PROGESTIN CONTROL PILLS (MINI-PILLS). SCIENTIFICALLY BASED INFORMATION FOR WOMEN.

General characteristics: composition, description

Mini-pills contain a small dose of a synthetic analogue of progesterone - progestin (about 150-500 mg). They are an excellent replacement for combined oral contraceptives. The tablets have a gentle effect on the female body and have a small number of contraindications, but their contraceptive effect is somewhat lower compared to COCs.

Chemical contraceptives

Chemical types of contraceptives, which are based on spermicides - active substances that kill sperm.

Such products are introduced into the vagina immediately before sexual intercourse, and after it it is advisable not to wash yourself and take a shower for 8-12 hours, which, naturally, brings significant inconvenience to users.

• They have a low degree of protection,
• may cause an allergic reaction,
• some other adverse reactions (violation of vaginal microflora, exacerbation of thrush),
• relative cheapness,
• reliability 75-80%.

Benefits: why women choose mini-pills

Advantages of progestin-based contraceptives:

1. Gentle on the body.
2. They do not affect the production of breast milk and do not impair its taste (unlike COCs). Can be used during lactation.
3. They have a quick effect: within 4 hours the contraceptive effect becomes maximum.
4. Do not contribute to the appearance of headaches with nausea at the beginning of use.
5. Taking the drug is not directly related to sexual contact.
6. They practically do not cause blood clots (due to the absence of estrogens in the composition).
7. Recommended for people over 35 years of age as a drug with a low risk of developing thrombosis.
8. They do not contribute to a rise in blood pressure in people suffering from hypertension.
9. They do not affect emotionality compared to combined oral contraceptives.
10. Does not suppress sexual desire.
11. Allowed in preparation for surgical interventions (compared to COCs).
12. They have the ability to reduce menstrual pain.
13. When the mini-pill is discontinued, the possibility of fertilization is quickly restored: it takes about 1 month.
14. Women who smoke are allowed.

Inexpensive birth control pills

Modern hormonal pills, if chosen correctly, have virtually no side effects. They suppress the activity of the ovaries, preventing unwanted pregnancy.

Such tablets are divided into 2 types:

• combined oral contraceptives (COCs). They include 2 active hormone substances: ethinyl estradiol in different concentrations and progestogen. In turn, COCs are divided into 3 subtypes: microdosed,
• low-dose,
• highly dosed.

Microdosed COCs

Microdosed tablets are most suitable for women who have not yet given birth, due to the very small dose of hormones and their gentle effect on the body, as well as for women over 35 years of age.

Low-dose COCs

Low-dose OCs are prescribed to young and mature women for whom microdoses were not suitable (there was spotting).

Such drugs have not only a contraceptive effect, but also a so-called beauty effect (they have an antiandrogenic effect - they reduce the greasiness of the skin and hair, and the appearance of acne).

High-dose COCs

High-dose OCs have a very strong effect on a woman’s body and in most cases are prescribed by doctors only for medicinal purposes.

The price range for COCs is quite wide, the effectiveness of the drugs as contraceptives is almost the same, the only differences are the impact on the individual characteristics of the body and the presence of a beauty effect.

Mini-pill

Unlike COCs, mini-pills can be used during breastfeeding, since they contain only progestogen.

Mini-pills have an effect on cervical uterine mucus and its quantity. Its increased viscosity due to the use of the drug interferes with the free movement of sperm.

Disadvantages of the mini-pill

If everything is so good, why haven’t all women switched to using gestagenic contraceptives? Unfortunately, like all medications, mini-pills have their drawbacks:

1. Regular intake of pills is required.
2. They are less effective compared to COCs.
3. They can influence a woman’s weight, causing it to increase.
4. They do not protect against sexually transmitted infections.
5. The contraceptive effect worsens during the combined use of anticonvulsants and antituberculosis drugs.

The Pearl index of the mini-pill is 0.5-3.

Operating principle

The progestin drug does not disrupt ovulation compared to COCs. The effect of birth control pills is based on a change in the quality of the cervical mucus: it becomes thicker and prevents sperm from entering the female reproductive cell, preventing conception. If the sperm does reach the egg and fertilization occurs, the fertilized egg cannot attach to the uterine wall, since the contraceptive changes the structure of the endometrium. Thanks to the mini-pill, the peristalsis of the fallopian tubes is slowed down, which is why the fertilized female reproductive cell has difficulty implanting into the uterus. The effectiveness of this group of contraceptives is believed to be 95%.

Who is recommended to take the mini-pill?

