Classification of contraceptive pills
- Combined oral contraceptives (COCs):
- monophasic (Regulon, Lindinet-30).Contains a constant dose of progestin and estrogen element in each tablet, differ according to the type of progestogen, estrogen dosage.Provide a high level of contraceptive (Pearl Index 0.06-0.08), effectively treat genital endometriosis, a positive impact on the course and duration of the menstrual cycle, levels of bleeding intensity.Cases mezhmestrualnyh bleeding rarely recorded;
- biphasic (Adepal, Anteovin).Keep me progestogen dose and continuous estrogen, women are shown with sensitivity to progestogens, with clinical symptoms of hyperandrogenism;
- three-phase (three-regolith, three-Mercy).Characterized by variable contents of steroids in accordance with the phases of the menstrual cycle.Differ pronounced physiological effects on the performance of the menstrual cycle, give a minimum of side effects, controlled cycle.Showing women over 35 years old, obese smokers.
- of the number of estrogen component:
- mikrodozirovannye: 15-20 etiniletradiola mcg / day (Logest, Lindinet-20);
- low-dose: 30-35 micrograms etiniletradiola / day (Yarina, Jeanine, Regulon);
- vysokodozirovannye: etiniletradiola 50 g / day (Ovidon).
- progestogens oral contraceptives ("mini-pill").
alternative to the use of COCs - pills containing progestins clean.Contraceptive effect of the "mini-pill" is associated with changes in the uterine cavity mucosa, likely complicating implantation of a fertilized egg, and the increase in the viscosity of cervical mucus prevents the penetration of sperm into the uterus.Progestogens drugs cause depression lutropin products that suppresses ovulation.Minus the "mini-pill": in some cases, while taking pills ovulation occurs - this explains a lower compared to COCs Pearl Index (0.3-0.6).
How do COCs
OK exposure mechanisms implemented at different levels of the hypothalamic-pituitary-ovarian, uterus, fallopian tubes.Synthetic steroids inhibit release of pituitary gonadotrophins and hypothalamic hormones that leads to suppression of ovulation, the time of sterilization.Along the way, synthetic progestins and ethinyl estradiol inhibit folliculogenesis, causing a decrease in size of the ovaries, decreased secretion of estrogen in 2 times.Undergoes deformation and endometrium - regression cycle occurs and premature secretory transformation observed atrophic changes, providing antiimplantatsionnoe action.Hormonal contraceptives inhibit the motility of the fallopian tubes, slowing the passage of the fertilized egg, thicken the cervical mucus, which decreases the penetration of sperm into the uterine cavity.
How to choose the pill
basic principle of the selection of PR - use the lowest possible dose of steroids, which would provide effective protection from unintended pregnancy.Women estrogen-type drugs are recommended, has a strong progestin component (Ovidon, Rigevidon).Preparations of the first line for women with a predominance of progestogen - Regulon, Logest.When you select OK should take into account the size of the uterus and quality of menstruation, since these parameters reflect the hormones are much better than the estimate of external signs: scarce menstruation indicate increased activity of progesterone, a long and plentiful - the activity of estrogen.Starting hormonal contraceptives should be combined with drugs with a minimum dosage of incoming items.Three-phase and low-dose pills are not opposed to each other - if it is used properly it amounts to safe and effective.Criterion for the correct selection OK - no intermenstrual bleeding, bleeding "breakthrough".More information about the range of OK can be found here.
How to drink pill:
- oral contraceptives begin in 1-5 days after the start of menstrual bleeding.Monophasic COCs start drinking with the corresponding day of the week pill, multiphase - tablets marked with "start reception";
- OR taken every day, at a particular time, for 21 days;
- after the last tablet from the packaging should be a week-long break, during which there menstrualnopodobnoe reaction.The next package preparation begins at 8 day break;
- in the absence of "withdrawal reaction" pills continues the traditional pattern to the exclusion of pregnancy.Otherwise, stop taking the drug;
- questions parallel COC and medications (anticonvulsants, antibiotics) are solved individually;
- need to know that after discontinuing COCs conception can occur in the first cycle cancellation.
Use of birth control pills:
- immediate effect, almost 100% contraceptive reliability;
- reversible method, a thorough study;
- possibility of independent control of fertility;
- low incidence of side effects;
- ease of use, the impossibility of overdose;
- reducing the risks of ectopic pregnancy;
- reduction in episodes of inflammatory diseases of the pelvic organs;
- prevent the development of benign tumors of the uterus and ovaries;
- relief of symptoms of dysmenorrhea, PMS;
- positive impact of endometriosis;
- therapeutic effect on the skin with seborrhea, acne vulgaris.
- increased risk of developing cervical cancer in women using OK for a long time (over 10 years).
control pills: contraindications
- malignant neoplasms of genital / breast;
- pregnancy / suspected pregnancy;
- severe pathology of the cardiovascular system;
- severe dysfunction, acute disease, liver tumors;
- thrombosis, thrombophlebitis, thromboembolism;
- unexplained bleeding.
- chronic nicotine intoxication;
- obesity, porphyria, immobilization;
- tuberculosis, the imminent surgery;
- epilepsy, prolonged depression, uterine fibroids;
- jaundice, migraine, hypercalcemia, hyperlipidemia.
Mitigating Factors reliability OK:
diarrhea, vomiting, concomitant use of laxatives, anticonvulsants, anti-bacterial.
- estrogenzavisimye: vomiting, nausea, jumps of arterial pressure, headaches, dizziness, weight gain, chloasma;
- progestagenzavisimye: decreased libido, depression, acne, dryness of the vaginal mucosa, headache, fatigue;
- lack estrogenic effect: reducing the size of the mammary glands, loss of libido, poor menstruation, intermenstrual bleeding;
- insufficient progestogen effect: delayed menstruation, intermenstrual discharge during the 2nd half of the cycle, heavy menstruation.
side effect in patients receiving oral contraceptives may be due to the action of individual intolerance or tablets.Side effects may be dangerous or not dangerous for the body regardless of the causes.Removal of the drug typically results in the disappearance of such a reaction under the influence of the treatment or independently.
With proper reception reliability oral contraceptives tends to 100%, the ratio of "safety / reliability" hormone pills are superior to condoms.To learn more about condoms here.COCs contain the latest generation of the hormones at low doses, without androgenic influence.To avoid possible adverse reactions allows a medical examination, which is recommended to take before you start taking the tablets.Hormonal contraception is reversible, the rate of regeneration cycle depends on the duration of the drug and starting hormonal.There is no ideal drug.New - does not mean the best.The main rule: hormonal contraception is chosen, controlled by the attending gynecologist, in accordance with the individual characteristics of the female body.