How to choose the right oral contraceptives and their side effects. How to choose birth control pills? Choosing hormonal contraceptives
Contraceptive drugs reliably protect against unwanted pregnancy, but they do not belong to the category of absolutely safe pharmaceuticals. You can reduce the risk of their side effects by using a system that helps you choose birth control pills by phenotype.
Contraception selection system
First of all, you need to remember that it is forbidden buy this type of medicine on the advice of your mother, friend or, say, sister, whom they seem to be "good fit". Female body has many individual characteristics, and in order to take them into account as much as possible, you need to undergo a certain medical examination before taking birth control pills.
As a rule, the gynecologist prescribes a test to determine blood sugar levels, study kidney enzymes and hormonal levels.
He also offers to undergo mammography, ultrasound of the pelvic and breast organs. It’s also a good idea to check with an ophthalmologist, because contraceptive medications can contribute to the development of eye diseases.
When selecting necessary funds, the constitutional and biological phenotypes of women should also be taken into account.
They are divided into three types: estrogen, progesterone and balanced or mixed.
This type includes women of average and short stature. Their chest is well developed. The skin and hair are dry, the voice is deep and feminine. Pubic hair - triangular shape. Menstruation lasts five days or more, causing nervousness and tension emotional condition. During this period, the mammary glands become denser.
Menstrual cycle last more than 28 days.
Their pregnancy proceeds virtually without symptoms, but the discharge of leucorrhoea is profuse. In general, representatives of this phenotype have fragile physical characteristics.
They are shown pharmaceuticals, containing an increased amount gestagen– Microgenon, Miniziston and Regividon.
Tall women with a boyish figure and a rather deep mutational voice belong to the progesterone phenotype.
Their mammary glands are poorly developed and small in size, and their pubic hair is arranged “in a male manner” in the shape of a diamond.
Menstruation is not particularly abundant, lasting less than five days, but it is accompanied by depression, pain in the lumbar region and lower extremities.
The menstrual cycle is shorter than the traditional 28 days. Poor selection whiter. During pregnancy, nausea and vomiting may occur, and significant weight gain is also possible. Hair is oily. The same type includes skin, which can have various rashes - acne, seborrhea.
It is better to focus on drugs that have antiandrogenic effect - Bepara, Klaira, Diana, Jess, Chloe, Yarina, Midiana, Janine.
Mixed or balanced phenotype
Representatives of this phenotype are of average height, have a feminine voice and figure. Their chests are of medium size, but well developed. The menstrual cycle lasts 28 days, menstruation does not exceed 5 days and is virtually asymptomatic. Leucorrhoea is moderate. They tolerate pregnancy well. Hair and skin are normal. Pubic hair is arranged in a female pattern.
Most likely, Novinet, Logest, Mercilon, Lindinet - 20 and 30, Femoden, Regulon, Tri-Mercy will suit them.
When choosing contraceptive pharmaceuticals, it is also necessary to take into account age indicators.
- Yes, young nulliparous girls and mature women of late childbearing age are mainly prescribed medications from the Tri-Mercy group.
- And mini-pills, which include Exluton, Continuin, Ovret, Mikronor and Femulen, are recommended for women who have given birth, nursing mothers and more mature ladies.
The adaptation period to taking a new drug must be carried out under the supervision of a doctor. Only an experienced specialist can correct the situation, taking into account the entire list of symptoms that have appeared and the nature of the complaints.
Features of taking medications
Blisters with contraceptive drugs contain from 21 to 28 tablets. You should start taking it on the first day of your period, adhering to the following rules:
- It is better to place the box in a visible place so that if it catches your eye, it will remind you of the need daily intake pharmaceuticals.
- Contraceptive pills are taken at the same time.
- Having remembered the missed day, you need to immediately correct the situation, but during the day you must use condoms during sexual intercourse.
- If in the middle of the menstrual cycle appear bleeding, you should not refuse medications. Such symptoms are typical for the first three months of use.
- After vomiting from a birth control pill, you need to take another one.
- Day of the event medical abortion suitable for starting contraceptives. If this time is missed, you should wait for your period.
- Not all medications are compatible with such drugs.
