Evra patch (Evra) - it is a contraceptive, which are the active ingredients of ethinyl estradiol and norelgestromin. These substances are analogous to estrogen and progesterone Progesterone - norm and pathology Which are normally produced in the female body. Ethinyl estradiol and norelgestromin prevent the release of eggs from the ovaries increases the viscosity of the mucus on the cervix and changes the uterine lining - all this prevents pregnancy.

Evra increases the likelihood of clot formation and development of some cancers, such as cervical cancer and breast cancer. However, this drug protects against ovarian cancer and endometrial cancer. Before you write the contraceptive patch to the patient, the physician should explain to her in detail all the risks associated with its use, as well - its advantages.

Hormonal contraceptives protect against pregnancy only when used regularly. Evra patch should be changed every week. If you want it to take effect, stick the patch in the first day of menstruation. If you start using the patch later on, for at least the first seven days, you will be required barrier methods of contraception - Evra will start to operate only after this period.

Once you have started to use Evra patches, stick a new patch every seven days for three weeks. On the fourth week, no need to use plaster. Seven new patch glue; interruption should not last more than one week. At that time, women usually are bleeding - are generally less abundant than normal menstruation. Sometimes the bleeding does not start; it is unlikely that this is a sign of pregnancy, but if you are not sure what the correct use evru, still stands to make a pregnancy test. If you have no bleeding, two cycles in a row, contact your doctor immediately.

If shortly after the start of the contraceptive patch you started for no apparent reason to feel very sick, seek medical attention - perhaps this drug does not suit you.

In no case do not let evru other people, including a completely healthy adult women. Any hormonal contraceptives can be used only after consultation with the doctor; otherwise health can be seriously hurt.

Is it possible that you use Evra

Evra is contraindicated or has limitations for use in the presence of the following factors:

• Age older than 45 years;
• Allergy or hypersensitivity to any ingredients of the drug;
• The patient is undergoing tests appointed due to suspected breast cancer Breast cancer: what every woman needs to know , Endometrial, or any other cancer, the development of which is associated with exposure to estrogen;
• Diagnosed with breast cancer, endometrial cancer or other species which are sensitive to estrogen Estrogen - the key to bone health ;
• Postmenopause;
• Pregnancy;
• The presence of conditions such as jaundice, itching, gallstones, porphyria, chorea, skin rashes, or otosclerosis, which are exacerbated during pregnancy or hormonal contraceptives;
• Inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis;
• Diseases associated with the circulatory system;
• Depression;
• Diabetes;
• Epilepsy;
• Kidney disease;
• Liver diseases including hepatic tumors;
• Lupus or condition whose symptoms are similar to symptoms of lupus;
• Metabolic diseases in the personal or family history;
• Migraine;
• Thromboembolic disorders such as angina, heart attack, stroke or pulmonary embolism Pulmonary embolism - a dangerous violation ;
• Chloasma (even if it was a few years ago);
• The presence of risk factors for the development of thromboembolic disorders such as thrombosis in family history; high blood pressure; cardiovascular diseases; varices; thrombophlebitis; age over 35 years; smoking; prolonged restriction of mobility; obesity; recently transferred surgery, trauma, or birth in the last 6-8 weeks;
• Vaginal bleeding, the cause of which has not been established;
• Weight 90 kg.

Patients under 18 years old are usually not appointed Evra. This drug is also contraindicated in women who are breastfeeding.

It must be borne in mind that over time, the body's response to the drug may vary. If you have previously tolerated the use of the patch Evra, and then noticed that he began to cause undesirable side effects as soon as possible consult a physician.

Alcohol and food does not affect the efficiency of evryi.

Drug Interactions

The following drugs can decrease the effectiveness of the patch Evra:

• Bosentan;
• Carbamazepine;
• Cyclosporine;
• Etorikoksib;
• Felbamate;
• Griseofulvin;
• Lamotrigine;
• Nevirapine;
• Oxcarbazepine;
• Phenytoin;
• Primidone;
• Rifampicin;
• Ritonavir;
• Topiramate.

