How to take hormonal drugs. Hormonal contraceptives: how long can they be taken without harm to the body?

If previously in Russia the frequency of abortions was the highest in comparison with other countries, today the situation has changed in a positive direction. Much of the credit for this goes to modern contraception, which any woman can now afford. And if earlier hormonal contraceptives frightened women with the risks of weight gain and hormonal imbalances, today there are even hormonal contraceptives that can help you lose weight.

The pharmaceutical industry, being at the stage of development and search for harmless contraceptives, has released a new generation of hormonal contraceptives. Many of them have virtually no contraindications or side effects, help prevent unwanted pregnancy, and also improve overall health. You just need to know how to choose the right remedy, how long you can take it and how to take it correctly.

What are hormonal contraceptives?

Among the existing medications there are those that are prescribed only by prescription, for example, antibiotics and hormonal contraceptives. Such pills do not involve self-medication, since they may not only not solve health problems, but also aggravate the situation.

Hormonal contraceptives are contraceptives that mainly contain one or more synthesized hormones.

The hormones in contraceptives are practically a copy of the natural female hormones - progesterone and estrogen. Modern hormonal pills are usually low-dose, and they can prevent unwanted pregnancy and prevent ovarian and breast cancer.

For reference! For the first time, such drugs began to be sold in pharmacies back in the 60s of the last century, and they contained higher doses of hormones. As a result, women have developed a fear of oral contraceptives due to the risks of gaining excess weight.

Modern hormonal pills are not expected to have a negative effect on a woman’s body, since they are the means of the new fifth generation. With the help of such tablets you can also improve the condition of hair, skin, nails, restore libido, normalize the menstrual cycle, prevent a number of diseases and much more. In this case, there is also no need to expect withdrawal syndrome from hormonal contraceptives, since they are not addictive.

Life after hormonal contraception

Many women have been taking OK for many years.
As a rule, as prescribed by a doctor. In some cases - after passing the appropriate tests. But it often happens that you come to see a doctor and say that you want to take OK. “Nivapros,” says the doctor. - Drink these.

- A….

– If they don’t fit, then these are the ones.

And the woman goes to follow the doctor’s advice. There is another option to go to a paid clinic, but only a few go there, compared to the general mass.

If a woman lives with one partner for many years, then this method of contraception usually suits her. There is no need to think about what day of the cycle it is, whether you bought condoms or not, and whether he will have time to pull out.

I took a pill and forgot about the problem.

Often, taking these pills lasts for several years, especially if there are no obvious health problems.

The main advantages of OK:

– prevents unwanted pregnancy by 99.99

– have a positive effect on the condition of the skin, hair, nails (the so-called antiandrogenic effect)

– eliminate PMS and balance overall hormonal levels

What happens to the body while taking OK:

The hormones contained in OCs suppress the synthesis of their own gonadotropic hormones and inhibit the functioning of the female reproductive system, and natural pregnancy becomes impossible, because

According to the mechanism of their action, OCs imitate pregnancy in a woman’s body.

Thus, while taking pills, a woman’s body exists in two states - early pregnancy and post-abortion, and it is clear that such a “swing” does not add to health.

As a rule, when any hormonal substance enters the body, a malfunction occurs in the activity of the entire well-functioning system, which is the human body. As a result, many processes lose stability.

, because instead of optimally and productively interacting with each other, internal systems establish artificial, rough connections that function forcedly. That is, the body is subjected to functional violence.

When a woman takes OK, her own reproductive system stops producing these hormones on its own. It is quite understandable why do extra work if the hormone is present in the body in the required quantities.

If such a picture does not last long, then everything is still fixable, but with a long-term disturbance, dysfunction of non-functioning glands can (and does) occur.

Those. In the body, natural hormones are replaced with “crutches”. And when you remove these crutches, your body will have to make an effort to restore what has not been used for a long time.

So, OCs suppress the synthesis of gonadotropic hormones in the female body, which are responsible for ovulation (ovum maturation). But sometimes there are cases when ovulation still occurs while taking OK.

If this case is isolated, then there is no reason to worry, you can continue to take the pills.

If this happens more than once, then you need to visit a doctor and think about changing pills (if you still want to take them).

The longer you take hormones, the more they suppress the natural functioning of your body and the more problems appear.

The main thing is libido disappears. Not right away, no. Gradually.

If, for example, a woman takes OK for 5 years without a break, then somewhere in the third year sex already turns into a “compulsion” - the hormonal levels are even, ovulation does not occur, and if there is no ovulation, there is no desire to have sex (“continue the family”) . It turns out to be a paradox - they take OK so they can have sex without problems, but they don’t even want sex...

An important nuance: after 35 years, women are not recommended to take OK.

What is the harm from taking OK:

– oppression of the reproductive system

– thin the endometrium

– most often negatively affect the female body (decreased libido, weight gain, cellulite, vascular problems)

– increase the risk of thrombophlebitis

What happens to the body when OC is discontinued?

