The use of contraceptive pills in the treatment of uterine fibroids. The Best Medicines for Endometriosis Oral Contraceptives and the Risk of Venous Thrombosis

Contraception- this is achieved in various ways to prevent unwanted.

There are several types of contraception, and the most ancient are barrier methods of contraception . As early as the beginning of the 20th century. these were the only means to prevent unwanted pregnancy, but in modern world their popularity has declined significantly, due to the emergence of more effective contraceptives. However, barrier methods of contraception continue to develop and improve, because. they have much fewer unwanted complications and contraindications, as well as an increase in the number of sexually transmitted diseases.

There are a huge number of sexually transmitted diseases, and their prevalence, unfortunately, is growing. Such diseases are: genital , vulvovaginitis , mucopurulent , And non-gonococcal , and pubic louse , genital warts , various inflammatory diseases of the pelvic organs and intestinal infections, and others. In order to prevent infection with such diseases of the genital area, you need to maintain sexual relations with only one healthy partner, or reduce the number of such partners, get tested for STDs for you and your partner, exclude sexual contacts with those who have a large number of sexual partners, and also lead healthy lifestyle life.

There are several types of barrier contraceptives: men's And female , which are medical And barrier non-drug . In any case, barrier contraceptives block penetration seminal fluid into cervical mucus. The general advantages of barrier methods of contraception are a small amount side effects, protection from, they act only locally and do not cause systemic changes in the body, and have practically no contraindications. The disadvantages of barrier methods of contraception are the appearance on the materials from which these contraceptives are made ( rubber , latex , polyurethane ), and then they cannot be used, they are less effective than other methods of contraception, for their use it is necessary to perform some manipulations on the genitals and monitor their location during intercourse. Such methods of contraception are used in cases where it is impossible to use other means of contraception - intrauterine devices and, during lactation, when taking drugs that are not combined with oral contraceptives.

The most popular barrier contraceptive is. The condom is the only contraceptive in the world that is used by men. They are made of elastic rubber having a thickness of approximately 1 mm. Usually condoms are 10 cm long and can increase depending on the size of the penis. Condoms protect against diseases of the genital area caused by viruses and bacteria. In addition, the use of condoms protects all parts of the genital tract from infections, as well as from . A twisted condom is put on the erect penis. The prevalence of this method of barrier contraception is approximately 30%. Benefits of using a condom: ease of use, protection against sexually transmitted diseases. Condoms also protect against contracting AIDS. The disadvantages of condoms are: a decrease in pleasant sensations during intercourse, the possibility of using this method of contraception only at a certain stage of sexual intercourse, as well as the appearance of an allergy to the material from which it is made.

The use of condoms also has its own contraindications: the use of condoms made of natural materials that are passable for viruses, if there is a possibility of contracting a sexual disease, as well as the inability to maintain an erection when used condom .

vaginal diaphragm is a barrier method of contraception, and is a domed cap that is inserted into the vagina before sexual intercourse so that its dome covers the cervix. Usually, diaphragms have sizes from 50 to 150 mm, and are selected individually for each woman, depending on whether she gave birth, her complexion, etc. The first time it is difficult to correctly install the diaphragm, a doctor can help with this. The diaphragm has many advantages, it protects against genital infections that can be caught from a sick person, against ectopic pregnancy, as well as ease of use and the fact that it can be used several times. Side effects of the use of the cap are the possible infection of the urinary tract due to the pressure of the diaphragm on urethra , as well as inflammation of the walls of the vagina at the points of contact with the diaphragm.

The vaginal diaphragm also has contraindications for use, it is an allergy to rubber, as well as various diseases of the genital organs - prolapse of the walls of the uterus and vagina, endocervicitis , as well as anomalies in the development of the genital organs.

Another method of barrier contraception is cervical caps (cervical caps), which are made of latex rubber. There are 3 types of caps: Prentif cap , Vimul's cap And Dumas which differ in shape and size. Pick up suitable option a doctor will help you. It should be noted that a properly installed cap covers the upper part of the vagina and the cervix.

The next method of contraception is the use chemical methods contraception , namely, . Spermicides inactivate sperm and prevent its penetration into the uterus, and neutralize almost all viruses and bacteria. The drugs are available in the form foam aerosols , tablets , jelly , melting and foaming candles , creams applied topically, and protect against certain diseases of the genital area caused by infections and viruses, and from ectopic pregnancy. Modern spermicides consist of a carrier and a spermicide, both of which are important in providing a contraceptive effect. The function of the carrier is the implementation of the dispersion chemical into the vagina, by enveloping the cervix. And the sperm-killing active ingredient are potent surfactants that destroy the membrane of spermatozoa ( menfegol , octooctinol , benzalkonium chloride ). Spermicides are used both independently and together with barrier contraceptives. In the first case, they are inserted into the vagina 7-15 minutes before sexual intercourse.

The advantages of spermicides are: ease of use, protection against some infections that can be transmitted sexually. The disadvantages of this type of contraception: the need for manipulations on the genitals, a limited period of action, and with frequent use, the natural vagina may be disturbed, and local dysbacteriosis may develop. Also, they should not be used during pregnancy, as well as during inflammation of the external genitalia .

Incidentally, in order to improve contraceptive effect you can use spermicides simultaneously with the use of a condom, the effectiveness of this method is up to 98% protection against pregnancy and genital infections.

contraceptive sponge distributed in some countries - the USA, England and the Netherlands. A polyurethane sponge with a nylon loop is placed over the cervix and the sponge contains spermicide. The sponge should be inserted a day before sexual intercourse and left in the vagina. The contraceptive sponge protects against gonorrhea And .

