At what age should women stop taking birth control pills. How does menopause affect contraception choices. What are the safest birth control options during perimenopause. Can birth control pills delay menopause. What changes occur when stopping birth control pills.

Understanding Perimenopause and Menopause: Key Differences

Perimenopause and menopause are significant milestones in a woman’s reproductive journey. While often used interchangeably, these terms represent distinct phases with unique characteristics.

Perimenopause is the transitional period leading up to menopause. During this time, which typically begins in a woman’s 40s, hormone levels start to fluctuate, causing various symptoms:

• Irregular menstrual cycles
• Hot flashes
• Mood swings
• Sleep disturbances
• Changes in libido

Menopause, on the other hand, is defined as the point when a woman has gone 12 consecutive months without a menstrual period. The average age for menopause is around 50, though it can occur earlier or later for some women.

How long does perimenopause typically last? For most women, perimenopause spans 4-8 years before reaching menopause. However, some may experience this transition for a shorter or longer duration.

The Intersection of Birth Control and Menopause

As women approach menopause, questions often arise about the continued use of birth control. Is it still necessary? When is it safe to stop?

While fertility declines with age, it’s important to note that pregnancy is still possible during perimenopause. Ovulation can occur sporadically, even if menstrual cycles become irregular. This unpredictability makes contraception a continued necessity for women who wish to avoid pregnancy.

How long should women continue using birth control after their last period? Many healthcare providers recommend maintaining some form of contraception for at least two years following the last menstrual cycle. This precautionary measure ensures protection against unexpected pregnancies during the transition to menopause.

Optimal Birth Control Choices During Perimenopause

As women enter their mid to late 40s, certain forms of birth control may no longer be suitable due to increased health risks. What are the safest contraceptive options during this transitional phase?

• Condoms: A non-hormonal option that also provides protection against sexually transmitted infections
• Vasectomy: For couples who are certain they don’t want more children
• Intrauterine Devices (IUDs): Both hormonal and non-hormonal options are available
• Mini-pill: A progestin-only oral contraceptive with lower hormone levels

Why are traditional combination birth control pills not recommended for perimenopausal women? The high estrogen levels in these pills can increase the risk of blood clots and cardiovascular issues, particularly in women over 40.

The Impact of Birth Control Pills on Menopause

A common misconception is that birth control pills can delay the onset of menopause. Is there any truth to this belief?

Contrary to popular belief, birth control pills do not postpone menopause. Women will reach menopause around the average age of 50, regardless of whether they’re taking oral contraceptives. However, birth control pills can mask the symptoms of perimenopause and menopause by creating an artificial menstrual cycle.

How can women determine if they’ve entered menopause while on birth control? There are a few approaches:

1. Stop taking hormonal birth control for a few months to observe any menopausal symptoms
2. Undergo a follicle-stimulating hormone (FSH) test after pausing birth control for one month
3. Consult with a healthcare provider to discuss symptoms and potential tests

When to Consider Stopping Birth Control Pills

As women age, the risks associated with combination birth control pills increase. At what point should women consider discontinuing oral contraceptives?

Many healthcare providers recommend that women stop taking combination birth control pills in their early 40s. This recommendation is based on the increased risk of complications such as:

• Blood clots
• High blood pressure
• Cardiovascular issues

What factors influence the decision to stop taking birth control pills? Several considerations come into play:

• Age
• Weight
• Pre-existing medical conditions
• Family history
• Smoking status

Women should consult with their healthcare provider around age 40 to reassess their birth control needs and determine the most appropriate contraceptive method for their individual circumstances.

Navigating the Transition Off Birth Control Pills

Stopping birth control pills can lead to various changes in a woman’s body. What can women expect when they discontinue oral contraceptives?

Several common experiences include:

• Irregular menstrual cycles
• Return of premenstrual syndrome (PMS) symptoms
• Heavier menstrual bleeding
• Changes in mood and libido
• Possible acne flare-ups

Why do these changes occur? Birth control pills regulate hormone levels and create a predictable menstrual cycle. When discontinued, the body must readjust to its natural hormone production, which can lead to temporary disruptions.

