Hormonal contraception is considered safe for most people. But is there a limit to how long you can use such contraceptives?
Some women take birth control for most of their adult lives without stopping. Others use long-term hormonal contraception, such as intrauterine devices (IUDs), which can remain in place for several years. The safety of long-term use of hormonal contraceptives may depend on a person's risk factors, age, and medical history. In this article, we will talk about the short- and long-term effects of hormonal contraceptive methods.
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How to choose birth control pills
You cannot buy the pills that suit your mother/sister/friend. Each body is individual in its reaction to hormones and other substances, according to existing diseases, etc. Therefore, oral contraceptives are prescribed by a gynecologist, who collects anamnesis and prescribes a study to make sure that you have no contraindications to taking certain contraceptives.
When visiting a gynecologist, the following is assessed:
- skin (hypertrichosis: is there or not, hyperandrogenism: are there signs, petechiae, etc.)
- mammary glands (palpation is performed)
- BP (pressure)
- body weight
The following analyzes are carried out:
- blood sugar
- liver enzymes
- hormonal background
- blood coagulation system
- ultrasound examination of the pelvic organs
- ultrasound examination of the mammary glands (breasts)
- mammography in some cases
- examination by a gynecologist and taking smears
It is also a good idea to visit an ophthalmologist (eye doctor). After all, taking oral contraceptives affects the risk of developing eye diseases, including glaucoma.
Treatment drugs
This group is used for hormonal therapy and is available in the form of tablets and ointments. Tablets treat serious diseases caused by hormonal imbalances, and ointments have a local effect.
In girls experiencing a lack of hormone production, the skin suffers from cracks and wounds in the winter, as the synthesis of new cells is disrupted. To deal with such trouble. The doctor prescribes creams, ointments and lotions containing hormones. Typically, ointments contain corticosteroids, which are absorbed into the blood within a few hours.
Such drugs can seriously affect the body. Therefore, it is important to maintain the dosage and, when prescribing, immediately determine the duration of the course, since one wrong step can lead to complications of existing problems.
Phenotypes when choosing contraceptives
The constitutional-biological type is also taken into account by the gynecologist when choosing birth control pills for a particular patient. It includes the following factors:
- chronic diseases that a woman currently has
- amenorrhea or other menstrual irregularities
- symptoms before and during menstruation
- hair and skin condition
- presence and quality of hair in the pubic area
- mammary gland
- the patient's appearance and height
There are three phenotypes:
- estrogen predominance
The height of patients with this type is low or average. They look feminine, have dry hair and dry skin. Menstruation lasts a long time and a lot of blood comes out. The cycle is from 28 days. In such cases, high- and medium-dose combined oral tablets are prescribed:
- Triziston
- Milvane
- Rigevidon, etc.
The second type is balanced . Average height, feminine appearance, average breasts, normal hair and skin. There are usually no signs of PMS. Menstruation lasts 5 days. They are prescribed 2nd generation drugs:
- Femoden
- Microgynon
- Lindinet-30
- Silest
- Marvelon, etc.
The third type is the predominance of androgens/gestagens. Such patients are usually tall and look similar to men. The breasts are usually small, hair and skin tend to be oily. PMS is characterized by depressive moods and pain in the lower abdomen. Menstruation is in small quantities, lasts up to 5 days, cycle up to 4 weeks.
For women of the third phenotype, gynecologists prescribe the following contraceptives:
- Jess
- Yarina
- Janine
- Diana-35
How to use
Packs (blisters) of combined oral contraceptive pills often contain 21 tablets. Jess packs contain 24 tablets. There are 28 of them in Klaira. COCs should be taken daily, at the same time. Beginning of the course: the first day of menstruation.
To remember to take your pills, put them in a visible place, such as in your makeup bag. When the blister is finished, take a break of 7 days. During this period, blood will be released, as during menstruation. When the week has passed, the COC is started again (even if the bleeding has not yet stopped). If you take a pill and feel nauseous and vomit, take another one. If you notice that you have missed a day of dosing, take the pill immediately without delay and use condoms for 24 hours.
