How do hormonal drugs affect the body? Side effects. What are the dangers of hormonal drugs: is it worth being afraid of "hormones

This is a group of drugs that are used for hormone therapy. The effect of such drugs on the body has been studied well enough so that it does not cause concern.

To such a wide group as hormonal preparations include the following drug categories:

• Contraceptives.
• Therapeutic (drugs whose action is aimed at curing a disease caused by a lack of a hormone).
• Regulatory (for example, to normalize menstrual cycle).
• Maintenance (insulin for diabetics).

All drugs affect the body and women in different ways. It all depends on the general condition of the body, the presence of serious diseases and the state of the immune system.

Medications

This group is used for hormone therapy and is available in the form of tablets and ointments. Tablets treat serious diseases caused by deviations in the hormonal sphere, and ointments have a local effect.

In girls who lack the production of hormones, the skin suffers from cracks and wounds in the winter, as the synthesis of new cells is disrupted. To deal with such an annoyance. The doctor prescribes creams, ointments and lotions containing hormones. Usually corticosteroids are included in the ointment, which are absorbed into the blood after a few hours.

Such drugs can seriously affect the body. Therefore, it is important to maintain the dosage and, when prescribing, immediately determine the duration of the course, since one wrong step can lead to complications of existing problems.

Regulatory drugs

Due to the peculiarities of the lifestyle of a modern woman, deteriorating nutrition and a polluted environment, many of the fair sex are faced with menstrual irregularities. This can affect not only the genital area of ​​the body, but also general condition organism. Hormonal disorders may lead to the development oncological diseases breasts, as well as infertility. The action of hormonal drugs can help solve problems.

However, before admission, it is necessary to conduct examinations and tests. First, a blood test is done certain substances. He will be able to identify either their excess. Such tests are quite expensive, but in order to solve problems, it is necessary to start treatment in a timely manner. After detecting a deficiency or excess of hormones, regulation of their content begins. For this, courses of injections or tablets are prescribed. Properly selected oral contraceptives will help normalize the cycle without harm to health.

Any remedy containing hormones requires scrupulousness in determining the dosage, since it is quite simple to cross the line of the required dose. For example, exceeding the norm can lead to hair loss, swelling and pain in the mammary glands.

Hormonal preparations can be made on the basis of hormones natural origin or it is a synthetically produced substance. With a course of hormonal therapy, it is aimed at normalizing the hormonal background and normalizing metabolic processes. Depending on the functional state of one or another gland, hormone therapy is conditionally divided into replacement, stimulating and blocking.

Negative effects of hormones

For the body of both men and women, the use of hormonal drugs can cause such backfire, How:

• osteoporosis and mucosal ulcers duodenum and the stomach itself when taking glucocorticoids;
• weight loss and cardiac arrhythmia when taking hormonal drugs thyroid gland;
• too much a sharp decline blood sugar while taking insulin.

The effect of hormonal ointments on the body

Preparations containing hormones for external use can vary greatly in the degree of impact on the body. Ointments and creams are considered the most powerful, gels and lotions contain lower concentrations. Hormonal ointments used to treat skin diseases and allergic manifestations. Their action is aimed at eliminating the causes of inflammation and irritation on the skin.

However, if we compare ointments with tablets or injections, then their harm is minimal, since absorption into the blood occurs in small doses. In some cases, the use of ointments can lead to a decrease in the productivity of the adrenal glands, but after the end of the course of treatment, their functionality is restored on their own.

The effect of hormonal contraceptives on the body of a woman

Features of the influence of hormonal drugs on the human body are that many factors are perceived purely individually. The use of such drugs is not only an interference with natural physiological processes, but also an impact on the functioning of body systems during the day. Therefore, the decision to prescribe hormonal drugs can only be made by an experienced doctor based on the results. comprehensive survey and analyses.

Hormonal contraceptives can be made in various forms and dosages:

• combined;
• mini-drank;
• injections;
• plasters;
• subcutaneous implants;
• postcoidal drugs;
• hormone rings.

Combination preparations contain substances similar to female hormones produced by the ovaries. To be able to choose the optimal medicine, all groups of drugs can be monophasic, biphasic and triphasic. They differ in the proportions of hormones.

Knowing about the properties of gestagens and estrogens, certain mechanisms of action of oral contraceptives can be distinguished:

• decrease in the secretion of gonadotropic hormones due to the effects of progestogen;
• increased acidity of the vagina due to the influence of estrogens;
• increased viscosity of cervical mucus;
• in each instruction there is the phrase "implantation of the egg", which is a veiled abortive action drugs.

In the time that has passed since the appearance of the first oral contraceptives, the debate about the safety of the use of drugs does not subside, and research in this area continues.

What hormones are in contraceptives

Typically, hormonal contraceptives use progestogens, which are also called progestins and progestogens. These are hormones that are produced corpus luteum ovaries, in small amounts by the adrenal cortex and during pregnancy by the placenta. The main gestagen is progesterone, which helps prepare the uterus in a state favorable for the development of a fertilized egg.

Another component of oral contraceptives is. Estrogens are produced by the ovarian follicles and the adrenal cortex. Estrogens include three main hormones: estriol and estrogen. These hormones are needed in contraceptives to normalize the menstrual cycle, but not to protect against unwanted conception.

Side effects of hormonal drugs

Each drug has a number side effects, which can manifest themselves when a decision is made to immediately stop the drug.

The most frequently recorded cases of side effects of hormonal drugs:

• Hemolytic-uremic syndrome. It is manifested by such disorders as anemia, thrombocytopenia and acute renal failure.
• Porphyria, which is a violation of the synthesis of hemoglobin.
• Hearing loss due to otosclerosis.

All manufacturers of hormonal drugs indicate thromboembolism as a side effect, which is extremely rare. This condition is a blockage of the vessel by a thrombus. If the side effects outweigh the benefits of the medication, it should be discontinued.

Side effects of oral contraceptives are:

• (lack of menstrual flow);
• headache;
• blurred vision;
• change in blood pressure;
• depression;
• weight gain;
• soreness in the mammary glands.

