Types of contraceptives
Before we understand the side effects of birth control pills, let’s remember their classification.
Combined oral contraceptives
These contraceptives contain the hormones estrogen and gestagen. Therefore, contraceptives are divided depending on the amount of hormones into:
- microdosed drugs,
- low-dose drugs,
- high-dose drugs that are used for treatment.
In addition, combined contraceptive drugs are divided into mono-, two- and three-phase drugs.
Non-combined oral contraceptives
Non-combined contraceptive pills, called mini-pills , contain only one component - the hormone gestagen, and in a minimal dose.
Contraindications and rules of admission
Most often, blisters with COCs consist of 21 tablets (sometimes 24 or 28). Contraceptives are taken every day, preferably at the same time. If a woman has never taken OK, then the first tablet should be taken in the first three days of the start of menstruation. The first two weeks of use should be protected by a non-hormonal method of contraception. When the package runs out, you need to take a seven-day break before starting again (without two weeks of additional barrier protection). On the third to fifth day of the week-long break, withdrawal bleeding will begin. If the package contains 28 tablets, a break is not needed.
If vomiting or diarrhea begins earlier than five hours after taking the pill, the drug should be taken again, as the contraceptive effect may be reduced. If more than 10 hours have passed since you missed taking the pill, then you should find an alternative method of contraception and use it for about a week. Some antibiotics, St. John's wort and other drugs may reduce the effect of OCs.
Personal experience
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> 17 years old, right before the last call, I was taken to the ambulance with inflammation of the appendages. And this was not the worst thing: the gynecologist discovered a cyst in the ovary . A common thing at that age, as it turned out. And, of course, it was decided to go to the hospital to take a dose of antibiotics and vitamins every day, endure IVs and hospital food: on Thursdays - fish day (with disgusting herring), on Mondays - watery mashed potatoes.
Every day, up to a dozen girls appeared in the corridors who decided to have abortions; every day, operations were carried out to remove the reproductive organs and those same cysts, if they were suddenly malignant.
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For reference . A cyst is a cavity with thin walls, something like a sac filled with semi-liquid contents.
and is formed if hormonal levels are disrupted or during any inflammation in the body. Some cysts come and go on their own, while others require surgery because they can burst and cause internal bleeding. Also, a cyst can cause infertility, and in the worst case, develop into a cancerous tumor. By the way, the occurrence of a cyst does not depend in any way on whether you are sexually active or not. It can appear at either 15 or 45 years of age.
Before that, I suffered for six months from periodic abdominal pain (I had to run to the doctor right away) and terrible acne, which could not be removed with any expensive foams and scrubs. I thought it was a late transitional age. What I didn’t do: I went on diets, and applied chamomile with aloe to inflammation, and went to a cosmetologist - in vain. It was embarrassing to just go outside: I covered my cheeks with my hair or covered them with a thick layer of foundation, which made the situation worse.
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Then they told me that I needed to look for the problem inside. My stomach was fine, and by that time I had never been to a gynecologist. So I had to endure it. I endured it.
Upon discharge, I was prescribed hormonal pills, which I initially refused to take (I read a lot on the Internet). But the doctor explained that they are often prescribed to prevent cysts and to regulate the menstrual cycle. It was necessary to take it for at least three months for the body to adapt.
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Thus began my peculiar addiction to birth control. I decided that without the help of a doctor I could figure out when to take a break and when to start taking them again . And if at first the result was positive (acne disappeared and abdominal pain disappeared), then after the first pause everything changed. More precisely, my hormonal levels changed, and the previous pills were no longer suitable for me. In general, it took a lot of nerves before I decided to see a doctor and finally find the right drug.
To try to dot the i's (although I warn you again - this is impossible, because every organism is individual), I contacted two qualified psychologists and compared their opinions.
Andreeva Yulia Evgenievna , obstetrician-gynecologist, chief physician of the Nova Clinic .
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Averyanova Marina Gennadievna , obstetrician-gynecologist, ultrasound doctor, doctor of the highest category at the Clinic of German Medical Technologies GMT Clinic .
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How to choose oral contraceptives? And in what cases do doctors necessarily prescribe them?
Yulia Andreeva : Hormonal drugs are selected by the attending physician. The doctor relies on a number of examinations (data from examination, medical history, ultrasound, laboratory parameters and others). We especially insist on taking COCs after suffering from inflammatory diseases of the female genital area, termination of pregnancy, and a number of surgical interventions. A hormonal examination is carried out if the doctor considers it necessary.
Marina Averyanova : Contraceptives, as a rule, are selected for a long period of time, from six months to five to six years (maybe longer). To choose the most effective type of contraception, a consultation with a gynecologist is required to draw up a complete picture of the patient’s health, taking into account the woman’s lifestyle and health. Next, laboratory diagnostics of hormonal levels is carried out. After this, the necessary contraceptives are prescribed.
The period of habituation and adaptation to the drug is about three months. If side effects are detected during this period, a decision is made to change tablets; if not, then the patient continues to take protective equipment.
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Is it true that hormonal pills can cause cancer or infertility? Can breast problems occur? Is it possible to gain weight while taking pills?
Yulia Andreeva : Oncological diseases can develop intensively while taking COCs, as well as problems with the mammary glands. In most cases, these drugs, on the contrary, prevent the development of these diseases (for example, the risk of ovarian cancer is significantly reduced after taking COCs), and also prevent and treat infertility. COCs themselves do not make us fat, but they can somewhat stimulate the hunger center. If we watch our diet, weight gain can be avoided.