Many women do not perceive OCs as a medicine and often simply forget to name them when, for example, the doctor asks - are you taking any medications? But these are lyrics.

So, cancel.

That's right: drink the blister to the end and stop.

Wrong: quit halfway through or start crushing the tablets to reduce the dose “so that the body gets used to it”

In the first three months of withdrawal, you will experience the “joy” of your hormonal system going wild. Hormones are a natural regulator of most processes in the body, and you kept it at a stable dose for several years, and then suddenly this dose does not arrive. And a so-called hormonal imbalance occurs.

During the first six months of stopping OCs, all dormant diseases in the body can emerge. Do you have a family history of joint problems? receive and sign. With your stomach? Please. I’m not even talking about neuroses and other joys of life - no arguments or calls for calm will help when you literally pull a bunch of your hair out of the bathtub drain.

The first month of withdrawal - it seems like nothing is happening. But it only seems so. The body begins to try to start metabolic processes without the usual doses of pills. Do you like headaches? And she you. The most common withdrawal symptom in the first month is headache.

To support the body, it is advisable to start taking vitamins. Ideally, of course, withdrawal should be carried out under the supervision of a doctor, but there are cases when this is not possible. Take the vitamins you usually take. The best special complexes for women are Perfectil, Merz, Alphabet - it all depends on your wallet.

It is also advisable to take a course of hepatoprotectors before or after a course of vitamins (if you don’t want to poison your body further with pills, drink milk thistle oil, either in capsules or liquid).

The second month of withdrawal - if the critical days came almost on time (fluctuations of 2-3 days in any direction are not considered a deviation from the norm), then the body is relatively healthy and ready to resist. (if the patient wants to live, medicine is powerless).

It is advisable to take herbal sedatives in small doses - valerian, motherwort - from the end of the second month. In small ones! because they have a cumulative effect. Depending on your body, during this period you will either begin to lose weight or, on the contrary, gain weight.

The appearance of inflammation on the skin – acne vulgaris.

For some, skin inflammation begins to appear immediately in the first month of withdrawal. But again, for most this is the second month.

We will consider further considerations taking into account the amendment that a woman’s body is generally healthy and is between 30 and 35 years old.

The third month of withdrawal is the most interesting thing - you begin to feel ovulation. Yes Yes. These aching pains in the abdomen (not severe) are not intestines. And not appendicitis. This is your ovulation. And the fact that you feel it is also good, it means your reproductive system is still working.

Fourth or fifth month of withdrawal - everything seems to be going well. Acne gradually goes away, the pain of ovulation decreases and libido begins to recover.

During this period, it is advisable to undergo a thorough examination by a gynecologist, do an ultrasound, donate blood for gonadotropic hormones and thyroid hormones and insulin. Everything is fine? Amazing.

And now the most unpleasant part. By the end of the fifth month, heavy hair loss begins. In two months you can lose about a third of your hair and then the loss will slow down slightly.

It is recommended to take sedatives and multivitamins again. Hair loss will return to normal within 3-4 months from the onset of hair loss. And new hair will grow too.

True, their structure may change (for example, they will begin to curl).

The sixth month of withdrawal - by this period the cycle should have settled down (let me remind you that fluctuations of 2-3 days are the norm).

According to most doctors, hormonal levels should more or less return to normal after six months. But this is ideal. In reality, everything is a little worse - hormone fluctuations can last up to two years.

During this period, it is advisable to be more attentive to your health. Get enough sleep. Eat properly. And the body, if it is relatively healthy, will recover.

Source: https://pikabu.ru/story/zhizn_posle_gormonalnoy_kontratseptsii_6120253

How do they work?

Hormonal contraceptives are aimed at protecting a girl from an unwanted pregnancy. To do this, you just need to know how to take such tablets correctly, and also strictly follow the instructions for use. Sex hormones in such tablets affect the genitals, making changes in the functionality of the ovaries. And in order to understand in more detail how such drugs work, you need to consider each type separately.

Types and method of action of hormonal pills:

1. Combined - monophasic tablets containing female hormone. Taking such pills, the female hormone in the body does not change, but pregnancy cannot occur due to the fact that the egg does not leave the ovaries, and therefore is not capable of fertilization.
2. Three-phase contraceptives - taking such pills, a girl’s hormonal levels gradually change, in particular during menstruation.
3. There are also progestin contraceptives or mini-pills , the mechanism of action of which is slightly different. Such drugs are prescribed to those women for whom estrogen is contraindicated. The principle of action with antiandrogenic action is suitable for nursing mothers.

In addition, hormonal contraceptives are further divided into:

• microdosed, which is usually prescribed to women who have not yet given birth;
• low-dose for women who have given birth and for those for whom the first group is contraindicated;
• high-dose, which protect against pregnancy and also restore hormonal imbalances (it is impossible to select such remedies on your own).

For reference! All of the above remedies prevent ovulation and the release of the egg for fertilization, and also thicken the cervical mucus in the vagina, which is why the man’s sperm cannot penetrate the uterine cavity.

