How do hormonal pills affect a woman’s body? Add your price to the Comment database. Should I take hormones?

Doctor's orders are checked online and often not followed. Hormonal drugs are especially disliked: “Doctor, not hormones!” How dangerous are these drugs? Let's figure it out.

Case from practice

Young woman, 8 weeks pregnant. The level of thyroid-stimulating hormone of the pituitary gland (TSH) is increased. I inform the patient that she has hypothyroidism - decreased function thyroid gland. I prescribe treatment and explain: the hormonal drug is needed for the normal development of the fetus. The patient appears before giving birth. TSH is still high. She doesn’t take the medicine - her mother-in-law forbade it: “These are hormones!”

A few years later we meet by chance on the street, she leads her son by the hand: “Hello, doctor, this is my Mitya.” Mitya has a vacant look, he does not speak yet, and is noticeably behind his peers in development. His mother has a pale, puffy face, her voice has become rough and low: it looks like hypothyroidism is progressing. The outcome could have been different. But the doctor’s prescriptions were opposed by an “iron” argument - “I don’t want to take hormones!”

Set in motion

Hormones are produced by special endocrine glands. “Hormon” is translated from Greek as “I set in motion, excite, motivate.” Hormones act distally, that is, at a distance from the gland where they were formed, their effects are diverse and unique.

When there are few or many

We have many different hormones, and their production is controlled by strict laws. But in some diseases, the formation of hormones is disrupted.

Sometimes the work of the endocrine glands decreases. If you do not make the correct diagnosis in time and do not start correct treatment, trouble will happen. What is the correct treatment for a deficiency of a certain hormone? Of course, compensation for the missing factor. Here are some examples.

Diabetes mellitus type 1- a disease in which the hormone insulin ceases to be produced. Without it, glucose does not enter the cells and is not formed from it necessary for the body energy. Thanks to insulin medications, people with diabetes live full lives.

Another example - adrenal insufficiency: increasing weakness, weight loss, blood circulation is impaired. Fortunately, there are medications similar to adrenal hormones (glucocorticoids and mineralocorticoids).

Hypothyroidism- decreased thyroid function - requires compensation for the deficiency of levothyroxine, a thyroid hormone. It is inactive, but when it enters cells, it is converted into active triiodothyronine, which is responsible for protein biosynthesis.

Hypogonadism- insufficiency of the function of the gonads. It occurs in both men and women. Main symptom- infertility. Treatment with sex hormones can solve the problem.

It happens the other way around: Too many hormones are produced. The cause may be an adenoma of the endocrine gland or the appearance of stimulating antibodies that force the gland to work in the “pot, cook!” mode.

An excess of hormones is no less dangerous than a deficiency: “a flood is no better than a drought.” It is treated with drugs that block the gland or by removing the “unruly” gland.

From allergies to sclerosis

All of the above applies to diseases endocrine system and the principles of their treatment. However, the use of hormones in medicine is much wider. Thus, drugs similar to adrenal hormones (glucocorticoids) are used to treat autoimmune diseases: bronchial asthma, rheumatoid arthritis, multiple sclerosis and others.

Glucocorticoids quickly improve the patient's condition. But they are prescribed, observing certain principles, so that the therapeutic effect is optimal and side effects are not expressed.

Female hormone preparations(estrogens and progestins) are used as effective and safe contraceptives and for the treatment of perimenopausal symptoms.

Male hormone preparations, anabolic steroids, are used in the treatment of dystrophic conditions. Unfortunately, these drugs are sometimes abused by athletes to increase muscle mass, forgetting about possible complications: damage to the liver, heart, sexual function.

Do not forget: any medicine if used incorrectly can cause harm. Medicines, including hormonal ones, are prescribed by a doctor who, when planning treatment, takes into account many different factors: your gender, age, weight, accompanying illnesses, bad habits and previous allergic reactions, heredity.

The drugs do not cause tumor formation. However, in the presence of cancer, such drugs can stimulate them further development. Therefore, before you start taking pills, go through the full examination. Please note that hormone therapy requires caution.

As you know, the endocrine system of each of us is a kind of “hormonal skeleton” of our body, while all the glands that produce hormones, regardless of their location, are in close relationship, providing all the most important functions, both physical and psycho-emotional.

From coordinated work These glands depend on our mental abilities, general well-being, and appearance, and mood, and proper digestion, and sleep, etc.

In the event that for any reason the body experiences hormonal disbalance, in which the production of hormones is disrupted in one direction or another, then the person is prescribed appropriate treatment.

When planning a pregnancy

Lack of hormones is especially dangerous in situations where a woman dreams of motherhood, but, unfortunately, a lack of female hormones estrogen can become an obstacle to conception and normal development of the fetus.

For this reason, in the case when the desired pregnancy does not occur, the woman needs to undergo examination by an endocrinologist, and this must be done even when everyone else physical indicators hers are within normal limits.

In some cases, a woman may be prescribed hormones that serve as a stimulator for egg maturation. Hormone therapy can prevent or minimize the likelihood of miscarriage.

Of course, before using hormonal therapy, you should contact more simple ways, capable of activating the work of the endocrine glands, because it is likely that the functional failure is insignificant.

Sometimes it is enough to normalize your diet, ensure sufficient physical activity, visit more fresh air etc., that is, to lead healthy image life.

It is also necessary to remain calm, since fatigue and chronic stress reduce the likelihood of conception by half. The fact is that listed factors negatively affect the functioning of the adrenal glands, which, in turn, begin to produce the wrong hormones that are necessary for the maturation of the egg.

For contraceptive purposes

One cannot fail to mention the category of women who use hormonal therapy to prevent unwanted pregnancy.

Moreover, oral contraceptives can be purchased in our pharmacies without much difficulty, and low content hormones in them can prevent not only the onset of pregnancy, but also help in solving problems with excess weight, liver, and blood vessels.

Of course, no one can give an absolute guarantee that pregnancy can occur, but gynecologists still admit that birth control pills are one of the most reliable means.

