Which contraceptives are better to choose after 40 years: rating of the best contraceptives

Mini-pill

The main feature of the mini-pill is that this drug contains a small dose of hormones and does not harm the body. You can take mini-pills until the onset of menopause.

No. 4. Lactinet

An oral contraceptive provides a greater degree of protection against pregnancy. The drug is prescribed by gynecologists; tablets can only be taken in strict accordance with the regimen.

pros

• favorable price when compared with other drugs of similar effect;
• low dose of hormones.

Minuses

• it is necessary to strictly follow the schedule of taking pills;
• possible side effect in the form of mood swings;
• a large list of side effects, consultation with a doctor is necessary.

No. 3. Microgynon

Country of origin: Switzerland. The package contains 21 tablets - for a full cycle. It is necessary to take the drug every day (except during menstruation), at the same time, according to the regimen prescribed by the doctor. If the drug is chosen correctly, it does not cause serious hormonal changes in a woman’s body, for example, there is no significant weight gain or impact on appetite or quality of sleep. An important nuance to consider is that Microgynon is not recommended for women suffering from varicose veins.

pros

• low price compared to similar drugs;
• a small amount of hormones in the composition;
• prescribed by a doctor for the treatment of certain chronic diseases;
• protection against unwanted pregnancy.

Minuses

• a large list of contraindications;
• not suitable for varicose veins.

No. 2. Charosetta

Charozette is a medication that suppresses ovulation. Some gynecologists consider it one of the safest contraceptives. In order for the drug to be most effective, it must be taken strictly according to the instructions. According to studies, taking Charozetta tablets provides a 99.6% guarantee that pregnancy will not occur. Before starting to take the drug, it is recommended to discuss all the details with your doctor and receive detailed instructions that will take into account all the individual characteristics of a woman’s cycle.

pros

• the drug does not affect the quality of breast milk;
• suitable for women over 40 years of age;
• high efficiency;
• may have a positive effect in the treatment of certain female diseases.

Minuses

• presence of contraindications;
• incompatibility with some other drugs;
• side effects such as changes in menstrual patterns;
• not permissible in the presence of varicose veins.

No. 1. Exluton

The tablets must be taken according to a simple regimen prescribed by the doctor. In total, the package contains 28 tablets - for one cycle. In order for the drug to act most effectively, it is necessary to choose one time for taking it and follow it regularly. To ensure that the effectiveness of the product remains high throughout the course, it is recommended not to skip taking pills. If unpleasant sensations occur, for example, nausea that does not go away for 2-3 days, you need to choose another drug.

pros

• allowed during lactation with the approval of a gynecologist;
• high degree of protection against pregnancy;
• Can be used after 35 years;
• favorable price;
• do not increase blood pressure;
• suitable for the treatment of endometriosis.

Minuses

• pigment spots may appear on the skin;
• bloody discharge may occur;
• Side effects include nausea or vomiting, decreased mood.

Combined oral contraceptives (COCs)

COCs are combined oral contraceptives; doctors most often prescribe these drugs for the treatment or correction of serious pathologies caused by disruption of the hormonal system. Such medications are not used as protection against pregnancy unless indicated, however, they reliably protect against unwanted conception. COCs can be used only if indicated and on the recommendation of a doctor, in order to avoid disruption of the endocrine system.

No. 5. Silest

Silest tablets are a combined hormonal oral contraceptive, one of the main actions of which is protection against unwanted pregnancy. Silest differs from other drugs with similar effects in that it contains Norgestimate, a drug with high hormonal activity. The drug is prescribed by gynecologists for the treatment of certain female diseases, as well as for cycle correction. One blister contains 21 tablets - for one menstrual cycle.

pros

• a correctly selected drug does not cause negative consequences;
• it is possible to treat diseases such as polycystic ovary syndrome;
• high efficiency.

Minuses

• high price;
• a large list of side effects;
• can have a strong impact on the functioning of the body;
• must be selected individually by a doctor.