Studies on the side effects of oral contraceptives

IN foreign countries Studies are constantly being conducted on the side effects of hormonal drugs on a woman's body, which revealed the following facts:

• Hormonal contraceptives are used by over 100 million women worldwide. different countries.
• The number of deaths from venous and arterial diseases is fixed at 2 to 6 per million per year.
• The risk of venous thrombosis is important in younger women
• Arterial thrombosis is relevant for older women.
• Among smoking women taking OK, the number of deaths is about 100 per million per year.

The effect of hormones on the male body

The male body is also seriously dependent on hormones. The male body also contains female hormones. Violation of the optimal balance of hormones leads to various diseases.

Either estrogen leads to decreased testosterone production. This can cause problems:

• in the cardiovascular system;
• with memory;
• age;
• decrease in immunity.

If the balance of hormones is disturbed, a course of hormone therapy is necessary, which will help to avoid further deterioration in health.

Progesterone has a calming effect on the male nervous system and helps men suffering from premature ejaculation to solve sexual problems.

Normal levels of estrogen in male body has a number of useful properties:

• maintaining optimal levels of "good cholesterol";
• pronounced muscle growth;
• regulation nervous system;
• libido improvement.

When noted:

• inhibition of testosterone production;
• body fat according to the female type;
• gynecomastia.
• Erectile dysfunction;
• decreased libido;
• depression.

Any of the symptoms is extremely unpleasant, so do not hesitate to visit the doctor. A competent specialist will be able to full examination and prescribe a course of drugs that will significantly improve the condition of the body.

Bibliography

1. Sudakov K. V., normal physiology. - M.: LLC "Medical Information Agency", 2006. - 920 p.;
2. Kolman Ya., Rem K. - G., Visual biochemistry // Hormones. Hormonal system. - 2000. - pp. 358-359, 368-375.
3. Berezov T.T., Korovkin B.F., Biological chemistry // Nomenclature and classification of hormones. - 1998. - pp. 250-251, 271-272.
4. Grebenshchikov Yu.B., Moshkovsky Yu.Sh., Bioorganic chemistry // Physicochemical characteristics, structure and functional activity of insulin. - 1986. - p.296.
5. Orlov R. S., Normal physiology: textbook, 2nd ed., corrected. and additional - M.: GEOTAR-Media, 2010. - 832 p.;
6. Tepperman J., Tepperman H., Physiology of metabolism and the endocrine system. Introductory course. - Per. from English. - M.: Mir, 1989. - 656 p.; Physiology.

Elena Berezovskaya

How impossible to imagine modern world without a computer and the Internet, it is impossible to imagine the life of a modern woman without hormonal contraceptives. Hormonal contraceptives have appeared on the market for a long time - since the creation of a tablet form of synthetic progesterone - ethisterone in 1938 by German chemists, although the Second World War prevented the widespread use of the first hormonal contraceptive. However, we can safely say that for almost 60 years, women in the world have been using hormonal contraception. Is it possible to draw conclusions about its safety, taking into account side effects arising on the background of taking hormones and after a certain period of time after the completion of their intake? This question is also relevant because talking about growth malignant formations what is popularly called cancer are heard everywhere. Are levels really rising? different crayfish or diagnostic technologies can detect many types of cancer on early stages What was missed and not treated before?

Hormonal contraception has many supporters, but there are many opponents - and all make allegedly convincing arguments about the benefits and harms of this type of contraception. I, as a doctor who does not want to be a hostage to myths and rumors, must provide my patients with accurate and truthful information about everything related to human health, including hormonal contraception, often leaving my personal views and preferences aside. But when in the thousandth once the question arises, how long can you take hormonal contraceptives and does it hurt women's health, I decided that it was time to express my point of view, which will be a mixture of the point of view of a doctor and a woman.

We often make false conclusions just because we do not know much about what we are making conclusions about. Therefore, in order to answer the question of how long you can take OK without harm to the body, we will discuss several important facts.

Another 100-150 years ago average duration life of women was 35-40 years. Many married in adolescence(14-18 years old) and fell into a repeating cycle of pregnancies, childbirth, breastfeeding giving birth to 7-12 children. Such women did not need contraception - their destiny was predetermined by Nature itself: a woman was created to be a mother. For many, even menstruation was rare due to repeated pregnancies and periods of lactation (milk production). The cessation of menstrual cycles in the majority occurred at 35-37 years old, and many did not live up to menopausal age at all.

With the increase in life expectancy, women began not only to menstruate earlier (from 12-13 years), but also longer (up to 50-55 years). It means that reproductive age a modern woman, when there is an opportunity to become pregnant, has increased significantly and is about 40 years old. If the level of conception of offspring is not high in adolescence (up to 18-19 years) and premenopausal (after 37-38 years) ages, one way or another, almost 20 reproductive years of life remain. Most women in Europe, North America, Australia do not want to have more than 1-3 children, which takes from 1 to 6 years of their life, when reliable contraception is not so important. Many people postpone childbearing until a later age. average age of women giving birth for the first time in developed countries is 29-32 years. And before and after that, they try to use the methods of contraception that are optimal for them.

Before the advent of hormonal contraception, affordable price in many countries, especially in those where there were no other contraceptives, artificial abortions flourished - abortions, both legal and criminal. The world leader in the number of abortions since 1964 (possibly earlier) was the USSR, until its collapse - up to 80% of all conceived pregnancies were interrupted. These figures did not include the level of criminal abortions, which were also common in the Soviet republics, since far not all women advertise unwanted pregnancies.

Until now, in many post-Soviet countries, up to 65-70% of unplanned pregnancies are interrupted, despite the fact that almost any pharmacy has several types of hormonal and other contraception, and the younger generation of women constantly abuse emergency hormonal contraception. Why are there so many abortions? The still unaltered mentality of society is that prevention of pregnancy and getting rid of an accidental "flight" is the prerogative of a woman, not a man, against the backdrop of the high cost of hormonal contraceptives (many of our women still cannot afford these drugs).

If you look at the data of the UN report on the use of contraception in different countries of the world, published in 2011, about 67% of Ukrainian women aged 15-49 use different methods contraception, of which only 4.8% use hormonal contraceptives (2007 figures). The most popular form of birth control is the intrauterine device (17.7%) and the male condom (23.8%).