By the way, such oral hormonal drugs are often prescribed when gynecological problems ah, for example, with ovarian dysfunction, absence of menstruation (amenorrhea) in adolescence and so on.

However, there is one significant “but”: long-term use of drugs of this kind can “wean” the body from working independently, as a result of which it simply stops producing the necessary hormones in the required quantities.

Ultimately, this development of events is fraught with ovarian dysfunction, and, as a consequence, premature aging. For this reason, it is important to determine “your” drug by consulting a specialist and conducting an examination, which involves performing the necessary tests.

If you start taking one or another oral contraceptive uncontrollably, this can cause serious gynecological problems, including problems with conception.

If at this time it is determined that the body continues to function normally without taking medications, then you can return to their further use.

If you want to prolong youth

During the period of extinction reproductive function, in order to prolong youth, some ladies also resort to hormone replacement therapy.

This method was especially popular in the USA and Great Britain in the sixties of the last century. But, at present, experts are skeptical about this method of prolonging youth, since, in their opinion, the use hormonal drugs can provoke the development of breast and ovarian cancer, and also promotes the process of blood clots.

At the same time, some researchers are inclined to believe that the entry of additional amounts of estrogens into female body is a good prevention of the development of osteoporosis, because this hormone prevents the leaching of calcium from the body. These arguments are put in opposition to those who argue that hormone therapy can cause more harm than good.

Nevertheless, if you, for whatever reason, decide to use hormonal therapy, first of all, clearly understand for yourself for what purpose you need it. So, for example, in the case of a complex course of menopause, accompanied by hot flashes, increased sweating, and emotional swings, taking medications of this kind is completely justified.

But if the motives are only to postpone impending old age indefinitely, then in this case it will be more effective and safer to visit a psychologist and conduct a course of psychotherapy.

And if, for one reason or another, you have to take hormonal drugs for a long time, then you must first undergo a full examination, which in the future must be repeated every six months. The total duration of hormone replacement therapy should not exceed three to five years.

So you should still be careful when using hormonal treatment. Some gynecologists advise giving preference not to tablets, but to patches, suppositories, and gels, since these products contain fewer hormones.

For many of us, the term “hormonal medications” sounds ominous. In the minds of most people who are not involved in medicine and pharmaceuticals, hormones are monstrous pills that bring a lot of equally monstrous side effects.

What are these fears based on? And if hormones are so harmful, why are they used so widely? Let's try to figure out together what they really are hormonal pills.

Classification

Hormonal medications contain hormones or substances that have properties similar to hormones (hormonoids). Hormones are produced in the human endocrine glands and spread through the bloodstream to various organs and systems, regulating vital important functions body.

Hormonal drugs can be divided into hormone preparations:

• pituitary gland
  These include human chorionic gonadotropin and oxytocin, known probably to every woman;

• thyroid gland.
  These drugs are used to treat insufficient production own hormones (for example, with hypothyroidism) and the opposite condition - excess production of hormones;

• pancreas.
  The most famous drugs in this group are insulin preparations;

• parathyroid glands;

• adrenal cortex.
  This group includes glucocorticosteroids, which are widely used in many branches of medicine as anti-inflammatory, antiallergic and analgesic agents;

• sex hormones: estrogens, gestagens, androgens;

• anabolic agents.

What is treated with hormonal pills?

Despite the very wary attitude towards hormonal drugs on the part of patients, we can safely say that these drugs are extremely necessary and important. Often only hormonal drugs can provide a chronically ill person with a decent quality of life, and sometimes save life itself.

Therapy with hormonal pills is necessary for:

- oral contraception;

- hormone replacement therapy in postmenopausal women and elderly men suffering from testosterone deficiency;

- treatment of inflammatory and allergic diseases;

- treatment of hormonal deficiency.
These pathologies include hypothyroidism, type 1 diabetes mellitus, Addison's disease and other diseases;

- treatment of many oncological diseases.

Oral contraception. Achievements of modern medicine

The first studies that laid the foundation for the development of hormonal contraceptives were carried out back in 1921. Ten years later, scientists had already precisely clarified the structure of steroid hormones and discovered that high doses of sex hormones inhibit, that is, block ovulation.

The first combined hormonal contraceptive was released in 1960 by American pharmacists. It contained really high doses of hormones, and therefore had not only contraception, but also a lot of side effects.

Over time, the situation has changed dramatically. In the 90s of the last century, hormonoids were synthesized, which, along with high activity, have excellent tolerability. That's why modern women may not worry about the extra pounds gained from taking hormonal birth control pills. This side effect is a thing of the past with loading doses active substances contained in the first contraceptives.

The effectiveness of all contraceptives is assessed using the Pearl index, which determines the probability of pregnancy within one year at constant use drugs. On average, the Pearl index of hormonal contraceptives ranges from 0.3% to 2-3%. The maximum value of this indicator reaches 8%.

If a woman has average fertility and does not become pregnant from her husband's toothbrushes, the chance of pregnancy rarely exceeds 1%. Of course, subject to daily use of the tablets.

However, let's return to classifications. Modern hormonal contraceptives can be:

1. combined;

2. non-combined (mini-pill);

3. tablets for emergency contraception.

Let's try to figure out how these groups differ.

1. Combined hormonal contraceptives: COCs

The funny abbreviation COC hides very serious medications, which are the most popular modern contraceptives. All COCs include two active ingredients - estrogen and gestagen. Ethinyl estradiol is used as estrogen, and levonorgestrel, norgestrel, desogestrel and other synthetic hormones can act as a gestagen.

The dose of ethinyl estradiol in modern COCs is much lower than in the first “killer” tablets. Due to this, symptoms rarely develop when taking new medications. side effects estrogen: weight gain, breast tenderness and nausea.

Monophasic COCs have a constant dose of estrogen and progestin in each tablet. Despite the fact that during the menstrual cycle the concentration of hormones in a woman’s body is not constant, monophasic contraceptives are a strictly defined dose taken daily.

