Many women, trying to insure themselves against unplanned pregnancy, take hormonal drugs, as a result of which they begin to develop serious problems with health.
What consequences can occur from contraceptive drugs in women?
Long-term use of hormonal drugs provokes disruption of the hypothalamus and pituitary gland. Their impact on nervous system leads to an imbalance in the mechanisms of wakefulness and sleep, which manifests itself in irritability, insomnia, headaches, aggressiveness, deep depression. A woman often gets inflamed after taking birth control pills. optic nerve, vision deteriorates, swelling of the eyes appears.
Long-term exposure to contraceptive drugs leads to changes in blood sugar levels. Tissues gradually lose their sensitivity to insulin, resulting in the development of diseases such as pancreatitis and diabetes.
Effects of oral contraceptives on organs
The consequences of taking contraceptives can manifest themselves in liver dysfunction. Acting as a detoxifier, the liver neutralizes harmful substances introduced along with hormonal drugs. Gradually wearing out, the organ loses its ability to neutralize poisons, which provokes the occurrence of cholecystitis, hepatitis, and liver adenoma.
The consequences of taking contraceptives also manifest themselves in dysfunction of other organs. From exposure hormonal drugs the stomach suffers. The protective film does not withstand the aggressive effects of the drug and is destroyed, which entails thinning of the walls of the stomach and the occurrence of diseases such as duodenitis, gastritis, ulcers, and dysbacteriosis.
The urinary system is also negatively affected by synthetic contraceptives. Consequences of taking birth control pills can lead to cystitis and kidney disease. Long-term use of contraceptives can lead to thyroid dysfunction. There is a change in the concentration of hormones, which entails disruption of the ovaries.
Negative consequences of taking contraceptives that affect the reproductive system
Hormonal contraception has a negative impact on the female reproductive system. Artificial hormones provoke:
- weakening of ovarian function, which leads to disruption of the menstrual cycle;
- suppression of the endometrium, which entails the occurrence of tumors and uterine bleeding.
Taking contraceptive hormonal drugs leads to the fact that the reproductive system gradually atrophies as unnecessary (if the drugs are taken for more than 5 years). A woman who decides to conceive a baby, but takes hormonal pills for at least a few months, is at risk of premature birth and late miscarriages.
How do oral contraceptives affect body weight?
Reception hormonal contraceptives may subsequently lead to slight weight gain. Even in the body healthy woman occurs under the influence of drugs hormonal disbalance, and if the patient’s history contains problems with thyroid gland- then weight gain can be significant. Synthetic hormones suppress the body's own glands and interfere with the body's metabolic processes.
The consequences of long-term use of contraceptives lead to the development of a stable depressive state. Women are increasingly experiencing Bad mood, irritation and even nervous breakdowns. A stable dependence on the drug occurs: the female body requires the use of a contraceptive to maintain hormonal balance.
Femininity and youth
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Long-term exposure to synthetic hormonal agents causes premature ovarian hypofunction. They decrease in size and their hormonal activity is inhibited. The effects of birth control pills lead to active synthesis male hormones. A woman develops masculine traits and loses her femininity.
With the onset of menopause, a woman stops artificially “defending herself” from unwanted conception. After stopping oral synthetic contraceptives, her body begins to age quickly. He no longer receives the hormones he needs for normal functioning. The consequences of taking birth control pills lead to the fact that a woman’s health deteriorates, her body weakens, and fatigue occurs quickly.
How do oral contraceptives affect heredity?
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Taking hormonal drugs by the mother has a negative impact on the future female generation. Often in girls, the menstrual cycle is disrupted and endocrine diseases occur. The consequences of birth control pills can manifest themselves as follows: having conceived a child, it becomes difficult for young women to carry a pregnancy to term normally, and there is a risk of developing a defective fetus.
Before starting to take hormonal pills, a woman must consult a doctor and, after weighing all the negative aspects, as well as the consequences of taking birth control pills, make a decision.
Oral contraception is considered the most effective method of preventing unwanted pregnancy. New contraceptive drugs are developed every year, with virtually no side effects. But many women, knowing the consequences of taking birth control pills, prefer other methods of contraception. They explain this choice by their reluctance to get health problems and interfere with the body’s natural hormonal processes.
A gynecologist will help you choose a method of contraception on an individual basis.
The effectiveness of taking oral contraceptives in preventing unwanted conception is undeniable. Therefore, before categorically rejecting such a method of protection, it is necessary to carefully weigh the pros and cons. Modern oral contraceptive pills have the minimum possible list of adverse reactions, therefore, their effectiveness is much higher and more significant than the unpleasant consequences. As a rule, COCs correct the hormonal status of patients, however, such changes almost always benefit women.
- The mechanism of action of the tablets is realized at the cellular level, because gestagens and estrogens block receptor functions in a woman’s reproductive structures. As a result of this effect, ovulation is inhibited. Due to a decrease in the production of pituitary hormones (FSH and LH), the maturation and development of female germ cells is suppressed.
- Contraceptives also affect the uterine body, more precisely, its internal endometrial layer, in which a kind of atrophy occurs. Therefore, if it happens that a female cell nevertheless matures, leaves the ovary and is fertilized, then it will no longer be able to implant into the uterine endometrium.
- In addition, oral contraceptive pills change the properties of cervical mucus, increasing its viscosity. Due to such changes, the uterine cavity is protected from the penetration of sperm into it.
- COCs also affect the fallopian tubes, reducing their contractile capabilities, which significantly complicates the passage of the germ cell through these channels, making it almost impossible.
The brightest action oral contraception expressed in ovulatory inhibition. These drugs lead to the creation of female body new, artificial monthly cycle, but normal, natural, they suppress. In fact, the reproductive system functions according to the mechanism feedback, when pituitary hormones are produced due to a decrease in estrogen-progestogen production. That is, if a sufficient amount of gestagenic and estrogenic hormones enters the body from the outside, then the pituitary gland stops producing tropic hormones hormonal substances. As a result, the growth and development of female germ cells stops.
You should not take any medications yourself, as this can cause irreparable harm to your health.
It is impossible to say for sure how much the patient’s hormonal background will change while taking oral contraception, since the body is individual. The degree of changes depends on the amount of adipose tissue and weight, as well as on the content of SSG (sex-binding globulin) in the blood, which is responsible for binding and transporting estradiol and testosterone. It is not advisable to conduct studies of estrogens and progesterone hormones when taking oral contraceptives. When taking high-dose contraceptives, the patient’s hormonal background acquires “pregnant” indicators, but if low-dose drugs were taken, then these indicators will still be higher than normal, but lower than when carrying a child.
The effect of oral contraception on the patient’s body
As a rule, when any hormonal substance enters the body, the activity of the entire system malfunctions, connections and interactions between intraorganic structures and glandular organs are disrupted. As a result, the processes of stress resistance, immune defense and self-regulation lose stability, and immune endocrine and nervous system structures begin to function in super-tension mode. Amid such intense activity, a disruption soon occurs.
Instead of interacting optimally and productively with each other, internal organs and glandular structures establish artificial, rough connections that function forcedly. That is, the body is subjected to functional violence. If the patient takes any hormonal medications, the intrasecreting glands stop producing these hormones on their own. It is quite understandable why do extra work if the hormone is present in the body in the required quantities. If such a picture does not last long, then everything is still fixable, but with a long-term disturbance, drying out of the glandular body can occur, its atrophy, and, accordingly, problems arise in the functioning of all structures that depend on this gland.
