Almost every woman has felt the need to use contraceptives at least once in her life. And during such a period, many questions arise, namely, which contraceptives to choose, how to take them, whether there are side effects, and much more. Let's look at all the features of birth control and figure out which pills are best to take at a certain age.
Groups of contraceptives for women
The pharmacological market currently offers a wide range of drugs to prevent pregnancy. All of them are divided into the following groups:
- Combined oral contraceptives are based on hormones similar to the action of estrogens, these are progestogen and ethinyl estradiol. There are two-, three- and monophasic drugs.
- Mini-drink. Contains exclusively progestogen. The principle of action is a local effect on the peripheral zones of the reproductive organs. As a result of taking such drugs, there is a change in the biochemical and morphological parameters of the endometrium, so the development of the fertilized egg does not occur. In most women, the ovulation process is suppressed. Effective representatives: Microlut, Laktinet, Exluton, Charozetta.
COCs are divided into 3 groups based on the active substance content in the tablets:
- Monophasic - contain a low level of hormones. Therefore, they are recommended for use by young girls who have not given birth before. And for people who are encountering contraceptives for the first time, such medications will be the most suitable.
- Biphasic - prescribed to young and middle-aged women, especially relevant in the postpartum period. These pills should be taken by those who experience discharge while taking microdosed contraceptives. These drugs have an antiandrogenic effect, therefore they have a positive effect on the skin and prevent unwanted hair growth. These include: Regulon, Marvelon, Siluet.
- Triphasic - characterized by a high content of female hormones. They are prescribed for some gynecological diseases and to restore hormonal levels. Representatives: Trikvilar, Ovidon, Trizeston.
Each age has its own productive range of drugs.
Up to 20 years old.
The most crucial period. The choice of contraception before the age of 20 should be taken very seriously, since the wrong choice can negatively affect the further development of the body. It is not recommended to take the drugs for girls whose height is below 160 cm, who do not have regular sex life, as well as for those girls who had their first menstruation earlier than 2 years ago. As a rule, these are drugs containing a minimum amount of estrogens - low-dose or micro-dose, for example:
- Logest - find out the price,
- Marvelon - find out the cost,
- Femoden - find out the price,
- Jess - find out the cost.
20-30 years
In this age category, the female body is already fully formed. The use of high-dose contraception is recommended. Low-dose products are recommended for use by girls with high progesterone levels.
Over 30
For those women who have already had experience of childbearing, low-dose drugs will be optimal; it is also recommended to use single-phase drugs at this point.
Over 35
Since at this age, the level of hormones decreases, hormonal imbalances appear more often, and also at this age, most representatives of the fair sex do not plan to give birth and therefore microdosed products or mini-pills should be used during this period.
Over 40
Contraception for women over 40 years of age is necessary. Since in this age category there is a risk of fetal abnormalities, as well as other complications. In particular, single-component drugs are used, which provide maximum protection, although they have some side effects.
How to choose the right birth control pills
In no case is it recommended to choose and start a course of taking contraceptives on your own. This should only be done by a doctor.
Before prescribing a contraceptive method, the specialist collects the patient’s medical history, takes into account the presence of any diseases in the present or future and pays attention to the individual characteristics of the body.
The next stage is a complete examination of the woman, the doctor evaluates the constitution, body weight, skin condition and blood pressure level. Additionally, he prescribes instrumental and laboratory tests, it is especially important to conduct ultrasound and mammography.
Also, when choosing contraceptives, be sure to take into account:
- Breasts, their shape and structure.
- Type of hair growth on the genitals.
- Growth.
- Health status of skin and hair.
- Peculiarities of the flow of menstruation.
- Presence of chronic diseases.
The benefits of oral contraceptives
Some diseases and conditions of the female reproductive system are associated with hormonal imbalance: cysts, polyps, irregular cycles. There are other problems that cause significant discomfort to women, such as acne (this is the result of an excess of androgens, that is, male sex hormones). In such cases, the use of OK is advisable.
For such problems, therapy involves short-term use of oral contraceptives. For example, for the treatment of acne or polyps, the course is 1 month. To normalize the cycle, birth control pills are taken for 1–3 months.
