Whether hormonal pills. How to take birth control pills correctly

Currently, oral contraceptives, the list of which is quite large, are used very widely by women. But when using hormonal contraceptive pills for women, you should be clearly aware of both the positive and negative aspects of using these drugs.

Considering that the list of hormonal drugs currently offered is very large, women need to understand what classification of these drugs is used, what contraindications and side effects they have, in order to take into account all the risks associated with their use. It is also necessary to take into account the positive aspects that such contraception provides for women.

Thus, every woman should be clearly aware that when interfering with the natural processes occurring in the body, there are consequences that manifest themselves differently for everyone.

Therefore, any contraceptives for girls and women should be selected by a gynecologist who can adequately assess all contraindications and side effects hormonal drugs . It is the doctor who must tell you in detail what it is oral contraceptives , how to take modern oral contraceptives, as well as explain all their pros and cons.

You can also find a lot of information on the Internet, as well as photos and videos on this topic.

Groups of contraceptives, their action

Modern pharmacology offers a very wide range of new generation contraception. It is the list of new generation hormonal contraceptives that is the most in demand and popular. But even if it is easy to obtain the necessary information in the modern world, not everyone knows how to choose the right medications for contraception, what the side effects may be, and how long the treatment may last.

Wikipedia indicates that hormonal birth control pills are divided into two large groups:

• (abbreviated as KOK);

COCs contain (those who are interested in ethinyl estradiol - what it is, should know that this substance is a synthetic analogue), and also progestogen (gestodene, norgestrel, norethisterone, desogestrel, etc.). Depending on what hormones the drugs contain, three-phase, biphasic and monophasic contraceptives are distinguished.

Text: Anastasia Travkina

Using hormonal contraception, of course, it’s already difficult to surprise anyone, but it’s easy to get lost in the myths that surround this topic. In the United States, up to 45% of women 15–44 years old prefer hormonal contraception, while in Russia only 9.5% of women have ever used it. With the help of gynecologist-endocrinologist Valentina Yavnyuk, we figured out how it works, what medicinal properties it has, whether it poses a danger to women’s health, and what feminism has to do with it.

What is hormonal contraception

A distinctive feature of the modern world is a large-scale movement to free the individual from various cultural, religious and social stereotypes. A significant part of this process is related to women gaining reproductive freedom. This means that a woman is given back the right to control her own body: to live a sexual life that suits her, and to independently decide whether to become pregnant or terminate an unwanted pregnancy. In many ways, it was the emergence and development of hormonal contraception that allowed women to take control of their bodies.

Hormonal contraception is a method of protection against unwanted pregnancy that a woman can completely regulate independently. Moreover, its effectiveness is higher than all other options for protection - subject to the rules of use, of course. Thus, a possible pregnancy becomes something that partners can consciously choose. True, such contraceptives do not protect against sexually transmitted infections - a condom is the only way to protect yourself.

All hormonal contraceptives generally work on the same principle: they suppress ovulation and/or prevent the egg from attaching to the surface of the uterine mucosa. This occurs due to the fact that a small amount of synthetic sex hormones constantly enters the body. Suppression of ovulation puts the ovaries into an artificially induced, controlled “sleep”: they decrease in size and the follicles stop releasing eggs in vain.

How do hormones work?

Hormones are substances that actively influence all functions of the human body. Yes, in most cases they help improve the quality of skin and hair, stabilize weight and have many non-contraceptive benefits. However, you should never take hormones on your own without consulting your doctor. In addition, these drugs should not be prescribed by a cosmetologist or gynecologist without a referral for consultation with a gynecologist-endocrinologist.

Sex hormones are biologically active substances in our body that are responsible for the development of male or female sexual characteristics. We have two types: estrogens are produced by the ovaries and, from the onset of puberty, form the female characteristics of the body and are responsible for libido and menstruation. Progestogens are produced by the corpus luteum of the ovaries and the adrenal cortex and provide the possibility of conception and continuation of pregnancy, which is why they are called “pregnancy hormones”.

It is these two types of hormones that provide our monthly cycle, during which the egg matures in the ovary, ovulation occurs (when the egg leaves the ovary) and the uterus prepares for gestation. If fertilization does not occur, then after ovulation the egg dies, and the endometrium, that is, the mucous lining of the uterus, begins to be rejected, which leads to the onset of menstruation. Despite the opinion that menstruation is a “bursting egg,” in fact, bleeding is caused by mucosal rejection. An unfertilized egg does come out with it, but it is too small to see.