Biphasic contraceptives contain two types of pills in one package. The main difference between the second type of tablets is increased content gestogen, which is also characteristic of the physiological cycle.

However, three-phase COCs are traditionally considered the most adapted to the menstrual cycle. They include three groups of tablets. The concentration of active substances in each group approaches the content of estrogens and gestagens in a certain phase of the menstrual cycle. The first group of tablets imitates the follicular phase, which lasts 5 days, the second - the periovulatory phase, which lasts 6 days, and the last - the luteal phase, the longest 10-day phase. At the same time, the concentration of estrogen in three-phase COCs, as well as in the menstrual cycle, is maximum, and the level of gestagen increases from the first phase to the third.

Pharmacology: how do hormonal birth control pills work?

The contraceptive effect of all hormonal birth control pills, regardless of composition and dosage, is based on blocking the release of hormones responsible for ovulation and implantation. The ovaries practically “fall asleep”, decreasing in size. Ultimately, hormonal pills:

• suppress ovulation;
• change the properties of cervical mucus. As a result of this effect cervical canal becomes a real barrier for nimble sperm;
• change the state of the endometrium, as a result of which the “lining” inner surface The uterus does not allow the egg to implant if fertilization does occur.

How to take hormonal birth control pills?

The answer to the question of how to take hormonal pills that protect against pregnancy can be expressed in one single word: regularly. Depending on the period for which the course is designed - 21 or 28 days - the tablets should be taken once a day throughout the entire treatment period, preferably at the same time.

An important question that concerns most women taking COCs is what to do if the patient forgot to take the pill on time. First of all, don't panic. The situation is solvable and, in general, very banal.

Secondly, the missed pill should be taken immediately after memory is restored. Take the next pill as scheduled, even if you have to take two pills at the same time.

Thirdly, the period during which the woman forgot about the need to use protection should be assessed. The following actions depend on the statute of limitations.

If the delay is no more than 12 hours, you can calm down - the effectiveness of contraception will remain the same, that is, close to 100%. If this period lasted more than 12 hours, you will have to use additional methods protection, for example, barrier or spermicidal.

Monophasic COCs: effectiveness and popularity

The most popular and widespread hormonal contraceptives include monophasic drugs. Many gynecologists believe that these products are the best hormonal pills for women under the age of 35, and patient reviews confirm this.

Monophasic contraceptives contain tablets of the same color. Despite the fact that the packaging may contain a strict diagram of the use of tablets (usually in order of priority), this does not carry any special meaning. And if you manage to take a pill at the very beginning of the cycle, intended for use, say, on day 25, absolutely nothing bad will happen - after all, all the pills have the same composition.

Most COCs that saturate the Russian pharmaceutical market are monophasic. The choice of drugs is so wide that even experienced gynecologists sometimes hesitate before prescribing the drug to patients. Therefore, we will consider only those hormonal pills that can be classified as “new”, modern means.

The German drug Logest, which is produced by the well-known company SCHERING, S.A., contains 20 mcg of ethinyl estradiol and 75 mcg of gestodene. The product is available in a package of 21 tablets. Logest is an excellent drug for young women.

Lindineth

Hormonal tablets Lindinet 20 are a complete analogue of the German Logest. The drugs have the same composition, and the only difference can be considered the color - Lindineta tablets have a pale yellow shell. Lindineta is manufactured by the Hungarian company GEDEON RICHTER.

Lindinet 30 differs from its brother only in the dosage of estrogen (30 mcg).

Hormonal tablets Zhanine produced by SCHERING contain 30 mcg ethinyl estradiol and 2 mg progestin (dienogest). The Pearl index with regular use of Janine does not exceed 1%.

The main difference between Zhanine and other COCs is the antiandrogenic activity that dienogest has. Therefore, Janine is prescribed to patients with increased level male sex hormones. In addition, the hypocholesterolemic, that is, lowering cholesterol levels in the blood, effect of dienogest has been proven.

The German drug Yarina is one of the most popular monophasic hormonal contraceptives in tablets. The medicine contains 30 mcg ethinyl estradiol and 3 mg drospirenone.

The properties of Yarina and Zhanin are very similar. Yarina helps reduce lipoprotein levels high density and has an antiandrogenic effect. Thanks to this quality, Yarina is also considered a remedy for acne: hormonal tablets are prescribed as part of complex acne therapy. The drug helps reduce sebum production and reduce the manifestations of the disease.

One of the very well-known hormonal contraceptives in tablets is Diane-35, which is produced by SCHERING. The drug contains 35 mcg ethinyl estradiol and 2 mg of the antiandrogenic gestagen cyproterone acetate.

Diane has pronounced antiandrogenic activity, which makes it possible to prescribe it for the treatment of acne and seborrhea. In addition, Diane-35 is the drug of choice for contraception in women who have mild manifestations of hirsutism - excess hair growth.

Among tablets with antiandrogenic activity, the popular hormonal contraceptive Jess occupies a special place. It contains 20 mcg ethinyl estradiol and 3 mg drospirenone. The gestagen included in Jess neutralizes the side effects of estrogen. In this regard, the drug is very well tolerated, and swelling and weight gain are practically excluded.

In addition, drospirenone mitigates the symptoms premenstrual syndrome, including pronounced ones. To all positive properties Jess can also have a beneficial effect on cholesterol levels, which is manifested in an increase in the concentration of high-density lipoproteins (HDL). But it is HDL that removes excess cholesterol from the body.

COCs containing drospirenone also include the Hungarian hormonal tablets Midiana. They differ from Jess only more high content ethinyl estradiol, the dose of which is 30 mcg.

Among the low-dose COCs, it is also worth noting the hormonal tablets Rigevidon, Femoden, Novinet, Miniziston, Microgynon, Regulon.

This is not the end of the list of monophasic contraceptives registered in Russia. However, they are used much less frequently, so we will immediately move on to the following categories of COCs.

