What are the best contraceptives for women? The latest birth control pills: freedom of choice. Hormonal and non-hormonal, used after intercourse. Which ones are better to use? Nuvaring contraceptive ring

Means for preventing pregnancy can rightfully be considered one of the oldest. After all, they were used in ancient times. For example, women of the indigenous population of America used douching for this purpose with a remedy prepared from lemon and a decoction of red tree bark. IN Ancient Egypt tampons soaked in honey and acacia decoction were used. Even condoms aren't modern method protection against unexpected pregnancy.

Of course, the effectiveness of all these tools was extremely low, and there was no need to talk about ease of use at all. Everything changed around the second half of the 20th century, when doctors first started talking about combined oral contraceptives (COCs). The first drug created for the purpose of protection was Enovid, which appeared on the pharmacy market in 1960. This is where the development began hormonal contraception.

What is hormonal contraception?

The mechanism of action of birth control pills is based on the ability of substances that are synthetic analogues of sex hormones produced by the female body to influence hormonal levels. At the same time, the brain receives a signal that there are enough hormones in the blood and the command to the ovaries to produce their own does not go through.

Hormones entering the body, depending on the type, trigger several mechanisms at once. All of them lead to the fact that pregnancy, even if ovulation has occurred and the egg has been fertilized, does not occur.

Estrogens contribute to:

• The next egg does not mature in the ovaries and ovulation does not occur.
• There is a disturbance in the uterus secretory processes, which cause the development of swelling of the mucous membrane - the endometrium, which, in turn, makes implantation of a fertilized egg impossible.
• A process called luteolysis begins - that is, reverse development corpus luteum, which is normally formed after ovulation and serves to synthesize the hormone progesterone, which prepares the body for a possible pregnancy.

• They stimulate the thickening of cervical mucus, which clogs the cervix and makes it impenetrable to sperm.
• They inhibit the activity of enzymes that help sperm penetrate the egg.
• Reduce contractile activity fallopian tubes and the uterus itself and prevent the egg from moving through them.
• They thin the endometrium, making it unsuitable for egg implantation.
• Block the release of hormones that are responsible for ovulation in the middle of the cycle.

Regardless of the type of components and composition, all hormonal contraceptives have almost the same mechanism of action.

Features of application

Any hormonal pills should be taken strictly according to the schedule, preferably at the same time of day. You cannot skip the next appointment. Depending on the composition and type of drug, if missed, the contraceptive effect will last on average only up to 12 hours. After this time, the effectiveness of the drug decreases.

The start of most COCs coincides with the first day of the cycle. At the same time, you can independently choose the most convenient time for you. Most women prefer to drink birth control pills in the evening, before bed. In this case such negative effects, as nausea, headache or changes in mood are not so pronounced.

All hormonal contraceptive pills are prescription drugs and are used only as prescribed by a doctor. Before you start taking the drug, carefully read the instructions and rules of administration.

Advantages

Of course, the main advantage of COC contraception using both monophasic and multiphasic drugs is the simplicity of the method itself. Agree, taking a pill is much easier than, for example, using a vaginal ring. And with such means as injection contraception or intrauterine devices, which cannot be used without a doctor, there is no comparison at all.

However, this is far from the only advantage; the undoubted advantages of hormonal contraception are:

• High efficiency, even for three-phase drugs the reliability indicator does not exceed 0.6%. In other words, out of one thousand women using this method of protection for one year, pregnancy occurred in only one case.
• Safety. Despite the fact that all birth control pills interfere with hormonal levels, their effects are much less harmful than the consequences of abortion.
• Normalization menstrual cycle, which, while taking the pills, becomes regular, and the menstruation itself is not so painful, long and heavy.
• By improving the barrier properties of cervical mucus, there is a decrease in the incidence of inflammatory diseases or exacerbations chronic pathologies almost twice.
• The use of hormonal contraceptives for a year reduces the risk of endometrial cancer by 50%, ovarian cancer by 30%, and the risk of developing mastopathy becomes less by 70%.

Flaws

Despite many positive aspects, hormonal birth control pills also have disadvantages. The main one, of course, is side effects, which sometimes make taking the drug simply impossible. In addition, birth control pills:

• They do not protect against sexually transmitted infections, including such dangerous ones as HIV or cytomegalovirus.
• They affect the blood coagulation system and can increase the risk of blood clots and thromboembolism.
• May worsen the course chronic diseases liver and gall bladder or provoke the occurrence of cardiovascular pathologies, disorders in circulatory system, as well as severe headaches and migraines.

Types of COCs

The whole variety of birth control pills can be divided into two main groups. The first includes drugs containing only gestagens, another name for them is mini-pills. The second group is combined contraceptives, which contain several hormones.

Usually these are synthetic analogues of estrogens and progesterone. It is this group that is most popular and is most often prescribed by doctors. Combination drugs are also divided into three types.

Monophasic

They are the first generation of drugs intended for hormonal contraception. They contain two hormones: estrogen and progesterone, which are contained in the same amount in each tablet. The most famous of this group are Janine, Yarina or Diane-35.

Despite the fact that this generation of drugs is not new and has existed for quite a long time, in terms of their effectiveness they are practically in no way inferior to multiphase drugs.

The advantage of monophasic contraceptives is their ease of administration and the possibility of doubling the dose in case you forget to take another pill. But with multiphase agents this is not always possible, and their use requires more caution and attention.

In addition, monophasic drugs can help treat endometriosis, normalize the menstrual cycle, reduce its duration and pain. Also, with monophasic drugs, cases of intermenstrual bleeding are less common than with other groups.

Monophasic contraceptives are by far the most studied and frequently prescribed group of drugs by doctors.

Two-phase

Second generation of contraceptives hormonal drugs differs in that each tablet contains a constant dose of estrogen, and the concentration of the second component, gestagen, varies depending on the day of the cycle. Among the drugs in this group, Anteovin is used today, for example.

Biphasic contraceptives are prescribed mainly only to women with abnormal sensitivity to gestagens. Another indication for such drugs is hyperandrogenism. This is a pathology in which a woman’s body begins to produce a large number of male sex hormones.

Three-phase

This group of drugs differs in that in tablets intended for different days cycle contains its own specific dose of hormones. This change in the concentration of estrogens and gestagens is as close as possible to those hormonal fluctuations that occur in a woman’s body. Thanks to this, three-phase contraceptives are considered the most physiological.

Typically, this group of drugs is prescribed to women over 35 years of age or under 18, as well as those who smoke or are obese. Such drugs include, for example, Tri-regol, Triziston or Tri-Mercy.

