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The combined oral contraceptives
November 4, 2012
In recent years the combined oral contraceptives are widely used for protection from undesirable conception. Hormonal contraceptives by right are considered as one of the most effectively influencing and at the same time well-tried remedies. Besides, such contraception exerts a positive impact on a female organism, strengthening reproductive health.
For understanding of the mechanism of influence of such contraceptives it is necessary to address physiology of an organism of the woman. All changes which in it happen are cycling and through an accurate span repeat. The cycle is time of the first day of periods prior to the beginning of the following bleeding. The cycle can proceed from 21 to 35 days, however at most of women it makes 28 days. The ovulation comes in the middle of a cycle. At this time the mature ovum leaves an ovary. On condition of its connection with a spermatozoon there is a conception. All these processes are regulated by estrogen and progesterone. Throughout a cycle the ratio of these sex hormones changes several times.
How work the COOK?
Action of the combined oral contraceptives is based on influence on an organism of sex hormones. The combined oral contraceptives (in abbreviated form the COOK) consist of synthetic analogs of hormones of estrogen and progesterone. Depending on amount of active ingredients in drug and their ratios such means subdivide into single-phase, two-phase and three-phase drugs. These are the best oral kontartseptiva for modern women as it is possible to pick up them depending on specific features of an organism.
Three-phase the COOK contain such amount of hormones which as much as possible approaches natural fluctuation of estrogen and progesterone in the woman's organism. In two-phase oral contraceptives the ratio of sex hormones changes twice, and it already has a certain distinction with natural processes of a female organism. But, defining, what means to choose, the woman has to consider that single-phase contraceptives least answer natural processes. But in general all the COOK influence the woman's organism equally, without allowing undesirable pregnancy.
Therefore, recommending to the woman reception of these means, the doctor pays special attention to individual portability of such drugs. In certain cases the organism which is normally perceiving the single-phase combined contraceptives negatively reacts on three-phase, means. But in general modern the COOK are so positively perceived by a female organism that their use is allowed from the beginning of sexual life and till the period of a menstrual pause. In the period of a climax oral contraceptives can be applied as replaceable hormonal treatment to the prevention of pathological changes in tissue of bones and cartilages which happen because of calcium loss.
The COOK have several ways of impact on an organism owing to what the contraceptive effect takes place. First of all, under their influence the ovulation therefore the ovum does not ripen is suppressed and does not leave in a uterine tube. Also drugs of this type change structure of a secret of a neck of uterus. At a normality this secret promotes penetration of spermatozoa into a uterus, and owing to influence the COOK it turns into more dense and viscous weight. As a result, spermatozoa cannot get inside, besides they become almost impractical, getting into a neck of uterus. Besides, at reception of such contraceptives the structure of a mucous uterus considerably changes: the cover utonchatsya considerably. Therefore, even if fertilization process nevertheless will happen, then the ovum with an embryo will not be able to be attached to a uterus wall. Thus, the triple level of influence the COOK guarantees the high level of protection against undesirable conception. According to statistical information at reception of oral contraceptives on 100 women 0,1 pregnancies are fixed.
Hormonal contraceptives are also an efficient prophylactic for the prevention of a number of diseases of the gynecologic sphere, a hormonal imbalance. Also reception of these means facilitates a current of periods, reducing amount of the emitted blood.
As it was already told above, hormonal contraceptives are subdivided into several versions. Single-phase oral contraception has identical amount of synthetic analogs of progesterone and estrogen as a part of all tablets of packaging. Drugs Mersilon, Marvelon, Regulon, Novinet, Diane-35, Logest, Femoden, Silest, Ovidon, Rigevidonum, Non-Ovolon, Miniziston belong to the COOK this type. Such contraceptives are a suitable method of protection for the young not giving birth women. Basic distinction of the transferred funds are doses of hormones which contain in them. Therefore an important condition is individual selection of such means at which also the general state of health of the woman is surely considered, and existence of chronic illnesses and pathologies, and, at last, an opportunity to get more expensive contraceptives.
Speaking about two-phase means, it should be noted that this category includes less drugs. Anteovin contains in drug ethinylestradiol and levonorgestrel. Two-phase contraceptives, except the main influence, promote treatment from acne rash, seborrhea. The matter is that these illnesses are often provoked by too high content of androgens in an organism, contraceptives allow to balance the content of hormones. Specialists define two-phase the COOK as intermediate drugs between single-phase and three-phase means.
Three-phase hormonal contraception allows to simulate a natural menstrual cycle, to contain in drug hormones in the ratio, as close as possible to physiological. Drugs Trikvilar, Triziston, Trinovum, Tri-Regol belong to this group. These drugs contain hormones in different ratios. Such means positively influence an organism in the presence of initial dysfunction of ovaries and other diseases. Three-phase the COOK is recommended to accept to women after 27-year age.
How to accept the COOK?