Hormonal contraception was created to prevent pregnancy and nothing more. The fact that it is used for other purposes, and quite often not justified, without any evidence, is another story.

In all hormonal contraceptives, the main contraceptive role is played by a synthetic progestin. In fact, the main purpose of obtaining progesterone in the past and producing it on an industrial basis was to create a contraceptive "medicine", because progesterone is an excellent contraceptive (that's right, I did not make a reservation).

Estrogens can also be used as contraceptives, because in large doses inhibit the maturation of germ cells in the ovaries, but have a more pronounced negative effect on a number of hormone-dependent organs and tissues, so they have not been used as contraceptives. They were added to progestins to better mimic the natural menstrual cycle and obtain better withdrawal bleeding (artificial menstruation), especially with the advent of the 28-day hormone regimen (hormone pills are taken for 21 days and pacifiers for 7 days, or a 7-day break without hormones is taken). Such a regimen in the early 50s made it possible to calm the nerves of most women who, against the background of continuous intake hormonal pills did not have periods, and therefore worried whether the pills work or not. He also allowed the adoption of hormonal contraceptives by the Catholic and other churches without major opposition and criticism. And the boom of hormonal contraception began!

There are many supporters and opponents different modes taking hormonal contraceptives, but clinical researches showed that none of the methods has advantages.

There are a lot of progestins, on which the action of oral contraceptives (OCs) is based, and it is they that determine the additional action of OCs, which is based on how the drug is absorbed, with which cell receptors it binds. For example, some OK can suppress the level of male sex hormones, while others, on the contrary, increase, etc. This additional function of hormonal contraceptives is used with therapeutic purpose for a number of diseases.

It's important to know that there are four generations of progestins, which is the basis for the classification of hormonal contraceptives. And it is natural that the younger (newer) the generation of drugs, the better it should be. In fact, the improvement occurred in lowering the doses of synthetic hormones that are part of the OK, while maintaining the effectiveness contraceptive action. Therefore, the negative effect of hormones on the woman's body decreased with a decrease in the dose. Scientists around the world are constantly looking for such progestins that could be taken less frequently, but at the same time side effects, including long-term ones, were less, and the contraceptive effect did not decrease.

Now let's talk about the safety of using hormonal contraceptives.

It is extremely important to understand that hormonal contraceptives are drugs, not lollipops, chocolates, vitamins. These are medicines! And that says a lot. This means that, like any medication, hormonal contraceptives have their own indications and contraindications for use, the method and forms of use, side effects. Also, drugs can interact with other substances, including medicines. The most important thing is that familiarization with the instructions for using the drug is somehow missed. The answer to the question of what awaits me in the future if I start taking hormonal contraceptives is presented in the side effects section of the instructions. How many women read this column? How many women read the instructions for use of the drug?

The most interesting thing is that the side effects section includes a description negative impact hormonal contraceptives only for the period of taking the drug. But there are also long-term effects of any drugs. However, most often they are not mentioned, because this can significantly reduce the level of sales and use of medicines. Hormonal contraceptives also have long-term side effects, which we will talk about later.

So, the fact that hormonal contraceptives (any) are drugs is understandable. But many do not pay attention to the word "hormonal". When a person is told: "You need to take hormones," this often causes backlash and fear. “Hormones? And it's not dangerous? It's all hormones! It doesn't matter what hormones they are - for the treatment of diabetes, diseases of the joints, the thyroid gland, etc. "I was put on hormones" - often sounds like a sentence. But when it comes to hormonal contraception, the perception of the word “hormone” changes dramatically. “I have pimples on my skin. What do you recommend from hormonal contraceptives? “My one friend took “”, and the other - “”, and my doctor says that it is better to insert Mirena into the uterus, but I have not yet given birth. What do you think should be preferred?"

Hormonal contraceptives are hormonal drugs, and in most countries of the world they are not prescribed in absentia without examining the woman, and they also require a prescription to purchase them.

All hormones, unlike other drugs, in a small amount can affect, including negatively, cells, tissues, organs and organ systems that have special sensors - receptors through which hormones exert their effect. Hormonal contraceptives are no exception, therefore they have contraindications. How many women, looking at the instructions, thought that if the list of contraindications is so impressive (impressive in terms of different systems organs, and not for one group of diseases), then these are really not vitamins, and not pills for headaches or to lower body temperature. Even most antibiotics, which are prescribed right and left by many doctors, have much fewer contraindications and side effects than hormonal contraceptives (for the sake of interest, open the instructions for use and compare).

The traditional phrase "Millions of women have been taking hormonal contraceptives for years and nothing bad happens to them" can be used as a "knock-off" if the doctor does not want to answer the woman's question, "What threatens taking OK for my health?" A more professional answer: “Read the instructions” (and figure it out for yourself). But, after reading the instructions, the woman will again ask how then millions of other women take these hormones, will she enter the percentage of those who will have side effects, will taking hormones increase the risk of developing some kind of cancer in the future ...

What is important to know in such cases? The assimilation of hormonal contraceptives and their impact with the development of side effects in each woman is individual and unpredictable in most cases. The only guaranteed OK action that works in 99% of cases when they correct reception, there will be a contraceptive effect - for this they are created. Everything else as an additional or side effect, sometimes even positive (improved skin condition, for example), appears as an individual reaction of the body to taking OK.

Now let's talk about the long-term effects of hormonal contraceptives. As mentioned above, modern women have big periods life, when the conception of children is not planned, but there are sexual relations. And regardless of the frequency of these sexual relations, regardless of age and chances of getting pregnant, they want to be sure that there will be no pregnancy.

To answer the question of what threatens long-term use of hormonal drugs, it is necessary to weigh many factors.

1.What kind of OK or other types of hormonal contraceptives does a woman take? Very often, women in the post-Soviet space prefer the old high-dose OK, many of which have ceased to be used in developed countries. They are cheaper than OK of new generations, so it is more profitable to buy and sell them. For a long time already the countries of the "second and third worlds" have become a convenient testing ground for fusion of everything that the "first world" refuses.