Basics positive quality this group of drugs – reducing the development of risks side effects from progestins. The main disadvantage is the higher frequency of bleeding between menstruation compared to monophasic drugs. A more complex dosage regimen and not always possible to double the dose if you miss another pill.

Studies have shown that triphasic contraceptive drugs are inferior to monophasic ones in terms of reliability of protection against unplanned pregnancy.

The Pearl index for monophasic drugs is 0.15–0.18, while for three-phase drugs, depending on the composition, the values ​​can range from 0.19 to 0.68.

Criterias of choice

If a woman has no previous experience of taking hormonal contraceptives, then the doctor usually gives preference to monophasic drugs containing minimal doses of hormones. But only after receiving the results of everyone necessary tests. Such as: cytology smear, hormone analysis, general and biochemical analysis blood, ultrasound of the pelvic organs. In some cases, an additional consultation with a mammologist may be necessary. In addition, the doctor must take into account the characteristics of the menstrual cycle and the woman’s phenotype.

It is simply impossible to choose the right drug without consulting specialists and a series of tests. You should not buy hormonal contraceptives yourself, as this can harm your health.

Today, combined oral contraceptives are considered one of the most reliable methods of protection against pregnancy. However, they require a woman to pay close attention to her condition and strictly follow the dosage regimen.

The most effective method prevention unwanted pregnancy Currently, hormonal contraception is accepted.

The modern pharmacological industry has developed a large number of its varieties with different combinations of doses and active ingredients. This allows you to choose the contraceptive pills that are best suited for a woman, taking into account her age and hormonal cycle.

Classification of hormonal methods of contraception

All hormonal contraceptives are divided into two large groups:

1. Combined, containing synthetic analogues of estrogens and progesterone.
2. Single-component, containing only progesterone analogues.

Combined hormonal contraceptives

They consist of a synthetic estrogen component - ethinyl estradiol and various progesterone derivatives.

According to the method of use, drugs are divided:

1. Oral – available in tablets, used by mouth.
2. Parenteral – forms of drugs with in various ways introductions:

• patches (Evra transdermal contraceptive system);
• vaginal rings (NovaRing).

In turn, combined oral contraceptives are divided according to dosage regimen:

• single-phase (Zhdes, Novinet, Logest, Regulon, Zhanin, Yarina);
• biphasic (anteovin);
• three-phase (tri-regol, triziston, trinovum).

Depending on the amount of active drug in the tablet, contraceptives are divided:

• microdosed (contraceptive pills Mercilon, Novinet, Logest);
• low-dose (birth control pills Yarina, Zhanin, Diane-35, Regulon, Marvelon);
• high-dose (contraceptive pills Non-Ovlon, Ovidon).

Single-component hormonal contraceptives

Single-component hormonal contraceptives are divided according to the method of administration:

1. Oral (minipils) - hormonal contraceptive pills for oral administration (Microlut, Exluton, Charozettau).
2. Parenteral:

• injections (medroxyprogesterone);
• implants (desogestrel);
• intrauterine hormonal systems (Mirena).

It is impossible to say unequivocally which contraceptive pills are better and which are worse, since the choice of drug is influenced by age, hormonal status, the presence bad habits and chronic diseases, as well as many other factors.

Combined oral contraceptives (COCs)

Mechanism of action

The basis of the contraceptive effect of COCs is the suppression of ovulation. This effect is realized due to the action of ethinyl estradiol, which replaces its own estradiol and blocks the growth and maturation of the follicle.

The synthetic progestins included in COCs affect slime layer uterus, lead to its changes and prevent the implantation of a fertilized egg (even if ovulation has occurred).

Thickening of mucus in the cervix is ​​another mechanism of contraceptive action. In this case, the penetration of sperm into the uterine cavity becomes extremely difficult. Also, in addition to the contraceptive effect, the thickening of cervical mucus prevents infections from entering the uterine cavity.

Side effect

It should immediately be noted that by the presence or absence of side effects it is impossible to say which birth control pills are better and which are worse. Since the same drugs can different periods a woman’s life is both suitable and not suitable.

COCs are combination drugs; therefore, side effects are represented by the action of each component of the contraceptive.

Side effects of ethinyl estradiol

• increased blood pressure;
• headache;
• dizziness;
• nausea and vomiting;
• pain and heaviness in the chest;
• hyperpigmentation on the face;
• irritability;
• weight gain.
• headache;
• low mood;
• reduction of mammary glands;
• decreased lubrication in the vagina;
• bleeding in the middle of the cycle;
• decreased sex drive;
• scanty periods.
• headache;
• depressive states;
• decreased performance;
• increased skin greasiness;
• acne;
• decreased sex drive;
• gain varicose veins veins;
• vaginal dryness;
• weight gain.
• delayed menstrual flow;
• bleeding in the second part of the cycle;
• severe menstrual bleeding.

Side effects associated with suppression of your own estrogens

Side effects of synthetic progestins

Side effects associated with insufficient progestin dosage

In the initial few months, taking birth control pills is associated with side effects in 11–42% of cases. Subsequently, the occurrence adverse reactions decreases to 4 – 9%. If after 3–4 months of continuous use side effects persist or intensify, then the drug should be discontinued or replaced.

Also, a mention should be made about a rare but extremely dangerous complication of hormonal contraception - venous thrombosis and embolism. The likelihood of their development directly depends on the presence of risk factors such as smoking, age over 35 years and obesity.

The best birth control pills in terms of minimal risk thrombosis are microdosed COCs (Novinet, Jess, Qlaira). It has been proven that the risk of developing thromboembolic complications when taking them is lower than during pregnancy.

Contraindications

1. Presence of leg vein thrombosis or thromboembolism pulmonary artery. As well as diseases in which there is a high risk of developing thrombosis, for example, large surgical operations, bone fractures (especially the femur) with long wearing plaster cast.
2. Cardiac ischemia.
3. Stroke.
4. High blood pressure.
5. Heart valve diseases.
6. Diabetes mellitus with experience of more than 20 years.
7. Oncological disease of the breast.
8. Smoking in women over 35 years of age.
9. Pregnancy.
10. Liver diseases.
11. Breastfeeding in the first 6 weeks after birth.

All of the listed contraindications to taking birth control pills are absolute. That is, it is strictly forbidden to take hormonal contraceptives if there is at least one item from the above list.

How is individual selection carried out?

To make it as clear as possible, let’s look step by step at which birth control pills are best to take.

For a woman who has never taken contraceptives before, the selection scheme will consist of three stages:

1. Prescription of the drug of first choice.
2. Selection of a drug based on availability hormonal disorders and gynecological diseases.
3. Changing the contraceptive if side effects develop.