Now it has gained wide popularity intrauterine contraception , which began at the very beginning of the 20th century. Initially, this type of contraception consisted of several silk threads twisted into a ring and inserted into the uterus. A little later, instead of silk threads, silver or copper threads began to be used, but the construction was solid and caused pain and difficulty in insertion and extraction. Spirals were made of flexible plastic only in 1960. Today, more than 50 types of IUDs are known, and they differ in rigidity, size, shape, and generations. First-generation intrauterine devices include inert IUDs, such as the S-shaped polyethylene IUD ( Lipps loop ). To date, inert IUDs are banned in most civilized countries due to their low efficiency compared to next generation IUDs. The second generation of this type of contraceptives are copper containing IUDs , the main advantage of which is a fairly high contraceptive efficacy, as well as ease of use. Initially, these IUDs were made of copper, and they had a validity period of 2-3 years. To increase their service life, a silver rod was included in the copper wire, the most popular Navy of this generation are Koper T Ku 380 A, Multiload Ku-150 and Funcoid. The third generation are hormone-containing IUDs . They were created as a combined remedy, combining the advantages of the IUD and oral contraceptives. This type of intrauterine contraception includes the LNG-20 IUD and Progestasert, the helix stem of which is filled or . The use of these IUDs reduces the incidence of inflammatory diseases, but at the same time, discharge between menses .

IUDs have contraindications, they are absolutely contraindicated for those who suffer from acute and subacute inflammatory diseases of the genitals, various malignant processes in the genital organs, as well as pregnancy, including the intended one. The IUD also has relative contraindications, these are anomalies of the genital organs, anemia and some others.

IUDs are usually inserted by the doctor on days 4-6 menstrual cycle(at this time, the woman can already be sure that she is not pregnant) into the cervical canal, which facilitates the manipulation. IUDs can also be inserted a few weeks after birth or at a later date. The IUD is also removed in a hospital setting using a forceps or uterine hook, depending on the type of spiral.

A few days after the establishment of the spiral, an examination is carried out, after which the doctor gives permission for sexual life without any other type of protection other than the IUD. The advantages of intrauterine devices are: they can be used during breastfeeding, IUDs can be used by older women and those who are not recommended to use. IUDs can be used for several years, which is cost-effective. In addition, after the establishment of the spiral, only periodic monitoring by a doctor is necessary. It should be noted that, according to studies, against the background of the use of spirals, the generative function in women is not disturbed, and pregnancy occurs in almost 90% of women within a year after the removal of the IUD.

Adverse reactions to the use of the IUD are pain in the lower back, spotting for several weeks after the establishment of the spiral. Sometimes uterine bleeding may bother you, there may be discharge between periods, and the volume of blood during menstruation may increase. To reduce during menstruation, prostaglandin synthetase inhibitors are prescribed. The risk of inflammatory diseases when using the IUD is especially high in the first 3 weeks after the introduction of the intrauterine device. However, if a woman is sexually promiscuous, then the risk of catching inflammation increases. The rarest, but also the most dangerous type of complication is perforation of the uterus . With perforation of the first degree, when the IUD is partially located in the uterine muscle itself, it is removed vaginally, however, with the second and third degree of perforation, when the spiral is in the uterine muscle or even goes into abdominal cavity, then the abdominal way of removing the spiral is assigned.

It is believed that the Navy is the best remedy contraception for women who have given birth, who have one permanent partner and do not suffer from inflammatory diseases of the genitals.

Intrauterine contraception also has contraindications. The IUD is not inserted in women with diseases of the pelvic organs, with acute gonorrhea , chlamydia , purulent cervicitis , postpartum in the last few months, with cervical erosion, with tumors of the uterus. Also, the spiral is not installed for pregnant women, and those who suspect pregnancy. In addition, the IUD is not recommended for administration in pathological vaginal bleeding and suspected uterine cancer. However, the IUD is a postcoital contraceptive that can be used up to 5 days after unprotected intercourse.

Relative contraindications for the establishment of a spiral are: the presence of ectopic pregnancies in the past, the presence of recurrent vaginal infections, leucorrhea , in diseases that cause weakness immune system, with stenosis of the cervix, as well as with severe anemia, with painful menstruation.

The most common contraceptive method is the use hormonal contraceptives . They are divided into several types. The most common type of hormonal contraceptives are combined estrogenic drugs . They are hopeful, relatively inexpensive and generally well tolerated, and fall into 3 types:

monophasic , which contain a constant dosage and gestagen ;
two-phase , in which one part of the tablets contains estrogen, and the rest - both estrogen and progestogen;
V three-phase oral contraceptives contains a varying dose of estrogens and a gradually increasing dose of progestogens.

Next come, which contain up to 500 mcg of the progestogen component in 1 tablet. They are taken every day, starting from the first day of the cycle. Hormonal contraceptives also include postcoital drugs, which include large doses of progestogen or estrogen. The doses of the active substance here are 50 times higher than in combined estrogen preparations. Postcoital drugs are used within 24 hours after unprotected intercourse. You can't take them often. In addition, it should be noted vaginal rings containing progestogen, which are administered during the 1st or 3rd day of the cycle, and subcutaneous implants ( norplant ) in the form of capsules that release levonorgestrel . They provide contraception for 5 years. Also, not very long ago, an intrauterine device appeared - Rogestasert , which contains levonorgestrel, which is released throughout the year.

As already noted, the most common type of contraception in modern women is taking combined oral contraceptives. Modern combined oral contraceptives contain much less steroids and progestin elements, their dosage has decreased by more than 5 times. Modern preparations contain up to 1 mg norethisterone and 125 mg levonorgestrel. The development of oral contraceptives went through 3 stages, depending on the type of progestogen. The first generation OK contained norethinodrel acetate , in the second generation, the more effective levonorgestrel began to be used instead of norethinodrel. The third generation includes oral contraceptives, which contain , . Oral contraceptives of the third generation do not disrupt the process lipid metabolism , and do not increase the risk of developing diseases of the heart and blood vessels.