Thus, the higher the dose of hormonal components of OK and the longer they are taken, the risk of developing side effects and long-term effects higher.

Also, different types progestins can have side effects in different ways - this must also be taken into account by both doctors and women.

2. Woman's age plays important role selection OK. The older the woman, the more urgent the question of the optimal dose of estrogens and progestins, as well as the advisability of taking hormonal contraception, becomes. Indeed, many women do not really need this type of contraception, but live with false beliefs imposed by doctors that the ovaries “rest” while taking OK, that hormonal contraceptives “preserve the ovarian reserve”, “prolong youth”, “rejuvenate the ovaries and the body ”, “increase the sexuality of a woman”, etc. No, hormonal contraceptives only protect against pregnancy, but do not prevent the aging of the ovaries, and the whole organism as a whole, and even more so, do not rejuvenate.

3.Aging of the body with age is accompanied by the appearance of various diseases. especially if the woman does not lead a healthy lifestyle. Some diseases can be aggravated by taking hormonal contraceptives. For assimilation and manifestation of action, OK require Good work gastrointestinal tract(through it, hormones enter the bloodstream, and the products of their metabolism are excreted with feces), liver (here they partially decompose and partially bind to special proteins) and kidneys (through them, the products of hormone metabolism are excreted from the body). Adipose tissue plays an important role in the metabolism of hormones and often the role of a warehouse (depot), where they can accumulate in the form of metabolic substances (metabolites) and be stored for many months and years. It is the cumulative effect of hormone metabolites in adipose tissue that plays a negative role in the development of some serious diseases, including a number of cancers.

4. Although a woman at the time of taking OK may not have diseases and conditions that are included in the list of contraindications, but there is such a thing as hereditary predisposition to develop the disease. This does not mean that a person will necessarily get sick with what his close relatives get sick. healthy image life that includes healthy eating, physical activity and healthy psycho emotional condition, can prevent the occurrence of most diseases, even if there are cases of such diseases in the family. Hereditary predisposition is found in diabetes mellitus, high blood pressure blood (hypertension), migraine, blood and vascular clotting diseases, some diseases of the liver and kidneys. The list of diseases can be expanded, and most of them will be on the list of contraindications for the use of OK. It is rational to undergo periodic examination while taking hormonal contraceptives in order to timely detect deviations that can lead to the development of diseases.

It is also important to remember that hormonal contraceptives can interact with drugs and other drugs, worsening the woman's condition and the course of the disease.

5. Availability bad habits primarily smoking. Smoking itself is a risk factor for the development of many diseases, primarily such dangerous ones as lung cancer and cardiovascular disease. Smoking is also a risk factor for 13 other types of cancer: throat, esophagus, stomach, oral cavity and lips, pharynx, nasal cavity, Bladder, pancreas, kidneys, liver, intestines, ovaries, cervix, some types of blood cancer (leukemia). There is evidence of increased levels of breast cancer in women who smoke.

What many people probably don't know is that the first publications about the relationship between smoking and lung cancer appeared in the 1930s, and the tobacco companies carefully checked these data through their own research. The data were confirmed, but instead of presenting the results to the public, every effort was made to conceal and falsify them.

Today, the warning on cigarette packages that smoking increases the risk of developing lung cancer is no surprise. But it took more than fifty years of struggle for brave scientists, doctors, public figures, many of whom lost their jobs, positions, positions, reputations, families and even lives, to issue this warning. It took about thirty years to pass a law banning smoking in public places.

Of course, doctors often warn that smoking while taking OK is not desirable (hardly speaking, not compatible). But many women "naughty" periodically, smoking and ignoring the warnings of doctors.

In addition to smoking, the use of alcohol and drugs also increases the risk of developing serious diseases, especially in combination with OCs.

Interestingly, many women, especially those planning a pregnancy, know that alcohol is a teratogen, that is, it is involved in the appearance of fetal malformations. Not everyone knows that there is a proven link between alcohol intake and the risk of developing cancer of the neck and head (throat, larynx, mouth, lips), esophagus, liver, mammary glands, and large intestine. For example, daily consumption of 2 bottles of beer (350 ml each), or 2 glasses of wine (300 ml), or about 100 ml of strong alcoholic beverage increases the risk of developing breast cancer twice as compared to those who do not drink alcohol (data from the National Institute of Cancer, USA However, such warnings on labels alcoholic beverages you won't find.

And here I would like to draw your attention to such a concept as carcinogens. Many people know that carcinogens are substances that are directly or indirectly involved in the development of malignant processes. The fact that smoking (more precisely, a number of substances contained in smoke) and alcohol are classified as carcinogens is no surprise to anyone - they write and talk about it a lot. Natural estrogens and progesterone can also cause the growth of certain malignant tumors in a woman's body (however, in men too), which we often call hormone-dependent tumors. Therefore, estrogens and progesterone are classified as carcinogens.

It's hard to believe, isn't it? If doctors have known about the carcinogenic effect of estrogens (both natural and synthetic forms) and the risk of developing breast and uterine cancer for a long time and try not to prescribe them without strict indications, especially at an older age, many doctors have created almost a panacea from progesterone and its synthetic forms. from all female diseases.

The WHO, in the monograph of the Human Carcinogenic Risk Study Program, together with the International Agency for Research on Cancer (IARC), argued back in 1999 that both hormones, estrogen and progesterone, are not without reason considered human carcinogens. This claim has been supported by the US Department of Health and Human Services National Toxicology Program in carcinogen reports for nearly 15 years. In the latest report of this program (13th edition), progesterone is still on the list of carcinogens - not gone anywhere.

Synthetic hormones that are part of OK and replace the action of estrogen and progesterone do not fundamentally differ from the action of natural hormones. They are also carcinogens, which means they can be put on a par with smoking and alcohol.

Moreover, manufacturers of hormones, including progestins and progesterone, have long been no longer hiding the information that these are carcinogens. For example, in information about the products of Sigma-Aldrich Corporation, one of the world's largest manufacturers of progesterone, which has offices in 40 countries of the world, in the description of biochemical and physiological properties progesterone it is said that the hormone “Causes the maturation and secretory activity of the endometrium of the uterus, suppresses ovulation. Progesterone is involved in the etiology (occurrence) of breast cancer.” The same company, like many others, conducts its own research, the results of which are not hidden, as was done before.

