th century, when doctors first started talking about combined oral contraceptives (COCs). The first drug created for the purpose of protection was Enovid, which appeared on the pharmacy market in 1960. It was with him that the development of hormonal contraception began.

What is hormonal contraception?

The mechanism of action of contraceptive pills is based on the ability of substances that are synthetic analogues of sex hormones produced by the female body to influence the hormonal background. In this case, the brain receives a signal that there are enough hormones in the blood and the command to the ovaries to produce their own does not pass.

The hormones that enter the body, depending on the type, trigger several mechanisms at once. All of them lead to the fact that pregnancy, even with the occurrence of ovulation and fertilization of the egg, does not occur.

Estrogens help:

• The next egg does not mature in the ovaries and ovulation does not occur.
• In the uterus, there is a violation of secretory processes, due to which the development of edema of the mucous membrane - the endometrium occurs, which, in turn, makes it impossible to implant a fertilized egg.
• A process called luteolysis is launched - that is, the reverse development of the corpus luteum, which normally forms after ovulation and serves to synthesize the hormone progesterone, which prepares the body for a possible pregnancy.

• Stimulate the compaction of cervical mucus, which clogs the cervix and makes it impermeable to sperm.
• They inhibit the activity of enzymes that help the sperm enter the egg.
• They reduce the contractile activity of the fallopian tubes and the uterus itself and prevent the egg from moving along them.
• They thin the endometrium, making it unsuitable for egg implantation.
• Block the release of hormones that are responsible for ovulation in the middle of the cycle.

Regardless of the type of components and composition, all hormonal contraceptives have almost the same mechanism of action.

Application features

Any hormonal pills should be taken strictly according to the scheme, preferably at the same time of the day. You can't miss another appointment. Depending on the composition and type of the drug, in case of omission, the contraceptive effect will last on average only up to 12 hours. After this time, the effectiveness of the drug decreases.

The start of taking most COCs coincides with the first day of the cycle. At the same time, you can choose the most convenient time for you. Most women prefer to take birth control pills in the evening, before bed. In this case, negative effects such as nausea, headache or mood changes are not so pronounced.

All hormonal birth control pills are prescription drugs and are used only on prescription. Before you start drinking the drug, carefully read the instructions and rules for taking.

Advantages

Of course, the main advantage of COC contraception using both monophasic and multiphasic drugs is the simplicity of the method itself. Agree, taking a pill is much easier than, for example, using a vaginal ring. And with such means as injectable contraception or intrauterine devices, which can not be used without a doctor, there is no comparison at all.

However, this is far from the only plus, the undoubted advantages of hormonal contraception are:

• High efficiency, even for three-phase preparations, the reliability index does not exceed 0.6%. In other words, out of one thousand women using this method of protection for one year, pregnancy occurred in only one case.
• Security. Despite the fact that all birth control pills interfere with the hormonal background, their effect is much more harmless than the consequences that abortion is dangerous for.
• Normalization of the menstrual cycle, which becomes regular while taking the pills, and the menstruation itself is not so painful, long and plentiful.
• Due to the improvement of the barrier properties of cervical mucus, the incidence of inflammatory diseases or exacerbation of chronic pathologies is almost halved.
• The use of hormonal contraceptives during the year reduces the risk of endometrial cancer by 50%, ovarian cancer by 30%, and the risk of developing mastopathy is reduced by 70%.

disadvantages

Despite the many positive aspects, hormonal contraceptive pills also have disadvantages. The main one, of course, is the side effects, which sometimes make taking the drug simply impossible. In addition, birth control pills:

• They do not protect against sexually transmitted infections, including dangerous ones such as HIV or cytomegalovirus.
• They affect the blood coagulation system and can increase the risk of blood clots and the development of thromboembolism.
• They can aggravate the course of chronic diseases of the liver and gallbladder or provoke the occurrence of cardiovascular pathologies, disorders in the circulatory system, as well as severe headaches and migraines.

Types of COCs

The whole variety of birth control pills can be divided into two main groups. The first includes drugs containing only gestagens, their other name is mini-pills. The second group is combined contraceptives, which contain several hormones.

Usually these are synthetic analogues of estrogens and progesterone. It is this group that is most popular and is prescribed by doctors most often. Combined drugs are also divided into three types.

Monophasic

They are the first generation of drugs intended for hormonal contraception. They contain two hormones: estrogen and progesterone, which are contained in each tablet in the same amount. The most famous of this group are Janine, Yarina or Diane-35.

Despite the fact that this generation of drugs is not new and has been around for a long time, in terms of their effectiveness they are practically in no way inferior to multi-phase drugs.

The advantage of monophasic contraceptives can be considered ease of use and the possibility of doubling the dose in case you forget to take another pill. But with multi-phase agents, this is not always possible, and their use requires more caution and attention.

In addition, monophasic drugs can help treat endometriosis, normalize the menstrual cycle, reduce its duration and pain. Also, in monophasic drugs, cases of intermenstrual bleeding are less common than in other groups.

Monophasic contraceptives are by far the most studied and frequently prescribed group of drugs by doctors.

Two-phase

The second generation of hormonal contraceptives is different in that each tablet contains a constant dose of estrogen, and the concentration of the second component, gestagen, varies depending on the day of the cycle. Of the drugs in this group, for example, Anteovin is currently used.

Two-phase contraceptives are prescribed mainly only for women with abnormal sensitivity to progestogens. Another indication for such drugs is hyperandrogenism. This is a pathology in which a woman's body begins to produce a large amount of male sex hormones.

Three-phase

This group of drugs differs in that the tablets intended for different days of the cycle contain their own, specific dose of hormones. Such a change in the concentration of estrogens and gestagens is as close as possible to those hormonal fluctuations that occur in a woman's body. Due to this, three-phase contraceptives are considered the most physiological.

Typically, this group of drugs is prescribed to women over 35 or under 18, as well as smokers or obese. Such drugs include, for example, Tri-regol, Triziston or Tri-merci.

The main positive quality of this group of drugs is to reduce the risk of side effects from progestins. The main disadvantage is higher, compared with monophasic drugs, the incidence of bleeding between periods. A more complex regimen and not always possible to double the dose in case of missing the next pill.

Studies have shown that triphasic contraceptives are inferior to monophasic contraceptives in terms of reliability of protection against unplanned pregnancy.

The Pearl index for monophasic preparations is 0.15–0.18, while for three-phase preparations, depending on the characteristics of the composition, the values ​​can range from 0.19 to 0.68.