The main estrogen in the female body is the hormone estradiol, produced in the ovaries. A high concentration of estradiol in the blood in the middle of the cycle leads to the pituitary gland actively “turning on” in the brain. The pituitary gland triggers ovulation and the production of the main gestagen - progesterone - in case of pregnancy. Hormonal contraceptives work like this: they suppress the ovulatory activity of the pituitary gland, which controls this entire complex process “from above,” and maintain a stable level of the pregnancy hormone progesterone. Thus, the pituitary gland takes a break from reproductive concerns, and the female body experiences a state of so-called false pregnancy: there is no monthly fluctuation in hormones, the eggs quietly “sleep” in the ovary, so fertilization becomes impossible.

There is another type of hormonal drugs. The gestagens in their composition change the quantity and quality of vaginal mucus, increasing its viscosity. This makes it more difficult for sperm to enter the uterus, and changes in the thickness and quality of its coating prevent egg implantation and reduce the mobility of the fallopian tubes.

How to start using hormonal contraceptives

You can take hormonal contraceptives from late puberty, when the monthly cycle has established (on average from 16–18 years), until the cessation of menstruation and the onset of menopause. In the absence of complaints and with regular preventive diagnostics, women are recommended to take a break from taking hormones only if necessary to become pregnant, during pregnancy and lactation. If there are no contraindications, hormonal contraception can be taken the rest of the time.

Remember that a gynecologist-endocrinologist must collect information about the condition of your body as carefully as possible in order to effectively select a drug and avoid unnecessary risks. This information includes a history—gathering information about thromboembolic diseases, diabetes, hyperandrogenism, and other diseases in your family—and an examination. The examination should include a general gynecological examination, examination of the mammary glands, measurement of blood pressure, taking a smear from the cervix, donating blood for coagulation and sugar, and assessing risk factors based on the results.

What are the types of hormonal contraception?

There are several types of hormonal contraception: they differ in the method of use, regularity, composition and dosage of hormones. Oral contraceptives are one of the most popular. For example, in the States it accounts for about 23% of all methods of contraception. These are tablets that are taken every day with a break, depending on the properties of the particular drug. There are two types of tablets: mini-pills contain only synthetic gestagen (they can be used by nursing mothers), and combined oral contraceptives (COCs) contain synthetic estrogen and one type of synthetic gestagen - depending on the indications and condition of the body, you may need certain substances.

Oral contraceptives have the lowest dosages of hormones and are highly effective in protecting against unwanted pregnancy. Recently, a natural analogue of estrogen was found - estradiol valerate. The drug based on it has the lowest concentration of the hormone to date while maintaining the contraceptive effect. The only downside to the pills is the need to take them at the same time every day. If this condition seems difficult, then you should choose a method that requires less care, since violation of the rules of administration leads to an increased risk of pregnancy and possible complications.

The lifestyle of a modern woman often not only does not involve constant pregnancy, but also requires her to withstand a large social burden

Mechanical contraceptives are placed on or under the skin or inside the vagina or uterus. They constantly release small concentrations of hormones and need to be changed periodically. The patch is fixed on any part of the body and is changed once a week. The ring is made of an elastic transparent material and is inserted into the vagina for a month, almost like a tampon. There is also a hormonal intrauterine system or IUD, which is inserted only by a doctor - but it lasts up to five years. Hormonal implants are installed under the skin - and can also last for almost five years.

There are also hormonal injections, which are also administered for a long period of time, but in Russia they are practically not used: they are mainly popular in poor countries where women do not have access to other methods - injections are highly effective and not too expensive. The disadvantage of this method is that it cannot be reversed: you can remove the patch, take out the ring, remove the coil, and stop taking the pills - but it is impossible to stop the effect of the injection. At the same time, implants and spirals are also inferior to rings, tablets and patches in mobility, since they can only be removed with the help of a doctor.

What is treated with hormonal contraceptives

It is precisely because hormonal contraceptives help stabilize the hormonal levels of the female body that they have not only contraceptive, but also. that modern women suffer from ecological-social reproductive dissonance - simply put, from the dramatic difference between the way we live and the way our ancient biological mechanism works. The lifestyle of a modern woman often not only does not involve constant pregnancy, but also requires her to withstand a large social load. Since the advent of contraception, the number of monthly cycles a woman has in her life has increased significantly. Monthly hormonal changes are not only associated with a monthly risk of symptoms of premenstrual syndrome or dysphoric disorder, but also deplete the body as a whole. A woman has the right to spend these energy resources at her discretion on any other type of constructive activity - and hormonal contraceptives help with this.

Due to the action described above, hormonal contraceptives treat the symptoms of premenstrual syndrome and are even able to cope with the manifestation of its more severe form - premenstrual dysphoric disorder. And through combined estrogen-gestagen contraceptives, endocrinologists correct hyperandrogenism - an excess of male hormones in a woman’s body. This excess can lead to cycle disruption, infertility, heavy menstruation and its absence, obesity, psycho-emotional problems and other serious conditions. Due to hyperandrogenism, other problems may also bother us: hirsutism (increased male-pattern hair growth), acne (inflammation of the sebaceous glands, pimples) and many cases of alopecia (hair loss). The effectiveness of COCs in the treatment of these diseases is quite high.