Review of tablets to improve erection (list of pharmaceutical drugs and products with reviews)

Have you been trying to cure PROSTATITIS for many years?

Head of the Institute: “You will be amazed at how easy it is to cure prostatitis by taking it every day...

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30% of men over 40 years old experience sexual dysfunction to varying degrees - some with one-time difficulties, others with constant ones. It is important to find out the cause of the dysfunction and eliminate it. And to temporarily improve potency, you can use stimulants. In this article we will look at the most effective means for increasing erection: we will find out the composition of the tablets, features of use, what results to expect from them, what side effects they have and how much they cost. We will also study reviews of erection pills.

Types of products for men

Before you go buy medicine for erection, you need to find out - is it necessary? To do this, it is necessary to determine the cause of sexual dysfunction. For example, if the problem is stress and physical fatigue, then just calm down, get enough sleep, relax - and the problems will go away on their own, without any stimulant pills.

Until the course of treatment is completed, you can improve the quality of sexual intercourse by taking drugs to improve erection. They may be as follows:

1. Phosphodiesterase type 5 inhibitor tablets. These erection drugs increase blood flow to the penis. What tablets fall into this category? These include Viagra, Vardenafil, Cialis, and Udenafil tablets.
2. Medicines from the group of NO synthase activators. The main tablet in this category is Impaza. Activators help relieve muscle spasms in the groin area and improve blood flow in the genitals. The tablets normalize the sexual functions of men - they increase libido, erection strength and duration of sex.
3. Hormonal pills (primarily testosterone preparations). You can buy it at the pharmacy only with a prescription; it should be taken only according to medical indications (if the erection has weakened due to hormonal imbalance). They have a strong effect and have quite a lot of contraindications. Not accepted for prophylaxis.
4. Dietary supplements with natural composition. Nowadays, many similar drugs are produced to increase erection: Tribestan, Yakortsev dried flower, Golden Horse, etc. Such tablets have reduced effectiveness compared to synthetic drugs, but they have fewer side effects on a man.

Increased caution

Medicines to improve erection must be taken very carefully - all pills have their own contraindications and side effects (even the best remedies are not completely safe). That’s why you should definitely read the instructions and reviews before taking the product.

Most often, pills that improve erection in men should not be taken if there are pathologies in the heart or diseases of the circulatory system. The main contraindications for the drugs are:

• Pressure changes (especially with high blood pressure).
• Cardiac ischemia.
• Leukemia.
• Stroke.

As for side effects, in reviews men most often write that erection enhancement pills can cause allergies, nausea, intestinal upset, increased blood pressure, migraines, and tachycardia. The listed adverse reactions are aggravated by improper use of medications. To mitigate the “side effects”, you can replace the tablets with another type of stimulating drugs - now you can find a transdermal analogue of any drug for sexual stimulation (with transdermal action).

Main characteristics of popular stimulants

Nowadays, pharmacological companies produce various products to improve erection. Let's list the most popular pills for men who want to improve their erections:

• Cialis

Cialis belongs to the group of “drugs for enhancing erection with a phosphodiesterase type 5 inhibitor.” Valid for 1.5 days after use. Strengthens natural erection by more than 2 times. In addition to improving erections, Cialis helps achieve better sex drive and ensures longer-lasting sexual intercourse. We are talking about pills that are compatible with alcohol (but only in the absence of heart problems).

• Dapoxetine

Tablets for strong and long-lasting erections, as well as for the prevention of premature ejaculation. They are also useful for potency because they increase the duration of sexual intercourse by more than 3-4 times. Contraindications for the drug are standard for a male stimulant; it is incompatible with alcohol.

• Cialigra

The erection enhancing drug Cialigra is a fairly effective remedy that improves erectile function in men and also temporarily increases the size of the male organ. 1 tablet is effective for up to 2 days (the effect is noticeable 40 minutes after administration). Ingredients: shark bone powder, Peruvian ginseng, Tribulus terrestris, Ganoderma lysidium extract.

It is not prohibited to take with alcohol. The price is quite affordable compared to analogues (approximately 550 rubles per bottle of tablets).

• Biomanix

Biomanix tablets belong to the category of dietary supplements with a natural composition. Contains Muira Puama (a strong erection appears thanks to this component); Tongkat Ali (a component that increases blood flow in the genitals), L-Arginine (provides an increase in testosterone levels); Tribulus Terrestis (provides longer sexual intercourse); Maca root (improves erectile function and slightly increases penis size). You need to take 1 capsule 2 times a day, the effect will be noticeable on the 3rd day.

• Viagra

When listing drugs to improve erection in men, one cannot ignore Viagra, the most popular drug that stimulates erectile function. The use of these blue pills will give results only if there is natural sexual arousal. If there is a complete absence of male erection, phosphodiesterase inhibitors will not help.