Only a gynecologist can adjust the dosage options.
When choosing pharmacological agents you need to remember that bad or good drugs does not exist. There are only those that are suitable for a particular woman and those that are strictly contraindicated for her or are ineffective in her case.
Signs of choosing the right drugs
Selecting birth control pills based on phenotype is quite simple. But since individual characteristics The body always makes its own adjustments; to be more convincing, it is necessary to take into account several important criteria.
A woman’s well-being should not only return to normal over time, but also improve. According to experts, "mine" a contraceptive drug can serve to prevent the formation of cysts and even benign tumors. There are also cases of improvement in the condition of the skin and hair.
To prevent unwanted pregnancy, doctors can prescribe not only drugs that prevent sperm from entering the uterus. Together with intrauterine devices the most popular are oral contraceptives. This material is about choosing birth control pills.
Before visiting the pharmacy, go to an appointment with a gynecologist. Oral contraceptives should be chosen exclusively by a specialist. He will write out a referral for blood donation for hormones. This test will help the doctor determine your phenotype. Depending on this factor, birth control pills are selected. They come in two types:- progestational;
- combined.
The composition of progestin preparations contains synthetic analogue progesterone and no more hormones. Combined contraceptives come in high-dose, micro-dose and low-dose. This classification is related to the concentration of hormones in the drugs. Microdosing drugs are universal and are prescribed to women of a balanced phenotype. They are suitable for young girls under 35 years old.
Adolescents are prescribed drugs with an antiandrogenic effect. They help get rid of skin rashes and significantly improve a girl’s mood. Before menstruation, taking such drugs reduces pain in the lower back and legs.There are three phenotypes of women:
- progestin;
- estrogenic;
- balanced.
Content
To choose birth control pills with minimal side effects, it is difficult to do without the help of a specialist. However, there is special instructions and tables that allow you to independently determine the appropriate type of oral contraception.
Types of oral contraceptives
The classification of these drugs is quite complex. This is because such COCs (combined oral contraceptives) are developed for patients of different age groups and those with certain diseases of the reproductive system. There is a group of simple oral contraceptives that are prescribed to women of childbearing age without gynecological and endocrine diseases.
Important! The mechanism of action of most COCs is based on inhibition of ovulation and egg release.
For these reasons, fertilization of the egg cannot occur. In addition, hormonal medications change the structure and thickness of the inner mucous membrane of the uterus - the endometrium, due to which the fertilized egg cannot attach and begin to grow.
But that's not all. Hormones help thicken the mucus secreted by the glands of the cervix. This is additional protection against unwanted pregnancy. Thus, oral contraceptives are considered the most reliable and give an error of around 0.1-1 per 100.
There is a table of contraceptives developed by experts that helps you choose the right medicine, taking into account many factors. But first you need to know their main types. COCs are:
- single-phase;
- two-phase;
- multiphase.
The simplest ones are single-phase. Each tablet contains an equally stable dose of estrogens and gestagens. Their intake is simple and does not differ from the day of the cycle.
Biphasic and triphasic tablets contain different concentrations of hormones. Their reception is much more difficult. The doctor can select a regimen based on the duration and characteristics of the cycle.
Such drugs must be taken strictly, without skipping, so as not to harm the body and not reduce protection against unplanned pregnancy.
To choose the right type of COC, the dosage of hormones in the drug is also taken into account. There are micro-dose, low-dose, medium-dose and high-dose, containing one or more types of hormones. The former are suitable for young and active girls of childbearing age, the latter are selected only by a specialist in the presence of pathologies.
Indications and contraindications for use
Despite the fact that modern contraceptives have maximum effectiveness and minimal side effects, not everyone can accept them. There is a list of contraindications that prohibits the use of this means of protection and requires the selection of others. These are diseases and conditions such as:
- pregnancy;
- malignant tumors of the breast and other organs;
- hypertension;
- liver diseases.
Taking COCs is questionable in the following situations:
- varicose veins and the risk of developing thrombophlebitis;
- diabetes;
- mastopathy;
- smoking;
- epilepsy;
- hepatitis;
- cholecystitis.
A narrower list of contraindications can be found and reviewed in the instructions for the selected contraceptive.