Numerous clinical studies have proven an association between increased levels of breast, cervical, and liver cancer and OC use. A positive effect is observed in the reduction of ovarian and endometrial cancer in women taking hormonal contraceptives. At the same time, hormone replacement therapy, which contains a smaller dose of the same synthetic estrogens and progestins, on the contrary, increases the level of endometrial and ovarian cancer in premenopausal and menopausal women.

How long can I take OCs without causing serious side effects and increasing the risk of developing a number of malignant tumors? There is no exact answer, because it all depends on individual characteristics body and all of the factors listed above. But data from a number of studies have shown that, for example, taking OCs for more than 5 years increases the risk of developing precancerous conditions and cervical cancer (the level drops to the average 10 years after stopping hormonal contraceptives).

In assessing the impact of something on something in medical statistics, there are different types of risk, but most often they use relative and individual risks. The risk of developing a disease under the influence of some risk factor is the ratio of cases of the disease in two groups of people - with and without a risk factor. This risk can be calculated taking into account other risk factors for a group of people or for a specific person, taking into account his risk factors (individual risk).

Over the past fifteen years in medical literature a huge number of publications have appeared on the relationship between breast cancer and the use of hormonal contraceptives, and some data indicate existing risk for the period of taking hormonal contraceptives (not only tablet forms) and a short period after the end of the intake, others - about the risk during long period after the end of the hormones. Independent from pharmaceutical companies and medical institutions organizations also conduct their own research, and the evidence from such studies is not encouraging.

In general, the risk of developing cancer increases by 50% after one year (12 months) of taking hormonal contraceptives, and slowly decreases over the next 10 years after stopping hormones to the level of risk of those who did not take hormones. Such data relate primarily to OK containing high doses estrogen (old generation of hormonal contraceptives). Also, some types of progestins (ethinodiol diacetate) can double the risk. Three-phase hormonal contraceptives, especially those containing norethindrone, which are rarely used in developed countries, but are still widely prescribed (due to cheapness) in post-Soviet countries, increase the risk of developing breast cancer by three times (already within a year of taking the drug). Modern low-dose drugs have a lower level of risk. Since low-dose OCs have been on the market for a relatively short time and breast cancer occurs in older women (pre-menopausal and menopausal), studies on the effect of these types of contraceptives on the occurrence of cancer require more time.

Also, there are more and more disputes, especially in medical circles, how safe it is to take hormonal contraceptives for women after 40 years, which lead active sex life, and therefore can become pregnant, despite low level conceptions in this age category. Some doctors suggest using more alternative methods of contraception. Others, on the contrary, argue that there is nothing wrong if a woman takes OK before menopause (which may not be noticed while taking hormones). I believe that if a woman still wants to take OK, then it is best to switch to low-dose hormonal drugs with regular monitoring of the state of those organs for which the risk of cancer is increased.

The data presented may cause some shock to readers, especially women. There will also be many opponents, especially among proponents of hormonal contraception and those who prescribe and take hormones (estrogens and progesterone) for other reasons, who would be outraged by such a review of hormonal contraception. But, even if we do not take into account the risk of developing cancer, hiding behind the phrase “there is, but minimal,” I would like to ask each reader a question: would you take a substance (any, including a drug), if you knew that it is a carcinogen, then is involved in the development of cancer? Would you buy a product that says, like on a cigarette package, that it increases your risk of developing cancer (any)? Of course, many people who smoke do not pay attention to such warnings - this is their personal choice. Many carcinogens are present in our lives all the time. Some drugs can also cause cancer, but fortunately, their dose and intake are limited, and people do not take them for months and years most often. But hormonal contraceptives have been taken by women for years...

Why are millions of women around the world taking hormones for so many years? Because it's profitable

(1) Manufacturers of hormonal contraceptives,

(2) Sellers of hormonal contraceptives,

(3) Men, because they do not need to take or share responsibility with women for the consequences of unprotected sex,

(4) Women, because they have gained some independence from men and now they can control their own reproductive function.

The most indignant readers will say: “Well, if hormonal contraceptives are so bad, then what remains for women? To return to the era of abortions again or to refuse sexual life in general?

Indeed, abstinence or renunciation of sexual activity is the most reliable means protection against unplanned pregnancy, but it is not suitable for most couples. It can also undermine and break up the relationships of many men and women. Of the reliable methods of contraception, the same male condoms remain, but they require the active participation of a man in this type of protection. In developed countries (USA, Canada, some European countries) and countries Latin America male and female sterilization began to grow rapidly (20-25% of cases of contraception), which also has its pros and cons and is not suitable for all people (most often for those who have completed their childbearing function and no longer plan to have children). Popularity intrauterine device(Navy, but without hormones) is also increasing worldwide. Other methods of contraception have different levels of effectiveness, require certain skills from sexual partners, and therefore also cannot be used by all people.

The decision is always up to the woman (this is her personal decision), however, if doctors provided truthful information about what they prescribe (this applies not only to hormonal contraception), then many diseases and complications of direct treatment and medication can be avoided.

Thus, my answer as a doctor to the question of how long you can take hormonal contraceptives in a safe mode for health will be as follows: hormonal contraceptives are hormonal drugs, so their degree of safety will be determined by the type constituent parts, dose, regimen, method and duration of administration, compliance with indications and contraindications, individual tolerance, the presence of other diseases, bad habits and timely detection of side effects.

As a woman, in the depths of my soul there is a hope that modern men will not only enjoy sexual relations with women, but will increase their level of responsibility by taking a more active role in protecting their beloved and dear women (sex partners) from unplanned pregnancies.

Hormonal preparations are intended for the treatment endocrine disorders. They are prescribed for women and men. There are more than 50 drugs for hormone replacement therapy.

All hormonal agents divided into natural and synthetic. Natural contain hormones derived from fresh or frozen cattle glands, as well as from biological fluids animals or humans. Synthetic analogues are chemically obtained, but perform similar functions.

