Such sensitive topic how to receive oral contraceptives, should definitely be discussed with a gynecologist. But if you have questions and have absolutely no one to ask, then we will try to answer them.
Around hormonal contraception There are many rumors and myths that are so scary that they quickly begin to be discussed by girls and women in a narrow friendly circle. But their validity remains questionable, since they are invented by the same women who have no knowledge of gynecology. So that you no longer have doubts, let's dispel these fears and concerns.
Indications for use
Oral contraceptives were invented in the 50s of the twentieth century, and 10 years later, after numerous studies, they were approved for use by women. These were the first pills that became an alternative to other means of contraception, but soon women began to feel other side effects.
Today contraceptives not only protect against pregnancy, but also cure some gynecological and dermatological diseases.
Indications for taking OK include:
- restoration of hormonal levels after childbirth or abortion;
- normalization menstrual cycle;
- women suffering from anemia;
- endometriosis;
- fibrocystic mastopathy;
- with painful periods;
- with PMS;
- ovarian cyst;
- acne;
- alopecia.
Depending on the composition, hormonal contraceptives can lower testosterone in the blood, as a result of which acne and acne disappear, hair loss stops, and the figure becomes more feminine.
What are oral contraceptives?
All birth control pills are divided into 3 groups, each of which is suitable for its age and health condition. They are divided into microdose (20-25 mcg estradiol), low-dose (30-35 mcg estradiol) and high-dose (40-50 mcg estradiol).
Types of OK and their purpose:
- Microdosed. Suitable for young girls, women who have not yet given birth, and people over 35 years old.
- Low dosage. Prescribed to women who have given birth, as well as to girls in whom microdosed OCs caused bleeding.
- Highly dosed. Prescribed for serious hormonal disorders and only in extreme cases.
Estradiol or its derivatives are active ingredient each type birth control pills. And it depends on what the auxiliary hormone is therapeutic effect drug. Drospirenone, dienogest, chlormadinone acetate, cyproterone acetate and levomefolate have antiandrogenic properties, that is, they suppress the production male hormones.
Side effects
Since birth control pills are medicine, they not only have the desired effect, but also cause some side effects. In most cases, they appear extremely rarely, but women with sensitive bodies should be more careful.
Side effects OK:
- feeling of nausea and dizziness;
- frequent mood swings, moodiness and irritability;
- decreased sexual desire;
- migraine;
- prostration;
- swelling and painful sensations in the chest;
- bloody issues.
Typically, these symptoms appear in the first three months of taking OCs, and after the body gets used to the new condition, they disappear. If you experience discomfort for a long time, your spotting does not go away, your head often hurts and you feel dizzy, then OK is not suitable for you and you will have to change it.
Contraindications
Also, hormonal contraceptives have a number of contraindications, without taking them into account, you will only worsen your health condition. Be sure to tell your doctor your medical history and any problems that concern you. this moment so that he can adequately assess the situation and prescribe the correct OC.
Contraindications for use:
- the presence of malignant tumors;
- dysfunction of the liver and kidneys;
- vascular diseases;
- pregnancy;
- hypertension;
- frequent headaches;
- bleeding of unknown cause;
- thrombosis;
- the period before and one month after the operation;
- prolonged immobility;
- breastfeeding period.
If you decide to take birth control pills, then, in order to avoid complications, get rid of the smoking habit, as there is a risk of vegetative-vascular dystonia. You should also consult your doctor if you are overweight or diabetes.
How to choose the right oral contraceptives
When choosing OK, many girls are guided by two principles: price and reviews from girlfriends. This is a fundamentally wrong decision. Since everyone’s body is different and does not have the same level of certain hormones. To choose the right drug, you need to undergo tests and identify the overall picture of the state of the body and hormonal levels. Based on this, the doctor will prescribe the best option.
It is also worth taking into account your wishes and complaints. Acne, hair growing in unwanted places, baldness on the scalp and other cosmetic problems can be solved with the help of birth control pills if chosen correctly. To many hormonal drugs are prescribed in extreme cases of manifestation of these problems.
But the tests taken and an experienced doctor will not give you a guarantee that the body will accept the interference in its hormonal background. If you observe severe side effects, it is better to change the drug. For example, with continuous bleeding, the level of estradiol needs to be increased. Constant headaches and high blood pressure, on the contrary, indicate that the remedy is too “strong” for you.
Today, all birth control pills are available in convenient packages with a calendar printed on them and the days of the week indicated. Therefore, it is difficult to confuse anything. On the first day of your period, you start with a pill that says start above it and then go around in a circle until you take all 21 pills. Drink them at the same time, it’s best to set yourself a reminder on your phone so you don’t miss the next dose. This should be followed by a seven-day break.
For the convenience of women, some manufacturers also produce placebos along with active tablets. There are 7 pieces in a package and they are designed to be taken during a break. That is, when the package contains not 21, but 28 tablets, then the next pack should be started after the end of the previous one, without making a weekly skip.
On the second and third days of the cycle, you can also start taking pills, but they will not give a quick effect, and you will have to take additional protection for some time. You cannot start taking it some time before your period; you must wait until it arrives. This can only be done if you have already drunk at least 2 packs of OK.