How to choose the right birth control pills
You need to understand that the correct or incorrect selection of oral contraceptives is a risk for the woman’s health and future pregnancy planning. They have many disadvantages and advantages, which special cases may play a negative role in the functioning of the reproductive system.
Most the right step- refer to a good specialist, but if for some reason a woman cannot do this, you can choose the type of hormonal protection yourself. Let's start with what you need to take note of.
When selecting contraceptives, pay attention to the following information:
- age;
- presence or absence of pregnancies, abortions;
- severity of PMS;
- intensity of menstrual flow;
- the presence of pathologies of the reproductive system organs (cysts, fibroids);
- frequency of inflammatory processes.
In addition, to eliminate any risks, a woman needs:
- do an ultrasound of the pelvic organs and mammary glands;
- take a smear from the cervix for oncocytology;
- pass general and biochemical analysis blood.
If all indicators are normal, there are no complaints or pathologies, you can choose low-dose birth control pills. Usually these are single-phase pills - the easiest to use and quite effective.
Warning! If there are any deviations from the norms, it is prohibited to select birth control pills on your own.
How to choose birth control pills yourself
Sometimes it is enough for an experienced specialist to look at a woman to determine her phenotype and select the right COC. Below is a table of phenotypes that are considered when choosing tablets.
To determine her phenotype, a woman needs to evaluate appearance and status by points in the table. The most important points are “PMS” and “appearance”. It is recommended to select a contraceptive after determining the estrogen dependent phenotype, balanced or androgen dependent.
For the first phenotype, the following drugs were selected from the table:
- "Novinet";
- "Regividon";
- "Lindynet";
- "Mersilon";
- "Microgynon".
These drugs contain an increased dose of gestagen.
For the second phenotype you can choose:
- "Tri-Mercy";
- "Regividon";
- "Logest".
For the third phenotype you can choose:
- "Yarina";
- "Jess";
- "Janine";
- "Diana is 35."
If there is a lack of estrogen, the following are suitable:
- "Diana-35";
- "Triziston";
- "Chloe."
In each individual case, age indicators and the presence or absence of pregnancies are taken into account. So, for the young and nulliparous woman up to 25 years of age with an estrogen phenotype, you can choose Miniziston-20. If androgens predominate in phenotype, Yarina is more suitable for such women.
Table of hormonal contraceptives
In order to choose the drug as correctly as possible and not get confused in their diversity, there is a selection table hormonal contraceptives. More precisely, there are two of them. One describes micro-dose contraceptives, the second describes low-dose. They contain the names of drugs with a dose of hormones for young people, those who have given birth and mature women without pathologies of the reproductive system.
Table 1: Microdosed birth control pills.
Table 2: Low-dose birth control pills.
How to understand that birth control pills are not suitable
The body reacts differently to a dose of synthetic hormones. Doctors warn that during the first 2-3 months the reproductive system becomes accustomed and adapts to the effects of COCs. At this time, the patient may experience attacks of nausea, unpleasant abdominal discomfort, and frequent, mild headaches. There are often scant bloody issues. All this is considered the norm during the adaptation period.
To monitor the body's reaction and monitor the condition of the ovaries and endometrium of the uterus, you can undergo an ultrasound examination once a month.
Important! You can tell that the remedy is not suitable by the deterioration of the condition, which does not go away within several weeks.
Possible manifestations of pressure surges, copious red-brown discharge, and headaches. In this case, the drug is canceled and another one is selected or the COC is completely abandoned.
If you managed to choose the right contraceptives:
- the patient feels well;
- bleeding stops in the middle of the menstrual cycle;
- the condition of the skin and hair improves.
Another indicator of a harmonious selection of a drug is the normalization of the emotional state.
Are birth control pills sold without a prescription?
Today, you can buy birth control pills without a doctor's prescription only from a narrow list. This is due to frequent cases of unsuccessful use of contraception without consulting a specialist. Basically, this group of drugs contains COCs with ethinyl estradiol and desogestrel in a low dose.
What birth control pills are available without a prescription?
