Does the temperature increase when taking contraceptives? Temperature from birth control pills

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Questions and answers on: temperature from birth control pills

2015-10-22 19:13:16

Maria asks:

Good afternoon. I stopped taking birth control pills for 2 weeks. My husband and I want a child. On Saturday the follicle was 12 cm, until Monday (on) they tried very hard on the “pregnancy” issue. After 5 days, a transparent yellow liquid appears from the breast when pressed. Perhaps This happens quickly during pregnancy up to a week. I had 2 births. My breasts don’t hurt, there are no lumps or temperature. Only the mammary gland is felt.

Answers Medical consultant of the website portal:

Hello Maria! The cause of discharge from the mammary gland may be pregnancy, or it may be a change in hormonal levels, possibly related to discontinuation of the contraceptive drug. As you are planning a pregnancy, it is best to discuss changes in your breasts with your doctor. Take care of your health!

2014-03-03 09:41:30

Tatyana asks:

Hello. Please help me understand the problem. Two months ago I stopped taking birth control pills (I took them for 8 months), they were prescribed to me to regulate my cycle (long, heavy periods). The pills didn't help me. Ultrasound, MRI - signs of focal adenomyosis, smear is normal. In the last cycle, a strange situation occurred: on the 7th day of the cycle there was no dominant follicle, the endometrium was 6 mm; discovered on the 23rd day of the cycle dominant follicle 16 mm, was recognized as unovulated, but a day later he was no longer visible on the MRI. In this cycle, on day 11, the dominant follicle is 16 mm, the endometrium is 8 mm, on day 17, the follicle is 25 mm (recognized as persistent), the endometrium is 8 mm. On the 21st day of the cycle, the follicle decreased to 15 mm, the endometrium is still 8 mm. At the same time, on the 18th day of the cycle, my basal temperature up to 37 (in the first phase it was 36.5-36.6, then on days 15 and 16 - 36.8) and has been lasting for a week. Should I hope to have my periods on my own? It was necessary to take Duphaston from the 16th to 25th day of the cycle, but they were afraid to prescribe it to me, since it intensifies menstruation. Is it worthwhile, on the advice of a doctor, to inject Pregnil in the next cycle to rupture the follicle? Or would it be better to take hormones of three phases one cycle, and then think about Pregnyl? Could it be hormonal disorder the cause of long, heavy periods? Wouldn't it be better for me to have a hysteroscopy?

Answers Gritsko Marta Igorevna:

I would advise you to first donate blood for sex hormones; you have endocrine disorders, which is why ovulation does not go away. The hCG drug (pregnyl, choragon or ovitrel) should only be injected if you are planning a pregnancy. There is no point in performing hysteroscopy yet.

2013-08-05 14:31:00

Anastasia asks:

Hello. I have a question - I had polycystic ovary syndrome. The doctor prescribed me to take birth control pills to normalize my cycle, since my periods could come once every 2-3, or even 4 months. The last time I had an ultrasound, the doctor said that there were significant improvements, up to initial stage polycystic disease. Since May, I stopped taking pills and my husband and I are waiting for good news. At the end of May - beginning of June I had my last period. But positive results the test doesn't show up. After sexual intercourse on June 12, I began to experience changes in my body, but the test again showed negative result and after a couple of days it began to hurt on the right side of the lower abdomen and smear. But my period has not started since then. The lower abdomen seems to have become denser, I can’t draw it in as much as before, my breasts are sensitive, but not like before my period, the temperature constantly jumps from 36.6 to 37.2. Yesterday I took a pregnancy test, but it again gave a negative result. Please tell me, can the test be wrong or is my polycystic ovary syndrome manifesting itself again?

Answers Stezhka Marina Petrovna:

2013-07-10 20:36:48

Anna asks:

Hello! Please help me understand the reason for not getting pregnant. I am 26 years old, height 162 cm, weight 78 kg. Menstruation began at the age of 13, regular, every 28-30 days. The first 2 days sometimes with aching pain. Sometimes the chest hurts in the middle of the cycle, there is no discharge from the chest. At 17 years old it was uterine bleeding(it was smeared for about a month) we stopped it with Nonovlon, after another 3 months I took birth control pills. Now my husband and I have been living openly for more than a year, but pregnancy has not occurred. According to the spermogram results, the husband is normospermic. I did MSG, the tubes are passable. Half a year ago, after 5 massage sessions, my menstruation began a week earlier and lasted 10 days, from the beginning it was scanty, and then as usual. (My menstruation lasts 5-7 days) 2 months ago, my menstruation did not end for 20 days, it stopped after I started taking duphaston as prescribed by a doctor (hemostatic drugs did not help) During this year I took the following tests:
Testosterone 2.12 nmol/l on day 11 of the cycle, a few months later on day 28 of the cycle
LH 10.7 mIU/ml (1-11.4)
FSH 3.2 mIU/ml (1.7-7.7)
Progesterone 11.25 ng/ml (1.7-27.0)
a few more months later on day 4 of the cycle
DHEA 339.9 mcg/dl (98.8-340.0)
17-OH-progesterone 1.33 ng/ml (0.1-0.8)
also on the 25th day of the cycle
TSH 2.36 (0.23-3.4 µIU/ml)
Prolactin 405 (40-530 mIU/ml)
Diagnostics diabetes mellitus
Glucose 1 serving 4.57 mmol/l (4.1-5.9)
2 servings 6.07 mmol/l (4.1-5.9)
Insulin 1 serving 8.46 µIU/ml (0-28.4)
2 servings 38.8 µIU/ml (0-28.4)
I keep graphs of basal temperature, they turn out to be two-phase, but the temperature difference is no more than 0.3. Ovulation according to schedules on day 21 of the cycle and the second phase less than 10 days.
According to the results of the ultrasound on the 15th day of the cycle, the uterus is 48 * 33 * 30 mm, the structure is homogeneous, m-echo 9.3 mm. The ovaries are located typically, the contours are smooth, clear, the structure is normal, the vascularization is normal. Standard sizes: right ovary 25*20*17mm dominant follicle 15mm thin wall, left ovary 26*20*17mm dominant
no follicles.
In this cycle, according to the basal temperature chart, ovulation was on the 17th day of the cycle, I went for an ultrasound on the 21st dc, and there was still a dominant follicle there, the doctor said that it was overgrown with vessels and the capsule was dense, it would not burst, she prescribed me to drink duphaston so that did not develop into a cyst.
According to ultrasound, there is always a dominant follicle, but it turns out that it does not ovulate.
Tell me, can I get pregnant, what treatment do I need?

Answers Gritsko Marta Igorevna:

According to ultrasound, there is always a dominant follicle, but it turns out that it does not ovulate. Tell me, can I get pregnant, what treatment do I need? First of all, you need to contact an endocrinologist. You are definitely observing overweight, A adipose tissue is a depot of estrogens, which can cause endometrial hyperplasia and, as a result, bleeding and, in addition, be one of the causes of infertility. Weight loss must be moderate physical activity, rational nutrition and taking the drug. I don’t quite like the result of your glucose tolerance test, consult an endocrinologist about taking metformin, I have no right to make virtual prescriptions. Then I would advise folliculometry; if the dominant follicle grows but does not burst, then during the ovulation period it is necessary to administer hCG and actively plan pregnancy. If you do not become pregnant after several cycles under ultrasound control, you should contact a fertility specialist.

2012-12-24 12:16:54

Faith asks:

Hello! I have such a situation, I was pregnant for 20 weeks, I was admitted for preservation with minor bleeding. Trichomoniasis was discovered and antibiotic treatment was prescribed. Unfortunately, the pregnancy had to be terminated because trichomoniasis colpitis began with a high fever. Afterwards they did a cleansing. After discharge, they were treated My husband and I repeated the course of treatment with trichopolum + ginalgin vaginally after 2 weeks. this moment I haven’t had my period yet, a month has passed, I suspect pregnancy, a weak second line (the doctor prescribed birth control pills only after menstruation) Is it possible to persist in my situation, and will treatment with trichopolum affect the fetus?

Answers Tarasyuk Tatyana Yurievna:

Trichopolum is contraindicated during pregnancy before 12 weeks. Its use, and especially repeated courses, can harm the fetus. You had to protect yourself in any other way... If pregnancy is very desirable, some women do not terminate it, and at 12-13 weeks. biochemical screening (analysis of some chromosomal pathologies) and ultrasound are performed. Then they already determine tactics.