Menstruation during the period of taking hormonal contraceptives occurs on the same day, that is, the cycle is exactly 28 days. If you've been drinking them long enough, you can move them away. critical days. When you don't want them to start, just don't take a break. But you shouldn’t abuse it.
When does the effect of OK occur?
If you started taking pills on the first day of menstruation, you can stop using additional methods of protection the next day. If this happened later, you need to wait another week.
Many girls, especially those who are not yet familiar with this method of protection against unwanted pregnancy, fear that it will not be effective. To date this is the most reliable way, which gives a guarantee in 99 percent of cases, but only if you took the pills correctly.
What happens if you forget to take a pill?
Some girls are inattentive and forget to take the next dose of hormones, but remember about it only a few hours later. If this happens, follow the instructions included with the tablets. If more than 12 hours have passed, you need to urgently take a contraceptive and use additional methods of protection for a week.
If this time has not yet expired, then the pill should be taken as soon as possible, but there is no need to worry about a decrease in the effectiveness of the drug. Diarrhea or vomiting several hours after swallowing the pill may affect the effectiveness of the OC, so it is better to take the next pill out of sequence.
It's true that birth control pills make you fat
The myth that hormonal contraception leads to rapid weight gain is based on real facts. The first tablets released contained a large dose of estradiol and could cause this side effect. They also led to accelerated body hair growth and other unpleasant manifestations.
Modern drugs contain tens of times less hormones than they did half a century ago, so they cannot affect metabolic processes in the body and are absolutely safe for your figure.
It is worth talking separately about such a property of OK as getting rid of acne. Today, many doctors consider hormonal contraceptives effective way combat them, especially in adolescence when appearance is very important. This method is safe if you choose the right drug. These should be microdosed OCs with an antiandrogenic effect.
Do not be alarmed if the problem only gets worse in the first month of taking it, as the body gets used to the intervention of synthetic hormones. This side effect should soon go away, and the skin will clear up, become smooth and beautiful.
Does hormonal contraception cause infertility?
Many people believe that if you interfere with the body’s functioning, it will malfunction and will not be able to perform its functions independently. But, in the case of birth control pills, this will not happen.
While we are taking them, the ovaries “rest”, and after completing the course they completely restore their functions in 1-2 months. During this period, they become very active, which, on the contrary, promotes rapid conception.
Is it possible to stop drinking OK?
If something does not suit you or you have found an alternative to this method, you can stop taking the drug after finishing 21 active tablets. It is strictly not recommended to do this in the middle of the pack and is only possible under strict indications.
When you do not drink the full course, it occurs hormonal disbalance, That is severe stress for the body. You will not only make yourself feel worse, but also provoke some diseases.
The decision to start taking OK is a responsible step. Therefore, remember that hormonal drugs cannot be prescribed to yourself, but only after consultation with a gynecologist. Also pay attention to contraindications to avoid health problems. If there are no obstacles to starting treatment, then you can safely try this safe and reliable method contraception.
Video: 4 important questions about the choice and duration of treatment
Hormonal drugs are medications containing hormones or substances that exhibit effects similar to hormonal ones. Natural hormonal medicines are obtained from the glands, blood and urine of animals, as well as from human blood and urine.
Synthetic hormones are produced in pharmacological workshops and laboratories. They can be either structural analogues of true hormones, or differ from them in chemical structure, but exhibit a similar effect.
Around hormonal pills for various purposes almost the most a large number of threatening myths: patients are afraid of infertility, weight gain, excess body hair growth, loss of potency. The list of negative ones is scary and alarming.
How true are myths, and what types exist? hormone therapy?
Hormonal drugs are classified depending on their origin (producing gland) and purpose. Based on their origin, medications are divided into:
- adrenal hormones (cortisol, adrenaline, glucocorticoids, androgens);
- pancreatic preparations (insulin);
- pituitary hormones (TSH, human gonadotropins, oxytocin, vasopressin, etc.);
- thyroid and parathyroid hormones;
- sex hormones (estrogens, androgens, etc.).
Human hormones regulate metabolism in the body. However, if there is a malfunction of one of the organs endocrine system a perfectly adjusted mechanism of correction and interaction may fail, which will have to be eliminated by introducing synthetic analogues of hormones.
According to their intended purpose, hormonal drugs are divided into:
- synthetic substances for replacement therapy (sodium levothyroxine, insulin, estrogens);
- hormonal contraception (synthetic analogues of estrogen and progesterone);
- hormonal agents that inhibit the production of hormones (for example, therapy with pituitary hormone analogues for prostate cancer);
- symptomatic medications (anti-inflammatory, antiallergic drugs).
Hormonal drugs often also include antidiabetic and other non-hormonal drugs.
What is treated with hormonal medications?
Hormone-based medications are used for both chronic and treatable conditions. You cannot do without the help of hormonal drugs when:
- hypothyroidism;
- hyperthyroidism;
- diabetes mellitus type 1, sometimes type 2;
- hormone-dependent tumors of the reproductive system;
- prostate cancer;
- asthma and other diseases associated with the immune response to allergens (including allergic rhinitis);
- endometriosis;
- hormonal imbalances;
- menopause;
- sleep disorders;
- other diseases associated with hypofunction of the glands.
Inflammation and allergic manifestations treated with glucocorticoids. Drugs based on them - Prednisolone, Metipred, Dexamethasone - reduce inflammation and suppress leukocyte function.
