Oral contraceptives: harm or benefit? Gynecologist answers questions

*Review of the best according to the editors of expertology.ru. About the selection criteria. This material is subjective in nature, does not constitute advertising and does not serve as a purchase guide. Before purchasing, consultation with a specialist is required.

Hormonal contraceptives still have a bad reputation among Russian women and, oddly enough, among some doctors. In fact, 60 years ago, when such contraceptives first appeared, they contained huge, by modern standards, dosages of hormones and caused many serious complications. But let us remind you once again, more than half a century has passed since then. The composition of birth control pills has changed, the amount of hormones in the drugs has decreased tenfold, but prejudices remain.

Meanwhile, modern hormonal contraceptives are not only harmless when used correctly, but can also significantly support women's health. It has been proven that when taking birth control pills regularly:

1. the risk of mastopathy is reduced,
2. Reduces the likelihood of endometriosis:
3. the amount of blood loss during menstruation is reduced, and, therefore, the likelihood of developing anemia, which affects 10% of Russian women of childbearing age;
4. the severity of premenstrual syndrome decreases,
5. menstrual migraines become less frequent,
6. the likelihood of developing “female” inflammation decreases,
7. less risk of ectopic pregnancy
8. the risk of endometrial, ovarian, and colon cancer is reduced,
9. In perimenopausal women, the development of osteoporosis slows down.

Some birth control pills can normalize the normal balance between female and male sex hormones and are successfully used to treat acne (pimples) - we will talk in more detail about such remedies in the relevant sections of the rating.

Overall, regular use of hormonal contraceptives reduces the risk of death from gynecological cancer by 29%, according to an observational study that followed the health of 46,000 women over 39 years.

For women over 30 years of age, there are no special restrictions on taking contraceptives: they can be taken until menopause. But the older a woman is, the more diseases she has, and some of them may become a contraindication to taking contraceptives.

How to choose birth control pills

In popular Russian-language articles you can often find the statement: in order to choose the right hormonal contraceptives, you must do a lot of tests, including expensive hormonal profile studies.

WHO experts categorically disagree with this opinion, whose methodological recommendations state that if, according to the anamnesis (translated into Russian - after a conversation with a doctor), no contraindications have been identified, then we can safely recommend any of the modern low-dose and micro-dose birth control pills. Indeed, no analysis, no study of hormonal levels can predict possible side effects or prevent their occurrence. Therefore, selecting a drug by trial and error (these pills didn’t work - let’s try others) is normal practice. However, do not forget that with most birth control pills, adverse effects decrease after 2 to 3 months of use.

But since the article is about women over 30 years old, the age when various chronic diseases begin to appear, it is wise to undergo examinations to detect contraindications to the use of hormonal contraceptives:

1. Measure blood pressure, ideally twice a day for a week, or at least 2-3 times with an interval of several days.
2. Get a mammogram to rule out breast cancer.
3. Get a Papanicolaou smear (Pap test) to rule out cervical cancer.

Considering modern Russian realities, and the extreme dislike of partners for barrier methods of contraception, we would also recommend getting tested for the human papillomavirus, since it increases the likelihood of developing cervical cancer, and while taking hormonal contraceptives, this process accelerates (but COCs themselves , we remind you again, the risks of cancer do not increase).

Otherwise, when choosing birth control pills, it is enough to be guided by common sense and financial capabilities:

1. “ordinary” women without health problems and with normal skin can use any micro-dosed modern drug;
2. if there are signs of excess androgens: excess hair growth, oily hair, oily skin with acne, it is better to choose a product with an antiandrogenic effect.
3. if there are contraindications to taking COCs, check whether you can take progestin-based contraceptives and use them.

Proposals circulating on the Internet to divide women into “estrogen”, “progestin” and “balanced” types based on appearance and, based on this, choose a drug, have nothing in common with modern recommendations for the prescription of hormonal contraceptives.

Hormonal contraception in Russia

Today, 85% of Russian women use various methods of contraception to prevent unwanted pregnancy. Condoms are the most popular. They were chosen by 45% of women. Oddly enough, it was KOC that came in 2nd place. They are accepted by 30% of women surveyed. The last place in the ranking of popular contraceptive methods is interrupted coitus, which in general cannot be classified as such. But this method of avoiding pregnancy is chosen by about 23% of respondents.

