The principle of action of hormonal contraceptives

In a woman's body produces two types of female hormones: estrogen and progestin (progesterone). Estrogens promote the maturation of the egg in the ovary and its exit from the ruptured follicle, first in the abdomen and then into the fallopian tube to meet with sperm. Progesterone begins to be developed on the site of the ruptured follicle, which has turned into a new hardware - the corpus luteum. The task of progesterone - to prepare the uterine lining for the introduction of the fetus and to prevent maturation of new follicles, which can prevent the development of pregnancy. It was on this property - braking follicle under the influence of progesterone and construction principle of all hormonal contraceptives. Almost all modern drugs of this series also contain progestins and estrogens. The latter is necessary to enhance the effect of progestogens.

Hormonal contraceptives but can be different in its composition and dosage of drugs contained in it. There hormonal contraceptives that consist of one progesterone (single component), but nowadays often produced combined contraceptives, which are composed as progesterone Progesterone - norm and pathology And estrogen Estrogen - the key to bone health . Monophasic kontratsptivy consist of drugs that are taken in the same dose throughout the cycle. There are drugs that change the dosage during the cycle (two- and three-phase preparations).

Hormonal contraceptive rigevedon

Rigevidon is a combined low-dose monophasic oral contraceptives. One tablet contains rigevidon 0, 15 mg of levonorgestrel (synthetic progesterone), and 0, 03 mg of ethinyl estradiol (synthetic estrogen). This is much lower than, for example, in such contraceptives as trikvilar and triziston. Like all hormones, rigevidon has an inhibitory effect on ovulation Ovulation - How to determine as accurately as possible? Preventing unwanted pregnancies. Due optimally small amount of active substances, side effects are rare. Admission Rigevidon has no negative effect on subsequent pregnancy.

Indications for use

Rigevidon appointed only after examination and on prescription, the indication for its use are:

• protection from unwanted pregnancy;
• menstrual irregularities, including painful menstruation;
• functional uterine bleeding;
• predominance of estrogen in the woman's natural hormonal background.

Contraindications

Contraindications rigevidon are:

• idiosyncrasy of the drug;
• Pregnancy and breast-feeding Breast-feeding: feed - and no nails!   Child;
• condition after suffering a hepatitis;
• diseases associated with impaired liver function;
• inflammatory diseases of the bile ducts (cholelithiasis, cholecystitis);
• Chronic colitis (inflammation of the colon);
• disorders of lipid metabolism (obesity);
• severe cardiovascular diseases, including hypertension;
• endocrine diseases (diabetes, etc.).
• the tendency to form clots in the blood vessels;
• malignant tumor.

Side effects that may occur while taking Rigevidon

When taken at the beginning of Rigevidon may occur violations of the gastrointestinal tract (nausea), breast tenderness, irregular appearance scant vaginal discharge. It usually does not require discontinuation of the drug, since the future of his state of normal reception. The frequency of irregular uterine bleeding (as scant and abundant) is reduced for subsequent courses receiving rigevidon, over time, they usually stop. When excessive bleeding should stop taking the drug and consult a gynecologist.

Side effects can manifest as changes in body weight (increase or decrease), headaches, mood variability, fatigue, changes in sex drive, skin rash, leg cramps. Smoking may increase the frequency and severity of adverse events.

But in some cases it requires removal of the drug:

• If a pregnancy;
• in case of thrombophlebitis;
• when a disturbance of cerebral circulation;
• myocardial infarction;
• when suddenly encountered visual impairment;
• with strong persistent headaches;
• with any serious illness.

Precautions should be taken rigevidon women over the age of 40 years, the presence of varicose veins, seizures, permanent high blood pressure, mild diabetes, mental disorders, accompanied by mood changes, benign tumors of the uterus and breast.

Admission Rigevidon should be stopped 6 weeks before any elective surgery.

