Contraception. How to take birth control pills. Birth control pills: both orally and vaginally

For every family, the birth of a child is happiness, but not everyone can provide him with good conditions and proper upbringing. To avoid unwanted pregnancy, there are means, methods and methods of contraception that enable women and men to maintain a safe sex life, these are oral and hormonal contraceptives. The following describes the types of contraception and their percentage of safety.

What is contraception

This is to prevent unwanted pregnancy. Means are divided into mechanical, chemical and other preparations for safe sexual intercourse. Modern contraceptives are divided into female and male. Using this technique, they not only prevent pregnancy, but are protected from:

• various sexually transmitted diseases (syphilis, herpes, chlamydia or gonorrhea);
• human immunodeficiency virus.

Contraceptives for women

For women, there are many contraceptive options for safe sex, all of them have a different Pearl index. This is a special study that determines annually what percentage of women who used one or another method of protection became pregnant. Means of protection (contraceptives) are divided into:

• physiological;
• barrier;
• spermicidal;
• hormonal;
• non-hormonal;
• emergency protective equipment;
• traditional methods.

Male contraceptives

There is no such range of contraceptives for men, but scientists are actively developing methods of contraception for men. Basically, a man can use a condom or sterilization - these methods are not always comfortable, so there are little-known protection options: these are subdermal implants, birth control pills for men and the male IUD. To use one of these methods of contraception, a man will need to discuss them with his healthcare provider.

Modern contraception

If earlier people simply abstained from sex to avoid having a child, today there are many ways to protect against various diseases or pregnancy. For example, modern oral contraceptives for women have now become popular. They are convenient, and if the couple decides to have a child, the pills can be stopped, and the pregnancy rate increases.

Why are they needed?

Such funds are needed in order to avoid abortion (termination of pregnancy in the early stages), which can lead to problems and diseases of the reproductive system, infertility and other complications. The products help to avoid early pregnancy: at this age, a girl cannot always carry a child. Contraceptive methods can be used by women after 40 years of age. Pregnancy at this age can cause the birth of a child with abnormalities in chromosomes.

Contraceptive effectiveness as a percentage

In total, there are 3 groups of contraceptives: barrier, chemical, mechanical. A wide range of contraceptives allows women and men to choose methods of protection that are convenient for them. To select the optimal contraceptive option, it is recommended to contact your treating gynecologist. Next, we will consider the groups and types of contraceptives, determine their effectiveness, advantages and disadvantages.

Barrier methods of contraception

The most common and simplest methods of contraception today are barrier contraceptives. These include:

• male condoms;
• female condoms;
• vaginal diaphragms.

The mechanism of action of this group is that the products block the penetration of sperm into the cervical mucus. The male condom comes in the form of a thin, oblong latex shell. The product for women is a polyurethane tube (dimensions: diameter - 8 cm; length - 15 cm). Vaginal diaphragms or cervical caps are made from latex or silicone. Pearl index (efficiency):

• male/female contraceptives – from 7 to 14%;
• cervical caps – 5%;
• vaginal diaphragms – from 6 to 20%.

The principle of operation of the male condom: is put on the penis during an erection. Its advantages: protects the mucous membranes of partners during direct contact; prevents infections, hepatitis, HIV, pregnancy; has different sizes and surfaces. Cons: may tear; requires a stable erection. How the female condom works: it is inserted into the vagina. Pros: the contraceptive is used for weak erections; can be left in the vagina for several hours. Cons: these products are not sold in the CIS countries.

Vaginal diaphragms and cervical caps: Placed into the vagina using special spermicidal creams. Pros:

• reduce the risk of transmission of infections;
• can be used repeatedly;
• prevent pregnancy.

Disadvantages of cervical caps: you can become infected with HIV; not always effective for women who have given birth; may cause discomfort during sex; Sizes with recommendations can be obtained from a gynecologist. Disadvantages of the diaphragm: after childbirth, you need to select a different size, as when a woman’s weight changes from 5 kg; the risk of cervical inflammation increases; possible infection.

Chemical methods of protection

In addition to barrier ones, chemical contraceptives are popular. These are: vaginal creams, suppositories (suppositories), tampons. The products have contraceptive properties, protect against viruses and bacteria (staphylococci, herpes, chlamydia, candidiasis). Suppositories, vaginal tablets and films are inserted into a girl’s vagina 25 minutes before sex: during this time they have time to dissolve. Popular products are Patentex Oval and Pharmatex. The Pearl index of chemical methods of protection is from 6 to 20%. The products are used 15 minutes before sex. Foam, gel and cream begin to act after use.