Under the influence of taking oral contraceptive drugs, a woman’s normal monthly cycle disappears. The patient regularly experiences withdrawal bleeding, however, it has nothing to do with menstruation, since the woman actually does not have a menstrual cycle. The female cycle is very sensitive to intraorganic changes; it is the cyclical nature of processes in the body that ensures the full functioning of all systems, and not only reproductive ones.
If there is a disorder in the functioning of organs and systems in the body, then the body will need a lot of effort to maintain normal functioning. As a result, all systems get used to working hard under stress. When taking contraceptives for a long time and constantly, one cannot count on maintaining normal female cycle in future.
What consequences may arise if canceled?
Almost every woman knows about the potential harm of birth control pills. But today pharmaceutical companies are massively promoting drugs from the mini-pill category among young girls and women. The annotation states that they contain only small doses of progesterone hormone, so there is no need to worry about adverse reactions such as serious hormonal imbalance when taking them. But this is not true at all.
Attention! Mini-pills do not in any way guarantee the absence of adverse reactions, and their mechanism of action is practically no different from COCs. As a result of taking these “safe” contraceptives, the body receives a signal about the state of pregnancy for a long time. And all the time. But the female body does not have such resources to be able to bear a child for several years.
While taking the mini-pill, egg maturation and conception are also blocked, the production of luteinizing and follicle-stimulating hormones is suppressed, which negatively affects the activity of other endocrine glands. If we look at the problem from the other side, then the use contraceptives can have both negative and positive consequences.
Positive
Properly selected pills have a beneficial effect on the female body
To the effects positive character When taking contraceptive pills, a lack of ovulation can be attributed. Over the course of a month, the uterine body prepares to receive the egg, but it does not mature. Normally, when menstruation occurs, there is a sharp drop in hormonal levels, which is a stress factor for the body. When taking COC drugs, ovulation does not occur, the ovaries rest, so the uterus is not subject to monthly stress.
Another positive aspect of taking contraceptive pills is the absence of hormonal surges, which ensures the elimination of PMS, which is also closely associated with strong fluctuations in hormonal levels. The absence of premenstrual syndrome ensures a woman’s nervous system stability, eliminating the likelihood of conflicts that often occur against the background of PMS.
According to many gynecologists, hormonal contraception allows you to regulate your periods. Yes, when taking COCs, monthly bleeding actually becomes regular, and its abundance and duration are noticeably reduced. In addition, oral contraceptives minimize the risk of developing ovarian and uterine tumor processes and reduce the frequency of inflammatory pathologies.
It cannot be denied that taking pills that prevent conception prevents the development of osteoporosis, which develops against the background of estrogen deficiency. COCs do contain estrogen. In addition, COCs have a therapeutic effect against pathologies caused by androgen excess. Contraceptives suppress androgen secretion, eliminating fairly common problems such as acne, alopecia, oily skin or hirsutism.
Negative
As for the undesirable consequences of using oral contraception, they are generally due to the estrogen effect on the female body. Taking these drugs does not cause pathologies, however, they can provoke various exacerbations and complications of existing predispositions to certain hormone-dependent diseases. Although, if you maintain a healthy lifestyle, limit alcohol and give up cigarettes, then Negative consequences contraceptive use will be minimal. Such consequences include:
Such reactions are not obligatory and do not occur in all patients. If some of them do arise, they usually neutralize on their own after a couple of months, until the body gets used to the drugs being taken.
Is it possible to become dependent on COCs?
With uncontrolled and long-term use of hormonal contraceptives, ovarian atrophy can develop, which will only progress over time. Against the background of such a complication, a woman will not be able to give up oral contraceptives, as she will become dependent on them. Hormonal substances of synthetic origin are so naturally integrated into intraorganic metabolic processes that they suppress the activity of glandular organs. Therefore, if you refuse hormonal contraception, the body will begin to experience an acute deficiency of hormonal substances, which is much more dangerous than taking COCs. It’s just that the body, or more precisely, its glands, have forgotten how to function fully, so the abolition of contraceptives becomes a serious problem for many girls.
As a result, women continue to take contraceptives, not so much to prevent conception (it becomes impossible due to ovarian atrophy), but to avoid the onset of rapid and early aging of the body. Therefore, when deciding on the use of hormonal oral contraception, it is necessary to contact a highly qualified specialist who will competently select the drug and determine the safe timing of its use. Self-prescription of such medications can result in irreversible consequences.
Should I take contraceptive pills or not?
Undoubtedly, every girl/woman must decide for herself whether to take hormonal contraceptives or not. If you have decided to use oral contraception for a while, then you need to select pills only according to the recommendations of a practicing gynecologist, and not according to at will. Before taking COCs, it is imperative to undergo an examination, take a smear and blood test, and undergo ultrasound diagnostics for possible tumor processes. Only based on the tests will the doctor be able to select the right drug.
Phenotypes when choosing contraceptives
Today, contraceptive tablets containing hormones are in great demand. Not all ladies take into account that changing the balance of hormones in the body is quite dangerous. And not everyone knows that long-term use of oral hormonal contraceptives is prohibited. It is advisable to first undergo examinations prescribed by the gynecologist, and then start taking medications.
Hormonal pills for preventing conception are divided into:
- combined oral contraceptives (COCs)
- mini-pill
In the first group, the active ingredients are:
- progestogen (can be desogestrel, gestodene or norgestrel instead)
- ethinyl estradiol (which is analogous to the action of the hormone estrogen)
Combined oral contraceptives operate by blocking the release of a mature egg. This is achieved by inhibiting the formation of luteinizing and follicle-stimulating hormone in the pituitary gland of a girl or woman. A local obstacle to the ovulation process is also created. COCs prevent the egg from implanting in the uterus.
Based on the dose of active hormones, there are three types of COCs:
- microdosed (prescribed to patients under 25 years of age and to those who will be taking birth control pills for the first time. These are COCs such as Qlaira and Zoely)
- low-dose (can be prescribed to those who have given birth before, as well as to those who have experienced such a side effect of micro-dosed contraceptives as spotting of blood from the genitals not during menstruation):
— Tri-mercy
— Silhouette
— Femoden
— Rigevidon
— Microgynon
- Marvelon, etc.
Mainly used for therapy. These are tablets such as Tri-regol, Trizeston, Ovidon, Triquilar, etc.
Mini-pill
Included active substance is a progestogen that affects certain areas reproductive system. Under the influence of these drugs, the quality and quantity of cervical mucus changes. In the middle of the monthly cycle, it becomes less, but throughout the entire cycle the viscosity increases, so sperm do not reach the egg (which makes the fertilization process itself impossible).
The constitutional-biological type is also taken into account by the gynecologist when choosing birth control pills for a particular patient. It includes the following factors:
- chronic diseases that a woman currently has
- amenorrhea or other menstrual irregularities
- symptoms before and during menstruation
- hair and skin condition
- presence and quality of hair in the pubic area
- mammary gland
- the patient's appearance and height
The height of patients with this type is low or average. They look feminine, have dry hair and dry skin. Menstruation lasts a long time and a lot of blood comes out. The cycle is from 28 days. In such cases, high- and medium-dose combined oral tablets are prescribed:
- Triziston
- Milvane
- Rigevidon, etc.