First choice drug

The first, as a rule, is prescribed micro or low-dose monophasic COC containing estrogen no more than 35 mcg/day and progestin with minimal androgenic effect (Novinet, Logest, Mercilon, Jess).

Selection of a drug taking into account the presence of hormonal disorders and gynecological diseases

Let's take a closer look at the main women's diseases and which birth control pills are best to take with them.

Changing the contraceptive if side effects develop

If side effects develop while taking contraceptives, further selection and change of drugs should be carried out by the attending gynecologist. Most often, a transfer is made to three-phase drugs with the selection of the required dose of ethinyl estradiol.

How are they accepted?

COCs are available in calendar blisters of 21 or 28 tablets. People start taking COCs, usually on the first day of menstruation. When irregular cycle or absence of menstruation, you can start taking it on any day, provided that pregnancy is excluded. Tablets are taken one daily:

• pack of 21 tablets - 21 days of taking tablets, 7 days break, then starts a new pack;
• pack of 28 tablets (21+7) - taken continuously, after the end of the pack the next one begins.

Also, there is a method of continuous use, when the drug is taken in the same dose, regardless of the cycle. The main goal of this method is drug delay of menstruation. Most often, the continuous reception technique is used in medical purposes, for example, for the treatment of endometriosis. But it can also be used for a short-term delay of menstruation during significant events in life, for example, a wedding, honeymoon, vacation.

What to do if you miss a dose?

1. One tablet not taken:

• less than 12 hours have passed - take the drug, continue further use as before;
• more than 12 hours have passed - take the forgotten pill:
• if a dose is missed in the first week of the cycle, use barrier methods of contraception for 7 days;
• if a dose is missed in the second or third week, additional contraception is not required.

2. If 2 or more tablets are missed, take 2 tablets per day until the intake returns to normal. And also use it for 7 days additional ways protection. If, after missing pills, your period begins, you must stop taking the drug and start a new pack after 7 days.

Combined parenteral contraceptives

At the moment, there are only two parenteral combined contraceptives:

• transdermal contraceptive system Evra;
• Vaginal contraceptive ring NuvaRing.

The Evra transdermal contraceptive system is a beige patch containing 0.6 mg ethinyl estradiol and 6 mg norelgestromin. Moreover, the dose that is absorbed per day corresponds to taking microdosed COCs.

The patch is applied for 7 days; three transdermal systems are required for one cycle. Just like when taking birth control pills, after 21 days (3 patches) a break is taken for 7 days.

The NovaRing vaginal contraceptive ring is a hormonal combined contraceptive with a vaginal route of administration. The doses absorbed per day are lower than in microdose COCs (0.015 mg ethinyl estradiol, 0.12 mg etonogestrel), which allows for a good contraceptive effect with fewer adverse reactions.

NuvaRing is inserted by a woman into the vagina from days 1 to 5 of the menstrual cycle for 21 days, then removed and a break is taken for 7 days.

The advantages of the parenteral method of administration are:

• ease of use;
• lower doses of hormones;
• fewer side effects.

Of course, the advantages of parenteral drugs are undoubted, but there are also some disadvantages that somewhat limit their popularity:

• the patch may come off and go unnoticed;
• Not all areas of the body can be pasted;
• may develop local reaction for drugs.

Given all these disadvantages, hormonal birth control pills remain the best solution to prevent unwanted pregnancy.

Progestin oral contraceptives (minipils)

These drugs contain very small doses of synthetic progestins, approximately 15–30% less than in COCs. Accordingly, the contraceptive effect of taking them is much lower.

Indications

Taking a minipill is justified only in women who are breastfeeding (6 weeks after birth) and in case of contraindications to other methods of contraception. Otherwise, they are not the best birth control pills.

Contraindications

The same as when prescribing combined contraceptive drugs.

Side effect

• menstrual irregularities;
• headaches and dizziness;
• nausea and vomiting;
• low mood;
• weight gain;
• decreased sex drive.

Parenteral progestin contraceptives

Parenteral forms of gestagen contraceptives are presented much more widely than combined ones:

• injectable – medroxyprogesterone (Depo-Provera);
• implants – desogestrel (Implanon);
• intrauterine hormonal device (Mirena).

The drug is available in tablets, aerosol, and suspension.

For injection contraception, a suspension is used that contains 0.15 g of medroxyprogesterone.

The mechanism of action of the drug is to suppress ovulation, thicken cervical mucus and changes in the inner lining of the uterus. The effectiveness of contraception when using injectable medroxyprogesterone is very high (more than 99%).

Side effects are the same as for oral progestins.

The drug is administered intramuscularly once every three months. The first injection is on the 5th day from the beginning of menstruation.

The disadvantages of the drug are:

• long-term restoration of the ability to become pregnant;
• it is impossible to stop contraception at will;
• must be contacted regularly medical Center for repeated injections.

It should be noted that after the last injection of medroxyprogesterone, it may take up to a year and a half to restore normal ovulation and menstrual cycle. Therefore, birth control pills are better because they give you the opportunity to choose to continue contraception or not continue

Implants

The only contraceptive implant registered in the Russian Federation is Implanon. The drug is a polymer rod, 4 cm long and 2 mm wide. Using a special needle, it is injected subcutaneously into inner surface shoulder, for a period of 3 years.

The mechanism of action, contraceptive effectiveness and disadvantages are the same as those of injectable forms.

The drug is intrauterine device, containing levonorgestrel in a very low dose (52 mg).

The main effect of the drug is local, since the released daily dose levonorgestrel is very small to have a systemic effect on the body. This is the reason for the minimal number of side effects when using Mirena. Levonorgestrel, acting on receptors in the endometrium, leads to its transformation and prevents implantation of the egg. Just like other progestins, Mirena causes thickening of the cervical mucus, preventing sperm from moving into the uterine cavity.

In this article we will look at 2 “sides of the coin” - the positive aspects of taking oral contraceptives and the potential health hazards:

• at the beginning of the article we will look at the classification, contraindications, side effects and all the positive aspects of taking hormonal contraceptives
• then about the potential risk of developing long-term consequences of taking such drugs even by a healthy woman.

With this we want to draw the attention of women to a longer-term prognosis of their health and think about the fact that any intervention in natural processes in the female body is fraught with consequences - for some minor, barely noticeable, for others much more serious, even tragic.

In no case do we encourage you to refuse medications prescribed by your doctor; the article is for informational purposes and the decision to take oral contraceptives is made by a woman after consultation and examination with a gynecologist. But every woman should know about possible risks to which she is exposed during long-term use of oral contraception.

