Hormonal contraceptives involve the use of estrogen and progestin analogues to prevent unwanted pregnancy. The contraceptive effect is mediated by negative feedback in the hypothalamus, which ultimately leads to a decrease in the pituitary gland's secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Ovulation cannot occur without sufficient LH in the body. Low progestin levels reduce the likelihood of egg implantation by changing the structure of cervical mucus, reducing tubal motility and endometrial proliferation. Today, taking hormonal contraceptives is the most common form of contraception.
Types of hormonal contraceptives
The most famous are oral medications in the form of tablets, but there are other types of medications designed to change hormonal levels in the body. Among them:
- plasters - patches with specialized impregnation;
- injections - injections to prevent fertilization of the egg;
- vaginal rings and intrauterine devices ;
- Implants are hormonal contraceptives that are installed by a doctor in a gynecological office.
In combined monophasic oral contraceptives, the dose of estrogen and progestin remains constant, while in multiphasic preparations it changes during one cycle.
Reduced doses of multiphase OCs reduce some side effects. These include unpleasant symptoms such as breast tenderness, nausea, bloating, bleeding and conditions such as venous thromboembolism. Due to complications associated with taking OCs, their use is contraindicated in patients with severe symptoms of hypertension, coronary heart disease, or a history of stroke.
At the Harmony clinic, experienced specialists receive patients who want to individually select an effective means of contraception. After the examination and examination, the doctor writes out recommendations for preventing unwanted pregnancy. Since the products are selected taking into account the personal characteristics of the patients, the effectiveness is very high, and adverse reactions are minimal.
Task for a pharmacist
All hormonal contraceptives are prescription drugs. They should be prescribed exclusively by a doctor. However, it cannot be said that the role of the pharmacist is limited to reading the prescription and dispensing the drug.
The range of modern hormonal contraceptives, especially oral contraceptives, is very large. Among them there are many generics, and the trend in recent years to increase their range will apparently continue in the future. A pharmacist, looking with a professional eye at a shelf with hormonal contraceptives, must be able to quickly and correctly select the drug according to the international name written in the prescription. Moreover, select according to the financial capabilities of the buyer.
That’s why it’s so important not to get lost in the tricky names of estrogens and gestagens and the equally tricky dosages of hormones. And knowledge about the difficult world of hormonal contraception is a tool in the fight for both the client and the quality of his service.
Review of drugs: the effect of hormonal contraceptives (COCs)
Oral contraceptive pills constitute the most popular group of medications used by modern women to control conception. These drugs are a combination of estrogen and progesterone. They can be prescribed for polycystic ovary syndrome, endometriosis and amenorrhea.
Side effects include the risk of venous thromboembolism, hypertension and liver adenoma. For women over 35 years of age who smoke or have estrogen-sensitive tumors, combined oral contraceptives are contraindicated. The following types of COCs :
- monophasic - each tablet contains the same dose of estrogen and progestin.
- multiphasic —biphasic pills contain a fixed dose of, for example, ethinyl emtradiol and increasing doses of norethindrone, while triphasic pills have varying doses of each component over a standard 21-day cycle.
The indication for the use of this method is not only contraception, but also hyperandrogenism (acne, hirsutism), menstrual irregularities, control of symptoms of endometriosis and leiomyomas. Among the modern pharmaceuticals in this group, the most popular brands can be identified.
Jess
Optimal formula for young women. Since the content of the hormonal component is extremely low, these tablets pose virtually no risk of developing vascular pathologies. Practice has shown that taking hormonal contraceptives of this spectrum is easily tolerated. Adverse reactions from the digestive system rarely occur. Regularly taken tablets guarantee relief from pronounced premenstrual syndrome. They help cope with such complex conditions as hormonal acne and improve the condition of hair and nails. By taking a contraceptive, you will normalize your cycle, reduce heavy bleeding, and regulate your weight.
Novinet
Contains ethinyl estradiol per tablet in the amount of 20 mcg and desogestrel 150 mcg. The medicine has a beneficial effect on the regulation of the menstrual cycle. It has a minimal number of adverse reactions. Like Jess, it is allowed to be taken 21 days after birth if the woman is not breastfeeding.
Janine
Monophasic oral contraceptive with a low dosage of active substances. It has a good antiandrogenic effect, easily eliminates pimples, acne, blackheads and seborrhea from the surface of the body. Normalizes the fat balance of the skin and regulates hair growth.