2012-12-14 11:22:08

Olga asks:

Hello. I can’t say that I have cystitis, the urologist did not give me such a diagnosis. I will describe my problem. For 12 years now I have been suffering (in recent years) severe pain in the lower abdomen, with pain radiating to the lower genital organs. Several years ago I began treatment with a gynecologist - my doctor was “from God,” as they say. Everything was rechecked by the gynecologist, the birth control pills were stopped (since I had been taking them for many years), according to the doctors, the pain should have gone away (hormones, after all, it’s good not to eat) the pain really decreased. They checked the bladder, took pictures, nothing special about it was not noticed, they just assumed that there might be adhesions between the bladder and the uterus (due to their special location) - but this has not been confirmed by anything. Now about the symptoms: Pain when urinating (especially at the end), there is an increase in body temperature for 1 day to 37, the pain is simply unbearable!!! frequent urination (sometimes I just don’t leave the toilet), the urge is almost false (i.e. the amount of urine is two drops), nausea. Occurs due to hypothermia of the legs, physical activity, nervous stress. During an exacerbation, it is simply unrealistic to go to the doctor. The last time the urine was cloudy, with white flakes (similar to particles of epithelium), the urine was with blood (the color of cherry compote) throughout urination. I would like to clarify right away that there are no coloring products I didn’t eat urine (beets, etc...) I went to the urologist after 10 days, because... Then I also had my period. Result: gynecologist - everything is normal, urologist: general urine test - nothing found, general blood test - normal, culture test - waiting for the result, ultrasound - everything is normal only in bladder the presence of fine sediment. (What is this?) The urologist doesn’t want to do anything, throws up his hands: (My husband and I started planning a child last month, I assume that this was the cause of the exacerbation .. but I’m not a doctor, I’m tired of suffering: (Please help with advice ,recommendation, please.

Answers Klofa Taras Grigorievich:

Dear Olya, your case is far from ordinary. First, wait for the results of the sowing. Secondly, not against the background of an exacerbation, I recommend doing a cystoscopy and possibly a biopsy of the bladder mucosa (to rule out interstitial cystitis). Thirdly, sediment is a sign of an inflammatory process in the bladder. And fourth - only having EVERYTHING necessary examinations adequate treatment should be prescribed.

2012-06-14 14:38:50

Tatiana asks:

Good afternoon, help me... I am 18 years old, a 2nd year student. It all started a year ago, I was vacationing in Kazakhstan with my beloved, I came back from there with a two-week delay in my period, and away we go! they soon arrived, but for about six months every month I was absolutely sure that I was pregnant, that pregnancy tests were lying, and doctors couldn’t see... It was terrible, I started taking birth control pills, but they didn’t help either! Now everything has calmed down... BUT a new phobia has appeared - fear of oncology! I just see illness in myself in every place. I have chronic tonsillitis, I will soon have an operation to remove my tonsils, because... constant temperature 37-37.2, pus in the throat, bones ache, swollen lymph nodes on the neck, an incomprehensible cough... I have already checked everything I can, chest, veins in the legs, lungs, done a FGS and ultrasound internal organs and pelvis, ultrasound of the kidneys (they, however, get sick, chronic pyelonephritis against the background of tonsillitis). Now it seems to me that I have throat cancer, i.e. The lymph nodes on the neck are very inflamed...tell me, could this be tonsillitis or not? ESR in the blood is normal, because According to the analysis, there is no inflammation... what should I do? I feel like I’m going crazy. I also have VSD, I may have seizures, my vision gets dark, I’m out of breath, my hands are shaking... I’m so scared

2012-02-28 20:27:25

Olga asks:

Hello, I am 29 years old and have had my periods regularly since I was 13. I was pregnant in 2006 for 2 weeks, I had an abortion, after that I didn’t get pregnant because I started living with a man (the abortion was not from him) I got married, he had a bad spermogram, after an ultrasound I was diagnosed with anovulatory syndrome hypoilasia of the uterus with insufficiency of the 1st and 2nd phases of the menstrual cycle, I have had my period for 4 years, a maximum of 2 days or even 1 day, the body of the uterus is 45 mm long, thickness 25 mm, width 28 mm, the contour is not displaced, the contour is even, the clear shape is correct.
Endometrium 8 mm (5th day after menstruation from 21 to 23) right ovary, size 30, increased to 32 mm, cystically changed, left ovary, size 40 mm, increased to 45 mm, cystically changed, Prescribed to take birth control pills for 2 months, regulon, husband Tribistan to keep a graph of basal temperature (previously I didn’t do this) and I never took birth control with my husband, I lived openly, I don’t understand much about this, tell me how bad it is! Thank you and the treatment method suits me, the ultrasound specialist told me to take a hormone test and my doctor asked a number of questions and said that I don’t need height. I’m 162 cm, weight 73 kg, I’m doing sports, I’m slowly losing weight, I’ve lost 2.5 kg since December. My husband also plays sports and drinks dry proteins, I don’t use anything like that and haven’t used anything before

Answers Kravchuk Inna Ivanovna:

Dear Olga. Your case is not ordinary; a constructive dialogue in your situation is possible after familiarization with all the results of the examination.