• Super Vidalista

Another name for these tablets is Super Tadarise. Provides increased libido and increased erection due to the active substances tadalafil and dapoxetine. You can also drink to increase the time of sexual intercourse and enhance the sensations of orgasm. The product cannot be called cheap - it costs from 1,500 rubles, but it has a minimum of contraindications.

• Alicaps

Alicaps refers to biologically active supplements (dietary supplements) recommended for use by men who want to slightly increase potency. It is not able to strengthen an erection very much, it is more suitable for use for minor disorders and for prevention. The composition is completely natural. Must be taken for a month.

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• Dynamico

An inexpensive drug that improves erections well. The tablets work due to sildenafil citrate. They begin to act within 1-2 hours. Restore erectile function by increasing blood flow in the penis. They act quite quickly - the enhancing effect occurs approximately 20 minutes after administration.

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• What is hormone replacement therapy
• Indications for use of HRT
• Preparing for hormone replacement therapy
• Choice of remedies: types and forms of hormonal drugs for menopause
• Hormonal drugs for HRT - list
• Non-hormonal drugs for menopause
• Contraindications to the use of HRT

Menopause is the second “transitional age” in a woman’s life, which, unlike teenage changes, is very difficult. This happens because the body gradually fades away the functions of the sex glands. A decrease in hormonal levels cannot but affect a woman’s condition, and in 90% of cases only HRT, that is, hormone replacement therapy, can normalize it - during menopause, this method is used quite often.

The main task of the doctor when using HRT is to combat the symptomatic manifestations of menopause, which are expressed by:

• sudden mood swings;
• a feeling of a rush of heat to the upper part of the body and face;
• uncontrolled fluctuations in blood pressure;
• the appearance of delays in menstruation and/or their complete cessation;
• demineralization of bone tissue;
• deterioration of hair, skin and nails;
• structural (physiological and physical) changes in the mucous membranes, especially in the genitourinary system.

To achieve maximum effect in preventing and eliminating changes in the functions of internal organs and glands, the HRT complex uses drugs of herbal or synthetic origin, which in the vast majority of cases need to be taken for quite a long time - from a year to 2-3 years. In some cases, the course must be continued for 10 years or more.

What is hormone replacement therapy

In the classical sense, hormonal therapy for menopause is treatment with medications that contain sex hormones (mainly female). The goal of treatment is to eliminate the acute deficiency of estrogen and progesterone resulting from a decrease in their synthesis by the endocrine glands.

In medicine, there are two types of HRT:

1. Short-term hormone therapy is a treatment that is aimed against the symptomatic manifestations of menopause, not complicated by severe depressive states, vasomotor pathologies and changes in the functions of other organs and systems. The period during which it is recommended to take medications prescribed by a doctor ranges from 12 to 24 months.
2. Long-term hormonal therapy is a treatment that is aimed against climacteric disorders aggravated by serious changes in the functioning of the central nervous system, cardiovascular system, and endocrine glands. The period during which you need to take hormonal drugs ranges from 2 to 4, and in rare cases up to 10 years.

If you follow your doctor's recommendations, you can achieve a significant improvement in the condition of menopausal women. Thus, hormonal drugs, especially the new generation, reduce phenomena such as hot flashes and nervous agitation, reduce pain and restore the condition of the mucous membranes, skin, hair and nails. In short, they prevent a woman’s body from rapidly aging.

Indications for use of HRT

Complex measures, including HRT, are used as symptomatic and prophylactic agents. In the first case, their action is directed against existing symptoms of menopause, in the second – against possible pathologies that arise as a result of hormonal changes at the late stage of menopause (osteoporosis, arterial hypertension, etc.).

The list of unconditional indications for the use of HRT includes:

• cases of early menopause;
• medical history suggesting a high risk of osteoporosis;
• pathologies of the heart and blood vessels accompanying menopause;
• high risk of developing cardiovascular pathologies (diabetes, hyperlipidemia, hereditary predisposition to arterial hypertension).

Preparing for hormone replacement therapy

Before starting to use HRT as a method of overcoming the unpleasant symptoms of menopause, you need to conduct a thorough examination, which includes laboratory and instrumental studies for existing changes. The list of diagnostic measures includes:

• ultrasound examination of the abdominal cavity and thyroid gland;
• external and instrumental examination of the mammary glands (mammography, ultrasound of the mammary glands, etc.);
• laboratory examination of a cervical smear;
• laboratory blood tests for hormones (establishing hormonal status, degree of susceptibility to thrombus formation);
• blood pressure measurement;
• general medical examination.

When chronic diseases are identified, it is necessary to select treatment directed against the causes that provoked their occurrence, as well as to eliminate the changes that have occurred.