The second type is balanced. Average height, feminine appearance, average breasts, normal hair and skin. There are usually no signs of PMS. Menstruation lasts 5 days. They are prescribed 2nd generation drugs:
- Femoden
- Microgynon
- Lindinet-30
- Silest
- Marvelon, etc.
The third type is the predominance of androgens/gestagens. Such patients are usually tall and look similar to men. The chest is usually small, hair and skin tend to be oily. PMS is characterized by depressive moods and pain in the lower abdomen. Menstruation is in small quantities, lasts up to 5 days, cycle up to 4 weeks.
Features of contraception depending on the woman’s age
Young, nulliparous women are more often prescribed microdosed birth control pills. The following drugs are ideal for them:
20, Jess, Logest, Mercilon, Klaira, Novinet.
Low-dose and medium-dose hormonal drugs are suitable for women who have given birth. These include: Yarina, Marvelon, Lindinet-30, Regulon, Silest, Janine, Miniziston, Diane-35 and Chloe.
Selecting birth control pills is a difficult task that can be solved together with your doctor. The goal of the task is reliable protection against the occurrence of unwanted pregnancy. The criteria may be effectiveness, absence of side effects, ease of use of the pills and speed of restoration of fertility after discontinuation of the contraceptive.
Undoubtedly, the choice of contraceptive drug depends on age characteristics.
The periods of a woman’s life are divided into adolescence - from 10 to 18 years, early reproductive - up to 35 years, late reproductive - up to 45 years, and perimenopausal - lasting 1-2 years from the last menstruation.
It is advisable to start contraception in adolescence, if, of course, there is a need for it. IN last years There is a decrease in the age of first pregnancy and childbirth, and the frequency of abortions at a young age is increasing.
According to WHO, the most effective for adolescents are combined oral contraceptives containing small doses of steroids and third-generation drugs containing progestogens. Three-phase drugs are best suited for adolescents: Triziston, Triquilar, Tri-Regol, as well as single-phase drugs: Femoden, Mercilon, Silest, Marvelon, which regulate the course of the menstrual cycle.
Between the ages of 19 and 35, women can use all known methods of contraception. However, it should be borne in mind that the use of combined oral contraceptives is more reliable and effective.
In addition to oral contraceptives, other methods are popular in our country: insertion of an intrauterine device, use of a condom, and use of injection methods of contraception.
It has been proven that birth control pills are used not only for contraception, but also for therapeutic and preventive purposes for diseases such as infertility, inflammatory and oncological diseases, and menstrual irregularities. The only drawback that you need to be aware of is that hormonal contraceptives do not protect a woman from sexually transmitted infections.
The most common remedies at this age are Janine, Yarina, Regulon.
Doctors say that at this age women should protect themselves from unwanted pregnancy by using intrauterine devices, because At this age, steroids, due to the presence of diseases acquired by the woman, are contraindicated.
A woman may suffer from cervical diseases, endometriosis, endocrinological diseases - diabetes mellitus, thyrotoxicosis, obesity. Many women smoke. These factors complicate the selection of hormonal contraceptives.
Steroids are prescribed only if there are no contraindications. The latest generation combined contraceptive pills and three-phase drugs are preferred: Femoden, Triziston, Silest, Triquilar, Marvelon, Tri-regol.
For this group of women, products with a low content of hormones, as well as “mini-pill” preparations, are excellent. Hormonal contraception is combined with the therapeutic effect of new generation drugs. The most popular of them is Femulen. It can be used if a woman has diseases such as thrombophlebitis, previous heart attack and stroke, hypertension, severe migraine-type headaches, and some gynecological diseases.
After 45 years, ovarian function gradually decreases, the likelihood of pregnancy decreases, but is still possible. Many women at this age still ovulate, and fertilization of the egg can occur.
Undoubtedly, a woman is able to become pregnant and give birth to a child, but pregnancy often occurs with complications, since at this age there is a fairly large bouquet of various diseases. Diseases of the cardiovascular system, liver and kidneys are usually present, chronic disorders functions of the reproductive system.
Very often, by the age of 40, women no longer plan a pregnancy, and unwanted pregnancies are artificially terminated. Abortion, especially during this period, has consequences that threaten a woman’s health. Frequent complications of abortion are the development of uterine fibroids, oncological diseases, severe manifestations of menopause. The possibility of developing diseases indicates the need for contraception during this period.
Birth control pills are also prescribed for many gynecological diseases, osteoporosis, to prevent the development of ovarian and uterine cancer.
At the age of over 45 years, it is promising to use low-dose hormonal drugs, mini-pills, injections and implants that are implanted under the skin (for example, Norplant).
Combined-action contraceptive pills are contraindicated in women over 45 years of age in the following cases:
- if a woman smokes;
- if a woman suffers from heart and vascular diseases - heart attack, stroke, thrombosis;
- with type 2 diabetes mellitus;
- in severe liver diseases with development liver failure;
- for obesity.
At this age, the modern drug Femulen is often used, which has virtually no side effects.
Is it possible to get pregnant on birth control?
When deciding to use oral contraceptives, a woman wants to know what percentage of their effectiveness. Pregnancy cannot be 100% excluded with any method of contraception, including taking COCs. You can get pregnant if you missed a pill, took it at the wrong time, or used expired contraceptives. If vomiting occurred or other medications were taken along with oral contraceptives, the chances of pregnancy also increase.
If you find out you are pregnant while taking birth control, just stop taking the pill. There is no need to have an abortion.
When do birth control pills start working?
It is better to start taking contraceptives on the first day of your period - only then the pills take effect immediately. If taken on the fifth day of menstruation, additional precautions should be taken. Women with
can start taking contraceptives on the first day of the cycle, being confident that there is no pregnancy.
In the absence of lactation, it is better to start taking it 21 days after birth. If breastfeeding, taking oral contraceptives should be postponed for six months.
After an abortion, it is necessary to start using birth control pills on the day of the abortion.
Standard regimen for the use of hormonal contraceptives The drug is taken daily for 21 days, followed by a seven-day break, then continues to be taken from a new package. Menstrual-like bleeding goes away during a break from taking the pills.
Special modes The 24 4 mode is typical for the Jess contraceptive, the package of which contains 24 hormonal and 4 inactive tablets. The tablets are used daily, without breaks.
Extended regimen consists of taking a product containing only “active” tablets (continuously, more than one package). A three-cycle regimen is common - taking 63 tablets of monophasic drugs followed by a 7-day break.
Thus, the number of menstrual bleeding per year is reduced to four.
Take the missed pill as soon as possible!
Take the remaining tablets at your usual time.
If one or two tablets are missed, or a new pack is not started within one to two days, take the tablet. There is a risk of pregnancy.
Missing three or more tablets in the first 2 weeks of use, or not starting a new pack within three days Take a tablet. Use barrier methods of contraception for 7 days. If sexual intercourse has taken place within 5 days, use emergency contraception.
Missing 3 or more tablets during the third week of use Take the tablet as soon as possible. If the package contains 28 tablets, do not take the last seven tablets. Don't take a break. Use barrier methods of contraception for 7 days. If sexual intercourse has taken place within 5 days, use emergency contraception.
At correct technique The tablets begin to act immediately after the start of the course.