Contraceptives block ovulation , change gamete transport and disrupt the functions of the corpus luteum.

It is believed that oral contraceptives prevent pregnancy with a 100% probability, they are simple and convenient to use. It must be remembered that combined oral contraceptives are medicines and should only be used with the permission of your doctor. In any case, each woman is given this lowest dose. steroids providing required level protection. Usually, women are advised to take contraceptives containing no more than 35 micrograms and 150 micrograms of levonorgestrel. And it is the doctor who can determine which women hormonal contraception is contraindicated. So taking oral contraceptives is categorically contraindicated in women suffering from, or who have suffered in the past, various diseases of the cardiovascular system and other vital organs. This , thromboembolism , varicose veins , liver and kidney disease, epilepsy , . This includes malignant tumors of the genital organs, tumors of the mammary glands, cerebral vessels, anemia, severe headaches, various diseases of the gallbladder, and they are also contraindicated for those who have, who suffer from increased blood pressure and smokers, especially over the age of 40.

Usually combined oral contraceptives do not suppress pharmachologic effect other medicines, but some medicines can affect the effectiveness of contraceptives, for example, barbiturates And cyclophosphamide . To date, studies of the interaction of COCs and other medicinal substances are ongoing, therefore it is better to use spermicides simultaneously with oral contraceptives.

Interaction of oral contraceptives with other drugs and medicines:

Alcohol- COCs can enhance the intoxicating effect of alcohol, so you need to use it at the same time with caution.

Antibiotics- Antibiotics can reduce the effectiveness of COCs, especially those with a low content of ethinyl estradiol. It is better to choose another method of contraception.

Under the supervision of a doctor and in the absence of contraindications, a woman can use oral contraceptives for many years in a row.

Side effects when taking oral contraceptives, which are usually observed in the first two months after the start of their use, include the appearance of a headache, fatigue, nausea, weight gain, the appearance of leg cramps, increased irritability, thrombophlebitis , etc.

Unlike COCs, which suppress ovulation and make the cervix impassable to sperm, mini-pills affect the cervical mucus and change the lining of the uterus so that a fertilized egg cannot attach itself to it. The composition of the mini-pill includes microdoses of gestagens (levonorgestrel, norgestrel), and no estrogen. This type of contraception is used every day, starting from the first day of the cycle. The main side effect of taking the mini-pill is the appearance of intermenstrual bleeding. Mini-pills may be given to women with liver disease, hypertension , as well as suffering, with diabetes ,varicose veins .

Contraceptives of the latest generation, or low-dose oral contraceptives, are called norplant, which is 6 capsules that are inserted into the forearm of the left hand and provide a protective effect for 5 years. Also applies in the form of an aqueous suspension medroxyprogesterone acetate , which is introduced into the body in the form of 4 injections. Low-dose oral contraceptives are categorically contraindicated: for those who suffer from heart and vascular diseases, diabetes mellitus, thrombosis , heart defects , ischemia of the heart , liver cirrhosis , liver tumors , during pregnancy and lactation. Low-dose OCs can be used without restrictions for uterine myoma , sexually transmitted diseases , at , epilepsy , iron deficiency anemia .

When choosing the type of hormonal contraception, a woman usually donates blood for, does hemostasiogram , Ultrasound of the pelvic organs, and also receives advice from a mammologist and a therapist.

One of the most reliable remedies for unwanted pregnancy and various sexually transmitted diseases is the combination of a latex condom and spermicides. In this case, protection against HIV infections, various diseases caused by viruses and bacteria is guaranteed. For example, it protects against herpes , chlamydia , trichomonas , gonorrhea and many other diseases.

Many people practice douching after intercourse, but this can only increase the likelihood of infection, because. in this case, there is a high chance of damaging the mucous membranes of the vagina, as well as washing off its protective mucus.

There is no perfect contraceptive. If we prevent the physiological feature of a woman - pregnancy, then there will definitely be side effects. To minimize them, choose contraceptives with a good doctor.

After all, it is right choice contraception affects the course of any other disease, and the effectiveness of methods of protection in this case is different, therefore, when prescribing contraception, a comprehensive examination of the woman's body should be carried out.

If a woman suffers from various genital diseases, then contraception is necessary to avoid the risk of ill health if pregnancy suddenly occurs. by the most best method protection against unwanted pregnancy in diseases of the genital organs is the use of a condom and spermicides. These methods of contraception are available, easy to use, and do not negative impact on the genitals of a woman, as well as their effect is reversible after the end of their use.

Cardiovascular diseases

In diseases of the heart and blood vessels, it is recommended to use female diaphragms in conjunction with spermicides , when used correctly, this method is quite effective. Coitus interruptus or is unlikely to improve the quality of your intimate life. The best method of contraception for cardiovascular diseases is the continuous intake of small doses of gestagens. In minimal amounts, they do not affect blood clotting, however, they can lead to an increase in body weight. In addition, this method can contribute to the violation of the menstrual cycle.

At arterial hypertension , heart failure , if present in the past thrombosis , thromboembolism , with congenital heart defects, rheumatic diseases, as well as the presence of hypertension in one of the relatives, it is strictly forbidden to use combined oral contraceptives. Also unacceptable for use in diseases of the heart and blood vessels, drugs that contain more than 50 micrograms of estrogen. When using oral contraceptives, to reduce the likelihood of thrombosis, you should not use anticoagulants , because at the same time there are changes in blood coagulability. Action norplanta on those suffering from cardiovascular diseases has not been studied. In addition, the use of hormonal birth control pills can lead to hyperplasia, as well as to a decrease in the digestibility of carbohydrates, which is especially dangerous for diabetics.