Table “Monophasic COCs”:

Drugs	Manufacturer, country	Compound
Logest, analogue - Lindinet 20		Ethinyl estradiol 20 mcg Gestodene 75 mcg
Femoden, analogue - Lindinet 30	Schering, Germany (Gedeon Richter, Hungary)	Ethinyl estradiol 30 mcg Gestodene 75 mcg
Miniziston	Jenafarm, Germany	Ethinyl estradiol 30 mcg Levonorgestrel 125 mcg
Mercilon, analogue - Novinet		Ethinyl estradiol 20 mcg Desogestrel 150 mcg
Microgynon	Schering, Germany	Ethinyl estradiol 30 mcg Levonorgestrel 150 mcg
Marvelon, analogue - Regulon	Organon, Netherlands (Gedeon Richter, Hungary)	Ethinyl estradiol 30 mcg Desogestrel 150 mcg
Silest	Silag, Belgium-Switzerland	Ethinyl estradiol 35 mcg Norgestimate 250 mcg
Diana-35	Schering, Germany	Ethinyl estradiol 35 mcg Cyproterone acetate 2 mg
Janine, analogue - Silhouette	Schering, Germany (Gedeon Richter, Hungary)	Ethinyl estradiol 30 mcg Dienogest 2 mg
Regividon	Gedeon Richter, Hungary	Ethinyl estradio 30 mcg Levonorgestrel 150 mcg
Jess, analogue - Dimia	Bayer, Germany (Gedeon Richter, Hungary)	Ethinyl estradiol 20 mcg Drospirenone 3 mg
Yarina	Schering, Germany	Ethinyl estradiol 30 µg Drospirenone 2 mg
Midiana	Gedeon Richter, Hungary	Ethineestradio 30 mcg Drospirenone 3 mg

Two-phase and three-phase COCs: time-tested

As we have already said, two- and three-phase hormonal contraceptives act more physiologically. However, most often doctors prefer to use the first group of drugs. What causes this?

The fact is that changes in hormone concentrations are associated with an inevitable increase in the dose of active substances. As a result, the side effects of biphasic and triphasic drugs are more pronounced than low-dose monophasic drugs.

Biphasic COCs are among the rarely used drugs. Among them there are products whose names are often unusual even for the pharmacist, not to mention the patients - Anteovin, Nuvelle, Orfo-Novum, Bi-Novum.

Three-phase contraceptives are better known and popular. However, their disadvantages in the form of standard side effects are no less pronounced than those of biphasic drugs. Three-phase COCs are easy to “calculate” by their name, which, as a rule, begins with “three”: Triziston, Triquilar, Tri-mercy, Tri-regol, Trister.

Tablets of two- and three-phase hormonal contraceptives are colored different colors depending on the composition: in two-phase preparations - in two colors, and in three-phase preparations - in three. Such medications must be taken strictly according to the schedule. Usually, the COC currency is replete with various arrows and other bright marks designed to help a woman understand the peculiarities of using multi-colored tablets. After all, if you accidentally mix up the color of the pills, the contraceptive effect is reduced.

Useful contraceptives? Advantages of COC

Oral contraceptives are designed not only to provide direct, contraceptive effect. They have a lot of other, often no less important, indications, including:

— treatment of menstrual disorders and PMS.
The use of COCs helps to normalize the cycle, reduce blood loss during menstruation, and also reduce premenstrual syndrome;

- treatment of acne, seborrhea and acne.
Complex therapy for dermatological diseases in women often includes COCs with an antiandrogenic effect. Hormonal tablets significantly reduce sebum synthesis, helping to reduce the appearance of acne. In patients suffering from seborrhea who take COCs, the level of sebum is normalized and hair loss is noticeably reduced;

— prevention of benign diseases of the mammary gland and pelvic organs.
COCs suppress the stimulation of the ovaries by follicle-stimulating and luteinizing hormones. Therefore, regular use of hormonal birth control pills significantly reduces the risk of the formation of functional cysts and benign nodes in the mammary glands;

- prevention of ovarian cancer and endometrial carcinoma.
When taking oral contraceptives regularly, the risk of ovarian cancer is reduced by as much as 40%. This protection lasts even 15 years after stopping taking hormonal pills. The longer you take a COC, the longer it takes for the anti-cancer effects to appear.

And that is not all. The likelihood of developing endometrial adenocarcinoma (uterine cancer) in women treated with hormonal birth control pills is reduced by 50%. The protective effect persists for 15 years after stopping COC use.

Negative aspects of combined hormones

We would be lying if we say that COCs are extremely healthy drugs. During treatment with hormonal contraceptive pills, sometimes adverse consequences cannot be avoided. TO negative aspects COCs include:

- the likelihood of side effects, including nausea, breakthrough bleeding, increased sensitivity and breast enlargement. However, some ladies use hormonal pills just to enlarge their bust, so sometimes this effect can be attributed to positive qualities COOK;

- the need for regular daily use;

— the likelihood of delayed ovulatory cycles after discontinuation of COCs.

When is hormonal contraception prohibited?

There are several conditions in which the use of any hormonal contraceptive pills is excluded. These pathologies include:

• cardiovascular diseases;
• deep vein thrombosis;
• diabetes mellitus with vascular complications;
• oncological diseases;
• abnormal vaginal bleeding;
• liver diseases;
• age over 35 years;
• smoking.

Drugs containing drospirenone - Jess, Angelique and others - are also contraindicated in patients with kidney, adrenal or liver diseases. This is due to the fact that drospirenone has an antimineralocorticoid effect.

Hormonal contraceptives and venous insufficiency: incompatibility No. 1

Many women know that hormonal pills are not recommended for varicose veins veins and are strictly contraindicated in thrombophlebitis. But the answer to the question of what causes such a ban is unknown to most patients.

It turns out that the constant component of all hormonal birth control pills - estrogen - activates the blood clotting mechanism, resulting in an increased risk of blood clots. It is known that modern drugs with low estrogen levels are associated with a low risk of thromboembolism, while high-dose hormonal pills do the opposite.