You cannot buy the pills that suit your mother/sister/friend. Each body is individual in its reaction to hormones and other substances, according to existing diseases, etc. Therefore, oral contraceptives are prescribed by a gynecologist, who collects anamnesis and prescribes a study to make sure that you have no contraindications to taking certain contraceptives.
When visiting a gynecologist, the following is assessed:
- skin (hypertrichosis: is there or not, hyperandrogenism: are there signs, petechiae, etc.)
- mammary glands (palpation is performed)
- BP (pressure)
- body weight
The following analyzes are carried out:
- blood sugar
- liver enzymes
- hormonal background
- blood coagulation system
- ultrasound examination of the pelvic organs
- ultrasound examination of the mammary glands (breasts)
- mammography in some cases
- examination by a gynecologist and taking smears
It is also a good idea to visit an ophthalmologist (eye doctor). After all, taking oral contraceptives affects the risk of developing eye diseases, including glaucoma.
Today, in developed countries, couples in which the woman is over 40 years old undergo sterilization. This allows you to prevent pregnancies, which at this age occur with significant complications and sad consequences. If you decide to use hormonal contraceptives, your doctor will prescribe mini-pills or combination pills.
If a woman is over 25 years old, has heart disease, and also smokes (or is at risk of cancer), then it is very undesirable to take COCs. When you reach 40 years old, you can switch to mini-pills. They are also prescribed to those who have hyperplastic processes in the endometrium or have fibroids in the uterus.
Contraindications
The drug is advised not to be used by patients who have:
- sarcoidosis
- myasthenia gravis
- lymphogranulomatosis
- thyrotoxicosis
- multiple sclerosis
- rheumatoid arthritis
- bronchial asthma
- Gilbert's syndrome
- kidney dialysis
- thalassemia
- retinitis pigmentosa
COCs should absolutely not be used by those who have the following pathologies and conditions:
- diseases in which blood clots form
- diabetes mellitus that has been present for a long time or is progressing
- smoking ladies over 25 years old
- obesity
- patients who will undergo any surgery in four weeks
- for those who are immobile for a long time
- for endocrine gland cancer
- patients with genital cancer
- for gestational herpes
- for hypertension of the second A or 3rd degree
- for idiopathic bleeding from the genitals
- ladies with idiopathic migraines
- those who have tumors or other liver diseases
- at pathological changes cerebral vessels
- with diseases of the cardiovascular system
- with a real or suspected pregnancy
- for those who have passed less than 1.5 months after childbirth
- for those who are breastfeeding
Pure progestins cannot be used for the following conditions and diseases:
- genital cancer
- ectopic pregnancy in the anamnesis
- heart and/or vascular diseases
- idiopathic bleeding from the genital tract
- acute liver diseases
- malignant neoplasms in the breast
- real or suspected pregnancy
Manufacturers of oral contraceptives say that modern drugs contain a minimal amount of hormones. Like, it's not harmful to health. But we must remember that long-term use is harmful to absolutely all women! Irreversible changes occur that do not appear immediately when taking birth control pills.
Consequences of taking birth control pills
Oral contraceptives (birth control pills) are very popular today. About 60% of the fair sex accept them.
But there are often situations when there is no need for oral contraceptives, but women are afraid to stop taking birth control. Some women are afraid of gaining excess weight, others are afraid of rapid aging and deterioration of appearance, growth of facial hair, etc.
What is true and what are myths associated with the abolition of birth control?
So, when should you consider stopping birth control?
- The couple decided to have a child.
- The couple broke up, the love has passed, there are no former feelings.
- The relationship moved into a calm phase and physical intimacy became less frequent.
- The woman began to experience a phobia or fear of hormonal drugs, possible consequences their reception.
- Problems with well-being and health appeared.
- There is a need for barrier contraception.
- Despite the protection, an unwanted pregnancy occurred.
A woman may not be aware of developing cancer (or the risks of cancer) and may be taking pills to prevent pregnancy. In this case, her risk of developing a tumor increases significantly. Danish researchers claim that long-term use of oral contraceptives leads to an increase in the risk of brain tumors in women by 1.5-3 times. The risk of blood clots also increases. Additional risk factors are:
- smoking
- high blood pressure
- genetic disposition
When taking COCs, the risks of the following conditions and symptoms increase:
- chronic venous insufficiency
- spider veins on the legs and face
- breast cancer
- inflammatory pathologies of the cervix
- infertility
- dark spots
- multiple sclerosis
- scalp hair loss
- depression
- significant decrease in sexual desire, etc.
Is it harmful to take birth control pills?
There are important periods in a woman’s life when she thinks about the advisability of using birth control pills. These include periods after
Periods after
A woman wonders if birth control pills will harm her.
Birth control pills, which contain predominantly one type of hormone - progestin, can be used during lactation and breastfeeding. Such contraceptives include “mini-pills”: Charozetta, Exluton, Microlut and others.
The hormones that are part of combined oral contraceptives affect the child’s body through the mother’s milk. Therefore, the use of such products during breastfeeding is strictly contraindicated.
Combined oral contraceptives are recognized as the most reliable when used in the period after induced abortion and miscarriage. In addition to reliable contraceptive action, they have medicinal properties. These drugs are used for menstrual irregularities, for the prevention of endometriosis, in the treatment of fibrocystic
Perhaps these remedies are the best in terms of protection after artificial termination of pregnancy, as they help to avoid inflammatory diseases.
Birth control pills should be started on the day of the abortion. Of the combined contraceptives, new generation drugs are prescribed: Mercilon, Regulon, Tri-Mercy, Femoden, Marvelon, Logest, Novinet, Diane-35, Silest, Yarina, Belara. The proportion of estrogen in them does not exceed 35 mcg. The contraceptive effect occurs when using COCs immediately after the first tablet. There is no additional need to provide barrier methods of contraception.
If you start taking COCs from the fifth day after an abortion, it is necessary to additionally apply barrier methods. This start is not correct; it is advisable to start taking contraceptives on the first day of the next menstruation, and before that use other methods of contraception.
Sometimes they resort to contraception in the period after an abortion using progestin drugs or mini-pills. They are less reliable than combined agents, but cause far fewer side effects.
The problem of abortion and its complications is currently relevant. The use of modern contraceptives promotes motivation to prevent abortion among women. Correct Application contraceptives that are suitable for a woman help to significantly reduce the number of unwanted pregnancies and abortions.
After childbirth
On reproductive health women influence various factors. The onset of an unplanned pregnancy has an extremely adverse effect on the body. postpartum period. According to research by experts, in our country, every tenth woman, within one year after giving birth, seeks help from medical institutions to terminate an unwanted pregnancy.
On modern stage Many drugs have appeared to prevent pregnancy during the postpartum period. The choice of birth control pills in the postpartum period should be individual for each woman.
In the postpartum period, all functions of the woman’s body are gradually restored. So, on the tenth day after birth, the formation ends cervical canal, a month after birth, the external os completely closes, and the menstrual cycle is restored after four to five months.
When breastfeeding and having amenorrhea, a woman in 98% of cases remains infertile for six months. In this case, the use of oral contraceptives can be abandoned.
You can start taking contraceptives no earlier than six weeks after giving birth.
More often, women in the postpartum period use gestagen-containing drugs (mini-pills): Charozetta, Exluton, Microlut.
