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Hormonal Contraception

- Combined oral contraceptives
- Mini-pill
- Hormone injections
- Emergency contraception

Hormonal contraception is based on the use of synthetic analogues of the natural ovarian hormones and is a highly effective means of preventing pregnancy.

Combined oral contraceptives are the most common oral contraceptives due to its high reliability, the reversibility of the action, affordability and good tolerability. In turn, oral contraceptives (OCs) are divided into three main types: monophasic, containing a constant dose of estrogen (ethinyl estradiol) and a progestin, two-phase, in which the first 10 pills contain estrogen, and the remaining 11 tablets are combined, ie contain both estrogen and progestin component; triphasic preparations contain stepwise increasing dose progestogen and estrogen dose changing its contents to a maximum at mid-cycle.

The mechanism of action is based on the OK blockade of ovulation, implantation, changes in gamete transport and function of the corpus luteum, as well as changing the properties of the cervical mucus. The mobility and the ability of sperm to penetrate the cervical mucus is disturbed due to its compaction and thickening; cervical mucus becomes a mesh structure and is characterized by a reduced crystallization.

COC meet all the requirements for modern contraceptives:
- High effectiveness in preventing pregnancy
- Ease of use (coitus-independent)
- Reversibility of the impact.

COCs should be chosen with the help of a gynecologist, because There are a number of serious contraindications.

Mini pili contain 300-500 mg per tablet progestogens not substantially restrict ovarian function. Admission start from the 1st day of the menstrual cycle and produce daily continuously.

As a rule, at the beginning of the use of the mini-pill marked intermenstrual spotting, the frequency of which gradually decreases to a 3-month admission is completely stopped. If the intake of the mini-pill appear intermenstrual spotting, we can recommend the appointment of 3-5 days, 1 tablet app that gives you quick hemostatic effect. Since the side effects of other mini-pill is given, their use in clinical practice has broad prospects.

The mechanism of action of contraceptive mini-pill is as follows:
1. Change in the number and quality of cervical mucus, increasing its viscosity.
2. Reduction of penetrating ability of sperm.
3. Changes in the endometrium, excluding implantation.
4. Inhibition of motility of the fallopian tubes.

Theoretically, the effectiveness of the mini-pill is 0.3-4 pregnancies per 100 woman-years. Based on the features of the mini-pill, they can be recommended as a method of contraception for women with extragenital diseases (diseases of the liver, hypertension, tromboflebiticheskimi conditions, obesity).

Mini-pill is especially recommended for the following situations:
- Women complaining of frequent headache or an increase in blood pressure when used combined oral;
- In lactation at 6-8 weeks after birth;
- Diabetes;
- For varicose veins
- Diseases of the liver;
- Women over 35 years old.

Hormonal injections
Long-acting formulations contain 150 mg depot medroxyprogesterone acetate or norethisterone enanthate 200 mg. Injection drugs do one every 1-5 months.

To the category of injectable contraceptives should also include:
- Depo-Provera, long-acting injectable medroxyprogesterone acetate;
- Depo-Progesterone (norethisterone enanthate).

Emergency contraception

Postcoital preparations consist of large doses of progestin (0.75 mg levovonorgestrela) or high doses of estrogen (diethylstilbestrol, ethinyl estradiol). The dose of 2-5 mg estrogen, i.e. 50 times higher than the combined estrogen-progestin formulations. These tablets are used for the first 24-28 hours after sexual intercourse (in rare cases). The method of emergency contraception should be discussed with your doctor.

Postcoital contraception can not be recommended for continuous use, since each of the methods is an extraordinary intervention in the functional state of the reproductive system with the formation of subsequent ovarian dysfunction.

To postcoital contraception include:
1. Postinor containing one tablet of 0.75 mg of progestin levonorgestrel.
2. Oral contraceptives, containing 50 mg of ethinyl estradiol.
3. Danazol.
4. IUD insertion of Cu-T-380 or multiload in the first 5 days after intercourse.
5. Ru-486 antiprogestin (Mifepriston).