In addition, the likelihood of developing blood clots increases significantly in smoking women, patients with high blood cholesterol, severe diabetes, hypertension or obesity.

2. Mini-pills: special hormonal contraceptives

Under the affectionate and usually little-understood name “mini-pill” are hidden hormonal contraceptive pills containing only one component - gestagen. Moreover, the dose of the active substance in the mini-pill is really minimal.

Hormonal mini-pills can be prescribed to patients over 35 years of age, including those over 40, as well as to women with diabetes. Even breastfeeding is not an obstacle to the use of these medications. However, minipills have a lower Pearl index compared to COCs. In addition, drugs in this group can cause intermenstrual bleeding, the appearance of cysts in the ovaries, and even ectopic pregnancy.

Note that contraceptive effect mini-pills are reduced if taken at different times of the day. This drawback often tips the scales in favor of combined hormonal pills.

Among the mini-pills, we will name several drugs registered in Russia: Norgestrel, Levonorgestrel, Linestrenol.

3. Urgent contraception: when you can’t wait

Hormonal emergency contraception drugs are a kind of emergency pills in case of unforeseen circumstances. They hurried, forgot, broke, didn’t find and other verbs in the past tense can briefly describe the standard reasons why women begin to rush around in search of miracle cures for all problems.

And, of course, there are such drugs. They contain high doses of hormones that either prevent ovulation if the problem happened in the first half of the cycle, or change the state of the endometrium if fertilization does occur.

The most well-known emergency contraceptives include Postinor, Microlut and Escapelle. These pills should be used as rarely as possible - after all, the hormonal surge that occurs after taking the drugs is akin to a blow. And not a single organism can withstand being hit with high doses of hormones regularly.

Down with amateur performances!

All hormonal contraceptives, including tablets, are prescription drugs only. And this is no coincidence. After all, the wrong medicine can easily cause menstrual irregularities and other gynecological problems.

Therefore, if you decide to take a hormonal drug, the first person who should tell you about it is find out - doctor obstetrician-gynecologist. Remember: the right to select a hormonal contraceptive should be given not to a neighbor, not to a friend on the forum, or even to a pharmacist, but to a doctor.

Menopause: if there is little estrogen

Unfortunately, menopause brings with it a lot of clinical symptoms, which are hard to miss. Classic symptoms of menopause are characterized by irregular or absent menstrual cycles. In 60% of women sharp drop estrogen levels lead to vascular disorders, which are manifested by hot flashes, sweating and increased heart rate.

Other, no less striking symptoms are also possible. After all, it is estrogens that provide sufficient hydration to the vagina and regulate urination. Until the woman’s body adapts to the new hormonal levels, inevitable and neurological manifestations menopause: depression, insomnia, mood swings.

Extremely dangerous consequence The onset of menopause is a catastrophic decrease in bone mass. As a result, a disease associated with brittle bones develops - osteoporosis.

If no action is taken, these manifestations can poison a woman’s life for many years. However, the body can be “deceived” if such necessary estrogens are introduced from the outside. And this can be done with the help of hormonal pills, which for some reason some patients are so afraid of. Is the game worth the candle? Let's figure it out together.

Add estrogen: hormonal pills

Hormonal pills used during menopause may contain:

• estrogen only;
• a combination of estrogen and progesterone;
• a combination of estrogen, progesterone and androgen.

The most popular are estrogen preparations. Hormonal pills are taken constantly, that is, daily, or in cycles of several weeks.

In most cases these medicines contain so-called conjugated estrogen, which is obtained from the urine of mares. Among them, we note Estrofeminal, Premarin and Hormoplex. All these medications are used cyclically for 21 days, followed by a week-long break.

Biphasic agents

These tablets consist of two components - estrogen and progestogen.

Divina- a drug produced by the Finnish company Orion. The first group of tablets contains only estradiol in a dose of 2 mg, and the second - a combination of 2 mg of estradiol valeriat and 10 mg of gestagen (medroxyprogesterone).

Klimonorm- a German medicine from the Bayer corporation. The main difference from Divina lies in the gestagen: 0.15 mg of levonorgestrel is used as a progesterone-containing component in Klimonorm.

Klymen contains the same 2 mg of estradiol and 1 mg of cyproterone (gestagen).

In addition, other hormonal replacement pills are no less popular among Russian gynecologists, including Cycloprogynova, Femoston, Divitren, Angeliq.

Triphasic hormonal pills

These drugs are designed for continuous use and include three groups of tablets: the first and third contain estrogens, the latter in a lower dose, and the second group includes a combination of estrogen and progestogen.

Only two three-phase drugs are registered in Russia - Trisequens and Trisequens forte.

Hormone replacement pills: contraindications and side effects

Hormone therapy during menopause is contraindicated for breast or endometrial cancer, serious illnesses liver, thrombophlebitis, endometriosis, fibroids.

Side effects of hormone therapy include mood swings, breast engorgement, and intermenstrual bleeding.

And one last thing. Before prescribing hormonal replacement pills, a thorough examination of the woman is carried out, which includes a general urine test, an analysis of sugar levels and lipid profile blood, ultrasound of the pelvic organs, ECG, cytological examination of cervical scraping and mammography. And if replacement therapy is not contraindicated, the benefits significantly outweigh the risks.

Hormones for the treatment of inflammation: why are glucocorticoids needed?

A separate group of hormonal tablets are glucocorticosteroids (GCs). They have three properties at the same time: anti-inflammatory, antiallergic and analgesic. This unique triad is the basis for wide application glucocorticoids in almost all areas of medicine.

Synthetic hormonal tablets containing HA are taken continuously for autoimmune diseases, including multiple sclerosis and rheumatoid arthritis.

It is impossible to do without hormonal tablets containing HA in the treatment of allergic diseases, including bronchial asthma. Glucocorticoids can reduce inflammatory reaction and counteract the activity of immune cells that are involved in the pathological process. Most often, HA is administered by inhalation, but in some severe cases, hormonal drugs in tablets and ampoules are used.