Spermicides (contraceptives) have the following advantages: increase protection against herpes, chlamydia and other sexually transmitted diseases; have a bactericidal effect. Disadvantages: increase the permeability of the vaginal walls (there is a possibility of HIV infection); upon contact with soap, the active effect is destroyed; short-term effect (except tampons); requires replacement at the next sexual intercourse.

The following hormonal contraceptives are distinguished: combined oral contraceptives, injections, mini-pills, emergency contraception. They help protect against unwanted pregnancy by “replacing” the work of the ovaries. According to the principle of action there are multiphase, two-phase or three-phase, according to the form of release - tablets, implants, injectable drugs. Efficiency:

• combined contraceptives (oral) – from 0.15 to 5%;
• mini-pills – from 0.6 to 4%;
• injections – from 0.3 to 1.4%;
• implants – up to 1.5%.

Combined oral contraceptives are used daily for 21 days, at the same time, starting from the first day of menstruation. Mini-pills are used immediately before sexual intercourse, half an hour. Injections are administered 2-3 times per month. Benefits: improves facial skin condition; the menstrual cycle is normalized; the risk of ovarian cancer is reduced; the breasts enlarge and become firm; protect against unwanted pregnancy; use is possible in the absence of various diseases. Flaws:

• no protection against sexually transmitted diseases;
• with long-term use, the risk of developing candidiasis, heart attack, breast, liver and cervical cancer increases;
• there are many contraindications; during the break between doses, the risk of becoming pregnant increases;
• side effects may occur.

Mechanical contraception

The most popular mechanical contraceptives are the vaginal ring (NovaRing) and the contraceptive patch (Evra). Their main purpose is to prevent pregnancy. The ring is made of elastic material, the patch is made of thin soft polyurethane. Efficiency:

• hormonal ring – from 0.4 to 0.65%,
• hormonal patch - from 0.4 to 0.9%.

The ring is inserted into the vagina, adjusting to the contours of the girl’s body; The patch is glued to different parts of the body (under the shoulder blade, lower abdomen, buttock or forearm). Advantages: does not reduce the sensitivity of partners during sex; does not prevent the girl from playing sports; does not affect blood clotting; designed for 1 cycle (21 days). Disadvantages: does not protect against STDs and HIV.

The contraceptive patch has the following advantages: changes every week; can be glued to any part of the body, convenient for travel, natural conditions, where it is not possible to use another method of contraception. Its disadvantages: contraindicated for girls who smoke (10 or more cigarettes per day); does not protect against STDs, is effective for women from 18 to 45 years old.

Intrauterine contraceptives

The following are the most popular intrauterine contraceptives:

• IUD Mirena;
• Levonov's hormonal IUD;
• hormonal Nova-T;
• CooperT 380A;
• MultiloadCu-375.

Mechanism of action: the fertilized egg does not attach to the wall of the uterus when using this type of contraceptive. The installation is carried out only by a gynecologist. Contraception for women of this type is installed in the uterine cavity. An IUD or IUD is considered a reliable method of birth control, but there are possible complications and contraindications:

• inflammatory processes in the pelvic organs;
• hidden chronic or acute infections;
• the presence of tumors of the reproductive system;
• cervical dysplasia;
• anemia;
• uterine bleeding;
• diseases of the endocrine glands.

Complications:

• the risk of exacerbation of inflammatory processes in the uterus and appendages increases;
• During menstruation, menstrual blood loss increases and periods last longer than usual;
• the likelihood of an ectopic pregnancy increases;
• vaginal discharge appears;
• perforation of the uterus.

Advantages: the spiral is installed for 5 years; it is possible to remove it if necessary; contraceptives are suitable for nursing mothers. Disadvantages: the risk of infection and the development of inflammation and infections increases. All questions regarding installation must be discussed with a doctor; such a decision cannot be made independently (depending on hormonal levels and other factors).

Natural methods of contraception

Natural biological methods of contraception are ways to protect against unplanned pregnancy. They are used only by women who have a regular and stable menstrual cycle. Girls keep records of dangerous and safe days for unprotected sexual intercourse. These methods are divided into calendar, temperature, cervical methods and interrupted coitus.

Calendar

The calendar method is the calculation of the day of ovulation. Suitable for girls and women with regular menstruation. Ovulation occurs in the middle of the menstrual cycle, from this day the girl can calculate the period when she can become pregnant (2-4 days before and 2-4 days after). Unfortunately, the method is not always effective, because ovulation can occur on other days of menstruation.