How long do these transitional effects typically last? The duration varies for each woman, but most find that their bodies adjust within a few months to a year after stopping birth control pills.

Alternative Contraception Methods for Perimenopausal Women

As women transition away from combination birth control pills, what alternative contraception methods are available and suitable?

• Progestin-only mini-pill: A lower-dose hormonal option with fewer risks
• Copper IUD: A non-hormonal, long-acting reversible contraceptive
• Hormonal IUD: Provides both contraception and potential relief from heavy menstrual bleeding
• Barrier methods: Condoms, diaphragms, and cervical caps
• Sterilization: Tubal ligation for women or vasectomy for male partners

How do these methods compare in terms of effectiveness and side effects? Each option has its own set of benefits and potential drawbacks. For instance:

• IUDs offer long-term, highly effective contraception but may cause initial discomfort during insertion
• Barrier methods are free from hormonal side effects but require consistent and correct use for optimal effectiveness
• Sterilization provides permanent contraception but is not easily reversible

Women should discuss these options with their healthcare provider to determine the most suitable method based on their individual health profile, lifestyle, and preferences.

Managing Perimenopausal Symptoms Without Birth Control

As women transition off birth control pills, they may experience perimenopausal symptoms that were previously masked by the hormones in their contraceptives. How can these symptoms be managed effectively?

Several approaches can help alleviate perimenopausal discomfort:

• Lifestyle modifications: Regular exercise, stress reduction techniques, and dietary changes
• Natural remedies: Herbal supplements like black cohosh or evening primrose oil (consult with a healthcare provider before use)
• Hormone therapy: Low-dose hormone replacement therapy under medical supervision
• Non-hormonal medications: Specific treatments for symptoms like vaginal dryness or hot flashes

What role does diet play in managing perimenopausal symptoms? A balanced diet rich in phytoestrogens (plant-based estrogens) may help alleviate some symptoms. Foods to consider include:

• Soy products
• Flaxseeds
• Whole grains
• Fruits and vegetables

How effective are these non-contraceptive approaches in managing perimenopausal symptoms? The efficacy varies among individuals, and a combination of strategies often yields the best results. Women should work closely with their healthcare providers to develop a personalized management plan.

The Importance of Regular Health Screenings

As women transition through perimenopause and into menopause, regular health screenings become increasingly important. What key health assessments should perimenopausal women prioritize?

• Bone density scans to monitor for osteoporosis risk
• Mammograms for breast cancer screening
• Pap smears and HPV tests for cervical health
• Cholesterol and blood pressure checks for cardiovascular health
• Thyroid function tests

How frequently should these screenings be conducted? The recommended frequency varies based on individual risk factors and health history. Generally, women should discuss an appropriate screening schedule with their healthcare provider.

Why are these screenings particularly crucial during the perimenopausal transition? The hormonal changes during this period can impact various aspects of health, making early detection and prevention of potential issues essential for long-term well-being.

Emotional and Psychological Aspects of the Transition

The perimenopausal transition involves not only physical changes but also emotional and psychological shifts. How can women navigate these changes effectively?

Several strategies can support emotional well-being during this transition:

• Open communication with partners, friends, and family about experiences and feelings
• Seeking support through support groups or counseling
• Practicing mindfulness and stress-reduction techniques
• Maintaining social connections and engaging in enjoyable activities
• Exploring new interests or hobbies

What role do hormonal fluctuations play in mood changes during perimenopause? The varying levels of estrogen and progesterone can influence neurotransmitters in the brain, potentially affecting mood and emotional stability. Understanding this connection can help women and their support systems approach mood changes with compassion and appropriate interventions.

Sexual Health and Intimacy During Perimenopause

As hormonal changes occur during perimenopause, many women experience shifts in their sexual health and intimacy. What are some common concerns, and how can they be addressed?