Glucocorticoids are certainly included in the treatment regimen for oncological diseases. Their main purpose is to reduce side effects chemotherapy. In addition, hormonal pills can help destroy cancer cells for lymphoblastic leukemia, Hodgkin's lymphoma, non-Hodgkin's lymphoma and multiple myeloma.

Glucocorticoids in tablets

Most often, several tableted glucocorticoids are used.

The drug effectively reduces inflammation by suppressing the function of leukocytes. Interestingly, the anti-inflammatory effect of Dexamethasone is 30 times greater than the activity of another GC - hydrocortisone.

Dexamethasone tablets are indicated for the hormonal treatment of Addison's disease, hypothyroidism, bronchial asthma, rheumatoid arthritis, nonspecific ulcerative colitis, eczema, malignant tumors in advanced stages.

The dosage of Dexamethasone is selected individually.

The drug is an analogue of hydrocortisone. Prednisolone is able to influence all stages of the inflammatory process and have a pronounced anti-inflammatory effect.

There are indeed many indications for the use of Prednisolone tablets - hormonal treatment prescribed for systemic lupus erythematosus, multiple sclerosis, joint diseases, bronchial asthma, oncological diseases, adrenal insufficiency, allergies, autoimmune pathologies and many others.

The drug produced by the Polish plant Polfa contains triamcinolone GC in a dose of 4 mg. The main indications for Polcortolone include joint diseases, allergic pathologies that are difficult to treat, rheumatic, dermatological, hematological, oncological and other diseases.

Side effects of glucocorticoids

HAs have truly unique qualities. Therefore, glucocorticoids could be called healing drugs, if not for the side effects. Because of large number adverse events due to treatment, long-term use of these drugs may even be dangerous.

We list the most common side effects of hormonal tablets of the glucocorticoid group:

• decreased immunity;
• increased blood sugar levels. With long-term treatment with GC, the development of diabetes mellitus is possible;
• decreased calcium absorption, which can lead to osteoporosis - dangerous disease bone tissue;
• amyotrophy;
• increased levels of cholesterol and triglycerides in the blood;
• mood changes, depression, memory impairment, in severe cases - psychosis;
• gastritis and peptic ulcer;
• menstrual irregularities, decreased libido;
• slow wound healing;
• weight gain.

Another extremely unpleasant side of corticosteroids is withdrawal syndrome: after stopping long-term use of hormonal pills, there is a possibility of severe side effects. To avoid such a development of events, medications should be discontinued gradually, gradually reducing the dose over a certain period of time.

Hormonal deficiency: when can you not do without pills?

The most common pathologies that require constant use of hormonal medications are diseases of the thyroid gland.

Thyroid insufficiency - hypothyroidism - is a common disease in which the production of hormones is reduced. Treatment is based primarily on compensating for the lack of hormones. For this purpose, hormonal tablets are prescribed, which include sodium levothyroxine.

Levothyroxine sodium is a levorotatory isomer of thyroxine. It is a synthetic analogue of thyroid hormone. Thyroxine is the first-line medicine for hypothyroidism, euthyroid goiter, and also after removal or resection of the thyroid gland.

Despite the fact that thyroxine is a hormonal medicine, when the correct dosage is prescribed according to indications, there are practically no side effects.

Hormones in oncology: when drugs save lives

Hormone therapy in oncology, along with chemotherapy, is one of the main drug treatments for cancer. Hormone treatment is used for several types of hormone-sensitive tumors, including breast, prostate, endometrial (uterine cancer), and adrenal cortex.

Most drugs used to treat hormone-dependent tumors inhibit, that is, block the release of hormones. These drugs include one of the most well-known drugs for the treatment of breast cancer - Tamoxifen.

Many drugs can reduce the production of other hormones, which are responsible for the growth of malignant tumors. Often, hormonal treatment is almost the only opportunity to fight the tumor and prolong the patient’s life.

Hormonal pills are a whole pharmaceutical world, in which there is a place for effectiveness, uniqueness, and side effects. And only doctors can untie this tangled tangle of complex concepts, indications and contraindications. Then the correctly prescribed remedy turns out to be the right path to a fulfilling life.

Hormonal drugs are medications containing hormones or substances that exhibit effects similar to hormonal ones. Natural hormonal medicines are obtained from the glands, blood and urine of animals, as well as from human blood and urine.

Synthetic hormones are produced in pharmacological workshops and laboratories. They can be either structural analogues of true hormones, or differ from them in chemical structure, but exhibit a similar effect.

Around hormonal pills for various purposes, almost the most a large number of threatening myths: patients are afraid of infertility, weight gain, excess body hair growth, loss of potency. The list of negative ones is scary and alarming.

How true are the myths, and what types of hormonal therapy are there?

Hormonal drugs are classified depending on their origin (producing gland) and purpose. Based on their origin, medications are divided into:

• adrenal hormones (cortisol, adrenaline, glucocorticoids, androgens);
• pancreatic preparations (insulin);
• pituitary hormones (TSH, human gonadotropins, oxytocin, vasopressin, etc.);
• thyroid and parathyroid hormones;
• sex hormones (estrogens, androgens, etc.).

Human hormones regulate metabolism in the body. However, if the functioning of one of the organs of the endocrine system is disrupted, the perfectly adjusted mechanism of correction and interaction may fail, which will have to be corrected by introducing synthetic analogs of hormones.

According to their intended purpose, hormonal drugs are divided into:

• synthetic substances for replacement therapy (sodium levothyroxine, insulin, estrogens);
• means for hormonal contraception(synthetic analogs of estrogen and progesterone);
• hormonal agents that inhibit the production of hormones (for example, therapy with pituitary hormone analogues for prostate cancer);
• symptomatic medications (anti-inflammatory, antiallergic drugs).

Hormonal drugs often also include antidiabetic and other non-hormonal drugs.

What is treated with hormonal medications?