After consulting with your doctor, some tablets can be taken in such a mode that even withdrawal bleeding will not occur

Hormonal contraceptives treat abnormal uterine bleeding - this is a general designation for any deviations in the menstrual cycle from the norm: changes in frequency, irregularity, bleeding that is too heavy or too long, and so on. The reasons for such failures and the severity of the condition may vary, but hormonal contraceptives are often prescribed as part of complex treatment. In the absence of contraindications, the IUD will most likely be chosen: it daily releases progestogen into the uterine cavity, which effectively causes changes in the lining of the uterus, due to which it corrects heavy menstrual bleeding. The risk of developing ovarian cancer and uterine cancer with the use of hormonal contraceptives is reduced, since the ovaries decrease in size and “rest”, as during pregnancy. Moreover, the longer the reception lasts, the lower the risk.

Hormonal medications are designed primarily to mimic a monthly cycle, so there is a monthly withdrawal bleed—a “period”—with a few days between drug cycles. Good news for those who hate periods: after consulting with your doctor, some pills can be taken in such a way that there will be no bleeding.

Who should not take hormonal contraceptives

According to WHO, there is an impressive list of contraindications that cannot be ignored. Combined contraceptives should not be taken by pregnant, non-breastfeeding mothers earlier than three weeks after childbirth and nursing mothers - earlier than six months after childbirth, smokers after thirty-five years of age, hypertensive patients with thromboembolic diseases or their risk, diabetics with vascular disorders or experience of more than twenty years, and also for breast cancer, gallbladder diseases, coronary heart disease or complications with the valve apparatus, hepatitis, liver tumors.

There are fewer restrictions on taking progestogen contraceptives. They should not be taken again by pregnant women, breastfeeding women earlier than six weeks after birth, or those with breast cancer, hepatitis, tumors or cirrhosis of the liver. Combining some antibiotics, sleeping pills, and anticonvulsants with hormonal contraception may also be undesirable: tell your doctor if you are taking other medications.

Are hormonal contraceptives dangerous?

Hormones have an effect not only on the reproductive system, but also on the entire body as a whole: they change some metabolic processes. Therefore, there are contraindications for taking hormones based on possible side effects. Ever since the first and second generations of high-dose hormonal contraceptives, there have been many horror stories about weight gain, hair growth, strokes, chemical dependence and other sad consequences of taking high concentrations of hormones. In new generations of products, the concentration of hormones is reduced tenfold and often different substances are used than before. This allows them to be used even for non-contraceptive medicinal purposes - therefore, transferring stories about the first generations of drugs to them is incorrect.

The most common side effect of hormonal contraception is increased blood clotting, which can lead to a risk of thromboembolic disease. Women who smoke and women whose relatives have had any thromboembolic complications are at risk. Since smoking itself increases the risk of blood clots, most doctors will refuse to prescribe hormonal contraceptives for women who smoke after thirty-five years of age. The risk of thrombosis is usually higher in the first year of taking and in the first six months after stopping hormones, which is why, contrary to popular belief, you should not take frequent breaks in taking hormones: it is not recommended to take them for less than a year and return to them earlier than after a year's break, so as not to damage your health. health. Prevention of thrombosis, in addition to quitting smoking, is an active lifestyle, drinking enough liquid and an annual blood test for homocysteine ​​and coagulogram.

While taking hormones, other types of intoxication can also have a negative effect: the use of alcohol and various psychoactive substances, including marijuana, psychedelics and amphetamines, can provoke problems with blood pressure, blood vessels of the heart and brain. If you are not going to reduce your intake of toxic substances while taking hormonal contraception, you should inform your endocrinologist about your habits to avoid unnecessary risks.

The risks of cervical cancer when taking contraceptives increase when a woman has human papillomavirus, chlamydia, or a high risk of contracting sexually transmitted infections - that is, neglect of barrier contraception with non-regular partners. The pregnancy hormone progesterone suppresses the body's immune response, so women who fall into this risk group can take hormonal contraceptives, but they must undergo a cytological examination more often - if there are no complaints, once every six months. There is no convincing evidence that modern contraceptives increase the risk of liver cancer, although the first generations of drugs had a bad effect on liver health due to their high dosage. Many women are afraid that taking medications will cause breast cancer. Most studies have failed to make a reliable connection between the use of hormonal contraceptives and the occurrence of breast cancer. Statistics show that women with a history of breast cancer, late menopause, giving birth after forty, or who have never given birth are at risk. In the first year of using GC, these risks increase, but disappear as you take them.