Criterias of choice

If before this experience of taking hormonal contraceptives a woman did not have, then usually the doctor prefers monophasic preparations containing minimal doses of hormones. But only after receiving the results of all necessary tests. Such as: smear for cytology, hormone analysis, general and biochemical blood tests, ultrasound of the pelvic organs. In some cases, an additional consultation with a mammologist may be necessary. In addition, the doctor must take into account the peculiarities of the menstrual cycle and the phenotype of the woman.

It is simply impossible to choose the right drug without consulting specialists and a series of tests. You should not buy hormonal contraceptives on your own, this can harm your health.

To date, combined oral contraceptives are considered one of the most reliable methods of protection against pregnancy. However, from a woman they require a careful attitude to their condition and strict adherence to the regimen.

Modern hormonal contraceptive pills can be divided into several groups, each of which is suitable for a certain category of women. This takes into account the age, whether the woman gave birth or not yet, whether she suffers from any hormonal or other body disorders.

1. Combined birth control pills

Contraception for women who have given birth or women of late reproductive age who have regular sex life, in case of contraindications to the use of combined oral contraceptives (estrogens). These drugs have fewer side effects and a slightly lower degree of reliability.

Sikirina Olga Iosifovna

Many women are afraid to take birth control pills for fear of side effects. Innovative technologies allow the production of contraceptive preparations containing a minimum amount of hormones and affecting only the process of conception.

pharmachologic effect

New generation birth control pills contain a complex of progestogens and estrogens. These sex hormones inhibit the synthesis of gonadotropins (follicle-stimulating and luteinizing hormone) in the pituitary gland of the brain. As a result, the process of egg maturation and rupture of the follicle is blocked, so pregnancy cannot occur.

Oral contraceptives contribute to the thickening of cervical mucus, which makes it difficult for sperm to move and enter the uterus. After taking birth control pills, a secretory transformation of the endometrial layer occurs, even if spontaneous ovulation occurs, fertilization of the egg, the embryo cannot be implanted into the uterine wall.

Third-generation progestogens have a high affinity for progesterone hormonal receptors, so they can bind to them and have a contraceptive effect, blocking ovulation and the release of FSH, LH. At the same time, progestogens have a low affinity with androgen receptors, which reduces the risk of side effects in the form of male-type hair growth, acne, excess weight, hair loss, irritability, etc.

The contraceptive effect of the pills is mainly provided by progestogens, estrogens support the proliferation of the inner layer of the uterus, control the course of the menstrual cycle, replace the lack of estradiol, the synthesis of which is blocked along with ovulation. Thanks to synthetic estrogens, intermenstrual bleeding does not occur while taking modern birth control pills.

Depending on the composition of the active substances, COCs are distinguished - combined oral contraceptives containing progestogens + estrogens, and purely progestogen contraceptive pills (mini-pills).

Taking into account the daily dosage of synthetic estrogens, COCs are classified:

• High-dose contain up to 50 mcg / day. ethinylestradiol.
• Low-dose contraceptives include no more than 35 mcg / day. estrogen component.
• Microdosed tablets differ in the smallest amount, not exceeding 20 mcg / day.

High-dose hormonal contraceptives are used only for medicinal purposes and for emergency protection after unprotected intercourse. Currently, preference is given to low and microdosed contraceptives for the prevention of unwanted pregnancies.

Depending on the combination of progestogens and estrogens, COCs are divided into:

• Monophasic tablets are characterized by a constant daily dose of both sex hormones.
• Multiphasic contraceptives are characterized by a variable dosage of estrogens. This creates an imitation of fluctuations in the hormonal balance in a woman's body at different phases of the menstrual cycle.

Pills with a low content of hormones provide reliable protection against unplanned pregnancy (99%), are well tolerated, and allow you to control the menstrual cycle. After stopping the use of COCs, reproductive function is restored within 1-12 months.

In addition to the contraceptive effect, oral contraceptives are prescribed for the treatment of dysmenorrhea, reducing blood loss during menstruation, ovulatory pain, and reducing the frequency of recurrence of inflammatory diseases of the genitourinary system. COCs reduce the risk of endometrial cancer of the uterus, ovaries, rectum, anemia, ectopic pregnancy.

Pros and cons of taking COCs

The main benefits of taking combined birth control pills include:

• high level of reliability - 99%;
• additional therapeutic effect;
• prevention of chronic diseases, cancerous tumors;
• rapid contraceptive effect of tablets;
• protection against ectopic pregnancy;
• accidental use of COCs in early pregnancy is not dangerous;
• prevent the appearance of intermenstrual, dysfunctional uterine bleeding;
• contraceptives are suitable for long-term contraception;
• the possibility of canceling pills if you want to get pregnant;
• the condition of the skin improves.

After a short-term use of combined oral contraceptives (3 months), the sensitivity of hormonal receptors in the ovaries increases, therefore, after the abolition of COCs, there is an increased stimulation of ovulation and the release of gonadotropins - a rebound effect. This method of therapy helps women suffering from anovulation to become pregnant.

The disadvantages of taking birth control pills include the high cost and possible side effects. Undesirable manifestations are rare (10-30%), mainly in the first few months. Later, the condition of women is normalized. Simultaneous use of COCs and anticonvulsants, anti-tuberculosis drugs, tetracyclines, antidepressants reduces the therapeutic effect of contraceptives.

Common side effects include:

• irritability, aggressiveness, tendency to depression;
• migraine;
• swelling of the mammary glands;
• impaired glucose tolerance;
• weight gain;
• chloasma - the appearance of age spots on the skin;
• acne, seborrhea;
• breakthrough bleeding;
• intermenstrual bleeding;
• thrombophlebitis;
• decreased libido;
• amenorrhea due to endometrial atrophy;
• increase in blood pressure.

If the side effects do not go away after 3 months of taking contraceptives, the pills are canceled or replaced with other drugs. A complication such as thromboembolism is extremely rare.

Indications and contraindications for taking COCs

Combined oral contraceptives are suitable for women who have a regular sex life, suffering from painful, heavy menstruation, endometriosis, and benign tumors of the mammary glands. Perhaps the appointment of birth control pills in the postpartum period, if the mother is not breastfeeding.

Contraindications:

• thrombophlebitis;
• diseases of the cardiovascular system;
• diabetes;
• pregnancy or suspicion of a possible conception;
• pancreatitis;
• inflammatory diseases, liver tumors;
• kidney failure;
• lactation;
• uterine bleeding of unknown etiology;
• migraine;
• individual intolerance to the active ingredients.