They can be used both internally (if systemic action is necessary) and externally (for hemorrhoids, thrombophlebitis, dermatological diseases, allergic rhinitis). When used externally, they are practically not absorbed into the main bloodstream and do not have any effect. negative impact on the body.
Even if the cause of inflammation is unknown, adrenal hormones help relieve swelling, pain and redness. Hormonal anti-inflammatory drugs are among the vital drugs.
Vasopressin and epinephrine may be administered along with anesthetics. Due to their property of constricting blood vessels, these hormones are actively used in anesthesia (including local).
Melatonin also belongs to hormonal drugs. This substance, produced in, has an anti-stress effect, regulates circadian rhythms, affects metabolism, slows down the processes of aging and weight gain, and also stimulates the production of antibodies to infectious agents and tumor cells.
What is hormone replacement therapy?
For chronic conditions associated with dysfunction of the glands or their partial removal, medications with synthetic and natural hormones provide high quality and longevity of the patient’s life.
There are several types of hormone replacement therapy:
- treatment with synthetic thyroid hormones;
- insulin therapy;
- taking analogues of sex hormones.
Deficiency and excess of thyroxine and triiodothyronine are fraught with disturbances in mood, sleep, dry skin, problems with memory and performance, proliferation of glandular tissue and other unpleasant symptoms.
Clinical hypothyroidism is most often associated with diseases and tumors thyroid gland Therefore, replacement therapy with analogues of iodine-containing hormones is prescribed for life.
Substitution therapy uses drugs such as:
- "Euthirox";
- “L-thyroxine” (one of the Russian or German brands).
Treatment of hyperthyroidism has a somewhat more complex scheme: to reduce the synthesis of one’s own iodine-containing hormones, thyreostatics are used, and in particularly difficult cases, removal of part of the gland or radioiodine therapy is justified. Then normal level triiodothyronine and is restored using their synthetic analogues.
Insulin is a hormone of β-cells of the pancreas, the main task of which is to reduce blood glucose levels by regulating its entry into cells and stimulating the conversion of monosaccharides into glycogen.
Impaired functionality of the cells that secrete this hormone is called type 1 diabetes. Patients with such pathology are necessarily prescribed replacement therapy with the drugs “Humodar”, “Apidra”, “Novorapid”, “Actrapid”, “Humulin”, “Insulin Lente”, etc.
For type 2 diabetes, which is associated with impaired tissue sensitivity to insulin, hormone administration may also be prescribed.
Finally, female hormonal replacement therapy (HRT) is a pharmacological replacement of the function of the sex glands (ovaries) lost during their removal or menopause. The most commonly used drugs are:
- "Climodien";
- "Divina";
- "Ovestin";
- "Trisquence";
- "Femoston";
- "Estrofem" and others.
During treatment, androgens, estrogens and gestagens can be used (mainly the last two subtypes of hormones are used in the drugs).
Oral contraception
Oral contraceptives - the most famous hormonal pills for women. The action of OCs is based on their ability to prevent ovulation (the maturation of the egg and its release from the follicle). Synthetic hormones thicken the mucus on the cervix, which complicates the movement of sperm, and also thin the uterine lining (endometrium), which prevents the fertilized egg from firmly attaching.
The triple mechanism of action of hormones reliably protects the patient from unwanted pregnancy: the Pearl index for oral contraceptives (the percentage of pregnancies that occur while taking OCs) does not exceed 1%.
When using oral contraceptives menstrual bleeding do not stop, but become more orderly, less abundant and painful. A certain regimen of hormones allows, if necessary, to delay the onset of menstruation.
Modern contraception classified into three categories:
- Single-component preparations (Continuin, Micronor, Charozetta, Exluton).
- Combined oral contraceptives (COCs). COCs are the most by reliable means. They contain synthetic estrogen () and progestogen (levonorgestrel, desogestrel, norgestrel, etc.).
- Postcoital (emergency) hormonal tablets (Postinor, Escapelle). Emergency contraceptives contain an increased dose of hormones, but are less effective.
The dosages of active hormones in modern contraceptives are much lower than in drugs of the last century, so the side effects of taking estrogen do not appear or appear only slightly.
Combined hormonal contraceptives
COCs are divided into mono-, two- and three-phase. Single-phase COC tablets contain a strictly defined amount of hormones, which does not change during the cycle. Multiphase agents are designed to be more physiological: dosages of active ingredients in tablets for different days cycles are not the same.
Three-phase COCs (with three types of tablets changing per cycle) are often recommended by doctors, but two-phase drugs are practically not used.
Combined contraceptives:
| A drug | Active substance | Manufacturer country |
| Monophasic COCs | ||
| Microgynon | Germany | |
| Miniziston | Germany | |
| Regividon | Hungary | |
| Novinet | Ethinyl estradiol, desogestrel | Hungary |
| Mercilon | Netherlands | |
| Regulon | Hungary | |
| Marvelon | Netherlands | |
| Jess | Drospirenone, ethinyl estradiol | Germany |
| Dimia | Hungary | |
| Yarina | Germany | |
| Logest | Ethinyl estradiol, gestodene | Germany |
| Lindinet 30 | Hungary | |
| Diana-35 | Ethinyl estradiol, cyproterone acetate | Germany |
| Three-phase COCs | ||
| Tri-regol | Levonorgestrel, ethinyl estradiol | Hungary |
| Triquilar | Germany | |
| Triziston | Germany | |
Different dosages of the active substance (levonorgestrel) allow you to adapt to hormonal fluctuations during the menstrual cycle and ensure high degree protection from unplanned pregnancy at low concentration.