What are hormones?

• pituitary gland (anterior and posterior lobes);
• thyroid and antithyroid substances;
• pancreas (insulin and glucagon);
• sugar-reducing substances;
• parathyroid gland;
• adrenal cortex;
• sexual;
• anabolic substances.

Hormonal preparations can be in the form of water or oil solution, tablets, ointments. They are administered subcutaneously, intramuscularly, taken orally or rubbed into the skin.

13 Facts About Hormone Therapy

1. Hormones are not always harmful. Hormonal agents provide miscellaneous action often give side effects.
2. Hormonal agents have different effects on people. Those drugs that helped a relative or friend can harm you with the same diagnosis.
3. young patients and nulliparous girls you can take hormones. They are prescribed even from a young age, and hormonal contraceptives are allowed for adolescents.
4. Hormonal drugs do not always have a contraceptive effect. One month after hormone therapy reproductive function is fully restored. It is also possible to conceive twins or triplets, as certain hormones cause multiple eggs to grow.
5. Breaks in hormone therapy are optional. Most often, hormones are prescribed as a continuous course.
6. Breastfeeding women can also take hormonal drugs. The ban applies only to some pills that affect lactation.
7. Not all hormonal drugs cause weight gain. If the patient is inclined to be overweight or began to recover during treatment, the doctor may reduce the number of progestogens in therapy.
8. There are hormones for men.
9. Hormonal drugs are prescribed not only for severe diseases. They help to cure mild pathologies of the thyroid gland, pituitary gland or pancreas.
10. Hormones do not accumulate in the body. These substances break down almost immediately and are excreted from the body over time.
11. Preparations with hormones are prescribed for pregnant women. If a woman had hormonal disruptions before conception, during pregnancy she needs drug therapy. Without the normalization of the hormonal background, it is impossible to bear a child.
12. Hormones do not always reduce libido. Many patients report an increase in sex drive with hormone therapy. If the desire is reduced, you can ask your doctor to prescribe drugs with less progesterone.

When are hormonal drugs prescribed?

Natural hormones are produced endocrine glands our body. These substances have a distal effect, that is, at a distance from the gland in which they were formed. Hormonal drugs are prescribed for dysfunction of the pituitary gland, thyroid gland, adrenal glands, pancreas and ovaries, as well as some diseases that do not affect the endocrine system.

What diseases are hormones prescribed for?

1. Diabetes. The disease is diagnosed in the absence of the hormone insulin, without which glucose does not enter the cells and not enough energy is created for normal life. Insulin preparations solve this problem.
2. Adrenal insufficiency. With adrenal dysfunction, the patient becomes weak, loses weight, and suffers from symptoms of impaired circulation. The hormones glucocorticoids and mineralocorticoids allow to restore the stable functioning of the organ.
3. Hypothyroidism. This condition develops with a decrease in the functionality of the thyroid gland, when levothyroxine ceases to be produced. The hormone itself is inactive, but in cells it turns into triiodothyronine and regulates protein biosynthesis.
4. Hypogonadism. The disease is characterized by insufficiency of the gonads. With hypogonadism, infertility develops in women and men, and hormone therapy is the only way to conceive a child.

In addition to glandular insufficiency, there is also excessive activity. Often, patients are diagnosed with an excess of hormones. This condition is no less dangerous and also requires treatment. To reduce the amount of hormones, drugs are prescribed that block secretion or remove the gland itself.

Estrogens and progestins - female hormones - have the effect of contraception. They may also be prescribed during perimenopause to relieve symptoms. Anabolic steroid male hormones are effective in the treatment of dystrophic conditions.

Contraceptives are divided into combined with estrogen and progestogen and drugs with progesterone. Hormonal contraception is preferred if the woman has one regular partner. Protection against infections during chaotic sexual intercourse will only be condoms.

The action of hormonal contraceptives is due to the fact that the substances provoke changes in the cervix that prevent the penetration of spermatozoa. Pathological changes that can cause infertility can develop with long-term use hormonal contraceptives (without stopping for more than 3 years). However, many experts claim that after the abolition of contraception, the likelihood of pregnancy only increases.

Hormonal contraceptives do not affect weight, help cleanse the skin and reduce the amount of body hair. Hormones can regulate the cycle and reduce the risk of ovarian cancer. Some note breast enlargement and an increase in its elasticity when taking hormonal contraceptives.

Modern contraceptives have a minimum of side effects. With the help of hormones, you can postpone the timing of menstruation and reduce the symptoms of SCI.

Hormones for contraception are prescribed for a maximum of a year. It is advisable to take breaks for several months and visit the gynecologist regularly. Oral contraceptives contraindicated in smokers, patients with tumors and varicose veins veins.

The main method is hormone therapy. Depending on the severity of the pathology, doctors prescribe contraceptives, drugs with progesterone, drugs with the hormone danazol, or gonadotropin analogues.

Hormonal contraceptives for endometriosis reduce pain syndrome and shrink the endometrium. Usually drugs are prescribed for six months, if necessary, you can extend the course for 3-6 months. At successful treatment areas of endometriosis are significantly reduced.

Popular contraceptives:

• Regulon;
• Yarina;
• Marvelon.

With endometriosis, drugs with progesterone may be prescribed. This substance inhibits the secretion of estrogens, which provoke the growth of the endometrium of the uterus. The course of treatment is 6-9 months. The best drugs of the group are considered to be Vizanne and Depo-Provera.

The hormone danazol in endometriosis reduces the amount of sex hormones, which reduces the foci of pathology. The optimal course of treatment is 3-6 months

Another method of treating endometriosis is analogues of gonadotropin-releasing hormones. They reduce the functionality of the ovaries and suppress the production of sex hormones. During therapy, menstruation disappears and menopausal symptoms may occur. To prevent this, doctors prescribe small doses of hormones. Treatment is a maximum of six months. After the drug is discontinued, ovarian function is restored.

Preparations with gonadotropin-releasing hormones:

• Buserelin;
• or ;
• Sinarel.

