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Contraceptive pills reliably protect a woman from an unplanned pregnancy and can help in the treatment of gynecological diseases. Together with an expert, we will figure out which contraceptive pills are considered the most effective, how they work and who can take them.
Any contraceptive for oral use contains synthetic analogues of female sex hormones – gestagens and estrogens. There are monopreparations, which include only gestagens. These are the so-called one-component products or mini-pills. Pills based on gestagens and estrogens are called combined oral contraceptives or COCs.
Minipill and COCs have different mechanisms of action. The former change the structure of the uterine mucosa and interfere with the attachment of a fertilized egg, and also increase the viscosity of cervical mucus and reduce sperm motility1. COCs work differently – they affect the pituitary gland and suppress ovulation, that is, the process of maturation of the egg1.
Single-component birth control pills are usually prescribed to women who are contraindicated in drugs with estrogens.1. Mini-pills are less reliable than COCs, but have fewer side effects and contraindications. They are suitable for women from the “risk group” – with high blood pressure, diabetes, migraines, liver diseases.1. Mini-pills can be taken as early as 6 weeks postpartum and during lactation1.
COCs have a greater effect on the reproductive system and the body as a whole – both in a positive and negative sense. They are prescribed not only for contraception, but also for therapeutic purposes.
Combined drugs are divided into monophasic, biphasic and triphasic. Monophasic contains the same dose of hormones in each tablet. In biphasic, the first 10 tablets contain only estrogen, and the remaining 11 contain estrogen in combination with a progestin. In three-phase COCs, the dose of gestagens increases gradually, and the concentration of estrogens changes and reaches a maximum in tablets that are taken in the middle of the cycle.
List of top 5 effective and inexpensive birth control pills for women
Together with an expert, we have selected 10 effective birth control pills for women of all ages. The rating contains single-component drugs and combined oral contraceptives, which are prescribed to prevent pregnancy, treat and prevent gynecological diseases.
We remind you that all birth control pills are available by prescription and, if taken uncontrolled, can cause serious harm to health.
Mini pili
Another name for this group is oral gestagens or progestogen-containing tablets (PST). As mentioned above, mini-pills contain only one type of hormone – gestagens (usually desogestrel or linestrenol).
Mini-pills have a complex effect: they reduce the production of certain hormones and inhibit the process of ovulation, change the structure of the uterine mucosa, increase the viscosity of cervical mucus and slow down the movement of “cilia” in the fallopian tubes. Because of these changes, unfavorable conditions for conception are created.
Compared to COCs, minipills provide less reliable contraception, but have fewer contraindications. They can be taken during lactation and in the first 6 weeks after childbirth. Mini-pills can be prescribed to women at risk: smokers, those with hypertension, obesity and diabetes.
Contraindications for use : venous thromboembolism, hypersensitivity to gestagens, malignant hormone-dependent tumors, pregnancy, vaginal bleeding of unknown origin.
Combined oral contraceptives
Combined oral contraceptives block ovulation, change the composition and structure of cervical mucus, and thereby minimize the likelihood of unwanted pregnancy. Among the advantages of COCs are ease of use, effectiveness, the ability to control the menstrual cycle and the lack of connection with sexual intercourse 2 .
In addition, COCs also have a therapeutic effect: they help reduce menstrual pain, blood loss and manifestations of PMS, reduce the incidence of inflammatory diseases of the pelvic organs. There are COCs with antiandrogenic activity, which are prescribed to patients with elevated levels of male sex hormones.
The disadvantages of COCs include possible side effects: headache, irritability, nervousness, increased blood pressure and blood viscosity, weight gain and the development of edema.
Contraindications : venous and arterial thrombosis, venous and arterial thromboembolism, diabetes mellitus, migraine, liver failure, uncontrolled arterial hypertension, pregnancy, lactation.
All COCs contain an estrogenic component (synthetic or natural ethinyl estradiol) and synthetic gestagens. Not so long ago, COCs appeared on the market that contain estrogens that are identical to natural ones. They are much less likely to cause side effects and are suitable for older women.
Depending on the composition, type of progestogen, dosage of ethinylestradiol, all COCs are divided into several groups.
Monophasic
Monophasic COCs contain a constant dose of estrogen and progestogen in each tablet. Such drugs are often prescribed to young girls with an unstable menstrual cycle.