This situation inspires hope in the hearts of gynecologists, since almost a third of women choose the most reliable method of contraception existing today - COCs. It was noticed that they are preferred mainly by young girls who are not married and do not yet have children. But it demonstrates their interest in avoiding traumatic abortions and preserving their reproductive health.

However, official statistics from the Ministry of Health of the Russian Federation and pharmacy sales indicators provide more depressing data. According to them, no more than 13% of Russian women use COCs.

Tablets or spiral

With all the advantages of modern birth control pills, they have one significant drawback: you need to remember to take the medicine every day. In addition, many women are still afraid to take hormones. It would seem that in such a situation an intrauterine device would be optimal. But even here there are pitfalls.

A spiral is a foreign body that itself forms aseptic (microbial-free) inflammation in the uterine cavity. And the slightest infection turns the aseptic process into a septic one - with all the ensuing female problems. That is why the IUD is not recommended for women who often change sexual partners (although no methodological manual specifies how many times this change can be considered “frequent”).

The IUD increases blood loss during menstruation. We already mentioned at the beginning of the article. that 10% of Russian women have iron deficiency anemia, and 50% have hidden, that is, not yet clinically manifested, iron deficiency. Increased monthly bleeding may well turn this hidden deficiency into an obvious one.

And one more unpleasant moment: a foreign body - a spiral - disrupts the normal motility of the fallopian tubes, and therefore increases the likelihood of an ectopic pregnancy.

On the other hand, once you install the IUD, you can forget about it for several years; it can be used during breastfeeding, and it is much more economical in cost, given the long period of use.

Effect on insulin sensitivity

In Italy in 2009, studies were conducted on the effect of COCs on the sensitivity of cell receptors to insulin. The effects of contraceptive pills containing low doses of ethinyl estradiol and progestins with antiandrogenic properties (CMA and desogestrel) were evaluated.

Their results showed that when using COCs with CMA for six months, there is no change in carbohydrate metabolism, while lipid metabolism improves. The opposite results were obtained for drugs containing desogestrel. This makes contraceptives containing chlormadinone acetate (CMA) preferable for a wide range of patients as a contraceptive.

At the same time, COCs based on CMA do not lead to weight gain while maintaining the same level of physical activity and nutrition . This was proven by several year-long observations and the results of surveys of more than 2.5 thousand women.

An additional advantage of drugs of this kind is a decrease in the concentration of matrix metalloproteinases. This ensures the prevention of the development of oxidative stress and the progression of endothelial dysfunction, which reduces the likelihood of cardiovascular complications and latent infectious diseases.

Rating of the best birth control pills after 30 years

Brief facts

Modern COCs are highly safe and are the most effective means of contraception. But when prescribing them, it is necessary to take into account a number of criteria, and the doctor must carefully evaluate the indications and possible risks. Particular attention is paid to the patient’s presence of high blood pressure, obesity, diabetes mellitus, migraines, and the presence of blood coagulation diseases in the woman and her blood relatives. Be sure to take into account smoking, which has an extremely negative effect on the condition of blood vessels and the likelihood of complications.

So, COCs can boast the following features:

• The potential benefit significantly outweighs the total risks in patients under 40 years of age.
• Provides a reduction in the risk of developing a number of cancers.
• They increase the risk of thrombotic complications, but it remains at a low level and is almost completely eliminated with proper history taking when the gynecologist selects a contraceptive method. As a result, the likelihood of vascular accidents when taking COCs is many times lower than during pregnancy, air travel, or smoking.
• When planning surgery, the drug should be discontinued at least 4 weeks before surgery. In this case, it is necessary to finish the started course to the end.
• The first use of COCs increases the risk of vascular complications, as does taking rest breaks. The latter are extremely undesirable, and long-term use of drugs for more than 12 months reduces the likelihood of such undesirable consequences and increases the beneficial effect of COCs on the body.
• The occurrence of nausea, rare headaches, acyclic bleeding, and discomfort in the mammary glands during the first months is a normal reaction of the body to the start of taking hormonal drugs.
• The appearance of symptoms of vascular complications should be a reason to immediately consult a doctor.
• Does not protect against STDs.
• Allows a woman to independently control the onset of pregnancy, regardless of the man.