Organism healthy woman works like a well-oiled machine. Knowing him physiological processes can be used to improve quality of life, plan pregnancy and treat certain diseases. And at the same time, detecting failures in these processes can be an excellent method for diagnosing various ailments.


One of the criteria for the health of a woman’s body is the menstrual cycle. It reflects the work of the ovaries: the release of eggs and the production of sex hormones. Normal cycle consists of several successive phases and lasts on average 28-30 days. The first phase begins with menstruation and lasts about 14 days. It is characterized by the production of sex hormones estrogen and the maturation of the follicle in the ovary - the vesicle in which the egg is located. In the middle of the cycle, ovulation occurs - the release of an egg ready for fertilization from the ovaries. The second phase also lasts two weeks. At this time in female body other sex hormones - gestagens - are synthesized. The body is preparing for pregnancy. And if it does not occur, the entire menstrual cycle repeats again and again. The minimum cycle length is 21 days, and the maximum is 35.

Such cyclical changes are the basis of some methods functional diagnostics. Thanks to them, you can plan a pregnancy, carry out contraception, and monitor the state of a woman’s hormonal levels. These methods include measuring basal temperature, which is widely used in modern gynecology.

Basal temperature is the most low value body temperature, which is reached during a long night's sleep. It shows the degree of heating human body only due to the work of internal organs without additional heating due to muscle energy.

How is basal temperature measured?

To minimize the effect of muscle heat on basal temperature, it should be measured immediately after waking up, without getting out of bed with eyes closed. Its most accurate reading will be in the vagina or rectum. The woman records the data obtained in a special diary, noting it on a graph. IN separate column Next to the dates, notes are made about events that may affect the value of basal temperature (for example, drinking alcohol or having sexual intercourse).

How to measure basal temperature correctly?

To accurately measure basal temperature, several rules should be followed:

  • Night sleep should be at least 5-6 hours in a row.
  • It is advisable to sleep in the same pajamas and under the same blanket.
  • The measurement should be daily and taken at the same time, immediately after waking up and before any physical activity.
  • Basal temperature is measured in the rectum or vagina.
  • You should place a thermometer and a clock near the bed in advance to count the time.
  • Measurement time is usually 5-8 minutes.
  • During the period of measuring basal body temperature, you should avoid taking alcoholic drinks, oral contraceptives.
  • A prerequisite is the absence inflammatory processes in the pelvic area.
  • All thermometer readings are recorded in a special diary.

What thermometer is used to measure basal temperature?

Basal temperature can be measured as usual mercury thermometer, and electronic. The only difference is that for mercury thermometer The measurement time should be at least 5 minutes, and for electronic - about 2-3 minutes.
Why does a woman need to measure her basal temperature?

Basal temperature is very sensitive to changes in hormonal levels in a woman’s body. This is explained by the fact that secreted in the second phase menstrual cycle gestagens have a stimulating effect on the heat production center, thereby increasing the general and basal temperature. By analyzing basal temperature graphs, you can judge the condition menstrual function, about the presence of ovulation and about possible pathology.

In what cases can measuring basal temperature be useful?

  • When planning pregnancy in order to determine auspicious days for conception.
  • If infertility is suspected, when pregnancy does not occur within a year with regular sexual activity.
  • For the purpose of contraception.
  • In cases of menstrual irregularities, in order to determine the woman’s hormonal levels.

In what cases is measuring basal temperature useless?

  • If it is not possible to carry out measurements regularly and in compliance with all rules.
  • For diseases accompanied by a general rise in temperature.
  • At intestinal infections, inflammatory diseases pelvic organs.

Decoding basal temperature values

A normal menstrual cycle is characterized by a temperature curve, which shows an increase in basal temperature in the second phase by approximately 0.4 degrees. “Preovulatory” and “premenstrual” drops in temperature must also be present.

If in the second phase the rise in temperature is insignificant and does not exceed 0.2 degrees, then this may indicate hormonal deficiency in the woman’s body. In the case where the basal temperature rises shortly before menstruation and there is no “premenstrual drop”, and the second phase lasts no more than 10 days, then insufficiency of the second phase can be suspected. If the curve on the graph is monotonous without clear changes in temperature, they speak of an anovulatory cycle (the egg did not leave the ovary).