When pregnancy occurs, birth control pills should be discontinued immediately. But if a woman drank the medicine after conception, there is no significant risk for the intrauterine development of the child.

COC regimens

Contraceptives are selected individually for each woman. This takes into account the presence of diseases of the gynecological sphere, concomitant systemic ailments, possible contraindications.

The doctor advises the patient on the rules for taking COCs, conducts observation for 3-4 months. During this period, an assessment of the tolerability of tablets is carried out, a decision can be made to cancel or replace the contraceptive. Dispensary records are maintained during the entire period of use of contraceptives.

First-line drugs include monophasic COCs containing no more than 35 mcg of estrogen per day. and gestagens with a weak androgenic effect. Three-phase tablets are prescribed for primary or secondary estrogen deficiency, decreased sexual desire, dryness of the mucous membranes of the vagina, menstrual irregularities.

After the start of taking birth control pills, side effects may occur in the form of spotting, intermenstrual, breakthrough uterine bleeding caused by changes in hormonal levels. After 3 months, all symptoms should be gone. If the discomfort persists, the drug is replaced taking into account the problems that have arisen.

Birth control pills are taken every day at the same time. For convenience, serial numbers are indicated on the blister. Take COC start on the first day of the menstrual cycle and continue for 21 days. Then they take a break for 1 week, during this period there is withdrawal bleeding, ending after the start of a new package.

If you miss taking another birth control pill, you need to drink it no later than 12 hours later. If more time has passed, the contraceptive effect of the drug will be lower. Therefore, over the next 7 days, it is necessary to use additional barrier means against unwanted pregnancy (condom, suppositories). Do not stop taking COCs.

Admission schemes

Schemes of prolonged use of combined oral contraceptives for menstrual irregularities:

• Short dosing of birth control pills allows you to increase the interval between periods by 1-4 weeks. Such schemes are used to delay spontaneous menstruation, prevent bleeding, and cancel after a course of oral contraceptives.
• Long-term dosing is prescribed to delay menstruation from 7 weeks to several months. Treatment with contraceptive pills is prescribed for anemia, endometriosis, premenstrual syndrome, hyperpolymenorrhea.

Some women prefer cyclic use of COCs with a seven-day break due to fear of pregnancy and infertility. Some patients believe that menstruation is a physiological process.

Popular combined oral contraceptives

Microdosed low hormone tablets:

• The median is a monophasic estrogen-progestin COC. The drug contains drospirenone, which has an antimineralcorticoid effect, prevents the accumulation of excess body weight, the appearance of edema, acne, oily skin, seborrhea.
• contains ethinylestradiol 20 mcg, dospirinone 3 mg. A contraceptive drug is prescribed for contraception, for the treatment of severe acne, painful menstruation.
• Lindinet 20 tablets include ethinyl estradiol 20 mcg, gestodene - 75 mcg. It is indicated for use in painful menstruation, with an irregular cycle, for contraception.
• Zoely. Active ingredients: estradiol hemihydrate - 1.55 mg, nomegestrol acetate - 2.5 mg. Nomegestrol acetate is a highly selective progestogen with a similar structure to progesterone. The active component has a mild androgenic activity, does not have mineralcorticoid, estrogenic and glucocorticoid effects.

mini pili

Popular contraceptive pills with a minimum content of hormones - mini-pills are an alternative method of contraception for women who are contraindicated in taking COCs. The composition of the preparations includes microdoses of progestin, an analogue of progesterone. One capsule contains 300–500 mcg/day. The effect of mini-pills is inferior to COCs, but they have a milder effect, they are recommended for women who experience side effects after taking combined contraceptive pills.

Women can take low-dose progestin preparations during lactation, the active substance does not affect the taste of breast milk and does not reduce its volume. Unlike COCs, mini-pills do not cause blood clots, do not contribute to thrombosis, increase blood pressure, therefore they are approved for use in cardiovascular pathologies, thrombophlebitis.

Contraceptive progestin pills do not affect ovulation, they thicken the cervical mucus, preventing the penetration of sperm into the uterine cavity and ovaries. In addition, the peristalsis of the fallopian tubes slows down, proliferative changes in the endometrium occur, which does not allow the embryo to be implanted in the event of fertilization of the egg. When taking gestagenic drugs, the menstrual cycle and regular bleeding are preserved.

The contraceptive effect is achieved 3-4 hours after taking the pill and persists for a day. Mini-pills provide 95% protection against unplanned pregnancy.

Rules for using the minipill

Before starting the use of contraceptives, women need to be examined by a gynecologist to exclude pregnancy, chronic diseases of the reproductive system. To get the desired result, you must strictly follow the rules for using the mini-pill:

• Taking pills starts from the first and continues until the 28th day of the menstrual cycle, they are drunk continuously at the same time. Skipping the next intake of contraceptives for more than 3 hours completely eliminates the contraceptive effect.
• During the first few weeks, nausea may bother you, usually this symptom gradually disappears. To reduce discomfort, it is recommended to take the tablet with meals.
• If vomiting occurs after taking the mini-pill, the tablet should be taken again as soon as the patient feels better. This recommendation also applies to diarrhea. In the next 7 days, you must use additional contraception (condom) to protect against unwanted pregnancy.
• When switching from COCs, you need to drink mini-pills immediately after finishing the packaging of combined contraceptives.
• Pregnancy can occur in the first month after the abolition of progestin tablets. Ovulation occurs 7-30 days (on average 17) after the end of the 56-day course.
• Women who are prone to developing age spots (chloasma) after exposure to the sun should avoid prolonged exposure to ultraviolet radiation.
• With the simultaneous administration of mini-pills and barbiturates, activated charcoal, laxatives, anticonvulsants, Rifampicin, the effectiveness of contraceptives becomes less.
• In the postpartum period, progestin contraceptives are prescribed on the first day of the onset of menstruation, but not earlier than 6 months after the birth of the child.
• After an abortion, the pills begin to drink immediately after the operation, additional contraceptives are not required.
• The contraceptive effect of the mini-pill is weakened if the gap between taking the next contraceptive pill is more than 27 hours. In the case when a woman forgot to take the medicine, it is necessary to do this as soon as possible and strictly follow the treatment regimen in the future. Over the next week, you need to use additional means of protection against the onset of pregnancy.

Contraindications

It is contraindicated to take oral contraceptives with a low dose of hormones during pregnancy, with uterine bleeding of unknown etiology, liver disease, steroids, exacerbation of herpes, liver failure. You can not drink pills if ectopic pregnancies have previously occurred, if malignant tumors of the mammary glands are detected or suspected of them. Contraindication is lactose intolerance, glucose-galactose malabsorption.

