Unwanted pregnancy is the biggest concerned of many women. Everybody knows that abortion is harmful for health and that’s why pregnancy prevention is the most important issue. Gynecologists are worried, as taking some birth control of new generation, unplanned pregnancies still occur and end in abortion.
Medicine and pharmacology are not standing still. New modern drugs protecting against pregnancy are being constantly developed and improved. This allows reducing number of abortions and their consequences.
Contraception is means and methods used for birth control. There distinguished:
- mechanical contraceptives (male condom, female cap);
- chemical contraceptives (vaginal pastes, pills and other substances causing detrimental effect on sperm cells);
- intrauterine devices (introduced into uterus);
- hormonal contraceptives (ingestible estrogen-gestagen drug).
Besides, with contraception purpose people use vaginal douching and so-called rhythmic method (periodic abstinence from sexual contacts) and interrupted sexual intercourse. In some special cases, there conducted surgical intervention – depriving of ability to conceive (operative sterilization). Nowadays researches on creation of male oral contraceptives (birth control pills) which inhibit spermatogenesis are being carried out. Immunological method based on antibodies to sperm cells production in female body is now at the initial research stage.
The most effective are intrauterine and hormonal contraceptives, but because of contraindications and sometimes arising complications, not all women can use them. Therefore, traditional contraception means and methods continue to develop (e. g., mechanical, chemical). High contraceptive effect gives combination of different contraceptive methods and techniques, such as mechanical and chemical, hormonal and physiological methods of contraception, and so on. While appointing contraception, it is necessary to have an individual approach to choice of contraceptive methods, taking into account health, reproductive analysis and possible complications for this contraception form. Contraceptives not only help to dispel fears of unwanted pregnancy, but prevent sexual dysfunction, create intimacy harmony necessary for happy family life.
Birth Control Pills
Female birth control pills prevent pregnancy. Most of these pills are a combination of estrogen and progesterone hormones to prevent ovulation – release of eggs during menstrual cycle. Woman can’t get pregnant because there is no egg to be fertilized.
Depending on package, some pills are taken every day at one and the same time for 21 days, followed by a 7-day break or non-hormonal pills intake (in case of 28-day pack). Menstruation appears after last taken pill containing hormones.
Menstruation frequency can be reduced by a different type of pills, taken for 12 weeks and then followed by inactive pills for 7 days. It reduces cycle frequency to one every three months, rather than once a month. Other pills, which reduce menstruation frequency, contain low progesterone doses and are also called «mini pills». These pills contains only one kind of hormones. They work by changing cervical mucus and endometrium and affecting ovulation. It should be taken regularly atone and the same time, without missing a single day. These pills may be less effective in preventing pregnancy.
Despite relatively high efficiency of this method still not many women use pills for contraception. When properly received, absence of contraindications and compliance with all recommendations on their use female birth control pills effectiveness is as high as 99%. Modern oral contraceptives contain either only one hormone – progesterone, or else estrogen. Accordingly, they are divided into mini pills (monophasic) and combined pills.
Mini pill is a pill to be taken on a daily basis from the first day of menstruation cycle, once a day. When for any reason missed, efficiency is lost for 48 hours and there is pregnancy risk. In this case, other methods of contraception are necessary.
Combined Oral Contraceptives (COCs)
Combined pills are taken in the same way, but missing in reception should not exceed 12 hours. In this case it is still necessary to take missed pill, despite the fact that at this time the following pill should be taken. After this contraceptive effect is reduced for 7-days and additional contraceptive means are necessary. If while taking combined pills antibiotics are needed, it is necessary to take additional protection measures during antibiotics course, plus the following 7 days.
Each pill of combined oral contraceptives contains estrogen and progestogen. As estrogen component synthetic estrogen is used – ethinylestradiol, as progestagen component – various synthetic progestogens (progestins).
COCs action mechanism:
- ovulation suppression;
- cervical mucus viscosity increase;
- endometrium change, preventing implantation.
Progestogen component provides contraceptive effect. Ethinylestradiol as part of COC supports endometrial proliferation and provides cycle control (absence of intermediate vaginal hemorrhage when taking COCs).
Besides, ethinylestradiol is necessary for endogenous estradiol substitution because when receiving COC there is no follicle growth and, hence, estradiol in ovaries is not produced.
The main clinical differences between modern COCs – individual tolerance, side effects frequency, influence on metabolism specifics, therapeutic effects and others – are explained by progestogens properties.
What is the secret of birth control pills effectiveness? When these drugs enter the body, women receive an additional dose of hormonal substances. They inhibit ovulation process and mucus contained in cervical canal becomes a great obstacle for sperm cells, which ultimately minimizes fertilization and attaching eggs to uterus risk.
Theoretically, contraception pills should be administered only by gynecologist, and only in this case proper protection from unwanted pregnancy and reduced side effects risk can be provided. Female birth control pills can be used both by young girls and mature women.
Birth Control Online Alesse
Pharmacological class – contraceptive (estrogen + progestogen).
Alesse is a combined contraceptive estrogen-gestagen drug. At ingestion inhibits gonadotrophin hypophysial secretion. Contraceptive effect is possible due to several mechanisms.
As gestogen component (progestin) contains a 19-nortestosterone derivative – levonorgestrel, surpassing luteosterone – progesterone – activity, it acts on receptor level without prior metabolic transformations. Estrogen component is ethinylestradiol. Under levonorgestrel influence there appear blockade of hypothalamus releasing factors (LH and FSH) release, inhibition of secretion by gonadotrophin hypophysis, which leads to ready for fertilization egg maturation and release suppression (ovulation).