Groups of birth control pills, names and their effects

Despite the fairly rich assortment of contraceptives available in pharmacies, hormonal birth control pills occupy a leading position today (and bring their manufacturers billions of dollars a year). Unfortunately, not everyone knows about contraindications to their use, side effects, rules for taking pills, that their use should not be long and the choice of oral contraceptives should be made only by a doctor after a thorough diagnosis and collection of the patient’s medical history.

All contraceptive hormonal pills are divided into two “companies”: combined oral contraceptives (COCs) and mini-pills.

Monophasic tablets In these tablets, the percentage of estrogen and progestogen components does not change in each tablet.
Desogestrel and ethinyl estradiol: Regulon (400-1100 rubles) prices 2018.	Ethinyl estradiol and dienogest: Janine (price 1000 rubles) Silhouette (price about 680 rubles)	Gestodene and ethinyl estradiol: Lindinet (380-500 rub.), Logest (800 rubles), Femoden (950 rubles)
Rigevidon (price 280 rubles)	Microgynon (380 rubles)	Miniziston (450 RUR)
Biphasic drugs In them, the dose of estrogen is the same in all tablets, and the dose of gestagen changes in the 1st and 2nd periods of the menstrual cycle.
Femoston Dydrogesterone + Estradiol (900 rubles).	(Ethinyl estradiol + Levonorgestrel): Anteovin, Binordiol, Sequularum, Adepal, Sequilar, Biphasil	Binovum (Ethinyl estradiol + Norethisterone) Neo-Eunomin (Ethinyl estradiol + Chlormadinone acetate)
Triphasic tablets In the OK data, the doses of hormones change three times in one package, which is associated with changing periods of the menstrual process.
Tri-Regol (280 rubles)	Three merci (120 rubles)	Triziston

The main point in the mechanism of action of COCs is the blocking of ovulation, caused by inhibition of the formation of FSH and LH in the pituitary gland. At the same time, ovarian function and a local obstruction to ovulation are blocked. In addition, “glandular regression” occurs in the structure of the uterine mucosa, which makes implantation of a fertilized egg impossible. Changes also occur in the mucus of the cervical canal; it thickens, which disrupts the movement of sperm deeper into the uterus.

COCs are also divided into 3 groups based on the quantitative content of active components:

Microdosed OK

The dose of hormones in these pills is minimal, so they are ideal for young women under 25 years of age, and, in addition, for those who are faced with the need to take birth control pills for the first time. Examples of drugs: Zoeli (monophasic), Qlaira (3-phase) and other monophasic drugs - Jess, Dimia, Logest, Mercilon, Miniziston, Lindinet, Novinet.

Low-dose OK

Such tablets are recommended for young and mature representatives of the fairer sex, including those who have gone through childbirth, or are prescribed to those patients who experience intermenstrual spotting when using microdosed drugs. According to manufacturers' research, a group of low-dose tablets has an antiandrogenic effect (hair growth in uncharacteristic places decreases, acne and increased skin greasiness disappear, decreases). The list of birth control pills includes: Diane, Yarina (Midiana), Femoden, Siluet, Janine, Tri-mercy, Lindinet, Silest, Miniziston, Regulon, Marvelon, Microgynon, Rigevidon, Belara, Chloe, Demoulen.

High-dose OK

The dose of hormones in these contraceptive pills is quite high, so they are prescribed either for the purpose of treatment (for example, endometriosis) or at the stage of treatment of hormonal disorders (Non-ovlon, Triquilar, Ovidon, Trizeston, Tri-regol) only as prescribed by a doctor.

We can say about mini-pills that they contain only progestogen. The mechanism of their action lies in the local effect on peripheral areas reproductive system. Firstly, mini-pills affect the composition of cervical mucus and its quantity. So, in the middle of the cycle, its volume decreases, but the viscosity of the mucus remains high in any phase of the menstrual cycle, which interferes with the free movement of sperm. Changes also occur in the morphological and biochemical structures of the endometrium, which create “bad” conditions for implantation. In about half of women, ovulation is blocked. Mini-pills include: linestrenol (Exluton, Microlut, Orgametril), desogestrel (Lactinet, Charozetta).

Charozetta (1300 rubles) desogestrel	Lactinet (600 -700 rubles) desogestrel	Orgametril (RUR 3,300) linestrenol	Exluton (RUB 3,300) linestrenol

How to choose good birth control pills

Which birth control pills are good, the best, you can’t figure this out on your own, much less buy them at the pharmacy on the recommendation of friends or a pharmacist. To find the best birth control pills, you need to visit your doctor. The gynecologist will collect an anamnesis, focusing specifically on family history, existing diseases or those suffered in the past, since all of the above may be a contraindication to the use of hormonal contraceptives.

After this, the doctor will conduct an examination, during which he will evaluate:

• skin (telangioexaia, petechiae, signs of hyperandrogenism, presence/absence of hypertrichosis, etc.)
• measures weight and blood pressure
• palpates the mammary glands
• will prescribe tests for liver enzymes, blood sugar, blood coagulation system, hormonal tests, ultrasound of the mammary glands, ultrasound of the pelvic organs, and, if necessary, mammography
• then conduct a gynecological examination with taking smears
• a woman should also visit an ophthalmologist, because long-term use OK increases the risk of developing other eye diseases.

To prescribe tablets that are most favorable for a given patient, her constitutional and biological type is taken into account, which takes into account:

• height, appearance
• mammary gland
• pubic hair
• skin, hair
• menstruation and premenstrual symptoms
• cycle irregularities or absence of menstruation
• as well as existing chronic diseases

There are 3 phenotypes:

Prevalence of estrogens

Women of short or medium height, very feminine in appearance, skin and hair tend to be dry, menstruation with significant blood loss and long, and the cycle is more than four weeks. Medium and high-dose COCs are suitable for patients with this phenotype: Rigevidon, Milvane, Triziston and others.

Milvane (ethinyl estradiol and gestodene): Logest (720 rubles) Femoden (600-650 rubles) Lindineth ( average price 320 rub)	Rigevidon (price 180 rubles), Microgynon (320 rubles), Miniziston (370 rubles) Tri-regol (200 rubles), Triquilar (530 rubles), Triziston

Balanced type

Women are of average height, feminine, medium-sized and developed mammary glands, normal oily skin and hair, no premenstrual signs, menstruation 5 days every 4 weeks. Second generation drugs are recommended for such women: Marvelon, Silest, Lindinet-30, Microgynon, Femoden and others.