No. 4. Triquilar

Triquilar tablets for protection against unwanted pregnancy are produced by the company Ynepharm, in Germany. The main components of the drug are ethinyl estradiol and levonorgestrel. The package of tablets is designed for 21 days. One of the main advantages of the product is the reduction of painful menstruation. The tablets are suitable for women over 40 years of age and can have a positive effect on the body.

pros

• convenient calendar for tracking pill intake;
• detailed instructions;
• favorable price;
• small amounts of hormones;
• many positive effects.

Minuses

• possible decrease in libido;
• presence of contraindications.

No. 3. Regulon

In some cases, doctors prescribe Regulon tablets not only to protect against unwanted pregnancy, but also to treat certain diseases. Regulon is highly effective and works no worse than other expensive drugs. Its main advantage is a small amount of hormones and a slight effect on weight. During the first 2 days of use, nausea may persist, which soon disappears.

pros

• no weight gain;
• hair condition improves;
• high efficiency, protection against pregnancy;
• favorable price.

Minuses

• Despite the fact that the amount of hormones is not large, they have an effect on the body.

No. 2. Marvelon

Marvelon is one of the drugs that is most often prescribed to women aged 40+. Manufacturer: Organon (Ireland). It protects well against unwanted pregnancy, and is also used to treat some chronic diseases. In the first days after you start taking it, you may experience some discomfort, but if it goes away after a while, you can continue taking it.

pros

• the negative effect of hormones is minimal compared to other drugs;
• helps in the treatment of some female diseases;
• aligns the cycle;
• Suitable for women over 40 years old.

Minuses

• high price;
• presence of contraindications;
• It is unacceptable to use in the presence of varicose veins, migraines, cancer and many other diseases.

No. 1. Janine

Zhanine tablets are manufactured in Germany by Bayer. One package contains 21 tablets - for a full cycle. The main advantage is convenient marking by days of the week.

pros

• convenient blister marking;
• high degree of protection against pregnancy;
• sold in all pharmacies without a prescription;
• often recommended by gynecologists;
• does not affect weight provided the diet is followed.

Minuses

• possible negative impact on the cardiovascular system;
• The tablets can only be taken as prescribed by a doctor.

COC for PCOS

PCOS or polycystic ovary syndrome is one of the indications for the use of combined oral contraceptives. They help restore the menstrual cycle, as well as eliminate dermatological diseases.

With the hyperandrogenic phenotype of PCOS, it is preferable to use products containing progestins with antiandrogenic properties. These include:

• HMA;
• desogestrel;
• cyproterone acetate (CPA);
• drospirenone.

But with PCOS, it is extremely important to follow a diet, since the main trigger for its development is insulin resistance. It is found in 44-80% of patients with diagnosed PCOS, and in the presence of obesity - in 95% of patients. Therefore, without correcting the diet and lifestyle, it is impossible to achieve lasting positive results during the course of the disease, even while using COCs. With this diagnosis, it is recommended to sharply limit the consumption of foods with a high glycemic and insulin index, i.e., switch to a low-carbohydrate diet. The following are prohibited:

• flour prepared on the basis of white flour;
• all types of sweets and sugar;
• polished cereals, in particular white rice;
• vegetables high in carbohydrates, especially potatoes;
• sweet fruits and dried fruits.

Low-calorie and low-carbohydrate diets should not be confused, although they have common features.

What to consider when choosing birth control pills for a woman over 40 years old

According to numerous studies, it has become known that menopause occurs in women aged 45 to 55 years. Before menopause, a woman who is sexually active has every chance of becoming pregnant. To prevent this, you can consult your doctor for a prescription for oral contraceptives, however, there are several important nuances that must be taken into account:

• any oral contraceptives are chosen only in consultation with a gynecologist. If you choose the remedy yourself, you can greatly harm the body;
• Not all contraceptives are suitable for women over 40 years of age - this must be taken into account when choosing;
• The drug is taken according to a strictly prescribed regimen. To avoid unpleasant consequences, you need to prepare to not miss a single day and follow the schedule.

Pharmacies sell several types of oral contraceptives, and the cost starts from 200-300 rubles and can reach up to 3,000 thousand per package. When choosing pills, it is also worth considering that you will have to take them for more than one month, so it is also important to consider financial capabilities.