Thus, COCs can bring both tangible health benefits and harm due to incorrect selection or ignoring contraindications. Therefore, it is important to find “your” gynecologist who will help you choose the right method of contraception, and when choosing a COC, he will take into account all the individual characteristics of the patient and select a drug with the optimal type and content of hormones.

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The best combined oral contraceptives

Combined oral contraceptives (COCs) are birth control pills that contain synthetic analogues of 2 types of female sex hormones - estrogens and progestins, imitating the normal hormonal background of a healthy woman. When the active substance of such tablets regularly enters the bloodstream, the body takes it for its hormones and “puts to sleep” the activity of the ovaries, which produce such substances. In this case, the egg does not mature and does not leave the follicle, and if there is no egg, then conception is impossible. If you take combined contraceptive pills strictly according to the instructions, without skipping a dose, then the chance of pregnancy is less than 1%.

It is best to take them in the morning: if for some reason a woman forgets about the pill, she will have another whole day to remember and take the medicine. If the missed pill is discovered the next day, then you need to take two pills at once. If two or more days are missed, you need to take two tablets and continue to take one tablet at a time until the end of the package. If this happened with one of the last 7 tablets in the package, then you just need to start a new pack without taking a break for a week. The effectiveness of contraception is reduced, therefore, if pregnancy is absolutely not necessary, over the next 7 days you need to use an additional method: a condom, vaginal suppositories or cream.

The traditional regimen for using combined contraceptive pills is 21+7, that is, three weeks of continuous use, and a week of withdrawal, during which menstrual-like bleeding occurs. While taking any hormonal contraceptives, real menstruation does not occur, since the ovaries, which regulate the change of female cycles, “fall asleep” against the background of the pills and stop producing hormones. Those discharges that appear in between cycles of taking pills are actually just a signal of a sharp decrease in hormonal levels. Therefore, if suddenly during the break week no bleeding occurs, and the pregnancy test is negative, there is nothing to worry about.

It is curious that 60 years ago, the inventor of birth control pills developed such a scheme of use precisely in order to imitate menstruation - he believed that imitation of a normal female cycle would make it possible to present a new type of contraception in a more positive light and, perhaps, gain approval from the Catholic Church (as is known, The Catholic Church prohibits any type of birth control except the calendar method and coitus interruptus, the most unreliable of all options). The trick failed: Dad did not approve of hormonal contraceptives. But the scheme remained.

Now doctors are gradually moving away from this tradition, seeing nothing wrong with taking COCs for 2-3 months in a row without a break. Moreover, this method increases the reliability of the contraceptive effect. New drugs are appearing, initially designed for 3 months of continuous use. In Russia, only one of these funds has been registered so far, which we will talk about now.

Modell Libera

Rating: 4.9

These contraceptive pills appeared on the market relatively recently: the drug was registered in Russia at the end of 2021.

The product has a non-standard dosage regimen. You need to take pills for 84 days in a row. containing 100 mcg of levonorgestrel and 20 mcg of ethinyl estradiol, then within a week - tablets in which there is no progestin levonorgestrel at all, and the amount of estrogen ethinyl estradiol is reduced by 10 times. At this time, menstrual-like bleeding occurs.

This scheme of use makes the contraceptive effect many times more reliable, even in the event of a one-time missed pill (but it is still not recommended to abuse it). Another advantage is that “periods,” with all the inconveniences that come with them, occur only four times a year.

Since the package is designed for three months of use, these birth control pills may seem relatively expensive - but on a monthly basis they are cheaper than many conventional COCs.

Advantages

• increased reliability;
• low price per month of admission.

Flaws

• No

Novinet

Rating: 4.6

And these contraceptive pills have been known in Russia for more than 15 years and over the past time they have proven themselves well.

Like all the drugs in our rating, Novinet is a microdosed COC. This means that the concentration of hormones in it is extremely low: 0.02 mg (20 mcg) of ethinyl estradiol and 0.15 mg (150 mcg) of the synthetic progestin desogestrel.

