Can birth control cause ovarian cysts. How does birth control affect ovarian cyst formation. What types of ovarian cysts exist and what are their symptoms. When should you seek medical attention for ovarian cysts. Which birth control methods are most effective in preventing ovarian cysts.

The Relationship Between Birth Control and Ovarian Cysts

Contrary to popular belief, birth control does not cause ovarian cysts. In fact, hormonal contraceptives can help prevent the formation of certain types of ovarian cysts by regulating ovulation. This misconception often leads to confusion among women seeking to manage their reproductive health.

How does birth control prevent ovarian cysts? By suppressing ovulation, hormonal contraceptives reduce the likelihood of functional cysts forming. These cysts typically develop during the normal menstrual cycle when an egg-containing follicle fails to release or dissolve properly.

Benefits of Birth Control for Ovarian Health

Beyond cyst prevention, birth control offers several advantages for ovarian health:

• Protection against ovarian cancer
• Reduced risk of endometrial cancer
• Prevention of unintended pregnancy
• Alleviation of menstrual cramps
• Regulation of menstrual cycles

Understanding Ovulation and Cyst Formation

To comprehend how ovarian cysts develop, it’s crucial to understand the process of ovulation. During each menstrual cycle, the ovaries prepare to release an egg. A fluid-filled sac, called a follicle, forms around the egg to facilitate its journey. Ovarian cysts occur when this sac grows larger than expected or fails to dissolve after releasing the egg.

The Ovulation Process

1. Follicle development: Several follicles begin to grow in the ovaries
2. Dominant follicle selection: One follicle becomes dominant and continues to mature
3. Egg release: The mature follicle ruptures, releasing the egg
4. Corpus luteum formation: The ruptured follicle transforms into the corpus luteum
5. Hormonal changes: The corpus luteum produces progesterone to prepare for potential pregnancy

Types of Ovarian Cysts: From Harmless to Concerning

Not all ovarian cysts are created equal. While many are benign and resolve on their own, others may require medical intervention. Understanding the different types can help women recognize when to seek medical attention.

Functional Ovarian Cysts

These are the most common type of ovarian cysts and are typically harmless. They form as part of the normal menstrual cycle and often disappear without treatment.

• Follicular cysts: Occur when the follicle doesn’t rupture to release the egg
• Corpus luteum cysts: Develop when the corpus luteum doesn’t dissolve after ovulation

Pathological Cysts

These cysts are less common but can be more serious, potentially requiring surgical intervention.

• Dermoid cysts: Contain tissue such as hair, skin, or teeth
• Cystadenomas: Develop from cells on the outer surface of the ovary
• Endometriomas: Form due to endometriosis

Recognizing Ovarian Cyst Symptoms

While many ovarian cysts are asymptomatic, some may cause noticeable symptoms. Being aware of these signs can help women seek timely medical attention when necessary.

Common Symptoms of Ovarian Cysts

• Pelvic pain or discomfort
• Bloating or swelling in the lower abdomen
• Painful intercourse
• Changes in menstrual patterns
• Frequent urination or difficulty emptying the bladder
• Lower back pain

When do ovarian cyst symptoms warrant medical attention? If you experience sudden, severe abdominal pain, fever, or vomiting, it’s crucial to seek immediate medical care as these could indicate a ruptured cyst or ovarian torsion.

Serious Complications of Ovarian Cysts

While most ovarian cysts are benign and resolve on their own, some can lead to serious complications that require immediate medical intervention.

Ovarian Torsion

This occurs when a large cyst causes the ovary to twist on its blood supply, potentially leading to tissue death if left untreated. Symptoms include severe pelvic pain, nausea, and vomiting.

Cyst Rupture

A ruptured cyst can cause sudden, intense abdominal pain and internal bleeding. While some ruptures are minor and heal on their own, others may require surgical intervention.

Malignancy

In rare cases, ovarian cysts may be cancerous. Regular check-ups and prompt attention to unusual symptoms can help detect any malignancies early.

Diagnosing and Treating Ovarian Cysts

Proper diagnosis and treatment of ovarian cysts are essential for maintaining reproductive health and preventing complications.

Diagnostic Methods

• Pelvic examination
• Ultrasound imaging
• Blood tests to check hormone levels and tumor markers
• CT scan or MRI for more detailed imaging

Treatment Options

How are ovarian cysts treated? The approach depends on the type, size, and symptoms of the cyst:

• Watchful waiting for small, asymptomatic cysts
• Hormonal birth control to prevent new cyst formation
• Pain medication for symptom relief
• Surgical removal for large or persistent cysts

Choosing the Right Birth Control for Ovarian Cyst Prevention

While all hormonal birth control methods can help prevent ovarian cysts to some extent, certain types may be more effective than others.

Most Effective Birth Control Methods for Cyst Prevention

1. Combined oral contraceptives (estrogen and progestin)
2. Hormonal IUDs
3. Birth control implant
4. Birth control patch
5. Vaginal ring

Which birth control method is best for preventing ovarian cysts? Combined oral contraceptives are often considered the most effective option as they consistently suppress ovulation. However, the best choice depends on individual factors and should be discussed with a healthcare provider.

Lifestyle Factors and Ovarian Cyst Risk

While birth control plays a significant role in preventing ovarian cysts, certain lifestyle factors can also influence their development.

Factors That May Increase Ovarian Cyst Risk

• Hormonal imbalances
• Obesity
• Fertility treatments
• Early menstruation
• Endometriosis
• Pelvic infections

Lifestyle Changes to Reduce Risk

How can you naturally reduce your risk of developing ovarian cysts?

• Maintain a healthy weight
• Exercise regularly
• Manage stress levels
• Eat a balanced diet rich in fruits, vegetables, and whole grains
• Avoid smoking and excessive alcohol consumption

By combining these lifestyle changes with appropriate birth control methods, women can significantly reduce their risk of developing ovarian cysts and maintain optimal reproductive health.

When to Seek Emergency Care for Ovarian Cysts

While many ovarian cysts are harmless, certain symptoms may indicate a medical emergency requiring immediate attention.

Warning Signs of Ovarian Cyst Complications

• Severe, sudden abdominal pain
• Pain accompanied by fever or vomiting
• Signs of shock, such as cold, clammy skin or rapid breathing
• Dizziness or fainting
• Heavy vaginal bleeding

What should you do if you experience these symptoms? Seek emergency medical care immediately, as they could indicate a ruptured cyst, ovarian torsion, or internal bleeding.

Emergency Room Treatment for Ovarian Cyst Complications

In an emergency situation, healthcare providers may perform the following:

• Rapid assessment and stabilization
• Pain management
• Imaging studies to determine the cause and extent of the problem
• Emergency surgery if necessary
• Intravenous fluids and medication to prevent infection

The Future of Ovarian Cyst Prevention and Treatment

As medical research advances, new strategies for preventing and treating ovarian cysts are emerging.

Promising Developments in Ovarian Cyst Management

• Improved imaging techniques for earlier detection
• Minimally invasive surgical procedures
• Novel hormonal therapies with fewer side effects
• Genetic testing to identify those at higher risk
• Personalized treatment plans based on individual risk factors

How might these advancements change ovarian cyst management in the future? They could lead to more precise diagnoses, less invasive treatments, and better overall outcomes for women with ovarian cysts.

The Role of Telemedicine in Ovarian Health

Telemedicine is playing an increasingly important role in women’s reproductive health care, including the management of ovarian cysts.