Frequent issues include:

• Decreased libido
• Vaginal dryness and discomfort during intercourse
• Changes in sexual response and arousal
• Body image concerns

How can these challenges be managed? Several approaches can help maintain a healthy and satisfying sex life during perimenopause:

• Open communication with partners about changing needs and desires
• Use of lubricants or moisturizers to address vaginal dryness
• Exploration of new techniques or forms of intimacy
• Pelvic floor exercises to improve muscle tone and sensation
• Consultation with a healthcare provider or sex therapist for personalized advice

What role does hormone therapy play in addressing sexual health concerns during perimenopause? For some women, low-dose local estrogen treatments can help alleviate vaginal dryness and discomfort. However, the decision to use hormone therapy should be made in consultation with a healthcare provider, considering individual health risks and benefits.

Nutrition and Exercise for Perimenopausal Health

Proper nutrition and regular exercise play crucial roles in supporting overall health during the perimenopausal transition. What dietary and fitness recommendations can benefit women during this phase?

Key nutritional considerations include:

• Adequate calcium and vitamin D intake for bone health
• Increased protein consumption to maintain muscle mass
• Omega-3 fatty acids for heart and brain health
• Fiber-rich foods for digestive health and weight management

What types of exercise are particularly beneficial during perimenopause? A well-rounded fitness routine should include:

• Weight-bearing exercises to promote bone density
• Strength training to maintain muscle mass and boost metabolism
• Cardiovascular activities for heart health and weight management
• Flexibility and balance exercises to improve overall functional fitness

How can women overcome common barriers to maintaining a healthy lifestyle during perimenopause? Strategies may include:

• Setting realistic and achievable goals
• Finding enjoyable forms of physical activity
• Meal planning and preparation to support nutritional needs
• Seeking support from fitness groups or personal trainers
• Gradually incorporating healthy habits into daily routines

Long-term Health Considerations Post-Menopause

As women transition through perimenopause and into post-menopause, certain health risks become more prominent. What long-term health considerations should women be aware of?

Key areas of focus include:

• Cardiovascular health: Increased risk of heart disease post-menopause
• Bone health: Higher risk of osteoporosis due to decreased estrogen levels
• Metabolic changes: Potential for weight gain and insulin resistance
• Cognitive function: Possible increased risk of cognitive decline
• Urinary and vaginal health: Increased risk of urinary tract infections and vaginal atrophy

How can women proactively address these health concerns? Preventive strategies may include:

• Regular health screenings and check-ups
• Maintaining a healthy diet rich in nutrients supporting bone, heart, and brain health
• Engaging in regular physical activity, including both cardiovascular and strength training exercises
• Managing stress through relaxation techniques and mindfulness practices
• Staying socially active and mentally engaged

What role does hormone therapy play in managing long-term health risks post-menopause? While hormone therapy can address certain menopausal symptoms and health risks, its use should be carefully considered on an individual basis. Women should discuss the potential benefits and risks with their healthcare providers to make informed decisions about hormone therapy and other preventive measures.

At what age should you stop taking birth control pills?

Menopause is a big milestone in every woman’s life. As it approaches, you may experience unpleasant symptoms like hot flashes, mood swings and trouble sleeping. And when menopause arrives, you’ll stop ovulating and getting your period.

But when is menopause “over”? When is childbearing really off the table?

“When am I safe to quit using birth control pills?”

As a certified menopause practitioner and midwife at Park Nicollet’s Women’s Center, this is a question I get often.

The answer usually isn’t black and white, as menopause symptoms can vary by woman and by age. But here are a few important things to consider when it comes to birth control and menopause.

What’s the difference between perimenopause and menopause?

Perimenopause is menopause’s opening act. It’s the time leading up to menopause when your hormones begin to change. You’ll still have periods during this time, but they become more irregular. Perimenopause usually begins about 4-8 years before menopause. For most women, perimenopause starts in their 40s, but some women experience perimenopause in their late 30s.

Menopause is the final period you have – it’s the curtain closing, so to speak. When you haven’t had a period in 12 months, you’re in menopause. The average age women experience menopause is 50, though some women may go into menopause in their late 40s. Everything after that is post-menopause.