Scientists have proven that birth control pills do not affect the child in early period pregnancy. But it is still recommended to cancel them immediately after pregnancy is confirmed. It is always necessary to remember the rule of canceling contraceptives during pregnancy.
In other cases, when contraceptives are discontinued, ovulation is restored after some time, but sometimes the woman remains infertile for several months. Experts recommend that after stopping contraception, you should see a gynecologist, be examined for inflammatory diseases, infections, and cancer of the uterus, and only after that plan a pregnancy.
Women taking hormonal drugs of the new generation, if they are discontinued, have an excellent opportunity to become pregnant. All favorable conditions have been created for conception: while taking contraceptives, the ovaries have rested, the uterus is prepared for a new pregnancy. A woman can successfully plan her pregnancy and the birth of a healthy child.
But, unfortunately, there are also contraindications for the use of birth control pills.
If a woman suffers
Uncomplicated diabetes
Then you can use birth control pills only under the supervision of your doctor.
In rare cases, after stopping hormonal contraceptives, a woman experiences some discomfort: skin problems, mood lability, even depression, and menstrual irregularities may appear. Women are scared - are these signs of addiction to steroids? I would like to reassure women.
There is no dependence on the use of hormonal contraceptives. All these surprises in well-being are observed only after discontinuation of a drug that was chosen incorrectly or was not suitable for the woman. It must be remembered that birth control pills should only be selected by a gynecologist.
What reasons force a woman to stop taking contraceptives on her own? The first reason Sometimes doctors prescribe hormonal contraceptives not only to protect against pregnancy, but also to increase fertility - the ability to conceive. During the use of contraceptives, the ovaries have time to rest; when discontinued, the ovaries are ready for intensive work, and after some time the woman can become pregnant.
By the way, this activity of the ovaries leads to the above reactions during the period of discontinuation of birth control pills.
If pregnancy does not occur within three months after stopping the pills, you should consult your doctor.
The second reason is the absence of a permanent partner - then there is no need to take contraceptives. In this case, it is advisable to cancel them.
Women with skin and other problems, even in the absence of sexual activity, do not need to cancel contraceptives.
Third reason Many women are sure that contraceptives should not be taken for a long time. And women simply stop drinking them. This is mistake. Properly selected birth control pills can be taken for a long time without side effects. "From the moment last birth and until menopause you can take the same contraceptives,” experts advise.
When discomfort after discontinuation of hormonal contraceptives, it is necessary to allow the body to get used to the new condition, regularly take vitamin supplements, healthy image life.
If your menstrual cycle is irregular, you should consult a doctor who will tell you what to do. Establishing a cycle duration of 21-36 days is considered the norm.
Helps with mood changes herbal tea with common twig, which affects the level of testosterone in the body.
Skin problems such as acne, oily hair, greasiness? talk about an imbalance of hormones in the female body. In this case, combined oral contraceptives with antiandrogenic action are selected.
Doctors believe that it is better to stop taking the pills two to three months before the planned conception. However, it should be borne in mind that the likelihood of conception increases already in the first month after discontinuation of the contraceptive.
Periods after
Periods after
The abolition of birth control pills must follow certain rules. When you refuse contraceptive treatment, a variety of adverse reactions occur. To ensure that these phenomena occur in a mild form, you should take into account all the recommendations of a specialist.
Cancellation of protective therapy is carried out for a variety of reasons. The need to stop using contraceptives arises in the following cases:
- conception planning;
- lack of sex life;
- mandatory break in treatment;
- the appearance of various complications;
- concomitant therapy.
The main reason for refusing contraceptives is planning to conceive. It has been found that contraceptives taken for a long time can reduce a woman's reproductive function. For pregnancy to occur, the body must restore its functioning. For this reason, doctors recommend stopping treatment six months before planning conception. During this period, side effects may occur. The doctor will help you quickly eliminate undesirable consequences and normalize the function of the reproductive system.
In some patients, the need for contraception disappears when sexual activity ceases. If there is a change of partner or the woman is left alone, it is recommended to stop taking the pills. This will give the body the opportunity to rest and recover.
You need to take the pills according to certain rules. When using this method for a long time, doctors advise taking a short break every two years. Rest is necessary to maintain the natural functioning of the ovaries. Refusal to take a break can result in cessation of ovarian function. Further chances of a quick pregnancy are reduced.
Each person has different reactions to taking medications. All birth control pills contain synthetic types of hormones. Such therapy often causes undesirable reactions from various systems. During the first three months, side effects should disappear on their own. If this does not happen, you should replace the drug with an analogue or choose another method of protection.
A waiver is also required upon appointment. concomitant treatment. Detection endocrine diseases, neoplasms of unknown etiology, hypertensive disease leads to the prescription of additional therapy. Many medications are incompatible with birth control pills. For this reason, the doctor selects another method of protection.
If the patient has such reasons, she should visit a specialist. The doctor will explain how the withdrawal should be carried out and what side effects may occur. Proper preparation will help a woman easily endure the recovery period.
Rules for stopping treatment
A specialist should explain how to stop taking birth control pills. Most adverse reactions occur due to improper cessation of treatment.
There is a certain algorithm of actions:
- take all the tablets in the package;
- proper nutrition;
- consultation with a gynecologist.
To properly discontinue the drug, you must completely finish all the tablets in the last blister. You should not stop treatment halfway through the package. This can have a detrimental effect on the hormonal system. This influence is accompanied by a background failure. The patient’s cycle will take a long time to recover.
Most birth control pills have a certain undesirable effect - weight gain. After cessation of protective therapy, an increase in this effect is observed. The woman begins to gain weight. For this reason, you need to follow a special diet. Proper nutrition reduces the risk of weight gain and helps strengthen metabolic processes.
After graduation contraceptive treatment It is recommended to visit a gynecologist. The doctor will conduct an examination reproductive organs using an ultrasound machine. If there are any pathological processes, the gynecologist will prescribe the appropriate medication.
Restoration of the body
The first consequences of stopping birth control pills become apparent gradually. Recovery period may last for different times. The following changes occur:
- development of the endometrial layer;
- the appearance of follicle-stimulating and luteinizing substances;
- construction of a three-phase menstrual cycle;
- qualitative changes in cervical discharge.
Menstrual fluid consists of the endometrial layer, blood and secretory fluid. While taking birth control, the endometrium stops growing. This fabric necessary for attachment of the blastocyst after fertilization. Tissue growth is caused by the presence of follicle-stimulating hormone. Elimination of this substance leads to the absence of the endometrium. Thanks to this feature, menstrual-like discharge appears after each pack of the drug. After refusal, the development of the endometrium is observed. This is due to the restoration of hormonal levels.
The main change is the restoration of the production of important substances: luteinizing and follicle-stimulating hormone. FSH is detected in the bloodstream after menstruation has stopped. The substance stimulates the ovaries to mature the egg. Under his influence begins to grow dominant follicle. Luteinizing hormone is also restored. The substance helps the growing follicle burst. This causes the development of a favorable period - ovulation. In the first months after withdrawal, the amount of substances is not always sufficient. Ovulation may resume after six months.
The menstrual cycle of a healthy woman consists of several phases. There are three main stages: estrogen, luteinizing and progesterone. During contraceptive therapy, the luteinizing phase disappears. This makes conception impossible. After discontinuation of contraceptives, the phases return to normal.