• Remote consultations for initial assessments
• Virtual follow-ups for monitoring cyst progression
• Online prescription and management of birth control
• Improved access to specialist care for women in rural areas

By leveraging technology, healthcare providers can offer more accessible and convenient care for women dealing with ovarian cysts or seeking preventive measures.

Empowering Women Through Education and Awareness

Knowledge is power when it comes to reproductive health. By understanding the relationship between birth control and ovarian cysts, women can make informed decisions about their health care.

The Importance of Regular Check-ups

Regular gynecological exams are crucial for maintaining reproductive health and catching any potential issues early.

• Annual pelvic exams
• Pap smears as recommended by your healthcare provider
• Discussion of any changes in menstrual patterns or pelvic pain
• Review of birth control options and effectiveness

Self-advocacy in Reproductive Health

How can women better advocate for their reproductive health?

• Keep track of menstrual cycles and any unusual symptoms
• Ask questions and seek clarification from healthcare providers
• Stay informed about the latest research and treatment options
• Discuss concerns openly with healthcare providers
• Seek second opinions when necessary

By taking an active role in their reproductive health care, women can ensure they receive the best possible care and prevention strategies for ovarian cysts and other gynecological issues.

Can Birth Control Cause Ovarian Cysts?

Women’s reproductive health is a topic that doesn’t get discussed very often. This can lead to a lot of misinformation to exist, especially in the worldwide web. You’ll start to ask yourself questions like, can birth control cause ovarian cysts? Village Emergency Centers have decided to give you a complete overview of ovarian cysts and offer you treatment methods that will help you live a healthier and painless life.

Can Birth Control Cause Ovarian Cysts?

There is a big misconception that birth control can cause ovarian cysts. Birth control actually regulates ovulation so it’s the best way to prevent cysts from causing you discomfort. Birth control not only helps prevent cysts but also improves ovarian health in a number of ways.

• It can protect against ovarian cancer
• It can protect against endometrial cancer
• Prevents pregnancy
• Alleviates cramps

Learn More:  Should I go to the emergency room for a UTI?

Ovulation and the Formation of Cysts

In order to understand cysts, you need to first know about ovulation. During ovulation, your body’s getting ready for pregnancy. Your ovaries will release an egg every month. For the egg to travel, a sac filled with fluid will form around it. A Cyst occurs when that sac of fluid grows more than expected. 

An Overview of Cysts

There is more than one type of cyst. Cysts may sound alarming, but more often than not you will not realize that you ever had a cyst as they tend to dissolve on their own. However, it’s still important to know that some are more harmful than others, here we will list them all so you know which to keep an eye on.

Functional ovarian cysts-Most common type found in women. They are harmless and go away on their own. Some functional cysts include: 

• Follicular cysts: This type forms when the sac of fluid, or follicle, does not get released. The egg may not get released as well. It goes away after several weeks.
• Luteal ovarian cysts: This type is less common and forms when the tissue that is left behind from the egg fills up with blood. This cyst will go away within a few months. This type can lead to pain if it ruptures.

Pathological cysts-This type has the chance to be malignant, meaning it could be cancerous. Some pathological cysts include:

• Dermoid cysts: These cysts are mostly benign. They form from the same cells the eggs are made from. Surgery is required to remove them. They are often found in women under the age of 30.
• Cystadenomas: Formed from cells that surround the outer part of the ovaries. These also require surgical removal and are common in women over the age of 40.

• Endometriomas: Cysts formed due to endometriosis when the uterine lining begins to grow outside of the uterus.

Signs You Should Seek Treatment for a Cyst

Symptoms

While cysts might not always produce symptoms, when they do, you should be careful and monitor the progression of them. Here are just a few you should watch over:

• Irregular and painful periods
• Pelvic pain
• Pain during sex
• Irritable bowel
• Bloating 
• Urinary problems
• Hormonal imbalance 

Serious Issues

Serious problems can develop with cysts. If you feel you have any of these, please seek immediate medical attention: 

• Torsion: The stem of the ovary twists when the cyst is growing on it. It will then block the blood supply to the cyst and lead to severe abdominal pain.
• Burst Cyst: A burst cyst will result in severe pain in the abdomen.
• Cancer: A cyst could be malignant. It’s best to know of cysts as early as possible to catch cancer at an early stage. Cervical cancer is one of the most aggressive forms of cancer and one of the deadliest. 

Further Reading:

• • • • Cancer Misdiagnosis: How common is it?
    • • STD Facts: Top 5 things you need to know

Seek Help For Ovarian Emergencies 

Now that you’ve learned all about ovarian cysts you will understand that birth control doesn’t cause ovarian cysts, it can actually help. Our River Oaks emergency room, Katy emergency room, Clear Creek emergency room, and our new Jersey Village emergency room are ready to assist you at a moment’s notice. At Village Emergency Centers, we strive to provide you and your loved ones quality medical emergency care. 

Our emergency centers are conveniently open 24/7 and accept walk-ins for your convenience. Get directions here to visit one of our locations.

Find The Best Birth Control For Lowering Risk Of Ovarian Cysts

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated March 2, 2021

Birth control and ovarian cysts 

While ovarian cysts typically have a negative stigma, they are normal and can heal on their own or with minor treatment. There are multiple interventions that can reduce the likelihood of developing this health condition. The following article will cover the relationship between ovarian cysts and hormonal birth control.

How can birth control prevent ovarian cysts from forming?

Taking hormonal birth control, such as the pill, patch, ring, or IUD, can be an effective method in preventing ovarian cysts from forming.

Combination birth control pills, which contain estrogen and progesterone, are the most effective at blocking ovulation. The mini-pill, which contains only progestin, has an unpredictable effect on ovulation and is, therefore, less effective at preventing cysts from forming.

Individuals who skip their periods while on birth control further decrease their likelihood of developing cysts. To learn more about how to skip your periods using birth control, check out our #PeriodsOptional page. 

Birth Control for Ovarian Cysts

Don’t let ovarian cysts disrupt your life – explore the best birth control options for symptom management and prevention. Get expert advice and take control of your reproductive health today.

What is an ovarian cyst?

TL;DR: An ovarian cyst is a bubble of fluid that can be found in or on an ovary (the organ in the female reproductive system that produces eggs).

During the menstrual cycle, the ovaries release an egg in a process called ovulation. In order for this process to occur, a fluid-filled sac, or follicle must develop around the egg. In some cases, this sac grows larger than normal and becomes a cyst.

What symptoms occur if an ovarian cyst is present? 

A cyst can grow to around a half-inch to an inch and may even double the size of the ovary. In most cases, the body will reabsorb the fluid from the cyst within a few weeks or months, and the individual will not notice any bodily changes. However, some cysts may lead to unpleasant symptoms, including, but not limited to:

• Abdominal pain and bloating = feeling of fullness or heaviness in your stomach
• Intermittent pelvic pain = on and off pain in your lower abdomen
• Pain or discomfort during bowel movements = difficulty pooping
• Pain or discomfort during sex = more pain than usual while having penetrative sex

If detected early, a cyst can be treated quickly. In some cases, a cyst can keep growing and lead to additional complications. For instance, the growth may lead to ovarian torsion, in which the ovary becomes twisted. An abnormally large cyst may also rupture, or burst, and cause internal bleeding. Symptoms of a problematic cyst include:

• Sudden, severe pain in the pelvis or lower abdomen
• Fever and vomiting
• Dizziness or fainting

If you experience one or more of these symptoms, consult a doctor immediately. They can help determine the best course of action going forward. 