The drug is well tolerated with the standard 21+7 regimen; it is not forbidden to take it for 2 months in a row if for some reason you need to avoid bleeding. Many women who take it note a decrease in the amount of inflammation on the skin. Among the unobvious but useful bonuses, the product helps to normalize lipid metabolism, increasing the content of high-density lipoproteins (“good” cholesterol) in the blood, which is important for women after 30 years.

Advantages

• improves skin condition,
• low price.

Flaws

• No.

Logest

Rating: 4.4

Like the previous drug, this one is far from new on our market. Contains: 20 mcg ethinyl estradiol and 75 mcg gestodene.

The peculiarity of these contraceptive pills is gestodene - it has antimineralocorticoid activity. That is, it reduces the effect of the adrenal hormone aldosterone on the body, which causes water retention in the body. Gestodene helps reduce edema, which means that against its background the likelihood of such side effects as swelling and pain in the chest, weight gain, increased blood pressure, and, in fact, edema, is much reduced.

Among the disadvantages, it is worth noting the relatively high cost. Those who cannot afford Logest can use the more budget-friendly analogue Lindinet 20.

Advantages

• time-tested remedy
• prevents water retention in the body.

Flaws

• high price

Zoely

Rating: 4.3

These birth control pills appeared in Russia about 6 years ago. Contains 2.5 mg of nomegestrol acetate and 1.55 mg of estradiol hemihydrate. The molecule of estradiol hemihydrate in chemical structure is one of the closest to natural estradiol among the molecules known today, and nomegestrol acetate is a highly selective gestagen. All this minimizes the likelihood of adverse events.

The regimen for taking this COC is slightly different from the traditional one. Usually, birth control pills are recommended to be taken for 3 weeks in a row, and then take a break for a week. Here the pack contains 24 active tablets containing hormones and 4 placebo tablets, which are needed only to make it easier to count the days.

Because of this, withdrawal bleeding becomes shorter, which replaces menstruation while taking COCs. Often, after six months of use, it disappears completely, which can frighten many young women, but, in fact, there is absolutely no reason for concern.

Advantages

• The hormone molecule is as close to natural as possible.

Flaws

• “menstruation” may disappear,
• high price.

Possible side effects of COCs

In this section of the rating, we have collected only low-dose drugs - that is, tablets containing minimal amounts of hormones. But with all the advantages, birth control pills, like any truly effective medicines, can cause undesirable effects:

1. pain in the mammary glands;
2. headache;
3. spotting bloody discharge;
4. decreased sex drive;
5. mood swings;
6. cholestasis;
7. swelling;
8. increased fatigue.

It must be said that the side effects when taking COCs are most pronounced in the first month and as the body adapts to the hormones, they disappear - usually three cycles are enough. This is especially true for spotting. But sometimes the cause of “spotting” is too low hormone levels. Then you need to look for tablets with a higher ethinyl estradiol content (but not more than 35 mcg).

In any case, it is highly not recommended to stop taking birth control pills in the middle of the cycle; you need to finish the package to the end. But, of course, when it comes to cholestasis, severe migraine or a severe allergic reaction, this recommendation does not apply. In life-threatening conditions, which include the above, you should stop taking the medicine immediately.

Who should not take COCs:

1. pregnant women;
2. nursing;
3. in the first 3 weeks after birth for women who do not plan to breastfeed;
4. smoking women over 35 years old;
5. women who have undergone resection of part of the stomach or small intestine (the active substance simply will not have time to be completely absorbed);
6. with arterial hypertension (BP>140/90);
7. with coronary heart disease, stroke, complicated valvular heart defects;
8. with intermittent claudication;
9. if an operation lasting more than half an hour is planned with subsequent long-term limitation of mobility;
10. with prolonged stay in a wheelchair or paralysis;
11. women suffering from systemic lupus erythematosus with a positive test for antiphospholipid antibodies;
12. for migraines with aura and focal symptoms;
13. women who have had breast cancer or have a mutation in the BRCA1 and BRCA2 genes;
14. women with HIV receiving antiretroviral therapy, as these drugs reduce the effectiveness of COCs;
15. with complicated diabetes mellitus (diabetic angiopathy, neuropathy, retinopathy) or with a disease duration of more than 20 years;
16. with acute viral hepatitis;
17. with complicated liver cirrhosis (ascites, jaundice, encephalopathy, gastrointestinal bleeding);
18. for liver cancer.

