What will happen if you don’t take hormonal pills? Hormonal drugs: should you be afraid of side effects?

Sex hormones for women play a very important role in their bodies. But recently, hormonal disorders have become quite common, which can be associated with poor ecology, constant stress and other negative factors. To bring the content of these elements back to normal, special preparations were developed - female hormones in tablets. They not only help a woman be healthy and beautiful, but also protect her from unwanted pregnancy.

Main sex hormones

The most significant hormones in women are progesterone and estrogen. The ovaries produce estrogen, which affects the health and puberty of the fair sex. In addition, this hormone affects the formation of a woman’s figure and the gentleness of her character. If the body suffers from a lack of estrogen, then it begins to age quickly, but too much of it can lead to various disorders and diseases, such as excess weight or, worse, benign tumors. Progesterone is also important for women’s health, because the distribution of adipose tissue, the formation of mammary glands, genital organs, and the development of the embryo depend on it. The production of this hormone occurs in the corpus luteum of the ovaries and the placenta.

Use of hormonal drugs

To eliminate hormonal imbalances in a girl’s body, it is used in tablets. This is necessary, since an unstable one can provoke serious consequences, such as sudden changes in blood pressure, menstrual irregularities, chronic fatigue, digestive system disorders, and headaches. Everything will be reflected in your appearance: acne, acne may appear, your hair becomes greasy, your skin begins to peel. They are also often used as contraceptives, which helps avoid unwanted pregnancy. It is thanks to this that female hormones in tablets are widely used.

Types of hormonal drugs

Hormonal products available in tablet form can be divided into two types:

It should be noted that it is necessary to take drugs of this kind only if they have been prescribed by an endocrinologist or gynecologist. After all, improper use of hormonal drugs can cause serious harm to a woman’s body.

Common to all hormonal pills– oral contraceptives is the presence of two main hormonal components – “estrogen” and “gestagen”, although in different doses and combinations. Prada, in order to reduce the side effects of estrogen, also produces a purely progestogen “mini-pill”, which appeared on the pharmaceutical market not so long ago.

To date hormonal pills have been studied quite meticulously by doctors and are very reliable drugs for preventing unwanted pregnancy.

Their advantage lies in the high efficiency and reversibility of the process.

The occurrence rate with prescribed use is approximately two hundred times lower than even with the use of coitus interruptus.

All oral contraceptives are divided into:

• monophasic, among them"Regulon", "Ovidon", "Novinet" and others;
• two-phase (“Anteovin”),
• three-phase, which include Trikvilar, Tri-regol and Triziston.

A box with a monophasic product contains twenty-one tablets; they are absolutely identical in composition, while in biphasic and triphasic preparations the amount of hormones varies depending on the day of the menstrual cycle, thus allowing for a much more accurate simulation throughout the cycle.

Mechanism of action of hormonal pills

The mechanism of action of these tablets is to block ovulation (the appearance of an egg). And even if fertilization has occurred, the drugs destroy the attachment mechanism of the fertilized egg. In addition, the drugs increase the viscosity of cervical mucus, preventing the movement of sperm. They also disrupt the process of transporting the egg or developing embryo.

Use oral contraceptives All young women who have a regular sexual partner and are sexually active can.

These remedies can also be successfully used by spouses who are temporarily postponing the birth of children to future periods, or by women after childbirth, provided that they are not breastfeeding.

Such drugs are also needed for women who are in a post-abortion state, who suffer from functional ovarian cysts, or whose relatives have had ovarian cancer.

Contraindications to the use of hormonal pills

There are also a number of women who You should not take hormonal pills. These are pregnant women, since these drugs, while preventing pregnancy, still do not disrupt it. These drugs are not recommended for women over thirty-five years of age who smoke, have severe liver dysfunction, suffer from breast cancer, have problems with the blood coagulation system, or have frequent bleeding of unknown origin.

For women who do not have a regular sexual partner, nothing better than a condom has yet been invented.

Taking oral contraceptives can be started from the first day after the start of menstruation, from the fifth day, or from the beginning of the week closest to the end of menstruation.

Over the years, no one remembers who was the first to come up with hormone replacement therapy (HRT). The German Langerhans, who discovered islets in the pancreas, and our compatriot Sobolev, who established their role in the production of insulin, and the Canadians Banting and Best, who obtained insulin from the bovine pancreas in 1922, also distinguished themselves.

It is probably worth including here also the one who was the first to comprehend the simple truth: it is not the symptoms that need to be treated, but the disease. His name is unknown, but his tactics helped his descendants: since there is not enough hormone, let’s add it, and everything will immediately fall into place. That's what they did.