Hormonal contraceptives from modern producers let out in plates which contain 21 tablets or 28 tablets. That the woman easily oriented in priority of administration of drug, new three-phase and two-phase tablets have special designations on packaging in a look strelochek or days of the week. Reception the COOK has to begin in the first day of a menstrual cycle then drug needs to be accepted every day. Doctors advise, whenever possible, to take a pill at the same time. The latest researches demonstrate that at so accurate reception the COOK hormonelike materials are acquired better. In the presence in a plate it is necessary to take 21 pill drug from the first day of periods then there comes the break for seven days. In days when a pill is not taken, use of other methods of protection as the contraceptive effect remains is not required. In the presence in a plate of 28 tablets reception of means is conducted continuously. After one year of reception the COOK the woman has to take a break for three months that function of ovaries could be recovered fully, and there were no undesirable side effects. These days it is necessary to be protected from conception, using other methods.
The woman taking such pill has to know that she categorically is not combined with the COOKS some medicines accurately. These are anticonvulsants, a number of prepartaov-antibiotics, pulmonary diseases medicine. But even if to the woman treatment by any other drug is appointed, then she has to warn the doctor about reception of oral contraceptives surely.
How to choose the COOK?
Contraceptives for women, as well as man's contraceptives, it is necessary to choose, having carefully weighed all individual pros and cons. Before beginning use of any drugs, consultation of the specialist gynecologist is necessary. The dl of the correct selection the COOK should pass a number of researches surely. So, usual gynecologic inspection is initially performed, the smear undertakes. It allows to exclude a number of diseases among which – oncological pathologies. Twice in the period of a menstrual cycle ultrasonic research of bodies of a small pelvis is conducted. Ultrasonography needs to be carried out right after monthly and before the following periods. Such research will allow to learn about growth and a condition of a mucous cavity of the uterus, about features of an ovulation. To the woman also consultation at the specialist mammologist, carrying out ultrasonography of mammary glands is appointed. Sometimes it is also necessary to determine the level of hormones in the patient's shelter.
Approximately in three months after the woman began to take regularly a pill, she needs to visit the doctor for the purpose of control over impact on an organism of hormonelike materials again.
In general oral contraceptives for women have many visible advantages among which — the high level of reliability, fast occurrence of effect, simplicity in use, good tolerance of an organism. Besides such female contraceptives provide the normal level of reversibility, that is after the termination of reception of such tablets the woman can become pregnant in 1-12 months. Such tablets are suitable also for young girls as they allow to adjust a monthly cycle, to eliminate painful manifestations at periods, to receive a certain medical influence at some diseases, to reduce manifestation of inflammatory processes.
The COOK reduce risk of emergence of cysts, oncological diseases, benign tumors of a mammary gland, and also allow to avoid an iron deficiency anemia. Their use is reasonable for women at whom the high level of content of men's hormones is noted.
Owing to braking of an ovulation of a tablet provide also protection against development of an extrauterine pregnancy. In certain cases they also allow to eliminate some factors provoking infertility. Therefore after the treatment termination by such drugs pregnancy comes with higher probability.
By the way, monophase the COOK allow "to otstrochit" the next periods, if necessary. To reach such effect, it is necessary to begin to take a pill from the following packaging of single-phase contraceptives at once after previous terminated. Besides the COOK provide an emergency contraception.
Except the described number of advantages these contraceptives have also some shortcomings. First of all, it is probability of decrease in contraceptive effect in case of interaction with some medicamentous drugs. It is rather difficult to some women to provide the accuracy and a regularity in reception of tablets. At the same time admissions of reception of tablets increase risk of undesirable pregnancy. As side effects at reception of drugs the amenorrhea, intermenstrual bleedings, decrease in a sexual inclination, headaches, mood swings, morbidity in breasts, growth of body weight, vomiting, nausea can be shown. However all listed phenomena arise, as a rule, in the first months of reception of tablets, and later they disappear at once after full adaptation of an organism to the COOK.
Essential minus at reception of such drugs as contraceptives is lack of protection at sexual contacts, both from AIDS, and from diseases which indulge sexually.
There are several absolute contraindications at which oral contraceptives are not applied categorically. It is pregnancy or suspicion on the fact that conception already happened; the period after the delivery when the woman nurses the child, or the first half a year after the delivery; diseases and tumors of a liver; hypophysis tumors; cardiovascular diseases; breast cancer; the progressing diabetes mellitus forms; number of mental disturbances.
As relative contraindications define a hypertension, obesity, varicosity, active smoking, tendency to depressions. Reception of such contraceptive tablets stops yes one month to planned surgeries, and also before reception of some antibiotics. In all listed cases women are recommended to use non-hormonal contraceptives.
What to do if the woman did not take a pill in time?
In spite of the fact that at the admission of timely reception of a tablet the risk of conception at once increases, the woman should not panic in that case. The pill needs to be taken at once as soon as such opportunity appeared. If admissions of reception happened just in days of an expected ovulation, then use of an additional method of contraception about day of the following periods will be the way out. However modern the COOK affect an organism in such a way that the admission of one tablet for 12 hours does not affect contraceptive effect. At the admission of two tablets follows at the first opportunity to take two forgotten pill, and next day – two more. At the same time it is important to apply an additional method of protection. Such changes can provoke emergence of bloody allocations which arise as an effect of high concentration of hormones. In several days this side effect disappears.
If it was missed reception of three and more tablets, then in that case it is necessary to pass to additional methods of contraception, and the COOK to begin reception already again, from the first day of monthly. Therefore each woman before the beginning of reception of such contraceptives has to analyze carefully whether she will be able to provide regular administration of drug as irregular and chaotic reception of such tablets can negatively affect on health of the woman.