As you can see, most of the contraindications are associated with the ability of COCs to increase the likelihood of arterial thrombosis. But such a completely natural condition as pregnancy increases the likelihood of thrombosis by 10 times, and in the first three weeks after birth it increases up to 100 times, while modern COCs increase it by 2–4 times.

Effect on the tendency to develop atherosclerosis

Today, studies have proven that estrogens help reduce cholesterol and LDL levels in the blood and increase the concentration of HDL. All this together leads to a reduction in the risk of developing vascular atherosclerosis, which can further provoke the occurrence of arterial hypertension, coronary artery disease and other cardiovascular complications. But the antiatherogenic effect of estrogens largely depends on their dose and the nature of the progestin component.

Very low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and cholesterol are factors that contribute to the formation of atherosclerotic plaques in artery walls.

Although at the end of the twentieth century, an article was published in the American journal of obstetrics and gynecology that COCs provoke an increase in the concentration of VLDL and, with long-term use, can adversely affect the functioning of the heart and blood vessels. But at that time, the drugs in this group were mainly represented by high-dose ethinyl estradiols. Today, it has been fully proven that modern low-dose drugs are safe in terms of their effect on metabolism . The same fact was recognized by the author of the above article.

A randomized multicenter study was also conducted on the effect of COCs with different types of progestins on lipid and carbohydrate metabolism. Chlormadinone acetate (CMA), levonorgestrel (LNG) and desogestrel were evaluated. With their use, an increase in the concentration of triglycerides and pro-atherogenic lipoproteins was observed, but drugs containing CMA provoked a more pronounced increase in the level of anti-atherogenic HDL. COCs with desogestrel increased the concentration of high-density lipoproteins, which protect blood vessels from the formation of atherosclerotic plaques, to a lesser extent. The LNG-containing drug was disappointing in this regard.

The best pills with antiandrogenic effect

All COCs in one way or another have an antiandrogenic effect - the ability to reduce the influence of male sex hormones on the body, creating a completely artificial hormonal background. But some of them neutralize the effects of androgens more actively than others. It is these tablets that are recommended for conditions of severe hormonal imbalance: increased hair growth (hirsutism), acne, polycystic ovary syndrome. Of course, they are much more in demand among young women, and for teenagers with severe forms of acne or excessively heavy menstruation, they are often prescribed even in the absence of sexual activity. But COCs with an antiandrogenic effect are also necessary for mature women, so we included them in the rating.

Jess

Rating: 4.8

These contraceptive pills compare favorably with other drugs with antiandrogenic effects in their low ethinyl estradiol content: 0.02 mg. Among drugs with a similar effect, there is simply no second one with such a small amount of estrogen - at least in Russia at the time of creating this rating.

Another positive point: the substance drospirenone is used as a progestin in a dosage of 3 mg. Drospirenone is one of the relatively new substances that has not only antiandrogenic, but also antimineralocorticoid effects. That is, not only does it not cause weight gain, which is often feared by women who start taking COCs, but it can also help reduce it. In addition, drospirenone helps normalize the lipid profile of blood serum, which, again, is useful after 30 years of age.

Among the disadvantages, the high price should be noted. Cheaper products with a similar composition are Dimia, Modell Trend.

Advantages

• low hormone levels,
• prevents fluid retention,
• may promote weight loss.

Flaws

• high price.

Yarina plus

Rating: 4.5

This drug is in many ways similar to the previous one - similar active ingredients, but the amount of estrogen is slightly higher (0.03 mg versus 0.02 mg for Jess). On the one hand, this may increase the frequency of adverse events, on the other hand, these drugs, with a slightly higher content of ethinyl estradiol, may be indispensable for women in whom microdose drugs cause spotting in the middle of the cycle. But this is not the main feature of Yarina Plus.