Equivalent replacement

The first “experimental subjects” on whom hormone replacement therapy was tested were patients with diabetes mellitus. Unfortunately, the results of insulin therapy were far from perfect. Of course: the hormone was extracted from the first available animals, the methods of its purification left much to be desired, and the administration regimens required improvement. Only in the 1960-1980s did things start to improve, and on the wave of this success, all the now known hormone replacement therapy rose - treatment aimed at replacing missing hormones in the body.

Dwarfism began to be treated with somatotropin - growth hormone, hypothyroidism - with hormones, Addison's disease - with cortisol and aldosterone. Naturally, this also falls into the category of conditions that can be corrected by HRT.

Not all women take menopause for granted and find positive aspects in it (like saving on pads and contraceptives). Most people are seriously concerned about the drop in the level of sex hormones (estrogens and progestins), because it is accompanied by mood swings, hot flashes, thinning of the skin, dry mucous membranes of the vulva and vagina, osteoporosis, loss of interest in sexual activity, and neurocirculatory dystonia. In a word, a whole set of unpleasant symptoms.

Hormone replacement therapy was just right for these ladies. By the end of the twentieth century, more than 20 million women in the West were taking hormone medications daily, and for many years they did not want to give them up. So far, inquisitive scientists have not been overcome by doubts: is it really useful to interfere with the hormonal background of the body and give it a dose of the active substance day after day?

Sayechka for fright!

Large-scale studies at that time showed that HRT cures one thing and cripples another. Women who used sex hormones for more than five years really looked great and felt good, but... It turned out that the use of estrogens increases the likelihood of developing breast and endometrial cancer: estrogens stimulate cell division, including cancer cells. Again, hormone replacement therapy then triples the risk of thrombosis and embolism, including pulmonary embolism.

However, the attempt to link HRT with coronary heart disease, hypertension and liver disease failed miserably.

It turned out that all cases of weight gain due to HRT are associated with a late start of treatment, when obesity has already begun, and precisely from a lack of sex hormones. And American doctors, together with the All-Russian Scientific Society of Cardiology, have proven that hormone replacement therapy, on the contrary, improves survival in women with coronary heart disease. The 10-year survival rate for patients who took hormones was 97% versus 60% for those who never took them. If we talk about the risk of cancer, it has been reduced by using combined estrogen-progestogen drugs.

Today, “heavy” low-purity hormonal drugs have been replaced by the latest low-dose products of biochemical technologies and genetic engineering. However, many doctors still remain in the camp of opponents of HRT. And that's why.

The main thing that is alarming about the rosy prospect of mass propaganda of HRT is the dosage. All hormones are present in the blood in negligible quantities; their balance is extremely individual and can change from day to day. You can, of course, study the daily rhythm of the production of a particular hormone in the body, but how to calculate the required individual dose of hormone replacement therapy?

Let's reveal a little secret. Until now, all hormones are prescribed in average doses. That is, by and large, with each medication taken, patients deal a powerful blow to their tissue receptors, which have to adapt, roughly speaking, not react so actively to the stimulus. It’s not hard to guess how it will all end: their sensitivity to hormonal drugs gradually decreases, and then disappears completely.

Expert commentary
I prescribe hormone replacement therapy to menopausal women, but when my patients hear about hormones, they often refuse to take them. Therefore, I prefer to use homeopathic remedies or dietary supplements, the effects of which have been tested experimentally. By the way, I take them myself.
Regarding true hormone replacement therapy, I can say that in all my many years of practice I have observed only three cases of complications. These were edema and exacerbation of hypertension.
Zubanova I.V., gynecologist

Another disadvantage: the hormone introduced from outside suppresses the work of the gland that normally synthesizes it. The principle of negative feedback. While a foreign hormone circulates in the blood, practically no own hormone is produced - the gland rests, without receiving an order from above (from the hypothalamus and pituitary gland). If the replacement treatment lasts for a long time, she loses her skills altogether, and her abilities do not return when HRT is stopped.