What are the different types of ovarian cysts?

The two most common types of cysts are as follows: 

Follicular 

Halfway through the menstrual cycle, an egg bursts out of its sac, or follicle, and travels down the fallopian tube. In the event that an egg is not released, but the follicle continues to grow, a follicular cyst will form.  

Corpus luteum 

Once the follicle releases an egg, it becomes a corpus luteum. If fluid accumulates inside, the corpus luteum will grow into a cyst. 

Follicular and corpus luteum cysts are benign (non-cancerous) and typically resolve on their own. If they are particularly large, a doctor might opt for monitoring via ultrasound for up to six months to ensure that no further complications occur. 

There are a few other types of ovarian cysts that are less common as they are not related to the normal function of an individual’s menstrual cycle:

Dermoids

These contain tissue, such as hair, skin, or teeth, form on embryonic cells during a woman’s reproductive years. Dermoids can also occur on the face, inside the skull, or on the lower back, and can be removed via medical techniques such as surgery. In most cases, they are benign.

Cystadenomas

These develop on the surface of an ovary and are typically filled with a watery or mucus material. In most cases, they go away on their own and do not cause symptoms. However, in the event that they become malignant, they may become painful and require removal.  

Endometriomas

These develop as a result of endometriosis, a condition in which endometrial cells grow on areas outside of the uterus such as the ovaries, bowels, and pelvis. Individuals who develop endometriomas may experience symptoms regardless of the size of the actual cyst. Being that these cysts are common in those with endometriosis, birth control may be implemented to slow their growth and, in turn, manage pain. 

How are cysts treated?

Thankfully, many cysts resolve on their own without intervention being required. However, those that have grown abnormally large or ruptured may need to be removed in order to relieve the individual of symptoms. 

A cyst can be detected via a pelvic exam. Depending on its size and whether it contains fluid, the doctor may recommend further tests in order to determine the best course of action. For instance, an ultrasound may be taken to create an image of the uterus, which can be further analyzed to confirm the presence of a cyst.  

If it is determined that a cyst is present, treatment options available will vary based on the severity. In some cases, the doctor may have an individual wait and come back for an exam at a later date to monitor any changes. In the event that a cyst becomes large and causes pain, removal may be necessary. This could occur in the form of laparoscopy, a process in which an instrument is inserted into the abdomen. In some more serious cases, the entire affected ovary may be removed via a surgery called oophorectomy. 

While cysts cannot be entirely prevented, an individual may be able to decrease their risk of developing one if they take hormonal birth control. As ovarian cysts form during the process of ovulation, stopping this process can reduce the likelihood that a cyst will form. With that said, birth control should not be used as a means to shrink a cyst that is already present.

Is the presence of ovarian cysts always an indicator of PCOS?

Polycystic Ovarian Syndrome (PCOS) is a hormonal condition that affects women of child-bearing age. The word “polycystic” means “many cysts” – individuals with PCOS develop many fluid-filled sacs inside their ovaries. There are several symptoms associated with the disorder, including, but not limited to, irregular periods, acne, weight gain, and headaches. 

With all of that being said, having ovarian cysts alone is not an indicator of PCOS. However, if additional symptoms are present, the affected individual should consult a doctor. They may order a blood test or pelvic examination to determine whether or not PCOS is the underlying issue. 

Are ovarian cysts cancerous?

Many ovarian cysts are benign, but some can be cancerous. Cancerous cysts are more common in older, post-menopausal women.

All cysts should be checked by a doctor. If they find a cyst to be cancerous, they may refer you to a gynecologic cancer specialist. In some cases, a total hysterectomy (removal of the uterus, ovaries, and fallopian tubes) may be necessary.

Birth Control for Ovarian Cysts

Don’t let ovarian cysts disrupt your life – explore the best birth control options for symptom management and prevention. Get expert advice and take control of your reproductive health today.

Who is most at risk of getting ovarian cysts?

Individuals with uteruses who have regular periods are at the highest risk for getting ovarian cysts. The majority of those who menstruate every month will form at least one follicle or corpus luteum each month during ovulation. For this reason, skipping periods using birth control will reduce the likelihood of developing ovarian cysts. 

Most cysts do not cause any symptoms and may not even be noticed by the affected individual. The cyst becomes problematic if it grows large enough to cause pain and other unpleasant symptoms. Thankfully, only around 8% of women who ovulate regularly will have developed a cyst that causes complications. For postmenopausal women — women who have not gotten their period in over a year — an ovarian cyst is a risk factor for cancer.

What’s the takeaway?

While many ovarian cysts will not lead to further complications, it’s important to consult a doctor if you notice abnormal symptoms. Thankfully, ovarian cysts can be resolved quickly once they’ve been identified. If you develop an ovarian cyst, know that it is normal and common! 

How can Pandia Health help? 

Did you know that hormonal birth control has other health benefits, in addition to preventing pregnancy and reducing the risk of ovarian cysts developing? Using birth control pills for at least five years can lower an individual’s risk of developing ovarian cancer by up to 40%, even if there is a family history. Birth control can also lower the risk of developing endometrial cancer. 

At Pandia Health, believe people who ovulate should have the choice to have ultimate control over their reproductive systems. Stopping your periods completely with #PeriodsOptional can be incredibly beneficial for both a person’s mental and physical health. 

To explore how birth control can be beneficial to you and to find a type of birth control that aligns with your needs and lifestyle, sign up with Pandia Health today! With just one $25 payment a year, you can get access to our expert doctors (available in these states) for 364 days.

Disclaimer: The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

Prevention of the formation of functional cysts uMEDp

The lecture describes the pathogenetic mechanisms of the formation of functional cysts, taking into account the features of the function of the reproductive system in different periods of a woman’s life. Methods of diagnostics, as well as modern principles of therapy and prevention of functional cysts are outlined.

Introduction

In recent years, there has been an increase in the frequency of functional ovarian cysts, which can be explained both by the influence of external factors (ecology, mental, physical stress) and by an increase in gynecological morbidity (inflammatory diseases of the pelvic organs, adhesions, endometriosis) [1]. An important role is given to the physiological features of the function of the reproductive system in different periods of a woman’s life, when the formation of functional cysts is natural. At the same time, the issue of differential diagnosis of ovarian cysts and tumors remains relevant, since the therapeutic approach in these cases is fundamentally different [2].

A retrospective analysis of removed ovarian tumors showed that in 11.8% of cases, ovarian formations turned out to be functional cysts, therefore, there were no indications for their surgical removal [3]. The frequency of occurrence of functional cysts, according to a retrospective analysis of operations, ranges from 15 to 30% [2]. Existing methods (even ultrasound-controlled aspiration) do not allow to differentiate functional cysts from true tumors in more than 70% of cases [3].

Most cysts accidentally detected during ultrasound examination (ultrasound) do not require treatment [4]. According to some reports, a woman with a cyst even up to 10 cm in diameter can safely remain under observation [4]. The duration of observation is several menstrual cycles. If during this period of time the cyst does not spontaneously disappear, it is probably not a functional cyst, and active actions should be taken [5].

It is impossible to completely avoid the practice of removing functional cysts. However, the annual analysis of operational activity helps to reduce the frequency of cyst removal by 30% [3]. The most effective way to prevent unnecessary surgery is to prevent the formation of ovarian cysts. In this regard, the possibility of using combined hormonal contraceptives has long been widely discussed in scientific and practical medical circles.