There is no evidence to suggest that a woman taking hormonal contraceptives has a reduced egg supply

There is an opinion that taking hormonal contraceptives can lead to depression. This can happen if the gestagen included in the combined contraceptive is not suitable for you: with this problem, you need to consult a doctor in order to change the combined drug - most likely, this will help. But in general, depression and even observation by a psychiatrist is not a contraindication for taking birth control pills. However, be sure to tell both doctors about the medications you are using because some may reduce the effects of each other.

There is a myth that hormonal contraceptives, due to inhibition of the reproductive system, lead to infertility, subsequent miscarriage and fetal pathologies. This is wrong . The so-called ovarian sleep, or hyperinhibition syndrome, is reversible. At this time, the ovaries are resting, and the entire body is in a hormonally balanced state of “false pregnancy.” There is no evidence to show that a woman taking hormonal contraceptives has a reduced egg supply. Moreover, hormonal therapy is used to treat infertility, because after discontinuation of the drug and recovery, the ovaries work more actively. Taking hormonal contraceptives in the past does not affect the course of pregnancy and fetal development. In most cases, the risks and side effects of taking hormonal contraceptives are significantly lower than those of terminating an unwanted pregnancy.

Also, hormonal contraceptives do not cause amenorrhea, the pathological cessation of menstruation. After stopping the drug, it often takes at least three months for menstruation to return (if it has not been there for more than six months, it is better to see a doctor). Hormonal contraceptive withdrawal syndrome is a condition that occurs after stopping taking hormones, when the body returns to constant monthly hormonal changes. In the first six months after withdrawal, the body may experience storms, and therefore during this period it is better to be observed by an endocrinologist. Without medical necessity, you cannot interrupt taking hormones in the middle of the cycle: sudden breaks contribute to uterine bleeding and cycle disorders.

In the endocrinological environment, there is a poetic phraseology that characterizes the status of “balanced” women’s health: harmony of hormones. Modern hormonal contraceptives still have contraindications and side effects, but with proper selection, adherence to rules of administration and a healthy lifestyle, they can not only eliminate the risk of unwanted pregnancy, but also significantly improve the quality of life of a modern woman - freeing her energy for desired activities.

Content

Contraception is a pressing issue for many married couples and women who are sexually active. The highest degree of protection against unwanted pregnancy is provided by hormonal oral contraceptives. The harm of birth control pills is still being studied by many laboratories, as well as the benefits of their use.

Pros and cons of hormonal contraceptives

Modern oral contraceptives contain a minimal dose of synthetic hormones similar to those produced by a woman’s endocrine glands. They first appeared in the United States and over several decades have become one of the most popular and reliable methods of protection against unplanned pregnancy. They contain analogues of estrogen and gestagen.

It is difficult to assess the pros and cons of contraceptives in each individual case. But as a result of numerous studies conducted by dozens of independent laboratories, the most common consequences of their prolonged use were identified.

Without a doubt, the main advantage of combined oral contraceptives (COCs) is their 98% reliability and effectiveness. The chance of getting pregnant is minimal. In addition, they are easy to use; just take a tablet with water. Everything is painless, without hassle, and at first glance, does not cause harm to health.

The disadvantages include a large list of contraindications, a sharp decrease in effectiveness if a dose of the medicine is missed. More details about everything.

The benefits of birth control pills

The female body works under the control of the hormonal system. First of all, the reproductive and endocrine systems influence the well-being, appearance and ability to give birth to a child. Any failure in their work leads to a disorder of reproductive function, an unstable emotional background, and the development of pathologies. The latter include cysts, fibroids, and tumors.

If the balance of hormones in the body is disturbed, oral contraceptives will not cause harm, but only benefit. They are able to correct the balance of hormones and thereby prevent the appearance of cysts on the ovaries and mammary glands. In addition, according to some studies by American scientists, the use of tablets lies in the prevention of benign formations in the uterine cavity.

Sometimes it is enough to take 3 courses of birth control pills to stabilize your periods, make them less heavy, eliminate PMS symptoms and increase the likelihood of pregnancy in the future.

But that's not all. Many girls with elevated levels of the male hormone (testosterone) suffer from acne, pimples and oily hair. Birth control pills are also effective here. Their short-term use will not harm the body.

There is an opinion that the benefit of hormonal contraception is that during the period of using the pills the ovaries rest, and this is good. Different doctors look at the situation differently. Some consider this to be a truly positive effect, for others it is harmful.

If you look in more detail, it turns out that ovarian rest is useful for mature women after 35 years of age who have already had 1 or more pregnancies and are no longer planning children. For young girls who have not given birth, rest is not necessary. There is evidence that it is difficult to restore full ovarian function later. These are the dual consequences of taking birth control pills.

Why are birth control pills dangerous?