When can I stop using birth control after menopause?

I usually recommend that you use some form of birth control for the first two years after having your last period. But the patch, pill or ring are not recommended as you enter your mid to late 40s. This is due to the high levels of estrogen in these forms of birth control and a risk of blood clots.

The safest options for women are condoms or vasectomy. But I also suggest an intrauterine device (IUD) during menopause, which can help with the associated bleeding problems. The mini pill can be used, too. However, if you’re experiencing symptoms of menopause and being treated with the progesterone-only mini pill, it can affect how well you’re protected from pregnancy.

Fertility declines with age. You’re far less likely to get pregnant in your 40s and early 50s, but pregnancy can still happen. That means even if you’ve gone a few months without a period, you can still get pregnant. And while it’s rare, some women can ovulate and have a random period. So if you want to prevent pregnancy, it’s better to be on the safe side when it comes to protection.

At what age should you stop taking birth control pills?

I recommend that most women stop taking birth control pills in their early 40s. Birth control pills, sometimes called combination birth control pills, contain estrogen and progestin. Estrogen increases your risk of developing blood clots, high blood pressure or other heart conditions. Other factors like your weight, pre-existing conditions, medical history and whether you smoke can also increase your risk of complications from birth control pills that contain estrogen.

If you’re on the pill, consider talking to your primary care doctor or OB-GYN when you turn 40 to make sure it’s still a safe option for you. If combination birth control pills aren’t recommended, the mini pill might work best – it only contains the hormone progestin, making it safer for women during perimenopause.

Do birth control pills delay menopause?

No, you’ll reach menopause around age 50 whether you’re taking birth control pills or not. But because birth control pills use hormones to create an artificial cycle, they can mask the symptoms of perimenopause and menopause. You’ll continue to have a period as long as you take birth control pills, making it difficult to know if you’re in menopause.

If you’re in your late 40s and aren’t sure if you’ve entered perimenopause, consider stopping your hormonal birth control for a few months. During this time, you can watch for menopause symptoms like irregular periods, hot flashes, night sweats and mood changes. Or you can ask your doctor for a follicle stimulating hormone (FSH) test to see if you’ve entered menopause. You’ll only need to pause your birth control for a month before getting this test.

What can you expect when you go off the pill?

Just as you experienced changes when you started taking the pill, you’ll notice some changes after you stop using it. Many women have irregular periods, the return of PMS symptoms and heavier mestrual bleeding after they stop using birth control pills.

The hormones in birth control pills regulate your period. While on the pill, most women will have their period on a regular schedule. Going off the pill can feel like throwing out the calendar. You may notice missed or late periods, and possibly longer-lasting periods. Eventually, your periods will stop altogether.

Birth control pills can also help lessen PMS symptoms like period cramps, bloating, headaches, fatigue and mood swings.

Are there any benefits to taking birth control pills during perimenopause or menopause?

Oral hormonal contraceptives like the pill are often the best birth control option for perimenopause symptoms.

The biggest benefit of taking birth control pills during perimenopause or menopause is that it keeps you from getting pregnant. You have a chance of getting pregnant as long as you’re still getting your period. Birth control pills are 99% effective at preventing pregnancy when taken as directed.

Birth control pills can help regulate periods, reduce bleeding and pain, and help with acne, as well as keep your hormones at consistent levels. So, during perimenopause, this can mean fewer hot flashes. Oral contraceptives can also help maintain bone health and strength, which is important because estrogen deficiency can be linked to postmenopausal osteoporosis.

But I suggest my patients stop taking the pill once they reach menopause. While every woman’s situation is different, there are sometimes risks with staying on the pill. It’s best to talk with your primary care doctor or OB-GYN to help decide what’s best for you.

Are there any risks with taking birth control pills during menopause or perimenopause?

Hormonal contraceptives can sometimes mask symptoms of perimenopause. This can make it difficult to know when you’ve reached perimenopause. And even after menopause, some women can continue to cycle if they stay on hormonal contraceptives.