Temperature

The temperature method consists of constructing a graph of basal body temperature, that is, when a woman is at rest. It can be measured using a rectal thermometer. During the first phase of menstruation, a woman’s temperature is slightly lower, and during ovulation it rises and remains this way until the next one. By making this chart, you can understand when ovulation occurs in order to avoid sex on these dangerous days.

Cervical method

The essence of this method is that during the day the girl should observe the vaginal mucus after the end of menstruation. If the endometrium does not contain mucus, then you can continue to have sex without restrictions. It becomes viscous during the maturation of the egg. On such days it is better to use additional means of protection.

Coitus interruptus

Coitus interruptus is the cessation of sexual intercourse before ejaculation, outside the girl’s vagina. This is a safe method of contraception, because, for example, hormonal contraceptives can cause side effects. However, the possibility of getting pregnant always exists: during sex, pre-seminal fluid is released (it contains up to 20 million sperm).

Hormonal methods of contraception

There is a classification of hormonal methods of contraception: gestagenic and combined. The first group includes monophasic, multiphasic oral contraceptives, as well as injections, patches and a vaginal ring. Combined ones include implants, IUDs and vaginal rings with progestogen. Next, we will consider contraceptives, and which of them belong to one of the two groups.

Oral contraceptive pills

Progestin oral contraceptive pills are divided into monophasic, biphasic and triphasic:

• Monophasic drugs include: Gestodene, Desogestrel, Regividon, Microgynon, Miniziston.
• The following drugs are classified as biphasic: Femoston; Binovum, Neo-Eunomin, Adepal and Biphasil.
• The following drugs are classified as three-phase: Tri Mercy, Triziston, Tri-Regol.

Vaginal rings and patches

The group refers to combined hormonal methods of contraception. At the moment, Evra is considered the most popular patch, and among vaginal rings, Nova-Ring is distinguished. The latter remedy is used frequently: there are few side effects, and there are more benefits than in oral contraceptives. The Evra contraceptive patch is more convenient to use: you don’t need to insert anything into the vagina that could damage its walls, and you also don’t have to swallow it like pills, which can lead to liver problems.

Mini-pill

Small pills are contraception for women and are recommended to be taken during lactation, when smoking in older women and for heart pathologies. Mini-pills are classified as progestogen hormonal contraceptives. This includes drugs such as: Charozetta, Continuin, Exluton, Primolut-Nor, Micronor, Ovret. For consultation on the choice, it is recommended to contact your treating gynecologist.

Hormonal injections

Injections or hormonal injections belong to the group of combined drugs. The advantage of protection is that the woman does not need to take daily pills or insert new vaginal rings. For injections, drugs such as Net-en and Depo-Provera are used. The disadvantage of these contraceptives is that you need to use a condom for the first 20 days.

Capsules for implantation

Special capsules for implantation belong to the group of progestin hormonal contraceptives. These capsules are implanted under the skin. This implant is called Norplant. When using it, you can not use contraceptives for 3-5 years. The product can be used during lactation and various diseases for which other hormonal contraceptives are strictly prohibited.

Postcoital contraception

Emergency contraception is used in case of unprotected sexual intercourse. Such tablets can be used within 1-3 days after the end of sexual intercourse. With their help you can avoid unwanted pregnancy. Contraceptives are used in the following cases:

• rape;
• incorrectly performed interrupted sexual intercourse;
• unprotected sex;
• in case of condom breakage.

Sterilization

Complete sterilization is a method of contraception for both women and men. Male sterilization is a vasectomy, and for women it is tubal occlusion. During the surgical operation, an artificial obstruction of the fallopian tubes is created for a woman, and the vas deferens is ligated for men, while the testicles and ovaries are not removed, and there is no negative impact on the couple’s sex life.

Methods of contraception after childbirth

Immediately after childbirth, it is recommended to abstain from sex for 1-2 months to avoid infection at the vaginal sutures. After the period has passed, it is recommended to go to the gynecologist and buy the contraceptives you need. Gynecologists recommend using the following as contraception:

• intrauterine device;
• barrier, hormonal contraceptives;
• sterilization

Video

Contraceptives

Contraceptives are traditionally divided into mechanical, biological and chemical. Different products naturally have varying degrees of effectiveness. Almost none of the methods of preventing pregnancy (except sexual abstinence) can give a 100% guarantee. Quite often, in order to achieve greater safety and reliability, various contraceptives are combined. However, it is best to select a contraceptive after consulting a gynecologist.

In this article we will talk in detail about the most popular types of contraception.