It is assumed that by suppressing ovulation, hormonal contraceptives reduce the likelihood of detecting follicular cysts and cysts of the corpus luteum on ultrasound [6]. Epidemiological research in the 1970s–1990s demonstrated conflicting data on the relationship between oral contraceptives and functional cysts. It was generally accepted that the use of short courses of oral contraceptives is an effective treatment for ovarian cysts in the early stages [4]. However, according to the results of recent meta-analyses, there is no difference between the use of oral contraceptives and placebo in the treatment of ovarian cysts [5].

An analysis of eight randomized controlled trials (n = 686) showed that treatment with combined oral contraceptives did not accelerate the disappearance of ovarian cysts. This applies both to cysts that appeared spontaneously and to cysts that formed after ovulation induction. Most cysts disappeared without treatment after a few cycles. Those cysts that did not disappear were most likely pathological (for example, endometrioma or paraovarian cysts). According to the results of the meta-analysis, expectant management was recommended for two to three cycles. If during this period of time the cyst did not regress, it was recommended to plan surgical treatment [7].

Over the past nine years, more than 170 patients with ovarian cysts have been referred to our clinic for surgical treatment (laparoscopy). According to the anamnesis, clinical picture and examination results, the preliminary diagnosis suggested the presence of functional cysts. The tactics of doctors was expectant for two to three months. The conducted antigonadotropic therapy, which will be described below, proved to be effective in 82.5% of patients, which made it possible to avoid surgical intervention.

Pathogenetic mechanisms of formation of functional cysts in different periods of a woman’s life

Puberty

Puberty is characterized by the gradual maturation of the central structures of the reproductive system, the formation of cyclic secretion of gonadotropin-releasing hormone, ovulatory cycles. In the physical development of a girl, the formation of secondary sexual characteristics, the skeletal system, not only a progressive increase in the production of sex steroids, but also an increased production of insulin is important. Supraphysiological secretion of insulin occurs under the influence of somatotropic hormone, the production of which in puberty is increased and decreases only by the age of 18. Thus, physiological hyperinsulinemia is necessary for the normal physical development of a girl.

It is known that in normal concentrations, insulin does not affect the processes of follicle and steroidogenesis in the ovaries. At supraphysiological concentrations, insulin not only enhances the luteinizing hormone-dependent androgen synthesis, but also, by directly affecting the pituitary gonadotrophs, increases the production of gonadotropins. As a result, gonadotropic stimulation of the ovaries increases, which causes the formation of functional cysts (follicular or corpus luteum). This occurs after menarche during the formation of ovulatory cycles.

Childbearing age

At childbearing age, the reproductive system is fully formed and functions stably. Most often in this period of life, cysts of the corpus luteum are observed, which is associated with the growth of a large preovulatory follicle.

Reasons for the formation of functional cysts in this period:

• mental, physical stress, neuroinfections, climate change, etc.;
• adhesive process as a result of inflammatory diseases of the pelvic organs, surgical interventions on the pelvic organs, resection of the ovaries, unilateral oophorectomy, hysterectomy without appendages;
• external genital endometriosis – as a result of the functioning of the heterotopic endometrium, the composition of the peritoneal fluid is disturbed and pro-inflammatory cytokines are activated that disrupt the processes of folliculogenesis;
• metabolic syndrome.

Recurrent functional cysts occur due to a decrease in ovarian reserve, which is accompanied by a gradual increase in the secretion of follicle-stimulating hormone and an increase in gonadotropic stimulation of the ovaries.

Let us recall the main stages of folliculogenesis, since ignorance of them often leads to an incorrect diagnosis.

1. From primordial to precavitary follicles – gonadotropin-independent growth that continues until the formation of follicles with a diameter of 1-4 mm and lasts at least four months.

2. From preantral (precavitary) to antral (cavitary) follicles – gonadotropin-independent stage lasting 60 days. This stage explains the presence of small cavitary follicles, which are determined echographically on any day of the menstrual cycle. As a result, there is an overdiagnosis of polycystic ovaries with ultrasound and, unfortunately, unnecessary surgical interventions (cauterization of the ovaries) during laparoscopy. As a result, the ovarian reserve decreases.

3. Gonadotropin-dependent growth and maturation of a cohort of follicles, the number of which depends on the ovarian reserve, since the end of the previous cycle (if pregnancy has not occurred). Selection, growth and maturation of the dominant follicle, luteinization of granulosa cells, formation of the corpus luteum. In the early follicular phase until the fifth day of the cycle, the growth of follicles is dependent on the follicle-stimulating hormone, the size of the follicles is 5–6 mm in diameter.

The level of follicle-stimulating hormone reaches its maximum value by the fifth day of the cycle, after which it decreases to an increase simultaneously with luteinizing hormone to the ovulatory peak. It is believed that the selection of the dominant follicle occurs during the growth of the pool of antral follicles by the fifth day of the menstrual cycle with a follicle size of 5–6 mm. The follicle with the largest diameter becomes dominant; in the preovulatory period, the synthesis of estradiol in it is carried out independently and is regulated exclusively with the help of auto- and paracrine factors.

In the main cohort of follicles, the synthesis of estradiol remains dependent on the follicle-stimulating hormone, and a decrease in the concentration of gonadotropin as a result of feedback causes an atresia process, the mechanism of which is associated with the activation of apoptosis.

The composition of the follicular fluid of dominant and atretic follicles is different. The dominant follicle is characterized by a high concentration of estradiol. In the atretic follicle, on the contrary, the concentration of androgens is high, mainly androstenedione.

The process of ovulation occurs when the maximum level of estradiol is reached in the preovulatory follicle (at least 18 mm in diameter), which, by positive feedback, stimulates the ovulatory release of luteinizing and follicle-stimulating hormones by the pituitary gland. Ovulation occurs 24-36 hours after the peak of the luteinizing hormone.

The important role of progesterone, which is synthesized in luteinized cells of the preovulatory follicle under the influence of the luteinizing hormone peak, in the activation of proteolytic enzymes involved in the rupture of the basement membrane of the follicle has been shown. It is endogenous progesterone that plays an important role in the process of full ovulation. Many practitioners prescribe progesterone preparations from the 11th day of the cycle in expected fertile cycles, which has no physiological justification and can reduce the preovulatory peak of luteinizing hormone secretion if the progestogen has an antigonadotropic effect.

After ovulation, granulosa cells undergo further luteinization with the formation of a corpus luteum secreting progesterone under the influence of luteinizing hormone and auto- and paracrine factors. The structural formation of the corpus luteum is completed by the seventh day after ovulation, which corresponds to a progressive increase in the concentrations of sex steroids. The regression of the corpus luteum to white occurs within two menstrual cycles, therefore, in each cycle there will be both a functioning corpus luteum and a corpus luteum that has not completely regressed from the previous cycle. On ultrasound in such situations, an unjustified diagnosis of ovarian endometriosis is often made, since the echographic picture is very similar to a small endometrioid cyst.