Despite the low doses of hormones contained in contraceptives, their harm to the body is noticeable. The worst thing that these drugs can provoke is cancer of the ovaries, uterus and mammary glands. In each individual case everything is individual. The harm from birth control pills has been scientifically confirmed by several laboratories.

This mainly applies to women who have been taking pills for a long time. The danger lies in the decline of the body's ability to reproduce, decreased libido, and the risk of developing thrombophlebitis and diseases of the cardiovascular system.

Is it harmful to take birth control pills?

In the course of scientific studies that were conducted with the participation of thousands of women, the percentage of negative consequences from taking COCs was identified. Thus, in subjects who took the pills for more than 8 years, the risk of developing cancer increased by 23%. This applies not only to the reproductive system, but to the entire body.

The harm of oral contraceptives is that the incidence of cervical cancer doubles with long-term use of birth control pills. That is, the longer a woman uses this method of protection from pregnancy, the more susceptible she is to a terrible diagnosis. Therefore, taking pills for longer than 3 years without breaks is potentially harmful.

In the United States, studies have been conducted to study the connection between breast cancer and COCs. It was found that drugs with high estrogen content increase the risk of the disease by 44%. This is not all the information confirming the harm of hormonal contraception. Briefly about them in the list:

• gradual decline of sexual desire;
• development of polycystic ovary syndrome;
• swelling;
• weight gain;
• long and difficult adaptation to drugs;
• increased risk of developing cardiovascular diseases.

The harm of contraceptives is most often felt by young girls who started taking them before their first pregnancy, and by mature women after 35-40 years.

Indications and contraindications for use

First of all, the list of indications includes contraception. Instructions for use often indicate the possibility of using the product for the treatment of acne and severe PMS. In addition, doctors prescribe COCs to stabilize hormonal levels.

Here is a list of contraindications for birth control pills:

• phlebeurysm;
• thrombophlebitis;
• history of stroke or heart attack;
• the presence of benign or malignant tumors;
• diabetes;
• renal failure;
• pancreatitis;
• migraine;
• individual intolerance to the components of the drug.

Attention! Harm from birth control pills is likely during pregnancy and breastfeeding.

How do birth control pills affect a woman's body?

These contraceptives work according to a single scheme. Hormones block ovulation and the release of an egg. In fact, the ovaries cease to perform their function, decrease in size, and with long-term use of contraceptives are difficult to restore. In addition, the structure of the endometrium of the uterus changes. It becomes thinner and it is very difficult for the fertilized egg, if fertilization does occur, to attach to the walls of the uterus.

The effect of the pills can be expressed in the release of colostrum from the mammary glands, bleeding in the middle of the cycle, and changes in the emotional state. COCs also often provoke the development of edema and weight gain.

Do hormonal contraceptives affect the thyroid gland?

The hormonal system is closely related to the endocrine system, at the center of which is the thyroid gland. If hormones enter the body from the outside, their synthesis by the body’s own glands decreases or stops. With the thyroid gland everything is more complicated. Studies have shown that taking birth control pills is harmful if you have low thyroid function and are taking thyroxine. They provoke an increase in the TSH hormone, and the levels of TSH and T4 remain virtually unchanged.

If a woman has a healthy thyroid gland, there will be no significant changes in its functioning, but if there is a goiter, cysts and nodes, as well as unstable hormone levels, contraception can harm the entire endocrine system.

Side effects after birth control pills

The severity of the consequences of taking hormonal contraceptives depends on many factors. If a change in well-being is observed within 1-3 months, this is the norm. During this period, the woman’s body adapts to the influx of hormones and adjusts to a new operating mode. The most commonly observed side effects are:

• nausea;
• swelling;
• pain in the lower abdomen;
• arterial hypertension.

Nausea while taking birth control pills

This condition is provoked by estrogen in COCs. It does not develop immediately, but towards the end of using the first package. A woman experiences bouts of nausea soon after taking the pill. To make this side effect less noticeable, doctors recommend taking the pills in the evening before bed, after dinner.

Swelling when taking birth control pills

In some women, the use of birth control pills causes fluid retention in the body. This is why many people confuse swelling with excess weight gain. If at the end of the adaptation period the swelling does not go away, the drug should be replaced with another one. Especially if the swelling is very strong and, in addition to it, cellulite develops.

Stomach hurts when taking birth control pills

This is the so-called estrogen-dependent epigastric pain. Many women experience this in the first 1-3 months of taking COCs. The problem can be solved by taking pills in the evening or replacing the drug with another one with a lower dose of estrogen. The drug is replaced after 1-3 months or immediately in case of severe pain. If your lower abdomen hurts when taking birth control pills and your periods come quickly, there is no reason to worry. There is no harm to the body - these are echoes of PMS.