As mentioned above, I often recommend quitting the pill and similar methods of birth control for women over 40. This is because hormonal contraceptives can increase the risk of blood clots – especially as you age. They also increase your risk of high blood pressure, stroke, heart attack, heart disease and breast cancer. This is especially true of patients who have diabetes, smoke, are overweight or have a history of estrogen-dependent cancers.

I suggest patients around their late 40s try hormone therapy instead. The lower dose of estrogen decreases risks, but still provides similar benefits as the pill.

Are birth control pills considered hormone therapy?

No, birth control pills aren’t used as hormone therapy (HT). The hormones in birth control pills are used to stop ovulation, so they’re at a much higher dose than the amount of hormones you find in HT.

The goal of HT is to get your postmenopausal hormone levels close to what they were before menopause. Typically, lower doses of hormones are used during HT. And the dose of hormones given during each HT session often varies depending on your individual needs.

When should I start talking to my doctor about birth control and menopause?

Some women choose not to see their doctor when they begin experiencing symptoms. Instead, they wait until their annual wellness visit to talk with their doctor about these changes. This is a common, safe approach to managing menopause symptoms.

However, if you experience symptoms that are concerning like heavy, irregular periods, make sure to talk with your primary care doctor or OB-GYN. Same thing goes if you feel the symptoms are affecting your quality of life. Menopause is a common, and important, phase of life. And your doctor can help determine what the best options are for you.

How to Tell if You’ve Reached Menopause on Birth Control

Written by Alexandra Benisek

Medically Reviewed by Nivin Todd, MD on August 29, 2022

• Birth Control Choices for Women in Perimenopause
• Pros and Cons of Birth Control Around Menopause
• Menopause When You’re on Birth Control
• When to Stop Your Birth Control

When you’re in perimenopause, or the time before your body shifts into menopause, you may be unsure if you still need to use birth control to avoid pregnancy. If you’re worried about pregnancy, you shouldn’t stop birth control until your doctor has told you it’s safe to do so.

There are many birth control choices to choose from if you’re near menopause. You can use hormonal or nonhormonal options:

• Birth control pills
• Hormonal injection
• Skin patch
• Vaginal ring
• IUDs
• Sterilization for either men or women, which isn’t reversible
• Barrier methods such as condoms, diaphragms, or sponges

The rhythm method, also called natural family planning, is not as effective as other birth control methods if you’re in perimenopause. This is when you track your menstrual pattern to know when you’re most likely to get pregnant. When you’re in perimenopause, you’ll have irregular periods that make it hard to track your menstrual cycle. If you can’t tell when your next period will come, the rhythm method won’t help you avoid pregnancy.

Hormonal birth control can help you in many ways when you’re in perimenopause:

• Helps maintain bone strength
• Treats acne, which may get worse when you’re in menopause
• Lowers your chances of ovarian and uterine cancer
• Lessens hot flashes
• Eases period pain and bleeding
• Makes your periods more regular

Hormonal birth control is usually safe for women in perimenopause. But using birth control after age 35 can raise your risk of blood clots, heart attacks, strokes, and breast cancer. Hormonal methods may not be safe options for you if you smoke or if your doctor has diagnosed you with:

• Cancer
• Heart disease
• High blood pressure
• Diabetes
• Blood clots

There’s no test to tell if you’ve gone through menopause yet or not. The best way to tell is through your period.

You’ve most likely gone through menopause if you’re over 50 years old and haven’t had a period in more than 1 year, or if you’re under 50 years old and haven’t had a period in more than 2 years. But you may not be able to tell if you’ve reached menopause if you’re still on birth control.

Hormonal birth control may hide some of the symptoms of menopause, such as an abnormal period, hot flashes, or night sweats. If you take combination pills (pills that have estrogen and progestin), even after menopause, you may continue to bleed similarly to how you would on your period. This can make it hard to tell if you’ve gone through menopause and whether you’re still able to get pregnant.

In most cases, you should stop the combined pill when you’re at the age of 50. Women in this age group may have other health issues that could make it dangerous to use. Talk to your doctor to see if it’s safe for you to use it if you’re 50 or older.