The drug also affects the quality of cervical mucus. When the luteinizing substance disappears, the secretion does not liquefy. The discharge remains thick. Discontinuation of treatment is accompanied by thinning of vaginal discharge. During the first months, the patient may complain of increased vaginal secretion.
Possible negative reactions of the body
Before stopping taking birth control pills, a woman should know what negative reactions they can cause. Birth control pills cause the following side effects:
While taking birth control pills, the risk of blood clots increases. Thrombophlebitis is diagnosed in 10% of patients. The disease is associated with an abnormal increase in the number of platelets. These cells capture red blood cells and form a seal in certain areas of the vascular tissue. Blood clots pose a threat to the patient’s life. To reduce the risk of such a complication, coagulation therapy is prescribed.
In some cases, an increase in blood pressure is detected. The disease causes severe narrowing of the lumen of blood vessels. Blood pressure increases, hypertension develops. Pathology can be eliminated only at the first stage of its development. Doctors carry out special measures aimed at normalizing the elasticity and patency of vascular tissue.
Some women experience ectopic pregnancy after stopping the drug. Cancellation may cause a rebound effect. The effect causes a sharp increase in the work of the ovaries. They begin to actively produce germ cells. With unprotected contact, fertilization can occur before entering the fallopian tubes. In this case, the fertilized egg is attached to the walls of the tube. The pathology is dangerous due to the loss of a woman’s reproductive abilities.
Other reactions
A healthy woman has a constant menstrual cycle. The contraceptive helps to achieve a length of 28 days. Many patients, after discontinuation, experience a side effect such as a change in cycle duration.
It may vary in length over the course of several months. This is due to the restoration of the hormonal system. After the background has stabilized, the cycle is restored. If the normal duration does not return, you should visit a medical center.
A common reason for prescribing birth control pills is not only to prevent pregnancy, but also to eliminate a variety of diseases of the reproductive organs. For fibroid lesions and changes in the quality of the endometrium, short-term therapy with barrier drugs is used. After withdrawal, the disease may return in some women. In such cases, the selection of another type of treatment is required.
When canceling, please follow dietary food. Normalization of hormonal levels causes a surge in the level of various substances. This feature is accompanied sharp increase weight within a few weeks. Body weight can rarely stabilize on its own. To eliminate the unpleasant side effects of withdrawal, you need to follow a diet and lead an active lifestyle. If you don't do this, the weight may remain.
Some contraceptives include androgenic medicinal substances. These medications have a cleansing effect skin from various rashes. The androgenic effect persists after discontinuation for a month. If the condition of the skin does not return to normal, acne may return. An increase in sebum secretion is also often observed. Fat is produced in sebaceous glands under the influence of hormonal substances. Background stabilization enhances this side effect.
It was also found that the abolition of contraceptives is accompanied by an increase in body hair. Unwanted hair may appear on the area of the nipple areolas and the umbilical sulcus. Restarting therapy may resolve the side effect. But in most women, hair growth can only be treated cosmetically.
Negative phenomena
After a girl stops taking contraceptives, the following side effects may appear:
- resumption of pain;
- increased volume of menstrual flow;
- breakthrough bleeding;
- disappearance of menstruation;
- type 1 infertility.
Many patients complain of pain before menstruation. During treatment, the pain disappears. The first real period after withdrawal can cause severe pain in the lower abdomen. The side effect can be eliminated by taking additional painkillers.
An increase in the volume of menstrual flow may also occur. The appearance of the endometrium affects their quality. Menstruation becomes heavy and prolonged. This effect cannot be eliminated with drugs. Stabilization occurs independently.
A common side effect is breakthrough bleeding. Prolonged rest of the ovaries leads to thinning of the vessels that supply the walls of the uterine body. Resumption of the menstrual cycle may cause the damaged areas to rupture. Breakthrough bleeding should be managed under the strict supervision of a specialist. You cannot treat yourself. Large blood loss can be fatal.
There is also a side effect such as the disappearance of menstruation. It occurs due to hormonal imbalance. Such patients do not ovulate. Pregnancy becomes impossible.
Side effects after discontinuation can only be eliminated under the strict supervision of a specialist. You should not treat yourself.
From previous publications we know about the abortifacient effect of hormonal contraceptives (GC, OK). IN Lately In the media you can find reviews of women who suffered from the side effects of OK, we will give a couple of them at the end of the article. To shed light on this issue, we turned to a doctor who prepared this information for the ABC of Health and also translated for us fragments of articles with foreign studies on the side effects of GCs.
Side effects of hormonal contraceptives.
The actions of hormonal contraceptives are the same as those of others medicines, are determined by the properties of the substances included in them. Most birth control pills prescribed for routine contraception contain 2 types of hormones: one gestagen and one estrogen.
Gestagens
Progestogens = progestogens = progestins- hormones that are produced yellow body ovaries (formation on the surface of the ovaries that appears after ovulation - the release of the egg), in small quantities - by the adrenal cortex, and during pregnancy - by the placenta. The main gestagen is progesterone.
The name of the hormones reflects their main function - “pro gestation” = “to [maintain] pregnancy” by restructuring the uterine endothelium into the state necessary for the development of a fertilized egg. The physiological effects of gestagens are combined into three main groups.
- Vegetative influence. It is expressed in the suppression of endometrial proliferation caused by the action of estrogens and its secretory transformation, which is very important for a normal menstrual cycle. When pregnancy occurs, gestagens suppress ovulation, lower the tone of the uterus, reducing its excitability and contractility (“protector” of pregnancy). Progestins are responsible for the “maturation” of the mammary glands.
- Generative action. In small doses, progestins increase the secretion of follicle-stimulating hormone (FSH), which is responsible for the maturation of follicles in the ovary and ovulation. In large doses, gestagens block both FSH and LH (luteinizing hormone, which is involved in the synthesis of androgens, and together with FSH ensures ovulation and progesterone synthesis). Gestagens affect the thermoregulation center, which is manifested by an increase in temperature.
- General action. Under the influence of gestagens, amine nitrogen in the blood plasma decreases, the excretion of amino acids increases, and the separation of gastric juice, the secretion of bile slows down.
Oral contraceptives contain various gestagens. For some time it was believed that there was no difference between progestins, but it is now certain that differences in molecular structure provide a variety of effects. In other words, progestogens differ in spectrum and in the severity of additional properties, but the 3 groups of physiological effects described above are inherent to all of them. The characteristics of modern progestins are reflected in the table.
Pronounced or very pronounced gestagenic effect common to all progestogens. The gestagenic effect refers to those main groups of properties that were mentioned earlier.
Androgenic activity characteristic of not many drugs, its result is a decrease in the amount of “good” cholesterol (HDL cholesterol) and an increase in the concentration of “bad” cholesterol (LDL cholesterol). As a result, the risk of developing atherosclerosis increases. In addition, symptoms of virilization (male secondary sexual characteristics) appear.
Explicit antiandrogenic effect only three drugs have it. This effect has a positive meaning - improvement in skin condition (cosmetic side of the issue).
Antimineralocorticoid activity associated with increased diuresis, sodium excretion, and decreased blood pressure.
Glucocorticoid effect affects metabolism: the body's sensitivity to insulin decreases (risk of diabetes), the synthesis of fatty acids and triglycerides increases (risk of obesity).
