Those who firmly believe in the harmlessness of hormonal contraceptives are not recommended to read this article - you will find too much negativity in it. At the same time, it is necessary and very important for every woman to know the consequences of taking hormonal drugs that prevent unwanted pregnancies. Possess information, even if it concerns such an unpleasant aspect as , vital. Only in this case it is possible to protect oneself from serious diseases and disturbances in the normal functioning of all body systems, which may result from the use of artificial hormones.
First, some general information. When a person is healthy, when all organs and systems are working normally, all processes in his body are regulated. Therefore, the hormonal background is also in order, since hormones are produced in the required amount.
The harm of hormonal contraceptives lies in the fact that they roughly interfere with this mechanism, fine-tuned by nature itself. And as we know, any violent intervention from the outside cannot but cause negative reactions, consequences, changes.
The use of hormonal contraceptives for several years leads to a rapid aging of the whole organism, which becomes impossible to prevent and stop in the future. But the hardest consequences of taking birth control pills are transferred after the end of the course. The body "gets used" to artificial hormones, and when their amount drops sharply, the entire hormonal system as a whole experiences severe stress. From now on, all the forces of the woman's body are aimed at restoring the ideal balance, but, unfortunately, it is no longer possible to return to the original state. Therefore, after such shocks, the functions of the body finally deteriorate.
Hormones suppress the maturation and release of the egg, damage the function of the ovaries (gonads), and inhibit the regulatory functions of the hypothalamus. That is, natural connections are grossly violated and in their place there are connections of artificial interaction of all parts of the genitourinary (primarily) system. As a result, the ovaries become smaller, the blood vessels in them narrow, and the supply of nutrients decreases. The normal functioning of the ovaries becomes impossible. Exactly the same changes take place in all other parts of the female reproductive system.
Under the influence of contraceptive drugs, changes occur on the uterine lining that can lead to precancerous diseases. The structure of the tissues of the cervix can be damaged so much that it can cause the formation of cancerous tumors. Any deviation in the work of the genital organs is certainly reflected in the structure of the tissues of the mammary glands, as a result of which the risk of adenomas, nodular and diffuse mastopathies, and breast cancers increases.
The harm of hormonal contraceptives oral administration is also observed when they enter the gastrointestinal tract. Tablets become an irritating factor for the mucous membranes of the stomach and intestines, resulting in the development of gastritis, ulcers, duodenitis. The natural flora of the gastrointestinal tract is noticeably disrupted, which leads to diseases such as dysbiosis and colitis.
The liver, pancreas, kidneys - all these important organs are also affected by artificial hormones. Under the influence of toxic substances, which, in fact, are hormonal contraceptives, these organs are destroyed, which causes the occurrence of cirrhosis, hepatitis, liver adenomas, pancreatitis and cholecystitis, diabetes.
Further, the composition of the blood changes, its coagulability increases, and thromboembolism begins. As a result, the risk of myocardial infarction and stroke increases at a young age. As a result of prolonged use of hormonal drugs, the condition of the blood vessels deteriorates, which automatically leads to hypertension, increased blood pressure, etc., the work of the urinary and endocrine systems is disrupted. The functions of the thyroid gland are completely imbalanced, there are noticeable changes in the functioning of the immunological system.
Under the influence of hormonal contraceptives, metabolism is disrupted, that is, a rapid weight gain occurs. The nervous system is also affected, which affects the normal sleep and behavior of a woman. This manifests itself in insomnia, irritability, unreasonable aggression, frequent depression, headaches.
Everything that we talked about is far from a complete picture of all possible negative changes occurring in a woman's body under the influence of hormonal drugs. Of course, in some cases, when hormones are prescribed as a remedy for serious illnesses or as a means for the treatment of infertility, their use is justified. As for contraceptive hormonal drugs, you need to think seven times before choosing for yourself just such a method of preventing pregnancy.
Contraception is not only protection against unwanted pregnancy, but also a way to maintain health and the ability to give birth to the desired healthy child.