Hormone therapy for menopause

Closer to 50 years, a woman's body undergoes restructuring. Fading in reproductive function, estrogen levels decrease, bones become brittle, and tissues less elastic. woman feels characteristic symptoms: hot flashes, headaches, sweating, emotional instability, osteoporosis.

Hormone replacement therapy for menopause helps to reduce the number of strokes, heart attacks, pathologies of the musculoskeletal system, as well as maintaining pelvic tone and stabilizing the nervous system. Menopause symptoms disappear.

If there are no contraindications, substitution therapy can be prescribed for 5-8 years. Hormones are not recommended in the presence of a malignant tumor, circulatory disorders, uterine bleeding, stroke and heart attack in history, liver disease.

What hormones are prescribed for menopause:

1. Angelique. With estradiol and drospirenone.
2. Femoston. Contains estradiol and dydrogesterone, which improves the natural cycle.
3. Ovestin. Contains estriol - necessary to restore the elasticity of the mucosa.
4. Livial. Includes synthetic tibolone. It has a complex estrogen-gestagenic effect.
5. Norkolut. A progestogen-based agent with norethisterone.

Hormones during pregnancy

One of the main causes of early miscarriage is the instability of the hormonal background of a woman. As a rule, abortion occurs when there is a lack of progesterone or estrogen.

Lack of progesterone is dangerous because the conditions necessary for the development of the fetus are not created, and estrogen deficiency leads to thinning of the endometrium of the uterus and rejection of the embryo. During pregnancy, it is necessary to treat not only problems with sex hormones, but also all hormonal disorders.

Progesterone preparations:

1. Duphaston. The drug contains a synthetic analogue of progesterone - dydrogesterone. It is much more active and stable natural hormone therefore effectively supports pregnancy. As a rule, the drug is canceled after 20 weeks, when the body's need for progesterone decreases. Duphaston does not affect the skin, hair, sleep and blood glucose levels. When spotting urgently need to see a doctor to increase the dose. Dufaston is incompatible with phenobarbital, which is prescribed for epilepsy.
2. Utrozhestan. The drug contains micronized progesterone. Utrozhestan normalizes the level female hormones and affects androgens (male sex hormones). An excess of androgens in a woman's body can harm pregnancy. The drug can affect the reaction rate and cause drowsiness.

When taken correctly, these drugs do not provoke malformations in the fetus. They help to normalize the endocrine system and hormonal levels, which only support pregnancy and ensure the full development of the child. Refusal of therapy affects not only the mother's body, but also the physical and mental development child. However, hormones are not prescribed for diabetes, liver disease, bronchial asthma, circulatory disorders, malignant tumors and epilepsy.

Hormone therapy for men

Already from the age of 25, testosterone levels gradually decrease, and by 45, the indicators fall by 30%. During this period, hormones may be prescribed to eliminate symptoms (fatigue, mood deterioration, weakness, decreased sexual desire). Hormones are also suitable for the treatment of erectile dysfunction.

It is possible to use tablets, capsules, gel, injections and even patches with testosterone. Among the most common drugs are Andriol, Methyltestosterone, Androgel, Androderm, Nebido injections, Sustanon-250 and Testenat.

Hormone therapy in men sometimes causes side effects. Can increase risk of cancer prostate, increased oiliness of the skin, problems with sperm and androgenetic alopecia.

It must be remembered that any medication can be dangerous if used improperly. When choosing hormones, it is important to take into account the gender and age of the patient, comorbidities, habits, allergies, heredity and lifestyle.

Alcohol is harmful to health even by itself. And if in combination with drugs - even more so. This is known to every sane person. Alcohol is a toxic substance, and its combination with drugs can be accompanied by serious troubles, up to lethal outcome. Let's not talk about and. Let's discuss how alcohol affects the body when taking hormonal drugs? What drugs are strictly forbidden to combine with alcohol?

Alcohol and hormonal drugs

Many women use hormonal drugs for treatment or as a means of contraception. Moreover, treatment with hormonal drugs usually lasts a very long time, and contraceptives are used at all regularly. And, sooner or later, many are wondering - and Is it possible to combine a hormonal drug with alcohol? After all, there can be many reasons - a birthday, a wedding, just a vacation in the company, and the course of admission is long. How to be? What do experts say about this topic?

• Alcohol is not recommended with any medications .
• Consequences simultaneous reception drug and alcohol unpredictable .
• Hormonal drugs are those drugs that are forbidden to be combined with alcohol. .

Consequences of taking hormonal pills with alcohol

In the process of taking hormonal drugs, the female endocrine system starts in a different mode. When combined with alcohol, the following happens:

• "Turns on" the activation of the adrenal glands and gonads. This, in turn, becomes a consequence of an increase in the blood of adrenaline, cortisone and aldosterone. going on oversaturation of the body with hormones and, accordingly, their overdose.
• The opposite result is also possible. That is, the absence therapeutic effect from taking drugs due to the inhibition of the action of drugs by alcohol. But this is a relatively safe situation, which you should not count on.
• Very severe consequence combinations of artificially introduced hormones and alcohol can become exacerbation peptic ulcer, development of thrombophlebitis, headaches and convulsions.
• The consequences of such a thoughtless act can be many. And no one can predict the reaction of alcohol with hormonal drugs to a specific organism. It cannot be ruled out that the endocrine system will completely stop working in the previous habitual mode. In this case, the problems associated with hormonal background, can cover the body like an avalanche.

Almost every instructions for medicinal product contains a warning that combining it with alcohol is undesirable or prohibited. And in the treatment of hormonal drugs, the intake of which in itself is stressful for the body, it is better to refrain from alcohol and follow clear instructions.

When something is missing in the body, the deficiency is compensated from the outside. This is how diabetes, thyroid diseases are treated, and more recently, purely female problems have been eliminated.

Many women are afraid hormones like fire and admit that only in last resort consent to their treatment. But sometimes you really can't do without these drugs. And until we figure out for ourselves what they bring more - benefit or harm, a lot of questions will arise in the future.

We asked the candidate to answer some of them medical sciences, obstetrician-gynecologist at the Isida clinic, head of the department prenatal diagnosis Jan Ruban.