Marina Averyanova : You need to know and remember that hormonal drugs do not lead to cancer. There are situations when cancer, for example, of the breast or ovaries, is genetically embedded in the body and the likelihood of tumors occurring in the case of taking a contraceptive can contribute to the manifestation of the pathological process. In most cases, contraception protects against the risk of developing ovarian cancer. Therefore, to be sure, I recommend conducting research and selecting medications individually. As a rule, hormonal drugs affect metabolic processes in the body; some patients can gain up to three kilograms in the first two to three months (during the adaptation period), then the weight returns to normal. If the patient has pronounced PMS, that is, there is a slight manifestation of bulimia (peaks of increased appetite occur), this feature stabilizes while taking medications.
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Today, hormonal pills are called new generation drugs. What does it mean?
Yulia Andreeva : The new generation of hormonal drugs has very low dosages of hormones, even lower than in the patient’s natural cycle. In addition, they contain components that make it possible to provide various therapeutic effects (reduce the level of male sex hormones: remove acne, oily skin, excess hair growth), as well as remove the manifestations of premenstrual syndrome - swelling, irritability, depression, and so on.
Marina Averyanova : Now there are a large number of options for new generation drugs on the market. For example, a great way for forgetful ladies is a vaginal ring, which allows you to receive contraception for three weeks by absorbing hormones through the vaginal mucosa. Subcutaneous preparations are also hormonal and are classified as contraceptives; they are sewn under the skin and are valid for up to five years. Perhaps the only inconvenience may arise during removal, since surgical intervention is required. There is also a transdermal form - a patch. It is recommended for patients who have problems with the gastrointestinal tract and direct absorption of the drug is contraindicated. I want to emphasize that the choice of contraceptive method depends on many factors and it should be prescribed and taken under the supervision of a gynecologist only.
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Is it true that such drugs reduce immunity, and infections (like thrush) are much more difficult to get rid of while taking them?
Yulia Andreeva : They do not affect immunity. But due to changes in hormonal levels, the biocenosis of the vagina (“microbial population”) can change, and therefore, the nature of vaginal discharge can indeed change. You need to see a doctor to find out what kind of discharge it is, and then choose a treatment method.
Marina Averyanova : Hormonal drugs a priori cannot reduce immunity, since they are not directly related to our immune system. If the patient feels a deterioration in her health, then this is a reason to consult a doctor and undergo an examination. The likelihood of a recurrence of candidiasis or thrush may increase while taking a contraceptive, this is due to the hormonal effect on the body. There is no need to stop taking pills because of this, you just need to select the right medications with the help of a gynecologist.
One of the side effects is decreased libido. Is it possible to somehow avoid this?
Yulia Andreeva : Unfortunately, the decrease in libido cannot be reversed. Once you stop taking the pills, it all comes back immediately! Libido is associated with the pool of hormones that penetrate the brain, and when taking COCs, they become smaller.
Marina Averyanova : Indeed, desire in a small percentage of women may decrease. This happens because the drug reduces the peaks of ovulation (it almost disappears, so pregnancy does not occur). After all, what is ovulation - the release of estradiol, the female sex hormone. Against the background of the growth of estrogen, the body is quite active - the eyes burn, desire increases, and while taking a contraceptive, the effect of the hormone is suppressed. This causes a decrease in libido, which returns after getting used to the drug.
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How do you know when it’s time to change your pills (they say your chest starts to hurt)?
Yulia Andreeva : You need to take OCs under the supervision of a doctor - the doctor will understand when they need to be discontinued or replaced. If your chest hurts while your body gets used to the pills, it’s just a side effect, but if it happens, for example, after a year, it’s a reason to see a doctor.
Marina Averyanova: The manifestation of pain in the mammary gland when using a contraceptive is called mastodynia and can manifest itself during the period of addiction. However, if you have been taking the drug for, for example, two years and you begin to experience pain, you should immediately make an appointment with a gynecologist. This is not a reason to stop taking the drug, but a reason to consult a specialist.
Should I take a break from taking COCs? Is it true that in the first months after stopping the drug, the risk of getting pregnant increases.
Yulia Andreeva : There is no need to pause, in this case we are simply rocking the poor body. After cancellation, there is indeed a greater chance of getting pregnant - the ovaries are very active! In addition, gynecologists prescribe COCs to women who cannot get pregnant. And this usually works.
Marina Averyanova : If the drug is suitable, there are no problems with its tolerability and the patient is not planning a pregnancy, then, in accordance with the recommendations of the World Health Organization, the drug can be taken without interruption for up to five years. On average, a break can be taken from three months to six months. Why is that? The body will not perceive the withdrawal effect in one month; it needs more time.
The likelihood of pregnancy after stopping the drug is quite high. This can be explained simply: during the period of taking hormonal pills, the ovary rested, so after withdrawal it begins to work with renewed vigor.
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What is the risk of getting pregnant if you do not adhere to your medication regimen?
Yulia Andreeva : If there is a violation in taking medications, the risk that ovulation will “overshoot” increases, and then the patient will be able to get pregnant. Therefore, you should not only try to take the drug at a certain time, but also make sure that the missed pill is taken within the next 24 hours.
Marina Averyanova : There is a “forgotten pill” rule, when we forget to take it, in this case the drug must be taken as soon as we remember. The next tablet is taken as usual. Provided that the patient has been receiving the drug for a long time and such cases are rare, it is recommended to use protection for the next seven days, the main thing is that no more than a day should pass between taking the pills.
Source: peopletalk.ru