Ethinyl estradiol and desogestrel: Marvelon (630 rubles), Novinet (330 rubles), Regulon (280-320), Tri-mercy (650rub) Mercilon (630 RUR)	Ethinyl estradiol and Norgestimate: Silest	Eethinyl estradiol and gestodene (Milvane): Lindinet (280-350 rub.), Logest (720 rubles), Femoden (600-650 rub.)	Ethinyl estradiol and levonorgestrel: Rigevidon (180rub), Tri-regol (200rub) Microgynon (320r), Miniziston (370rub) Trikvilar (530r), Triziston

Prevalence of gestagens/androgens

Women are tall, have a “boyish” appearance, the mammary glands are underdeveloped, skin and hair high fat content, depression on the eve of menstruation and pain in the abdomen, in the lumbar region, scanty menstruation, less than 5 days, short cycle, less than 28 days. IN in this case the doctor will recommend hormonal drugs with an antiandrogenic component: Diane-35, Janine, Yarina, Jess.

Yarina (price 800 rubles)	Ethinyl estradiol and drospirenone: Jess (820 RUR)	Ethinyl estradiol and drospirenone: Dimia (550 RUR)	Nomegestrol and Estradiol Zoely (1000 rubles)

Ethinyl estradiol and dienogest: Janine (800 rubles), Silhouette (400 rubles)		Ethinyl estradiol and cyproterone: Diana 35 (820 rubles), Chloe 35 (450 rubles), Erica 35 (360 rubles)

How to take hormonal oral contraceptives correctly

Standard blisters with COCs contain 21 tablets. There are only a few exceptions, for example, Jess - a new generation of birth control pills, which contain 24 tablets and are often prescribed by gynecologists to young women. For women over 35 years of age, the doctor may recommend Qlaira tablets, a new generation of oral contraceptives containing 28 tablets.

How to take birth control pills:

• You should take the pills every day, at approximately the same hour, starting on the first day of menstruation.
• In order not to forget about taking the next pill, it is better to put them in a place where a woman looks every day (in her cosmetic bag, to her toothbrush, or attach it to the refrigerator with a magnet).
• Take one tablet every day until the blister runs out.
• Then you need to take a break for a week.
• During this time period, menstrual-like bleeding will begin.
• At the end of 7 days, start taking COCs again, regardless of whether menstruation has ended or not.
• In case of vomiting, you must take an extra pill.
• If you miss taking a pill, you need to take it as quickly as possible.
• In these two cases, you need to take additional protection during the day.
• At the very beginning of taking COCs, if they have not been used before, you should additionally use protection for the first 14 days.
• Intermenstrual bleeding is not considered a reason to stop taking pills (see)
• They are usually observed in the first 2–3 months, and indicate a reconfiguration of the body from hormones that are synthesized in the ovaries and pituitary gland to hormones coming from outside.

Taking hormonal combination drugs after a medical termination of pregnancy, it should begin either on the day ) or a month later, when the first menstruation begins.

The contraceptive effect of hormonal drugs may decrease with simultaneous use with a number of drugs, for example, rifampicin (it stimulates the activity of liver enzymes). Therefore, when prescribing treatment for any disease, inform your doctor about taking oral contraceptives, and carefully study the instructions for use of the drugs prescribed to you. If you are prescribing medications that reduce the effect of COCs, additionally use other methods of protection (condoms).

A standard mini-pill blister contains 28 tablets. These tablets are taken without a break for 7 days, just like COCs, at the same hour. Mini-pills are suitable for women who are breastfeeding breast milk. If a woman does not lactate or prefers artificial feeding, then low-dose COCs (Belara, Miniziston, Regulon and others) are recommended for her. You can start taking COCs as early as 21–28 days after delivery.

It is worth knowing that the contraceptive effect begins to manifest itself after 2 weeks of taking the pills, and 100% effect and reliability of such a contraceptive method as OK occurs in the second month of taking the drugs. Ovarian blockade begins as soon as hormones begin to flow from outside, but the maximum guarantee comes after monthly course their applications.

Side effects of birth control drugs

Side effects are signs or conditions that develop when using contraceptives, but do not threaten women’s health. They are divided into 2 groups:

In case of serious, as well as persistent minor side effects, contraception is discontinued.

Regardless of the chosen OC, a woman needs periodic assessment of her health in connection with possible side effects from taking them, namely:

• Blood pressure: measure once every 6 months
• Physical examination (breast, liver palpation, gynecological examination), urine test: 1 r/year
• Monthly breast self-examination.

It is no secret that in many developing countries, regular screening is unlikely, and there are programs (in some countries) to distribute OCs to women who do not have access to medical care. This indicates a high likelihood that OCs will be used by high-risk groups of women. Consequently, it will be more difficult for such women to obtain medical care in case of dangerous side effects.

Absolute contraindications to oral contraceptives

Diseases for which the use of oral contraceptives is not advisable: (congenital hyperbilirubinemia), bronchial asthma, rheumatoid arthritis, multiple sclerosis, thyrotoxicosis, ), myasthenia gravis, sarcoidosis, retinitis pigmentosa, thalassemia, renal dialysis.

At the end of the article there is a video of a TV show detailing the dangers of using OCs by any woman, since even in the absence of the contraindications listed above (the woman and the doctor may not be aware of them), a seemingly healthy woman has the risk of developing pulmonary thromboembolism, the development of oncology is extremely high.

Hormonal contraceptives and possible pregnancy

You can get pregnant while taking contraception?

This question worries many women. Of course, pregnancy while using hormonal oral contraceptives is not excluded, but its likelihood is too low.

• First of all, an unwanted pregnancy occurs when the rules for taking pills are violated (missing, irregular, different time intake, the expiration date of the drug has expired).
• It should also be taken into account possible vomiting in case of poisoning or joint reception with agents that reduce contraceptive effect hormonal pills.

Is it possible to take contraceptives when pregnancy has already occurred or is suspected?

The answer to this question is negative. If pregnancy after taking contraceptive drugs and it happened, it was desired, then there is no indication for its termination (interruption). You just need to stop taking the pills right away.

Taking hormonal pills in late childbearing years

Currently, in economically developed countries, about half of married couples after 40 years of age prefer sterilization. Hormonal medications include COCs or mini-pills. Women who are over the age of 35 should stop using hormones if they have cardiovascular pathology coupled with smoking high risk oncology. A good alternative for women after 40-45 years of age are mini-pills. These drugs are indicated for uterine fibroids, endometriotic inclusions and endometrial hyperplasia.

Emergency and non-hormonal contraception

• Emergency contraception

If sexual intercourse occurs without the use of means that protect against pregnancy, emergency (fire) contraception is performed. One of the well-known and widely used drugs is Postinor, Escapelle. You can take Postinor no later than 72 hours after coitus without using contraceptives.

First you need to take one tablet, and after 12 hours the second one is taken. But you can also use COCs for fire contraception. The only condition is that one tablet must contain at least 50 mcg of ethinyl estradiol and 0.25 mg of levonorgestrel. First, you should take 2 tablets as soon as possible after coitus, and repeat 2 more tablets after 12 hours.