I was assigned hormonal treatment, but it doesn't work. I have been taking the pills for over a month and still feel bad. I read that this can be due to completeness. Is it true?

In the presence of excess weight we recommend that a woman first sit on a rational low calorie diet and increase physical activity and only then prescribe hormone replacement therapy (HRT). In some cases, we additionally prescribe drugs that reduce body weight. This is necessary, since normalization of weight is one of the main conditions. positive result. In general, it takes at least 3 months to evaluate the effectiveness of hormone therapy.

I heard that women who receive HRT age later. It's right?

Treatment hormones assigned for different purposes. This is not only a cosmetic effect, which consists in improving the condition of the skin, hair and nails, but also the effect on the cardiovascular, nervous and skeletal systems, the state of memory and performance, the ability and desire to have a regular sex life. With HRT in female body the required amount of estrogens is supplied, their concentration is constantly maintained at the same level, which not only allows you to feel young longer, but also improves the quality of life during this “autumn” period.

The doctor has appointed or nominated to me treatment by hormones - meanwhile on half a year. How long can this take?

Obstetrician-gynecologist, head of the department of prenatal diagnostics at the ISIDA clinic

The main task of hormone therapy is the elimination of early and late complications associated with the termination normal functioning ovaries. Therefore, several options are possible.

• FIRST - short term treatment aimed at eliminating early symptoms eg hot flashes, palpitations, depression, irritability, headaches. Duration of admission - 3-6 months (it is possible to repeat the course);
• SECOND - long-term, aimed at preventing later symptoms (such as itching and burning in the vagina, pain during intercourse, dry skin, brittle nails), cardiovascular diseases, osteoporosis, as well as eliminating metabolic disorders.

I'm afraid to take hormonal drugs, because I heard that they increase weight. How to be?

Taking combined oral contraceptives (COCs) in some cases is indeed fraught with such an “effect”, but this is not true for all drugs (much depends on their constituent components). The process, as a rule, is reversible - the weight is restored after the end of the course. When deciding to take COCs, be sure to consult your doctor.

At the same time, if a woman notices that she begins to recover in parallel with the appearance of manifestations of the climacteric syndrome, then timely and individually selected HRT, on the contrary, will help to reduce and stabilize weight. True, there is mandatory conditions for this age period: increase physical activity, diet control, smoking cessation and reduced alcohol consumption.

Three years ago, the uterus was removed. The ovaries are working normally, but have recently appeared. Can I be treated with HRT?

It is possible and necessary (provided that it is prescribed by a doctor), since after such an operation, a decrease in ovarian function inevitably progresses. But first you should conduct a complete examination of the body by visiting a gynecologist, mammologist, endocrinologist, gastroenterologist, cardiologist and therapist. In the absence of contraindications, no combined preparations, and monotherapy with natural estrogens in the form of tablets, patches, skin gels, subcutaneous implants, suppositories. You can take it both periodically and continuously - depending on the phase of menopause (peri- or postmenopause).

Whether it is possible to use instead of hormonal preparations homeopathic - Remens,? How fully do they perform the functions of hormone therapy?

The listed medicines, as well as, belong to the group homeopathic remedies, the main component of which is an extract of phytoestrogen - rhizomes of cimicifuga. Its mechanism therapeutic action based on estrogen-like effect. Due to this, the emotional state of a woman is stabilized, hot flashes, sweating, irritability and nervousness are reduced. At the same time, the drugs are safe for health and well tolerated. But they have a selective effect: they do not have any effect on the state of the endometrium, skeletal system, skin and blood composition. They are shown to women with slightly severe symptoms menopause, as well as in the presence of contraindications to HRT, unwillingness to take hormonal drugs.

result severe stress I have a menstrual irregularity. After a course of hormones, everything returned to normal. Is it possible to refuse them now?

If you feel well, then do not hesitate to stop taking the medicine after drinking the last pill from the package. Expected period will start on time. Next, control and be sure to mark subsequent periods on the calendar. If you do not plan pregnancy, be sure to use other methods of contraception.

Sometimes, after taking hormonal contraceptives, menstrual irregularities are observed in the form of oligo- (rare menstruation) or amenorrhea (their complete absence). In this case, you should immediately consult a doctor.

I have mastitis. I recently started menopause and the doctor suggested hormone therapy for me. But I read that it is dangerous for breast diseases.

If breast cancer is suspected, hormones are not prescribed. Against the background of taking drugs during the first 3 months, there may be swelling and soreness of the mammary glands, which disappears over time. In this case, the principle of individual selection of the drug is always observed. In addition, a mammogram should be done once a year.

? Is it possible to apply hormonal contraceptives for medicinal purposes?

Indeed, they are used not only to prevent pregnancy, but also to achieve a therapeutic effect.

WHO international studies have shown that the use of COCs significantly reduces the risk of ovarian cancer (by 50%) and endometrial cancer (by 60%). COCs create functional rest for the ovaries, therefore they are used to treat and prevent menstrual irregularities, (), premenstrual syndrome. They are also used in complex therapy benign diseases breast, uterine fibroids, endometriosis, inflammatory processes in the pelvic organs. They are effective in the treatment of both polycystic syndrome and certain types of infertility. Oral contraceptives are effective in eliminating cosmetic defects skin, such as increased hair loss. The main thing is to choose the right drug, taking into account the individual characteristics of the body. In this case, the benefit / risk ratio must be evaluated to minimize side effects.

How to determine if hormone therapy is right for me, are there any contraindications?

Like any medicines, hormonal preparations For replacement therapy also have certain limitations. They are not prescribed to women who have been diagnosed and treated with breast or endometrial cancer, with acute hepatitis and thromboembolic complications, liver dysfunction, untreated tumors of the genital organs and mammary glands, as well as allergies to the components of the drug.

There are diseases in which hormonal agents can be used if the benefits are greater than the predicted risk of side effects. This applies to uterine fibroids, endometriosis, migraine, previous venous thrombosis and embolism, cholelithiasis, epilepsy, ovarian cancer. In the presence of relative contraindications only a doctor can decide whether to prescribe hormonal drugs and which ones.