A decrease in the effectiveness of contraceptives can be observed in violation of the rules of admission, the use of laxatives, barbiturates, anticonvulsants, after vomiting, diarrhea. Against the background of progestogen tablets, irregular menstruation may appear. In such cases, it is necessary to stop taking the mini-pill, exclude a possible pregnancy (including ectopic) and only then resume the course.

Side effects of birth control pills

Mini-pills have fewer side effects than COCs. The negative effects of taking birth control pills include:

• vaginal candidiasis (thrush);
• nausea, vomiting;
• intermenstrual bleeding;
• intolerance to contact lenses;
• swelling of the mammary glands, discharge from the nipples;

• contraceptives cause weight gain;
• the appearance of chloasma;
• urticaria, erythema nodosum;
• headache;
• acne;
• breakthrough bleeding while taking drugs that affect liver function;
• decreased libido;
• follicular ovarian cyst;
• amenorrhea, dysmenorrhea.

Mini-pills may increase the need for insulin in diabetic patients. Therefore, before taking birth control pills, it is necessary to consult an endocrinologist and, if necessary, adjust the dosage of hypoglycemic agents. Women should constantly monitor their blood sugar levels during the first month of taking the mini-pill.

In rare cases, the use of progestogens can provoke the development of thromboembolism. It should be borne in mind that in women over 40 years of age, the risk of developing breast cancer increases during treatment with hormonal drugs. If serious side effects appear, mini-pills are canceled.

If after the onset of pregnancy there was an accidental use of contraceptives, there is no risk to the fetus, but a further course of pills should be canceled. At high dosages of progestogens, masculinization of the female embryo can be observed. During lactation, part of the active substances of the drug penetrates into breast milk, but its taste does not change.

Popular mini-pills

• Femulen (ethinodiol).
• Exluton (linestrenol 0.5 mg).
• Charosetta. The active substance is desogestrel at a dosage of 75 mcg. Tablets do not cause significant disturbances in carbohydrate, lipid metabolism, hemostasis.
• Microlut (levonorgestrel 0.03 mg).
• Continuin (ethinodiol acetate 0.5 mg).

The disadvantages of using progestin contraceptive pills include the possible formation of follicular ovarian cysts, menstrual irregularities, edema, weight gain, irritability. The contraceptive effect of the mini-pill is lower than that of COCs, it is 90-97%.

Modern contraceptives contain small doses of hormones, provoke the development of side effects to a lesser extent, and provide reliable protection against unplanned pregnancy. The attending physician prescribes tablets, taking into account the individual indications of the woman. The patient should be registered with the dispensary for the entire period of COC or mini-pill use. Particularly careful monitoring is carried out during the first 3-4 months from the start of the use of oral contraceptives.

Reception of hormonal contraceptives is reliable: it is easy to take them, they give a therapeutic effect in women's diseases. Which tool from a large list of proposals is better?

The only way to eliminate unwanted pregnancy is abortion. This unpleasant procedure is dangerous for a woman. To avoid it, you need to think in advance and protect yourself from unplanned conception. Medicine offers many ways to prevent. The most effective is the use of hormonal contraceptives.

Hormonal has long been known in Russia and is widely used. Effectively copes with the task - protects against unplanned pregnancy. It is based on the use of hormones that are derived synthetically: estrogen and progesterone. In their action, they are similar to the natural ones that the ovaries produce.

In the preparation, their number is different. The dose depends on the type of contraceptive and the form in which it is produced. Hormonal contraceptives of the new generation may contain either one substance or both.

There are two types of drugs:

• one-component;
• combined.

In such preparations, ethinylestradiol can be used as the main substance. It is similar in structure to estrogen. Therefore, it has a similar effect - it protects against unplanned pregnancy.

Previously, the concentration of the main substance was large, amounting to about 160 µg/day. Today, manufacturers offer drugs with a low content of synthetic hormones. The daily dose does not exceed 30 mcg.

Replace with analogues not only estrogen, but also progesterone. There are a lot of connections with a similar composition. For example, noretinodrel, gestodene, drospirenone and others.

Operating principle

The mechanism of action of the funds is to prevent ovulation by interfering with the natural movement of the egg. She does not leave the ovary, fertilization becomes impossible.

There are changes inside the uterus itself. This is especially true of its inner layer. The egg will not be able to attach to it, even if conception has occurred.

Synthetic hormones increase the density of the cervical mucus of the cervix. This leads to the fact that male sex cells cannot enter the uterus. The female body is reliably protected from pregnancy.

Hormonal contraceptives have a beneficial effect. They help:

• normalize menstruation. The volume of blood secretions decreases, which is important for women suffering from iron deficiency anemia;
• reduce pain accompanying ovulatory syndrome and pre-monthly period;
• increase the protective properties of the female body. Reduces the likelihood of infection of the genital organs;
• prevent dysfunctional uterine bleeding;
• reduce the development of benign breast disease. Multiphasic oral preparations containing progestogens are suitable for this;
• suppress the formation of androgens;
• cure seborrhea, acne and other diseases;
• improve bone density. Synthetic hormones contribute to the fact that calcium is well absorbed.

When not to use

Low-dose hormonal contraceptives are not suitable for all women. There are a number of cases when it is better to refuse them, since the likelihood of side effects is high.

The main contraindication is pregnancy. To make sure in its absence, consult a gynecologist. He will conduct an examination, the results of which will determine the conception and the possibility of taking hormonal contraceptives.

• hypersensitivity to the components of the drug. The likelihood of an allergic reaction is high;
• liver problems and breast cancer;
• bleeding with unknown etiology;
• poor blood clotting;
• breastfeeding.

Choosing the best hormonal contraceptives is difficult. Reception depends on the individual characteristics of the woman. Before using them, you should consult a gynecologist. He will advise the drug that is best for a woman.

Advantages and disadvantages

Hormonal contraceptives have both pros and cons.

The main advantage: reliability, convenience and availability.

Hormonal contraceptive pills and other means are highly effective. The method is reversible, that is, after stopping the pills, pregnancy can quickly occur. Side effects are rarely observed.

Sometimes doctors prescribe such drugs in the treatment of diseases of the female genital organs. Their reception reduces the likelihood of developing tumors, stabilizes menstruation. Used to treat dysmenorrhea.

