Birth control pills for women who smoke. Smoking compatible

Today, many representatives of the fair sex use contraceptive pills, including not only young girls, but also women over 35 years old. The point here is not only about protection against pregnancy; these same medications are prescribed for hormonal imbalances and some other gynecological problems. According to statistics, about 30% of all women have the bad habit of smoking, and this is where the question arises: is it possible to take contraceptives and smoke at the same time?

In order to understand this, you will have to study contraceptives deeper.

Classification and composition of contraceptives

All hormonal contraceptives are divided into 2 large groups: combined and progestin only.

Combined hormonal contraceptives contain estrogens and gestagens, and:

high-dose contain 50 mcg ethinyl estradiol;
medium dose – 35-40 mcg ethinyl estradiol;
low-dose – 30 mcg;
microdosed – 20 mcg.

Pure progestin contraceptives (contain only gestagens).

The combination of cigarettes with estrogens contained in combined contraceptives is considered undesirable. These include not only tablets, but also injectable drugs, as well as vaginal rings and spirals.

Today, drugs with low estrogen content are mainly used; they belong to the new generation of drugs and cause fewer side effects.

The effect of estrogens on the heart and female genital organs

Studies of this issue provide conflicting data. On the one hand, estrogens protect against the development of strokes, heart attacks and thrombosis. This is evidenced by the fact that heart problems in women begin to appear after menopause, when sexual function declines.

On the other hand, scientists say that for those who took combined contraceptives, the risk of developing a heart attack, stroke or thrombosis increased several times. They attribute this effect to the large dose of estrogen in the older generation of tablets.

There are estrogen-dependent forms of malignant tumors (breast, uterine, ovarian cancer). These conditions are caused by an excess of sex hormones in a woman’s body, including after the use of medications.

Birth control pills and smoking

Very often on forums women ask whether birth control pills are compatible with smoking? We will look into this important issue together with Evgeniy Konkova, our consultant on hormonal contraception. It's no secret that smoking is harmful to health in itself. And in combination with taking estrogen-containing* birth control pills, the harmful effects of nicotine increase several times.

* Estrogen-containing contraceptives are combination contraceptives that contain the hormone estrogen. It is also contained in the Evra hormonal patch and in the Nuvaring vaginal ring.

The effect of smoking on the body:

blood pressure increases
the frequency of contractions of the heart muscle increases
short-term vasospasm occurs
blood clotting increases
the movement of blood through the vessels and veins is hampered

Side effects of estrogen-containing birth control pills

blood clotting increases
the movement of blood through the vessels and veins is hampered

The biggest problem for those who like to smoke a cigarette is that this addiction leads to the formation of blood clots. And thrombosis is the cause of atherosclerosis, myocardial infarction and stroke. That is why WHO does not recommend that women who smoke (especially if they are over 35 years old) use estrogen-containing hormonal drugs.

Factors that provoke the formation of blood clots:

smoking;
excess body weight (obesity);
arterial hypertension (high blood pressure);
diabetes;
heart valve defects;
long-term immobilization;
serious surgical interventions or extensive trauma,
forced standing or sedentary work (hairdressers, salespeople, drivers, office workers);
hereditary predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age in one of the immediate family);
dyslipoproteinemia;
dyslipidemia.

Therefore, if you are over 35 years old and you fall under at least one item on this list, then you need to choose a contraceptive that does not contain estrogen.

A woman who smokes should understand that even the smallest dose of estrogen contained in the drug increases blood clotting. Under no circumstances should you listen to the advice of “well-wishers” that modern microdosed birth control pills can be taken without health risks.

If birth control pills contain ethinyl estradiol, estradiol valerate or estradiol hemihydrate, then this drug is contraindicated for you. You also cannot use the Evra hormonal patch and the Nuvaring vaginal ring as contraception.

Women who smoke can take birth control pills without estrogen (called progestin-only birth control pills or "mini-pills"). These include: Lactinet, Charozetta, Exluton and Microlut.

These drugs also reliably protect against unwanted pregnancy, but they have an unpleasant drawback. Purely gestagenic drugs, unlike combined ones, control the menstrual cycle worse and when taking them, intermenstrual bleeding may occur. This bleeding is not harmful to health, but can cause some discomfort. Therefore, you need to set priorities: either tolerate intermenstrual bleeding, or quit smoking and switch to more convenient combined contraceptive pills.

There are other methods of hormonal contraception for women who smoke - this is the Mirena hormonal device, which is installed in the uterine cavity for a period of 5 years. Or the hormonal implant Implanon. It is injected under the skin and provides reliable contraception for up to 3 years.

If you have irregular sex life, you can use non-hormonal contraceptives: contraceptive suppositories or creams, a regular intrauterine device or a condom.