Family planning is a priority for contraception. Currently, the choice of modern methods of contraception is very large. It is best to seek the advice of a specialist in choosing a contraceptive method, rather than trying to choose them yourself, since each method has its own contraindications and side effects, which depend on the woman's age.
Incorrectly selected methods of contraception can be not only useless, but also cause complications of the hormonal, genitourinary, cardiovascular systems, as well as the gastrointestinal tract and other systems and organs of a woman. The essence of hormonal contraception is the use of synthetic estrogenic and gestagenic or only progestogenic components, which are analogous to a woman's natural sex hormones. Hormonal contraception is the most effective and most common method of birth control.
There is the following classification of hormonal contraceptives:
- combined estrogen-gestagenic oral contraceptives;
- gestagenic contraceptives:
- oral contraceptives containing microdoses of gestagens (mini-pills);
- injection;
- implants;
- vaginal rings with estrogens and progestogens.
As a result of the action of these contraceptives, growth, development of follicles and ovulation are simply not possible. Progestogens increase the viscosity of cervical mucus, making it impenetrable for sperm, and gestagens slow down the peristalsis of the fallopian tubes and the movement of the egg through them, as a result of which implantation of the ovum, if fertilization does occur, becomes impossible.
Combined contraceptives, depending on the level of ethinyl estradiol, are divided into high-dose (they are not used now), low-dose, micro-dose.
Side effects and complications.
A small percentage are women who, when taking these contraceptives in the first months of taking, experience nausea, vomiting, edema, dizziness, heavy bleeding during menstruation, irritability, depression, increased fatigue, decreased libido. Now such symptoms are considered in the form of adaptation of the body to drugs, they usually disappear by the end of the third month of constant use.
A more serious side effect of taking combined oral contraceptives is the effect on the hemostatic system. The estrogenic component of COCs increases the risk of coronary and cerebral thrombosis. However, this applies only to women at risk, namely, women over 35 years old, smokers, obese, hypertension, etc. It has been proven that the use of these contraceptives does not affect the hemostasis system of healthy women.
Under the influence of estrogen, the level of sugar in the blood rises, resulting in latent forms of diabetes mellitus. Gestagens have a negative effect on fat metabolism, as a result, with an increase in cholesterol levels, the risk of developing atherosclerosis and vascular diseases increases. The influence of modern third-generation COCs, which include gestagens, is exactly the opposite, that is, it does not violate lipid metabolism, but protects the vascular walls. An increase in body weight under the influence of gestagens is not observed when taking modern COCs. Acne, various rashes are possible when taking gestagens with a pronounced androgenic effect. The modern highly selective gestagens used, on the contrary, have not only a contraceptive, but also a therapeutic effect. Remember that combined oral contraceptives cause swelling of the cornea of the eye, which is inconvenient for contact lens wearers.
With prolonged use of combined oral contraceptives, the vaginal microflora changes, which contributes to the development of bacterial vaginosis, vaginal candidiasis. The use of these contraceptives is a risk factor for the transition of cervical dysplasia (if any) to carcinoma. Women taking COCs must have a cervical smear taken for a medical examination. Any component that is part of the COC can cause an allergic reaction. The most common and frequent side effect of COC use is uterine bleeding.
The causes of bleeding may be a lack of hormones for a particular patient (estrogens - when bleeding occurs in the first half of the cycle, gestagens - in the second half). In most cases, such bleeding disappears on its own within the first 3 months of taking COCs and does not require their cancellation. COCs do not have any adverse effect on a woman's fertility. It recovers within the first three months, from the day you stop taking contraceptives. In case of accidental use of COCs in the early stages of pregnancy, side effects were not revealed, and no negative effect on the fetus was observed.
Modern contraceptives provide women with many options that were previously unthinkable. Contraception, planning, choosing a convenient time to start menstruation, reducing discomfort, including pain during "these days" - all this has become available now. The variety of options allows most women to easily find a convenient method of taking contraceptives for themselves. However, many people still do not have enough information about contraception, and in addition, there are a large number of myths in which both women and men believe. Several of these myths were debunked by gynecologists who commented on Business Insider.