Doctors' opinion

Ignatieva Margarita Sergeevna, 40 years old, Moscow

From personal experience I know that if the drug is chosen correctly, the harm from it is minimal. On the contrary, the woman becomes calmer, is not subject to hormonal changes, and has good facial skin. The main thing is to regularly visit a gynecologist twice a year to do an ultrasound and monitor the functioning of the internal organs.

Sviridov Kirill Anatolyevich, 50 years old, Sevastopol

The complexity and problematic nature associated with the use of hormonal-type contraceptives is that it is very difficult to individually select the right drug. In my practice, there were cases when a woman changed 3-4 medications until she found one that did not cause complications.

Nikiforova Olga Vladimirovna, 34 years old, Tula

According to recent studies, most pathological changes in the functioning of the female genital organs occur due to the fault of estrogen. It follows that the additional influx of this hormone in the tablets increases the risk of cancer. Of course, studies definitely do not provide such information, much less provide statistics, but it is better to use COCs for a short time. This way the harm will be minimal.

Conclusion

Not every woman experiences harm from birth control pills. It all depends on the duration of use, age, health status and individual sensitivity of the body. However, you need to know the side effects and disadvantages of use in order to assess their impact on your own body and decide on the duration of use.

Oral contraceptives solve several problems: they inhibit the development of eggs in the ovaries, make the mucus contained in the cervix more viscous, making it impenetrable for sperm, and also prevent the preparation of the uterine mucosa for the attachment of the embryo. With this set of functions, the onset of birth while taking birth control pills becomes impossible.

In addition, hormonal drugs have a therapeutic effect, so they can be taken by those who do not have regular sex life. It can improve the menstrual cycle, eliminate premenstrual syndrome, prevent ovarian and uterine cysts, endometriosis and mastopathy, reduce the risk of ovarian and endometrial disease, the development of osteoporosis and atherosclerosis. In addition, taking hormones has a positive effect on the skin of the face in the presence of acne, increased sebaceous glands and excessive hair growth.

The described effect on the female body is due to the fact that oral contraceptives contain synthetic analogs of the hormones: estrogen and progesterone. Their regular use suppresses the production of one’s own hormones, forms an artificial menstrual cycle and normalizes the processes associated with it.

Previously, it was recommended to take a break of 3-4 months after 2 years of taking pills, but this opinion is quite controversial, and many doctors currently reject it. A break in taking pills creates hormonal stress for the body: synthetic hormones are not supplied, and the functioning of its own system for their production does not improve immediately after a long rest. Therefore, it is more beneficial to take the pills continuously for several years.

If a woman is planning a pregnancy, then oral contraception should be stopped at least 3 months before the expected conception. This time is required to restore the body, resume the work of the ovaries to produce eggs and prepare the uterine cavity for bearing a baby.

Do not forget that there are a number of contraindications for taking hormonal drugs. In particular, women who smoke after 35 years of age should switch to other methods of contraception. In addition, the tablets are not recommended for women suffering from diabetes, hypertension, thrombosis and thromboembolism, and liver cirrhosis.

When choosing oral contraceptives as a way to prevent unwanted pregnancy, you should first discuss this with your doctor, who will help you choose the right drug. You should undergo a gynecological examination, do an ultrasound of the uterus, appendages and mammary glands, take tests for the levels of hormones, glucose and cholesterol in the blood, measure blood pressure, and, if necessary, consult with a therapist and endocrinologist. 3 months after starting to take hormonal medications, you need to undergo a re-examination.

In the absence of side effects and contraindications, you can use oral contraceptives for many years, not forgetting to see a gynecologist twice a year and a mammologist once a year. It is advisable to annually examine the biochemical composition and blood clotting, monitor blood pressure and do an ultrasound of the pelvic organs. If necessary, the doctor may prescribe a more thorough examination and consultation with specialized specialists (endocrinologist, cardiologist, neurologist, etc.).

Hormonal drugs are medications containing hormones or substances that exhibit effects similar to hormonal ones. Natural hormonal medicines are obtained from the glands, blood and urine of animals, as well as from human blood and urine.

Synthetic hormones are produced in pharmacological workshops and laboratories. They can be either structural analogues of true hormones, or differ from them in chemical structure, but exhibit a similar effect.

Almost the largest number of threatening myths have been created around hormonal pills for various purposes: patients are afraid of infertility, weight gain, excess body hair growth, and loss of potency. The list of negative ones is scary and alarming.

How true are the myths, and what types of hormonal therapy are there?

Hormonal drugs are classified depending on their origin (producing gland) and purpose. Based on their origin, medications are divided into:

• adrenal hormones (cortisol, adrenaline, glucocorticoids, androgens);
• pancreatic preparations (insulin);
• pituitary hormones (TSH, human gonadotropins, oxytocin, vasopressin, etc.);
• thyroid and parathyroid hormones;
• sex hormones (estrogens, androgens, etc.).