Rigevidon quality low-dose hormonal contraceptive marketed known pharmaceutical company Gedeon Richter (Hungary).

  Galina Romanenko

Pharmacological methods

The basis of this method is the use of the drug mifepristone, which is an anti-progestin and prevents the action of progesterone Progesterone - norm and pathology   (pregnancy hormone responsible for its preservation and development), thereby causing it to interrupt. In ordinary cases, mifepristone is used in combination with drugs that increase uterine contractions and cause rejection of the ovum (prostaglandins). This method is applied at a delay menstruation to 49 days (7-8 weeks) and is carried out in two stages. At the first stage the patient in the presence of a doctor taking mifepristone and should be observed for one to two hours. Then, 36-48 hours after ingestion added prostaglandins. Rejection of the ovum, accompanied by minor abdominal pain and spotting begins within one to two days after ingestion.

Advantages of medical abortion

• High efficiency (up to 97%)
• Almost complete painless
• It does not require the use of anesthesia
• The impossibility of contracting infections (HIV, hepatitis)
• No risk, characteristic for surgical termination of pregnancy and the occurrence of complications such as bleeding, damage to the walls of the uterus or the formation of cervical incompetence, leading to miscarriage
• In case of deviations in the arrangement and structure of the uterus (the bending of the uterus, fibroids, the presence of septum in the uterus)
• Suitable for interruption in primiparas and young pregnant women

Contraindications to the use of this method

• Ectopic pregnancy (only surgery)
• Inflammatory processes of sexual sphere
• Common infectious diseases
• The presence of the scar in the uterine wall (after cesarean section, myomectomy)
• Chronic adrenal insufficiency
• Severe asthma
• Individual intolerance to the drug
• Blood clotting

The surgical method of abortion

To carry out the so-called mini-abortion method is used vacuum aspiration of the fetus, the timing of when the diameter of the ovum allows him to slip through tube vacuum suction. Such an abortion is carried out at a delay menstruation Delayed menstruation - when to sound the alarm?   up to 21 days (5-6 weeks gestation). The optimal period of interruption - 14 days delay, as in the earlier periods have not removed the risk of gestational sac (failure to abortion) because of its small size, and later - to preserve the remaining ovum.

The benefits of surgical approach interrupts

• Not applicable cervical dilators, thereby injure the cervix
• The duration of the manipulation is 5-7 minutes
• It does not require general anesthesia
• The possibility of abortion in the early stages
• The procedure for removal of the ovum by a vacuum aspirator less traumatic compared with curettage Curettage - how dangerous it is?   metal tools
• The healing process of the wound surface of the uterus is faster than after abortion at a later time
• The method does not require hospitalization and is performed on an outpatient basis
• Shorten the life of sexual abstinence (up to three weeks, whereas in normal abortion is necessary to respect the sexual rest 4-6nedel)

Disadvantages of the mini-abortion

• Carrying vacuum aspiration is only possible in the early stages (up to five weeks of pregnancy)
• The possibility of bleeding requiring curettage of the uterus (with all its consequences)
• The risk of infection of the pelvic organs

Preparing for pregnancy termination

• gynecological examination
• conduct a rapid pregnancy test
• the exclusion of ectopic pregnancy
• ultrasound to clarify the term pregnancy
• blood type, Rh factor
• vaginal smear on the flora
• general blood analysis
• coagulation (definition of indicators of blood coagulation)
• blood for syphilis Syphilis - punishment of Venus HIV and viral hepatitis

Rules of conduct in the post-abortion

• avoid hypothermia and exercise
• respect for sexual rest (2-3 weeks)
• visits to the doctor 10-14 days after abortion
• prohibition of bathing, baths, saunas
• avoid swimming in the pool and open water

Of course, abortion in early pregnancy is fraught with less danger, but does not exclude the occurrence of complications. Remember that abortion - is not a method of contraception, and every intervention in the natural process of pregnancy can lead to irreversible consequences.