What to do? The answer lies in competent tactics for treating hormone deficiency:

• There is no need to rush to switch to hormonal therapy. Let's remember the basics of endocrinology: first they try to cure thyroid gland insufficiency with iodine preparations, and to stimulate the ovaries with various physical procedures. And only if all these methods are ineffective should one resort to hormones as a last resort.
• If you can do without HRT, then it is better to do without it. For example, during menopause, hormones are prescribed for osteoporosis and severe menopausal disorders if they cause anxiety to the patient. Contraindications to hormone replacement therapy: malignant tumors, liver or kidney failure, acute thromboembolic diseases
• Choose the right medicine. Modern drugs for HRT are divided into herbal hormone-like agents, bioidentical hormones and synthetic analogues of natural hormones. The first ones are good from a psychological point of view, because a clear prejudice has formed against hormones, and a rare patient is eager to take them. Synthetic hormones have a quick and powerful effect, but their structure is slightly different from the natural hormones of our body, therefore the production of our own hormones is more actively suppressed. The golden mean is bioidentical hormones.
• Choose the optimal route of drug administration. For gastritis, ulcers and other diseases of the upper gastrointestinal tract, it is not recommended to swallow HRT tablets. Instead, you can give injections, glue hormonal patches and throw special quickly dissolving tablets under the tongue.
• Stop in time. You don't have to take hormones your whole life. Practice shows that 2-3 years are enough to relieve menopausal disorders; after discontinuation of the drug, hot flashes and other “delights” of menopause are unlikely to return. Lifelong prescription of hormones is justified only in cases where a woman has had one or both ovaries removed.

HRT against age

Recently, a new direction has appeared in medicine - anti-aging. Having seen enough of the vigorous Western women of Balzac’s age, ours decided not to lag behind and also took up the task of rejuvenating the body.

Müllerian inhibitory substance, or AMH, as anti-Müllerian hormone is also known, is produced in the gonads of both men and women. Hormone synthesis occurs from the first minutes of birth and reaches its highest peak during puberty. Then the AMH level gradually decreases and remains at the same level in men until the end of life, and in women until menopause. If the level of a substance during reproductive age falls below normal, this is a clear signal of serious problems in the body.

What happens in the body when AMH decreases

The standard AMH level for men aged 18 years and older is 0.49-5.98 ng/ml, for women aged 18 to 34 years – 1.0-2.5 ng/ml. Then the AMH concentration in the fair sex gradually decreases and reaches zero by the age of 49. In women of reproductive age, low anti-Mullerian hormone is in the range of 0.2-1.0 ng/ml. If the number drops below 0.2, it’s time to sound the alarm and start urgent treatment.

Reduced levels of Müllerian inhibitory substance are not a cause, but an effect. If the tests show low AMH, then dangerous changes have already occurred in the body.

What does a low AMH level mean in men and women?

If anti-Mullerian hormone is below normal during reproductive age, this is a clear sign that there is some kind of pathology. In women, AMH levels below 1 ng/ml may result from:

• early sexual development of girls;
• gonadal dysgenesis (rare chromosomal abnormality);
• hypogonadotropic hypogonadism (one of the forms of infertility);
• decreased ovarian reserve (the supply of healthy eggs at the time of analysis);
• disrupted menstrual cycle;
• the arrival of menopause.

In young girls, low concentrations of AMH often appear with ovarian dysfunction, endometriosis and granulocellular tumors of the ovaries. Anorexia and severe weight loss also provoke a decrease in Müllerian inhibitory substance in the blood. In late reproductive age, the opposite is true - a lack of the hormone is caused by obesity.

In young men, a low AMH level is often a sign of early puberty and so-called hormonal burnout. In older patients, the causes of hormonal imbalance may be anorchism (congenital absence of testicles), hypogonadotropic hypogonadism (functional testicular failure) and a rare pathology - persistent Müllerian duct syndrome. This is a hereditary congenital anomaly in which symptoms of false hermaphroditism appear (fully developed external genitalia and the presence of a hypoplastic uterus).

How to increase anti-Mullerian hormone

If a low level of anti-Mullerian hormone is detected, is it possible to get pregnant? This question torments every expectant mother who receives bad test results.

In this case, urgent treatment is required for the problem that caused the decreased secretion of hormones. The therapy will increase the number of viable eggs and ensure a long-awaited pregnancy. In some cases, doctors recommend artificial ovarian stimulation to produce active eggs. Including in vitro fertilization.

An AMH level within normal limits is the most important condition for conception. The only way to increase anti-Mullerian hormone in women is to cure the underlying disease. A number of modern hormonal drugs can temporarily increase the volume of the hormone in the blood, but this will not affect the number of valuable eggs, which means it will not cure infertility.

There is also a “home” way to increase anti-Mullerian hormone. This is taking vitamin D3, both in tablets and in the form of sunbathing. So, when analyzing for AMH in summer, its level is 15-18% higher than in winter - and this is due to vitamin D.

Prescribing hormonal medications often frightens people. There are many myths surrounding hormones. But most of them are completely wrong.

Myth 1: Hormonal drugs are special birth control pills for women.