What basal temperature should be during menstruation?

On the first day of menstruation, the basal temperature is usually approximately 37.0°C. Since most women have menstruation for 5 days, during this time the temperature drops to 36.4°C.

What basal temperature should be from days 5-7 of the menstrual cycle?

Since estrogens predominate in the female body in the first phase of the menstrual cycle, the basal temperature will be relatively low and fluctuate between 36.4-36.7°C.

What should your basal temperature be during ovulation?

Just before ovulation, there may be a slight drop in temperature on the graph followed by a sharp rise.

What should your basal temperature be after ovulation?

After ovulation, due to an increase in the level of sex hormones gestagens, the basal temperature will remain at a fairly high level, approximately 37.5-37.6 ° C. And only a few days before menstruation it will begin to decrease and by the first day of the next cycle it will reach 37°C.

What basal temperature should be if pregnancy occurs?

If pregnancy occurs, then the graph will not show a “premenstrual drop” in temperature readings. Basal temperature will remain high.

What is the normal basal temperature when taking birth control pills?

When taking birth control pills, a woman’s body blocks the production of its own sex hormones. Therefore, there is no phase change during the menstrual cycle. Basal temperature will not change much and rise above 37°C. The schedule will look monotonous throughout the menstrual cycle. There will be no ups and downs.

Basal temperature during pregnancy

Measuring basal temperature during pregnancy is sufficient important indicator. Using the schedule, you can determine both the fact of pregnancy and various signs, indicating . However, this technique is quite labor-intensive and requires regular measurement of basal temperature, both before and during pregnancy.

Determining pregnancy by basal temperature

If a woman regularly measures her basal temperature, then her chart can easily determine the onset of pregnancy. If at the end of the second phase there is no usual “premenstrual drop” and when menstruation is delayed, the temperature remains above 37 ° C, then the likelihood that fertilization has occurred is very high.

Another sign of pregnancy is the appearance of another jump in temperature after the second phase. Then the graph takes on a three-phase form.

Basal temperature chart during pregnancy

During a normal pregnancy, the basal temperature is consistently above 37°C. In some cases due to individual characteristics in a woman’s body its value can reach 38°C. A decrease in basal temperature during pregnancy may indicate a threat of miscarriage or a non-developing fertilized egg.
How to use basal temperature measurement for contraception?
Measuring and charting your basal temperature can determine your ovulation date. Based on the data obtained, it is possible to judge the days when the probability of pregnancy will be high and when protection should be used additional methods. With a regular menstrual cycle, such days are the interval 6 days before ovulation - 3 days after it.

When should you visit a gynecologist after measuring your basal temperature?

It is necessary to visit a gynecologist in the following cases:

  • There is no ovulation for several cycles according to the charts.
  • Increased basal temperature throughout the menstrual cycle.
  • Low temperature throughout the menstrual cycle.
  • High basal temperature in the second phase for more than 18 days with a negative pregnancy test.
  • If you have cycles shorter than 21 days.
  • If you have cycles longer than 35 days.
  • In the absence of pregnancy for several cycles with clear ovulation and regular sex life.

Today, measuring basal temperature is simple and accessible method monitoring the state of your body, which is available to absolutely every woman. His knowledge and correct use helps to independently solve some gynecological problems.

From previous publications we know about the abortifacient effect hormonal contraceptives(GK, OK). IN Lately In the media you can find reviews of women who suffered from the side effects of OK, we will give a couple of them at the end of the article. To shed light on this issue, we turned to a doctor who prepared this information for the ABC of Health, and also translated for us fragments of articles from foreign research side effects of GC.

Side effects of hormonal contraceptives.

The actions of hormonal contraceptives are the same as those of others medicines, are determined by the properties of the substances included in them. Most birth control pills prescribed for routine contraception contain two types of hormones: one gestagen and one estrogen.

Gestagens

Progestogens = progestogens = progestins– hormones that are produced yellow body 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 uterine endothelium into the state necessary for the development of a fertilized egg. The physiological effects of gestagens are combined into three main groups.