Contraceptive effect is enhanced by ethinylestradiol. It retains high cervical mucus viscosity (makes penetration into uterus difficult for sperm cells). Along with contraceptive effect when taken regularly stabilizes menstrual cycle and helps to prevent a number of gynecological diseases, including of tumoral nature.
- menstrual cycle functional disorders (including dysmenorrhoea without organic cause, dysfunctional metrorrhagia, premenstrual syndrome).
- hypersensitivity, hepatism, constitutional hyperbilirubinemia (Gilbert’s, Rotor’s and Dubin-Johnson syndromes), hepatic tumors (hemangioma, hepatic cancer);
- malignant tumors (especially breast or endometrial cancer);
- severe cardio- and cerebrovascular diseases, thrombembolia and predisposition to it (ischemic or hemorrhagic stroke, widespread atherosclerosis, myocarditis, decompensated CHF, cardiac abnormalities, severe arterial hypertension) present or in anamnesis;
- severe diabetes (accompanied by retinopathy and microangiopathy);
- sickle-cell anemia, chronic haemolytic anemia, vaginal hemorrhage of unknown origin, migraines;
- otosclerosis, molar pregnancy, otosclerosis with hearing disorders, idiopathic jaundice or itching – during previous pregnancy;
- congenital hyperlipidemia, age over 40 years.
- hepatic and gall bladder disorders;
- ulcerative colitis;
- uterine fibroids;
- renal disorders;
- adolescence age (without regular ovulatory cycles).
- breast tenderness;
- weight gain;
- loss of libido and mood;
- voice gruffness;
- intermenstrual blood-tinged discharges;
- in some cases: palpebral edema; conjunctivitis; vision disorders; discomfort while wearing contact lenses (these phenomena are temporary and disappear after treatment without any appointment cessation);
- at prolonged administration very rare may occur: chloasma, hearing loss, generalized itching, jaundice, cramp in legs, increased epileptic seizures frequency;
- rarely observed: hypertriglyceridemia, hyperglycemia, resolution of glucose intolerance, increased arterial blood pressure, thrombosis and venous thromboembolism, skin rashes, changes in vaginal secretion characteristics, vaginal candidiasis, increased fatigue, diarrhea.
- When using biphasic preparations reliable contraceptive effect occurs only during second cycle of drug administration, so other non-hormonal methods of contraception during first half of the cycle should be used.
- Adolescents and women under 35 years old are recommended triphasic low-dose drugs. Biphasic preparations are most suitable for women of moderate progestin phenotype and may also be used by young nulliparous women, while provides endometrium transformation.
- With therapeutic and prevention purposes it is advisable to use monophasic drugs.
- Generic Alesse appointment after labor or abortion (miscarriage) is recommended not earlier than after first normal menstrual cycle.
- Before Alesse contraception beginning and every 6 months general medical and gynecological examination is recommended to carry out (including breast and liver function examinations, arterial blood pressure and cholesterol concentration in blood control, urine analysis).
- In small amounts excreted with breast milk. Usually oral contraceptives are indicated only during long-term lactation period, because during short-term lactation period menstrual cycle as a rule does not recover. If Alesse contraception during this period is necessary lactation should be stopped.
- Treatment should be immediately ceased in case of pregnancy, migraine-like headaches, early signs of phlebitis or phlebothrombosis, jaundice, visual disorders, cerebrovascular disorders, stabbing pains of unknown origin when breathing or coughing, chest pains and tightness, increased arterial blood pressure.
- Moderate blood-tinged discharge during Alesse birth control therapy course do not require withdrawal.
After generic Alesse withdrawal normal functioning of «hypothalamus – pituitary – ovaries» system quickly restores. More than 85 – 90% of women become able to become pregnant within one year, which corresponds to biological fertility level. Administrating Alesse before conception has no adverse effects on fetus, pregnancy course and outcome. Incident Alesse pill administration at early pregnancy stage is not dangerous and does not serve as ground for abortion, but at first suspicion for pregnancy immediate withdrawal is necessary.
Short-term Alesse reception (within 3 months) causes hypersensitivity of «hypothalamus-pituitary-ovaries» system receptors, so after withdrawal tropic hormones release and ovulation stimulation occurs.
This mechanism is called «rebound effect», it is used in treatment of some forms of anovulation. In rare cases, after Alesse withdrawal amenorrhea may appear. Amenorrhea may be caused by atrophic endometrium changes, which occur when taking Alesse birth control. Menstruation comes after endometrium functional layer restoration independently or under estrogen therapy influence. Approximately 2% of women, especially during early and late fertility periods of after Alesse pills therapy cessation amenorrhea may be observed lasting for more than 6 months (hyperinhibition syndrome). Amenorrhea frequency and causes as well as therapy response among women using Alesse do not increase risk, but may mask amenorrhea with regular menstrual-like hemorrhage.
Are modern contraceptives harmful? If it is chosen incorrectly, it can harm female body. For example, side effects will appear, weight gain and hair growth increase may be observed. This concerns only hormonal drugs that are contraindicated at cardiovascular system diseases, diabetes. Even at hepatic or renal problems these drugs are contraindicated. Smoking women should choose other contraceptives as hormonal agents cause strong load on heart. Also, there is increased risk of thrombosis. According to medical reports, at regular long-term hormone drugs intake, sexual activity gradually decreases. This happens due to decreased testosterone production.