For full ovulation, the diameter of the preovulatory follicle must be at least 18 mm, up to 25 mm is acceptable. If, under the influence of various factors, gonadotropic stimulation increases, the diameter of the dominant follicle can reach 25 mm or more, and the secretion of estradiol increases accordingly. Active proliferation develops in the endometrium. Under the influence of luteinizing hormone, a corpus luteum cyst is formed with hemorrhages into the cavity and, possibly, with tearing of the capsule. Clinical manifestations in this situation can be:

• pain syndrome that prompts a woman to seek medical attention or emergency medical care;
• intermenstrual bleeding as a result of endometrial rejection is usually not abundant;
• acute pain in the mammary glands with a short-term increase in prolactin production due to absolute hyperestrogenism. In this case, the diagnosis of fibrocystic breast disease may be unjustifiably made.

When a cyst ruptures with bleeding into the abdominal cavity, surgical treatment is indicated, for massive intra-abdominal bleeding – laparotomy with ovarian resection, which reduces ovarian reserves and increases the risk of functional cysts that can recur in each cycle. A high frequency of adhesion formation is also a background for the formation of functional cysts.

Pre- and perimenopause

In pre- and perimenopausal age, due to involutive processes in the central and peripheral structures of the reproductive system, after 40 years, a gradual increase in the level of gonadotropins is observed. As a result, follicles persist in the ovaries or follicular cysts form, synthesizing a large amount of estradiol. However, absolute hyperestrogenism cannot, by the principle of negative feedback, reduce the production of gonadotropins. Firstly, the secretion of follicle-stimulating hormone is greatly influenced by inhibin, the production of which decreases with age. Secondly, the aging hypothalamic-pituitary system gradually loses the ability to adequately respond to the rapidly changing secretion of ovarian steroids. Against the background of the continuing increase in the level of gonadotropins in the ovaries, the reserves of follicles are gradually consumed. This process takes a long time and continues even in postmenopause. Thus, women of menopausal age need long-term prophylaxis.

Diagnosis

Diagnosis of functional cysts is usually straightforward. The first symptom is pain in the lower abdomen, blood discharge of varying intensity is possible as a result of a violation of the maturation of the endometrium and its excessive proliferation against the background of absolute hyperestrogenism. On echography in the ovary, an anechoic formation is determined with follicular cysts and a hyperechoic structure with cysts of the corpus luteum.

Differential diagnosis is between corpus luteum cysts and endometriomas. The latter are characterized by a thickening of the capsule, since the mechanism of endometrioma formation consists in the invagination of the primary focus into the ovary. In other words, the cyst bed is the ovarian cortex with a certain supply of primordial follicles.

Follicular cysts must be differentiated from paraovarian cysts that do not cause menstrual irregularities. In addition, true ovarian tumors that will not regress against the background of antigonadotropic therapy should be excluded.

Treatment

When determining the tactics of treatment, it is necessary to take into account the patient’s age, clinical manifestations, metabolic disorders, concomitant gynecological and extragenital diseases, contraindications and drug tolerance.

Hormone therapy

As stated above, the mechanism of formation of functional cysts is associated with gonadotropic stimulation of the ovaries, therefore, pathogenetic therapy implies suppression (suppression) of the gonadotropic function of the pituitary gland. The drugs of choice are third-generation combined hormonal contraceptives, which include desogestrel, which does not have androgenic effects (Marvelon). This progestogen, in combination with 30 µg of ethinyl estradiol, has a pronounced antigonadotropic effect. The frequent practice of using progesterone analogues in functional cysts is unfortunately not effective, since these progestogens do not suppress the synthesis of gonadotropins.

In case of corpus luteum cysts that are diagnosed on the 15-17th day of the cycle, it is especially important to suppress the secretion of gonadotropins, since the cysts increase under the influence of luteinizing hormone, similar to ovarian hyperstimulation syndrome. In such cases, desogestrel-containing combined hormonal contraceptives are first prescribed one or two tablets (for large cysts) for 15 days to suppress the secretion of luteinizing hormone and achieve the effect of hormonal “curettage”, which is important, since the endometrium in such cycles is not subject to normal secretory transformation. Further, from the fifth day of the cycle, combined hormonal contraceptives are used one tablet at a time in a cyclic or prolonged regimen (for large cysts) under ultrasound control until the cyst completely regresses. When using short treatment courses of combined hormonal contraceptives, a relapse is natural due to the stimulation of ovulation by the type of rebound effect, therefore, it is necessary to prevent relapse with low-dose combined hormonal contraceptives.

Non-hormonal treatments

It is considered reasonable to use non-steroidal anti-inflammatory drugs for seven to ten days in the form of tablets or rectal suppositories once or twice a day, depending on the drug used. In addition to the anti-inflammatory effect, such therapy has an analgesic effect, stopping the pain syndrome that often accompanies cysts.

Antibacterial therapy is indicated for apoplexy and the presence of blood in the pelvis, according to echography, or a temperature reaction with an increase in leukocytes in the blood.

Patients develop a fear of possible surgical treatment, which greatly exacerbates stress. To stabilize the emotional background, sedatives can be prescribed for ten or more days until the pain syndrome stops and the cyst regresses.

Prophylaxis

Adolescent girls may be advised to continue taking combined hormonal contraceptives with desogestrel in a cyclic regimen for six months. After the cancellation of combined hormonal contraceptives, the cyclic secretion of gonadotropin-releasing hormone normalizes and ovulatory cycles are established. Recurrence of functional cysts is rare.

For sexually active women, for the purpose of further contraception, it is advisable to use the NovaRing vaginal releasing system, which includes the lowest dose of ethinyl estradiol (15 mcg) and 120 mcg of etonogestrel, the active metabolite of desogestrel. The absence of primary passage through the liver and the constant entry of active substances into the bloodstream contribute to the creation of a stable concentration of ethinylestradiol and etonogestrel in the blood. That is why, when using the NuvaRing vaginal ring, good cycle control is noted and acyclic bleeding is rarely observed.

Women of reproductive age, especially those at risk of cyst recurrence (surgical interventions on the pelvic organs, ovarian resections, history of unilateral oophorectomy), need to take combined hormonal contraceptives for a long time. For this reason, the drug should contain a minimum of estrogen and be as convenient as possible to use. Today, one of the combined hormonal contraceptives that meets these requirements is the NovaRing vaginal ring. It should be noted that the minimum dose of estrogen (ethinyl estradiol) in oral combined hormonal contraceptives is 20 mcg. Numerous studies have shown excellent menstrual cycle control when using the NuvaRing vaginal ring in the usual 21/7 regimen and compared with combined hormonal contraceptives containing 30 and 20 mcg of ethinyl estradiol. Due to the ultra-low dose of estrogen, NovaRing rarely causes such side effects as weight gain, nausea, mastalgia, migraine, prompting a woman to refuse further use of combined hormonal contraceptives.

Our clinic has more than 10 years of experience in prescribing the NovaRing vaginal releasing system. In recent years, we recommend women with frequent recurrences of functional cysts or when they occur against the background of the 21/7 regimen, the use of the NovaRing vaginal ring without interruption – a change every 21-28 days. Against the background of the prolonged regimen, there is a more pronounced suppression of the pituitary secretion of gonadotropins and, accordingly, folliculogenesis. The results of studies on the use of various ring modes were published by us earlier [4].

If there are contraindications to taking estrogen, progestogen therapy is performed. In order to prevent relapse, it is recommended to prescribe desogestrel (Charosetta). Unlike the previous generation of mini-pills, Charosetta’s mechanism of action – suppression of ovulation – is comparable to that of combined hormonal contraceptives. The high selectivity of desogestrel ensures reliable suppression of ovulation, as well as the absence of androgen-dependent adverse reactions. Doses of 75 micrograms of desogestrel are sufficient to provide these effects. Like all progestogenic contraceptives, Charozetta is used continuously without seven-day intervals.