CONDOMS

SPIRAL

CONTRACEPTIVE PATCH

VAGINAL RING

LONG-ACTING INJECTIONS

NORPLANT

MALE AND FEMALE STERILIZATION

DIAPHRAGM

BIOLOGICAL REMEDIES

MINI PILL TABLETS

CALENDAR METHOD

Example:
The shortest cycle lasts 28 days, and the longest cycle lasts 30 days.
The beginning of the fertile phase is 28-18 = 10th day of the cycle.
End – 30-11=19th day of the cycle.

That is, from the 10th to the 19th day of the cycle, fertilization can occur, which means that on these days you need to use barrier contraceptive methods or abstain from sex altogether. The disadvantages of this method primarily include its unreliability, since initially it assumes a regular, constant menstrual cycle, which, unfortunately, not a single woman has.

TEMPERATURE METHOD

During the first half of the cycle, the basal temperature is usually below 37°C. 12-24 hours before ovulation, body temperature decreases by 0.1-0.2°C, and after ovulation it increases by 0.2-0.5°C (usually to 37°C or higher). And this temperature remains at this level throughout the second half of the cycle until the start of menstruation. The fertile period begins six days before the preovulatory decline and lasts another three days after it (the total duration of the fertile phase is 9 days).

The advantages of the temperature method of contraception include: ease of use; absence of any side effects; the most accurate determination of days of probable conception when planning pregnancy.
Disadvantages: high risk of unwanted pregnancy (because the level of basal temperature is influenced by a very large number of factors); the need to measure basal temperature daily.

SEXUAL WITHDRAWAL

EMERGENCY (aka post-coital, fire) CONTRACEPTION combines methods of preventing unwanted pregnancy, which are used after unprotected sexual intercourse has taken place. Most emergency contraception can be purchased in pharmacies without a prescription and used independently, but we strongly recommend that you consult a doctor so that he can select the most optimal method of emergency contraception for you, check for contraindications to the chosen method and select the required dosage.

TYPES OF EMERGENCY CONTRACEPTION:

2) Hormonal contraceptives
The first way to use hormonal contraception is to simultaneously take several types of COC tablets (combined oral contraceptives). The number of tablets required for taking is based on the dosage of the level of hormones in the drugs: Miniziston, Rigevidon, Femoden, Marvelon, Microgynon, Regulon - two times four tablets (interval between taking 12 hours), Logest, Mercilon, Novinet - two times five tablets. This method is called the Yuzpe method and it is effective for three days after unprotected sexual intercourse. The effectiveness of this method is not very high - 75-85%.

The main advantage of this method is its accessibility, since all drugs are sold in any pharmacy without prescriptions. Side effects after use - nausea, pain in the mammary glands, vomiting, dizziness, headache.

An alternative to COCs are drugs that contain only progestins and do not contain estrogens. The most effective drugs of this type are Escapelle and Postinor. Escapelle contains 1.5 mg of the hormone and is used once. Postinor contains 0.75 mg of levonorgestrel and must be used twice with an interval of 12 hours. Minor side effects that may be caused by hormonal emergency contraception usually go away within two days.

It must be remembered that after using emergency hormonal contraception methods, it is imperative to use additional methods of contraception until the next menstrual cycle: spermicides, condoms, etc.

3) Non-hormonal emergency contraception
Mifepristone (Gynepristone) is one of the most effective emergency protection drugs. A single dose of this drug within three days after unprotected sexual intercourse causes a slowdown in ovulation (this process depends on the phases of the menstrual cycle), changes in the endometrium, and also prevents the attachment of a fertilized egg.

This drug has fewer side effects - for example, the incidence of bleeding is only 15%, compared with 31% with levonorgestrel. The effectiveness of this method of emergency contraception is 98.8%. The advantages of this method include the fact that it can be used for a longer period compared to other means of emergency contraception, and also that after taking it there are practically no hormonal-dependent side effects.

4) Intrauterine devices
Another way to protect against unplanned pregnancy is to use an intrauterine device (IUD). To achieve the desired effect, copper-containing IUDs are inserted within five days after unprotected sexual intercourse.

Emergency contraception is an alternative to abortion, but it is strongly not recommended for use as permanent contraception, but only in “emergency” situations (maximum once every six months). Since frequent use of emergency contraceptive methods can lead to disruption of a woman’s reproductive functions.

There are a lot of rumors about hormonal contraceptives today, and not all of them are true. Many women, having heard enough “horror stories”, are still afraid to use this method of contraception. But in fact, hormonal contraceptives today are the most effective and gentle way to protect against unwanted pregnancy. If used correctly, the protection index will be 99.9%, which proves the effectiveness of this method of contraception.

What is the correct use of hormonal contraceptives, and what side effects can they cause? What prejudices prevent women from using this method of contraception and how far from the truth are they? How to choose the right type of hormonal contraceptive? We will try to find answers to these and other questions.