Lindet 20
The hormone content of these pills is low, which in no way detracts from their effectiveness in preventing unwanted conception. There are virtually no adverse reactions; in rare cases, minor headache and nausea are possible.
Yarina
This is pharmaceuticals at a new level. In addition to eliminating skin problems, Yarina helps to normalize weight and reduce the level of elevated BMI. Reduces the symptoms of PMS.
Side effects
Among the adverse effects of taking the drug, experts note:
- Short-term cycle disturbances: prolongation of menstruation, the occurrence of unscheduled menstrual flow or its complete absence (amenorrhea).
- Formation of ovarian cysts.
- Exacerbation of candidiasis in case of its chronic course.
- The appearance of weakness and nausea in diabetes mellitus.
- The formation of increased oiliness of the skin of the face.
- Breast engorgement and tenderness.
- Increased susceptibility to ultraviolet rays.
- Activation of hair growth on the body.
- The appearance of swelling in the lower extremities.
Mini-pills: a powerful little agent
The next group of drugs is progestin-only hormonal tablets (mini-pills or mini-pill contraceptives). This is a short-acting, reversible oral contraceptive containing low doses of norethindrone. This is an ideal contraception for women for whom estrogen supplements are contraindicated.
Among them:
- nursing mothers;
- overweight women;
- persons with individual estrogen intolerance and premenopausal women.
Charosetta
The basis of pharmacology of this type is desogestrel (75 mcg). An ideally mild product that is instantly absorbed, forming the biologically active metabolite etonogestrel. The half-life is up to 30 hours. The order of taking the tablets is indicated on the package.
Lactinet
Desogestrel is contained in the same dose as the previous drug. It does not have a negative effect on weight; if selected correctly, it even promotes weight loss. A good option for women undergoing lactation. One of the most common side effects is smearing with blood, which goes away within 3 months from the start of use.
Exluton
Contains linestrenol 500 mcg. Normalizes hormonal balance, has a beneficial effect on a woman’s sensuality and libido. Suitable for use by nursing mothers.
Hormonal patch: stick it on and go
The action of hormonal contraceptives of this kind is really as simple as possible. Externally, this patch is similar to a classic adhesive plaster; it is easily applied to the skin, fixed with a sticky layer and adheres flawlessly, despite clothing and simple hygiene procedures. The advantages of using such a patch are as follows :
- no need to interrupt sex to attach a sticker to your body;
- no need to be examined before use. However, remembering that this remedy is hormonal, you should use it with caution for the first time;
- reduces the flow of menstrual blood in those who suffer from heavy bleeding;
- reduces pain during menstruation;
- The sticker is changed according to the instructions provided by the manufacturer. One patch is applied once a week, this procedure is repeated for 3 weeks. Then 1 week - break;
- after final removal, the woman quickly returns to normal and can plan a pregnancy on the recommendation of a doctor.
Studies have shown that the patches are not inferior to combination oral contraceptives and mini-pills. It is enough to print the product and stick it on the cleansed skin of the shoulder, abdomen or buttocks.
The operating principle of this product is as follows:
- preventing the ovaries from producing eggs;
- thickening of the mucous layer in the cervix, which complicates the penetration of sperm into the organ and makes fertilization impossible;
- thinning of the uterine mucosa, which prevents the introduction of the egg into the endometrial layer.
The use of hormonal contraceptives in the form of patches has shown effectiveness in 91% of cases. Despite the good result, do not forget that the sticker does not provide protection against sexually transmitted infections, and therefore is recommended for use with other protective means. The disadvantage of this method of contraception is that it is noticeable, can become saturated with dust and look untidy on the skin. Not suitable for people with sensitive skin as it may cause irritation.
When should an IUD be removed?
The service life of intrauterine gynecological devices ranges from 1 to 7 years. At the request of the woman or after the time of using them has expired, you need to consult a doctor again to have them removed. Removing the spiral on your own is impossible and is fraught with dire consequences.
Before the removal procedure, the woman is examined in the same way as before the insertion of an IUD. The restrictive rules are the same and are followed during the first week after extraction. Changes in the menstrual cycle are noted only if a hormone-containing IUD was used. The cycle should return to normal within six months. Restoration of reproductive function after removal of the IUD occurs within one year. Although you can plan a pregnancy after two months.
