Answers To Common Questions

Each of us is unique. The human body has individual characteristics, it is almost impossible to predict the reaction to the appearance of new variables in this stable system in advance. The appointment of any drug may be associated with the risk of side effects. Oral contraceptives (OCS) are a very large group of drugs. In order to assess how effective and safe the use of birth control pills will be for you, you should visit a doctor so that you are interviewed in detail at the reception, told about the pros and cons of each type of drugs, warned about possible side effects.

There are two types of birth control pills: (COC) – combined oral contraceptives. They contain a combination of estrogen (synthetic or natural estradiol) and progestogen (an analogue of natural progesterone) in various dosages.

These drugs come in three different types – monophasic (each tablet contains the same dose of both hormones), two-phase (there are two types of tablets with the same dose of estrogen in the package, but the dose of progestogen in them differs, in tablets of the first phase of the cycle it is slightly less than in tablets for the second phase of the menstrual cycle) and three-phase (the package contains three types of pills, the ratio and doses of hormones in them are different). These drugs are very easy to use and, when taken correctly, provide almost 100% protection against unwanted pregnancy. Modern COCs contain microdoses or low doses of hormones and are well tolerated. According to recent studies, the use of COCs as a contraceptive reduces the risk of ovarian, endometrial and colon cancer. However, there are a number of situations in which taking such contraceptives should be treated with caution.

There are also oral contraceptives containing only the gestagenic component, the so-called "mini-pills". Their advantage lies in the fact that such hormonal contraception can be used during breastfeeding, they can be used by women who have contraindications for taking estrogens. But there is also a flip side of the coin – OK, containing only progestogens, more often cause adverse reactions in the form of spotting blood secretions (due to thinning of the endometrium against the background of estrogen deficiency), mood swings, swelling and heaviness in the mammary glands.

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

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

Hormonal contraceptives, especially combined ones, can enhance the side effects and toxicity of certain drugs (for example, analgin, some antidepressants and tranquilizers, drugs for the treatment of bronchial asthma), can weaken the effect of drugs for the treatment of hypertension and some other groups of drugs. Also, the effect of oral contraceptives themselves can be negatively affected by taking medications that affect the central nervous system due to changes in the hormonal background.

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

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 in the body, against this background, there may be a slight fluid retention in the tissues. This is an absolutely normal process if you do not have dense, tense edema. In addition, gestagens are a mandatory component of any contraceptive pills, have some effect on insulin metabolism, and, due to changes in blood sugar levels, can cause increased feelings of hunger. No modern hormonal contraceptive can cause weight gain if you follow a diet. In order to make it easier to control appetite during the period of adaptation to OK, gynecologists advise you to keep a food diary so that you can independently assess what and when you eat.

Contraceptives contain analogues 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 for certain hormones on the cell surface, the more of them – the more pronounced effect these substances have on a particular person) is different for everyone, and the doses of hormones in the most common OK are very low. If you take precautions during periods of high solar activity, using sunscreens, you are unlikely to encounter hyperpigmentation.

How do pills affect the reproductive system? Is there a risk of infertility (or certain complications) from taking them? 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;
• They increase the viscosity of mucus in the cervical canal, which makes it difficult for sperm to advance;
• 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 pregnancy. Modern birth control pills are an absolutely reversible method of contraception.

Most women who have stopped taking OK can become pregnant in the first month after the cancellation. In other cases, the stabilization of the menstrual cycle occurs in the period up to 3 months. If after the cancellation of OK, your cycle has not returned to its usual state as before taking pills for 3 months, you need to consult a doctor in order to exclude pregnancy or illness.

How? What should be included in their formula? Is there a risk of side effects - is it possible that the situation with rashes will only worsen from taking birth control pills? If you stop taking pills, can acne appear again?

One of the factors of acne development is 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 progestogens that reduce the production of male sex hormones in the body and affect their receptors. The composition of COCs with an antiandrogenic effect may include one of these hormones:

• Drospirenone;
• Dienogest;
• Chlormadinone;
• Ciproterone.

Most often, drospirenone and dienogest are found in the composition of microdosed and low-dose tablets. OK with ciproterone is recommended for use in the late reproductive period, 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 finish taking the COC, the hormonal background returns to the level it was before taking the pills. It often seems to girls that after the abolition of contraceptives, the situation with acne 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 implementation of all medical recommendations. COCs do not treat acne by themselves, they are prescribed as part of therapy, which must be selected at a dermatovenerologist's appointment.

Smoking does not affect the effectiveness of contraceptives in any way, the contraceptive effect does not decrease. Smoking increases blood clotting, estrogen in the composition of COC has a similar effect, which together can lead to thrombosis. Caution should be taken with the selection of OK if you smoke more than 15 cigarettes a day. In such a situation, it is better to refrain from estrogen-containing tablets and opt for drugs containing only progestogens.

Some complain of depression, mood swings and irritability due to taking contraceptives.

Birth Control pills can affect mood and overall emotional background. Estrogens stimulate the central nervous system, progestogens suppress.

There are observations showing a link between taking OK containing only progestogens and an increase in the number of depressive episodes in women, but this issue has not yet been investigated in detail. Many women, on the contrary, note 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.