Progestin contraceptives are prescribed in the following situations:

• For contraception in women of any age.
• Women who have reached 35-40 years of age. The fact is that at this age it is advisable to use contraceptives with a low content of hormones and a complete absence of estrogens.
• For nursing mothers. During the lactation period, despite the physiological absence of menstruation, there is a possibility of follicle maturation with the development of ovulation, which is fraught with the onset of an unwanted pregnancy. This is why it is important to use contraception during breastfeeding.
• Women with contraindications to the prescription of oral contraceptives containing estrogens.

Unlike COCs, the active substance of the mini-pill does not change the composition of breast milk, does not interfere with lactation and does not have a negative effect on the development of the child.

Basic information

Mini-pills are gaining popularity among other contraceptives. They contain a small dose of progestin, which is similar to the female hormone progesterone, produced by the ovaries. This remedy has virtually no contraindications and does no harm.

The principle of operation is to liquefy the mucus in the cervix, which prevents sperm from entering for fertilization. Unlike COCs, these contraceptives do not suppress ovulation.

The names of mini-pill drugs can be found in any modern medical reference book:

• Microlute;
• Femulen;
• Continuin;

• Micronor;

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• Exluton;
• Primolut-Nor;
• Norkolut;
• Lactinet;
• Anovlar;
• Lactimed;
• Microvapor;
• Charosetta;
• Ovret.

The price of the drug depends on the manufacturer; you can find both inexpensive and high-cost contraceptives. You can buy them at any pharmacy.

Mil-pili preparations are used as a means of contraception; they are less effective than combined oral contraceptive pills, which contain, in addition to progesterone, the hormone estrogen.

Side effects

Among the adverse effects of taking the drug, experts note:

• Short-term cycle disturbances: prolongation of menstruation, the occurrence of unscheduled menstrual flow or its complete absence (amenorrhea).
• Formation of ovarian cysts.
• Exacerbation of candidiasis in case of its chronic course.
• The appearance of weakness and nausea in diabetes mellitus.
• The formation of increased oiliness of the skin of the face.
• Breast engorgement and tenderness.
• Increased susceptibility to ultraviolet rays.
• Activation of hair growth on the body.
• The appearance of swelling in the lower extremities.

Indications for use of drugs

Every gynecologist has a list of medications, and it is the doctor who must offer the woman one or another means of contraception that will suit her for a number of indications. This contraceptive can be used in cases where taking COCs is prohibited:

• Cardiovascular diseases accompanied by high blood clotting.
• Breastfeeding period.
• When smoking by women over 35 years of age.
• During menopause, you can use mini-pills after 45 years.
• After an abortion.
• With uterine fibroids.
• For breast cancer.
• For endometriosis up to 35 years of age, it has a therapeutic effect.
• At risk of heart attack or stroke.
• For liver diseases.
• For diabetes mellitus.
• With thrombosis.

The use of the mini-pill while breastfeeding is permitted. It has been scientifically proven that the drug has no effect on milk and a woman can safely feed her baby.

Application diagram

Experts say that the accuracy of taking the mini-pill determines the effectiveness of the drug. The tablets must be taken every day, and at the same time. Under no circumstances should you skip taking the drug even for a day, much less try to compensate for the missed day with an additional pill.

Doctors recommend taking the pills at 18-20 hours, since the maximum contraceptive effect is achieved 4 hours after use.

Mini-pills are starting to be used:

1. From the 1st day of menstruation.
2. 6 weeks after delivery.
3. Immediately after the abortion.

Studies have shown that mini-pills are the optimal hormonal contraceptive for nursing mothers. There is data on long-term follow-up of women taking Charozetta. All nursing mothers took contraceptives starting 4-8 weeks after birth. The average duration of breastfeeding was 7 months. Children were observed up to 1.5 years (32 children) or up to 2.5 years (14 children). After assessing growth, physical and psychomotor development, no differences were found with babies whose mothers used other methods of contraception. These data suggest that Charozetta can be taken while breastfeeding, but monitoring the growth and development of the child will not be superfluous.

Note!

• When a woman switches from COCs to minipills, the latter can be used immediately after taking the previous combined oral contraceptive pill. After 14 days, full contraceptive effect occurs.
• If vomiting suddenly begins within 2 hours before the appointed time, and the lady is not able to take the pill, additional protection with condoms is required in the next 2-3 days. A similar situation occurs with diarrhea that began within 12 hours after taking the mini-pill. A woman needs to use barrier contraceptives.

What are progestin birth control pills?

Progestin-only tablets (synonymously known as minipills), approved for contraceptive use in most countries, contain 0.35 mg of norethindrone per tablet. There are also drugs containing levonorgestrel or desogestrel as the active substance. These active substances are synthetic analogs of the female sex hormone progesterone.

Mini-pill blister packs contain 28 tablets.

To ensure a stable contraceptive effect and reduce the likelihood of side effects, progestin tablets must be taken every day at the same time (the permissible variation in the time of administration is ± 3 hours).