How to take birth control
The nature and rules for taking COCs are specified in the instructions for the drug. This information can also be obtained from your doctor.
As a rule, the package includes a blister of 21 tablets, but there are exceptions. Taking the drug should begin at the start of menstruation and continue daily until the tablets run out. Afterwards, it is important to take a break for 7 days and resume taking it again.
If a dose is missed for some reason, you should immediately take the pill.
For more reliable protection against pregnancy, you need to use condoms.
What kind of hormonal pills are there?
Classification of hormonal contraceptives depending on the method of use:
• combined estrogen-gestagen contraceptives: • oral contraceptives; • vaginal rings; • transdermal patches; • progestin contraceptives: • oral contraceptives containing microdoses of gestagens (mini-pills); • injection; • subcutaneous implants.
Combined oral contraceptives (COCs) are birth control pills containing estrogen and progestogen components.
Based on the level of ethinyl estradiol, hormonal tablets are divided into:
- high-dose (more than 35 mcg; currently not used for contraceptive purposes),
- low-dose (30-35 mcg) and
- microdosed (20 mcg).
In addition, COCs are monophasic, when all the tablets included in the package have the same composition, and multiphase (biphasic, triphasic), when the package, designed for a cycle of administration, contains two or three types of contraceptive tablets of different colors, differing in the amount of estrogenic and gestagenic components. Stepped dosage causes cyclic processes in the target organs (uterus, mammary glands) of a woman, reminiscent of those during a normal menstrual cycle.
Rice. 1. The mechanism of contraceptive action of COCs.
Taking birth control pills
The rules for taking hormonal contraceptive pills are as follows. COCs are started to be taken from the 1st day of the menstrual cycle: 1 tablet daily at the same time of day for 21 days (as a rule, the drug package contains 21 tablets).
Just like a regular tablet, simply place it in your mouth and swallow. You must take the pill at the same time every day, regardless of whether you plan to have sexual intercourse or not. Forgetting to take the pill means weakening the effect of the contraceptive, which, as a result, increases the risk of an unplanned pregnancy. It should be remembered that multiphase drugs must be taken in a strictly specified sequence. Then they take a 7-day break, during which a menstrual-like reaction occurs, after which they begin a new cycle of administration. When performing an induced abortion, including medical termination of pregnancy, you can start taking COCs on the day of the procedure. If a woman does not breastfeed, the need for contraception arises 3 weeks after birth.
If you miss taking one or more tablets or start taking them late, you should read the instructions for use of the contraceptive. If in doubt, you should consult your doctor for advice.
If it is necessary to delay menstrual-like bleeding, you can not take a break in taking the drugs, continuing to take the tablets of the next package (for multiphase contraceptives, only the tablets of the last phase are used for this).
☺ ADVANTAGES OF USE:
• reduction in the risk of developing ovarian cancer (by 45-50%), endometrial cancer (by 50-60%), benign breast diseases (by 50-75%), uterine fibroids (by 15-30%), postmenopausal osteoporosis (increased mineralization of bone tissue), colorectal cancer (by 18%);
• reduction in the incidence of inflammatory diseases of the pelvic organs (by 50-70%) as a result of increased viscosity of cervical mucus, ectopic pregnancy, retention formations (cysts) of the ovary (up to 90%), iron deficiency anemia due to less blood loss during menstruation;
• weakening of PMS symptoms and menstrual pain;
• good therapeutic effect for acne, seborrhea, hirsutism (for the best third generation birth control pills), for endometriosis, uncomplicated ectopia of the cervix (for three-phase COCs), for some forms of infertility accompanied by ovulation disorders (“rebound effect” in the first months after stopping taking oral contraceptives);
☹ NEGATIVE SIDES
Rice. 2. Degrees of risk of vein thrombosis when taking hormonal pills
Side effects
Taking medications to prevent pregnancy may cause the following side effects:
- Headache, dizziness.
- Weight gain.
- Cessation of menstruation.
- Swelling of the limbs.
- Breast pain.
- Flatulence.