At cervical cancer the use of OK leads to a deterioration in the condition, as well as the development of glandular squamous cell carcinoma of the cervix.

In the presence of HIV infections The best method of contraception is the use of condoms and spermicides, preferably at the same time. For HIV prevention, a condom can be used in combination with other types of contraception, for example, during sexual intercourse with drug addicts, women of easy virtue and those who are at risk of STDs. Condoms should be used for all types of sexual intercourse ( vaginal , oral , anal ). Also, condoms must be used, even if one of the partners has had a sterilization operation or is in.

When using the IUD, the risks of transmitting other sexually transmitted diseases increase, in addition, it should not be used by HIV-infected people. There are studies that prostitutes who use oral contraceptives as protection are more susceptible to HIV infection.

Education: Graduated from Vitebsk State medical University majoring in Surgery. At the university, he headed the Council of the Student Scientific Society. Advanced training in 2010 - in the specialty "Oncology" and in 2011 - in the specialty "Mammology, visual forms of oncology".

Experience: Work in the general medical network for 3 years as a surgeon (Vitebsk Emergency Hospital, Liozno Central District Hospital) and part-time as a district oncologist and traumatologist. Work as a pharmaceutical representative for a year in the Rubicon company.

He presented 3 rationalization proposals on the topic “Optimization of antibiotic therapy depending on the species composition of microflora”, 2 works won prizes in the republican competition-review of student scientific works (categories 1 and 3).

In addition to the contraceptive effect, combined oral contraceptives (COCs) also have a therapeutic effect. Therefore, they can also be used for therapeutic purposes, which is used in the treatment of many gynecological diseases.

There are three types of COCs:
1) monophasic (contain a constant dose of estrogen and progestogen);
2) biphasic (10 tablets of the package contain only estrogen, the rest contain estrogen and progestogen);
3) three-phase (consist of three types of tablets with different amounts of estrogens and progestogen).

Most often used in medicinal purposes monophasic COCs, since they contain the same, but a large amount of estrogen and progestogen. However, the therapeutic effect of three-phase COCs is also quite significant.

Combined oral contraceptives are used by women, for example, to treat endometriosis. Although they, like other hormonal drugs, cannot contribute to a complete cure for endometriosis, their effect is important for women: oral contraceptives reduce the pain of endometriosis, while suppressing the menstrual cycle and inhibiting the growth of endometrioid tissue.
Since the body of different women may respond differently to treatment with such drugs, it is necessary to consult a specialist before starting to use these contraceptives.

6-8 weeks after the start of treatment with oral contraceptives, as with any other hormonal drugs, it is necessary to consult a gynecologist so that he can follow up on how the treatment is going. After that, every 6 to 8 months you should visit a gynecologist.

Endometriosis of the uterus is considered a dangerous disease that causes infertility. Often affects women of childbearing age. It is mainly treated surgically. But combined contraceptives also provide a good effect.

Contraceptives for endometriosis, acting on cells, inhibit their division. The development of pathology stops, the symptoms of the disease are relieved.

What is endometriosis

Endometriosis is a gynecological disease in which the cells of the inner layer of the lining of the uterine wall (endometrium) grow outside of it.

Most often, growths are observed:

in the lumen of the fallopian tubes;
in the vagina;
on the ovaries;
in the area of the peritoneum of the small pelvis;
on the cervix.

The appearance of the endometrium on the walls is rare. Bladder, intestines or navel.

Can birth control pills be used for endometriosis?

With the development of endometriosis (adenomyosis), treatment requires the use of hormonal drugs. Only a doctor should prescribe them.

Gynecologists most often prescribe injections, intrauterine devices. Capsules and tablets that are allowed to be taken at home are coated, have the least unwanted effects and side effects.

Therapy is prescribed for a long period (up to 1 year). Symptoms and consequences of the disease disappear.

Treatment and prevention

Hormone therapy - best option treatment of endometriosis. Removed not only unpleasant symptoms pathology, but, unlike surgery, the function of childbearing is preserved.

The composition of contraceptives includes synthetic analogues of sex hormones - estrogen and progesterone. Contraception for endometriosis not only prevents conception, but also has a therapeutic effect in the treatment of gynecological diseases.

After a thorough examination and based on the results of the tests, the gynecologist selects the remedy that is most suitable for the woman.

Hormone therapy helps in the treatment of endometriosis only for early stages development of pathology.

Gestagens

These are drugs similar to progesterone. Their main function is to suppress the growth of the uterine mucosa.

Main medications this row are as follows:

Duphaston. Produced in tablet form. It is necessary to take, starting from the 5th and ending with the 25th day of the menstrual cycle.
Bysanne. Take 1 tablet daily. It begins to act after the growth of the endometrium stops, the ovaries stop functioning, menstruation stops.
Orgametril. It is indicated to prevent the development of new foci of pathology and reduce the size of existing ones. It is recommended to take from the 14th to the 25th day of the cycle 1 tablet every day.

Medicines can be given in tablet form or by injection.

Gonadotropin-releasing antagonists

Representative of the class of hormones of the hypothalamus. The appointment of this remedy does not completely cure, but only stops the progression of the disease. This is necessary so that the woman's body can prepare for pregnancy, gestation and childbirth. Assign in cases where surgical intervention is contraindicated.

Buserelin is usually used. It causes a state similar to menopause in the body. The tool is highly effective, but when used for three months, it often leads to the development of osteoporosis.