Hormonal products for men
Male hormonal drugs are classified into recruiting agents muscle mass, directly medications to suppress the pathological process and hormones for replacement therapy.
In practice, hormones from the adrenal glands (in particular testosterone), pancreas (insulin) and the anterior pituitary gland (somatropin or growth hormone) are actively used. They are used to form muscle relief, accelerate weight gain and burn fat. Reception hormonal drugs without a doctor's prescription has a number of negative consequences, including organ damage excretory system and possible gynecomastia (swelling mammary glands) due to the conversion of excess testosterone into female hormone estrogen.
IN medical purposes hormonal agents are used for hormone-dependent tumors (for example, prostate cancer). Injections with pituitary hormone analogues sharply reduce the production of testosterone, which accelerates growth malignant neoplasm. This procedure is called "medical castration." The introduction of hormones makes it possible to slow down the development of the tumor and resort to more radical methods of treatment. Despite the threatening name, patients should not fear that the procedure is irreversible: some time after the end of treatment, erectile function and normal testosterone levels are restored.
Male hormone replacement therapy can be used both when the gland that produces them is completely removed, or when its functionality is reduced. After 40-45 years, the level of testosterone in a man’s blood begins to decline, which leads to problems in the sexual sphere. To restore potency, the following drugs are used:
- “Testosterone Undecanoate” and “Andriol” (tablets with one active ingredient – testosterone undecanoate);
- "Sustanon" (injection solution with four active ingredients - esters - decanoate, isocaproate, phenylpropionate and);
- "Nebido" (injection oil solution testosterone undecanoate);
- “Androgel” (a product for external use, the active ingredient is testosterone).
After complete removal testicles (due to a tumor of the prostate or gonad), replacement therapy is mandatory.
Attitudes towards hormonal drugs among people who are unfamiliar with medical reference books, predictably biased. Many drugs in this group have strong and a number of contraindications - for example, with long-term use of Prednisolone, rapid weight gain occurs, the face of a patient receiving premedication with this drug swells.
However, this is not a reason to refuse any product containing hormones, including effective birth control pills. When performing several simple rules the risk of complications from taking hormonal drugs is minimized.
Rules for taking hormonal drugs (GP):
- You cannot take GP without a prescription from your attending physician (endocrinologist or gynecologist). Particularly dangerous when self-prescribed are drugs that are classified as synthetic analogues of adrenal hormones.
- Before prescribing to a patient or patient hormonal treatment, the specialist must carefully examine the medical history, the results of blood tests for the concentration of sex hormones and biochemical parameters, results of pelvic ultrasound, mammography, cytological smear. It is necessary to inform your doctor about any existing chronic diseases: some of them are contraindications to taking COCs and other synthetic drugs.
- You should inform your doctor about any changes in your health status.
- Having missed a dose of the drug, it is strictly forbidden to “compensate” for negligence with a double dose of the drug at the next dose.
- It is necessary to take hormone tablets strictly at the same time with minimal errors. Some medications (for example, L-thyroxine) are taken in the morning, on an empty stomach.
- The duration of the course and dosage (including its changes during treatment) are determined by the attending physician.
The effectiveness and safety of hormonal treatment depends on the competence of the endocrinologist, the interaction of the doctor with the patient and strict compliance rules for taking medications.
For many of us, the term “hormonal medications” sounds ominous. In the minds of most people who are not involved in medicine and pharmaceuticals, hormones are monstrous pills that bring a lot of equally monstrous side effects.
What are these fears based on? And if hormones are so harmful, why are they used so widely? Let's try to figure out together what hormonal pills actually are.
Classification
Hormonal medications contain hormones or substances that have properties similar to hormones (hormonoids). Hormones are produced in endocrine glands person and spread through the bloodstream into various organs and systems, regulating vital important functions body.
Hormonal drugs can be divided into hormone preparations:
- pituitary gland
These include human chorionic gonadotropin and oxytocin, probably known to every woman;
- thyroid gland.
These drugs are used to treat insufficient production of one's own hormones (for example, hypothyroidism) and the opposite condition - excess production of hormones;
- pancreas.
The most famous drugs in this group are insulin preparations;
- parathyroid glands;
- adrenal cortex.
This group includes glucocorticosteroids, which are widely used in many branches of medicine as anti-inflammatory, antiallergic and analgesic agents;
- sex hormones: estrogens, gestagens, androgens;
- anabolic agents.
What is treated with hormonal pills?
Despite the very wary attitude towards hormonal drugs on the part of patients, we can safely say that these drugs are extremely necessary and important. Often only hormonal drugs can provide a chronically ill person with a decent quality of life, and sometimes save life itself.
Therapy with hormonal pills is necessary for:
— per oral contraception;
- hormone replacement therapy in postmenopausal women and elderly men suffering from testosterone deficiency;
- treatment of inflammatory and allergic diseases;
- treatment of hormonal deficiency.
These pathologies include hypothyroidism, type 1 diabetes mellitus, Addison's disease and other diseases;
- treatment of many oncological diseases.