These drugs can only be used when in case of emergency(rape, damage to the condom), WHO does not recommend their use more than 4 times a year, but in Russia they are popular and used by women much more often (see). Essentially they have abortifacient of course it's not surgical manipulation like a medical abortion, but no less harmful from the point of view of further reproductive function female body.

• Non-hormonal contraception

They are spermicides that are used topically to prevent desired pregnancy. Active ingredient Such tablets inactivate sperm and “prevent” them from entering the uterine cavity. Moreover, non-hormonal tablets have anti-inflammatory and antimicrobial effects. These tablets are used intravaginally, that is, they are inserted deep into the vagina before intercourse. Examples non-hormonal tablets: Pharmatex, Benatex, Patentex Oval and others.

Arguments FOR taking hormonal birth control pills

Contraceptive pills, especially new birth control pills (new generation) have advantages over barrier contraceptives. Positive aspects of using OK, which are promoted by gynecologists:

• one of the most reliable and high-quality methods of contraception (effectiveness reaches 100%);
• can be used at almost any age;
• while taking contraceptive pills, the menstrual cycle becomes regular, and pain during menstruation may disappear (see);
• good cosmetic effect (disappearance of acne, oily or dry hair and skin disappear, reduction of pathological hair growth);
• peace of mind (no fear of getting pregnant);
• the possibility of accelerating the onset of menstruation or delaying it;
• therapeutic effect - endometriosis, uterine fibroids, ovarian cyst (whether OCs have a therapeutic effect remains a highly controversial issue, since most studies are carried out by manufacturers of hormonal contraceptives);
• after stopping taking the pills, fertility is usually restored within 2-6 menstrual cycles (with rare exceptions, up to a year).

But despite all the advantages, there are many more negative consequences from taking hormonal contraceptives and they outweigh the arguments FOR. Therefore, the decision whether to take birth control pills is made by the doctor and the woman herself, based on the presence of possible contraindications. side effects these medications, general health, and the presence of chronic diseases. According to the results of many studies, taking oral contraceptives (long-term) has long-term effects. Negative consequences for the health of women, especially those who smoke and have any chronic diseases.

Arguments AGAINST oral contraceptives

IN modern world The pharmaceutical industry is a business like any other sector of the economy, and the material benefits from the sale of drugs that a woman needs every month are fabulous. Over the past decades, independent American experts have conducted several studies, the results of which suggest that taking hormonal contraceptives by a woman before the birth of 1 child increases the risk of cervical cancer. In addition, OCs cause depression, contribute to the development of osteoporosis, hair loss, and the appearance of pigmentation on the body.

Hormones produced by the body perform functions in the body certain functions, controlled in higher hormonal centers - the pituitary gland and hypotholamus, which are associated with the adrenal glands, thyroid gland and ovaries ( peripheral organs). The ovaries have a clear hormonal interaction with the entire body, the uterus waits for a fertilized egg every cycle, and even small doses of hormones coming from outside disrupt this fragile interaction.

With long-term use of hormonal contraceptives, the functions of the genital organs completely change. Every day, taking the pill suppresses ovulation, the release of an egg does not occur, the functions of the ovaries are suppressed, and this in turn inhibits the regulatory centers. With prolonged use of pills (for years), a woman’s uterus undergoes a change in the inner layer, as it is rejected unevenly (hence bleeding and). The mucous layer and tissue of the uterus gradually changes, which in the future (usually during menopause) threatens with oncological degeneration.

With long-term use of oral contraceptives, the amount of sex hormones is reduced, the ovaries decrease in size, and their nutrition is disrupted - this a strong beat on the reproductive function of the body. Both at the beginning of taking and after stopping taking OK, a failure occurs in hormonal system, therefore, in some women, restoration of reproductive function occurs within a year, and in some cases it may not be restored at all. So:

• Women who have the contraindications listed above should under no circumstances take oral contraceptives, since serious complications may develop, including death (vascular thrombosis), oncology;
• with long-term use of OCs, the elimination of vitamin B6 from the body is accelerated, which can lead to hypovitaminosis B6, as well as vitamin B2 (see), which negatively affects the nervous system (weakness, insomnia, irritability, skin diseases, etc. see);
• also OK interfere with the absorption of something very important for the body folic acid, which is very necessary 3 months before conception and during a future desired pregnancy and (see), the addition of which to some hormonal contraceptives is only a marketing ploy;
• Long-term use (over 3 years) doubles the risk of developing glaucoma. A study by scientists at the University of California showed that (3,500 women over 40 years of age took contraceptives from 2005 to 2008) when taking oral contraception for 3 years without interruption, women were more likely to be diagnosed with glaucoma.
• oral contraceptives significantly increase the risk of developing osteoporosis in women in the future (after 40 years, see);
• Taking OCs for 5 or more years increases the risk 3 times (see). Researchers associate the growth of this disease with the “Era of Hormonal Contraception”;

Today - in the age of oncological tension and unimproved early diagnosis initial asymptomatic stages of oncology, a woman taking OCs may not be aware of the presence of early stages of oncology, in which contraceptives are contraindicated and contribute to aggressive tumor growth;

• studies by Danish scientists show that long-term use in women is 1.5-3 times;
• oral contraceptives promote thrombus formation in any vessels, incl. and vessels of the brain, heart, and pulmonary artery, which increases the risk of stroke and death from pulmonary thromboembolism. The risk increases depending on the dose of hormones, as well as additional risk factors - high blood pressure, smoking (especially over 35 years), genetic disposition cm. ;
• taking oral contraceptives increases the risk of the appearance and development of chronic venous insufficiency - pain in the legs, night cramps, a feeling of heaviness in the legs, transient swelling, trophic ulcers;
• the risk of developing inflammatory diseases of the cervix and breast cancer increases
• in some cases, the return of fertility is delayed (1 - 2%), that is, the body gets used to the supply of hormones from the outside and in the future some women may have difficulties conceiving;
• do not provide protection against sexually transmitted infections, so their use is not advisable in the presence of many partners, for women who are promiscuous sex life(only condoms protect against sexually transmitted infections and viruses, including), syphilis, etc.);
• taking oral contraceptives can provoke the appearance of a woman’s body;
• according to American Studies women taking oral contraceptives are at risk early development multiple sclerosis increases by 35% (see, which today can occur in both a 20-year-old and a 50-year-old woman);
• one of them may be taking oral contraceptives;
• the risks of transient development increase;
• women taking OCs are more likely to develop depression;
• some women experience a significant decrease in libido;
• the need for self-monitoring and daily intake;
• errors cannot be excluded when using contraceptive pills;
• the need to consult a gynecologist before the appointment;
• the price is quite high

According to WHO, about 100 million women use oral contraception, which brings enormous profits to pharmaceutical cartels. Manufacturers of hormonal contraceptives are extremely uninterested in disseminating truthful information about the dangers of products that bring them huge profits.

