Combined oral contraceptives: comparison of the effectiveness of
The controversy surrounding hormonal contraceptives did not subside, both supporters and opponents of the method put forward their own arguments. We will try to understand what combined oral contraceptives, how they act on the body of women than their “pros” and “cons”.
Routes of exposure
To provide efficient and reliable contraceptives a result, the drugs act in several directions:
- Change the link pituitary — ovary, affecting the production of LH and FSH, Gomonov, responsible for ovulation, making it impossible for the process of oocyte maturation, its output is in the fallopian tube and the pregnancy.
- Due to insufficient amounts of progestins, which are to form the yellow body during ovulation, the uterine wall becomes thinner. She becomes unable to hold a fertilized egg, it is rejection.
- Thickening of cervical secretions inhibits the promotion of sperm into the uterine cavity and adversely affects their viability.
When this occurs such side-effect as a decline in the abundance of menstruation and inhibiting the development of endometriosis.
When prescribed combined contraception
The reception of combined oral contraceptives (COCs) are primarily due to their primary function — high degree of prevention of unplanned pregnancy, but this is not the only indication for the drug. In what other cases is justified hormonal therapy:
- Painful, heavy periods, severe premenstrual syndrome. Reception KOK reduces the intensity of pain, less bleeding, which reduces the risk of anemia.
- Irregular cycle due to hormonal imbalance. Oral contraceptives create a stable «artificial» cycle and allow you to adjust the onset of the «critical days», as desired.
- Proven their effectiveness as preventive measures in the fight against the recurrence of physiological ovarian cysts. There are data about the positive effect of the COC on the endometrium, a decrease in the progression of endometriosis and the development of fibroids. Combined oral contraceptives are often used for the treatment of hyperplastic processes in the pelvic cavity.
- Cosmetic problems: acne, excessive oiliness or dryness of the skin, which can hardly be other types of treatment; hirsutism — a condition caused by increased amounts of androgens in the female organism.
Composition and division into groups
Menstrual cycle is normally varies from 21 to 35 days, in different periods of the concentration of hormones produced by the various minimum at the beginning and sharply increases to ovulation period. The principle of action of oral contraceptives is based on replacement therapy.
Each tablet contains estrogen and progestin in various combinations. Estrogen is always the same – ethinylestradiol. Progestin in the COC structure can be different. From changing the ratio of hormones in dosage form and for how long, depends on the following division:
- Monophasic — a group of drugs in which all the tablets contain a constant concentration of hormones in equal amounts.
- Two-phase have an equal dose of hormones in the first week, the second and third phase the concentration of estrogen remains the same, and the amount of progestogen is changed.
- Three phase — group closest to the natural hormonal changes in the female body. The amount of both hormones changes during all three cycles.
In addition, to distinguish drugs, the concentration contained in them the hormonal component:
- Micro-dose (20 µg ethinyl estradiol). Minimum dosage suitable for young girls, not giving birth, not having problems in the sexual sphere.
- Low-dose (30 mcg of ethinyl estradiol). Oral contraceptives with low dosage are assigned to women after childbirth or women, having a pronounced androgenic effect.
- High-dose, highly (50 µg ethinyl estradiol). Drugs with high dosage is used to restore hormonal imbalance or endometriosis.
Will have a brief overview of drugs and identify situations in which they are appointed.
|The drug||Group||Application||The cost|
|contraception, cycle control||500 — 700 rubles|
|normalization of the cycle, contraception, dysmenorrhea||400 — 450 rubles|
|contraception, therapeutic effect||200 — 450 rubles|
|Neo-ionamin||two-phase||contraception, treatment of androgenic manifestations||600 – 800 rubles|
|Three regolith||three-phase, high dosed||ovarian dysfunction, contraception||200 — 500 roubles|
|Yarina||monophasic, low-dose||contraception, therapeutic effect||750-1, 000 rubles|
|LOGEST||single-phase, micro-dose||contraception, therapeutic effect||500 – 800 rubles|
|Novinet||single-phase, micro-dose||contraception, therapeutic effect||400 – 600 rubles|
|Jess||single-phase, micro-dose||contraception, therapeutic effect||850-1100 rubles|
How to choose “your” medication
Combined oral contraceptives — medications, selection of which should be only a specialist with all the features of a particular woman.