Oral contraception. Achievements of modern medicine
The first studies that laid the foundation for the development of hormonal contraceptives were carried out back in 1921. Ten years later, scientists had already precisely clarified the structure of steroid hormones and discovered that high doses of sex hormones inhibit, that is, block ovulation.
The first combined hormonal contraceptive was released in 1960 by American pharmacists. It contained really high doses of hormones, and therefore had not only contraception, but also a lot of side effects.
Over time, the situation has changed dramatically. In the 90s of the last century, hormonoids were synthesized, which, along with high activity, have excellent tolerability. That's why modern women may not worry about extra pounds, gained as a result of taking hormonal contraceptive pills. This side effect is a thing of the past along with the loading doses of active ingredients contained in the first contraceptives.
The effectiveness of all contraceptives is assessed using the Pearl index, which determines the probability of pregnancy within one year with constant use of the drugs. On average, the Pearl index of hormonal contraceptives ranges from 0.3% to 2-3%. The maximum value of this indicator reaches 8%.
If a woman has average fertility and does not become pregnant from her husband's toothbrushes, the chance of pregnancy rarely exceeds 1%. Of course, subject to daily use of the tablets.
However, let's return to classifications. Modern hormonal contraceptives can be:
1. combined;
2. non-combined (mini-pill);
3. emergency contraceptive pills.
Let's try to figure out how these groups differ.
1. Combined hormonal contraceptives: COCs
Behind the funny abbreviation KOK they hide very serious medications, which are the most popular modern contraceptives. All COCs include two active ingredients - estrogen and gestagen. Ethinyl estradiol is used as estrogen, and levonorgestrel, norgestrel, desogestrel and other synthetic hormones can act as a gestagen.
The dose of ethinyl estradiol in modern COCs is much lower than in the first “killer” tablets. Because of this, side effects of estrogen such as weight gain, breast tenderness, and nausea are rare when taking new medications.
Monophasic COCs have a constant dose of estrogen and progestin in each tablet. Despite the fact that during the menstrual cycle the concentration of hormones in a woman’s body is not constant, monophasic contraceptives are a strictly defined dose taken daily.
Biphasic contraceptives contain two types of pills in one package. The main difference between the second type of tablets is increased content gestogen, which is also characteristic of the physiological cycle.
However, three-phase COCs are traditionally considered the most adapted to the menstrual cycle. They include three groups of tablets. The concentration of active substances in each group approaches the content of estrogens and gestagens in a certain phase of the menstrual cycle. The first group of tablets imitates the follicular phase, which lasts 5 days, the second - the periovulatory phase, which lasts 6 days, and the last - the luteal phase, the longest 10-day phase. At the same time, the concentration of estrogen in three-phase COCs, as well as in the menstrual cycle, is maximum, and the level of gestagen increases from the first phase to the third.
Pharmacology: how do hormonal birth control pills work?
The contraceptive effect of all hormonal birth control pills, regardless of composition and dosage, is based on blocking the release of hormones responsible for ovulation and implantation. The ovaries practically “fall asleep”, decreasing in size. Ultimately, hormonal pills:
- suppress ovulation;
- change the properties of cervical mucus. As a result of this effect cervical canal becomes a real barrier for nimble sperm;
- change the state of the endometrium, as a result of which the “lining” inner surface The uterus does not allow the egg to implant if fertilization does occur.
How to take hormonal birth control pills?
The answer to the question of how to take hormonal pills that protect against pregnancy can be expressed in one single word: regularly. Depending on the period for which the course is designed - 21 or 28 days - the tablets should be taken once a day throughout the entire treatment period, preferably at the same time.
An important question that concerns most women taking COCs is what to do if the patient forgot to take the pill on time. First of all, don't panic. The situation is solvable and, in general, very banal.
It is impossible to do without hormonal tablets containing HA in the treatment of allergic diseases, including bronchial asthma. Glucocorticoids can reduce inflammatory reaction and counteract activity immune cells who participate in pathological process. Most often, HA is administered by inhalation, but in some severe cases use hormonal drugs in tablets and ampoules.
Glucocorticoids are certainly included in the treatment regimen for oncological diseases. Their main purpose is to reduce side effects chemotherapy. In addition, hormonal tablets can help destroy cancer cells in lymphoblastic leukemia, Hodgkin's lymphoma, non-Hodgkin's lymphoma and multiple myeloma.
Glucocorticoids in tablets
Most often, several tableted glucocorticoids are used.
The drug effectively reduces inflammation by suppressing the function of leukocytes. Interestingly, the anti-inflammatory effect of Dexamethasone is 30 times greater than the activity of another GC - hydrocortisone.
Dexamethasone tablets are indicated for the hormonal treatment of Addison's disease, hypothyroidism, bronchial asthma, rheumatoid arthritis, nonspecific ulcerative colitis, eczema, malignant tumors in advanced stages.
The dosage of Dexamethasone is selected individually.
The drug is an analogue of hydrocortisone. Prednisolone can affect all stages inflammatory process and have a pronounced anti-inflammatory effect.
There are indeed many indications for the use of Prednisolone tablets - hormonal treatment is prescribed for systemic lupus erythematosus, multiple sclerosis, joint diseases, bronchial asthma, cancer, adrenal insufficiency, allergies, autoimmune pathologies and many others.