Despite the fact that during menopause it can be very difficult to completely cure concomitant diseases, it is recommended to minimize their effect on the body. Only after chronic diseases have been treated, the woman begins to be selected drugs for HRT, which will effectively act against age-related and hormonal changes

Choice of remedies: types and forms of hormonal drugs for menopause

There are several types and forms of drugs that can be used to implement HRT. Firstly, they can be organic (homeopathic) and synthetic. The former are made from plants containing phytohormones, the latter are produced in laboratories from a variety of artificial chemical components. Secondly, drugs are divided into several groups depending on the route of entry of the active components into the body:

• oral form - tablets, pills, dragees;
• transdermal form - subcutaneous implants or injections;
• local form - suppositories, creams and gels for application to the vaginal mucosa or to the skin in the abdomen, thighs and chest.

Each dosage form, the names of which will be given below, has a list of advantages and disadvantages that must be taken into account when prescribing certain drugs to a specific patient. Thus, hormonal pills are convenient to take, they are absorbed fairly quickly and are inexpensive. However, many oral HRT drugs have a negative effect on the stomach and liver.

If a woman has diseases of these organs, she is recommended to use local or transdermal forms of hormonal drugs. They, unlike tablets, do not affect the gastrointestinal tract and practically do not interact with other medications. Thanks to this, they can be taken together with a large list of pharmaceuticals.

Hormonal drugs for HRT - list

Hormone-containing drugs as part of HRT are intended to eliminate the deficiency of progesterone and estrogen in a woman’s body, and, as a result, to reduce symptoms indicating their deficiency:

• tides;
• sleep disorders;
• involutive changes in the mucous membranes;
• headaches and dizziness;
• increased nervous excitability;
• pain that occurs in the lower back or suprapubic region after sexual intercourse.

Among the most popular and effective medications for menopause, doctors include the following hormonal drugs:

• Femoston is a two-phase combination medicine in tablet form;
• Dermestril is a one-component estrogen-containing drug in the form of a patch;
• Klimara is a combined hormonal agent for external use (patch);
• Klimonorm is a combination product in the form of dragees;
• Estroferm is a one-component drug in tablet form;
• Trisequence is a combination medicine in tablet form;
• Ovestin is a one-component medicine in the form of tablets and suppositories;
• Angelique is a combination product in tablet form;
• Cyclo-Proginova is a combination medicine in tablet form;
• Divigel is a one-component preparation in the form of a gel for topical use.

All of the listed drugs are new generation products that contain microdoses of hormones.
Thanks to this, they retain therapeutic properties, as they slow down the natural age-related decline in a woman’s hormonal levels. At the same time, while taking them, there are no changes in the functions of internal organs, as happens when taking hormonal anabolic steroids. When prescribing HRT with the use of hormonal drugs to patients who have entered menopause, the details obtained during the preliminary examination are taken into account. Based on the data obtained, the doctor calculates the dosage of hormones that the woman needs to take. You will have to take tablets and use creams and suppositories every day, preferably at the same time. Patches and injections are used less frequently - once a week or a month, depending on the concentration of hormones in them and the speed of their release.

Despite the absence of obvious harm to health, the doctor must weigh the pros and cons of hormonal drugs. If there is a slight risk, they should be replaced with medications containing herbal substitutes for human hormones.

It is not allowed to independently change the dosage of drugs from this group. This can lead to significant changes in a woman’s hormonal status and to changes in the functions of the endocrine glands and organ systems. In addition, systematically increasing dosages can lead to the formation of tumors, especially if women are diagnosed with benign tumors or have a hereditary predisposition to their occurrence.

Non-hormonal drugs for menopause

In addition to hormonal medications, doctors often prescribe pills that contain phytoestrogens - plant analogues of female hormones. They are used if a woman has contraindications to the use of hormonal drugs during HRT. Medicines in this group are also representatives of a new generation of drugs that contain exactly the dosages that actively act against the symptoms of menopause without causing negative changes.

Non-hormonal medications suitable for HRT include:

• Klimadinon and Klimadinon Uno in tablet form;
• Estrovel in tablet form;
• Menopace capsules;
• Qi-Klim in tablets;
• Red brush in drops and tea bags;
• Bonisan in the form of tablets and gel;
• Remens in tablet form;
• Climact Hel in gel form;
• Lady's Formula Menopause in capsule form;
• Klimaxan in capsule form.

The listed remedies are mostly represented by homeopathic medicines and biological food additives. To feel a noticeable therapeutic effect, you will need to drink them for at least 3 weeks. In this regard, the course of HRT with them lasts longer than when using hormones.

This group of drugs is especially effective if taken for a long time. At the same time, doctors recommend that women switch to a diet rich in fiber. Thanks to this, the effectiveness of HRT will be even higher.

Phytoestrogens do not act against symptoms very quickly, but they have a cumulative effect - after completing the course, the woman does not experience the so-called “withdrawal syndrome,” and the hormone level is maintained at the achieved level. It is recommended to take medications of this type daily in the dosages prescribed by your doctor. It is not recommended to increase or change the dosage of phytoestrogens, as this can worsen the woman’s condition or provoke serious complications.

Contraindications to the use of HRT

In the presence of certain pathologies, the use of HRT is strictly contraindicated.