Are hormonal contraceptives harmful to health?

The legend about the unimaginable harmfulness of birth control pills has been preserved since the time when the first pills appeared, which actually had a lot of unpleasant side effects. They contained too many hormones that caused headaches, palpitations, as well as nausea and inflammation of the pancreas. But that was more than 30 or 40 years ago. Modern tablets contain third-generation synthetic estrogens; they contain three times less hormones and the risk of side effects is much lower.

It is necessary to understand that modern hormonal contraceptives are not at all the drugs that frightened our mothers and grandmothers, these are completely new drugs that are successfully used not only to protect against unwanted pregnancy, but also to solve many other problems. They help correct hormonal levels and the menstrual cycle, cure skin problems and prepare the body for conceiving and bearing a child. Therefore, you should not be afraid of such medications; their effect on health is usually positive, and in case of a negative reaction, you can always choose another remedy.

Who should not use hormonal contraceptives

There are very few contraindications to the use of hormonal contraceptives, and most women can choose the optimal drug. There are medicines for young and older women, for women with various health problems, but there are also a number of contraindications in which this type of contraception is prohibited.

Hormonal contraceptives should not be used for thrombophlebitis and thrombosis of the pulmonary arteries and lower extremities. Also a contraindication to this type of contraception are hormone-dependent forms of neoplasms, which include various tumors of the breast, uterus and ovaries. The use of these medications is also prohibited for women with thyroid diseases, which are characterized by increased production of estrogen, diabetes mellitus and hepatitis. In addition, contraceptives are not compatible with pregnancy.

In the first seven days of use, the contraceptive effect remains weak, so it is necessary to use other methods of contraception in parallel. Only after seven days of regular use does the level of estrogen in the body allow a contraceptive effect to be guaranteed. During the first seven days, the drug accumulates in the body.

Oral contraceptives are usually taken according to a standard regimen, which includes 21 tablets. After finishing the dose, withdrawal bleeding begins, and after 7 days you need to start taking the pills on a new cycle. There are also regimens using dummy pills or placebo for a week. This allows you not to lose your rhythm and not miss the start of taking the pills.

If you take the pills correctly, after a few months all the inconvenience caused by taking them disappears. Side effects disappear, and taking the pill daily becomes habitual and automatic. If discomfort associated with taking the medication persists, you should consult a doctor about choosing a more suitable remedy.

Several popular questions about hormonal contraception (Video)

Hormonal contraceptives are still a novelty for many of our women and therefore raise a lot of questions. We will look at some of the most popular questions and their answers.

Women often ask How long after stopping contraceptives can you get pregnant?. If you took OK and did it correctly, then almost immediately after their cancellation, your ability to conceive will be restored. In just 3-6 months, the ability to conceive will be 85%, like most women who have not used hormonal contraception.

Does the use of hormonal contraceptives affect a woman's libido? There is no definite answer to this question, since this effect is very individual, but most women note an increase in sexual desire. This may be due to the lack of fear of unwanted pregnancy. If a decrease in libido is noted, the problem can be solved by changing the drug.

Very often women are concerned Do OCs really contribute to weight gain? The fear of gaining weight due to pills has been around for a very long time, and it is not without reason. Indeed, at the very beginning of taking the pills, a slight (2-3 kilograms) weight gain is possible due to fluid retention in the body, which then goes away on its own. In addition, OCs can increase blood pressure, which in the absence of nutritional control can lead to weight gain. But for many women, the use of this type of medication, on the contrary, provokes weight loss. Therefore we can say that the influence of OK here is insignificant and everything depends on the woman herself, on her diet and activity.

Types of contraceptives

• hormonal agents;
• contraceptive coils;
• contraceptives with spermicidal effect;
• barrier agents;
• natural methods.

Newest contraceptives

Hormonal contraceptives

It is very important to consult a doctor before using hormonal drugs, since there are many serious contraindications for their use.

The action of hormonal contraceptives is based on the suppression of ovulation and thickening of the mucous secretion secreted by the cervix. Thick mucus prevents sperm from entering the uterine cavity, and the supply of sex hormones from the outside prevents the production of one’s own sex hormones, so the egg does not mature.

Birth control pills can be divided into 2 groups:
1. Combined oral contraceptives. Contains 2 hormones: estrogen and gestagen.
2. Mini-pills contain only gestagen.

Combined oral contraceptives, depending on the composition, are divided into monophasic and triphasic. In monophasic contraceptives (Regulon, Marvelon, Jess, Janine, Logest, Novinet, Rigevidon, etc.), all tablets contain the same amount of hormones. Triphasic contraceptives (Tri-Mercy, Triquilar, Tri-Regol) contain different amounts of hormones.