Can't get pregnant while taking birth control
Of course, this is not the case. None of the contraceptives provide an absolute guarantee that a woman will not get pregnant. Even sterilization has an efficiency below 100%, albeit more than 99%.
Postcoital contraceptives work 100% of the time
And this is not the case. Emergency contraception in the form of a pill, taken the day after intercourse, delays ovulation, and if there is no egg that could be fertilized, pregnancy does not occur. However, ovulation could already have occurred, and then such pills are useless. There are other emergency contraceptives, such as an intrauterine contraceptive made of copper, but they are less than 100% effective.
Hormonal contraceptives are toxic and unnatural
Yes, hormonal protection has its drawbacks - however, in most cases, the advantages outweigh them. It is necessary to consult a doctor and not prescribe a remedy for yourself - then the likelihood that it will work will be much higher. When, for example, the condition of patients in many cases improves if they take hormonal contraceptives.
You need to take pills at the same time.
Not always. It depends on the type of pill - if they only contain progesterone, then yes, indeed, they need to be drunk on time. Otherwise, the effect of the pill fades away after 26 hours, and barrier contraception must be used to avoid unwanted conception. If the pills contain both progesterone and estrogen, the "window" becomes larger, and a few hours of the difference does not matter. However, doctors still recommend sticking to the same time for taking the pills, so that the appropriate habit is formed.
Lack of menstruation caused by taking birth control is harmful
In some cases, women skip a week of taking the placebo pills and immediately move on to the next pack of contraceptives, and sometimes they leave the hormone ring for four weeks instead of three. Sometimes funds mean a complete absence. All this is safe. The wives themselves may think that the blood stagnates inside in such cases, but this is not so - in fact, there is simply nothing to leave the body, the endometrial layer remains thin.
Intrauterine contraceptives are a mini-abortion
Wrong. Such means interfere with the fertilization of the egg and prevent it from attaching to the uterus. It does not come to abortion - the sperm simply do not have time to meet the egg. A thick layer of mucus is formed, which is aggressive for sperm. Hormone coils work a little differently, but the general principle is the same.
Postcoital contraceptives lead to abortion
Also incorrect for the same reasons as described earlier. The principle of action of a postcoital contraceptive is a delay in ovulation, which means that fertilization does not occur either.
The pills can affect fertility
The pills themselves do not affect fertility, but sometimes women are prescribed them due to irregular menstruation or hormonal imbalances. When a woman stops taking hormonal contraceptives, the problems return, and the same problems may occur as they were before the pills. In addition, fertility declines with age. In any case, the pills have nothing to do with it.
Intrauterine contraceptives affect fertility
Earlier, coils and other contraceptives were made from materials that could cause inflammation in the uterus. Now technology has stepped forward, and these contraceptives are completely safe. In some cases, they may even have anti-inflammatory effects.
Women on oral contraceptives gain weight
If the pills are selected correctly, they do not cause weight gain. Perhaps they appear for completely different reasons - for example, young girls often begin to protect themselves, and they begin to gain weight due to age factors or a change in lifestyle.
From previous publications, we know about the abortive effect of hormonal contraceptives (GC, OC). Recently, in the media, you can find reviews of women affected by the side effects of OK, we will give a couple of them at the end of the article. To illuminate this issue, we turned to a doctor who prepared this information for the ABC of Health, and also translated for us fragments of articles with foreign studies of side effects of HA.
Side effects of hormonal contraceptives.
The actions of hormonal contraceptives, like other drugs, are determined by the properties of the substances they contain. Most birth control pills prescribed for routine contraception contain 2 types of hormones: one progestogen and one estrogen.
Gestagens
Gestagens = progestogens = progestins- hormones that are produced by the corpus luteum of the ovaries (formation on the surface of the ovaries that appears after ovulation - the release of an egg), in small quantities - by the adrenal cortex, and during pregnancy - by the placenta. The main gestagen is progesterone.
The name of the hormones reflects their main function - "pro gestation" = "to [maintain] pregnancy" by restructuring the endothelium of the uterus to the state necessary for the development of a fertilized egg. The physiological effects of gestagens are grouped into three main groups.