Such diagnoses include:

• liver pathologies in acute and chronic form - hepatitis, oncology;
• thrombosis, thromboembolism;
• oncology of the mammary glands and/or genital organs and glands;
• oncology of the endometrial layer of internal organs;
• complicated diabetes mellitus;
• bleeding from the genitals of unknown origin;
• estrogen-dependent tumors;
• complicated pathologies of the heart and blood vessels.

In addition, pregnancy, which can occur at an early stage of menopause, is considered a contraindication to the use of hormone replacement therapy.

From the video you will learn in what cases hormonal therapy is required:

Why are they dangerous?

To evaluate the pros and cons of the hormonal method of contraception, the gynecologist must discuss the possible risks with the woman. If a specialist can select a hormonal agent as accurately as possible for an individual organism, no side effects or dangers from their use are expected.

If you choose such contraceptive medications yourself, there are the following consequences of taking them:

• skin rash;
• rapid weight gain;
• hormonal imbalances;
• disrupted menstrual cycle;
• infertility;
• spotting when taking;
• hormonal contraceptive withdrawal syndrome;
• the onset of pregnancy;
• decreased libido, etc.

It must be remembered that if one or another option of birth control pills is ideal for one woman, it may be strictly contraindicated for another woman. If a woman after 40 years of age takes incorrectly selected hormonal drugs, the resumption of reproductive capacity may not occur at all, if after 35 years of age - only within 2-3 years after stopping the use.

How to stop taking birth control pills correctly

Contraceptives should be discontinued gradually, especially if contraception with their help was long-term. The process will take several months, but this is the only way a woman’s body can avoid stress and unwanted consequences. It is better if a gynecologist recommends a withdrawal regimen. When stopping taking OK, follow two rules:

• reduce the daily dose by a quarter of a tablet each menstrual cycle;
• stop using hormones or reduce the dose, but only after the cycle is complete.

How to choose hormonal contraceptives?

Recently, tablets, patches, coils, implants and vaginal rings have been used as hormonal contraceptives. The implant is usually designed to protect a woman from pregnancy for 3 years. But vaginal rings and patches are a new generation of hormonal contraceptives that offer the same long period of protection, but can negatively affect the gastrointestinal tract.

A gynecologist knows how to choose hormonal pills. He must send the woman for a smear to detect oncocytology, an ultrasound of all pelvic organs, and also for a consultation with a mammologist. Also important is a blood test that will help study the lipid profile, the amount of ALT and AST, and glucose. The doctor also compares the patient’s age, weight and height, the number of births and abortions, the course of menstrual cycles, takes an anamnesis, and then makes a selection based on the results of the analysis.

If we are talking about a young nulliparous girl, she is usually prescribed microdosed hormones - Novinet, Jess or Logest. For a mature woman who has given birth, low-dose hormonal tablets - Silest, Yarina and Regulon - will be suitable. For women of late reproductive age, Demoulen, Chloe and Diane-35 are appropriate; these drugs have an average dosage of hormones.

Selection of hormonal contraceptives: table

For reference! High-dose hormonal contraceptives are prescribed only by a doctor for strict indications, such as Triziston or Milvane.

A conversation with a gynecologist about taking combined oral contraceptives

Oksana Valerievna Timofeeva, an obstetrician-gynecologist, gynecologist-endocrinologist with 17 years of experience, talks about what examinations a woman should undergo before starting to take COCs, how long you can take hormonal pills, why there is such a large list of side effects in the instructions for the drugs and Is it true that “hormones” make people fat?

Oksana Valerievna, which method of contraception do you personally have the least questions about? Which one do you consider the safest from the point of view of women's health?

It is impossible to answer this question unambiguously. It all depends on the type of relationship in the couple, the age of the patient, her physical health and reproductive plans.

If a woman is in a monogamous, trusting relationship, does not exclude the possibility of pregnancy, and at the same time the sexual partner categorically refuses to use a condom, then the calendar method can be recommended in combination with coitus interruptus (coitus interruptus - Ed.).

In this case, with a regular menstrual cycle, we track ovulation for several months, calculate safe days and offer them as open appointments. But it is worth understanding that in a fertile woman this method may fail due to the influence of external factors on a woman’s menstrual cycle. And, as a result, a change in the approximate date of ovulation.

If the sexual partner does not mind using a condom, then in addition to the contraceptive effect, the patient also protects herself from sexually transmitted infections. This method of contraception is the safest, but not the most reliable.

If we are talking about the most reliable method of contraception, then it is worth considering the use of hormonal contraceptives. There are several options for using COCs. One of them is in tablet form. However, here it is necessary to understand the importance of using drugs according to the schedule at the same time.

If discipline suffers, then it is possible to use a vaginal contraceptive ring, which is inserted into the vagina for 21 days and removed during menstruation. It is also possible to use a cutaneous contraceptive patch, which must be changed once a week for 3 weeks with a break for menstruation.

What is their action based on?