• The disadvantages of drugs include the lack of protection against diseases that are transmitted during intimacy.
• If the tablet form of the drug is chosen, then it should be taken regularly. Otherwise, the effectiveness of the contraceptive will decrease. It is suitable only for disciplined ladies.
• With tuberculosis and epilepsy, such drugs are not recommended for admission. Their effect is reduced by drugs that are used in treatment. St. John's wort extract, which is included in many antidepressants, has a similar effect.

• Alcoholic drinks are compatible with hormonal contraceptives only in minimal doses.

This method of contraception has side effects. They appear as:

• nausea;
• vomiting;
• pain in the abdomen;
• increase in total body weight;
• the mammary glands become heavy, amenorrhea develops.

Hormonal drugs have a negative effect on the limbic system. It is easy to notice: women complain of changeable mood, deterioration in the quality of sexual life.

Often in the early stages of taking pills, vaginal discharge is disturbing. If they are spotting, then you should not worry and stop taking it. They go away after a few months.

Form and composition of contraceptives

Single-component hormonal agents are available in different forms. There are several ways for the active substance to enter the body: tablets, injections, vaginal rings, patches on the skin, an intrauterine device, implants inserted under the skin.

The principle of their action is similar. The means differ in appearance and method of application. These products contain the synthetic hormone progestin.

parenteral administration

Common method of hormonal contraception. It is characterized by a prolonged action.

Injections

The active substance is medroxyprogesterone. It is carried out once every 3 months. The favorable period is from the first to the seventh day of the cycle. The effect of the procedure will be visible in a day. The duration of the drug is not less than a month. Injections are not allowed for everyone. There are several contraindications to their implementation. Gynecologists do not recommend parenteral administration during breastfeeding, venous pathologies, heart, blood vessels and liver.

The reliability of the injection method is 99% - one pregnancy per year was noted. The introduction is performed intramuscularly. A significant drawback is the long period of restoration of reproductive ability. This period is more than eight months after discontinuation of the drug.

Acceptance by women who have reached the age of 40 is allowed. The introduction is performed in the first few days of the cycle. The first two weeks require additional protection against unwanted pregnancy.

Subcutaneous silicone capsules

Silicone capsules are administered by a doctor. This should be done under the skin in the shoulder or forearm. Implanon is the only contraceptive implant registered in the Russian Federation. The active substance, desogestrel, is secreted into the blood and protects against unwanted pregnancy.

The implant is inserted for the first time during the cycle. The contraceptive effect persists for three years. There is another version of the drug - Norplant. It contains six capsules. The duration of their action reaches five years, but the drug is not used in Russia.
The capsule may be discarded before its expiration date. Indications for this may be side effects: blurred vision, surgery, thrombosis. Externally, the capsule is invisible. She does not require special care from a woman. Alcohol with this method of contraception is not contraindicated. The contraceptive effect does not become weaker.

Hormonal spiral

Mirena intrauterine device - the active substance is levonorgestrel in a very low concentration. It is inserted intravaginally and securely fastened. Designed for use by women giving birth. Otherwise, it can lead to infertility.
The term of the method is 3-5 years. The device is installed and removed by the doctor. The procedure does not require anesthesia. The effectiveness of the method reaches 100%, since two actions are combined: local and hormonal.

Solid dosage form

The solid dosage form is tablets. One pack is calculated for the first cycle. The number of tablets is 21 and 28 pieces. It is recommended to start taking from the first day of the cycle. As soon as a new pack starts, a break is necessary if there are 21 tablets in the pack.

Two types of combined tablets: mono- and polyphasic. Their main difference is in the dosage of hormones for each day of the cycle.

Hormonal contraceptives are high-, micro- and low-dose. This distinction is due to the composition of the drugs. Basically, different amounts of estrogen.

Such funds protect against unwanted pregnancy and are used for medicinal purposes in gynecology. Especially effective for endometriosis, ovarian cysts, infertility. Often prescribed in case of hirsutism, acne, seborrhea. Can be used for girls who are not sexually active. Their action is aimed at combating the disease of the female genital organs. Low-dose hormonal contraceptives are most commonly used by women of all ages.

Contraceptives must be taken regularly, every day. Only under this condition, their efficiency will be high and will be up to 99%. If you missed a missed dose, read the instructions for use and follow the steps indicated in it. This will rule out the possibility of pregnancy. Missing a dose again will further reduce the reliability of the contraceptive method.

• lactation period;
• age 36 and older;
• if a woman smokes;
• vascular diseases;
• headaches;
• thrombosis, poor blood clotting;
• malignant tumors of the breast;
• liver diseases.

Mini-pills belong to single-component hormonal preparations. They contain a gestagen in a minimal amount.

The reliability of protection is inferior to combined tablets. However, they are much safer, since the concentration of the hormone in the composition is minimal. Reception is indicated for women aged 40 years and older, with breastfeeding, thrombosis. Oral contraceptive is not recommended in case of breast cancer, headaches, functional cyst and ectopic conception.

There is another type of pill - postcoital means. They contain a shock amount of a substance similar to a progestogen. One or two tablets per pack. Their reception is carried out after sexual intercourse during the first three days. Such contraception refers to emergency. Contraindicated if the age is less than 17 years, with liver disease, pregnancy. You can use them no more than 4 times a year, as they contain a huge amount of hormones and their intake causes a huge blow to the hormonal system of a woman.

parenteral contraceptives

There are two types of this kind of contraception:

• Evra contraceptive patch;
• vaginal ring NuvaRing.

Patch

The duration of the hormonal patch is twenty-one days. There are three of them in one package. A new one is attached to the skin every week. When the patches run out, you need to take a break, consisting of seven days. During this period, bleeding may occur, which resembles menstruation.

The contraceptive contains ethinyl estradiol and norelgestromin, 0.6 mg and 6 mg, respectively. These components penetrate the female body in an amount corresponding to microdosed COCs. It is necessary to glue the patch on the skin in the area of ​​the shoulder, shoulder blades or thighs.

The transdermal system has one important drawback - inconvenient use. Under the influence of water or friction, it may spontaneously peel off. It cannot be reused, as it loses its properties.

vaginal ring

Flexible latex ring NovaRing. Inserted into the vagina. The number of substances in the ring is minimal: ethinyl estradiol and etonogestrel at a concentration of 0.015 mg / 0.12 mg.

The size of the ring is small: the diameter is 5 cm. The introduction into the female genital organ is carried out for the first time on the days of menstruation.

The device is less than a month old. On the twenty-first day, it must be removed. The break lasts a week. Then a new ring is inserted. In case of spontaneous removal, the device can be reused. To do this, it must be washed and put in its original place.