The drug produced by the Polish plant Polfa contains triamcinolone GC in a dose of 4 mg. The main indications for Polcortolone include joint diseases, allergic pathologies that are difficult to treat, rheumatic, dermatological, hematological, oncological and other diseases.
Side effects of glucocorticoids
HAs have truly unique qualities. Therefore, glucocorticoids could be called healing drugs, if not for the side effects. Because of large number adverse events Due to treatment, long-term use of these drugs may even be dangerous.
We list the most common side effects of hormonal tablets of the glucocorticoid group:
- decreased immunity;
- increased blood sugar levels. At long-term treatment GK may develop diabetes mellitus;
- decreased calcium absorption, which can lead to osteoporosis - dangerous disease bone tissue;
- amyotrophy;
- increased levels of cholesterol and triglycerides in the blood;
- mood changes, depression, memory impairment, in severe cases - psychosis;
- gastritis and peptic ulcer;
- menstrual irregularities, decreased libido;
- slow wound healing;
- weight gain.
Another extremely unpleasant side of corticosteroids is withdrawal syndrome: after stopping long-term use With hormonal pills, there is a possibility of significant side effects. To avoid such a development of events, medications should be discontinued gradually, gradually reducing the dose over a certain period of time.
Hormonal deficiency: when can you not do without pills?
The most common pathologies that require constant use of hormonal medications are diseases of the thyroid gland.
Thyroid insufficiency - hypothyroidism - is a common disease in which the production of hormones is reduced. Treatment is based primarily on compensating for the lack of hormones. For this purpose, hormonal tablets are prescribed, which include sodium levothyroxine.
Levothyroxine sodium is a levorotatory isomer of thyroxine. It is a synthetic analogue of thyroid hormone. Thyroxine is the first-line medicine for hypothyroidism, euthyroid goiter, and also after removal or resection of the thyroid gland.
Despite the fact that thyroxine is a hormonal medicine, when the correct dosage is prescribed according to indications, there are practically no side effects.
Hormones in oncology: when drugs save lives
Hormonal therapy in oncology, along with chemotherapy, is one of the main medicinal methods cancer treatment. Hormone treatment is used for several types of hormone-sensitive tumors, including breast, prostate, endometrial (uterine cancer), and adrenal cortex.
Most drugs used to treat hormone-dependent tumors inhibit, that is, block the release of hormones. These drugs include one of the most known drugs for the treatment of breast cancer - Tamoxifen.
Many drugs can reduce the production of other hormones that are responsible for growth malignant formation. Often, hormonal treatment is almost the only possibility fight the tumor and prolong the patient’s life.
Hormonal pills are a whole pharmaceutical world, in which there is a place for effectiveness, uniqueness, and side effects. And untie this tangled tangle complex concepts, indications and contraindications can only be given by doctors. Then the correctly prescribed remedy turns out to be the right path to a fulfilling life.
Today, contraception using hormones occupies a leading position in effectiveness among all methods of preventing unwanted pregnancy. These drugs contain estrogens and progestins - synthetically created female sex hormones.
Medicines produced in tablet form, the main ones active ingredients which are hormones used to prevent pregnancy, are called combined oral contraceptives.
Classification
Based on the amount of estrogen and progestin content, contraceptives are:
- Single-phase or monophasic - tablets containing the same amount of hormones are used daily throughout the menstrual cycle. The main drugs of the group have the following names: Regulon, Diane-35, Novinet, Logest. Such drugs are more often used by young people, nulliparous women up to 24–26 years old.
- Two-phase. Preparations with different contents of these hormones. A representative of this group is the drug Anteovin.
- Three-phase. Due to the variable amount of hormones, the drugs imitate their quantitative change in female body. Among the representatives of this group are: Triziston, Triquilar, Tri-regol.
Throughout the menstrual cycle, there are natural fluctuations in the levels of different hormones in a woman's body. By imitating them, three-phase contraceptives are the most physiological; monophasic drugs have this ability to the least extent. But this fact does not indicate the advantage of triphasic hormonal drugs over others. All contraceptives are selected personally.
According to experts, in most cases, monophasic tablets are more suitable for young girls. Women over 27 years of age are predominantly prescribed three-phase contraceptives.
One package of single-phase drugs most often contains 21 tablets, much less often there will be 28. And three-phase drugs, on the contrary, always contain 28 tablets of three different colors.
Based on the quantitative content of estrogen calculated per daily intake, drugs are divided into:
- Highly dosed.
- Low dosage.
- Microdosed.
Operating principle
The progestogen component of the drugs has the main effect of birth control pills.
Any contraceptive contains exogenous estrogen. Its main purpose is to compensate for its deficiency that occurs when taking medications. The predominant formation of estrogen in a woman’s body occurs in the ovaries. Combined oral contraceptives block its synthesis by stopping the growth and maturation of follicles. Fundamental Principle The action of estrogen is to control the course of the menstrual cycle and the physiological reproduction of cells in the uterine mucosa, which is clinically manifested by the absence of intermenstrual bleeding.
The principle of action of birth control pills is the same, regardless of the quantitative value of hormones:
- The development and release of the egg from the follicle is stopped.
- They impede the movement of sperm due to the strong viscosity of cervical secretions.