In recent years, long-term contraception (three years) has been successfully used – subcutaneous administration of the pure progestogen Implanon (etonogestrel), which suppresses ovulation, is comparable to combined hormonal contraceptives.

Premenopausal women also need long-term prophylaxis, as the secretion of gonadotropins progressively increases and the risk of developing follicular cysts increases in perimenopause. As a result, recurrent hyperplastic processes occur in the endometrium, requiring repeated diagnostic curettage, which adversely affects the health, working capacity and quality of life of a woman. The most common mistakes of practitioners is the appointment of progestogens (Dufaston, Utrozhestan) in the second phase of the cycle to patients with follicular cysts. As mentioned above, these drugs do not have an antigonadotropic effect and therefore do not contribute to the regression of follicular cysts and persistent follicles.

It is recommended to use NuvaRing until the age of natural menopause. Another advantage of this tactic is the stabilization of the growth of uterine fibroids, the relief of the symptoms of menopausal syndrome that occur in perimenopause. The appointment of combined hormonal contraceptives before the onset of menopause has obvious advantages over the use of menopausal hormonal therapy, since before the end of menstrual function, menopausal hormonal therapy is associated with a high incidence of breakthrough bleeding, the risk of cyst recurrence due to the lack of suppression of folliculogenesis, and the absence of a contraceptive effect in sexually active women.

Conclusion

Expectant monitoring of patients is possible with small sizes of functional cysts and for only two or three cycles, then it is advisable to carry out antigonadotropic therapy for the purpose of differential diagnosis with true ovarian tumors. With large corpus luteum cysts and the presence of pain, expectant management is not justified, since there is a risk of cyst rupture with bleeding into the abdominal cavity. Timely antigonadotropic therapy avoids traumatic surgical interventions that reduce ovarian reserves in women who have not realized their generative function. Frequent curettage in women of pre- and perimenopausal age with abnormal uterine bleeding against the background of follicular cysts leads to a decrease in working capacity, adversely affects health and quality of life. Combined hormonal contraceptives of the latest generation with minimal health risks allow avoiding surgical interventions and maintaining reproductive health.

Oral contraceptives, selection of contraceptive preparations Chelyabinsk.

Oral contraceptives, selection of contraceptive preparations Chelyabinsk

Oral hormonal contraceptives, or oral contraception, as they are called worldwide, consisting of synthetic hormones, prevent pregnancy by suppressing the process of ovulation and the impossibility of implantation of the egg to the uterine wall

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Remember! No other contraceptive provides such a reliable, almost 100% degree of protection against unwanted pregnancy!

The probability of getting pregnant while taking oral contraception is 0.2-0.5%! This is a huge advantage of hormonal contraception.
It is hormonal contraception that is now at the peak of popularity all over the world. In some European countries, combined oral contraceptives are used by up to 70% of women of reproductive age. In Russia, unfortunately, no more than 5-7%. But such contraception gives an almost 100% guarantee of preventing unwanted pregnancy, significantly surpassing all other contraceptives in efficiency. What’s the matter?

Apparently, many of us have heard about unwanted side effects – weight gain, acne, hair growth, etc. But all this applied to the old generation of contraceptives. Currently, highly effective low-dose hormonal preparations have been created that have practically no side effects. In addition, they have the ability to prevent many female diseases, such as endometriosis, hyperplasia, polyposis, fibroids and malignant neoplasms.

The peculiarity of reducing the risk of developing cancer of the reproductive organs should be paid attention to women after 40 years of age. If you take hormonal contraceptives for at least 2 years before menopause, the risk of developing ovarian cancer is reduced by 40%. And this effect persists for 10-15 years after the drug is discontinued! Naturally, women of late reproductive age should undergo the necessary examinations before starting to take hormonal contraceptives.

If the high level of hormones in the preparations of previous generations did not allow them to be prescribed to young girls, now low- and micro-dose oral contraceptives are ideal for nulliparous girls, in particular regulon and novinet. Moreover, they have a positive effect on the condition of the skin – it becomes healthy and smooth, youthful acne disappears, and also reduce hair growth, and not increase, as many believe. Naturally, you need to select hormonal contraceptives only on the recommendation of a doctor.

The use of hormonal contraceptives has a very positive effect on prolonged, heavy and painful menstrual bleeding. Already after 2-3 months of taking a properly selected drug, the irregular menstrual cycle normalizes, the phenomena of premenstrual syndrome, pain and profusion of menstruation disappear.
Now, if you go to a antenatal clinic for advice on preventing unwanted pregnancy, in almost all cases you will be advised birth control pills – oral hormonal contraceptives. And this is no coincidence. Most doctors consider the use of such funds the safest and most effective. Practice shows the same.

I am 38 years old and have 3 children. I have always been distrustful of hormonal drugs and used the calendar method. As you can see, it didn’t help me much. Somehow, by chance, I got an appointment with the head of the antenatal clinic. She told me literally the following: “Shame on you, but also an educated woman! You are protected in such a way as if you live in the cave age! Forget about your fears, now there are new modern means, the use of which does not threaten any complications.

It so happened that I have been taking rigevidon for 2 years now. And I must say, he did not let me down, and I do not feel any side effects.

Well what can we say? Yes, indeed, oral contraception is one of the most effective contraceptives. But, unfortunately, the more reliable the contraceptive, the more possible complications it has. Therefore, if you decide to entrust your fate to pills, you need to know at least the following.

Be sure to consult a gynecologist!

Only a specialist will be able to choose the right medicine for you, knowing your body and your medical history. But precisely “knowing”! If a gynecologist sits in the corridor in the queue for another 5 people, he doesn’t have much time to thoroughly know all the features of your body. But be sure to tell him about the main ones!

If the doctor says: “Take any of the 5 drugs of your choice”, and this is how they often answer us in consultations, do not rush to make such an important decision on your own. Remember that these are hormonal pills, and, therefore, with uncontrolled use, they can lead to sad, irreversible consequences. Perhaps you should look for another specialist, and do not hesitate to ask why this particular remedy is recommended to you.

Be sure to read the instructions for the drug before you buy it!

Hormonal contraceptives have a wide range of contraindications, so weigh the pros and cons. As a rule, doctors do not inform their patients about the possible negative consequences of oral contraceptives.
Examine the available literature on the subject. After all, who knows your body better than you?! So trust your knowledge and intuition.

After you start taking the pills, carefully monitor the reactions of your body. If anything goes wrong, see your doctor. Even if you do not experience any discomfort, do the necessary tests at least once a year. Only in this way can you be sure that no unwanted changes have occurred in your body.

Oral hormonal contraceptives do not protect against sexually transmitted diseases. Although due to the thickening of the cervical mucus, a mechanical obstacle is created not only for spermatozoa, but also for some pathogens.
Such drugs are recommended, first of all, to established couples, when partners can trust each other. If your sexual relationship is polygamous, then you will also need protection from genital infections.

Hormonal contraception is reversible!

Once you stop taking the pills, you can get pregnant right away! Moreover, there is a so-called reverse effect – the possibility of pregnancy increases. Therefore, use other means of contraception, such as barriers.

For the health of the planned child after the abolition of oral contraceptives, it is necessary to postpone conception for 3-4 months.
Currently, hormonal drugs can be taken for as long as necessary. Naturally, under medical supervision.