- Vegetative effect. It is expressed in the suppression of the proliferation of the endometrium caused by the action of estrogen, and its secretory transformation, which is very important for a normal menstrual cycle. When pregnancy occurs, gestagens suppress ovulation, lower the tone of the uterus, reducing its excitability and contractility ("protector" of pregnancy). Progestins are responsible for the "maturation" of the mammary glands.
- Generative action. In small doses, progestins increase the secretion of follicle-stimulating hormone (FSH), which is responsible for the maturation of follicles in the ovary and ovulation. In high doses, gestagens block both FSH and LH (luteinizing hormone, which is involved in the synthesis of androgens, and together with FSH provides ovulation and progesterone synthesis). Gestagens affect the center of thermoregulation, which is manifested by an increase in temperature.
- General action. Under the influence of gestagens, amine nitrogen in the blood plasma decreases, the excretion of amino acids increases, the secretion of gastric juice increases, and the secretion of bile slows down.
Oral contraceptives contain various gestagens. For a while, it was believed that there was no difference between progestins, but it is now known for sure that the difference in molecular structure provides a variety of effects. In other words, progestogens differ in spectrum and in the severity of additional properties, but the 3 groups of physiological effects described above are inherent in all of them. The characteristics of modern progestins are shown in the table.
Pronounced or very pronounced gestagenic effect is inherent in all progestogens. The gestagenic effect refers to those main groups of properties that were mentioned earlier.
Androgenic activity not characteristic of many drugs, its result is a decrease in the amount of "good" cholesterol (HDL cholesterol) and an increase in the concentration of "bad" cholesterol (LDL cholesterol). As a result, the risk of developing atherosclerosis increases. In addition, virilization symptoms (male secondary sexual characteristics) appear.
Explicit antiandrogenic effect only three drugs have. This effect has a positive meaning - improving the condition of the skin (cosmetic side of the issue).
Antimineralocorticoid activity associated with an increase in urine output, sodium excretion, and a decrease in blood pressure.
Glucocorticoid effect affects the metabolism: there is a decrease in the body's sensitivity to insulin (the risk of diabetes mellitus), the synthesis of fatty acids and triglycerides increases (the risk of obesity).
Estrogens
Another ingredient in birth control pills is estrogens.
Estrogens- female sex hormones, which are produced by ovarian follicles and the adrenal cortex (and in men, also by the testes). There are three main estrogens: estradiol, estriol, estrone.
Physiological effects of estrogens:
- proliferation (growth) of the endometrium and myometrium by the type of their hyperplasia and hypertrophy;
- development of genitals and secondary sexual characteristics (feminization);
- suppression of lactation;
- oppression of resorption (destruction, resorption) of bone tissue;
- procoagulant effect (increased blood clotting);
- an increase in the content of HDL ("good" cholesterol) and triglycerides, a decrease in the amount of LDL ("bad" cholesterol);
- sodium and water retention in the body (and, as a result, increased blood pressure);
- ensuring the acidic environment of the vagina (normal pH 3.8-4.5) and the growth of lactobacilli;
- strengthening the production of antibodies and the activity of phagocytes, increasing the body's resistance to infections.
Estrogens in oral contraceptives are needed to control the menstrual cycle, they do not take part in protection against unwanted pregnancy. Ethinyl estradiol (EE) is most commonly found in tablets.
Mechanisms of action of oral contraceptives
So, given the main properties of gestagens and estrogens, the following mechanisms of action of oral contraceptives can be distinguished:
1) inhibition of the secretion of gonadotropic homones (due to gestagens);
2) a change in the pH of the vagina to a more acidic side (the effect of estrogens);
3) increased viscosity of cervical mucus (gestagens);
4) the phrase "egg implantation" used in instructions and manuals, which hides the abortive effect of HA from women.
Gynecologist's comment on the abortive mechanism of action of hormonal contraceptives
When implanted into the wall of the uterus, the embryo is a multicellular organism (blastocyst). An egg (even a fertilized one) is never implanted. Implantation takes place 5-7 days after fertilization. Therefore, what is called in the instructions an egg cell, in fact, is not at all, but an embryo.
Unwanted estrogen ...