Today, all over the world there is powerful public opposition aimed at banning the sale of dangerous drugs, and information about them potential harm publicly available. The result of this is that European and American gynecologists strongly recommend protecting yourself with condoms, which protect not only from unwanted pregnancy, but also from sexually transmitted infections. Next in popularity is hormonal patch and then the spiral.

After reports of the dangers of OCs, several deaths and lawsuits, in some countries (USA, Germany, France) the drug Diane-35 was banned, and surveys of Europeans showed that 67% of people aged 15-63 years try to protect themselves with condoms, this and married couples and single women, 17% prefer a patch, 6% use a spiral, the remaining 5-10% continue to use OK.

Russian doctors actively continue to offer (advertise) oral contraception to women; moreover, they prescribe it to girls from 14-18 years of age, without informing them about the potential and very real threat to their health.

Oral contraceptives (OCs or birth control pills) are available by prescription and contain combinations of estrogen and progestin, or progestin alone.

Most women use a combination of hormonal pills. Women who experience severe headaches or high blood pressure due to estrogen, in the form combination tablets can take progestin tablets.

Birth control pills are the most popular method of contraception and are used by millions of women.
Birth control pills work like this:

Prevents ovulation. Ovulation is the release of an egg from the ovary. If the egg is not released, fertilization by sperm cannot occur;
- Prevents sperm from entering the uterus by keeping cervical mucus thick and sticky.

When a woman stops taking the pill, she usually regains fertility within 3-6 months.

Hormones used in birth control pills

Most pills contain a combination of estrogen and progesterone in a synthetic form (progestin). The estrogen compound used in most oral contraceptive (OC) combinations is estradiol. There are many different progestins, but common types include: levonorgestrol, drospirenone, norgestrol, norethindrone, and desogestrel.

These hormones may cause side effects, especially during the first 2-3 months of starting to use them. Common side effects of oral contraceptives include:

Bleeding during the first few months;
- nausea and vomiting;
- headaches (in women with a history of migraine);
- soreness and tightness of the breast;
- irregular bleeding or bleeding between periods;
- weight gain (this is not related to oral contraceptives).

Low-dose monophasic oral (oral) contraceptives

Combined oral contraceptives are aimed at blocking ovulation. These OCs contain a combination of estradiol and a progestin, levonorgestrel. They are divided into monophasic (the level of hormonal substances in the tablets remains unchanged throughout the entire intake) or triphasic (the tablets contain three combinations of hormones that change during the menstrual cycle).

Low-dose monophasic OCs are such as: Seasonal, Sisonik, Librel, Yarina.

Mini-pills are birth control pills containing a progestogen hormone similar to natural hormone progesterone, which is produced by a woman's ovaries. Progestogen-only pills contain only one ingredient and are different from the more common combination birth control pills, which contain progestogen and estrogen.

Below is a list of contraceptives taking into account age, whether the woman has given birth or not, and whether she suffers from any hormonal or other disorders of the body.

Microdosed birth control pills.They are suitable for young people nulliparous women leading regular sex life. Drugs in this group are easily tolerated and have minimal side effects. Great for those who have never used hormonal contraceptives. As well as contraception for mature women over 35 years of age (up to the onset of menopause).

Low-dose birth control pills. Recommended for young, nulliparous women who have regular sex life (in the event that microdosed drugs are not suitable - the presence of bleeding on the days of taking active tablets after the end of the period of adaptation to the drug). As well as contraception for women who have given birth, or women in late reproductive age.

High-dose oral contraceptives. These drugs are used only as prescribed by a doctor to treat various hormonal diseases, as well as for contraception during the treatment of hormonal disorders.

- “Mini-pill” or progestin contraceptives. Recommended for women during breastfeeding, as well as for women who have given birth or women of late reproductive age who have regular sex life, in case of contraindications to the use of estrogens.

Advantages and disadvantages of birth control pills

Benefits of oral contraceptives. In addition to preventing pregnancy, oral contraceptives may also have the following benefits:

Managing heavy menstrual bleeding and cramps, which are often symptoms of uterine fibroids and endometriosis (Natasia);
- prevention iron deficiency anemia caused by heavy bleeding;
- reduction of pelvic pain caused by endometriosis;
- protection against ovarian and endometrial cancer with long-term use (more than 3 years);
- reduction of symptoms of premenstrual dysphoric disorder.

Disadvantages and serious risks of oral contraceptives

Combinations of birth control pills may increase the risk of developing or worsening some serious illnesses. The risks depend partly on the woman's medical history. Some of the main risks associated with the combination of birth control pills are deep vein thrombosis, heart attack and stroke.

Smoker for more than 35 years;
- have uncontrolled high blood pressure, diabetes or polycystic ovary syndrome (PCOS);
- have a history of heart disease, stroke, thrombosis, or risk factors for heart disease (unhealthy cholesterol levels, obesity);
- have migraines with aura.

Serious risks The effects of birth control pills may include:

- venous thromboembolism (VTE)

All combinations of estrogen and progestin - birth control products - carry a risk of blood clots in the veins (venous thromboembolism), which can lead to blood clots in the arteries of the legs (deep vein thrombosis) or lungs ( pulmonary embolism). Birth control pills containing drospirenone (Yazev and Beyaz) may increase the risk of blood clots much more than other types of birth control. Because of the risk of VTE, the Centers for Disease Control and Prevention recommends that women not use combined hormonal contraceptives for 21 to 42 days after giving birth;

- Hormones and pregnancy.

Hormonal imbalances often lead to complications, the first of which is cycle failure. Due to this phenomenon, women who want to have children may encounter difficulties conceiving and more severe complications once pregnancy occurs. Planning pregnancy with an unstable ovulatory phase and hormone imbalance should be carefully monitored and healthy image life, eat right and monitor the level of sex hormones. The Time Factor complex helps maintain the natural ratio of progesterone and estrogen in the body. Biologically active substances as part of the complex will help not only alleviate symptoms premenstrual syndrome, but also normalize the cycle, and, accordingly, make it possible to designate days suitable for conception.