  1. Vegetative effects. It is expressed in the suppression of endometrial proliferation caused by the action of estrogens 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.
  2. 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 large doses gestagens block both FSH and LH (luteinizing hormone, which is involved in the synthesis of androgens, and together with FSH ensures ovulation and progesterone synthesis). Gestagens affect the thermoregulation center, which is manifested by an increase in temperature.
  3. General action. Under the influence of gestagens, amine nitrogen in the blood plasma decreases, the excretion of amino acids increases, and the separation of gastric juice, the secretion of bile slows down.

Oral contraceptives contain various gestagens. For some time it was believed that there was no difference between progestins, but it is now certain that the difference in molecular structure provides a variety of effects. In other words, progestogens differ in spectrum and severity additional properties, but the 3 groups described above physiological effects inherent in them all. The characteristics of modern progestins are reflected in the table.

Pronounced or very pronounced gestagenic effect common to all progestogens. The gestagenic effect refers to those main groups of properties that were mentioned earlier.

Androgenic activity characteristic of not 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, symptoms of virilization (male secondary sexual characteristics) appear.

Explicit antiandrogenic effect only three drugs have it. This effect positive value– improvement of skin condition (cosmetic side of the issue).

Antimineralocorticoid activity associated with increased diuresis, sodium excretion, decreased blood pressure.

Glucocorticoid effect affects metabolism: the body’s sensitivity to insulin decreases (the risk of diabetes mellitus), synthesis increases fatty acids and triglycerides (risk of obesity).

Estrogens

Another component of birth control pills is estrogens.

Estrogens– female sex hormones that are produced by the ovarian follicles and the adrenal cortex (and in men also by the testicles). There are three main estrogens: estradiol, estriol, estrone.

Physiological effects of estrogens:

- proliferation (growth) of the endometrium and myometrium according to the type of their hyperplasia and hypertrophy;

— development of genital organs and secondary sexual characteristics (feminization);

- suppression of lactation;

- inhibition of resorption (destruction, resorption) bone tissue;

- procoagulant effect (increased blood clotting);

- increasing the content of HDL (“good” cholesterol) and triglycerides, reducing the amount of LDL (“bad” cholesterol);

- retention of sodium and water in the body (and, as a result, increased blood pressure);

— ensuring an acidic vaginal environment (normal pH 3.8-4.5) and the growth of lactobacilli;

- increased antibody production and phagocyte activity, increasing the body's resistance to infections.

Estrogens in oral contraceptives are needed to control the menstrual cycle and protect against unwanted pregnancy they don't take part. Most often, the tablets contain ethinyl estradiol (EE).

Mechanisms of action of oral contraceptives

So, taking into account the basic properties of gestagens and estrogens, the following mechanisms of action of oral contraceptives can be distinguished:

1) inhibition of the secretion of gonadotropic hormones (due to gestagens);

2) a change in vaginal pH to a more acidic side (the influence of estrogens);

3) increased viscosity of cervical mucus (gestagens);

4) the phrase “ovum implantation” used in instructions and manuals, which is hidden from women abortifacient GK.

Commentary by a gynecologist on the abortifacient mechanism of action of hormonal contraceptives

When implanted into the wall of the uterus, the embryo is multicellular organism(blastocyst). An egg (even a fertilized one) is never implanted. Implantation occurs 5-7 days after fertilization. Therefore, what is called an egg in the instructions is in fact not an egg at all, but an embryo.

Unwanted estrogen...

In the course of a thorough study of hormonal contraceptives and their effects on the body, the following conclusion was made: unwanted effects tied in to a greater extent with the influence of estrogen. Therefore, the lower the amount of estrogen in the tablet, the less side effects, however, it is not possible to completely exclude them. It was precisely these conclusions that prompted scientists to invent new, more advanced drugs, and oral contraceptives, in which the amount of the estrogen component was measured in milligrams, were replaced by tablets containing estrogen in micrograms ( 1 milligram [ mg] = 1000 micrograms [ mcg]). There are currently 3 generations of birth control pills. The division into generations is due to both a change in the amount of estrogens in the drugs and the introduction of newer progesterone analogues into the tablets.

To the first generation contraception include “Enovid”, “Infekundin”, “Bisekurin”. These drugs have been widely used since their discovery, but later their androgenic effects were noticed, manifested in deepening of the voice, growth of facial hair (virilization).

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, most pronounced in Diane-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 estrogens 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, a division of hormonal contraceptives into high-, low- and micro-dose drugs has appeared.

Highly dosed (EE = 40-50 mcg per tablet).

  • "Non-ovlon"
  • "Ovidon" and others
  • Not used for contraceptive purposes.