In the course of a thorough study of hormonal contraceptives and their effect on the body, it was concluded that undesirable effects are associated to a greater extent with the influence of estrogens. Therefore, the less the amount of estrogen in the pill, the fewer side effects, but it is not possible to completely eliminate them. It was these conclusions that prompted scientists to invent new, more advanced drugs, and to replace oral contraceptives, in which the amount of the estrogen component was measured in milligrams, came pills with estrogen content in micrograms ( 1 milligram [ mg] = 1000 micrograms [ mcg]). There are currently 3 generations of contraceptive pills available. The division into generations is due to both a change in the amount of estrogens in drugs and the introduction of newer progesterone analogs into the tablets.
The first generation of contraceptives includes "Enovid", "Infecundin", "Bisekurin". These drugs have been widely used since their discovery, but later their androgenic effect was noticed, manifested in coarsening of the voice, growth of facial hair (virilization).
The second generation drugs include "Microgenon", "Rigevidon", "Triregol", "Triziston" and others.
The most frequently used and widespread drugs are the third generation: "Logest", "Merisilon", "Regulon", "Novinet", "Diane-35", "Zhanin", "Yarina" and others. A significant advantage of these drugs is their antiandrogenic activity, which is most pronounced in "Diana-35".
The study of the properties of estrogens and the conclusion that they are the main source of side effects from the use of hormonal contraceptives led scientists to the idea of creating drugs with an optimal reduction in the dose of estrogen in them. It is impossible to completely remove estrogens from the composition, since they play an important role in maintaining a normal menstrual cycle.
In this regard, the division of hormonal contraceptives into high-, low- and micro-dosage drugs has appeared.
High-dose (EE = 40-50 mcg per tablet).
- "Non-ovlon"
- Ovidon and others
- They are not used for contraceptive purposes.
Low-dose (EE = 30-35 mcg per tablet).
- "Marvelon"
- "Janine"
- "Yarina"
- "Femoden"
- "Diane-35" and others
Microdosed (EE = 20 μg per tablet)
- "Logest"
- Mersilon
- "Novinet"
- "Minisiston 20 Fem" "Jess" and others
Side effects of hormonal contraceptives
Side effects from the use of oral contraceptives are always detailed in the instructions for use.
Since the side effects from the use of various contraceptive pills are about the same, it makes sense to consider them, highlighting the main (severe) and less severe.
Some manufacturers list conditions that should be discontinued immediately if they occur. These conditions include the following:
- Arterial hypertension.
- Hemolytic uremic syndrome, manifested by a triad of symptoms: acute renal failure, hemolytic anemia and thrombocytopenia (decreased platelet count).
- Porphyria is a disease in which hemoglobin synthesis is disrupted.
- Hearing loss due to otosclerosis (fixation of the ossicles, which should normally be mobile).
Almost all manufacturers label thromboembolism as rare or very rare side effects. But this grave condition deserves special attention.
Thromboembolism is a blockage of a blood vessel by a thrombus. This is an acutely emerging condition that requires qualified assistance. Thromboembolism cannot occur out of the blue, it requires special "conditions" - risk factors or existing vascular diseases.
Risk factors for thrombosis (the formation of blood clots inside the vessels - thrombi - interfering with the free, laminar blood flow):
- age over 35;
- smoking (!);
- a high level of estrogen in the blood (which occurs when taking oral contraceptives);
- increased blood clotting, which is observed with a deficiency of antithrombin III, proteins C and S, dysfibrinogenemia, Markiafava-Micelli disease;
- trauma and extensive operations in the past;
- venous congestion with a sedentary lifestyle;
- obesity;
- varicose veins of the legs;
- lesions of the valvular apparatus of the heart;
- atrial fibrillation, angina pectoris;
- diseases of the cerebral vessels (including transient ischemic attack) or coronary vessels;
- arterial hypertension of moderate or severe degree;
- connective tissue diseases (collagenosis), and primarily systemic lupus erythematosus;
- hereditary predisposition to thrombosis (thrombosis, myocardial infarction, cerebrovascular accident in close blood relatives).