The effectiveness of the method is equivalent to the use of tablets of the combined type. The difference is in fewer side effects. The downside may be intolerance to latex.

Selection features

It is difficult to choose hormonal contraceptives. Such drugs have many contraindications, so before using them, you must undergo a complete gynecological examination. Based on the results obtained, the doctor will prescribe the best remedy for protection against unwanted pregnancy.

List of new generation hormonal contraceptives

Identify types of drugs, the use of which depends on the phenotype

• Estrogen. Recommended for women with dry skin, heavy periods, duration of the last twenty-eight days. Before menstruation, the mammary glands swell and become painful.
  • Rigevidon, Bisekurin, Miniziston;
• Balanced. Designed for use by girls with normal skin type. Menstruation proceeds normally, a few days before it, there are no changes in behavior and condition. The duration of the cycle is twenty-eight days.
  • Tri-Merci, Lindinet, Triziston, Regulon.
• progesterone. The woman looks like a teenager. Skin type acne or seborrhea. Monthly short: up to 3-5 days. The period before menstruation is characterized by pain in the abdomen, irritability.
  • Means that have an antiandrogenic effect are suitable: Janine and Yarina.

Particular attention should be paid to the choice of funds during breastfeeding.

You can take mini-pills, implants, spirals, injections. This list is also recommended for women over the age of forty.

negative action

Hormonal contraceptives rarely provoke side effects in women who do not have health complaints. There are a number of symptoms that will indicate their appearance. At the first sign of them, the drug should be discontinued. Be sure to go for a consultation with a gynecologist.

Side effects:

• blurred vision;
• liver disease, thrombosis;
• headache attacks;
• bleeding that has no logical explanation;
• weight gain;
• change in the size of fibroids;

Known side effects with a normal reaction of the body. They disappear on their own after a while. These include spotting, missing periods, decreased sex drive, changes in taste, skin problems, and mild headaches.

Rarely, taking oral contraceptives leads to the development of amenorrhea, an irregular cycle, and acne.

How does the body react to the abolition of the contraceptive

You can stop taking birth control pills on your own. A specialist will help to extract or implant. After a break, experts advise a contraceptive scheme.

Reproductive ability resumes over a different period of time. When using a ring, oral contraceptives and a patch, during the first months after the end of their use, it is possible to conceive a child. Injections, implants and coils require a longer time. Basically, it takes about nine months for pregnancy to occur.

If conception occurred while using contraceptives, stop taking them. They will not harm the fetus with a belated diagnosis of pregnancy. However, often their intake leads to ectopic conception.

What to be afraid of

The main function of the female body is the birth of children. If it doesn't, it gets old. The work of the genital organs worsens: less hormones are produced, the ovaries change their size, the vessels narrow.

The dangers of such contraceptives are debatable. Foreign substances adversely affect the smooth operation of the mechanism. They can damage the gonads. Natural connections are broken, artificial ones are formed.

Contraceptives prevent the active movement of the egg. As a result, the process of fertilization provided by nature does not occur. The body is sensitive to such changes and may fail in its work.

Long-term use of synthetic hormones is a serious test. They act on the mucous layer of the uterus for a long time and often lead to irreversible changes.

• Against the background of the uncontrolled use of this method of contraception, the number of heart attacks, thrombosis, strokes and anemia has increased. Diagnose diseases of the kidneys and urinary system. Sleep is disturbed, headaches are disturbing, the mood is changeable, the degree of aggressiveness is increased.
• The use of synthetic hormones without medical prescription leads to problems with the mammary glands. The risk of malignancies increases. There are violations in sexual life and a delay in menstruation.
• Taking contraceptives should be strictly under the supervision of a doctor because of the many side effects. Many women have varicose veins, cycle changes, weight fluctuations: you can both get better and lose weight. Even if there is no pronounced side effect from taking funds, it is not easy to predict what the consequences will be.

Hormonal contraceptives are a reliable method of protection against unplanned pregnancy. They can be used by women who are sexually active as the only method of protection or combined with condoms.

Almost all have a therapeutic effect, so they are used for various diseases of the female genital organs. If the doctor's advice is taken into account when choosing, the likelihood of side effects will be minimal.

Today, every couple can plan to have children and control their sex life thanks to the merits of the pharmaceutical industry. A huge selection of contraceptives allows you to choose the appropriate method of protection against pregnancy and / or sexually transmitted infections.

Overview of some contraceptives

The list of means and methods of protection is estimated at a dozen positions or more. This is the calendar method, and the use of spermicides (the so-called non-hormonal pills and suppositories), and common condoms, and hormonal patches, rings, and the intrauterine device, and injections, and patches, and oral contraceptives. More about each method, and especially birth control pills, - below.

Coitus interruptus

The most unreliable options for contraception are coitus interruptus and the calendar method. PPA is generally difficult to call a method of contraception. The essence of the method is to remove the penis before ejaculation.

In 60% of couples who are protected by PPA, pregnancy occurs in the first year of using the method. Yes, and according to statistics, 80% of women who became pregnant "accidentally" were protected precisely by interrupted intercourse. The problem is that not all men feel the onset of ejaculation. One "wrong" move, and the likelihood of getting pregnant increases significantly.

calendar method

The method is slightly more efficient than the previous one - 65%. There are 10-15 pregnancies per 100 women who take the risk of contraception in this way. This method becomes more relevant after 30 than for young girls. Only girls and women with a regular menstrual cycle can afford to be protected in this way.

The essence of the method is to calculate the so-called dangerous days on the calendar and not have sex during this period. In general, from the 16th day until the expected start of the next menstruation, the probability of conception is greatest. The most dangerous days fall in the middle of the cycle - from the 12th to the 18th day of the cycle (with a 28-day cycle).

Cons: errors, an irregular cycle, in which it is almost impossible to accurately calculate the day of ovulation, hormonal disruptions. There are other nuances - if sexual intercourse occurred a few days before the expected ovulation, spermatozoa can live in the genital tract for several days and fertilize the egg even after such a seemingly long time. To increase the reliability of this method of contraception, you need to learn how to correctly calculate dangerous days. In addition to the calendar method, you can use ovulation test strips or follow the charts of basal temperature.

Spermicides and non-hormonal pills

Another not very effective method (70% reliability) is spermicides. These are special substances that are introduced into the vagina and have a negative effect on spermatozoa, after which they can no longer fertilize the female egg. Drugs with a similar mechanism of action are sold in pharmacies in the form of suppositories, creams, capsules or tablets, which are injected directly inside before sex.