- Disorders of the skin.
- Nausea.
- Decreased appetite.
- Profuse bleeding.
- Pressure changes.
- Disturbance of consciousness.
- Allergic reactions.
- Heavy breathing.
If such symptoms occur, the use of tablets should be stopped.
Is it worth taking a break from hormones?
At the dawn of the use of hormonal contraceptives, they contained large amounts of hormones (50 mcg or more). Long-term use of such drugs suppressed the work of the ovaries, and in order for the ovaries not to “forget” how to work, a break was taken from taking the pills for 6–9 months. Now this need has disappeared: most manufacturers have managed to significantly reduce the dosage of hormones. While taking COCs, the physiological processes of follicle maturation continue in the ovaries, preserving the most genetically complete eggs until the drug is discontinued. So it is possible to take birth control pills without interruption for as long as there is a need for contraception [2].
“Pauses” in taking oral contraceptives without the consent of a doctor are fraught with disruption of the hemostatic system, lipid and carbohydrate metabolism. In addition, an unplanned pregnancy may occur.
Contraindications for contraception
Contraindications to the use of any group of contraceptives are:
- Breastfeeding.
- Diseases of the cardiovascular system.
- Pregnancy.
- Kidney diseases.
- Oncological processes in the body.
- Overweight.
- Severe form of hypertension.
- Liver pathologies.
- Diabetes mellitus.
- Preparation for surgery.
- Uterine bleeding of unknown origin.
Combination oral tablets
The body produces two types of female hormones: estrogen and progesterone. Combined oral medications contain similar hormones, but of artificial origin.
Ethinyl estradiol is used instead of estrogen, and progesterone is replaced with levonorgestrel. The clinic works with patients with different hormonal levels. Gynecologists will make a competent selection of the optimal drug.
Monophasic contraceptives
One package contains tablets that are enough to take daily for one or even several months. Progestogen and estrogen are contained in proportions, the value of which is constant. There are: Diana-35, Mercilon, Regulon, Novinet, Rigevidon, etc. Which of them to choose, the gynecologist-endocrinologist at the SM Clinic will tell you based on the test results and prescribe special treatment.
Biphasic agents
In tablets, the amount of gestagen varies depending on the period of the menstrual cycle. During the first half, you take tablets of one color, and in the second, a different color. Such means include Antevion.
Three-phase drugs
This group has fewer negative indications, since the doses of estrogen and progestogen are strictly regulated depending on the phase of the monthly cycle. In each of the three periods, the girl takes contraceptives, colored in three colors.
Thus, an optimally balanced ratio of hormonal substances is achieved, and there is minimal harmful effect on the girl’s body. They are prescribed after 35 years.
Overweight girls who smoke can safely take drugs from this group. These include Tri-regol, Tri-mercy, Triziston, Trimercy. It is worth noting that all tablets begin with the prefix “Three”.
Mini-pill
Side effects from taking such drugs containing only gestagen or progestin are minimal, so it is often prescribed to nursing mothers with cardiovascular diseases, diabetes, and congenital heart disease.
After taking them, the mucus in the vagina thickens and becomes viscous, the mucous membrane of the uterine cavity changes, as a result of which the egg traveling through the ovary cannot be implanted. Progestin contains: Exluton, Charozetta, etc.
Birth control pills for women over 40
For women who have crossed the age limit of 40 years, it is necessary to use contraceptives with small doses of the active substance and take into account all individual characteristics.
As contraception you can use:
- Janine.
- Novinet.
- Divina.
- Microlute.
- Excluton.
- Trisiston.
- Silest.
The above medications should be used after consultation with a specialist. It is important to follow the dosage and administration regimen, excluding any omissions.
Types of contraceptives
Drugs that can help prevent conception are:
- hormonal direction;
- non-hormonal.
Hormonal pills, in turn, are distributed into:
- oral;
- mini-pill.
Oral medications are taken orally daily to achieve maximum effect. These contraceptives contain different amounts of hormones. While some women can take pills with large amounts of hormonal substances without consequences, for others certain contraindications are identified. They are divided into:
- Monophasic;
- Two-phase;
- Three-phase.