Three-phase drugs are used less frequently. They are less well tolerated, despite the fact that their composition imitates changes in the content of sex hormones in women’s bodies during the menstrual cycle. Depending on the dose of the estrogen hormone, there are high-, low- and micro-dose combined oral contraceptives in the drug. Currently, low- and micro-dose tablets are more often prescribed. It is necessary to take oral contraceptives every day, at the same time.

Combined oral contraceptives should not be taken under the following conditions:

• cardiovascular diseases;
• blood clotting disorder;
• liver diseases;
• high blood pressure;
• severe headaches, migraines;
• excess body weight;

age over 35 years;
• malignant neoplasms of the genital organs and mammary glands;
• elevated cholesterol levels;
• gallbladder diseases;
• age over 40 years;
• pregnancy and lactation period.

Adverse reactions when using oral contraceptives may include irregular bleeding, fluid retention in the body and weight gain. Their severity and frequency depend on the dose of the hormone contained in the tablets.

Safe contraceptives used during lactation include:

• Mini-pill– the composition contains only gestagens, which reduces the risk of negative effects on the duration of breastfeeding, the quantity and quality of breast milk. Breastfeeding women can take them 5-6 weeks after birth. The disadvantage is the frequent occurrence of intermenstrual bleeding - a sign of the body’s adaptation to the drug. Before using oral contraceptives, you should consult a doctor.
• Injectable drug Depo-Provera, subcutaneous implant "Norplant" - also, due to their composition, do not affect lactation and are highly effective. They have a long period of contraception - 5 years for a subcutaneous implant and 12 weeks for Depo-Provera. The disadvantages of the method are that they are prescribed and administered only by a doctor. Side effects are the same as for drugs containing only gestagens. In the first 2 weeks there is a need to use additional methods of contraception.
• Intrauterine devices– do not affect breastfeeding, are prescribed for up to 5 years and begin to act immediately after administration. Disadvantages of this method: possible unpleasant sensations in the lower abdomen during feeding, heavy and painful menstruation in the first months of use. They cannot be used if a woman has suffered inflammatory diseases of the uterus and appendages before or after pregnancy. Inserted and removed by a doctor.
• Barrier methods of contraception(condom, diaphragm) - quite effective during lactation if the rules of use are followed. They do not affect the baby’s health, the quantity and composition of breast milk.
• Spermicides– can also be used during breastfeeding; due to its local action, it does not affect breast milk. Quite effective when used correctly - can be used independently, without additional funds.

Contraception for women over 45 years of age

Ages from 45 years and older are characterized by a gradual decline in ovarian function and a decrease in the ability to conceive. Despite this, the likelihood of an unplanned pregnancy remains quite high, especially if regular menstrual cycles are maintained. Therefore, contraception is especially relevant during this period. Pregnancy at this age is accompanied by a high risk of complications, such as miscarriage, gestosis, and abnormal location of the placenta. Childbirth and the postpartum period are more difficult, and child morbidity and mortality are higher. Concomitant diseases of women also play an important role - cardiovascular, diseases of the digestive system, liver, urinary system, most often of a chronic nature.

It is important to use contraception not only until menopause (when menstruation has completely stopped). It is recommended to continue taking it for 2 years if menopause occurred after 45 years, and for 1 year if menopause occurred after 50 years.

The choice of a contraceptive method at this age is quite difficult, and is carried out only in conjunction with a doctor. It is necessary to conduct an examination to identify possible contraindications for a particular method.

• Barrier means(condoms) - safe to use, but quite often cause some inconvenience. Chemical spermicides are also widely used not only due to their contraceptive effect - they can reduce the phenomenon of vaginal dryness, which is important for perimenopausal women.
• Intrauterine devices are often contraindicated at this age due to the large number of diseases of the body and cervix. If there are no contraindications to use, preference should be given to hormone-producing coils (Mirena), since they have not only a contraceptive, but also a therapeutic effect - in case of menorrhagia (uterine bleeding), they reduce the volume of menstrual blood loss, help prevent inflammatory diseases of the genital organs, and reduce the risk of developing iron deficiency anemia.
• Hormonal drugs– Progestin agents such as mini-pills, Depo-Provera, Norplant are used with advantage. They are not able to influence blood coagulation, lipid metabolism, or liver function. The use of combined oral contraceptives is quite limited. They are used only if the woman does not smoke (smoking is an absolute contraindication to their use), and there are no other risk factors for the development of thrombosis and coronary heart disease. Preference is given to low-dose drugs, such as Logest, Mercilon.
• Sterilization is the most reliable method of contraception, but it is rarely used because this method is quite invasive and involves surgery.
• Emergency contraception at the age of 45 it is used extremely rarely, since the use of large doses of hormones causes severe adverse reactions.