Antiprogestins

The drugs Danazol and Mifepristone have an overwhelming effect on female hormones. Menstruation stops, which is subsequently restored. They are considered effective means, although they have disadvantages.

There is a manifestation of male characteristics:

the mammary glands are reduced;
hairline appears in places uncharacteristic for a woman;
the patient's weight increases.

Available in the form of capsules and tablets.

Oral contraceptives

The composition of COCs (combined oral contraceptives) includes estrogens and gestagens, thanks to which the body finishes the production of hormones, the endometrium stops developing.

The best contraceptives:

Jeanine;
Jess;
Dimia;
Qlaira;
Yarina.

Taking birth control pills, a woman gets rid of menstruation and evens out the balance of hormones. Estrogen has no other effect on the development of the endometrium. The drugs should be taken strictly at the same time.

Intrauterine devices

Endometriosis in a mild form of development can be cured with the help of spirals. They act locally. Fewer hormones penetrate the body than when taking pills.

At the initial stages of use, a smearing discharge appears. Then the cycle begins to level off, menstruation becomes scarce and less long. Sometimes they stop altogether. With endometriosis, this is considered a positive thing.

Most often, doctors prescribe:

Mirena coil. It perfectly normalizes the cycle, eliminates pain, reduces the duration and volume of bleeding. The active substance (levonorgestrel) acts on the cells of the mucous membrane, reducing the sensitivity of endometrioid tissues to sex hormones, stopping their excessive growth. Not replaced within 5 years, does not grow into the uterine cavity.
Ring NovaRing. It has a similar effect, but its period of use is 30 days. Next, the ring is removed and a new one is inserted. Assign in mild variants of the development of the disease. Great for women over 45.

Spirals are prescribed to maintain a stable state of the uterus and prevent the next growth of endometrial cells.

Mechanism of action

Contraceptives for endometriosis have a positive effect on the woman's body.

Experts distinguish the following mechanisms of action of COCs, taking into account the properties of estrogen and progestogen:

an increase in the viscosity of cervical mucus (gestagens);
inhibition of secretion of gonadotropic hormones (due to gestagens);
reduction of premenstrual pain, blood loss;
protection against unplanned conception;
suppression of endometriosis foci by reducing blood flow in them;
preventing the emergence of new growths;
prevention of inflammatory complications.

The main condition for the use of pharmaceuticals for the conservative treatment of endometriosis is their safety and the absolute absence of severe side effects during long-term use.

Contraceptive shots for endometriosis

When choosing a drug, the gynecologist offers the patient pills or injections.

A hormonal injection is given intramuscularly by a gynecologist.

Reception features: how to choose the right

Before choosing a drug, the doctor refers the patient to an endocrinologist to identify the presence of chronic pathologies, allergies. A mammologist should also examine, because breast cancer is a contraindication for taking COCs. There should be a blood test for hormones and biochemistry.

Preference is given to COCs containing dienogest. This is Bonade and Clayra. Thanks to them, the foci will decrease, this will lead to a regression of the pathology, but less intensively than with the Bysanne preparation.

Qlaira acts as close as possible to the natural cycle of a woman. Adaptation to the drug is more gentle. It is recommended to take patients after 35 years and before the onset of menopause. Take at least 3 months required.

Bonade (Janine) is an oral contraceptive. The package contains 21 tablets, each containing the same dose of progestogen and tarragon. After taking them, they take a break for a week. Therapy should last 3 months, and if necessary, longer.

For patients after 35 years, Qlaira is more often prescribed, and for young and childless patients - Bonade, Jeanine.

The best pills for treatment and protection

The latest generation of medications are considered the most effective for the treatment of endometriosis; with their use, a woman will not be able to become pregnant.

The list includes:

Jeanine;
Duphaston;
Mirena;
Regulon;
Silhouette.

Contraindications

Before prescribing pharmaceuticals, the gynecologist evaluates contraindications to hormone therapy.

The main ones are:

an allergic reaction of the body to medicines;
increased blood clotting;
pathology of the mammary glands;
diabetes;
bleeding of unknown origin;
cervical dysplasia;
kidney disease;
liver pathology;
malignant organ damage;
arterial hypertension;
decrease in the level of platelets and leukocytes.

It is unacceptable to seek help from healers or folk healers who promise a quick recovery without surgery and taking pharmaceuticals. This can only cause harm to health.

Despite the high effectiveness of hormone therapy for many women, such treatment is contraindicated. Mud therapy, herbs and the use of heat on the lumbar region and lower abdomen are strictly prohibited.

It is necessary to balance the diet, including more fresh vegetables and fruits.

The mechanism of action of contraceptive pills is as follows: each pill contains a dose of estrogen and progestogen, which are similar to natural, but not identical. Entering the body regularly, hormones provoke a decrease in the production of their own by inhibiting the synthesis of FSH and LH by the pituitary gland. As a result, the level of own estrogens and gestagens decreases, ovulation does not occur. This is the main contraceptive effect.

In addition to this, there is a thickening of the cervical mucus, atrophy of the endometrium, as a result of which, in the event of fertilization, the fetal egg cannot attach to the wall of the uterus.

Against the background of taking oral contraceptives, the severity of all symptoms of endometriosis decreases: the pain goes away, the amount of discharge decreases, and the spotting no longer bothers. Therefore, for some time it was believed that birth control pills are one of the options for treating endometriosis and preventing the progression of the disease.

However, recent research has shown that taking birth control pills for endometriosis is not only not recommended, but can also lead to the progression of the disease. Indeed, the symptoms of the disease at the time of taking the medication are reduced.

In the initial stages in young girls, including to obtain a rebound effect - natural stimulation of ovulation after discontinuation of the drug.
If dienogest is included in the composition of oral contraceptives as a progestogen component.