Estrogens
Another component of birth control pills is estrogens.
Estrogens- female sex hormones, which are produced by the ovarian follicles and the adrenal cortex (and in men also by the testicles). There are three main estrogens: estradiol, estriol, estrone.
Physiological effects of estrogens:
- proliferation (growth) of the endometrium and myometrium according to the type of their hyperplasia and hypertrophy;
— development of genital organs and secondary sexual characteristics (feminization);
- suppression of lactation;
- inhibition of resorption (destruction, resorption) of bone tissue;
- procoagulant effect (increased blood clotting);
- increasing the content of HDL (“good” cholesterol) and triglycerides, reducing the amount of LDL (“bad” cholesterol);
- retention of sodium and water in the body (and, as a result, increased blood pressure);
— ensuring an acidic vaginal environment (normal pH 3.8-4.5) and the growth of lactobacilli;
- increased antibody production and phagocyte activity, increasing the body's resistance to infections.
Estrogens in oral contraceptives are needed to control the menstrual cycle; they do not take part in protection against unwanted pregnancy. Most often, the tablets contain ethinyl estradiol (EE).
Mechanisms of action of oral contraceptives
So, taking into account the basic properties of gestagens and estrogens, the following mechanisms of action of oral contraceptives can be distinguished:
1) inhibition of the secretion of gonadotropic hormones (due to gestagens);
2) a change in vaginal pH to a more acidic side (the influence of estrogens);
3) increased viscosity of cervical mucus (gestagens);
4) the phrase “ovum implantation” used in instructions and manuals, which hides the abortive effect of GC from women.
Commentary by a gynecologist on the abortifacient mechanism of action of hormonal contraceptives
When implanted into the wall of the uterus, the embryo is multicellular organism(blastocyst). An egg (even a fertilized one) is never implanted. Implantation occurs 5-7 days after fertilization. Therefore, what is called an egg in the instructions is in fact not an egg at all, but an embryo.
Unwanted estrogen...
In the course of a thorough study of hormonal contraceptives and their effects on the body, the following conclusion was made: unwanted effects associated to a greater extent with the influence of estrogens. Therefore, the lower the amount of estrogen in the tablet, the fewer side effects, but it is not possible to completely eliminate them. It was precisely these conclusions that prompted scientists to invent new, more advanced drugs, and oral contraceptives, in which the amount of the estrogen component was measured in milligrams, were replaced by tablets containing estrogen in micrograms ( 1 milligram [ mg] = 1000 micrograms [ mcg]). There are currently 3 generations of birth control pills. The division into generations is due to both a change in the amount of estrogens in the drugs and the introduction of newer progesterone analogues into the tablets.
The first generation of contraceptives include Enovid, Infekundin, Bisekurin. These drugs have been widely used since their discovery, but later their androgenic effects were noticed, manifested in deepening of the voice, growth of facial hair (virilization).
Second generation drugs include Microgenon, Rigevidon, Triregol, Triziston and others.
The most frequently used and widespread drugs are the third generation: Logest, Merisilon, Regulon, Novinet, Diane-35, Zhanin, Yarina and others. A significant advantage of these drugs is their antiandrogenic activity, most pronounced in Diane-35.
The study of the properties of estrogens and the conclusion that they are the main source of side effects from the use of hormonal contraceptives led scientists to the idea of creating drugs with an optimal reduction in the dose of estrogens in them. It is impossible to completely remove estrogens from the composition, as they play important role in maintaining a normal menstrual cycle.
In this regard, a division of hormonal contraceptives into high-, low- and micro-dose drugs has appeared.
Highly dosed (EE = 40-50 mcg per tablet).
- "Non-ovlon"
- "Ovidon" and others
- Not used for contraceptive purposes.
Low dosage (EE = 30-35 mcg per tablet).
- "Marvelon"
- "Janine"
- "Yarina"
- "Femoden"
- "Diane-35" and others
Microdosed (EE = 20 mcg per tablet)
- "Logest"
- "Mersilon"
- "Novinet"
- "Miniziston 20 fem" "Jess" and others
Side effects of hormonal contraceptives
Side effects from the use of oral contraceptives are always described in detail in the instructions for use.
Since the side effects from the use of various birth control pills are approximately the same, it makes sense to consider them, highlighting the main (severe) and less severe.
Some manufacturers list conditions that require immediate discontinuation of use if they occur. These conditions include the following:
- Arterial hypertension.
- Hemolytic-uremic syndrome, manifested by a triad of symptoms: acute renal failure, hemolytic anemia and thrombocytopenia (decreased platelet count).
- Porphyria is a disease in which hemoglobin synthesis is disrupted.
- Hearing loss caused by otosclerosis (fixation of the auditory ossicles, which should normally be mobile).
Almost all manufacturers list thromboembolism as a rare or very rare side effect. But this serious condition deserves special attention.
Thromboembolism- this is a blockage blood vessel thrombus. This is an acute condition that requires qualified assistance. Thromboembolism cannot occur out of the blue; it requires special “conditions” - risk factors or existing vascular diseases.
Risk factors for thrombosis (formation of blood clots inside vessels - thrombi - interfering with the free, laminar flow of blood):
— age over 35 years;
- smoking (!);
— high level estrogen in the blood (which occurs when taking oral contraceptives);
- increased blood clotting, which is observed with a deficiency of antithrombin III, proteins C and S, dysfibrinogenemia, Marchiafava-Michelli disease;
- injuries and extensive operations in the past;
- venous stasis with a sedentary lifestyle;
- obesity;
- varicose veins of the legs;
- damage to the valvular apparatus of the heart;
- atrial fibrillation, angina pectoris;
- cerebrovascular diseases (including transient ischemic attack) or coronary vessels;
- moderate or severe arterial hypertension;
- diseases connective tissue(collagenosis), and primarily systemic lupus erythematosus;
- hereditary predisposition to thrombosis (thrombosis, myocardial infarction, cerebrovascular accident in close blood relatives).
If these risk factors are present, a woman taking hormonal birth control pills has a significantly increased risk of developing thromboembolism. The risk of thromboembolism increases with thrombosis of any location, either currently present or suffered in the past; in case of myocardial infarction and stroke.
Thromboembolism, whatever its location, is a serious complication.
… coronary vessels → myocardial infarction ... brain vessels → stroke ... deep veins of the legs → trophic ulcers and gangrene … pulmonary artery(TELA) or its branches → from pulmonary infarction to shock Thromboembolism... … hepatic vessels → liver dysfunction, Budd-Chiari syndrome … mesenteric vessels → ischemic intestinal disease, intestinal gangrene … renal vessels ... retinal vessels (retinal vessels) In addition to thromboembolism, there are other, less severe, but still inconvenient side effects. For example, candidiasis (thrush). Hormonal contraceptives increase the acidity of the vagina, and fungi reproduce well in an acidic environment, in particular Candidaalbicans, which is a conditionally pathogenic microorganism.
A significant side effect is the retention of sodium, and with it water, in the body. This may lead to swelling and weight gain. Decreased tolerance to carbohydrates, as a side effect of the use of hormonal pills, increases the risk of developing diabetes mellitus
Other side effects, such as: decreased mood, mood swings, increased appetite, nausea, stool disorders, satiety, swelling and tenderness of the mammary glands and some others - although not severe, however, affect a woman’s quality of life.