In addition, the following group of drugs can interact with a patch Evra:

• Antibiotics;
• Barbiturates;
• Inducers of liver enzymes;
• Drugs used in the treatment of HIV patients;
• Penicillin;
• Tetracycline.

During the consultation with the doctor before applying the patch Evra is necessary to inform your doctor about any medications you are taking, as well as vitamin supplements and herbs. For example, St. John's wort interacts with Evra, so take them at the same time is not recommended.

Amenorrhea after abortion is often a consequence of the "shock" caused by neurohormonal system are women. But perhaps the emergence of organic changes in the reproductive organs of women, such as the cervical canal atresia and intrauterine adhesions.

Amenorrhea after abortion as a consequence of the hormonal impact

Normal functioning neurohormonal system of women is a multi-stage forming, in which the main, decisive role played by the cerebral cortex and the hypothalamus. Abortion - is abortion, which leads to a sharp sudden malfunction of the entire system. Such a violation of the same degree of impact shock, and sometimes completely destroy the system. Amenorrhea and infertility, are developing in such a case are called hypothalamic or central.

Depending on how great was the stress How to beat stress? Create an oasis   suffering from stroke, amenorrhea may last from several months to several years (of course, if left untreated). Thus, the longer a woman is not menstruating, the less the chance of restoring fertility as functional disturbances in neurohormonal regulation system can lead to organic changes in the ovaries.

Amenorrhea after abortion as a result of organic disorders in the reproductive organs of women

Sometimes after the abortion occurs atresia (complete or partial imperforate) the cervical canal, resulting in a false amenorrhea occurs. Imperforate cervical canal caused the destruction of its mucosa, which leads to the development of connective tissue adhesions - adhesions.

In such cases, there are no monthly after abortion, but there are monthly cyclic pain caused by violation of the outflow of blood from the uterus.

The diagnosis in this case is confirmed by means of ultrasound (US), which should be carried out when a monthly pain. In the US, you can see the accumulation of fluid in the uterus. Since the hormonal system in this case is operating normally, the content of hormones in blood is not usually altered.

Restore patency of the cervical canal by bougienage (extensions with special bougies with increasing diameter). If the abortion took place after more than six months, probing does not help, then spend colliotomy using a hysteroscope (hysteroresectoscopy).

The cause of amenorrhea after abortion may be the development of intrauterine adhesions (adhesions). Appears only such amenorrhea absence of menstruation, pain usually does not happen. Also confirms the diagnosis by ultrasound, the study is carried out using a vaginal probe. It held as diagnostic hysteroscopy, which in case of intrauterine adhesions can move in hysteroresectoscopy - colliotomy. Hormonal contraceptives after surgery is not indicated, as they inhibit the growth of the mucous membrane of the uterus and hamper the process of recovery.

Recovery after abortion

After an abortion, women need replacement therapy. It includes the prevention of infectious and inflammatory complications (antibiotics), reference ultrasound and, if necessary (if the uterus were not removed tissue) re scraping Scraping - heavy and unsafe procedure . To restore the normal function of the reproductive organs are appointed by reflexology courses Reflexology - a policy of non-drug therapies   and physiotherapy.

It held the appointment of combined oral contraceptives (COCs) to restore hormonal levels and prevent a new unwanted pregnancy. Assigns low-dose COCs only obstetrician based on identified hormonal disorders. Modern low-dose COCs allow gently restore the neurohormonal system and avoid such unpleasant consequences of abortion as amenorrhea, mastitis, ovarian cysts, and so on.

Great attention should be given after the abortion of immunity, since the accession of infection may negate the chances of a woman to have a child in the future. In order to strengthen immunity Strengthening the immune system - help the immune system   recommended nutrition, exposure to fresh air and moderate physical activity.

Abortion - it is always a stress for the women hit her hormonal system and the risk of developing complications from the organic genitals. Menstrual disorders after abortion should be identified as early as possible and treated. If this is not done in time, against the backdrop of sustained amenorrhea, infertility may occur.

Galina Romanenko