Almost every woman has felt the need to use contraceptives at least once in her life. And during such a period, many questions arise, namely, which contraceptives to choose, how to take them, whether there are side effects, and much more. Let's look at all the features of birth control and figure out which pills are best to take at a certain age.
Groups of contraceptives for women
The pharmacological market currently offers a wide range of drugs to prevent pregnancy. All of them are divided into the following groups:
- Combined oral contraceptives are based on hormones similar to the action of estrogens, these are progestogen and ethinyl estradiol. There are two-, three- and monophasic drugs.
- Mini-drink. Contains exclusively progestogen. The principle of action is a local effect on the peripheral zones of the reproductive organs. As a result of taking such drugs, there is a change in the biochemical and morphological parameters of the endometrium, so the development of the fertilized egg does not occur. In most women, the ovulation process is suppressed. Effective representatives: Microlut, Laktinet, Exluton, Charozetta.
COCs are divided into 3 groups based on the active substance content in the tablets:
- Monophasic - contain a low level of hormones. Therefore, they are recommended for use by young girls who have not given birth before. And for people who are encountering contraceptives for the first time, such medications will be the most suitable.
- Biphasic - prescribed to young and middle-aged women, especially relevant in the postpartum period. These pills should be taken by those who experience discharge while taking microdosed contraceptives. These drugs have an antiandrogenic effect, therefore they have a positive effect on the skin and prevent unwanted hair growth. These include: Regulon, Marvelon, Siluet.
- Triphasic - characterized by a high content of female hormones. They are prescribed for some gynecological diseases and to restore hormonal levels. Representatives: Trikvilar, Ovidon, Trizeston.
List of the best drugs that do not affect weight or help you lose weight
Birth control pills, which can help you lose weight, are available with a doctor's prescription. This is due to possible side effects and contraindications. The following drugs do not contribute to weight gain or, on the contrary, reduce it:
- Yarina is the most popular remedy that helps you lose weight thanks to the anti-edematous effect of drospirenone;
- Jess - by analogy with Yarina, the composition contains drospirenone, but also contains a lower level of estrogen;
- Siluet - reduces weight or does not affect it due to dienogest in the composition;
- Zoely contains nomegestrol, which has antiandrogenic activity, so weight loss does not occur.
How to choose the right birth control pills
In no case is it recommended to choose and start a course of taking contraceptives on your own. This should only be done by a doctor.
Before prescribing a contraceptive method, the specialist collects the patient’s medical history, takes into account the presence of any diseases in the present or future and pays attention to the individual characteristics of the body.
The next stage is a complete examination of the woman, the doctor evaluates the constitution, body weight, skin condition and blood pressure level. Additionally, he prescribes instrumental and laboratory tests, it is especially important to conduct ultrasound and mammography.
Also, when choosing contraceptives, be sure to take into account:
- Breasts, their shape and structure.
- Type of hair growth on the genitals.
- Growth.
- Health status of skin and hair.
- Peculiarities of the flow of menstruation.
- Presence of chronic diseases.
How to take birth control
The nature and rules for taking COCs are specified in the instructions for the drug. This information can also be obtained from your doctor.
As a rule, the package includes a blister of 21 tablets, but there are exceptions. Taking the drug should begin at the start of menstruation and continue daily until the tablets run out. Afterwards, it is important to take a break for 7 days and resume taking it again.
If a dose is missed for some reason, you should immediately take the pill.
For more reliable protection against pregnancy, you need to use condoms.
Side effects
Taking medications to prevent pregnancy may cause the following side effects:
- Headache, dizziness.
- Weight gain.
- Cessation of menstruation.
- Swelling of the limbs.
- Breast pain.
- Flatulence.
- Disorders of the skin.
- Nausea.
- Decreased appetite.
- Profuse bleeding.
- Pressure changes.
- Disturbance of consciousness.
- Allergic reactions.
- Heavy breathing.
If such symptoms occur, the use of tablets should be stopped.
Effect on the body
It’s worth making a reservation right away: if you want to use birth control pills not to protect against an unplanned pregnancy, but only to lose weight, this is a mistake that can cost you your health. Firstly, you will disrupt your hormonal levels. Secondly, your chances of getting rid of extra pounds are minimal, but the risk of gaining weight is very high. Thirdly, all side effects from such drugs will be yours.
It’s another matter if your primary goal is to prevent conception, and at the same time you have ballast in the form of fat on your sides and several extra pounds, and you want to get rid of all this. In this case, you should start selecting tablets. After all, if they fit into a woman’s hormonal background, they really contribute to weight loss:
- very often the cause of excess weight is hormonal imbalance, and contraceptives normalize it, as they contain progestin (a synthetic symbiosis of estrogen and progesterone) and estradiol (an estrogen compound);
- normalization of hormonal levels entails the smooth functioning of organs;
- this leads to the conversion of fats into energy, rather than storing them in reserve.
So birth control pills actually help you lose weight if they are chosen correctly. The results won't be stunning. But since the use of such drugs is regular and long-lasting, the weight will go away gradually, and this has a very beneficial effect on overall health.
