Combined oral contraceptives

At present, combined oral contraceptives are the most common type of oral contraceptive. Throughout the world, such contraceptives are at least 100 million women. In the 1960s, when combined contraceptives first became available, they contain up to five times more estrogen and up to ten times more progestin than the pills that are on the shelves of pharmacies today. After were numerous cases of severe complications (stroke, heart attack and pulmonary embolism) in taking these contraceptives women, doses of hormones in their composition are significantly reduced.

Variety of estrogen, which is included in most of the combined oral contraceptive is called ethinyl estradiol (usually just called estradiol). 50 mcg (micrograms) estradiol is considered a high dose of 30-35 micrograms - an average dose of 20 mg or less - a low dose. (What it is today called a high dose - it is still much less than the dose of the hormone that were part of the first generation of oral contraceptives). Doctors recommend the use of contraceptives with minimal hormones. The dose of estrogen by modern standards must not exceed 50 micrograms; The higher dose of hormone, the greater the risk of complications. Together with estrogen in a combined oral contraceptive composition may include the following types of progestin:

• Desogestrel - used since 1998, and is the first progestin, which was part of the combined oral contraceptives with a low dose of estrogen. Some scientists believe that desogestrel increases the risk of blood clots.
• Drospirenone - progestin, which is part of Yasmin and some other combined contraceptives. Because drospirenone increases the level of potassium in the blood, drugs of this substance can not be taken for women who have kidney disease, liver and adrenal glands.
• Levonorgestrel is a part of many modern means of contraception.

Other common progestins are norethindrone and norgestrel.

Many medicines and herbs (eg, acetaminophen, anti-epileptic drugs, antibiotics, and St. John's Wort) may decrease the effectiveness of progestin. For this reason, you must tell your doctor about any medications you are currently taking, even if they are sold without a prescription.

Packing

There combined oral contraceptives calculated 21 and 28 days of treatment. The package with the usual monophasic contraceptive contains 21 tablets, in each of which includes the same dose of hormones. The patient should take one tablet for 21 days, and then to do a seven-day break, and then begin taking pills from a new package.

The packs of pills, calculated at 28 days of admission, contains 21 tablets with hormones and 7 pills placebo, as part of which no hormones .  After hormonal tablets during the first three weeks, the patient during seven days receives inactive tablet .  Then, a new cycle begins receiving contraceptives .  Some of the new extended-cycle pills such as Yaz, are available in the following combination: 24 active pills plus 4 inactive .  Packages Mircette tablets comprise a tablet 21 with low doses of progestin and estrogen, 2 placebo tablets, and 5 tablets containing small amounts of estrogen .  Women who are assigned a combined oral contraceptives Loestrin Fe 24, for 24 days of a hormonal active tablet and then, during 4 days, the tablets containing iron - is useful because during menstruation iron levels in the blood may slightly decrease .  In addition, there are monophasic, biphasic and triphasic oral contraceptives .

The monophasic tablets containing the same dosage of hormones, and in packages with biphasic and triphasic contraceptives include tablets with different doses of estrogen and progestin. Since the monophasic pills provide the intake of equal doses of hormones over three weeks of the cycle, they cause fewer side effects associated with hormonal fluctuations than biphasic and triphasic contraceptives. Studies have shown that the difference in the effectiveness of these types of contraception is negligible. Monophasic pills are usually the first tool of choice for women who want to prevent pregnancy.

Admission combined pill

Start taking the combined contraceptive is recommended during the days after the onset of menstruation (in general, it can be done any day of the menstrual cycle The menstrual cycle - that occurs in different phases? But in this case, ovulation can still occur). Next, the tablet should be taken daily, preferably in one and the same time - until the package is emptied. If it 21 tablet, you need to wait seven days, and then begin taking pills from a new package. If a woman takes the pill, designed to receive within 28 days, the next day after taking the last tablet from the package you need to start a new course of taking contraceptives. In the first month of combined oral contraceptives it is recommended to use additional means to prevent pregnancy.

If you forget to take a pill on time, take it as soon as you remember about it. You can take two tablets at the same time. Within seven days after you miss a dose, use additional contraception.

If omitted pills for two days in a row as soon as you remember about this, take two pills, and the same - the next day. Then continue to take contraceptives as usual, but before the end of the cycle, use additional means of contraception.

If you do not take three or more pills, throw the package, and start over again oral contraceptives, the first day of menstruation.

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