In addition to side effects, the instructions for the use of hormonal contraceptives list contraindications.
Contraceptives without estrogen
Exist progestin-containing contraceptives (“mini-pill”). Judging by the name, they contain only gestagen. But this group of drugs has its own indications:
- contraception for nursing women (they should not be prescribed estrogen-progestin drugs, because estrogen suppresses lactation);
— prescribed for women who have given birth (since the main mechanism of action of the “mini-pill” is suppression of ovulation, which is undesirable for nulliparous women);
- in late reproductive age;
- if there are contraindications to the use of estrogens.
In addition, these drugs also have side effects and contraindications.
Particular attention should be paid to " emergency contraception". These drugs contain either a progestin (Levonorgestrel) or an antiprogestin (Mifepristone) in a large dose. The main mechanisms of action of these drugs are inhibition of ovulation, thickening of cervical mucus, acceleration of desquamation (squamation) of the functional layer of the endometrium in order to prevent the attachment of a fertilized egg. And Mifepristone has an additional effect - increasing the tone of the uterus. Therefore, a single use of a large dose of these drugs has a very strong immediate effect on the ovaries; after taking emergency contraceptive pills, there can be serious and long-term disturbances in the menstrual cycle. Women who regularly use these drugs are at great risk to their health.
Foreign studies of side effects of GCs
Interesting studies examining the side effects of hormonal contraceptives have been conducted in foreign countries. Below are excerpts from several reviews (translation by the author of fragments of foreign articles)
Oral contraceptives and the risk of venous thrombosis
May, 2001
CONCLUSIONS
Hormonal contraception is used by more than 100 million women worldwide. The number of deaths from cardiovascular diseases (venous and arterial) among young, low-risk patients is not smoking women from 20 to 24 years - observed worldwide in the range from 2 to 6 per year per million, depending on the region of residence, the estimated cardiovascular risk and the volume of screening studies that were carried out before prescribing contraceptives. While the risk venous thrombosis more important in younger patients, the risk of arterial thrombosis is more relevant in older patients. Among women who smoke, more mature age number of people using oral contraceptives deaths there are between 100 and just over 200 per million each year.
Reducing the dose of estrogen reduced the risk of venous thrombosis. Third-generation progestins in combined oral contraceptives have increased the incidence of adverse hemolytic changes and the risk of thrombus formation, so they should not be prescribed as first-choice drugs for new users of hormonal contraception.
The judicious use of hormonal contraceptives, including avoidance of their use by women who have risk factors, is absent in most cases. In New Zealand, a series of deaths from pulmonary embolism were investigated, and the cause was often due to a risk that doctors had not considered.
Judicious administration can prevent arterial thrombosis. Almost all women who had a myocardial infarction while using oral contraceptives were either older age group, either smoked or had other risk factors for arterial disease - in particular, arterial hypertension. Avoidance of oral contraceptives in these women may reduce the incidence of arterial thrombosis reported in recent studies from industrialized countries. The beneficial effect that third-generation oral contraceptives have on the lipid profile and their role in reducing the number of heart attacks and strokes has not yet been confirmed by control studies.
To avoid venous thrombosis, the doctor asks whether the patient has ever had venous thrombosis in the past to determine whether there are contraindications to the use of oral contraceptives, and what is the risk of thrombosis while taking hormonal medications.
Low-dose progestogen oral contraceptives (first or second generation) were associated with a lower risk of venous thrombosis than combination drugs; however, the risk in women with a history of thrombosis is unknown.
Obesity has been implicated as a risk factor for venous thrombosis, but it is unknown whether this risk is increased by oral contraceptive use; thrombosis is rare among obese people. Obesity, however, is not considered a contraindication to the use of oral contraceptives. Superficial varices are not a consequence of pre-existing venous thrombosis or a risk factor for deep venous thrombosis.
Heredity may play a role in the development of venous thrombosis, but its significance as a factor remains unclear high risk. Superficial thrombophlebitis history can also be considered a risk factor for thrombosis, especially if it is combined with a family history.
Venous thromboembolism and hormonal contraception
Royal College of Obstetricians and Gynecologists, UK
July, 2010
Do combined hormonal contraceptive methods (pills, patch, vaginal ring) increase the risk of venous thromboembolism?
The relative risk of venous thromboembolism increases with the use of any combined hormonal contraceptives (pills, patch and vaginal ring). However, the rarity of venous thromboembolism in women of reproductive age means that the absolute risk remains low.
The relative risk of venous thromboembolism increases in the first few months after starting combined hormonal contraception. As the duration of taking hormonal contraceptives increases, the risk decreases, but it remains as a background risk until you stop using hormonal drugs.
In this table, researchers compared the incidence of venous thromboembolism per year in different groups women (calculated per 100,000 women). From the table it is clear that in women who are not pregnant and do not use hormonal contraceptives (non-pregnant non-users), an average of 44 (with a range from 24 to 73) cases of thromboembolism per 100,000 women were registered per year.
Drospirenone-containingCOCusers - users of drospirenone-containing COCs.
Levonorgestrel-containingCOCusers - using levonorgestrel-containing COCs.
Other COCs not specified - other COCs.
Pregnantnon-users - pregnant women.
Strokes and heart attacks when using hormonal contraception
New England Journal of Medicine
Massachusetts Medical Society, USA
June, 2012
CONCLUSIONS
Although the absolute risks of stroke and heart attack associated with hormonal contraceptives are low, the risk increased from 0.9 to 1.7 with products containing 20 mcg ethinyl estradiol and from 1.2 to 2.3 with using drugs containing ethinyl estradiol in a dose of 30-40 mcg, with a relatively small difference in risk depending on the type of progestogen included in the composition.
Risk of thrombosis of oral contraception
WoltersKluwerHealth is a leading provider of expert health information.
HenneloreRott - German doctor
August, 2012
CONCLUSIONS
Different combined oral contraceptives (COCs) have different risks of venous thromboembolism, but the same unsafe use.
COCs with levonorgestrel or norethisterone (so-called second generation) should be the drugs of choice, as recommended by national contraceptive guidelines in the Netherlands, Belgium, Denmark, Norway and the UK. Other European countries do not have such guidelines, but they are urgently needed.
In women with a history of venous thromboembolism and/or known coagulation defects, the use of COCs and other contraceptives containing ethinyl estradiol is contraindicated. On the other hand, the risk of venous thromboembolism during pregnancy and the postpartum period is much higher. For this reason, such women should be offered adequate contraception.
There is no reason to withhold hormonal contraception in young patients with thrombophilia. Pure progesterone preparations are safe with respect to the risk of venous thromboembolism.
Risk of venous thromboembolism among users of drospirenone-containing oral contraceptives
American College of Obstetricians and Gynecologists
November 2012
CONCLUSIONS
The risk of venous thromboembolism is increased among oral contraceptive users (3-9/10,000 women per year) compared with non-pregnant and non-users (1-5/10,000 women per year). There is evidence that drospirenone-containing oral contraceptives have a higher risk (10.22/10,000) than drugs containing other progestins. However, the risk is still low and much lower than that during pregnancy (approximately 5-20/10,000 women per year) and in the postpartum period (40-65/10,000 women per year) (see table).Table Risk of thromboembolism.