Vaginal ring and injectable progestin
Indications for use are similar to those that accompany oral contraceptives. The vaginal ring is flexible and works through a combination of ethyl estradiol and etonogestrel. Inserted into the vagina, held in place for 3 weeks, and then discarded. After menstrual bleeding caused by withdrawal symptoms, a new ring is inserted and the whole process is repeated.
Injectable progestin is a synthetic form of progesterone. Used for contraception, as well as in the treatment of abnormal uterine bleeding and signs of endometriosis. Available as an intramuscular or subcutaneous injection. It is administered once every three months. Its effectiveness is often higher than that of other contraceptives, up to 94%.
Follow-up with a doctor
If a woman feels well, then a follow-up examination by a gynecologist should be done 10-14 days after the insertion of the IUD. If you experience a high or low-grade fever, severe bleeding and pain, or an unpleasant odor from the vagina, you should immediately run to the doctor.
An examination by a gynecologist is also necessary in the following cases:
- if you feel a spiral in the vagina;
- you suspect pregnancy;
- menstruation did not occur within 4-6 weeks;
- pain and bleeding appeared during sexual intercourse.
If the spiral is installed correctly and the procedure has a good outcome, observation by a gynecologist should be carried out as usual (once a year).
Intrauterine device and subdermal implant
When considering all types of hormonal contraceptives, the intrauterine device (IUD) cannot be overlooked. The small contraceptive device is often T-shaped. A doctor inserts it into a woman's uterus to prevent pregnancy. Non-hormonal IUDs and hormonal modifications are available
The material from which these contraceptives are made is varied. It can be plastic, copper, silver and even gold. The price of intrauterine devices varies widely. These are long-term monitoring devices that can remain in place for 3-5 years or more. It all depends on the type and brand. The efficiency is very high and is 99% . As for the implant, it is inserted subcutaneously into the forearm area and is effective for 3 years. The principle of action is the same, due to the content of progestin.
Price for the best drugs from this group
The price of contraceptives belonging to this group varies depending on the manufacturer and the number of blisters in the package.
Names of the most common mini-pill drugs and their prices:
- Charozetta from 700 rubles;
- Primolut-Nor from 150 rubles;
- Micronor from 150 rubles;
- Ovret from 400 rubles;
- Lactinet from 500 rubles;
- Exluton from 1300 rubles.
Find out more about how combined oral contraceptives work and how to take them correctly.
Will the drug Ginekol help with fibroids and endometriosis? Read what doctors say about it at the link.
What is nymphomania in women: .
Emergency methods of contraception
The general classification of hormonal contraceptives contains one more name. This is an emergency contraception technique that involves a small disruption in the body to prevent conception. As a rule, the drug is produced in the form of one, less often two, tablets. Effective in case of unprotected sexual intercourse if taken within 48-72 hours of sexual intercourse. The earlier the tablet is taken, the higher its effectiveness. Due to a large dose of hormones, the cycle changes. Not recommended for frequent use.
Indications for immediate cessation of hormonal contraceptive use
- sensory disorders, visual impairments;
- migraines, frequent headaches;
- epileptic seizures;
- detection of tumors of unknown etiology;
- growth of uterine fibroids;
- jaundice, pregnancy, suspected thrombophlebitis.
Studies have shown that taking hormonal contraceptives in premenopausal women increases the risk of developing cervical cancer, but reduces the likelihood of endometrial and ovarian cancer. To choose the most suitable method of contraception, make an appointment at the Harmony clinic. We are located at: Rostov-on-Don, st. Krasnoarmeyskaya, 170 (2nd floor).
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Preparing for insertion of the IUD
Before installing a gynecological spiral, you need to be examined in detail by a gynecologist. Diagnostics includes:
- gynecological examination with taking smears to determine the degree of vaginal cleanliness and oncocytology;
- examination of the mammary glands;
- general blood analysis.
At the time of the procedure, the woman should not have inflammatory or other diseases of the female genital area that could cause complications. All pathological conditions are first treated, and then, after a follow-up examination, the gynecologist decides whether to insert an IUD or not.
If you can still use this method of contraception, then immediately the day before the insertion procedure you should stop using intimate hygiene products and sexual intercourse.
