How to choose birth control pills?

The birth control pill has been known to the world for about 50 years. And although today's oral contraceptives compare favorably with their predecessors - the doses of hormones in them are reduced several times, which means that side effects are minimized to the limit, they do not get fat, they reduce the risk of ovarian cancer - you need to remember that before using the drug it is required to visit a doctor. It is he who, based on objective medical indications (taking into account the woman's age, her hormonal disorders or other diseases, the fact of childbirth, pregnancy or breastfeeding), can prescribe this or that remedy. We should not forget that oral contraceptives, or, in other words, contraceptive pills, are not harmless "vitamins", but serious drugs that have contraindications and side effects. This article is intended to provide an overview of currently available birth control pills, but is by no means a direct guide to action. The final decision, which remedy will be optimal for you personally, is made only by the doctor!

Birth control pills are hormonal oral contraceptives for women that suppress the production of eggs by the ovaries and prevent conception. They contain artificially synthesized hormones that are very similar in properties and composition to the natural hormones of the female body, estrogen and gestagen (progestin).

Determine what types of contraceptive pills are available.

Types of contraceptive pills

1. Combined oral contraceptives (COCs).

Their action is based on the introduction into the body of small doses of estrogen and progesterone. This inhibits or suppresses ovulation - the development of the egg. Moreover, progestogen blocks ovulation, and its dose in all COCs is the same. But estrogen, which does not affect conception and is introduced into the drug to control the menstrual cycle, can be in different dosages.

Administration begins on the first day of the menstrual cycle, after which the drug is taken daily, preferably at the same time. With such a clear rhythm, hormonal substances are better absorbed by the body. They do not have a negative effect on the psychological state of a woman, practically do not cause depression. Do not affect sex drive. Suitable for nursing mothers and women who, due to certain diseases, are not allowed to take combination drugs.

Disadvantages of gestagenic contraceptive pills.The need to adhere to an extremely precise regimen of the drug. Not suitable for those who find it difficult to properly organize their personal time. Less effective than COCs. When taken, the risk of ovarian cysts is high. Sometimes the amount of spotting increases. With a predisposition to candidiasis, thrush may worsen. The contraceptive effect is reduced if anticonvulsants and anti-tuberculosis drugs are taken at the same time. Increased secretion of sebum, the appearance of acne, swelling of the legs, body hair, strong sensitivity to ultraviolet light, as a result of which age spots appear. Sunbathing and solarium are not recommended. It is forbidden to take for liver diseases, breast cancer.

Let's summarize the main points in the table.

Combined oral contraceptives (COCs) (contain two types of synthetic hormones - analogs of estrogen and progesterone)High contraceptive efficiency of 99%.

Ease of use. Immediate result (when the beginning of the intake coincides with the first day of the cycle).

Prevents the development of ectopic pregnancy. Reduces the risk of pelvic inflammatory disease.

Improves the condition of hair and skin, helps fight acne (especially drugs with antiandrogenic effect).

Recommended for women with high levels of male hormones.

During the intake period, the body's iron stores increase: this prevents the development of endometriosis (as a cause of infertility), which, after discontinuation of the drug, promotes conception (you can become pregnant within a month).

Prevent the development of endometrial and ovarian cancer, breast diseases, and cyst formation.

Able to provide emergency contraception.

Do not cause excessive hair growth (male pattern).

Side effects in most cases are mild and do not require discontinuation of the drug.

Some types of antibiotics reduce contraceptive effectiveness (high risk of pregnancy).

COCs are incompatible with breastfeeding, diabetes mellitus, breast cancer, epilepsy, diseases of the cardiovascular system and liver.

Not recommended for women who smoke after 35 years of age (may cause risk of heart attack and stroke).

Are fraught with side effects such as visual and sleep disturbances, headaches, increased blood pressure, depression, development of thrush, edema, weight gain, bloating, chest pain, nausea, vomiting, thrombosis, jaundice, decreased libido.

Does not prevent infection with sexually transmitted diseases.