If you have not taken pills for contraception before, but have now started, then you need to use condoms for the first 2 weeks of taking COCs. You do not need to stop taking the pills if you start bleeding from the uterus in the middle of your cycle. This happens in the first two or even three months of taking it. This is due to changes in the hormonal balance in the body.
After a medical abortion, hormonal birth control should be taken on the same day or one month later when your period begins. Remember that taking other medications may affect the way COCs work. For example, you should not take rifampicin with oral contraceptives. When you consult a gynecologist about taking COCs, tell him about all your pathologies and medications that you are currently taking or plan to take soon.
If, for certain reasons, birth control pills have to be taken with other medications, other contraceptives (gels, condoms, etc.) must also be used during sexual intercourse.
Mini-pills are sold in 28 tablets. You need to drink every day, at a certain time, but without a week's break. These contraceptives are relevant for breastfeeding mothers. If the baby is formula-fed, it is better to use a COC with a low dosage of active ingredients, for example, Regulon. Combined oral contraceptives can be taken from 21-28 days after the baby is born.
The contraceptive effect appears after 2 weeks of taking the drugs. Therefore, you will get one hundred percent effect in the second month of taking COCs. The function of the ovaries will begin to be blocked with the first pill taken. But this is not a complete guarantee; you need to wait at least 2 weeks.
The effect of hormonal contraceptives on a woman’s body
The peculiarities of the influence of hormonal drugs on the human body are that many factors are perceived purely individually. The use of such drugs is not only an interference with natural physiological processes, but also an impact on the functioning of the body’s systems throughout the day. Therefore, the decision to prescribe hormonal drugs can only be made by an experienced doctor based on the results of a comprehensive examination and tests.
Hormonal contraceptives can be produced in various forms and dosages:
- combined;
- mini-pill;
- injections;
- plasters;
- subcutaneous implants;
- postcoidal drugs;
- hormonal rings.
Combination medications contain substances similar to female hormones produced by the ovaries. To be able to choose the optimal medicine, all groups of drugs can be monophasic, biphasic and triphasic. They differ in the proportions of hormones.
Knowing about the properties of gestagens and estrogens, we can identify certain mechanisms of action of oral contraceptives:
- reduction in the secretion of gonadotropic hormones due to the effects of gestagen;
- increased vaginal acidity due to the influence of estrogens;
- increased viscosity of cervical mucus;
- Each instruction contains the phrase “ovum implantation,” which represents a veiled abortifacient effect of the drugs.
Since the advent of the first oral contraceptives, debates about the safety of the drugs have not subsided, and research in this area continues.
Side effects
There are small (minor) and there are serious side effects of birth control pills. Small ones include:
- bleeding from the uterus between periods
- headache
- nausea
- swelling and pain in the mammary glands
- lack of menstruation
- very low appetite
- weight gain
- dizziness
- skin rash
- gas formation
- swelling of the lower extremities
- decreased libido
- hair growth is greater than usual
- chloasma
Significant side effects of COCs include the following:
- urticaria as an allergic manifestation of taking pills
- sudden changes in pressure (BP)
- manifestations of jaundice
- difficulty speaking
- loss of visual fields
- fainting
- cough that produces phlegm
- labored breathing
- hemicrania, migraine
- sharp pain behind the sternum
- pain and swelling of the calf muscle on the right or left
If you constantly experience certain side effects, even minor ones, you do not need to take the birth control pills you are currently taking. If a woman feels normal, she still needs to check her health from time to time: do a urine test, measure her blood pressure, feel her breasts on her own for lumps and discharge from the nipples.
