For the purpose of hormonal contraception synthetic analogues of female sex hormones, estrogens and progesterone, whose structure is close to natural, are used, and the activity is much higher. This allows you to get a contraceptive effect when using them in very low doses.
The most effective method of preventing unwanted pregnancy is hormonal contraception, based on the use of synthetic analogues of female sex hormones.
Hormonal contraception is very popular in Western Europe: 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 8.6% of women of reproductive age use it.
The 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;
- blockade of ovulation;
- condensation and thickening of cervical mucus, which is detected 48 hours after the initiation of administration of the gestagenic component, with cervical mucus becoming more viscous and characterized by reduced crystallization;
- violation of implantation due to changes in the morphological properties of the endometrium;
- violation of the function of the yellow body with the introduction of exogenous hormones, even with ovulatory cycles.
Efficacy of hormonal contraception
As studies show, the theoretical and practical effectiveness coincide almost completely for those methods of contraception, the use of which is not related to the presence of the consumer factor. The Perl index for injecting contraceptives is 0.3 in both cases, the implant efficiency is 0.04 for both values, respectively.
Medical control of women using hormonal contraception
When appointing hormonal contraception, as well as in control examinations of women already using contraceptives of this group, the doctor must take into account:
- Clinical analysis of the patient's complaints and condition.
- Dynamics of blood pressure.
- Indicators of the coagulation system and blood sugar level.
- Cytology of vaginal and cervical smears.
- Colposcopy data.
- Condition of mammary glands.
It is also necessary to remember the possible side effects of drugs when analyzing the complaints of patients, the question of individual acceptability of which is solved, as a rule, in the first 3-4 months. Use of a contraceptive. It is advisable to appoint a woman for the first follow-up examination at 3 months. (menstrual cycle) after prescribing. In the future, if there are no examinations due to the specifics of the application of the method, follow-up examinations are carried out once every 6 months.
Absolute contraindications to the use of hormonal contraceptives
- Arterial or venous thrombosis, thrombophlebitis, ischemic heart disease, hypertension, or previous use of COC hypertension.
- Cerebral ischemia, including severe local migraine.
- Diseases of the liver: cholestatic jaundice of pregnant women in anamnesis. Violations of the excretory function of the liver.
- Presence in the anamnesis of pathological conditions, on the occurrence or course of which sex steroids influence; diseases that occurred during pregnancy or complicated the course of a previous pregnancy (for example, herpes of pregnant women, hemolytic syndrome, chorea and otosclerosis).
- Malignant hormone-dependent tumors (eg, breast cancer).
- Bleeding from the genital tract of unexplained etiology.
Hormonal contraception and pregnancy
In those rare cases when a woman accidentally took hormonal contraceptives during an early pregnancy, their damaging effects on the fetus were also not revealed.