Such non-hormonal (which is better to choose, reviews of different types - below) are used by many women who, for one reason or another, are afraid to take conventional OK (oral contraceptives). Such non-hormonal tablets are recommended for use in premenopausal women, patients with endocrine system dysfunction, individual sensitivity and an adverse reaction to conventional OK. Importantly, these can be used for HB (breastfeeding).

How to choose non-hormonal contraceptives? The rating of the best is presented by such tablets:

1. Pharmatex. Available in the form of tablets, cream and suppositories. The average price of a pack of 12 tablets is 250 rubles.
2. "Gynekoteks". The same form of release, the price is 100 rubles for the same 12 tablets.
3. Benatex. The cost of 10 tablets is 250-300 rubles.
4. "Erotex". Price 5 pcs. - 110 rubles.
5. "Contratex".

How to choose tablets? It is advisable to consult a doctor, otherwise it is worth focusing on personal feelings when using. Some pills, for example, cause itching in some women, which disappears when switching to another brand of drugs.

Barrier contraception

Barrier methods protect not only from conception and unwanted pregnancy, but also from sexually transmitted infections. But the reliability of such means is not 100% (moreover, no contraceptive is 100% reliable, except for complete abstinence from any kind of sexual contact), but is only about 85%. Barrier methods include the use of condoms, but they can also break, and then all efforts will go in vain, and lubricate the sensations of sexual intercourse.

Hormonal patches and ring

Other non-invasive methods include patches and a hormone ring. The effectiveness of such funds reaches 92%. The patch adheres to the skin, but is noticeable, requires regular replacement, and is not suitable for use by women over 90 kg. The ring is inserted into the vagina, but also has disadvantages: in some cases, it can cause a change in the nature of menstrual bleeding and disrupt the regularity of menstruation. These methods do not have contraceptive side effects such as treating acne, relieving PMS symptoms, or preventing seborrhea.

Implants and injections

Hormonal implants and injections are essentially the same oral contraceptives, that is, birth control pills, only with a different mechanism of action. If substances from tablets are absorbed through the digestive tract, then injectable contraceptives are administered intramuscularly. The frequency of injections is once a month or every three months. Implants are inserted into the shoulder and require replacement only once every five years. The effectiveness of the methods is 90-99%.

Such contraception, however, can cause migraines, changes in the menstrual cycle, hormonal disruptions, decreased sex drive or weight gain. Injections and implants are generally not used by young women who have not yet given birth, this method of contraception is more suitable for women in their thirties and forties who do not plan to have a child in the near future.

Intrauterine device

The second most effective method of contraception after birth control pills is the intrauterine device. The method also refers to the barrier, only the spiral is installed in the uterine cavity, preventing the embryo from fixing. But the installation of a spiral can cause a change in the nature of menstruation, sometimes causes pain, increases the risk of developing various inflammations and the onset of an ectopic pregnancy.

Oral contraceptives

Oral contraceptives protect against unwanted pregnancy, but not against sexually transmitted diseases. The latest birth control pills have an additional effect: many drugs contain the active form of folic acid, so they alleviate the symptoms of PMS, have an antidepressant effect, help fight acne, improve skin and hair. The reliability of OK is 99.7%, but this method of contraception requires prior consultation with a gynecologist, the care and organization of a woman when taking it. It is about this method of planned contraception that will be discussed further.

Classification of OK according to the content of hormones

All are divided into 2 large groups: combined oral contraceptives (COCs) and mini-pills. COCs contain an estrogen analogue and a progestogen. The mechanism of action of such pills is that they block the onset of ovulation (the maturation of the egg and its readiness for conception), make the implantation of the egg into the uterine cavity impossible due to "glandular regression" and thicken the mucus, which disrupts the advancement of spermatozoa to the female reproductive cell.

COCs are divided into groups according to the variation of hormones and their content. So, there are monophasic, two- and three-phase tablets (more on them later), as well as microdosed, low-dosed and high-dosed COCs. Microdosed OK are suitable for young girls, since the content of active substances in tablets is minimal. The rating of contraceptive pills of this type is presented as follows:

1. "Jess".
2. Marvelon.
3. "Klayra" (the only three-phase tablets in the list of microdosed).
4. "Dimia".
5. "Zoeli".
6. "Logest".
7. Mercilon.
8. "Lindinette".
9. "News".

Low-dose OCs are suitable for both young and older women, and can be used by those patients who experience intermenstrual bleeding when using microdose tablets. Such birth control pills are suitable for women who have given birth. In addition, low-dose OCs prevent hair growth in unwanted places, eliminate increased oily skin and acne, and reduce the manifestations of seborrhea.

1. "Yarina.
2. Tablets "Janine".
3. "Silhouette".
4. "Diana".
5. Tablets "Femoden".
6. "Three-merci".
7. "Lindinette".
8. Tablets "Silest".
9. "Minisiston" and others.

High-dose OK can be taken only on the recommendation of a gynecologist. Such drugs are used, as a rule, for therapeutic purposes (for the treatment of endometriosis, hormonal disorders and other diseases). In the ranking of contraceptive pills with a high concentration of hormones, such OK:

1. "Non-Ovlon".
2. "Trikivlar".
3. "Ovidon".
4. "Trieseston".
5. "Three-Regol".

Another type of contraceptive - mini-pill - contains only progestogen. Mini-pills affect the reproductive system only at the local level:

• increase the viscosity and amount of cervical mucus, which interferes with the free movement of spermatozoa;
• change the biochemical and morphological structure of the uterine endometrium, which makes it impossible to fix the embryo even in the case of fertilization.

Mini-pills completely block ovulation in only half of women, but this does not affect the reliability of pills as a method of protection.

1. "Charozetta" (800 rubles per pack).
2. "Laktinet" (530 rubles).
3. "Orgametril" (1100 rubles).
4. "Exluton" (1250 rubles).

There is also emergency contraception, which is used if unprotected sex has occurred, which can lead to pregnancy. These birth control pills are taken within 72 hours after sex. A common example of this type of OK is Postinor. You need to take birth control pills within 72 hours after having sex, otherwise there will be no effect from emergency contraception. You can not use such drugs constantly.

Monophasic, two- and three-phase preparations

COCs also differ in the variation in the content of hormones, dividing into monophasic, two- and three-phase. In monophasic tablets, the percentage of substances does not change in each tablet, in two-phase tablets, the ratio of active components changes in the first and second halves of the cycle, in three-phase tablets, the percentage of substances changes three times per package.