Rebound effect after discontinuation of the contraceptive drug

Research recent years found that as a treatment for endometriosis, the most effective drug after agonists and antagonists of gonadotropic hormones (they act at the level of the pituitary and hypothalamus) is "Visanne" based on dienogest.

When taking the medicine for 3-6 months, there is not only a decrease in the severity of all symptoms, but also a decrease in the number and size of endometrioid ectopias. And the effect persists for a long time after discontinuation of the drug.

When choosing birth control pills for the treatment of endometriosis, preference should be given to those containing dienogest. These are "Bonade", "Janine" and "Klayra". It is believed that due to dienogest, endometriosis foci will decrease, which will lead to a regression of the disease, although not as intensely as with the Bysanne monodrug.

"Klayra"- a three-phase drug. The action is as close as possible to the natural cycle of a woman. It is believed that adaptation to such a remedy should proceed more smoothly. Also, "Klayra" is recommended for use by women after 35 years of age until the onset of menopause. You need to take at least 3 months.

"Bonade"(a complete analogue manufactured by another company - "Zhanin") ̶ monophasic oral contraceptive. The package contains 21 tablets, after taking which you need to take a break for 7 days, during which the woman has menstrual-like discharge. Each tablet contains the same dose of estrogen (ethinyl estradiol 0.03 mg) and progestogen (dienogest 2 mg).

During addiction to the drug, acyclic spotting is allowed between the expected days of menstruation. Treatment should last at least 3 months, and if necessary or desired, longer.

Treatment of endometriosis with contraceptives should be prescribed only by a doctor. taking into account the clinical form of the disease, its prevalence, as well as the constitution and preferences of the woman. For women after 35-40 years, preference is given to the appointment of "Klayra", young, especially those who have not given birth, - "Zhanina" ("Bonade").

With endometriosis, other methods of protection can be used. For the treatment of pathology and protection against pregnancy, the Mirena intrauterine system can be used. This is a special spiral that contains a microcapacity with a hormone (gestagen), which is released gradually and in doses over a period of 5 years.

The use of popular oral contraceptives ("Regulon", "Jess", "Yarina", "Zoeli", "Silhouette", "Belara", the vaginal ring "NovaRing" and others) with the established fact of the presence of endometrioid foci is inappropriate. This will lead to an improvement in the woman's well-being, but will not stop the progression of the disease.

The use of a conventional coil is not recommended for endometriosis as this may lead to the progression of the disease. Other methods of protection (spermicidal vaginal tablets, coitus interruptus, condoms) do not affect the course of the disease, but only protect against pregnancy.

For the treatment of endometriosis, other groups of hormonal agents are also used, which do not provide a reliable contraceptive effect, so they cannot be called contraceptives:

Gestagens:, "Susten". On the contrary, they favor the onset of pregnancy. Drugs similar to them, Novinet, Depo-Provera, with prolonged use, can suppress ovulation and thus prevent pregnancy, but it is difficult to find out exactly when this happens. Receiving "Visanna" also does not protect against pregnancy.
Agonists and antagonists of gonadotropic hormones ("Zoladex", "Bucerelin",) already on the 2nd month of admission, as a rule, lead to the absence of ovulation. However, fertility (the ability to conceive) is often restored immediately after the effect of the drug wears off. This is usually one month if the next injection is not given.

Given that all these drugs do not give reliable protection from pregnancy, during treatment it is recommended to use additional methods of protection, since the effect of these drugs on developing fetus it is not established, teratogenic (causing defects) effects are not excluded.

Prescribing birth control for endometriosis, the doctor pursues several goals at once:

reduce the severity of pain during sexual intercourse, during menstruation;
eliminate prolonged spotting on the eve and after menstruation;
reduce the amount of critical days and the amount of blood lost.

The impact on these factors leads to an improvement in the quality of life of a woman.

Read more in our article on birth control for endometriosis.

Read in this article

How birth control pills work

Under the concept of contraceptives, in most cases, oral contraceptives are meant. These are pills that were primarily invented to prevent unwanted pregnancies.

The mechanism of action of contraceptive pills is as follows. Each contains a dose of estrogen and progestogen, which are similar to natural, but not identical. Entering the body regularly, hormones provoke a decrease in the production of their own by inhibiting the synthesis of FSH and LH by the pituitary gland.

As a result, the level of own estrogens and gestagens decreases, ovulation does not occur. This is the main contraceptive effect. In addition to this, there is a thickening of the cervical mucus, atrophy of the endometrium, as a result of which, even in the event of fertilization, the fetal egg cannot attach to the wall of the uterus due to its changes.

Are they used to treat endometriosis?

It has long been noticed that while taking oral contraceptives, the severity of all symptoms of endometriosis decreases: the pain goes away, the amount of discharge decreases, and the daubing on the eve and after menstruation no longer bothers. Therefore, for some time it was believed that birth control pills are one of the options for treating endometriosis and preventing the progression of the disease.

However, recent studies have provided data that have refuted the prevailing opinion. It turns out that taking birth control pills for endometriosis is not only not recommended, but can also lead to the progression of the disease. Indeed, the symptoms of the disease at the time of taking the medication are reduced.

However, there are some exceptions. Birth control pills can be prescribed for endometriosis in the following cases:

In the initial stages in young girls, including to obtain a rebound effect ̶ natural stimulation of ovulation after discontinuation of the drug.
If dienogest is included as a progestogen component in oral contraceptives.
If endometriosis is only suspected, but does not have significant clinical manifestations.