COCs contain two active components: estrogens and gestagens. While taking the drug, a woman’s ovulation is suppressed, that is, the egg does not release from the follicle, and therefore pregnancy does not occur. The viscosity of cervical mucus also increases, which makes it difficult for sperm and pathogens to pass into the cervical canal.

If we are talking about combined hormonal contraceptives, then the absence of pregnancy can only be guaranteed if the woman takes the pills according to the instructions at the same time of day.

And also in the absence of vomiting or diarrhea within two hours after administration. Of course, there should be no contraindications for use.

Let's define who COCs are definitely contraindicated for?

There are quite a lot of contraindications, all of them are well described in the instructions. In short, they can be divided into several groups, without detailing. The presence of factors leading to microthrombotic formation and vascular spasm, metabolic disorders with vascular complications, severe pathology of the liver, kidneys, malignant neoplasms, including a history of bleeding of unknown etiology, lactation, hypersensitivity to the components of the drug.

What tests should a doctor prescribe before starting to take COCs?

Those that will more likely eliminate contraindications. Namely: liquid cytology (screening for cervical cancer), ultrasound of the mammary glands in the first 10 days of the menstrual cycle, excluding menstruation days; pelvic ultrasound, preferably on day 7-8 of the menstrual cycle; blood chemistry; general urinalysis, hemostasis, homocysteine, polymorphism of hemostasis genes (examination for at least two key mutations - Leiden mutation and prothrombin mutation). If the examination results do not reveal any significant deviations, then taking COCs can be recommended.

Let's say we find out that the woman is fine and can take COCs. How is a specific drug selected?

First of all, we evaluate hormonal levels. To do this, it is proposed to take hormones in a cycle. We take into account the amount of estrogens and androgens, pay attention to the patient’s age and weight, as well as manifestations such as acne, oily skin, hypertrichosis and libido level.

If the appointment is a healthy woman of fertile age, then I would recommend starting with a low-dose oral contraceptive containing 20 micrograms of ethinyl estradiol (Aethinyloestradiolum). If we talk about the gestagen component, then I personally prefer drospirenone, since it has a weak antiandrogenic effect, plus an antimineralocarticoid effect, and is able to prevent the appearance of hidden edema by removing excess fluid from the body.

Regarding “getting fat” - this is probably the most common question from girls - is it true that people gain weight when taking COCs?

Not at all necessary. Weight gain can occur without taking COCs. The first thing you need to understand is that hormonal drugs increase appetite. If a woman is able to control her eating behavior and leads an active lifestyle, then weight gain will not occur.

And second: slight weight gain can occur due to fluid retention in the body caused by the influence of the progestin component. This can be avoided by taking COCs that contain drospirenone as a progestin component.

The woman started taking COCs. What should she first of all pay attention to in matters of well-being?

The first is a headache.

If a woman starts taking the drug and suddenly develops a persistent headache, this is a reason to consult a doctor and undergo an additional unscheduled examination.

The second is bloody discharge from the genital tract of unknown etiology. Third - persistent nausea and vomiting. Fourth - swelling. Fifth - jaundice. Sixth - excess weight gain.

How long can you take COCs without harm to your health?

This is determined by the doctor. Each woman is individual, with her own somatic and reproductive characteristics. That is why annual preventive examinations and examinations are necessary. If no deviations are detected in the results, then everything is in order, you can continue taking COCs. Sometimes, rather for therapeutic purposes, COCs are prescribed for a fairly long period of time.

Until what age can you take COCs?

Here, again, it is impossible to answer unequivocally. It all depends on the patient’s health condition.

If a woman smokes, then taking COCs is only possible until the age of 35. If the patient leads a healthy lifestyle and reproductive function is achieved, then after undergoing a series of additional examinations, it is possible to take COCs after 35 years. Let me clarify: we are not talking about short-term medication use for 6-7 months, but a fairly long period, 3-4 years.

Is it recommended to take breaks while taking medications? Or can you take COCs without a break for a year, three, five?

There are several approaches to the regimen of taking COCs. In the first case, it is recommended to take a break from taking medications every year for 2 months. But with such a schedule, there is a possibility of missing hidden problems associated with premature depletion of the ovarian reserve, which it is advisable to check in the 3-4th cycle after stopping COCs.

Let me note right away that COCs do not preserve the ovarian reserve, since the process of follicle maturation occurs every cycle, only ovulation does not occur.

Since each woman has her own reproductive period, laid down in the womb, we can only control the ovarian reserve, but cannot influence it.

According to another approach, a woman can take the drug for 3-4 years without a break, with mandatory withdrawal for 6 months. The menstrual cycle should be restored during these six months. However, it should be understood that the state of physical health must be checked once a year, and it is advisable to monitor your ovarian reserve at least once every 3-4 years during the period of COC withdrawal.

The instructions for any hormonal drug contain a huge list of side effects. Which of them are most common?