The main benefit of these birth control pills is the addition of folic acid, a vitamin that is responsible for blood formation in adults and the formation of the brain and spinal cord in the fetus. Usually, against the background of long-term use of COCs, the amount of folic acid in the body is disrupted, and before planning a pregnancy it is recommended to take a course of vitamins. With this drug, you can become pregnant immediately after you stop taking birth control pills.

Advantages

• replenishes folic acid deficiency.

Flaws

• high price.

We did not include such a well-known drug as Diane 35 in this rating because of the large amount of ethinyl estradiol (0.035 mg or 35 mcg) compared to other drugs: these birth control pills have been around for many years and in the presence of more modern, low-dose and effective COCs, remember there is no point in talking about him.

Non-hormonal contraceptives

Their second name is spermicides. When she does not have regular sex life, non-hormonal contraceptives will provide her with an excellent service. Their action is of a local nature and their effectiveness is not inferior to hormonal pills, so it is better to choose them from all the available options. Ten minutes before sexual intercourse, 1 tablet should be inserted as deep as possible into the vagina.

There are some disadvantages:

• It is undesirable to use constantly so as not to disturb the sexual microflora. It is worth comparing your condition before and after using the pill;
• It is not allowed to take a bath or shower immediately after sexual intercourse and a couple of hours before it.

But these tablets also have many advantages:

• non-hormonal medications do not cause hormone imbalance;
• they are convenient to use;
• they have almost no contraindications, except for individual sensitivity to certain components that cause allergic pathologies;
• the price of the pills is affordable for most women. New birth control pills can be purchased without a prescription.

The best progestogen-only birth control pills

These hormonal contraceptives contain only analogs of the female hormone progesterone. They are no less effective than COCs, but are much more demanding regarding regularity of use: a delay of even 3 hours in relation to the usual time of use requires additional precautions for at least the next 2 days. When using pure progestins, intermenstrual bleeding appears much more often than when using COCs, and the cycle itself becomes difficult to predict: there are 28 tablets in the package that need to be taken without interruption, and somewhere during this period of time a menstrual-like reaction occurs - or does not come at all .

On the other hand, due to the absence of estrogens, which cause most of the side effects when taking COCs, progestins are safer. They can even be taken during breastfeeding and often this becomes the only available way to avoid too short a break between births.

Charosetta

Rating: 4.7

Sodarzhit 0.075 mg (75 mcg) desogestrel. This is a synthetic analogue of gestagens - hormones that are produced during pregnancy. It does not affect the activity of lactation and penetrates very little into breast milk, so these contraceptive pills can be used during breastfeeding. For women over 30 years of age, the drug may be useful in cases where it is impossible to take combined contraceptives containing both progestins and estrogens - the latter have much more contraindications.

Among the disadvantages, traditionally you will have to indicate a high price. Cheaper analogues: Laktinet, Diamilla, Modell Mam.

Advantages

• few contraindications,
• can be used during breastfeeding.

Flaws

• high price.

Exluton

Rating: 4.2

Another birth control pill that has proven itself for at least a decade. Contains 0.5 mg linestrenol.

The product has many good reviews and is well tolerated, but the picture is spoiled by the very high price (almost 3 thousand per package) in the absence of cheaper analogues.

Advantages

• can be taken by nursing mothers,
• good tolerability

Flaws

• high cost.

Like COCs, progestins can also cause side effects:

1. irregular cycle;
2. nausea;
3. weight gain;
4. acne;
5. headache;
6. mood swings.

Contraindications to the use of progestin contraceptives:

1. pregnancy;
2. arterial thrombosis in the acute phase;
3. cardiac ischemia;
4. stroke;
5. systemic lupus erythematosus with a positive test for antiphospholipid antibodies;
6. breast cancer, including in remission;
7. decompensated cirrhosis of the liver;
8. malignant liver tumor;
9. bleeding from the vagina of unknown origin;
10. taking certain anticonvulsants, antiretroviral drugs (you need to check the instructions), rifampicin.

Contraindications for contraception

Contraindications to the use of any group of contraceptives are:

1. ​Breastfeeding.
2. ​Diseases of the cardiovascular system.
3. ​Pregnancy.
4. ​Kidney diseases.
5. ​Oncological processes in the body.
6. ​Overweight.
7. ​Severe form of hypertension.
8. ​Liver pathologies.
9. ​Diabetes mellitus.
10. ​Preparation for surgery.
11. Uterine bleeding of unknown origin.