The best birth control pills for endometriosis

Recent studies have found that as a treatment for endometriosis the most effective drug after agonists and antagonists of gonadotropic hormones(they act at the level of the pituitary and hypothalamus) is "Visanne" based on dienogest.

Numerous observations have reliably proven that when taking the drug for 3-6 months, not only does the severity of all symptoms decrease, but also the number and size of endometrioid ectopias decrease. And, most importantly, the effect persists for a long time after the drug is discontinued.

Therefore, when choosing birth control pills for the treatment of endometriosis, preference should be given to those that contain dienogest. These are Bonade, Janine and Qlaira. It is believed that due to dienogest, endometriosis foci will decrease, which leads to a regression of the disease, although not as intensely as with the Byzanne monopreparation.

The effectiveness of "Visanne" in the treatment of endometriosis

"Klayra" ̶ three-phase drug. The action of the drug is as close as possible to the natural cycle of a woman. The package contains 3 types of tablets with different doses of estrogen and progestogen components. It is believed that adaptation to such a drug should go more smoothly, and Qlaira is also recommended for use by women after 35 years of age until menopause.

There is only an assumption that treatment with this oral contraceptive is effective for endometriosis. There are no reliable studies on this. You need to take the drug for at least 3 months.

"Bonade" (a complete analogue produced by another company ̶ Janine)̶ monophasic oral contraceptive. The package contains 21 tablets, after taking which you need to take a break for 7 days. During this, a woman has menstrual-like discharge. Each tablet contains the same dose of estrogen (ethinyl estradiol 0.03 mg) and progestogen (dienogest 2 mg).

Habituation to the drug allows the appearance of acyclic spotting between the expected days of menstruation. Treatment should last at least 3 months, and if necessary or desired to have permanent reliable contraception - longer.

The use of oral contraceptives involves taking pills daily at a strictly fixed time, otherwise protection against pregnancy is reduced.

Watch this video about which hormonal drugs are used in the treatment of endometriosis:

How to choose contraceptives for contraception

Treatment of endometriosis with contraceptives should be prescribed only by a doctor, taking into account the clinical form of the disease, its prevalence, as well as the constitution and preferences of the woman.

The choice of oral contraceptives is small. Women after 35-40 years of age give preference to the appointment of "Klayra", young women, especially those who have not given birth - "Zhanina" ("Bonade").

With endometriosis, other methods of protection can be used. For the dual effect of treating pathology and protecting against pregnancy, an intrauterine system can be used. This is a special spiral that contains a microcapacity with a hormone (gestagen), which is released gradually and in doses over a period of 5 years. The convenience of the Mirena Navy is as follows:

Expert opinion

Daria Shirochina (obstetrician-gynecologist)

The use of a conventional spiral is not recommended for endometriosis, as this can provoke the progression of the disease. Other methods of protection (spermicidal vaginal tablets, coitus interruptus, condoms) do not affect the course of the disease, but only protect against pregnancy.

What hormonal drugs do not protect against pregnancy

For the treatment of endometriosis, other groups of hormonal agents are also used, which do not provide a reliable contraceptive effect, so they cannot be called contraceptives. Namely:

Gestagens̶ "Utrozhestan", "Dufaston", "Susten" - on the contrary, favor the onset of pregnancy. Drugs similar to them, Novinet, Depo-Provera, with prolonged use, can suppress ovulation and thus prevent pregnancy, but it is difficult to find out exactly when this happens.

Agonists and antagonists of gonadotropic hormones("Zoladex", "Diferelin") already on the 2nd month of admission, as a rule, lead to the absence of ovulation, as a result of which pregnancy becomes impossible. However, fertility (the ability to conceive) is often restored immediately after the effect of the drug wears off. Usually it is 1 month if the next injection is not made.

Given that all these drugs do not provide reliable protection against pregnancy, it is recommended to use additional methods of protection during treatment. Since the effect of these drugs on the developing fetus has not been established, teratogenic (malformation) effects cannot be ruled out.

What effect to expect

When prescribing contraceptives for endometriosis, the doctor pursues several goals at once, trying to choose the best from the entire arsenal. Namely:

Reduce the severity of pain during sexual intercourse, during menstruation.
Eliminate prolonged spotting on the eve and after menstruation.
Reduce the number of critical days and the amount of blood lost.

The impact on these factors leads to an improvement in the quality of life of a woman. By prescribing drugs of the usual contraceptive series, it is possible to achieve an improvement in the woman's well-being, but only for the duration of treatment. The use of drugs based on dienogest has greater efficiency and the result is saved for some time.

Contraceptives for endometriosis should be chosen based on the stage of the disease, the woman's complaints, and the results of the examination. It is most rational to use drugs with dienogest in the composition (Bonade, Janine, Qlaira), as well as the Mirena Navy. When prescribing, it is necessary to take into account contraindications, possible side effects.

Useful video

Watch this video about when and how to treat endometriosis:

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

Despite the fact that modern contraceptive pills have the most positive and numerous reviews, disputes about their use continue both among consumers and among specialists. Such disputes are due to a number of side effects that can occur when taking drugs. Often the question arises as to whether it is possible to get pregnant while taking birth control pills. All the problems that have arisen, most often, are explained simply: the questions of how to take birth control pills and which birth control pills should be taken are incorrectly resolved.

The principle of action of hormonal drugs

In general, several conditions are necessary for conception: the maturation and release of the egg (ovulation), its meeting with the sperm in the fallopian tube, the penetration and fixation 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-type contraceptive 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 gaining a foothold on it. Thus, these drugs create the maximum obstacle to conception.