Among the most common is spotting after the end of menstruation during the first three menstrual cycles of taking COCs. This is acceptable, but if in the 4th month we still observe this side effect, the woman should choose another hormonal contraceptive.

Changes in libido, mood swings, and nausea may also occur, which, by the way, is usually absent if you take the drug before bed, for example, at 10 pm.

All other side effects are rare and are associated with individual characteristics and concomitant somatic diseases.

It is worth noting that the pharmaceutical company is required to indicate all side effects that happened to at least one woman, even once in her life. If the drug has no side effects, this should be alarming.

It is recommended to take COCs at the same time of day every day. How critical is this moment? After all, there are different life circumstances, and taking a pill strictly at a certain hour is not always convenient.

Let's immediately outline the importance of adhering to the regimen of taking COCs. The absence of ovulation is guaranteed only if the patient takes the drug daily, at approximately the same time of day.

The body of a young, healthy woman is set up for childbearing and is waiting for you to make a mistake. At the same time, skipping pills is also dangerous because it can lead to hormonal imbalance and acyclic bleeding. If a woman understands that she cannot maintain discipline in this matter, she should choose a different type of contraception.

If pregnancy does occur while taking COCs, how dangerous is this for the fetus?

If a woman becomes pregnant and continues to take COCs, this should not affect the health of the fetus. There is no danger, the pregnancy can be saved.

Let's say a couple decides they are ready for pregnancy. How soon can you start conceiving after stopping COCs?

At once. It is worth keeping in mind that sometimes in the first two cycles there is a high risk of conceiving twins. This happens because the previously sleeping ovaries were “awakened” and, relatively speaking, they began to work with redoubled force. In some cases, taking COCs is the first step towards pregnancy if the couple has had unsuccessful attempts for some time: the woman is advised to take COCs for 3-4 months, so that pregnancy can then occur when the drug is discontinued.

But all women are different, and it is also possible that the body, on the contrary, will need some time to restore ovulation.

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Experts: Oksana Valerievna Timofeeva

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How long can I take it?

Usually, only the attending gynecologist determines how long hormonal contraceptives can be taken. It is impossible to say in absentia the exact period of time during which it is permissible to take such drugs. For each type of contraceptive and for each organism, individual standards are provided.

For reference! If contraceptives with a minimum content of hormones are used, they are taken for a long time, if with a high content, they are taken for a period of time set by the doctor.

Medical statistics say that it is necessary to stop taking hormonal contraceptives no later than after 5 years. Otherwise, the risks of developing precancerous conditions or malignant oncology increase. In addition, doctors say that the longer a woman takes such drugs, the more predisposed she is to tumors.

All the nuances

When starting to take birth control pills, you should pay attention to what they are incompatible with. This will prevent the risks of side effects and hormonal disorders. In addition, such warnings will help protect a woman from a decrease in the reliability of contraception, and therefore prevent the onset of pregnancy.

For reference! At the moment, male hormonal contraceptives are at the development stage, although several versions of the drugs can already be seen on sale.

Contraceptives, the benefits and harms of which are already known, should not be taken together with antidepressants, tranquilizers and antibiotics . Combining hormonal contraceptives and alcohol is allowed, but this can significantly reduce the reliability of such protection. Flaxseed oil and hormonal contraceptives are prohibited, as the oil reduces the ability to absorb pills.

Birth control pills cause mood swings and irritability

Frequent mood swings and irritability are among the possible side effects, but these can also be caused by external factors. “It is very difficult to correlate mood swings and irritability with taking birth control pills because these are very subjective symptoms and can occur due to many external factors. We feel sad, upset and happy for various reasons, and most often it has nothing to do with taking oral contraceptives. Therefore, we cannot unequivocally answer that the statement above is fiction, but we cannot confirm it either. You must understand for yourself how comfortable you are with this method of contraception, because it is something very individual and multifactorial,” explains José Terrón.

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Break

The topic of how to take a break from taking hormonal contraceptives deserves special attention. Typically, a woman should take into account the doctor’s prescription, but there are generally accepted standards for each individual drug. Most often, the newest birth control pills are taken for 21 days, strictly at the same time of day without skipping. Next, a week-long break is required, which is allotted for menstruation.

A drug like Jess assumes slightly different standards - you need to take pills for 24 days, after which 4 days - a regular placebo without a hormonal composition. Thus, you can avoid confusion about the days of taking and stopping taking, replacing the withdrawal with the use of pills with a placebo effect. Many women, with the help of such pills, can postpone the expected menstruation for a while, extending the days of taking contraceptives. The fact is that usually after cancellation there are no periods for another 3 days.

Birth control pills make you hungry

You've probably heard complaints from friends and acquaintances that they gained weight after starting to take birth control pills. Probably, but it's not related. “No studies have shown a link between birth control pill use and weight gain. Oral contraceptives may cause slight fluid retention in the body in the first three months of adaptation, but they do not affect appetite. There are contraceptives that, on the contrary, promote weight loss due to their diuretic effect,” explains Sandra Ortega.

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