Monophasic birth control pills:

• "Regulon";
• "Rigevidon";
• "Janine";
• "Silhouette";
• "Lindinet";
• "Logest";
• "Femoden";
• "Microgynon" and others.

Biphasic OK:

• "Femoston";
• "Binovum";
• "Bifazil";
• "Adepal";
• "Anteovin" and others.

Three-phase drugs are represented by Tri-Merci, Triziston, Tri-Regol and others.

How to choose the right birth control pills

You cannot choose birth control pills on your own or even with the help of a pharmacist in a pharmacy. To find the right contraceptive, you need to go to the doctor. The gynecologist will interview the patient, find out if there are any diseases (whether they were in the past) and which ones, and conduct an examination. During the examination, the gynecologist will measure the patient's weight, blood pressure, assess the condition of the skin, palpate the breasts and prescribe tests. You may also need to visit an ophthalmologist, as long-term use of OCs increases the risk of various eye diseases.

The pills that are best for the patient, the doctor chooses depending on the phenotype. The phenotype takes into account the growth and appearance of a woman, the mammary glands, the degree of hair growth, the condition of the skin, hair, existing chronic diseases, the nature and frequency of menstruation, the presence and severity of PMS, and so on.

There are three main phenotypes:

1. Women of short or medium stature, whose skin and hair are prone to dryness. Menstruation is profuse and long, the cycle is more than 28 days. Such patients are suitable for medium and high-dose COCs, such as Milvane, Triziston, Femoden and others.
2. Women of average height, with normal oily hair and skin, with medium-sized breasts. There are no symptoms of PMS in this type of women or they do not cause negative, painful sensations. The menstrual cycle is standard - 5 days, every 28 days. Suitable tablets are Marvelon, Regulon, Tri-Merci, Silest, Logest, Tri-Regol and others (most COCs on the market).
3. Women who are tall, underdeveloped mammary glands, oily hair and skin. Menstruation is frequent and painful, but scanty, PMS symptoms are often severe. The tablets "Yarina", "Jess", "Zoeli", "Dimia" are suitable.

Rating of oral contraceptives

Oral contraceptives are too diverse to form an overall rating. But still, the recommendations of gynecologists and patient reviews allow us to highlight some of the best COCs of the new generation. The rating of contraceptive pills is represented by such drugs:

1. "Jess". They not only perform a direct function, that is, they protect against unwanted pregnancy, but also treat a number of gynecological diseases, hormone dependence, improve the condition of the skin and hair, reduce the manifestations of PMS and relieve painful periods. How to drink birth control pills "Jess"? According to the instructions, you need to start taking the first day of menstruation, pink pills should be taken every day, and on the 28th day - take white (placebo). After the end of the cycle, start the next pack.
2. Jess Plus. The same "Jess", only the composition also includes an active form of folic acid, which normalizes the psycho-emotional state and avoids unpleasant consequences if pregnancy does occur: the body will be ready to bear a child, despite taking pills. If the patient decides to stop taking OCs in order to become pregnant, planning can begin as early as the next cycle after stopping. In addition, Jess Plus is a birth control pill that does not make you fat. The latter is confirmed by the responses of patients.
3. Tablets "Janine". According to the girls and women who took Janine, this drug somewhat reduces sexual desire, but is reliable. In addition, "Janine" is a contraceptive pill that does not make you fat, which has been proven by many reviews.
4. Marvelon. OK are recommended for use by women after 25-35 years of age who are of childbearing age, but have already given birth. The content of hormones is minimal, but the tablets are suitable for patients who are sexually active. Like other OK, "Marvelon" improves the appearance, condition of the skin and hair, normalizes hormonal balance and reduces hair growth in unwanted places.
5. "Regulon", instructions for use, price, reviews of which are of interest to many women, costs about 1150 rubles (63 tab.). Tablets should be taken daily, from the first to the twenty-first day of the cycle. This is followed by a seven-day break. After a break, you need to start taking it again, even if your period has not stopped yet, the drug "Regulon". Instructions for use, price, reviews should be studied before buying. The opinions of the patients are contradictory: some women became irritable and gained weight, noted a significant deterioration in well-being and a menstrual cycle failure, others were completely satisfied with the drug, while others did not suit them.
6. Depo Provera. Tablets are recommended for women after forty years of age, can be used in the treatment of various kinds of gynecological diseases. There are injections - doctors say that Depo-Provera is much more effective than in the form of tablets.
7. Pharmatex. This is a non-hormonal contraceptive that is inserted directly into the vagina in the form of suppositories. It is recommended to apply "Pharmateks" to women from 45 years old, leading an active sex life.
8. "Yarina". The drug is low-dose and has an anti-adrogenic effect. Some patients claim that they managed to get pregnant while taking Yarina strictly according to the instructions. How to take contraceptive pills "Yarina"? You need to drink OK every day, starting from the 1st day of the cycle, in the order indicated on the blister.
9. "Lactinet" is not a combined remedy, but a mini-pills, which have a number of contraindications, so a doctor's consultation is a must before you start taking it. The tablets are suitable for women over 45 years of age, patients with diabetes, varicose veins, smokers, breastfeeding.
10. Contraceptive pills "Silhouette". Many patients note a visible improvement in the appearance of the skin and hair, stabilization of the menstrual cycle, reduction of pain during menstruation and symptoms of PMS. But birth control pills "Silhouette" can cause weight gain - about half of women complain of such a side effect.

Side effects of taking a contraceptive

Reliable, safe (if you consult a gynecologist before taking) and a convenient method of contraception - birth control pills. Side effects, however, also exist. Among them:

• nausea;
• lack of menstruation;
• lack of appetite;
• weight gain;
• uncharacteristic discharge between periods;
• dizziness, headaches;
• decreased libido;
• swelling of the legs;
• pain in the chest.

In case of side effects, birth control pills are canceled.

Contraindications for admission

Contraindications to taking OK can include:

• hypertension;
• kidney pathology;
• pregnancy;
• serious diseases of the cardiovascular system;
• migraines of unknown origin;
• preparation for surgery;
• overweight (more than 30%);
• smoking after 35 years (for some tablets, this fact is not a contraindication - a mandatory consultation with a doctor is needed);
• diabetes mellitus (you can use some OK) and so on.

Whether to take birth control pills is a personal choice for every woman. This is a reliable means of contraception, which is convenient to use for those who have an active sex life. At the same time, there are a number of side effects that occur if you choose the wrong remedy. So, the main thing to be guided by when choosing and taking birth control pills is the recommendations of a gynecologist.