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

Estrogens prevent the maturation of the egg in the follicle, inhibiting pituitary functions, disrupt the structure of the endometrium, increase the peristalsis of the fallopian tubes, inhibit the formation of the corpus luteum, and inhibit the production of their own hormone by the ovaries.
Progesterone increases the density of mucus in the cervical canal, inhibiting the movement of spermatozoa, disrupts the release of statins, blocking the production of GnRH, which inhibits the process of ovulation.

How non-hormonal drugs help

The second direction of contraceptives is non-hormonal contraceptive pills. Such funds, although they are available in the form of tablets, are not taken orally. They belong to the group of vaginal agents and are inserted into the vagina. The composition of the preparations contains an active substance that can suppress the activity of spermatozoa, thereby preventing the fertilization of the egg. In addition, the active component of the tablets increases the density of cervical mucus, blocking the passage of sperm through it.

Thus, the principle of action of non-hormonal drugs is based on a decrease in sperm motility and blocking their movement, without changing the hormonal balance. Benzalkonium chloride and nonoxynol are actively used as active substances. Other ingredients may also be used.

Non-hormonal drugs have less effect on the hormonal female 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 the lower contraceptive ability of such drugs compared with hormonal contraceptives (82-86% versus 98-99%). To increase efficiency, women sometimes additionally use vaginal diaphragms, cervical caps.

Why do we need funds after the act

Another way to prevent unwanted pregnancy is birth control pills after intercourse or postcoital pills. Such funds belong to the so-called emergency protection group. They are used after unprotected sex or after a condom breaks. Postcoital tablets contain 2 types of active substance: levonorgestrel or mifepristone. The principle of operation of the first group is based on blocking the ovulation process, increasing the density 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 abortive effect. When using such a remedy, it should be remembered that the drug is considered hormonal and can significantly affect the hormonal balance.

The second type of drug has pronounced antiprogestogenic properties, which prevents the uterine endometrium from preparing to receive the egg, and also increases the contractility of the uterus, which helps to remove the egg from the cavity.

What hormonal drugs are popular

Hormonal contraceptive pills are available in 2 main types:

combined preparations that include both main hormones;
mini-pill containing only progesterone.

The group of mini-pill drugs belong to a monophasic composition. Combined funds can be two-phase and three-phase. Mestranol and Ethinylestadiol are commonly used as estrogen substitutes. Progesterone is administered using the following substances: Norethindrone, Norgestrel, Levonorgestrel, Norgestimate, Desogestrel, Drospirenone. When contraceptive pills are chosen, the following names are preferred: Jess, Yarina, Tri-Merci, Mercilon, Logest, Jeanine, Regulon, Lindinet, Novinet, Marvelon, Charozetta, Diana 35.

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

microscopic dosing: provide efficiency, no side effects - these are contraceptive pills Jess, Miniziston, Yarina, Lindinet-20, Novinet, Tri-Merci, Logest, Mercilon;
low dosage: Lindinet-30, Silest, Marvelon, Microgynon, Femoden, Regulon, Regividon, Jeanine, Belara,
average dosage: Chloe, Diane-35, Demulen, Triquilar, Triziston, Tri-regon, Milvane;
drugs that require a high dosage and are used with low efficiency of the previous groups: Ovidon, Non-Ovlon.

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

Special allocation funds

Numerous reviews of women highlight the following as the best birth control pills:

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, hirsutism. Designed for women of all ages.
Yarina contraceptive 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. Serious side effects are practically not observed.
Tablets Novinet inhibits ovulation as a result of blocking the production of luteinizing hormone, increases the viscosity of cervical mucus.
Janine is a low-dose drug. It affects all 3 main areas of exclusion of conception. The active substances are ethinylestradiol and dienogest.
The drug Regulon contains ethinylestradiol and desogestrel. The main action is the inhibition of the ovulation process. A positive effect is noted for menstrual irregularities, treatment of uterine bleeding.

High-quality hormonal contraceptives provide very high efficiency with regular use, and strictly according to the recommendations of the instructions and the doctor. Can you get pregnant while taking birth control pills? This probability is estimated below 1%, and even it is associated with violations of the rules of admission and its regularity.

The choice of non-hormonal agents

Contraceptives of a non-hormonal type have lower protective properties, but they are recommended in a number of cases when hormonal drugs are contraindicated: neglected fibroids, breast-feeding 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 noted in the form of vaginal tablets:

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

An important property of these tablets is the simultaneous antifungal and antibacterial protection. They are especially effective against trichomonas, chlamydia, staphylococci, gonococci, proteus and other microorganisms. The disadvantages include a fairly short time of action, which requires an accurate calculation of the time of sexual contact.

Use of drugs after the act

Emergency protection in the implementation of unplanned sex is carried out by hormonal birth control pills after intercourse. different types funds allow you to use them through a different time after contact. Such a gap can be, when high-quality contraceptives are used, 72 hours. However, most drugs are designed to be administered within 20-50 hours.

The following contraceptive pills of this type are distinguished:

funds based on levonorgestrel: Postinor, Escapel, Eskinor F;
tablets containing estrogen and progesterone: Rigevidon, Non-ovlon, Silest, Ovidon;
preparations based on mifepristone: Ginepristone, Mifolian, Genale, Agesta.

When using such contraceptive pills, it should be remembered that the maximum period is 72 hours after sexual contact, but the greatest degree of protection is achieved when the drug is administered during the day. 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 aid, which is not recommended to get carried away. In view of the high content of hormones in them, the risk of serious complications and the occurrence of hormonal imbalance is quite high.

When not to take drugs

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;
with hepatic pathologies of a chronic nature;
with vaginal bleeding of unknown etiology;
with diseases of the endocrine nature;
before the planned surgical intervention for any reason;
after an abortion or miscarriage;
when breastfeeding a child.

With great care and only after consulting a doctor, tablets can be used in such conditions.

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