When these risk factors are present, a woman taking hormonal birth control pills has a significantly increased risk of developing thromboembolism. The risk of thromboembolism increases with thrombosis of any localization, both present and past; with myocardial infarction and stroke.
Thromboembolism, whatever localization it may be, is a serious complication.
| … Coronary vessels → | myocardial infarction | |
| ... cerebral vessels → | stroke | |
| … Deep veins of the legs → | trophic ulcers and gangrene | |
| ... pulmonary artery (PE) or its branches → | from lung infarction to shock | |
| Thromboembolism ... | ... hepatic vessels → | liver dysfunction, Budd-Chiari syndrome |
| ... mesenteric vessels → | ischemic bowel disease, intestinal gangrene | |
| ... renal vessels | ||
| ... retinal vessels (retinal vessels) |
In addition to thromboembolism, there are other, less severe, but still uncomfortable side effects. For example, candidiasis (thrush)... Hormonal contraceptives increase the acidity of the vagina, and fungi reproduce well in an acidic environment, in particular Candidaalbicans, which is a conditionally pathogenic microorganism.
A significant side effect is sodium retention, and with it water, in the body. This can lead to edema and weight gain... Reduced carbohydrate tolerance, as a side effect of hormonal pills, increases the risk of diabetes mellitus.
Other side effects, such as decreased mood, mood swings, increased appetite, nausea, upset stools, fatigue, swelling and soreness of the mammary glands and some others, although not severe, however, affect the quality of life of a woman.
In the instructions for the use of hormonal contraceptives, in addition to side effects, contraindications are listed.
Contraceptives without estrogen
Exists gestagenic contraceptives ("Mini-drank")... In their composition, judging by the name, only progestogen. But this group of drugs has its own indications:
- contraception for lactating women (they should not be prescribed estrogen-progestin drugs, because estrogen suppresses lactation);
- prescribed for women giving birth (since the main mechanism of action of "mini-pili" is the suppression of ovulation, which is undesirable for nulliparous);
- in late reproductive age;
- if there are contraindications to the use of estrogens.
In addition, these drugs also have side effects and contraindications.
Particular attention should be paid to “ emergency contraception "... These drugs contain either a gestagen (Levonorgestrel) or an antiprogestin (Mifepristone) in a large dose. The main mechanisms of action of these drugs are inhibition of ovulation, thickening of cervical mucus, acceleration of desquamation (desquamation) of the functional layer of the endometrium in order to prevent the attachment of a fertilized egg. And Mifepristone has an additional effect - increasing the tone of the uterus. Therefore, a single use of a large dose of these drugs has a very strong one-time effect on the ovaries, after taking the pills for emergency contraception, there can be serious and prolonged menstrual irregularities. Women who regularly use these drugs are at great risk to their health.
Foreign studies of side effects of GC
Interesting studies on the side effects of hormonal contraceptives have been carried out in foreign countries. Below are excerpts from several reviews (translation by the author of the article of fragments of foreign articles)
Oral contraceptives and the risk of venous thrombosis
May 2001
CONCLUSIONS
Hormonal contraception is used by over 100 million women worldwide. The number of deaths from cardiovascular diseases (venous and arterial) among young, low-risk patients - nonsmoking women from 20 to 24 years old - is observed worldwide in the range from 2 to 6 per year per one million, depending on the region of residence assumed cardiovascular -vascular risk and the volume of screening studies that were carried out before prescribing contraceptives. While the risk of venous thrombosis is more important in younger patients, the risk of arterial thrombosis is more relevant in older patients. Among older women who smoke who use oral contraceptives, the number of deaths ranges from 100 to just over 200 per million each year.
Reducing the estrogen dose decreased the risk of venous thrombosis. Third-generation progestins in combined oral contraceptives have increased the incidence of adverse hemolytic changes and the risk of thrombus formation, so they should not be prescribed as first-choice drugs for newcomers to hormonal contraception.
Reasonable use of hormonal contraceptives, including the avoidance of their use by women who have risk factors, in most cases is absent. New Zealand investigated a series of deaths from PE, often due to an unreported risk by doctors.