Prescribed depending on the individual characteristics of the patient.
a) single-phase (monophasic) (the level of hormones in the drugs is the same during the entire dose; all tablets are the same color)Often better tolerated than three-phase drugs.Least close to natural physiological processes in the female body.Assigned mainly to young nulliparous women, selected individually, taking into account the general state of health, the presence of chronic diseases.
b) biphasic (the content of estrogens is the same, and there are more progestins in the second half of the cycle; tablets of two colors)Ease of use: tablets of the same color are taken in the first half of the cycle, in the second - another. Helps to heal acne and seborrhea.Not very close to female physiology. Few drugs fall into this category.Selected individually. They may suit one woman and categorically not suit another.
c) three-phase (the preparations contain three combinations of hormones that change throughout the cycle; tablets of three colors)The combination of hormones changes similarly to fluctuations in their levels in the female body. It is believed that such drugs are the closest to natural processes in a woman's body.

Minimum side effects from administration. Almost do not affect the menstrual cycle, fat metabolism and blood clotting.

Positively affect the body in the presence of ovarian dysfunction and similar diseases.

Often worse tolerated than monophasic drugs.Prescribed in most cases to mature women, smokers and overweight.
Progestational contraceptive pills (mini-pills)

eliminates the side effects of estrogen. The lower the dose of gestagen, the less often complications occur. When used correctly, the efficiency reaches 95%.

They have a milder effect on the body. They are considered the most gentle type of contraceptive pill.

Suitable even for women with diseases that exclude the use of COCs (heart defects, varicose veins, migraines, high blood pressure, obesity, diabetes mellitus). Allowed to smokers after 35 years.

More effective for women over 40, especially those with obesity and underlying medical conditions. They do not load the cardiovascular system.

Promotes improvement in painful periods, inflammation of the pelvic organs, endometriosis, fibrocystic breast disease, pain associated with ovulation.

Prescribing to nursing mothers immediately after childbirth is possible (does not affect the quality and quantity of breast milk, does not affect the child) and adolescent girls.

Admission is allowed in the period before elective surgery (when COCs are contraindicated).

No diet required.

Contraceptive efficacy is not reduced with antibiotics.

Do not affect libido.

Less effective and reliable than combined hormonal drugs, as in some cases ovulation still occurs. The lower the dose of gestagen, the lower the effectiveness of the drug. They are inferior to COCs in terms of contraceptive effectiveness. The likelihood of getting pregnant is higher than with COCs.

Must be taken daily at the same time of day (exactly every 24 hours). Suitable only for very organized and responsible women (you need to strictly monitor the reception time). The effectiveness of protection is reduced, even if you are only 3 hours late with the appointment.

Does not prevent sexually transmitted diseases.

Bloody discharge from the genital tract appears irregularly, which can affect the rhythm of sexual activity.

Complications and side effects are possible, especially menstrual irregularities.

Increased risk of ectopic pregnancy and ovarian cysts.

Not to be used during pregnancy.

Suitable for contraindications to the use of estrogens.

For nursing mothers (can be started 6 weeks after delivery) and for older women.

Useful to ensure a 2 to 3 year interval between births.

Other helpful advice on choosing birth control pills

  1. The effectiveness of birth control pills is reduced by drugs such as griseofulvin, rifampicin, ritonavir, felbamate, phenylbutazone, and antibiotics (eg, amoxiclav, ampicillin, tetracycline, flemoxin). It is not recommended to take oral contraceptives at the same time as St. John's wort. Therefore, be sure to first study the instructions for the drug before you start taking it. It may be incompatible with other medications you need. If in any doubt, see your doctor.
  2. For the correct selection of the oral contraceptive, a number of studies (gynecological examination, taking a smear) are usually carried out. This makes it possible to exclude a number of pathologies, in particular, oncology. During the menstrual cycle, ultrasound of the pelvic organs is prescribed twice, which helps to learn about the state of the uterine mucosa, about the features of ovulation. Consultation with a specialist mammologist and ultrasound of the mammary glands is desirable. Sometimes the level of hormones in the patient's blood is also determined.

How to choose contraceptive pills

  1. The most important thing is that even after examining the issue in detail on your own, consult a doctor who will select the correct drug suitable specifically for a given patient.
  2. All oral contraceptives have both indications and side effects. The selection of a remedy must be taken very carefully, impartially evaluating all the pros and cons - the state of a woman's health depends on this.