Perhaps an oral hormonal method of contraception is exactly what you need. But, as often happens, this can only be verified in practice – the reaction to hormonal drugs in each organism is individual. Many of the prejudices against hormone pills are based on the high number of complications from older hormone drugs, but nowadays low hormone drugs can be taken by women of any age, even the youngest or those who are on the verge of the fall of life.

Mechanism of action of oral contraceptives

To better understand the mechanism of action of oral hormonal contraceptives, let’s delve a little into the features of the female body.
The average menstrual cycle is 28 days. Around the middle of this period, one of the ovaries produces an egg, which enters the fallopian tube. Thus, ovulation occurs. If the spermatozoa freely enter the uterus, and through it into the tubes, they are able to fertilize the egg, which then descends into the uterus and attaches to its mucous membrane.
If conception does not occur, the unfertilized egg, along with the mucous membrane lining the uterus, is removed from the body at the end of each menstrual period. There is what we call menstruation – menstrual bleeding.

The entire menstrual cycle is regulated by 2 groups of hormones that are produced in the ovaries. The beginning of each new cycle is characterized by an increase in the number of estrogens, which cause the uterine mucosa to grow so that the fertilized egg can easily implant into the uterine wall. After that, the body begins to produce progesterone, which slows down the growth of the uterine lining.

If pregnancy occurs, the ovaries, and then the placenta, continue to produce progesterone in increasing quantities, which prevents the maturation of new eggs. But if fertilization does not occur, the amount of hormones begins to decrease.

Knowledge of all phases of the menstrual cycle has allowed the production of oral hormonal contraceptives, which are similar in mechanism of action to natural hormones produced by the body during pregnancy to prevent the formation of new eggs.

Thus, oral contraceptives prevent the appearance of eggs, therefore, fertilization cannot occur. In addition, there is a significant thickening of mucus in the cervix, and spermatozoa cannot overcome this barrier. The third factor is the suspension of the preparation of the uterine mucosa for the implantation of a fertilized egg.

Currently, all oral contraceptives can be divided into 2 types:

• classic combined estrogen-progestin preparations and
• preparations called mini-pills containing only progestogens in microdoses

Combined estrogen-gestagenic tablets are used for 21 days, starting from the 1st or 5th day of the menstrual cycle. They are single-, two- and three-phase.

Monophasic – preparations containing a constant amount of hormones. On the Russian market, these are rigevidon, anovlar, ovidon. Monophasic tablets contain higher doses of hormones compared to bi- and triphasic tablets, but due to this they are more reliable. Currently, non-ovlon, bisecurine and ovulen, which also belong to this group of drugs, are older generation drugs due to the high content of hormones, so they are not recommended for contraception.

Biphasic – the content of estrogen in such preparations is the same, and the content of progestogen varies depending on the phase of the menstrual cycle – in the 2nd phase it is more. In Russia, these drugs are not widely used, the most famous is ante-ovine. Currently, they are not used as a contraceptive due to numerous complications.

Triphasic – drugs that mimic the natural phases of the menstrual cycle, contain 3 different combinations of ethinyl estradiol and gestagens. Known in Russia, trisiston and triquilar are taken from the 1st day of menstruation, tri-regol – from the 5th day of the cycle. Due to the low content of hormones, they are considered the safest in terms of unwanted complications, but for the same reason their effectiveness is somewhat lower than that of monophasic drugs.

Some women’s fear of interfering with the hormonal balance of their body, of course, is justified. But since the latest technologies for making birth control pills have significantly reduced the dose of hormones in these drugs, negative consequences after taking them are noted in a small number of women.

Absolute contraindications for taking oral contraceptives:

• pregnancy,
• breastfeeding,
• malignant tumors,
• history of breast and reproductive organs cancer,
• thrombotic tendency,
• diseases of the liver, kidneys,
• damage to cerebral vessels,
• cardiovascular disease,
• varicose veins,
• hypertension,
• multiple sclerosis, migraines,
• complicated diabetes mellitus,
• chlamydia, venereal diseases,
• vaginal bleeding of unknown etiology,
• depression, epilepsy

Relative contraindications:

• If you decide to become pregnant, stop taking hormones 3-4 months before the planned pregnancy, in which case you will avoid possible health complications for your baby.
• If you are going to have surgery, stop taking birth control pills 4-12 weeks before surgery. After the operation, it is also necessary to refrain from taking them for another 4-12 weeks.
• If your age is over 40 years, then the possibility of heart attacks and thromboembolism increases dramatically. At this age, preparations containing only estrogen, the so-called mini-pills, are more indicated.
• If you are over 35 and smoke a lot, you are at the same risk.

If during a previous pregnancy you suffered from toxicosis, jaundice, itching, be on the lookout. Be especially careful in case of severe immune diseases, uncomplicated diabetes mellitus, lupus, trophic ulcers of the leg, angiomas, mononucleosis, sickle cell anemia, gallbladder disease, uterine fibroma, bronchial asthma, Gilbert’s disease (increased bilirubin level in the blood from birth), myasthenia gravis, rheumatoid arthritis, thyrotoxicosis, benign tumors, overweight, mental illness, oligophrenia, drug addiction, alcoholism, secretions from the mammary glands such as colostrum.

In all these cases, you should discuss with your doctor the possibility of taking hormonal pills.
Possible side effects. And yet, the choice should remain with the woman, and she should make it, knowing all the possible side effects from taking OK. Each of us is not an average unit, but a living organism with its own problems and sores. Therefore, for the convenience of information perception, we will present the main, most important, probable side effects. I want to emphasize once again that in some cases there is no clear relationship between taking OK and the onset of side effects, but still it is better to be fully armed than to ask later: who is to blame and what to do?

So what can you expect after taking oral contraceptives:

• with long-term use of OK, a slight increase in the risk of breast cancer;
• there are currently no unambiguous studies linking the risk of cervical cancer with OCs, but women should still be warned about the possible presence of such a connection;
• there may be a slight increase in the risk of liver cancer;
• in women who smoke, in combination with other factors, the risk of myocardial infarction increases;
• even higher risk of stroke, especially in women who smoke;
• OK has little effect on the development of venous thrombosis and embolism;
• slightly increases the risk of infection with chlamydia;
• possible increase in blood pressure that does not go beyond the usual limits;
• blood lipids may increase, contributing to the development of atherosclerosis;
• yellowish-brown spots – chloasma may appear during pregnancy or taking OK;
• Some women are likely to gain weight.

You should immediately consult a doctor and stop taking the drug if you have severe headaches, pain in the chest and legs, shortness of breath, visual disturbances.

At the very beginning of taking hormonal contraceptives, you may experience nausea, sometimes vomiting. Therefore, you should not take the pills on an empty stomach. Sometimes this recommendation is enough for the side symptoms to stop.

In addition to the above, when taking hormonal contraceptives, you may experience the following negative consequences:

• bleeding between menses, irregularities in menses;
• uterine fibroids, breast swelling;
• headaches;
• visible changes in veins – bluish streaks and “mesh”;
• nausea, fatigue, decreased sex drive;
• puffiness, enlargement of the eyeball, which makes it difficult to wear contact lenses;
• candidiasis, fungal infection;
• high cholesterol;
• diseases of the gallbladder;
• increased risk of ectopic pregnancy;
• infertility after stopping hormones;
• incompatibility with products containing caffeine – under its influence, hyperactivity and insomnia appear;
• Increased body hair growth, oily skin and acne.