- Going history, on the basis of which is determined by the gynecological group.
- Inspected visually for the presence of abnormalities.
- Swabs taken from the vagina and samples from the cervix to identify possible violations of the microflora and detection of pathological processes.
- It is mandatory ultrasonic examination of organs of small pelvis. The estimated state of the endometrium, ovaries, eliminates the presence of cysts, tumors and inflammatory processes.
- Conducted blood tests for hormones.
- Ultrasonic breast examination and consult a doctor-mammologist.
- Women from the risk group shows gemostaziogramma (blood clotting).
After determining the drug and you start taking a woman goes through repeated observation, after three months to monitor the effectiveness of the funds and the absence of unwanted results.
It is important to understand that the self-selection of birth control medications can trigger hormonal disorders with negative consequences for the whole organism.
- The appointment coincides with the first day of menstruation.
- The tablets should be daily at the same time.
- Upon completion of the course is a break of seven days. In this period there is bleeding due to withdrawal of the drug. The next course starts in a week, regardless of the end of the bleeding.
- In the first days of the drug required additional contraceptive measures as a guaranteed contraceptive effect occurs two weeks later.
- In the first 3 months is not excluded the appearance of bloody smears in the period of reception of contraceptives, but that is no reason to cancel the cure.
- If another appointment is missed, take the pill should be as fast as possible, the course is unchanged. During the day after missing a birth control effect is supplemented by other methods of contraception.
- Combined oral contraceptives don’t mix with certain drugs. So if there is a need in the treatment, be sure to notify the attending physician about the contraceptive drugs.
- Some medications (antibiotics, etc.) reduce the effectiveness of the COC. During their reception it is necessary to additionally use barrier methods of contraception.
Who do not receive COC
Despite the fact that these contraceptives are proven to be effective in preventing unwanted pregnancy, and it allowed not for everyone. There are conditions in which hormonal contraception is contraindicated:
- lactating or suspected pregnancy;
- pathology of the heart and blood vessels (coronary artery disease, heart failure, hypertension, stroke);
- some diseases of the digestive tract;
- systemic diseases (diseases of the blood, lupus erythematosus, diabetes mellitus, long current);
- defeat deep vein (thrombosis, thrombophlebitis);
- malignant neoplasms of different localization;
- diseases of metabolism, obesity;
- diseases for which treatment used anticonvulsant drugs;
- age restrictions to women who crossed forty, recommended other methods of contraception;
- Smoking is a factor of increased risk in the use of combined oral contraceptives.
Side effects from taking COC occur, usually in the first few months, which indicates hormonal changes in the body. In the future, the incidence of negative reactions is reduced. Among the side effects are:
- violation of the menstrual cycle. Amenorrhea, which can manifest as during reception of contraceptives, in the absence of secretions at intercourse period and at the end of reception of contraceptives. The reverse situation — heavy bleeding between menstruation;
- increase in blood pressure, signs of which becomes intense headache, blurred vision;
- dyspepsia: nausea, vomiting, pain in epigastria, flatulence in the intestine;
- sleep disturbance, depression, irritability and fatigue;
- increased dryness of the vaginal mucosa, decreased libido;
- breast swelling, soreness, and discomfort;
- dramatic increase in body fat.
An existing, quite common, the fear that prolonged intake of hormonal drugs causes cancer, not unfounded. Recent studies have shown that the right choice of contraception with the appearance of tumors nothing in common.
When you need expert advice
Unpleasant effects of taking oral contraceptives in the norm should not take more than 3 months. If this situation is prolonged for a longer period, it is a reason to seek help from a doctor. Medical consultation is required in the following cases:
- appeared resistant headaches with impaired vision and speech;
- you have pain behind the breastbone, pressing sensation, shortness of breath;
- not passing abdominal pain, having no apparent reason;
- the increase in depression, neurotic conditions;
- profuse uterine bleeding in intercourse period.
- sharply decreased vision;
- there has been a rapid weight gain;
- there were swelling, pain and heaviness in the legs.
To accept or not
The decision on reception of the combined contraceptive drugs everyone takes for themselves. KOK have many advantages compared to other methods of protection, but this method requires responsibility from women and attention to their health. You should not choose drugs, and contraception is a medical tool guided by the advice of friends and incompetent sources. It is best to cope with the specialist, based on data analysis and research.