- They act on the mucous layer of the uterus, preventing the fixation of the embryo.
- Slow down the movement of sperm through the fallopian tubes.
All these mechanisms of influence on conception and further development fertilized egg elevate combined oral contraceptives to the rank of the most effective drugs to prevent pregnancy.
Doctor's help
Different groups of drugs contain different doses of hormones, which determines their specific medicinal effects and side effects. Therefore, personal selection of contraceptives is the task of a gynecologist.
You cannot buy or use combined oral contraceptives on your own without a doctor’s prescription and consultation!
To select a specific drug, the doctor prescribes necessary list examinations to assess risk factors and identify contraindications to taking different groups contraceptives:
- Examination by an obstetrician-gynecologist. Study of the cellular and microbial components of smears taken from the walls of the vagina and cervix. Examination for tumor and infectious diseases.
- Instrumental examination of the pelvic organs using ultrasound (ultrasound). The examination is performed twice after menstruation and before the next one during one cycle. When performing it, the doctor monitors the growth and differentiation of cells in the mucous wall of the uterus, the processes of follicle growth and ovulation. At the same time, concomitant anatomical and functional pathology of the pelvic organs is excluded.
- Examination of the mammary glands. It can be performed by a gynecologist and mammologist.
- Examination of the mammary glands using ultrasound (ultrasound) to exclude tumor formations. According to indications, mammography is prescribed.
- According to indications, it is possible to prescribe laboratory research to control hormone levels in the blood.
Only after conducting strictly individual studies can a doctor select a specific combination oral contraceptive drug for a woman.
Drug selection scheme:
- Survey about transferred and chronic diseases. Collection of information about family diseases. Gynecologist examination data. Using the World Health Organization's universal eligibility criteria, determining whether a given woman is eligible for different types contraception.
- Selection of a drug from a certain group of combined oral contraceptives, based on their properties and required therapeutic effects.
- Within a period of three to four months, monitoring a woman’s health and determining her general condition. Monitoring the effect of hormonal contraceptives. Determination of drug tolerability.
- If side effects or individual intolerance to drug components occur, replace or discontinue the contraceptive.
- Registration of a woman during the period of use of combined oral contraceptives. Scheduled gynecological appointment once every six months.
Symptoms that should alert a woman:
- Heaviness and intense pain in the legs.
- Unbearable pain in the abdomen and chest.
- The appearance of weakness and malaise for one month or more.
- Hearing loss.
- Speech and vision impairment.
If you experience these symptoms, seek medical advice immediately. They may be a manifestation of individual intolerance to drug components or symptoms of a disease, the occurrence of which could be provoked by the use of combined oral contraceptives.
How to take contraceptives?
Oral contraceptives are available in packages of 21 and 28 tablets. Using arrows or indicating the days of the week on the blister, manufacturers determine the order in which they should be taken. Birth control pills begin to work from the first week of taking them.
How to properly take birth control pills containing 21 capsules? To achieve the contraceptive effect of the drugs, they must be used one tablet daily. You need to start taking birth control pills from the first day of your menstrual cycle. At the end of their intake, a pause is made for seven days. After this, they begin a newly purchased pack of contraceptives. During this week, a reaction similar to menstruation appears. During the break, the contraceptive effect of the drugs is maintained, so additional precautions are not required.
It is imperative to start taking birth control pills containing 28 tablets from the first day of the cycle, but they are used without a seven-day interval. After finishing one package, immediately start a new one. A menstrual-like reaction occurs between days 21 and 28 of the cycle.
At the end of a year of taking oral contraceptives, it is necessary to pause their use for three to four months to resume the hormone-producing function of the ovaries. During this period, in order to protect against unplanned pregnancy, it is necessary to use other contraceptive measures.
Remember that combined oral contraceptives are incompatible with a number of other groups of drugs.
These are not compatible with:
- Anticonvulsants.
- Antibacterial drugs.
- Medicines needed to treat lung diseases.
The combined use of these groups of drugs initiates the appearance of side effects and leads to a decrease in contraceptive properties. This is the time when you need to find additional measures protection.
Every time doctors prescribe medications for the treatment of extragenital pathologies, it is necessary to warn about taking combined oral contraceptives.
Research has proven the absence harmful effects on the course of pregnancy and the fetus when using drugs before conception. At the first suspicion of pregnancy, it is necessary to interrupt the use of contraceptives. Occasional use of drugs in the early stages of pregnancy is also not scary. Also, taking them is not a reason to interrupt it.
Upon completion of taking oral contraceptives, adequate functioning of the endocrine-reproductive system is resumed in short time. Short-term use of drugs leads to stimulation of the growth and maturation of eggs by increasing the sensitivity of receptors of the hypothalamic-pituitary-ovarian system. Within a year of stopping the use of oral contraceptives, more than 80% of women become pregnant. This fact corresponds to the level of fertility in the population.
Menstruation appears after stopping the use of oral contraceptives in a period equal to the time of restoration of the uterine mucosa. A small number of women develop amenorrhea (lack of menstruation) lasting up to six months. If such a situation occurs, you should consult a doctor.
What to do if you miss an appointment?
If you forget to take one pill, you must take it immediately. The next dose of contraceptives should be taken at your normal time, even if you need to take two tablets a day. If you are less than 12 hours late in taking the drug, there is no need to use other contraceptive measures. If the time is exceeded, it is possible to use another type of birth control before the start of the next menstruation.