According to statistics. In the West, oral contraceptives are extremely popular. Whereas among Russian women, only 10% prefer this method of preventing unwanted conception.
Contraindications for contraception
Contraindications to the use of any group of contraceptives are:
- Breastfeeding.
- Diseases of the cardiovascular system.
- Pregnancy.
- Kidney diseases.
- Oncological processes in the body.
- Overweight.
- Severe form of hypertension.
- Liver pathologies.
- Diabetes mellitus.
- Preparation for surgery.
- Uterine bleeding of unknown origin.
How to preserve women's youth? Debunking myths about hormonal drugs
To figure out who should take hormonal contraceptives and why, we turned to the head of the gynecological department of the Penza Regional Clinical Hospital. N.N. Burdenko to Mikhail Belyaev . We also asked him to comment on the most common fears and questions* about treatment with such pills.
What is special about taking hormonal contraceptives?
The issue of taking hormonal medications is very important for a woman. I will not even express my opinion, but those recommendations that are accepted by the American Association of Obstetricians and Gynecologists, the same association of European countries. The point is that over the past 150 years, due to social conditions, a woman has changed her purpose. Previously, there was only one thing - to reproduce offspring. The girl started menstruating - she was married off and became pregnant. During the period of bearing the child and breastfeeding, she does not have periods, the ovaries are in a calm state. The second pregnancy occurred either immediately after the end of feeding, or during breastfeeding. And so, in principle, throughout a woman’s life.
There was an interesting report of a historical nature; it concerned the life of women in the Scandinavian countries at the beginning of the last century. The average age of her period was 15-16 years. This corresponded to the age of marriage. A woman had 10-12 pregnancies and births during her life. During this period, she had 30-35 menstrual cycles.
Now, when you work with 20-year-old girls, they say that they got their periods at 10-12 years old. This is common. If we remember that the average age of first birth in the Russian Federation is 27 years, it turns out that by this time the ovaries had been working for at least 15 years without any interruptions. Which ovaries are naturally designed for such a long period of work without breakdowns and rest? They are not meant for this.
What do hormonal birth control pills do? Yes, the name indicates that they are contraceptive, that is, they protect against pregnancy. This name has been preserved since the times when tablets were invented specifically for these purposes. No matter how strange it may seem, they began to be produced in the post-war years in France. They were intended for French prostitutes. At that time, of those women who took such “harsh”, by today’s standards, pills, every fourth died precisely from the complications they caused. But what do we have now? I would say that today these are hormonal treatment pills that have a concomitant contraceptive effect.
Is it true that taking hormonal medications can protect against a number of diseases and prolong women’s youth?
Modern tablets are low-dose. That is, their hormonal content is lower than what a woman’s own ovaries normally produce. Therefore, to say that if you take pills, you get more hormones than nature intended is nonsense.
Second point. Modern hormonal drugs are monophasic. What does this mean? The woman opens the instructions and sees that all the tablets in the package contain the same amount of two hormones. That is, every day she receives the same amount of the drug of two differently acting hormones. Why is it important? Normally, the female cycle is divided into two phases (this is done by nature for pregnancy to occur). In the first phase of the cycle, estrogen predominates. It has an amazing stimulating effect on any cells of the body (not only female organs) and is aimed at their reproduction. What is an oncological tumor at the very beginning? This is one cell that has divided incorrectly. Where does cancer most often occur? In those places where cells themselves divide more often. Therefore, these estrogen cycles are essentially a stimulator for the appearance of cancer in a woman.
Now let’s return to the fact that the average woman at 27 years old decided to become a mother. It turns out that for 15 years, for two weeks every month, she stimulated the growth of something in herself. In 15 years of such stimulation, can something bad happen? Maybe.
Let's return to monophasic tablets. The first hormone - estrogen - wants to produce a stimulating effect, but the second hormone contained in the tablet - gestagen - seems to calm it down. For example, the normal thickness of the endometrium before menstruation in a healthy woman is 15 mm; in one who takes hormonal pills, it is usually 2-3 mm. This comparison allows you to understand the hormonal load that is given to the body without taking pills.
Taking hormonal medications is a means of preventing oncology and other dangerous diseases. Moreover, these pills work for the ovaries. Neither follicles nor corpora lutea appear in them. That is, follicular reserves, which are later needed for planning pregnancy, are not lost. If a woman started taking hormonal pills, for example, at age 20 and took them until she was 40, and then decided to have a child, then she will become pregnant with her 20-year-old ovaries.
At what age can you start taking medications? What is its duration?
According to some recommendations, girls should start hormonal therapy a year after the arrival of menstruation; according to others, after two years. In China, since 2015, there has been a national program, which is supported by the state budget, within its framework, a nurse begins to give free hormonal contraceptive pills to girls in schools a year after they get their periods. This is a way to preserve their future health until the time they want to have children.