The main essence of birth control pills is that they are a means of preventing unwanted pregnancy, which has saved humanity from numerous abortions and spoiled destinies.

Despite the fact that modern birth control pills have the most positive and numerous reviews, debate about their use continues both among consumers and among specialists. Such disputes are due to a number of side effects that may occur when taking drugs. The question often arises about whether it is possible to get pregnant while taking birth control pills. All the problems that arise, most often, have a simple explanation: the questions of how to take birth control pills and what birth control pills should be taken were incorrectly resolved.

The principle of action of hormonal drugs

In general, several conditions are necessary for conception: maturation and release of the egg (ovulation), its meeting with the sperm in the fallopian tube, penetration and consolidation of the fertilized egg in the uterine cavity. The whole process is controlled by the pituitary gland of the brain, which regulates the production of sex hormones by the ovaries - estrogen and progesterone. It is these hormones, or rather their balance, that provide the necessary conditions for the process of conception.

Hormonal birth control pills or oral contraceptives prevent the maturation of the egg, interfere with the penetration of sperm into the fallopian tubes and affect the structure of the endometrium of the uterine cavity, preventing the egg from attaching to it. Thus, these drugs create the maximum obstacle to conception.

The contraceptive effect is achieved by the presence of estrogen and progesterone in the tablets. This results in the following effects:

1. Estrogens prevent the maturation of the egg in the follicle, inhibiting pituitary functions, disrupting the structure of the endometrium, increasing peristalsis of the fallopian tubes, inhibiting the formation of the corpus luteum, and inhibiting the ovaries' production of their own hormone.
2. Progesterone increases the thickness of mucus in the cervical canal, inhibiting the movement of sperm, disrupts the release of statins, blocking the production of gonadoliberin, which inhibits the ovulation process.

How non-hormonal drugs help

The second direction of contraceptives is non-hormonal birth control pills. Such drugs, although available in tablet form, are not taken orally. They belong to the group of vaginal products and are inserted into the vagina. The drugs contain an active substance that can suppress sperm activity, thereby preventing fertilization of the egg. In addition, the active component of the tablets increases the thickness of cervical mucus, blocking the passage of sperm through it.

Thus, the principle of action of non-hormonal drugs is based on reducing sperm motility and blocking their movement, without changing the hormonal balance. Benzalkonium chloride and nonoxynol are actively used as active substances. It is possible to use other ingredients.

Non-hormonal drugs have less impact on the female hormonal mechanism, which reduces the risk of side effects. Moreover, under their influence, a protective film is formed in the cervical canal, preventing the penetration of fungal and other infections. However, it should be noted that the contraceptive ability of such drugs is lower compared to hormonal contraceptives (82-86% versus 98-99%). To increase efficiency, women sometimes additionally use vaginal diaphragms and cervical caps.

Why do you need funds after the act?

Another way to prevent unwanted pregnancy is to take post-coital birth control pills or post-coital pills. Such funds belong to the so-called emergency protection group. They are used after unprotected sex or damage to the integrity of the condom. Postcoital tablets contain 2 types of active substance: levonorgestrel or mifepristone. The principle of action of the first group is based on blocking the ovulation process, increasing the thickness of cervical mucus and, most importantly, preventing the fixation of the egg on the uterine endometrium. By changing the structure of the endometrium, the active substance provides an abortifacient effect. When using such a remedy, you should remember that the drug is considered hormonal and can significantly affect the hormonal balance.

The second type of drug has pronounced antigestagenic properties, which prevents the uterine endometrium from preparing to receive an egg, and also increases the contractility of the uterus, which facilitates the removal of the egg from the cavity.

What hormonal drugs are popular?

Hormonal contraceptive pills are available in 2 main types:

• combination drugs that include both main hormones;
• mini-pill containing only progesterone.

The mini-pill group of drugs belongs to a monophasic composition. Combined agents can be two-phase or three-phase. Mestranol and Ethinylestadiol are usually used as estrogen substitutes. Progesterone is administered using the following substances: Norethindrone, Norgestrel, Levonorgestrel, Norgestimate, Desogestrel, Drospirenone. When choosing birth control pills, the preferred names are: Jess, Yarina, Tri-Mercy, Mercilon, Logest, Janine, Regulon, Lindinet, Novinet, Marvelon, Charozetta, Diane 35.