Human hormones regulate metabolism in the body. However, if the functioning of one of the organs of the endocrine system is disrupted, the perfectly adjusted mechanism of correction and interaction may fail, which will have to be corrected by introducing synthetic analogs of hormones.

According to their intended purpose, hormonal drugs are divided into:

• synthetic substances for replacement therapy (sodium levothyroxine, insulin, estrogens);
• hormonal contraception (synthetic analogues of estrogen and progesterone);
• hormonal agents that inhibit the production of hormones (for example, therapy with pituitary hormone analogues for prostate cancer);
• symptomatic medications (anti-inflammatory, antiallergic drugs).

Hormonal drugs often also include antidiabetic and other non-hormonal drugs.

What is treated with hormonal medications?

Hormone-based medications are used for both chronic and treatable conditions. You cannot do without the help of hormonal drugs when:

• hypothyroidism;
• hyperthyroidism;
• diabetes mellitus type 1, sometimes type 2;
• hormone-dependent tumors of the reproductive system;
• prostate cancer;
• asthma and other diseases associated with the immune response to allergens (including allergic rhinitis);
• endometriosis;
• hormonal imbalances;
• menopause;
• sleep disorders;
• other diseases associated with hypofunction of the glands.

Inflammation and allergic manifestations are treated with glucocorticoids. Drugs based on them - Prednisolone, Metipred, Dexamethasone - reduce inflammation and suppress leukocyte function.

They can be used both internally (if systemic action is necessary) and externally (for hemorrhoids, thrombophlebitis, dermatological diseases, allergic rhinitis). When used externally, they are practically not absorbed into the main bloodstream and do not have a negative effect on the body.

Even if the cause of inflammation is unknown, adrenal hormones help relieve swelling, pain and redness. Hormonal anti-inflammatory drugs are among the vital drugs.

Vasopressin and epinephrine may be administered along with anesthetics. Due to their property of constricting blood vessels, these hormones are actively used in anesthesia (including local).

Melatonin also belongs to hormonal drugs. This substance, produced in, has an anti-stress effect, regulates circadian rhythms, affects metabolism, slows down the processes of aging and weight gain, and also stimulates the production of antibodies to infectious agents and tumor cells.

What is hormone replacement therapy?

For chronic conditions associated with dysfunction of the glands or their partial removal, medications with synthetic and natural hormones provide high quality and longevity of the patient’s life.

There are several types of hormone replacement therapy:

• treatment with synthetic thyroid hormones;
• insulin therapy;
• taking analogues of sex hormones.

Deficiency and excess of thyroxine and triiodothyronine are fraught with disturbances in mood, sleep, dry skin, problems with memory and performance, proliferation of glandular tissue and other unpleasant symptoms.

Clinical hypothyroidism is most often associated with diseases and tumors of the thyroid gland, therefore replacement therapy with iodine-containing hormone analogues is prescribed for life.

Substitution therapy uses drugs such as:

• "Euthirox";
• “L-thyroxine” (one of the Russian or German brands).

Treatment of hyperthyroidism has a somewhat more complex scheme: to reduce the synthesis of one’s own iodine-containing hormones, thyreostatics are used, and in particularly difficult cases, removal of part of the gland or radioiodine therapy is justified. Then the normal level of triiodothyronine is restored with the help of their synthetic analogues.

Insulin is a hormone of β-cells of the pancreas, the main task of which is to reduce blood glucose levels by regulating its entry into cells and stimulating the conversion of monosaccharides into glycogen.

Impaired functionality of the cells that secrete this hormone is called type 1 diabetes. Patients with such pathology are necessarily prescribed replacement therapy with the drugs “Humodar”, “Apidra”, “Novorapid”, “Actrapid”, “Humulin”, “Insulin Lente”, etc.

For type 2 diabetes, which is associated with impaired tissue sensitivity to insulin, hormone administration may also be prescribed.

Finally, female hormonal replacement therapy (HRT) is a pharmacological replacement of the function of the sex glands (ovaries) lost during their removal or menopause. The most commonly used drugs are:

• "Climodien";
• "Divina";
• "Ovestin";
• "Trisquence";
• "Femoston";
• "Estrofem" and others.

During treatment, androgens, estrogens and gestagens can be used (mainly the last two subtypes of hormones are used in the drugs).

Oral contraception

Oral contraceptives are the most well-known hormonal pills for women. The action of OCs is based on their ability to prevent ovulation (the maturation of the egg and its release from the follicle). Synthetic hormones thicken the mucus on the cervix, which complicates the movement of sperm, and also thin the uterine lining (endometrium), which prevents the fertilized egg from firmly attaching.

The triple mechanism of action of hormones reliably protects the patient from unwanted pregnancy: the Pearl index for oral contraceptives (the percentage of pregnancies that occur while taking OCs) does not exceed 1%.