Low dosage (EE = 30-35 mcg per tablet).

  • "Marvelon"
  • "Janine"
  • "Yarina"
  • "Femoden"
  • "Diane-35" and others

Microdosed (EE = 20 mcg per tablet)

  • "Logest"
  • "Mersilon"
  • "Novinet"
  • "Miniziston 20 fem" "Jess" and others

Side effects of hormonal contraceptives

Side effects from the use of oral contraceptives are always described in detail in the instructions for use.

Since the side effects from the use of various birth control pills are approximately the same, it makes sense to consider them, highlighting the main (severe) and less severe.

Some manufacturers list conditions that require immediate discontinuation of use if they occur. These conditions include the following:

  1. Arterial hypertension.
  2. Hemolytic-uremic syndrome, manifested by a triad of symptoms: acute renal failure, hemolytic anemia and thrombocytopenia (decreased platelet count).
  3. Porphyria is a disease in which hemoglobin synthesis is impaired.
  4. Hearing loss due to otosclerosis (fixation) auditory ossicles, which should normally be mobile).

Almost all manufacturers list thromboembolism as a rare or very rare side effect. But this serious condition deserves special attention.

Thromboembolism- this is a blockage blood vessel thrombus. This is an acute 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 (formation of blood clots inside vessels - thrombi - interfering with the free, laminar flow of blood):

— age over 35 years;

- smoking (!);

— high level 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, Marchiafava-Michelli disease;

- injuries and extensive operations in the past;

— venous stasis at sedentary life;

- obesity;

— varicose veins leg veins;

- damage to the valvular apparatus of the heart;

- atrial fibrillation, angina pectoris;

- cerebrovascular diseases (including transient ischemic attack) or coronary vessels;

- moderate or severe arterial hypertension;

- diseases connective tissue(collagenosis), and primarily systemic lupus erythematosus;

— hereditary predisposition to thrombosis (thrombosis, myocardial infarction, violation cerebral circulation the closest blood relatives).

If 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 location, either currently present or suffered in the past; in case of myocardial infarction and stroke.

Thromboembolism, whatever its location, is a serious complication.

… coronary vessels → myocardial infarction
... brain vessels → stroke
... deep veins of the legs → trophic ulcers and gangrene
… pulmonary artery(TELA) or its branches → from pulmonary infarction to shock
Thromboembolism... … hepatic vessels → liver dysfunction, Budd-Chiari syndrome
… mesenteric vessels → ischemic intestinal disease, intestinal gangrene
...renal vessels
... retinal vessels (retinal vessels)

In addition to thromboembolism, there are other, less severe, but still inconvenient side effects. For example, candidiasis (thrush). Hormonal contraceptives increase the acidity of the vagina, and in acidic environment mushrooms reproduce well, in particular Candidaalbicans, which is a conditionally pathogenic microorganism.

A significant side effect is the retention of sodium, and with it water, in the body. This may lead to swelling and weight gain. Decreased tolerance to carbohydrates as a side effect of use hormonal pills, increases the risk of diabetes mellitus

Other side effects, such as: decreased mood, mood swings, increased appetite, nausea, stool disorders, satiety, swelling and tenderness of the mammary glands and some others - although not severe, however, affect a woman’s quality of life.

In addition to side effects, the instructions for the use of hormonal contraceptives list contraindications.

Contraceptives without estrogen

Exist gestagen-containing contraceptives (“mini-pill”). Judging by the name, they contain only gestagen. But this group of drugs has its own indications:

- contraception for nursing women (they should not be prescribed estrogen-progestin drugs, because estrogen suppresses lactation);

— prescribed for women who have given birth (since the main mechanism of action of the “mini-pill” is suppression of ovulation, which is undesirable for nulliparous women);

- 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 progestin (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 (squamation) of the functional layer of the endometrium in order to prevent the attachment of a fertilized egg. Does Mifepristone have it? additional action– increased uterine tone. Therefore, a single use of a large dose of these drugs has a very strong immediate effect on the ovaries; after taking emergency contraceptive pills, there can be serious and long-term disturbances in the menstrual cycle. Women who regularly use these drugs are at great risk to their health.

