What is hormonal contraception?

For the purpose of hormonal contraception, synthetic analogues of female sex hormones are used - estrogens and progesterone, the structure of which is close to natural ones, and the activity is much higher. This allows to obtain a contraceptive effect when using them in very low doses.

The most effective method of preventing unwanted pregnancy at present is hormonal contraception, based on the use of synthetic analogues of female sex hormones.

Epidemiology

Hormonal contraception is very popular in Western European countries: for example, in England this type of contraception is used by 22%, in France - 36%, in Germany - 48%, in Italy - 23% of women of reproductive age, while in Ukraine hormonal contraception is used by 8.6% of women of reproductive age.

Mechanism of action of hormonal contraceptives

The mechanism of action of hormonal contraceptives is based on:

• suppression of the secretion of gonadotropin-releasing hormone by the hypothalamus;
• ovulation block;
• compaction and thickening of cervical mucus, which is detected 48 hours after the start of the introduction of the gestagen component, while cervical mucus becomes more viscous and is characterized by reduced crystallization;
• disruption of implantation due to changes in the morphological properties of the endometrium;
• disruption of the function of the corpus luteum when introducing exogenous hormones even during ovulatory cycles.

Effectiveness of hormonal contraception

As studies show, theoretical and practical efficiency coincide almost completely for those contraceptive methods whose use is not associated with the presence of the consumer factor. The Pearl Index for injectable contraceptives is 0.3 in both cases, the efficiency of implants is 0.04, respectively, for both values.

Medical supervision of women using hormonal contraception

When prescribing hormonal contraception, as well as during control examinations of women already using contraceptives of this group, the doctor must take into account:

1. Clinical analysis of the patient's complaints and condition.
2. Dynamics of blood pressure.
3. Blood coagulation parameters and blood sugar levels.
4. Cytology of vaginal and cervical smears.
5. Colposcopy data.
6. Condition of the mammary glands.

When analyzing patient complaints, it is also necessary to remember the possible side effects of the drugs, the question of individual acceptability of which is decided, as a rule, in the first 3-4 months of using the contraceptive. It is advisable to assign the woman the first control examination 3 months (menstrual cycles) after prescribing the drug. Subsequently, if there are no examinations due to the peculiarities of the method, control examinations are carried out once every 6 months.

Absolute contraindications to the use of hormonal contraceptives

1. Pregnancy.
2. Arterial or venous thrombosis, thrombophlebitis, ischemic heart disease, hypertension or hypertension caused by previous use of COCs.
3. Cerebral ischemia, including severe local migraine.
4. Liver diseases: history of cholestatic jaundice of pregnant women, disorders of excretory function of the liver.
5. History of pathological conditions, the occurrence or course of which is influenced by sex steroids; diseases that arose during pregnancy or complicated the course of a previous pregnancy (for example, herpes of pregnancy, hemolytic uremic syndrome, chorea and otosclerosis).
6. Malignant hormone-dependent tumors (eg, breast cancer).
7. Bleeding from the genital tract of unknown etiology.

Hormonal contraception and pregnancy

In those rare cases where a woman accidentally took hormonal contraceptives during early pregnancy, no harmful effects on the fetus have been found.