Reasonable prescribing can prevent arterial thrombosis. Almost all women who had myocardial infarction while using oral contraceptives were either of the older age group, smoked, or had other risk factors for arterial diseases - in particular, arterial hypertension. Avoiding the use of oral contraceptives in such women can lead to a decrease in the incidence of arterial thrombosis, as reported by recent studies in industrialized countries. The beneficial effect that third-generation oral contraceptives have on the lipid profile and their role in reducing the number of heart attacks and strokes has not yet been confirmed by controlled studies.
To avoid venous thrombosis, the doctor asks if the patient has ever had venous thrombosis in the past to determine if there are contraindications to oral contraceptive use and what is the risk of thrombosis while taking hormonal drugs.
Non-dosed progestogenic oral contraceptives (first or second generation) were associated with a lower risk of venous thrombosis than combination drugs; however, the risk in women with a history of thrombosis is not known.
Obesity is considered a risk factor for venous thrombosis, but it is not known whether this risk is increased with oral contraceptive use; thrombosis is rare among obese people. Obesity, however, is not considered a contraindication to oral contraceptive use. Superficial varicose veins are not a consequence of preexisting venous thrombosis or a risk factor for deep venous thrombosis.
Heredity may play a role in the development of venous thrombosis, but its sensitivity as a high-risk factor remains unclear. A history of superficial thrombophlebitis can also be considered a risk factor for thrombosis, especially if it is combined with a burdened heredity.
Venous thromboembolism and hormonal contraception
Royal College of Obstetricians and Gynecologists, UK
July 2010
Do combined hormonal contraception methods (pills, patch, vaginal ring) increase the risk of venous thromboembolism?
The relative risk of venous thromboembolism is increased with any combination hormonal contraceptive (pill, patch, and vaginal ring). However, the rarity of venous thromboembolism in women of reproductive age means that the absolute risk remains low.
The relative risk of venous thromboembolism increases in the first few months after starting the use of combined hormonal contraception. As the duration of the use of hormonal contraceptives increases, the risk decreases, but as a background it remains until the termination of the use of hormonal drugs.
In this table, the researchers compared the incidence of venous thromboembolism per year in different groups of women (per 100,000 women). From the table it is clear that in non-pregnant women and not using hormonal contraceptives (non-pregnantnon-users), an average of 44 (with a range of 24 to 73) cases of thromboembolism per 100,000 women is registered per year.
Drospirenone-containingCOCusers - users of drospirenone-containing COCs.
Levonorgestrel-containingCOCusers - using levonorgestrel-containing COCs.
Other COCs not specified - other COCs.
Pregnantnon-users - pregnant women.
Strokes and heart attacks when using hormonal contraception
New England Journal of Medicine
Massachusetts Medical Society, USA
June 2012
CONCLUSIONS
Despite the fact that the absolute risks of stroke and heart attack associated with the use of hormonal contraceptives are low, the risk was increased from 0.9 to 1.7 when using drugs containing ethinyl estradiol at a dose of 20 μg and from 1.2 to 2.3 - with the use of drugs containing ethinylestradiol in a dose of 30-40 mcg, with a relatively small difference in risk depending on the type of progestogen included in the composition.
Oral contraceptive thrombosis risk
WoltersKluwerHealth is a leading provider of qualified health information.
HenneloreRott - German doctor
August 2012
CONCLUSIONS
Different combined oral contraceptives (COCs) have different risks of venous thromboembolism, but the same unsafe use.
COCs with levonorgestrel or norethisterone (called second generation) should be the drugs of choice, as recommended by the national contraceptive guidelines in the Netherlands, Belgium, Denmark, Norway and the United Kingdom. Other European countries do not have such guidelines, but they are badly needed.
For women with a history of venous thromboembolism and / or with known defects in the blood coagulation system, the use of COCs and other contraceptive drugs with ethinyl estradiol is contraindicated. On the other hand, the risk of venous thromboembolism during pregnancy and the puerperium is much higher. For this reason, such women should be offered adequate contraception.
There is no reason to abstain from hormonal contraception in young women with thrombophilia. Pure progesterone drugs are safe in relation to the risk of venous thromboembolism.