It is important to remember that for frequent migraines, varicose veins, excess weight, heavy bleeding and depression, it is recommended to choose another remedy, on a non-hormonal basis.

How to choose oral contraceptives?

The use of birth control pills can have many nuances, and above we have listed only a few of them. Before prescribing a particular drug, a woman’s medical history is collected (survey) and a possible susceptibility to diseases at risk is determined. Contraindications must also be taken into account.

Among the general criteria, doctors may look for the following signs:

• whether there is excessive hair growth on the body;
• whether there are signs of androgen excess;
• what condition is the skin in?
• what is the condition of the mammary glands;
• Are there any diseases of the pelvic organs?

Oral contraceptives contain varying dosages of hormones. Therefore, the most important criterion when choosing a drug will be the tendency of the woman herself to predominate in estrogens or androgens.

Disadvantages, side effects and contraindications of oral contraceptives

It must be remembered that taking hormonal drugs is still an intervention in the natural processes of hormone production. Women's health is a very delicate mechanism that requires delicate handling. The constant supply of hormones from the outside can change the functions of the ovaries. Suppression of ovulation, disruption of uterine function, and egg production are the real consequences of taking them. Such changes can lead to bleeding, dark discharge in the middle of the cycle, and increase the risk of cancer during menopause.

Headaches and migraines often occur while taking COCs. Women who smoke or 4 weeks before surgery should not start taking hormonal medications. A history of acute mononucleosis and sickle cell anemia are also relative contraindications, as is a history of breast cancer (even if it is in remission)1.

Regarding diseases, it is worth explaining. There are a number of diseases in which the use of OCs can lead to disastrous consequences. The list of such diseases with absolute contraindications for taking OCs includes:

• thrombosis and angina pectoris;
• strokes and ischemic diseases, even past ones;
• migraine;
• diabetes with complications;
• pancreatitis;
• various liver diseases;
• high degree of obesity.

A complete list of contraindications can be found in the instructions for the individual drug.

How to take oral contraceptives

To achieve an effect already in the current month, OK can be used from the first day of the next menstrual cycle. If it was decided to start taking it later (from the second to the sixth day of the cycle), then the contraceptive pills are combined for another 1-2 weeks with other methods of contraception (condoms). After the 6th day of the cycle, you can no longer expect a quick result - you must continue to use protection for a month, since the result of the contraceptive pill for a woman will not be guaranteed in the current cycle, and she may become pregnant.

To achieve a stable and high-quality effect, you must strictly adhere to the dosage schedule described in the specific instructions for the drug.

The duration of administration depends on the number of tablets in the blister. The drugs, 28 pieces per package, must be taken daily without interruption. When the blister contains 21 pieces, the drug must be taken for 21 days in a row, and then wait 7 days and start a new package.

An important point: if the rules for taking OCs are violated and menstruation does not occur after 7 days (provided you start taking it on the 1st day of the cycle), you must take a break and make sure that pregnancy does not occur.

The decision to cancel or continue the course is made by a specialist. Independent breaks and “rest” from contraceptive pills in women lead to additional stress on the body and undesirable consequences.

Womenfirst

• Savelyeva, G. Gynecology. National leadership / Ed. G.M. Savelyeva, G.T. Sukhikh, V.N. Serova, I.B. Manukhina, V.E. Radzinsky // M.: GEOTAR-Media, 2021 - 2nd ed. — P. 1048.
• Serov, V. Guide to outpatient care in obstetrics and gynecology / Ed. V.N. Serova, G.T. Sukhikh, V.N. Prilepskoy, V.E. Radzinsky // M.: GEOTAR-Media, 2021 - 3rd ed. — P. 1136.
• Sumyatina L.V. Modern hormonal contraceptives: new options for choice / L.V. Sumyatina // Problems of reproduction - 2014 - No. 6 - pp. 46-48.
• Radzinsky, V. Obstetrics. Gynecology. Infertile marriage. Clinical pharmacology / Ed. V.E. Radzinsky, R.N. Alyautdina // M.: GEOTAR-Media, 2021 - P. 672.

RUS2124800-2 from 03/20/2020