Combined oral contraceptives. The New Generation

More and more women of different ages are turning to our Center for the selection of modern contraception. The article is devoted to the most progressive and reliable means, unfortunately, very rarely used in Russia. According to some authors, only four percent, which is explained by insufficient awareness of the population.

Combination pills (combined oral contraceptives – COC) including https://pillintrip.com/medicine/desirett – the most widely used form of hormonal contraception. This article explores the specifics of the use of combined oral contraceptives, statistics of their use in Russia and abroad, the history of their appearance and features of the appointment of contraceptives.
Hormonal contraceptive pills can safely be called a unique discovery of the XX century, which has made a breakthrough in modern contraception. More than 50 percent of women in Europe and America prefer this method of protection against unwanted pregnancy. Unfortunately, in Russia oral contraceptives are not as popular.

According to statistics in Russia, the most common methods of contraception are the condom and interrupted intercourse. Only 4% of women in Russia use modern contraceptives. The most popular in European countries are combined oral contraceptives: 90% of women know about them, 45% have ever used them, and 16% use them now. The % of abortions in these countries is much lower.
The Russian market presents all generations of combined oral contraceptives to the last generation is the preparation of estradiol valerate – 3 mg and dienogest – 2 mg.

The direct protective effect is pro

vided by progestagens – they inhibit ovulation. Estrogen derivatives are necessary to control the menstrual cycle.

Combined oral contraceptives are divided by the content of the main substance (ethinyl estradiol – a derivative of the female sex hormone) into high-dose-50 mg, low-dose-30 mg and micro-dose-20 mg.

Combined oral contraceptives can be monophasic (all pills in a package have the same composition), biphasic and triphasic (pills taken during a menstrual cycle contain different doses of hormones).

Combined oral contraceptives are taken daily for 21 days, starting on the first day of your period. Then take a break for 7 days, during which menstrual bleeding occurs. The combined oral contraceptives inhibit ovulation (i.e. they prevent the maturation and release of the egg), they also thicken the cervical mucus (mucus in the cervical canal), thus making it impassable to sperm, and they change the uterine mucosa so that the fertilized egg can no longer attach to it. Combined oral contraceptives today, undoubtedly, are one of the safest and most effective methods of protection against unwanted pregnancy.

Combined oral contraceptives have a whole range of positive properties: they regulate the hormonal balance of the body – the skin becomes radiant and taut, improves health and mood, reduces the risk of osteoporosis. They reliably reduce the volume of blood loss during menstruation, thus preventing the development or reducing the manifestations of anemia (insufficiency of red blood cells and/or hemoglobin). In addition, these drugs help to normalize an irregular menstrual cycle, and modifications of the regimen allow you to change the time of the beginning of menstruation at will.

Scientists have proven that taking contraceptives reduces the risk of malignant tumors in the gynecological field. Women who use hormonal drugs are 1.5 times less likely to be hospitalized for inflammatory uterine diseases and appendages. Combined oral contraceptives significantly reduce the risk of ectopic pregnancy (mini-pills increase this risk). When taking combined contraceptives, mastopathy (breast pathology) is less common. When you stop taking oral contraceptives, fertility (ability to get pregnant) is restored very quickly.

The development of hormonal contraceptives went the hard way. The first combination drug was Enovid, which appeared on the market in the late 50s. It caused many side effects, mostly inherent to the action of estrogen. It led to the development of thrombosis and neoplasms. Therefore further evolution of hormonal contraceptives followed the way of imitation of the natural process of hormone production in a woman’s body. To do this, it was necessary to reduce the dose of estrogen (because it became clear what they were dangerous) and add artificial progesterone, simultaneously improving its quality and adjusting the dose.

This approach gave life to the next generations of hormonal drugs. They differ from each other in the dose of estrogen (high-dosed contain 50 mcg, low-dosed – 30-35 mcg and micro-dosed – 20 mcg) and the type of imitation of the female body cycle. The first of these are monophasic preparations; they contain the same daily dose of hormones (estrogen and progesterone) for the duration of these drugs. The second type is the more modern multiphase contraceptives.

In the former republics of the USSR, hormonal contraceptives did not appear until the early 1970s, and were, like many other drugs, in short supply. The pills were not produced in the USSR, and were imported mainly from Hungary. The first generation drugs had many side effects. Because of this, a negative attitude toward oral contraceptives developed, which persists to this day. There was a widespread belief that taking OCs led to severe weight gain, increased the risk of breast cancer and provoked male-pattern hair loss.

Today the development of new drugs goes in the direction of reducing the dose of hormones and improving the quality of these substances in the composition of funds, they are increasingly close to the natural hormones of the ovaries. One of the latest innovations offers a different dosage in each pill, varying depending on the day of the cycle and the natural rhythm of hormone release.

Another innovation is the inclusion of estrogen in the contraceptive, not in the form of ethinyl estradiol, but in the form of estradiol valerate. In the body, estradiol valerate is converted directly into the hormone naturally, the same way estrogen is synthesized in a woman’s ovaries and adrenal glands. As a result the preparation has been received, which reliably protects from pregnancy and simultaneously adjusts the menstrual cycle (it becomes regular, shorter, with less intensive discharge). Doses of hormones in this case constitute the lower threshold of the active quantity.

To choose the best birth control pills, it is necessary to visit a doctor. The gynecologist will gather a medical history, separately focusing on family history, existing diseases or suffered in the past, because all of the above may be a contraindication to the use of combined oral contraceptives. The doctor will then conduct an examination, during which he will evaluate:

-skin (telangiosequences, petechiae, signs of hyperandrogenism, presence/absence of hypertrichosis, and others);

– measure weight and blood pressure;

– will palpate the mammary glands;

– prescribe tests for liver enzymes, blood sugar, blood coagulation system;

– Hormone tests, breast ultrasound, ultrasound of the pelvic organs, if necessary, mammography, and then conduct a gynecological examination with smears.

A woman should also visit an ophthalmologist, because long-term use of combined oral contraceptives increases the risk of glaucoma and other eye diseases.

To prescribe the pills that are most favorable to this patient, consider her constitutional and biological type, which takes into account: height, appearance of breasts hair on the pubis skin, hair menstruation and premenstrual symptoms cycle disorders or lack of menstruation, as well as existing chronic diseases.

Contraceptive pills, especially the new birth control pills (new generation) have advantages over barrier contraceptives. But despite all the advantages, the negative consequences of taking hormonal contraceptives are much greater, and they outweigh the arguments for. Therefore the decision whether to take birth control pills, take the doctor and the woman herself, based on the presence of contraindications, possible side effects of these drugs, the general state of health, the presence of chronic diseases. According to the results of many studies taking oral contraceptives (long term), has long-term negative effects on a woman’s health, especially smoking and having any chronic diseases.

Over the past decades, independent American experts have conducted several studies that suggest that taking hormonal contraceptives before having one child increases a woman’s risk of breast cancer and increases her risk of developing liver and cervical cancer. In addition, combined oral contraceptives cause migraine attacks, depression, increase blood sugar levels, contribute to the development of osteoporosis, hair loss, and appearance of body pigmentation. Taking hormonal contraceptives for a long time completely changes the function of the genitals.

Even the absence of obvious contraindications cannot guarantee the safety of combined oral contraceptives for seemingly healthy women.