Hormone-based medications are used for both chronic and treatable conditions. You cannot do without the help of hormonal drugs when:

• hypothyroidism;
• hyperthyroidism;
• diabetes mellitus type 1, sometimes type 2;
• hormone-dependent tumors of the reproductive system;
• prostate cancer;
• asthma and other diseases associated with the immune response to allergens (including allergic rhinitis);
• endometriosis;
• hormonal imbalances;
• menopause;
• sleep disorders;
• other diseases associated with hypofunction of the glands.

Inflammation and allergic manifestations are treated with glucocorticoids. Drugs based on them - Prednisolone, Metipred, Dexamethasone - reduce inflammation and suppress leukocyte function.

They can be used both internally (if systemic action is necessary) and externally (for hemorrhoids, thrombophlebitis, dermatological diseases, allergic rhinitis). When used externally, they are practically not absorbed into the main bloodstream and do not have a negative effect on the body.

Even if the cause of inflammation is unknown, adrenal hormones help relieve swelling, pain and redness. Hormonal anti-inflammatory drugs are among the vital drugs.

Vasopressin and epinephrine may be administered along with anesthetics. Due to their property of constricting blood vessels, these hormones are actively used in anesthesia (including local).

Melatonin also belongs to hormonal drugs. This substance, produced in, has an anti-stress effect, regulates circadian rhythms, affects metabolism, slows down the processes of aging and weight gain, and also stimulates the production of antibodies to infectious agents and tumor cells.

What is hormone replacement therapy?

For chronic conditions associated with dysfunction of the glands or their partial removal, medications with synthetic and natural hormones provide high quality and longevity of the patient’s life.

There are several types of hormone replacement therapy:

• treatment with synthetic thyroid hormones;
• insulin therapy;
• taking analogues of sex hormones.

Deficiency and excess of thyroxine and triiodothyronine are fraught with disturbances in mood, sleep, dry skin, problems with memory and performance, proliferation of glandular tissue and other unpleasant symptoms.

Clinical hypothyroidism is most often associated with diseases and tumors of the thyroid gland, therefore replacement therapy with iodine-containing hormone analogues is prescribed for life.

Substitution therapy uses drugs such as:

• "Euthirox";
• “L-thyroxine” (one of the Russian or German brands).

Treatment of hyperthyroidism has a somewhat more complex scheme: to reduce the synthesis of one’s own iodine-containing hormones, thyreostatics are used, and in particularly difficult cases, removal of part of the gland or radioiodine therapy is justified. Then the normal level of triiodothyronine is restored with the help of their synthetic analogues.

Insulin is a hormone of β-cells of the pancreas, the main task of which is to reduce blood glucose levels by regulating its entry into cells and stimulating the conversion of monosaccharides into glycogen.

Impaired functionality of the cells that secrete this hormone is called type 1 diabetes. Patients with such pathology are necessarily prescribed replacement therapy with the drugs “Humodar”, “Apidra”, “Novorapid”, “Actrapid”, “Humulin”, “Insulin Lente”, etc.

For type 2 diabetes, which is associated with impaired tissue sensitivity to insulin, hormone administration may also be prescribed.

Finally, female hormonal replacement therapy (HRT) is a pharmacological replacement of the function of the sex glands (ovaries) lost during their removal or menopause. The most commonly used drugs are:

• "Climodien";
• "Divina";
• "Ovestin";
• "Trisquence";
• "Femoston";
• "Estrofem" and others.

During treatment, androgens, estrogens and gestagens can be used (mainly the last two subtypes of hormones are used in the drugs).

Oral contraception

Oral contraceptives are the most well-known hormonal pills for women. The action of OCs is based on their ability to prevent ovulation (the maturation of the egg and its release from the follicle). Synthetic hormones thicken the mucus on the cervix, which complicates the movement of sperm, and also thin the uterine lining (endometrium), which prevents the fertilized egg from firmly attaching.

The triple mechanism of action of hormones reliably protects the patient from unwanted pregnancy: the Pearl index for oral contraceptives (the percentage of pregnancies that occur while taking OCs) does not exceed 1%.

When using oral contraceptives menstrual bleeding do not stop, but become more orderly, less abundant and painful. A certain regimen of hormones allows, if necessary, to delay the onset of menstruation.

Modern contraceptives are classified into three categories:

• Single-component preparations (Continuin, Micronor, Charozetta, Exluton).
• Combined oral contraceptives (COCs). COCs are the most reliable means. They contain synthetic estrogen () and progestogen (levonorgestrel, desogestrel, norgestrel, etc.).
• Postcoital (emergency) hormonal tablets (Postinor, Escapelle). Emergency contraceptives contain an increased dose of hormones, but are less effective.

The dosages of active hormones in modern contraceptives are much lower than in drugs of the last century, so the side effects of taking estrogen do not appear or appear only slightly.

Combined hormonal contraceptives

COCs are divided into mono-, two- and three-phase. Single-phase COC tablets contain a strictly defined amount of hormones, which does not change during the cycle. Multiphase products are designed to be more physiological: the dosages of the active ingredients in tablets are not the same for different days of the cycle.

Three-phase COCs (with three types of tablets changing per cycle) are often recommended by doctors, but two-phase drugs are practically not used.

Combined contraceptives:

A drug	Active substance	Manufacturer country
Monophasic COCs
Microgynon		Germany
Miniziston		Germany
Regividon		Hungary
Novinet	Ethinyl estradiol, desogestrel	Hungary
Mercilon		Netherlands
Regulon		Hungary
Marvelon		Netherlands
Jess	Drospirenone, ethinyl estradiol	Germany
Dimia		Hungary
Yarina		Germany
Logest	Ethinyl estradiol, gestodene	Germany
Lindinet 30		Hungary
Diana-35	Ethinyl estradiol, cyproterone acetate	Germany
Three-phase COCs
Tri-regol	Levonorgestrel, ethinyl estradiol	Hungary
Triquilar		Germany
Triziston		Germany

Different dosages of the active substance (levonorgestrel) allow you to adapt to hormonal fluctuations during the menstrual cycle and provide a high degree of protection against unplanned pregnancy at low concentrations.