The risk of venous thromboembolism among those using drospirenone-containing oral contraceptives
American College of Obstetricians and Gynecologists
November 2012
CONCLUSIONS
The risk of venous thromboembolism is increased among those using oral contraceptives (3-9 / 10,000 women per year) compared with non-pregnant women who do not use these drugs (1-5 / 10,000 women per year). There is evidence that drospirenone-containing oral contraceptives have a higher risk (10.22 / 10.000) than drugs containing other progestins. However, the risk is still low and much lower than during pregnancy (about 5-20 / 10.000 women per year) and in the postnatal period (40-65 / 10.000 women per year) (see table).
Tab. Thromboembolism risk. 
Another name for birth control pills is oral contraceptives. The principle of action is based on the content of hormonal substances in the preparations, which are close to those produced by the female body.
The main division of currently existing oral contraceptives into monophasic (or mini-pills, i.e. those that contain only one hormone - progesterone) and combined (containing progesterone + estrogen). So an additional dose of hormones enters the woman's body, while the ovulation process is suspended (the development and release of the egg is difficult), and the mucus in the cervix interferes with the activity of sperm.
In general, when choosing contraceptive pills, the doctor takes into account the age, whether the woman gave birth or not, as well as the presence of hormonal disorders in the body.
Mini-pills are taken every day, starting from the first day of your period. If the pill is not taken on time, then its effect ends after 48 hours, and the risk of conception increases significantly.
Combined funds are taken every 12 hours. If this is not done, then it is necessary to take the missed pill, even if it is already time to take the next one. At the same time, the effectiveness of the remedy decreases for the next 7 days, so you will have to use additional contraception. The same applies if you need to take antibiotics while using the tablets.
Contraindications to the use of oral contraception are diseases of the gallbladder and liver, menstrual irregularities in nulliparous women, and malignant tumors. Do not take contraceptive pills during pregnancy, as well as; their use is not recommended for women over 40, as well as for smokers after 35.
Possible side effects of taking oral contraceptives: false pregnancy (nausea, vomiting, breast pain, irritability, headaches, etc.), decreased sex drive, weight gain, thrush.
If side effects are severe, then it is necessary to consult about the possibility of changing the drug. But you can change the drug or stop using it only after the end of the use of the package.
The action of the tablets is significantly hampered by smoking, large doses of alcohol, taking antibiotics, antidepressants, analgesics.
During the period of taking hormonal contraceptives, not only the possibility of pregnancy is reduced to a minimum, but also the menstrual cycle and pain during it normalize, the risk of breast and genital cancers is reduced.
Now about the common myths about the consequences of taking birth control pills. Young girls are not contraindicated in modern contraceptives with a low content of hormones, the effectiveness of which is also high. In addition, the use of oral contraceptives helps to cope with skin problems (pimples and acne on the body and face).
A common claim is that facial hair (mustache and beard) grows from birth control pills. This myth arose at the dawn of the development of oral contraceptives (in the 60s), when the content of hormones in them was quite high. The current drugs exclude this possibility. Tablets with a lot of hormones are intended only for the treatment of gynecological diseases. Another myth is the risk of a significant increase in body weight, which is also associated with a large proportion of hormones in some drugs.
They do not affect the development of infertility, contrary to popular belief.
Experts believe that the period of taking contraceptive pills can be as long as the woman needs and this will not affect her health in any way and will not give harmful consequences. Interruptions in taking oral contraceptives, on the other hand, are undesirable. Since the body has to rebuild from one regime to another.
Pregnancy can occur as early as 1-2 months after the end of taking oral contraceptives.
Rules for taking hormonal contraceptives. The tablets should be taken at the same time every day. Before starting use, carefully study the annotations and clarify all your questions with your doctor. Sufficient protection against unwanted pregnancy is guaranteed only from the time of taking the second package of the drug.
Remember that it is always best to consult your doctor regarding birth control pills and their effects. After all, any advertising will not give you accurate and objective data. This can only be done by a real professional. Remember also that oral contraception will not protect you from sexually transmitted diseases.
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