How to take birth control pills if you miss two pills? It is necessary to immediately take them as soon as you remember. The next day you need to take two next pills. Due to the excessive intake of hormones in the blood, spotting may occur. The contraceptive effect of the drugs decreases, which requires the use of other methods of birth control.
If you miss more pills, you should think about abandoning this method of contraception. This is the time when they begin to select and use other methods of birth control.
Prescribing hormonal medications often frightens people. There are many myths surrounding hormones. But most of them are completely wrong.
Myth 1: Hormonal drugs are special birth control pills for women.
No. Hormonal drugs are drugs obtained synthetically. They act similar to natural hormones produced in our body. There are many organs in the human body that secrete hormones: female and male genital organs, glands internal secretion, central nervous system and others. Accordingly, hormonal drugs can be different, and they are prescribed for a wide variety of diseases.
Female hormonal preparations (contain female sex hormones) may have both contraceptive effect, never possess it. Sometimes, on the contrary, they normalize hormonal levels and promote pregnancy. Preparations containing male sex hormones are prescribed to men when the quality of the ejaculate decreases (that is, sperm motility), hypofunction, or a decrease in the level of male sex hormones.
Myth 2: Hormones are prescribed only for very severe illnesses
No. There are a number of mild diseases for which hormonal drugs are also prescribed. For example, decreased thyroid function (hypofunction). Doctors often prescribe hormones in this case, for example, thyroxine or euthyrox.
Myth 3: If you don’t take a hormonal pill on time, nothing bad will happen
No. Hormonal medications must be taken strictly according to the clock. For example, a hormonal birth control pill is valid for 24 hours. Accordingly, you must drink it once a day. There are medications that you need to take 2 times a day. These are some male sex hormones, as well as corticosteroids (for example, dexamethasone). Moreover, it is recommended to take hormones at the same time of day. If you take hormones irregularly, or forget to drink them altogether, the level of the necessary hormone can drop sharply.
Let's give an example. If a woman forgot to take a hormonal contraceptive pill, the next day she should take the forgotten evening pill in the morning, and the next pill in the evening of the same day. If the interval between doses is more than a day (remember: a hormonal contraceptive pill is valid for 24 hours), then the level of hormones in the blood will decrease very significantly. In response to this, slight bleeding will certainly appear. In such cases, you can continue taking birth control pills, but use additional protection for the next week. If more than 3 days have already passed, you need to stop taking hormones, use other contraceptives, wait until your menstruation arrives and additionally consult a doctor.
Myth 4: If you take hormones, they accumulate in the body
No. When a hormone enters the body, it immediately breaks down into chemical compounds, which are then excreted from the body. For example, a birth control pill breaks down and leaves the body within 24 hours: that is why it needs to be taken every 24 hours.
However, hormonal drugs continue to “work” after they are no longer taken. But they influence indirectly. For example, a woman takes hormonal pills for several months, then stops taking them, and in the future she has no problems with her cycle.
Why is this happening? Hormonal medications act on different target organs. For example, female contraceptive pills affect the ovaries, uterus, mammary glands, and parts of the brain. When the pill “leaves” from the body, the mechanism that it started continues to work.
Need to know: The mechanism of prolonged action of hormones is not associated with their accumulation in the body. This is simply the principle of action of these drugs: to “work” through other structures of the body.
Myth 5: Hormonal medications are not prescribed during pregnancy
Discharged. If before pregnancy a woman had hormonal disorders, then during pregnancy she requires medicinal support so that the production of female and male hormones is normal and the child develops normally.
Or another situation. Before the woman became pregnant, everything was fine, but when she got pregnant, something suddenly went wrong. For example, she suddenly notices that intense hair growth has begun from the navel down and around the nipples. In this case, you should definitely consult a doctor who can prescribe a hormonal examination and, if necessary, prescribe hormones. Not necessarily female sex hormones - these could be, for example, adrenal hormones.
Myth 6: Hormonal drugs have a lot of side effects, primarily weight gain
There are practically no medications without side effects. But it is necessary to distinguish between side effects that do not require discontinuation of the drug. For example, swelling of the mammary glands when taking contraceptive hormones is considered normal. Scanty bleeding in the first or second months of use during the intermenstrual period also has the right to occur. Headache, dizziness, weight fluctuations (plus or minus 2 kg) - all this is not a pathology or a sign of a disease. Hormonal drugs are prescribed for a fairly long period. By the end of the first month, the body adapts and everything returns to normal.
But so that it doesn't really happen serious problems associated, say, with blood vessels, before prescribing a medicine and while taking it, it is imperative to be examined and tested. And only a doctor can prescribe you a specific hormonal drug that will not harm your health.
Myth 7: There is always an alternative to hormones
Not always. There are situations when hormonal drugs are irreplaceable. Let's say a woman under 50 has had her ovaries removed. As a result, she begins to age and lose health very quickly. In this case, her body must be supported with hormone therapy until she is 55-60 years old. Of course, provided that her underlying disease (due to which the ovaries were removed) has no contraindications to such a prescription.
Moreover, for some diseases, even a neuropsychiatrist can strictly recommend female sex hormones. For example, with depression.
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