Hormonal products for men

Male hormonal drugs are classified into drugs for gaining muscle mass, drugs for suppressing pathological process and hormone replacement therapy.

In practice, hormones from the adrenal glands (in particular testosterone), pancreas (insulin) and the anterior pituitary gland (somatropin or growth hormone) are actively used. They are used to form muscle relief, accelerate weight gain and burn fat. Reception hormonal drugs without a doctor's prescription has a number of negative consequences, including damage to the excretory system and possible gynecomastia (swelling of the mammary glands) due to the conversion of excess testosterone into the female hormone estrogen.

For medical purposes, hormonal drugs are used for hormone-dependent tumors (for example, prostate cancer). Injections with pituitary hormone analogues sharply reduce the production of testosterone, which accelerates growth malignant neoplasm. This procedure is called "medical castration." The introduction of hormones makes it possible to slow down the development of the tumor and resort to more radical methods treatment. Despite the threatening name, patients should not fear that the procedure is irreversible: some time after the end of treatment, erectile function and normal testosterone levels are restored.

Replacement therapy male hormones can be used both when completely removing the gland that produces them, and when reducing its functionality. After 40-45 years, the level of testosterone in a man’s blood begins to decline, which leads to problems in the sexual sphere. To restore potency, the following drugs are used:

• "Testosterone Undecanoate" and "Andriol" (tablets with one active substance– testosterone undecanoate);
• "Sustanon" (injection solution with four active ingredients - esters - decanoate, isocaproate, phenylpropionate and);
• "Nebido" (injection oil solution testosterone undecanoate);
• “Androgel” (a product for external use, the active ingredient is testosterone).

After complete removal testicles (due to a tumor of the prostate or gonad), replacement therapy is mandatory.

Attitudes towards hormonal drugs among people who are unfamiliar with medical reference books, predictably biased. Many drugs in this group have strong and a number of contraindications - for example, with long-term use of Prednisolone, rapid weight gain occurs, the face of a patient receiving premedication with this drug swells.

However, this is not a reason to refuse any product containing hormones, including effective birth control pills. When performing several simple rules the risk of complications from taking hormonal drugs is minimized.

Rules for taking hormonal drugs (GP):

• You cannot take GP without a prescription from your attending physician (endocrinologist or gynecologist). Particularly dangerous when self-prescribed are drugs that are classified as synthetic analogues adrenal hormones.
• Before prescribing hormonal treatment to a patient or patient, the specialist must carefully examine the medical history, the results of blood tests for the concentration of sex hormones and biochemical indicators, the results of pelvic ultrasound, mammography, cytological smear. It is necessary to inform your doctor about any existing chronic diseases: some of them are contraindications to taking COCs and other synthetic drugs.
• You should inform your doctor about any changes in your health status.
• Having missed a dose of the drug, it is strictly forbidden to “compensate” for negligence with a double dose of the drug at the next dose.
• It is necessary to take hormone tablets strictly at the same time with minimal errors. Some medications (for example, L-thyroxine) are taken in the morning, on an empty stomach.
• The duration of the course and dosage (including its changes during treatment) are determined by the attending physician.

The effectiveness and safety of hormonal treatment depends on the competence of the endocrinologist, the interaction of the doctor with the patient and strict adherence to the rules for taking medications.

Hormonal drugs are a huge achievement in the field of science. Currently, hormonal drugs are used not only to avoid pregnancy, but also to treat various diseases. But it is necessary to pay special attention that taking any hormonal drugs should be prescribed strictly by a doctor.

Also, a person using hormonal drugs should be under the strict supervision of a specialist, due to the fact that these drugs, without control of intake, can harm your health, especially if a pregnant woman uses hormonal drugs. The dangers of these drugs are often talked about, while their benefits are rarely remembered. Thus, when using hormonal drugs, there are both benefits and harms.

Let's consider the benefits of taking hormonal drugs. During analysis and numerous experiments, it was found that taking hormones reduces the risk of developing cancer in women, namely inflammatory processes uterus and mammary glands. Also, when taking hormonal devices, the skin, hair, and problem skin pimples and other cosmetic problems are eliminated on the face. For women it goes away smoothly menstrual cycle the duration and pain of menstruation is reduced.

Every woman experiences this crucial moment in life, like menopause, which is very difficult to bear - and here hormonal therapy can again help to maintain shape during this difficult period and not gain weight.

It is important to note that in the first three months there is an adaptation to the hormonal drug, which goes away over time in the person taking the pills. sharp changes mood, nausea, headaches.

Let's consider the harm from taking hormonal drugs. You should not confuse hormonal drugs of the 21st and 20th centuries. For our grandmothers and mothers, hormonal treatment immediately results in weight gain, cellulite, and swelling. Currently, there is no such effect from taking these drugs. But this effect does not exist if the tablets are chosen correctly. That's why special harm There are no hormonal medications; there are incorrectly selected medications that can cause incredible damage to health. Therefore, any hormonal drug comes with a huge instruction manual with rules of use, contraindications; it must be studied in full before use. It is also important that when prescribing a drug, a correct diagnosis is made. If you use modern hormonal drugs correctly and strictly follow all the rules, then they will bring you nothing but benefit. You should also not take long time hormonal drugs to avoid pregnancy, over time the production of its hormones stops, and the body will stop producing what it already has. That is, when you want to get pregnant, the likelihood of this decreases, so the longer you take it, the greater the risk.

After reading this article, we conclude that taking hormonal drugs should be done wisely, that is, according to the correct regimen, it will not cause harm, but will only be beneficial. But it is worth noting that you should not get carried away and take hormonal drugs unnecessarily. When taking the above-mentioned drugs, the human body is rebuilt in a new way and begins to work somewhat differently. Keep in mind that if your doctor has prescribed you hormonal medications, read the instructions in detail and take them according to a strict regimen, as prescribed in the attached instructions. If you have any questions or concerns, contact your doctor immediately, because taking hormonal medications is no joke.