Foreign studies of side effects of GCs

Interesting studies examining the side effects of hormonal contraceptives have been conducted in foreign countries. Below are excerpts from several reviews (translation by the author of fragments of foreign articles)

Oral contraceptives and the risk of venous thrombosis

May, 2001

CONCLUSIONS

Hormonal contraception is used by more than 100 million women worldwide. Number of deaths from cardiovascular diseases (venous and arterial) among young people, with low risk patients - not smoking women from 20 to 24 years - observed worldwide in the range from 2 to 6 per year per million, depending on the region of residence, the estimated cardiovascular risk and the volume of screening studies that were carried out before prescribing contraceptives. While the risk venous thrombosis more important in younger patients, the risk of arterial thrombosis is more relevant in older patients. Among women who smoke, more mature age of those using oral contraceptives, the number of deaths ranges from 100 to just over 200 per million each year.

Reducing the dose of estrogen reduced 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 new users of hormonal contraception.

The judicious use of hormonal contraceptives, including avoidance of their use by women who have risk factors, is absent in most cases. In New Zealand, a series of deaths from pulmonary embolism were investigated, and the cause was often due to a risk that doctors had not considered.

Judicious administration can prevent arterial thrombosis. Almost all women who had a myocardial infarction while using oral contraceptives were either older age group, either smoked or had other risk factors for arterial disease - in particular, arterial hypertension. Avoiding oral contraceptives in these women may reduce the incidence of arterial thrombosis reported in recent studies. industrial 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 control studies.

To avoid venous thrombosis, the doctor asks whether the patient has ever had venous thrombosis in the past to determine whether there are contraindications to the use of oral contraceptives, and what is the risk of thrombosis while taking hormonal medications.

Low-dose progestogen 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 unknown.

Obesity is considered a risk factor for venous thrombosis, but it is unknown whether this risk is increased by oral contraceptive use; thrombosis is rare among obese people. Obesity, however, is not considered a contraindication to the use of oral contraceptives. Superficial varices are not a consequence of pre-existing venous thrombosis or a risk factor for deep venous thrombosis.

Heredity may play a role in the development of venous thrombosis, but its significance as a factor remains unclear high risk. Superficial thrombophlebitis history can also be considered a risk factor for thrombosis, especially if it is combined with a family history.

Venous thromboembolism and hormonal contraception

Royal College of Obstetricians and Gynecologists, UK

July, 2010

Do combined methods increase hormonal contraception(tablets, patch, vaginal ring) risk venous thromboembolism?

The relative risk of venous thromboembolism increases with the use of any combined hormonal contraceptives (pills, patch, and vaginal ring). However, the rarity of venous thromboembolism in women reproductive age means that the absolute risk remains low.

The relative risk of venous thromboembolism increases in the first few months after starting combined hormonal contraception. As the duration of taking hormonal contraceptives increases, the risk decreases, but it remains as a background risk until you stop using hormonal drugs.

In this table, researchers compared the incidence of venous thromboembolism per year in different groups women (calculated per 100,000 women). It is clear from the table that in women who are not pregnant and do not use hormonal contraceptives (non-pregnant non-users), an average of 44 (with a range from 24 to 73) cases of thromboembolism per 100,000 women were 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

Although the absolute risks of stroke and heart attack associated with hormonal contraceptives are low, the risk increased from 0.9 to 1.7 with products containing 20 mcg ethinyl estradiol and from 1.2 to 2.3 with using drugs containing ethinyl estradiol in a dose of 30-40 mcg, with a relatively small difference in risk depending on the type of progestogen included in the composition.

Risk of thrombosis of oral contraception

WoltersKluwerHealth is a leading provider of expert 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 (so-called second generation) should be the drugs of choice, as recommended by national contraceptive guidelines in the Netherlands, Belgium, Denmark, Norway and the UK. Other European countries do not have such guidelines, but they are urgently needed.

Women with a history of venous thromboembolism and/or known defects in the blood coagulation system should use COCs and other contraceptives with ethinyl estradiol is contraindicated. On the other hand, the risk of venous thromboembolism during pregnancy and postpartum period much higher. For this reason, such women should be offered adequate contraception.

There is no reason to withhold hormonal contraception in young patients with thrombophilia. Pure progesterone preparations are safe with respect to the risk of venous thromboembolism.

Risk of venous thromboembolism among users of drospirenone-containing oral contraceptives

American College of Obstetricians and Gynecologists

November 2012

CONCLUSIONS
The risk of venous thromboembolism is increased among oral contraceptive users (3-9/10,000 women per year) compared with non-pregnant and non-users (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 that during pregnancy (approximately 5-20/10,000 women per year) and in the postpartum period (40-65/10,000 women per year) (see table).

Table Risk of thromboembolism.