No. Hormonal drugs are drugs obtained synthetically. They act similar to natural hormones produced in our body. There are many organs in the human body that secrete hormones: female and male genital organs, endocrine glands, central nervous system and others. Accordingly, hormonal drugs can be different, and they are prescribed for a wide variety of diseases.

Female hormonal preparations (contain female sex hormones) may or may not have a contraceptive effect. Sometimes, on the contrary, they normalize hormonal levels and promote pregnancy. Preparations containing male sex hormones are prescribed to men when the quality of the ejaculate decreases (that is, sperm motility), hypofunction, or a decrease in the level of male sex hormones.

Myth 2: Hormones are prescribed only for very severe illnesses

No. There are a number of mild diseases for which hormonal drugs are also prescribed. For example, decreased thyroid function (hypofunction). Doctors often prescribe hormones in this case, for example, thyroxine or euthyrox.

Myth 3: If you don’t take a hormonal pill on time, nothing bad will happen

No. Hormonal medications must be taken strictly according to the clock. For example, a hormonal birth control pill is valid for 24 hours. Accordingly, you must drink it once a day. There are medications that you need to take 2 times a day. These are some male sex hormones, as well as corticosteroids (for example, dexamethasone). Moreover, it is recommended to take hormones at the same time of day. If you take hormones irregularly, or forget to drink them altogether, the level of the necessary hormone can drop sharply.

Let's give an example. If a woman forgot to take a hormonal contraceptive pill, the next day she should take the forgotten evening pill in the morning, and the next pill in the evening of the same day. If the interval between doses is more than a day (remember: a hormonal contraceptive pill is valid for 24 hours), then the level of hormones in the blood will decrease very significantly. In response to this, slight bleeding will certainly appear. In such cases, you can continue taking birth control pills, but use additional protection for the next week. If more than 3 days have already passed, you need to stop taking hormones, use other contraceptives, wait until your menstruation arrives and additionally consult a doctor.

Myth 4: If you take hormones, they accumulate in the body

No. When a hormone enters the body, it immediately breaks down into chemical compounds, which are then excreted from the body. For example, a birth control pill breaks down and leaves the body within 24 hours: that is why it needs to be taken every 24 hours.

However, hormonal drugs continue to “work” after they are no longer taken. But they influence indirectly. For example, a woman takes hormonal pills for several months, then stops taking them, and in the future she has no problems with her cycle.

Why is this happening? Hormonal medications act on different target organs. For example, female contraceptive pills affect the ovaries, uterus, mammary glands, and parts of the brain. When the pill “leaves” from the body, the mechanism that it started continues to work.

Need to know: The mechanism of prolonged action of hormones is not associated with their accumulation in the body. This is simply the principle of action of these drugs: to “work” through other structures of the body.

Myth 5: Hormonal medications are not prescribed during pregnancy

Discharged. If a woman had hormonal disorders before pregnancy, then during pregnancy she needs medicinal support so that the production of female and male hormones is normal and the child develops normally.

Or another situation. Before the woman became pregnant, everything was fine, but when she got pregnant, something suddenly went wrong. For example, she suddenly notices that intense hair growth has begun from the navel down and around the nipples. In this case, you should definitely consult a doctor who can prescribe a hormonal examination and, if necessary, prescribe hormones. Not necessarily female sex hormones - these could be, for example, adrenal hormones.

Myth 6: Hormonal drugs have a lot of side effects, primarily weight gain

There are practically no medications without side effects. But it is necessary to distinguish between side effects that do not require discontinuation of the drug. For example, swelling of the mammary glands when taking contraceptive hormones is considered normal. Scanty bleeding in the first or second months of use during the intermenstrual period also has the right to occur. Headache, dizziness, fluctuations in weight (plus or minus 2 kg) - all this is not a pathology or a sign of a disease. Hormonal drugs are prescribed for a fairly long period. By the end of the first month, the body adapts and everything returns to normal.

But in order to avoid really serious problems associated with, say, blood vessels, it is imperative to be examined and tested before prescribing the medicine and while taking it. And only a doctor can prescribe you a specific hormonal drug that will not harm your health.

Myth 7: There is always an alternative to hormones

Not always. There are situations when hormonal drugs are irreplaceable. Let's say a woman under 50 has had her ovaries removed. As a result, she begins to age and lose health very quickly. In this case, her body must be supported with hormone therapy until she is 55-60 years old. Of course, provided that her underlying disease (due to which the ovaries were removed) has no contraindications to such a prescription.

Moreover, for some diseases, even a neuropsychiatrist can strictly recommend female sex hormones. For example, with depression.