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How to choose oral contraceptives?

Can I do it myself or do I need to go to the doctor? What tests should I take?

The human body has individual characteristics, therefore it is almost impossible to predict the reaction to the appearance of new variables in this system in advance. Prescribing any drug may carry the risk of side effects.

Oral contraceptives (OCs) are a very large group of drugs. Only a doctor can assess how effective and safe the use of birth control pills will be. At the reception, the specialist must interview the patient in detail, talk about the pros and cons of each type of drug, and warn about possible side effects.

There are two types of birth control pills. Combined oral contraceptives (COCs) contain a combination of the hormones estrogen (synthetic or natural estradiol) and progestogen (analogue of natural progesterone) in various dosages. These funds are of three different types:

∙ Monophasic - each tablet contains the same dose of both hormones.
∙ Biphasic - there are two types of tablets in the package with the same dose of estrogen, but the amount of gestagen in them is different. In tablets for the first phase, it is slightly less than in tablets for the second phase of the menstrual cycle.
∙ Three-phase - the package contains 3 types of tablets with different ratios and doses of hormones.

These drugs are very easy to use and, when taken correctly, provide almost 100% protection against unwanted pregnancies.

Modern combined oral contraceptives contain micro doses or low doses of hormones and are well tolerated.

There are also oral contraceptives containing only a gestagenic component, the so-called mini-pills. Their advantage lies in the fact that such hormonal contraception can be used during breastfeeding. Plus, they are suitable for women who have contraindications for taking estrogen. The flip side of the coin is that oral contraceptives containing only gestagens often cause side reactions in the form of smearing bleeding (due to thinning of the endometrium against the background of estrogen deficiency), mood swings, engorgement and heaviness in the mammary glands.

According to the standards of medical care, in order to prescribe hormonal contraception, you must tell your history in detail, answering all the doctor's questions, undergo an examination of the mammary glands and examination on a gynecological chair. If you are in good health and there are no risks, birth control can be prescribed. It will not be superfluous to conduct an ultrasound examination of the pelvic organs and mammary glands, duplex scanning of the vessels of the lower extremities and a blood clotting test , but this is not mandatory .

break from taking the contraceptive pill

Do I need to take a break from taking the contraceptive pill?

No, you don’t need to. Almost all modern hormonal contraceptives contain very low doses of hormones - they can be taken for years. In addition, when using COCs (tablets containing an estrogenic component), the risk of blood clots increases significantly in the first months of use. If you pause taking the pills and then start drinking them again , the period of increased risk of thrombosis increases by several months per year.

How do birth control pills interact with other medicines? Is it true that antibiotics become weaker?

Hormonal contraceptives, especially combined ones, can increase the side effects and toxicity of some drugs. For example, analgin, some antidepressants and tranquilizers, drugs for the treatment of bronchial asthma. They can also weaken the effects of drugs for the treatment of hypertension and some other groups of drugs.

The action of the oral contraceptives themselves can be negatively affected by the intake of drugs that affect the central nervous system by changing the hormonal background.

The only antibiotic that significantly reduces the effectiveness of both estrogens and gestagens is rifampicin. When you take this drug together with any OC, you must additionally protect yourself with a barrier method (condom) throughout the treatment. Most of the known antibiotics can be combined with oral contraceptives, provided that the rules for taking and dosing the drugs are followed .

Can oral contraceptives affect weight loss / gain? Many women say they provoke hunger. Is that so?

Most often, women notice a weight gain of 1-3 kg in the first months of taking OK. During this period, the body adapts to new conditions, against which there may be a slight retention of fluid in the tissues. This is completely normal unless you have dense, tense swelling. In addition , gestagens - an indispensable component of any birth control pill - have some effect on insulin metabolism and, due to changes in blood sugar levels, can cause an increase in hunger.

No modern hormonal contraceptive can cause weight gain if you follow your diet. In order to make it easier to control appetite during the period of adaptation to OK , gynecologists advise keeping a food diary so that you can independently estimate when and how much you eat.

Do birth control pills really increase melanin production and cause age spots?

Contraceptives contain analogs of natural sex hormones, estrogen and progesterone, which, through specific receptors, affect melanocytes, increasing the production of melanin. However, individual sensitivity (the number of receptors to certain hormones on the cell surface; the more there are, the more pronounced the effect these substances have on a particular person) is different for everyone, and the doses of hormones in the most common OC are very low. If you take precautions during periods of high sun activity and use sunscreen, you are unlikely to experience hyperpigmentation.

choose oral contraceptives

How do pills affect the reproductive system? There is whether the risk of infertility (or certain complications) from their reception?

Hormonal contraceptives have a complex effect on the female body:
∙ Block the production of hormones acting on the ovaries in the pituitary gland, suppressing ovulation.
∙ Increase the viscosity of mucus in the cervical canal, which makes it difficult for sperm to move.
∙ Reduce the thickness of the endometrium and change its structure.
∙ They have an effect on the peristalsis of the fallopian tubes.

These mechanisms provide reliable protection against unwanted pregnancies. Modern birth control pills are a completely reversible method of contraception. Most women who stop taking OK can become pregnant within the first month after discontinuation. In other cases, the stabilization of the menstrual cycle occurs within a period of up to 3 months. If, after canceling OK, the cycle has not returned to its usual state, as before the start of taking the pills, for 3 months, you must consult a doctor in order to exclude pregnancy or illness.

Do birth control pills help treat hormonal acne?

One of the factors in the development of acne is the hypersecretion of the sebaceous glands, which occurs both with an increased level of androgens (male sex hormones), and with high sensitivity to them.

There are COCs that contain gestagens that reduce the production of male sex hormones in the body and affect receptors for them. The composition of COCs with an antiandrogenic effect may include one of these hormones:
∙ drospirenone
∙ dienogest
∙ chlormadinone
∙ cyproterone

Most often , drospirenone and dienogest are found in the composition of micro- dose and low-dose tablets . OC with cyproterone is recommended for use in the late reproductive period, and at a young age it is better to choose a drug with a different composition.

Side effects in the form of increased rashes when using antiandrogenic COCs are very rare. However, it is necessary to clearly understand how the pills affect the hormonal background: while you are taking COCs, hormones act on the body, including reducing the number of rashes by suppressing the effects of androgens. When you stop taking COCs, the hormonal balance returns to the level it was before taking the pills.

It often seems to girls that after the abolition of contraceptives, the acne situation has become worse than it was before, but do not forget that acne treatment is a long process, and the main role in it is played by an integrated approach and conscientious observance of all medical recommendations. COCs do not treat acne by themselves, they are prescribed as part of therapy, which must be selected at the reception of a dermatovenerologist.

How does smoking affect the effectiveness of OK? What side effects can there be?

Smoking does not affect the effectiveness of contraceptives in any way , the contraceptive effect does not decrease. Smoking increases blood clotting, estrogen in COCs has a similar effect, which together can lead to thrombosis. With caution should be exercised in the selection of OK, if you smoke more cigarettes per 15 day. In such a situation, it is better to refrain from estrogen-containing pills and opt for drugs containing only gestagens.

Some complain of depression, mood swings and irritability due to the use of contraceptives . Can birth control pills affect mental health?

Birth control pills can affect your mood and overall emotional background. Estrogens stimulate the central nervous system, suppress gestagens. There are observations showing a relationship between the use of OCs containing only gestagens and an increase in the number of depressive episodes in women, but this issue has not yet been investigated in detail. On the contrary, many women report a decrease in PMS symptoms when taking hormonal contraception. This is due to the alignment of the hormonal background and the absence of cyclical changes.

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