According to these recommendations, hormonal drugs can be taken until menopause. The only reason for stopping the pills is a woman’s desire to become pregnant. She stops taking medications, goes into her desired pregnancy, and after giving birth and finishing breastfeeding, the return of her period, she remembers them.
How does a doctor choose which specific drug to prescribe?
It is believed that, on average, menopause occurs at 47-52 years of age. That is, until this time, a woman can take hormonal contraceptives. The only thing is that the pills themselves can change throughout life, because at some stages a different total amount of hormones is required. Which drug to choose is up to the doctor. Because, firstly, he sees the patient. Even those moments that she may not pay attention to are of interest to the doctor. For example, the presence of mustaches, skin condition, height and weight. The second point is studying the anamnesis.
Today, the choice of hormonal drugs of various chemistry is varied. There are tablets that can be used for diabetes, disorders of the cardiovascular system, and so on. Because of such diversity, it is sometimes difficult for a doctor to make a choice. In addition, the patient may have a disease that has not yet been identified, so some unpleasant phenomena are possible - swelling, headaches. It is impossible to say that no hormones suit this woman; you need to study the topic in depth and try to choose a chemically different drug. The second or third time, as a rule, the tablets are selected successfully, and the benefits of their use are higher than the negative phenomena that arise from the selection of the medicine.
Does taking hormonal drugs really lead to weight gain, which is then difficult to get rid of?
I will quote a phrase expressed by the chief endocrinologist of the Russian Ministry of Health, Ivan Ivanovich Dedov: obesity occurs because of one thing - because of the refrigerator. And here I completely agree with him. Think for yourself: if a woman takes pills that contain several times less hormones than if her body reproduced them on its own, how can she gain weight from this?
If we talk about obesity in general, then we should pay attention to what we eat. Low-dose monophasic hormonal drugs can improve metabolism, it becomes correct, and some women experience the so-called gluttony. But if you control it, then nothing happens. And if you don’t leave the kitchen table all day, then, naturally, you will gain weight. But what does the drug have to do with it? This is, first of all, self-control.
Is it true that taking hormonal drugs affects mood (a person becomes less emotional, tearful), and libido decreases?
Mood, like libido, first of all depends on the female head, and only secondly on hormones. If a woman has a difficult financial situation, stress at work and at home, even if she doesn’t take pills, what kind of libido is there?! She has no time for that. To desire something you need a comfortable state of mind.
Second point. There are a number of patients who note that their mood and libido have changed. To some extent, this is really due to the pills, since they provide an even hormonal balance. What is a woman in the natural cycle? If estrogen works correctly, then by the middle of the cycle - this is a dream woman. These are mischievous, sparkling eyes that desire you, a woman who feels like a goddess. Of course, when she takes the pills, there won't be such flowering. And in such a contrast, she may experience discomfort. What can I say? Any problem is multifaceted and needs to be considered from different points of view.
Should we believe statements that taking hormonal drugs provokes cancer?
There are cases when a woman takes medications and is diagnosed with a tumor. Firstly, the cancer could have appeared long before the pills were prescribed, it simply did not manifest itself in any way and was not diagnosed. For example, a tumor in the mammary gland can be easily detected when it has reached one centimeter. It grows to this size within six years. That is, there is simply no way to detect it until a certain point. But it begins to metastasize earlier - 3 years after the appearance of the first cancer cell. When operating on such a patient, the tumor can be removed, but metastases cannot always be removed. When taking hormonal drugs, the tumor can reach a size of one centimeter much earlier - after three years. It is learned that there are no metastases yet, but the tumor is already detected. In this case, an operation of the same volume will not affect the patient’s future life expectancy.
Is it true that hormonal drugs cause varicose veins and thrombophlebitis? How to prevent negative consequences?
Hormonal drugs do not cause varicose veins. They increase the risk of thrombosis, blood thickening, and so on. There are a number of patients who have contraindications due to these problems, but taking hormonal drugs is highly desirable to eliminate gynecological problems. Then the gynecologist must act together with the cardiologist and vascular surgeon. You can find the optimal solution to a problem by choosing a path that will bring more benefits than problems.
Does taking hormonal medications affect subsequent pregnancies?
When taking any hormonal medications, the cycle becomes regular. As a rule, 28 days. There is a myth that when you stop taking pills, you need to not try to get pregnant for a long time so that the body is cleared of hormones. Taking any hormonal medications involves taking one tablet every 24 hours. Think about what this is connected with. Maybe because after 24 hours it is no longer in the body? Then there is no point in abstaining from pregnancy after a course of hormonal medications.
*- questions to the obstetrician-gynecologist were prepared based on an analysis of women’s forums where the problems of taking hormonal contraceptives are discussed.
Birth control pills for women over 40
For women who have crossed the age limit of 40 years, it is necessary to use contraceptives with small doses of the active substance and take into account all individual characteristics.
As contraception you can use:
- Janine.
- Novinet.
- Grandaxin.
- Divina.
- Microlute.
- Excluton.
- Trisiston.
- Silest.
The above medications should be used after consultation with a specialist. It is important to follow the dosage and administration regimen, excluding any omissions.