A woman who has been taking COCs for a long time then cannot get pregnant - is this a myth or true?
The so-called “ovarian sleep”, or hyperinhibition syndrome, is reversible [6]. There is no reliable data yet that would prove that a woman taking oral contraceptives has a reduced supply of eggs. Moreover, hormonal therapy is used to treat infertility, because after discontinuation of the drug and recovery, the ovaries work more actively. Taking birth control pills in the past does not affect the course of pregnancy and fetal development. In most cases, the risks and side effects of taking hormonal contraceptives are significantly lower than those of terminating an unwanted pregnancy.
Sources
- World Health Organization, Medical eligibility criteria for contraception. 2015 // https://www.who.int/publications/i/item/9789241549158
- JJ Speidel, CC Harper, WC Shields, The potential of long-acting reversible contraception to decrease unintended pregnancy // Contraception. 2008 Sep;78(3):197-200 // https://pubmed.ncbi.nlm.nih.gov/18692608/
- Z. Pastor, K. Holla, R. Chmel, The influence of combined oral contraceptives on female sexual desire: A systematic review.// The European Journal of Contaception &Health Care. 2013; 18 // https://www.tandfonline.com/doi/abs/10.3109/13625187.2012.728643?journalCode=iejc20&
- N. Wentzensen, A. Berrington de Gonzalez, The Pill's gestation: from birth control to cancer prevention. // Lancet Oncology. 2015 Sep; 16(9):1004-6 // https://www.sciencedirect.com/science/article/abs/pii/S1470204515002119?via%3Dihub
- R. Burkman, J. Schlesselman, M. Zieman, Safety concerns and health benefits associated with oral contraception. // Am J Obstet Gynecol. 2004 Apr; 190(4 Suppl):5-22 // https://pubmed.ncbi.nlm.nih.gov/15105794/
- T. Girum, A. Wasie, Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. // Contracept Reproad Med. 2021 Jul;3:9 // https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055351/
Pharmacological educational program
Vaginal contraceptive pills are classified as local contraception and act locally, i.e. only at the injection site, without being absorbed into the systemic circulation. Contraceptive properties are due to the spermicides included in the composition.
Spermicides are chemical substances that prevent fertilization due to a destructive effect on sperm.
In addition, the viscosity of the mucus contained in the woman’s genitals increases, thereby complicating the further movement of sperm.
Another pharmacological effect that such drugs have is antiseptic. Thanks to its activity against pathogenic microflora (fungi, viruses and bacteria), it prevents the likelihood of certain infections that can be sexually transmitted.
The Russian pharmaceutical market offers nonoxynol and benzalkonium chloride as spermicides, produced by domestic and foreign pharmaceutical companies.
How to use vaginal contraceptives correctly
- First remove the tablet from the polymer packaging or remove it from the tube;
- Lie on your back and insert the tablet deep into the vagina;
- Wait for the time for the drug to become active (from 3 to 10 minutes) - this time can be devoted to mutual caresses;
- After sexual intercourse, toileting of the external genitalia is allowed. The introduction of water and other solutions is unacceptable, because this neutralizes the effect of spermicides;
- For repeated sexual intercourse, you need to insert another suppository (one tablet is designed for one sexual act).
Scheme: Method of inserting contraceptive vaginal pills (finger or applicator)
Remember!
Inserting the pill after sexual intercourse is not effective and can lead to pregnancy
If sexual intercourse lasts more than one hour, repeated administration is required.
To reduce possible dryness during use, the tablet can be pre-moistened with water.
Price for emergency contraception
Cost of the best contraceptives “after the act”
| Basic services | price, rub. |
| Consultation with a doctor on emergency contraception | 2 500 |
| Install a spiral (without product cost) | 5 000 |
| Tablets 72 hours Zhenale (including specialist consultation) | 3 500 |
| Contraceptive Ginepriston (including doctor's appointment) | 3 500 |
| access_time Make an appointment with a gynecologist-endocrinologist | |
| Find out more on the topic: | ||
| Genale | Gynepristone | Postinor |