Polyphase
Multiphasic COCs contain different dosages of hormones. Currently, three-phase COCs are used, which include 3 types of tablets with different ratios of gestagens and estrogens. Taking these pills allows you to simulate the hormonal fluctuations characteristic of a normal menstrual cycle.
Low dose
Low-dose COCs contain 30–35 micrograms of ethinyl estradiol. COCs from this group are the drugs of choice for hormonal contraception in women of reproductive age, in the absence of contraindications 2 .
Microdosed
The content of ethinylestradiol in these preparations is 20 mcg. Microdosed COCs are easier to tolerate and have a minimal effect on metabolism, therefore they do not lead to an increase in body weight and the development of edema. They can be recommended for women over 40 without cardiovascular or liver disease.
How to choose birth control pills for women
Most drugs from the rating are generics that are more affordable financially. – He speaks Elena Kollerova. But if possible, I advise you to purchase original drugs and, of course, as directed by a doctor.
When choosing a drug, the doctor takes into account:
- age;
- the presence of pregnancy and childbirth;
- hormonal background and characteristics of the body;
- sexual activity.
In addition to the contraceptive effect, oral contraceptives (OC) have a therapeutic effect. For example, some of them increase the level of female hormones and reduce the excess of male ones. To choose the right drug, the doctor may recommend:
- study of the hormonal background;
- blood clotting test;
- Ultrasound of the mammary glands;
- Ultrasound of the veins of the lower extremities;
- Ultrasound of the pelvic organs (gynecology);
- blood biochemistry test;
- analysis for oncocytology from the cervix;
- extended colposcopy.
A detailed and careful history taking allows you to exclude contraindications and risks, as well as to get the maximum effect from oral contraceptives.
Birth control pills are contraindicated in:
- possible or definite pregnancy;
- pathologies of the liver and kidneys;
- problems with the cardiovascular system;
- hypertension II or III degree;
- tumors of the mammary glands;
- pathologies of cerebral vessels;
- tumors of the endocrine and genital organs;
- diabetes mellitus with complications;
- smoking, especially over the age of 35;
- diseases that cause thrombosis;
- in the postpartum period (the first 1,5 months).
Reviews of doctors about birth control pills for women
The opinion of doctors about hormonal oral contraceptives remains ambiguous. Some believe that contraceptives have a negative impact on a woman’s gynecological health. Other experts believe that when used effectively, the pros of hormonal contraception outweigh the cons.
As expert Elena Kollerova notes, gynecologists prescribe combined oral contraceptives not only to prevent unwanted pregnancy, but also to treat:
- menstrual irregularities;
- ovulatory syndrome – pain in the lower abdomen, nausea, mood swings during ovulation;
- menorrhagia – excessively heavy menstruation.
COCs reduce the risk of developing benign breast masses, pelvic inflammatory disease and functional cysts, as well as reduce the likelihood of malignant tumors in the ovaries by 40% and endometrial adenocarcinoma by 50%.
Popular questions and answers
Unplanned conception and gynecological diseases are problems that concern many women. Birth control pills can help in both cases, but do not forget about contraindications and side effects. Obstetrician-gynecologist Elena Kollerova answers popular questions about the use of birth control pills.
Is it harmful to take contraceptives for a woman?
How does the body behave after the abolition of birth control pills?
How do birth control pills affect weight?
Sources of:
- Vidal. Encyclopedia. Hormonal contraception. https://www.vidal.ru/encyclopedia/gynecology/hormone-contraception
- Reference book of medicines. Charosetta. https://www.vidal.ru/drugs/cerazette__4467
- Vidal. Reference book of medicines. Lactinet-Richter. https://www.vidal.ru/drugs/lactinette-richter__24218
- Vidal. Reference book of medicines. Marvelon. https://www.vidal.ru/drugs/marvelon__40074
- Register of medicines of Russia. Chloe https://www.rlsnet.ru/drugs/xloe-35238
- Register of medicines of Russia. Vidora Micro https://www.rlsnet.ru/drugs/vidora-mikro-66556.
- Vidal. Reference book of medicines. Novinet. https://www.vidal.ru/drugs/novynette__1643
- Vidal. Reference book of medicines. Dimia. https://www.vidal.ru/drugs/dimia__32670
- Vidal. Reference book of medicines. Tri Mercy. https://www.vidal.ru/drugs/tri-merci__13152
- Vidal. Reference book of medicines. Belara. https://www.vidal.ru/drugs/belara__2719
- Vidal. Reference book of medicines. Qlaira. https://www.vidal.ru/drugs/qlaira__30035