The best emergency contraception pills

These birth control pills contain fairly high doses of hormones, so they cannot be used for contraception on a regular basis. But they can be indispensable in emergency situations, such as a broken condom, a mistake during coitus interruptus, or rape.

Technically, in such cases, you can take regular progestin or combined contraceptives containing levonorgestrel - just a few tablets at once, so that the total dose of the hormone reaches 1.5 mg. But if you use a COC for this, the estrogen level will also be extremely high, which can provoke thrombosis and other dangerous complications. Therefore, it is better not to risk it and buy 1 tablet.

Emergency birth control pills are most effective in the first 3 days after unprotected contact, but you can use them for 5 days, although the likelihood of an unwanted pregnancy will increase significantly.

Escapelle

Rating: 4.1

Under no circumstances should these pills be used continuously as contraceptives. This is a means for emergency contraception, situations where unprotected sexual intercourse for some reason happened, but pregnancy and childbirth are not included in the plans.

Contains a high dose of hormones: 1.5 mg levonorgestrel. For comparison: Modell Libera, mentioned at the beginning of the rating, contains 0.1 mg of levonorgestrel, that is, 15 times less. This amount of hormones is needed to inhibit ovulation (the release of an egg from the ovary), if contact occurred in the first half of the cycle, or to make the uterine lining unsuitable for egg implantation. But it is precisely this high content of hormones that is associated with a fairly large number of side effects:

1. vomit,
2. headache,
3. dizziness,
4. pain in the lower abdomen,
5. bleeding.

The drug should not be taken in case of severe liver failure and in adolescents under 16 years of age.

Advantages

• protects against unwanted pregnancy,
• a small number of contraindications.

Flaws

• high probability of adverse events.

Genale

Rating: 4.0

These contraceptive pills contain not an analogue, but a gestagen antagonist: mifepristone in a dosage of 10 mg. The result after use is similar: if ovulation has not yet occurred, it is blocked, and if the egg has already been released and fertilization is possible, the drug causes rejection of the uterine mucosa (approximately the same process occurs during normal menstruation), after which the fertilized egg is not implanted Maybe.

On the Internet you can find the opinion that the drug is not hormonal and therefore safer than Escapelle, but this is fundamentally incorrect - hormone antagonists change the normal background in the same way as their analogues.

In general, reviews of these birth control pills are not bad, and adverse events are rare. But somewhat more often, in comparison with drugs based on levonorgestrel, there are reviews about the ineffectiveness of the drug, even if taken correctly.

Possible side effects:

1. abdominal pain,
2. nausea,
3. vomit,
4. diarrhea,
5. exacerbation of “female” inflammations,
6. headache,
7. weakness.

Contraindications for use:

adrenal insufficiency, renal or liver failure, use of glucocorticosteroids, anemia,

porphyria, bleeding disorder.

Possible analogues:

gynepristone.

Advantages

• prevents unplanned pregnancy.

Flaws

• may not work.

Postinor

Rating: 3.9

Rating: 3.9.

The active ingredient is similar to the active ingredient of Escapel, but its amount is exactly half as much. And if it is enough to take Escapelle once, then Postinor will have to be taken twice, with the second tablet exactly 12 hours after the first, which can be extremely inconvenient. Or, ignoring the instructions, take two tablets at the same time, remembering the dosage of similar drugs.

Advantages

• protects against unwanted pregnancy.

Flaws

• Side effects often occur.

Side effects

Taking medications to prevent pregnancy may cause the following side effects:

1. ​Headache, dizziness.
2. ​Weight gain.
3. ​Cessation of menstruation.
4. Swelling of the limbs.
5. ​Breast pain.
6. Flatulence.
7. ​Disorders of the skin.
8. ​Nausea.
9. ​Decreased appetite.
10. ​Profuse bleeding.
11. ​Pressure changes.
12. ​Disturbance of consciousness.
13. Allergic reactions.
14. ​Heavy breathing.

If such symptoms occur, the use of tablets should be stopped.