Contraindications
The drug is advised not to be used by patients who have:
- sarcoidosis
- myasthenia gravis
- lymphogranulomatosis
- thyrotoxicosis
- multiple sclerosis
- rheumatoid arthritis
- bronchial asthma
- Gilbert's syndrome
- kidney dialysis
- thalassemia
- retinitis pigmentosa
COCs should absolutely by those who have the following pathologies and conditions:
- diseases in which blood clots form
- diabetes mellitus that has been present for a long time or is progressing
- smoking ladies over 25 years old
- obesity
- patients who will undergo any surgery in four weeks
- for those who are immobile for a long time
- for endocrine gland cancer
- patients with genital cancer
- for gestational herpes
- for hypertension of the second A or 3rd degree
- for idiopathic bleeding from the genitals
- ladies with idiopathic migraines
- those who have tumors or other liver diseases
- with pathological changes in cerebral vessels
- with diseases of the cardiovascular system
- with a real or suspected pregnancy
- for those who have passed less than 1.5 months after childbirth
- for those who are breastfeeding
Pure progestins cannot be used for the following conditions and diseases:
- genital cancer
- history of ectopic pregnancy
- heart and/or vascular diseases
- idiopathic bleeding from the genital tract
- acute liver diseases
- malignant neoplasms in the breast
- real or suspected pregnancy
Manufacturers of oral contraceptives say that modern drugs contain a minimal amount of hormones. Like, it's not harmful to health. But we must remember that long-term use is harmful to absolutely all women! Irreversible changes occur that do not appear immediately when taking birth control pills. When a woman has a stroke, pulmonary thromboembolism, or cancer in the future, it cannot be proven that oral contraceptives were the cause. But it is so.
Is it possible to get pregnant on birth control?
When deciding to use oral contraceptives, a woman wants to know what percentage of their effectiveness. Pregnancy cannot be 100% excluded with any method of contraception, including taking COCs. You can get pregnant if you missed a pill, took it at the wrong time, or used expired contraceptives. If vomiting occurred or other medications were taken along with oral contraceptives, the chances of pregnancy also increase.
If you find out you are pregnant while taking birth control, just stop taking the pill. There is no need to have an abortion.
Studies on side effects of oral contraceptives
In foreign countries, studies are constantly being conducted on the side effects of hormonal drugs on a woman’s body, which have revealed the following facts:
- Hormonal contraceptives are used by more than 100 million women in different countries.
- The number of deaths from venous and arterial diseases is recorded at 2 to 6 per million per year.
- The risk of venous thrombosis is important in young women
- Arterial thrombosis is relevant for older women.
- Among women who smoke and take OCs, the number of deaths is about 100 per million per year.
Side effects of oral contraceptives
Contraceptive drugs in late childbearing years
Today, in developed countries, couples in which the woman is over 40 years old undergo sterilization. This allows you to prevent pregnancies, which at this age occur with significant complications and sad consequences. If you decide to use hormonal contraceptives, your doctor will prescribe mini-pills or combination pills.
If a woman is over 25 years old, has heart disease, and also smokes (or is at risk of cancer), then it is very undesirable to take COCs. When you reach 40 years old, you can switch to mini-pills. They are also prescribed to those who have hyperplastic processes in the endometrium or have fibroids in the uterus.
Is it safe to use contraceptives for a long time?
Most people can safely use hormonal contraceptives for many years, but only with the advice of a doctor. However, many long-term birth control methods contain hormones. This can cause problems depending on the person's medical history, age, and overall health. Doctors may advise some people to avoid using certain types of contraceptives.
If your birth control pill is causing side effects, you should talk to your doctor and try other options until you find the one that works best for you.
Women who have blood clots may prefer a progesterone-only birth control pill or a hormone-free IUD.
Consequences of taking birth control pills
A woman may not be aware of developing cancer (or the risks of cancer) and may be taking pills to prevent pregnancy. In this case, her risk of developing a tumor increases significantly. Danish researchers claim that long-term use of oral contraceptives leads to an increase in the risk of brain tumors in women by 1.5-3 times. The risk of blood clots also increases. Additional risk factors are:
- smoking
- high blood pressure
- genetic disposition
When taking COCs, the risks of the following conditions and symptoms increase:
- chronic venous insufficiency
- spider veins on the legs and face
- breast cancer
- inflammatory pathologies of the cervix
- infertility
- dark spots
- multiple sclerosis
- scalp hair loss
- depression
- significant decrease in sexual desire, etc.