I already had 2 girls when I decided that it was necessary to use protection, and on the advice of my friends I opted for oral hormonal contraceptives. When I came to the pharmacy, I was offered several drugs to choose from. I read the instructions and chose Marvelon. In the annotation to it, it was painted what a wonderful drug it was, with practically no side effects. For a whole year I was protected with his help, and then decided to get checked out by a gynecologist, who said that a fibroma had formed in my uterus. Literally, she told me the following: “What do you want, you took hormonal pills.” Now I only use condoms. Currently, the effect of oral hormonal contraceptives on the occurrence of cervical, breast and skin cancers has not been fully investigated. The data are quite contradictory, perhaps the greater detection of cases of malignant tumors in women taking oral hormonal contraceptives is due to the fact that they are more likely to visit a gynecologist and more often give smears, which makes it possible to diagnose cancer at an early stage.

There are no drugs without side effects. But often a woman is concerned about problems that are primarily not directly related to health, but to beauty. Especially many are worried about extra pounds, and often for this reason a woman refuses OK. Of course, if you have a predisposition to be overweight, then almost all OCs improve your appetite, and you will gain weight just by eating everything. The way out can be in taking micro- and low-dose OCs, which do not affect appetite to the same extent as preparations containing large doses of hormones.

And such undesirable phenomena as excessive growth of hair on the body and face can be easily prevented by passing a preliminary blood test for hormones. If you find that you have high testosterone levels, you should not take drugs with a high content of male hormones, which can really provide you with a mustache. Only a doctor, knowing all the features of the drugs and the subtleties of your body, is able to choose the right remedy for you.

Microdosed drugs practically do not affect the hormonal balance of the body, that is, they do not increase body weight and facial hair growth. Such drugs, in particular, are recommended for use by young girls. These are marvelon, miniziston, logest, triregol, triziston.

The severity of adverse reactions depends on the characteristics of a particular organism, on the type and dose of hormonal drugs. This is primarily due to the violation of the estrogen-progesterone balance. Such reactions occur approximately 2 months after the start of taking the tablets.

Symptoms of possible hormonal imbalances:

• excess estrogen: headache, dizziness, nausea, vomiting, breast engorgement, hypertension, thrombophlebitis, leg cramps, bloating;
• lack of estrogen: scanty or no menstruation, early and mid cycle spotting, irritability, nervousness, depression, headache, hot flashes, reduced breast size, vaginal dryness;
• progestogen excess: weight gain, scanty menstruation, decreased libido, depression, headaches, fatigue, rash, acne, hot flashes;
• lack of gestagen: heavy periods with clots, intermenstrual spotting at the end of the cycle, delayed menstruation after taking the drug.

In all cases of such reactions, you need to consult a gynecologist.
You need to know that even with the correct intake of pills, missed periods are possible, which do not mean pregnancy. Naturally, this does not apply to cases when you missed the time of taking the pills: in such a situation, it is necessary to use other additional contraceptive measures, such as a barrier, in order to eliminate the risk of conceiving an unhealthy child.
Influence of drugs on the reliability of contraceptive pills. Often a woman is prescribed one or another contraceptive drug and is not warned that when taking even the most harmless drugs at the same time, a sharp decrease in the contraceptive effect is possible.

The following drugs affect the reliability of hormonal drugs:

• certain headache medicines, including analgin and paracetamol;
• antibiotics – ampicillin, tetracycline, etc.;
• sulfonamides;
• sedatives and tranquilizers;
• beta-blockers;
• anti-tuberculosis drugs;
• some anti-inflammatory drugs.

The list goes on, so be sure to check with your doctor if you are taking any medications along with birth control pills.
What else reduces the reliability of hormonal contraceptives? In the following cases, you will not be able to fully rely on hormonal protection:

• if you have diarrhea or vomiting – in this case, the hormones are not absorbed by the body;
• if you miss one, two or more tablets;
• if you have moved to a different time zone, do not change the time of taking the drug, because only the 24-hour interval between taking the tablets matters.

3 rules for taking hormonal contraceptives, p Remember to take pills:

• daily;
• at the same time;
• for the night.

This increases the reliability of contraception and reduces the occurrence of side effects.

What to do if you miss a pill? It all depends on the drug you are taking. Read the instructions carefully, there should be instructions for this case. However, if you miss more than 12 hours from the time of taking, there is a risk that taking another pill will not help (especially if this happened in the first half of the cycle). In this case, you should use additional contraceptive measures until the end of the cycle.

For some reason, many have full confidence that even if they have not taken pills for 3 days in a row, it is enough just to take 3 pills at the same time. Dear women, this will not protect you from pregnancy, but it will bring significant harm to the body. Therefore, in no case do not increase the number of tablets per dose in proportion to the number of days missed – this will not help! Protect yourself with additional contraception until the next cycle.

The use of hormones has the following positive effects:

• protects against malignant neoplasms – the incidence of ovarian cancer is reduced, the effect occurs after 2 years of taking hormones and persists for almost 10 years after stopping the use, the risk may decrease by 60-80%;
• reduces the risk of endometrial cancer by 50%;
• reduces the risk of colon and rectal cancer by up to 35%;
• promotes resorption and reduces the likelihood of developing benign breast tumors – fibromas and cysts;
• helps to reduce the size of benign ovarian cysts and reduces the risk of their formation;
• reduces the risk of developing certain pelvic inflammatory diseases that can lead to infertility;
• increases the likelihood of curing infertility – monophasic OK; after their cancellation, ovarian function is restored;
• helps with endometriosis – combined or progestin OK, injectable contraceptives;
• helps to cure cervical ectopia in nulliparous women – three-phase hormonal contraceptives;
• inhibits, thanks to the estrogens contained in OK, the development of osteoporosis – loss of bone tissue that begins after menopause – combined OK;
• reduces the risk of ectopic pregnancy, as OCs suppress ovulation;
• helps to cure iron deficiency anemia, as blood loss during menstruation is reduced – women begin to feel more energetic and healthier;
• helps to restore the normal menstrual cycle, especially in women suffering from heavy and prolonged bleeding, since OK dictates its cycle to the body – combined OK containing large doses of progestogens;
• relieves premenstrual syndrome;
• relieves practically from pain syndromes during menstruation;
• promotes the restoration of menstruation in women suffering from amenorrhea due to ovarian failure,
• combined estrogen-gestagenic contraceptives;
• relieves acne and seborrhea – increased greasiness of the skin – combined OK containing gestagens with androgenic action.

Who can take oral hormonal contraceptives. Currently, oral hormonal contraceptives are recommended:

• women of any age and with any history of pregnancies;
• suffering from inflammatory diseases of the pelvic organs, iron deficiency anemia, fibrocystic mastopathy, menstrual disorders, endometriosis, etc.;
• with a regular menstrual cycle, as well as women who have long and heavy menstruation;
• infected with HIV or tuberculosis.

Pros. The method is reversible, provides reliable protection, long-term use is possible, relatively inexpensive and easy to use, does not require prior preparation for sexual intercourse, has a positive effect on certain health problems.

Cons . Not suitable for everyone for medical reasons, good primarily for healthy, non-smoking women under 35; there is a risk of complications; requires punctuality and accuracy in use; reduced effectiveness in some conditions and the use of other drugs; can negatively affect sex drive.