When using oral contraceptives, menstrual bleeding does not stop, but becomes more regular, less heavy and painful. A certain regimen of hormones allows, if necessary, to delay the onset of menstruation.

Modern contraceptives are classified into three categories:

• Single-component preparations (Continuin, Micronor, Charozetta, Exluton).
• Combined oral contraceptives (COCs). COCs are the most reliable means. They contain synthetic estrogen () and progestogen (levonorgestrel, desogestrel, norgestrel, etc.).
• Postcoital (emergency) hormonal tablets (Postinor, Escapelle). Emergency contraceptives contain an increased dose of hormones, but are less effective.

The dosages of active hormones in modern contraceptives are much lower than in drugs of the last century, so the side effects of taking estrogen do not appear or appear only slightly.

Combined hormonal contraceptives

COCs are divided into mono-, two- and three-phase. Single-phase COC tablets contain a strictly defined amount of hormones, which does not change during the cycle. Multiphase products are designed to be more physiological: the dosages of the active ingredients in tablets are not the same for different days of the cycle.

Three-phase COCs (with three types of tablets changing per cycle) are often recommended by doctors, but two-phase drugs are practically not used.

Combined contraceptives:

Different dosages of the active substance (levonorgestrel) allow you to adapt to hormonal fluctuations during the menstrual cycle and provide a high degree of protection against unplanned pregnancy at low concentrations.

Hormonal products for men

Male hormonal drugs are classified into drugs for gaining muscle mass, drugs directly to suppress the pathological process, and hormones for replacement therapy.

In practice, hormones from the adrenal glands (in particular testosterone), pancreas (insulin) and the anterior pituitary gland (somatropin or growth hormone) are actively used. They are used to form muscle relief, accelerate weight gain and burn fat. Taking hormonal drugs without a doctor's prescription has a number of negative consequences, including damage to the excretory system and possible gynecomastia (swelling of the mammary glands) due to the conversion of excess testosterone into the female hormone estrogen.

For medical purposes, hormonal drugs are used for hormone-dependent tumors (for example, prostate cancer). Injections with analogues of pituitary hormones sharply reduce the production of testosterone, which accelerates the growth of malignant neoplasms. This procedure is called "medical castration." The introduction of hormones makes it possible to slow down the development of the tumor and resort to more radical methods of treatment. Despite the threatening name, patients should not fear that the procedure is irreversible: some time after the end of treatment, erectile function and normal testosterone levels are restored.

Male hormone replacement therapy can be used both when the gland that produces them is completely removed, or when its functionality is reduced. After 40-45 years, the level of testosterone in a man’s blood begins to decline, which leads to problems in the sexual sphere. To restore potency, the following drugs are used:

• “Testosterone Undecanoate” and “Andriol” (tablets with one active ingredient – ​​testosterone undecanoate);
• "Sustanon" (injection solution with four active ingredients - esters - decanoate, isocaproate, phenylpropionate and);
• "Nebido" (injectable oil solution of testosterone undecanoate);
• “Androgel” (a product for external use, the active ingredient is testosterone).

After complete removal of the testicles (due to a tumor of the prostate or gonad), replacement therapy is mandatory.

Attitudes towards hormonal drugs among people who are unfamiliar with medical reference books are predictably biased. Many drugs in this group have strong and a number of contraindications - for example, with long-term use of Prednisolone, rapid weight gain occurs, the face of a patient receiving premedication with this drug swells.

However, this is not a reason to refuse any product containing hormones, including effective birth control pills. By following a few simple rules, the risk of complications from taking hormonal drugs is minimized.

Rules for taking hormonal drugs (GP):

• You cannot take GP without a prescription from your attending physician (endocrinologist or gynecologist). Particularly dangerous when self-prescribed are drugs that are classified as synthetic analogues of adrenal hormones.
• Before prescribing hormonal treatment to a patient or patient, the specialist must carefully study the medical history, the results of blood tests for the concentration of sex hormones and biochemical parameters, the results of pelvic ultrasound, mammography, and cytological smear. It is necessary to inform your doctor about existing chronic diseases: some of them are contraindications to taking COCs and other synthetic drugs.
• You should inform your doctor about any changes in your health status.
• Having missed a dose of the drug, it is strictly forbidden to “compensate” for negligence with a double dose of the drug at the next dose.
• It is necessary to take hormone tablets strictly at the same time with minimal errors. Some medications (for example, L-thyroxine) are taken in the morning, on an empty stomach.
• The duration of the course and dosage (including its changes during treatment) are determined by the attending physician.

The effectiveness and safety of hormonal treatment depends on the competence of the endocrinologist, the interaction of the doctor with the patient and strict adherence to the rules for taking medications.