Combination birth control pills contain estrogen, which may increase the risk of stroke, heart attack, and blood clots in some women;

Several studies have found an association between an increased risk of cervical cancer and long-term (more than 5 years) use of oral contraception. Recent studies show that OCs slightly increase the risk of breast cancer;

IN in rare cases oral contraceptives have been associated in studies with liver tumors, gallstones, or hepatitis (jaundice). Women with a history of any liver disease should consider other methods of contraception;

Some types of medications may interact with each other, reducing the effectiveness of oral contraceptives. These drugs include anticonvulsants, antibiotics, antifungals, and antiretrovirals. Vegetable medicine St. John's wort may interfere with the effectiveness of birth control pills. The patient should ensure that their doctor knows all medications, vitamins or herbal supplements he or she is taking;

Birth control pills do not protect against all sexually transmitted diseases (STDs), including HIV. Unless a woman is in a monogamous relationship with a completely uninfected partner, she should ensure that a condom is used during intercourse - regardless of whether she is taking oral contraceptives.

Genetic disorders when taking oral contraceptives

“Genetic disorders” refer to any physical or mental pathology that can be inherited from parents. There are congenital diseases. Some genetic disorders do not appear at birth, but develop as a person grows and signs and symptoms appear. The pathology may remain unrecognized until a person reaches puberty or adulthood.

Complex genetic analysis genes of blood coagulation factors II and V to identify the risk of thromboembolic complications while taking hormonal oral contraceptives (OCs) will make it possible to make the right decision about safer methods of contraception and family planning.

The most serious complication when taking OCs of a hormonal nature is their effect on the hemostatic system. The estrogenic component of combined OCs activates the blood coagulation system, which increases the likelihood of thrombosis - first of all, coronary and cerebral, then thromboembolism.

In women using combined OCs, the risk of venous thromboembolic complications is low, but it is higher than in those who do not use these OCs. The risk level increases with age, overweight bodies, surgical intervention and thrombophilia.

In most cases, genetic risk factors for the development of thromboembolic complications are mutations in the genes of blood coagulation factors II and V. The likelihood of developing thrombosis associated with a genetic predisposition seriously increases when they are combined with other genetic defects.

The mutation of factor V and the use of hormonal contraceptives mutually affect the blood coagulation system, and this, when combined, significantly increases the risk of venous thrombosis. This risk while taking OCs in women who are carriers of the Leiden mutation is 6-9 times higher than in women with normal factor V, and more than 30 times higher compared to those who do not take OK.

With a mutation in the prothrombin gene (F2), its level increases and can be 1.5-2 times higher than normal, which leads to increased blood clotting. A pathologically altered genotype is an indicator of the risk of developing thrombosis and myocardial infarction. When mutations in the F2 and F5 genes are combined, the risk of developing thromboembolic complications while taking hormonal contraceptives increases significantly. In this regard, a number of experts consider screening for the presence of the Leiden mutation and prothrombin gene mutation necessary for all women who take hormonal contraceptives (or those who are planning to take them).

Low-dose hormonal contraceptives are a type of monophasic combined oral contraceptives that contain progesterone and ethinyl estradiol. The dosage of the latter in such preparations is 30-35 mcg.

Low-dose oral contraceptives have a high contraceptive effectiveness, and, in addition, affect the stability of a woman’s menstrual cycle, and also have a certain therapeutic effect. Such means of protection can be recommended for both young mothers and ladies of Balzac age. As for young girls who have not yet gone through childbirth, it would be better for them to be offered another category of COCs - microdosed tablets.

Impact of low-dose contraception

Since the advent of combined contraceptives on the market, scientists have been steadily moving towards reducing the dosage of hormones in them. According to generally accepted opinion, the smallest doses of progesterone and estrogen ensure a reduction in side effects when taking contraceptives against unwanted pregnancy.

Low-dose contraceptives have the following mechanism of action on a woman’s body, which contributes to the contraceptive effect:

1. suppression of ovulation, i.e. creating a hormonal background in which the development of the follicle and egg does not occur, and, as a result, ovulation of the ovaries;
2. preventing implantation of the embryo into the uterus;
3. slowing down the movement of the villi of the fallopian tubes, which are involved in the movement of the egg into the uterine cavity, as well as thickening the mucus that accumulates in the cervical canal and prevents sperm from penetrating through it.

Low-dose contraceptives, in addition to their proven high efficiency protection against pregnancy and safety, also have a number of other positive aspects. In practice, very often young women begin to take such drugs in order to achieve a certain cosmetic effect. Like all other COCs, contraceptives with low content hormones reduce the production of male sex hormones in the ovaries, and, as a result, contribute to the disappearance acne, oily skin, as well as reducing excess growth hair. Among the non-contraceptive properties of low-dose contraceptive drugs, others are widely known:

1. stabilization of a woman’s menstrual cycle, regulation of its duration, bleeding intensity and painful sensations;
2. reduction or complete withdrawal PMS symptoms;
3. reducing the risk of developing diseases of the female genitourinary system;
4. prevention of ovarian and endometrial cancer, etc.

Many people wonder which contraceptives contain fewer hormones, focusing when choosing COCs only on the doses of progesterone and estrogen they contain. This approach is fundamentally wrong, since when prescribing a particular drug, a large number of factors must be taken into account. This includes the woman’s age, the regularity of her menstrual cycle, and the characteristics of its course, drug tolerance, as well as the need to achieve certain therapeutic effects when receiving them.

There is a fairly large list of low-dose contraceptives, each of which has a different hormonal load. In this case, the tactics of prescribing COCs by doctors is determined by the following sequence - first they use contraceptives with a low content of the hormones estrogen and gestagen, the so-called microdosed contraceptive pills. But sometimes contraceptives with low estrogen content do not provide sufficient tolerance, causing women to spot spotting. bloody issues, cycle irregularity or not providing the necessary therapeutic, non-contraceptive effect. Then it makes sense to switch to low-dose birth control pills, in which the dose of estrogen varies from 30 to 35 mg.

Logest and Lindinet are considered the lowest-dose hormonal contraceptives today. Low-dose contraceptive pills (list of COCs available on the market today with low ethinyl estradiol content):

1. Yarina;
2. Midiana;
3. Femoden;
4. Tri-Mercy;
5. Silest;
6. Jeannine;
7. Lindinet-30;
8. Miniziston;
9. Marvelon;
10. Regulon;
11. Silhouette;
12. Rigevidon;
13. Belara;
14. Chloe;
15. Diana-35;
16. Microgynon.

It should be noted that these contraceptive pills should not be used by women over 35 years of age. This limitation is due to the fact that as women age, the production of estrogen begins to fade, and menopause is completely characterized by a complete stop in their secretion. To maintain the required level of estrogen, ladies of Balzac age should, on the contrary, take a closer look at which contraceptives contain more estrogen hormones and make a choice in their favor (naturally, after consultation with a personal gynecologist).