Among the combined agents, you can distribute the tablets according to the required dosage:

• microscopic dosing: ensure effectiveness, absence of side effects - these are birth control pills Jess, Miniziston, Yarina, Lindinet-20, Novinet, Tri-Mercy, Logest, Mercilon;
• low dosage: Lindinet-30, Silest, Marvelon, Microgynon, Femoden, Regulon, Regividon, Janine, Belara,
• average dosage: Chloe, Diane-35, Demoulin, Triquilar, Triziston, Tri-regon, Milvane;
• drugs that require high dosage and are used when the effectiveness of the previous groups is low: Ovidon, Non-Ovlon.

Common mini-pills include tablets such as Ecluton, Charozetta, Norkolut, Microlut, Micronor.

Specially allocated funds

Numerous reviews from women identify the following as the best birth control pills:

1. The drug Jess was developed by Bayer Schering Pharma. It contains a small amount of estrogen and a progesterone substitute - drospirenone. In addition to contraceptive abilities, it can help with acne, seborrhea, and hirsutism. Designed for women of any age category.
2. Yarina birth control pills are widely used. The drug is effective for normalizing the menstrual cycle and eliminating painful symptoms during menstruation. The main effect is aimed at blocking ovulation and changing the structure of the uterine endometrium. There are practically no serious side effects noted.
3. Novinet tablets inhibit ovulation by blocking the production of luteinizing hormone and increase the viscosity of cervical mucus.
4. Janine is a low dosage drug. It affects all 3 main areas of preventing conception. The active substances are ethinyl estradiol and dienogest.
5. Regulon contains ethinyl estradiol and desogestrel. The main effect is inhibition of the ovulation process. Positive effects are noted for menstrual irregularities and treatment of uterine bleeding.

High-quality hormonal contraceptives provide very high effectiveness when used regularly, and strictly according to the recommendations of the instructions and the doctor. Is it possible to get pregnant while taking birth control pills? This probability is estimated to be below 1%, and even it is associated with violations of the rules of administration and its regularity.

Choice of non-hormonal agents

Non-hormonal contraceptives have lower protective properties, but they are recommended in a number of cases when hormonal drugs are contraindicated: advanced fibroids, breastfeeding a child, endocrine pathologies, allergic reactions to hormonal drugs. The main advantage of non-hormonal tablets is the absence of contraindications and side effects.

The following non-hormonal agents are available in the form of vaginal tablets:

• Pharmatex (action up to 3 hours);
• Gynekotex, Erotex, Benatex (action 3-4 hours);
• Contratex (4 hours);
• Nonoxenol, Patentex, Traceptin.

An important property of these tablets is simultaneous antifungal and antibacterial protection. They are especially effective against Trichomonas, chlamydia, staphylococci, gonococci, Proteus and other microorganisms. The disadvantages include the rather short duration of action, which requires precise calculation of the time of sexual intercourse.

An important property of these tablets is simultaneous antifungal and antibacterial protection. They are especially effective against Trichomonas, chlamydia, staphylococci, gonococci, Proteus and other microorganisms. The disadvantages include the rather short duration of action, which requires precise calculation of the time of sexual intercourse.

Use of drugs after the act

Emergency protection during unplanned sex is provided by hormonal contraceptive pills after sexual intercourse. Different types of products allow them to be used at different times after contact. This interval can be 72 hours when high-quality contraceptives are used. However, most drugs are designed to be administered over 20-50 hours.

The following contraceptive pills of this type are distinguished:

• levonorgestrel-based products: Postinor, Escapel, Eskinor F;
• tablets containing estrogen and progesterone: Rigevidon, Non-ovlon, Silest, Ovidon;
• drugs based on mifepristone: Ginepristone, Mifolian, Zhenale, Agesta.

When using such contraceptive pills, you should remember that the maximum period is 72 hours after sexual intercourse, but the greatest degree of protection is achieved when the drug is administered within 24 hours. In this case, the probability of conception after taking the pills does not exceed 5%. In addition, it should be borne in mind that drugs of this type are considered emergency drugs, which are not recommended to be carried away. Due to the high content of hormones in them, the risk of serious complications and hormonal imbalance is quite high.

When not to take medications

There are a number of contraindications for taking birth control pills. They should not be used in the following cases:

• after a heart attack, stroke, angina pectoris, pulmonary embolism, venous thrombosis; in the presence of malignant tumors;
• for chronic liver pathologies;
• with vaginal bleeding of unknown etiology;
• for endocrine diseases;
• before planned surgery for any reason;
• after an abortion or miscarriage;
• when breastfeeding a child.

With great caution and only after consulting a doctor, you can use the tablets in such conditions.