Additional Information

On our forum, the question is often asked whether it is possible to use combined contraceptive pills with estrogen if a woman is under 35 years old and does not smoke very much. In such a situation it is possible, but before starting use it is advisable to take a blood test for hereditary thrombophilia. This test must be taken by those who have had problems with pregnancy, have APS syndrome, or have a history of thrombosis; if one of your close relatives died at a young age from a stroke or heart attack.

While taking birth control pills, a woman who smokes must have an annual blood clotting test (coagulogram). To prevent increased blood clotting, drink enough fluid (1.5 - 2 liters per day), especially in the heat. More physical activity, less fatty, fried and sweet foods. To thin the blood, you can eat onions, garlic, cherries, cranberries, blueberries and ginger. On the recommendation of a doctor, special blood thinning medications may be prescribed.

And the best way to avoid harmful effects on the circulatory system and other organs is to quit smoking, using, for example, Allen Carr’s effective method “The Easy Way to Quit Smoking.”

Forum: Birth control pills and smoking

New on the forum

2000–2017 © Olga Iosifovna Sikirina (gynecologist-endocrinologist, Moscow)

This site is not intended for viewing by persons under 16 years of age! The information published on the site cannot be used for self-treatment without consulting a doctor! Reprinting of copyright texts is possible only if a link to the source is provided. The author of the site is not responsible for the information published by visitors in the “Forum” section.

Website creation and support: Baulina Ksenia

Combination of cigarettes and estrogens

The likelihood of heart disease and breast cancer increases by 2 times when combining nicotine with combined birth control pills. This is confirmed by studies conducted in the USA. Moreover, even passive smoking has a negative impact on health.

Vein thrombosis in women who smoke and use contraceptives with estrogen is 10 times more common than in those who do not have this bad habit.

The negative effects of nicotine directly depend on the number of cigarettes smoked per day and the age of the woman. Heavy smokers (more than 15 cigarettes per day) over 40 years of age suffer most from heart attacks. Gynecologists advise this group of women to take purely progestin pills, such as the Mini-Pill.

The need for contraception for women

Contraceptives for women in the form of tablets for regular use appeared on the pharmaceutical market in the 60s. It was the emergence of freely available contraceptive pills, and not miniskirts, hippies and modern pop music, that ensured the sexual revolution in Western countries. Safe sex has become available to women.

The first pills contained high doses of hormones and could have a significant impact directly on a woman’s character and behavior. Medical products strive for universality; we would like the drug to be equally functional for everyone, and this affects the dosage of the active substance, bringing it closer to the maximum permissible. A significant amount of additional hormones may not have a positive effect on health.

Precautionary measures

It should be remembered that it is necessary to choose hormonal contraceptives together with a gynecologist, who will prescribe the drug depending on age, the presence of risks and concomitant diseases. What works for one woman may be harmful for another.

Also, those who take contraceptive drugs for the treatment of gynecological diseases should be more attentive to their health. It has been reliably proven that birth control pills significantly reduce the risk of developing benign breast tumors, uterine fibroids, ovarian cysts and endometriosis, and pelvic inflammatory diseases. In the treatment of these pathologies, drugs high in estrogen are used, which increases the risk of side effects, especially in women who smoke.

If a woman started taking the pills on her own and discovered symptoms such as pain in the lower abdomen, chest, calves, and headache, she should immediately consult a doctor.

Especially for skazhynet.ru Koreshkova Victoria

How to protect yourself while taking combined contraceptives

If it is difficult to quit smoking, but such a need has arisen in connection with the use of OCs, you can use auxiliary means that suppress the craving for smoking. The range of modern pharmacological products is diverse. Many of them have proven themselves well in practice. Everyone can find a convenient form of release for themselves.

Lollipops

Such drugs are available without a doctor's prescription. They contain medical nicotine. Regular consumption of pills reduces withdrawal symptoms without causing harm to the body. The active substance of an alkaloid nature in safe doses enters the blood, as a result of which the feeling of discomfort disappears.

Former smokers note their convenience due to their compact size and optimal speed of action (4-6 minutes). Women say that lollipops cope well with hunger. For females, the problem of gaining weight when quitting smoking is always relevant. The most popular in the post-Soviet countries are Nicotinette and Nicomel lollipops.

Chewing gum

Regular or nicotine-containing gum can be used. During the chewing process, nicotine from them enters the oral cavity and is absorbed through the mucous membrane and saliva. They also help fight the urge to take up a cigarette and alleviate smoking withdrawal symptoms. The dose of nicotine may vary. Nicorette elastic bands have proven themselves well.

Pills

Medicines in tablet form can be divided into three types:

nicotine-containing (Tabex);
antidepressants (Zyban, Brizantine);
blockers (Champix).

Tablets of the first group act by analogy with lollipops and chewing gum. Antidepressants affect the parts of the brain responsible for the formation of smoking addiction. And the third group of drugs allows you to form an aversion to smoking by binding to nicotinic acetylcholine receptors in the brain.