If you don’t want to be on the combined pill anymore but still want protection against pregnancy, you can use a progestogen-only pill or other forms of birth control, like condoms. If you’re over the age of 55, you can probably stop hormonal methods since your chances of pregnancy are very low. But to be safe, don’t stop any type of birth control until you haven’t had a period for a full year.

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Contraceptive pills for menopause – whether to stop taking

11/26/2020

3 min

post author

Dr. Lorraine Maitrot

Gynecologist-endocrinologist. Specialist in the treatment of endocrine gynecological diseases, in particular the perimenopausal transition and menopause.

Many women stop taking birth control pills after menopause because they believe that their reproductive function is reduced and the risk of getting pregnant becomes minimal. During the premenopausal period, the menstrual cycle really becomes irregular, however, this does not mean at all that a woman can practice unprotected intercourse, since the ability to bear children does not stop immediately.

Stopping birth control pills should be recommended by your gynecologist based on a physical examination or clinical findings. Self-cancellation of drugs can not only cause unwanted pregnancy, but also hormonal disruptions. That is why women in adulthood need to consult with their doctor, especially at the first stages of manifestation of symptoms characteristic of the menopause period.

Women can still be fertile after menopause.

Since fertility does not stop immediately, it is recommended to consult a gynecologist first.

If there is no immediate opportunity to visit a doctor, then it is better to postpone the discontinuation of contraceptives until it appears. Self-cancellation of hormonal drugs is strictly not recommended.

Reasons why you should not stop taking oral contraceptives on your own with the onset of menostasis

Premenopause refers to the transitional period preceding menopause, which can last from several months to several years. This is due to hormonal disorders of the body, which cause irregular menstruation. Therefore, against the background of premenopause, it is not recommended to conduct clinical studies or prescribe hormonal treatment, since the level of hormones in the blood is constantly changing and it becomes impossible to correctly interpret the obtained indicators. This is the main reason why at the stage of premenopause, doctors do not advise giving up effective methods of contraception – as long as the hormonal background of a woman is unstable, she continues to be fertile.

Starting from the age of 35, most women experience a decrease in the function of the reproductive system, which accelerates with the onset of menopause, which subsequently leads to the loss of the ability to bear children. This is affected by the cessation of the production of follicles and female sex hormones by the ovaries, which are responsible for the reproductive function of the female body.

Despite this, according to statistics, the probability of an unexpected pregnancy due to unprotected intercourse in women aged 45+ is about 15%. For this reason, premenopausal women who are sexually active should definitely use contraceptive methods (1).

After the age of 50, the risk of becoming pregnant is significantly reduced, however, without the consent of a gynecologist, it is also not recommended to cancel any method of contraception on your own. If you no longer want to take birth control pills, then do not rule out local contraception.

SOURCES

1. Lambert M, Begon E, Hocke C. La contraception apres 40 ans. RCP Contraception CNGOF 2018.

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

.

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 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 pills 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 has not occurred, 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 growth of the uterine mucosa 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 gestagens 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, bisekurin 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 – preparations 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,
• prone to thrombosis,
• diseases of the liver, kidneys,
• cerebrovascular disease,
• 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 diseases, uterine fibroids, 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 unequivocal studies linking the risk of cervical cancer with OCs, but women should nevertheless be warned of the possible presence of such a relationship;
• 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 increased risk of chlamydia infection;
• possible increase in blood pressure, not beyond the usual limits;
• blood lipids may increase, contributing to the development of atherosclerosis;
• yellowish-brown spots – chloasma – may appear during pregnancy or OC use;
• 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 periods, irregular periods;
• uterine fibroids, breast swelling;
• headaches;
• visible changes in the 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 progestogen: 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;
• certain 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 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 – bone loss that begins after menopause – combined OK;
• reduces the risk of ectopic pregnancy because 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 almost pain syndromes during menstruation;
• promotes the restoration of menstruation in women suffering from amenorrhea due to ovarian failure,
• combined estrogen-progestogen 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.