The most popular contraceptives, such as Yarina, Zhanine and Jess, cannot be bought without a prescription. By analyzing the offers of pharmacies, you can make a list of birth control pills without prescriptions available for free sale:
- "Regulon";
- "Novinet";
- "Escapelle";
- "Postinor".
Conclusion
It is possible to choose birth control pills on your own, although it is difficult due to insufficiency special knowledge. That is why a visit to the doctor is recommended, for which you can prepare in advance: necessary tests, clearly describe the cycle and analyze your own condition on the eve of and during menstruation. In this case, the selection of contraceptives will be the most thoughtful and correct.
Dear friends, hello!
Why are there so many of them? Or rather, WHY? Was it really impossible to release 3-4 drugs and stop there?
Why fool women, obstetricians-gynecologists and, of course, first-city residents who are forced to answer the eternal question of customers “which is better”?
Moreover, often they, in the sense of buyers, want to know everything “here and now”, and categorically do not want to go to the doctor to get a prescription for a remedy for women’s “”.
But you will have to... You know better than me how many contraindications are indicated in the instructions for hormonal contraceptives, and how many side effects they can cause.
Let's try to understand the abundance of hormonal pills that leave the stork almost no chance of bringing a human baby in its beak to the couple.
But this article is not intended for you to choose a hormone on your own!
Always, when I start talking about prescription drugs, I am afraid that you will use this information in your own way and will recommend them left and right, as, unfortunately, happens.
As I begin this conversation, I set myself four goals:
And again about the menstrual cycle
About women's reproductive system and the menstrual cycle, you and I have already been around for a while.
Before we begin to analyze hormonal contraceptives, I will remind you of a story that happens in a woman’s body every month.
The hypothalamus and pituitary gland control the menstrual cycle.
It all starts with the hypothalamus instructing the pituitary gland to release follicle-stimulating hormone into the blood.
Under his strict guidance, several follicles with eggs inside begin to grow and mature in the ovaries, synthesizing estrogens, which are necessary for their maturation. After some time, one of the follicles breaks forward in its development, while the others resolve.
Meanwhile, in the uterus, under the influence of estrogens, the preparation of a “pillow” for the fertilized egg begins, so that it feels warm, cozy and well-fed there. The uterine mucosa thickens.
On average, after 2 weeks from the beginning of the cycle, the level of estrogen reaches its maximum, and the egg reaches its “coming of age.” The “signal signal” for its exit from its native nest is the release of luteinizing hormone by the pituitary gland (in response to an increase in estrogen levels). The follicle bursts, the egg is released (this is called “ovulation”), enters the fallopian tube and makes its way into the uterine cavity.
And at the site of the burst follicle, a corpus luteum which produces progesterone.
Progesterone is enthusiastically involved in the process of preparing the uterus to welcome a fertilized egg. It loosens the endometrium, one might say, “fluffs the feather bed” for the newlyweds (if a fateful meeting takes place), reduces the tone of the uterus to preserve, changes the properties of cervical mucus to prevent infection, and prepares the mammary glands for a possible pregnancy.
If fertilization does not occur, the level of progesterone drops, and the overgrown functional layer of the endometrium is rejected as unnecessary. This is menstruation.
The maximum level of estrogen occurs during the period of ovulation, and progesterone - approximately on the 22-23rd day of the cycle.
Hormonal contraception for different target audiences
I divided all hormonal contraceptive drugs into 3 groups:
The first two groups are intended for those who conduct regular sex life with one partner, since they do not protect against sexually transmitted infections, for which casual relationships are famous. True, life with one partner does not always save you from them, but we will assume that everyone is faithful to each other, like swans, and none of the couple walks either to the left or to the right, or diagonally, or in a circle.
To the group "for those in charge"(according to my classification) includes drugs that need to be taken every day and preferably at the same time.
These include:
- Combined oral contraceptives. They contain a COMBINATION of estrogen and gestagen, simulating the menstrual cycle. Hence the name.
- Mini-drinks. This is the name given to products containing only gestagen.
Agree, not every woman (due to girlish memory) will be able to swallow pills every day, and even at the same time, often for several years.
In Group “for busy or “happy” There are medications that do not need to be taken every day, so the risk of missing a birth control pill is reduced.
“Happy” because, as the classic said, “ happy hours They’re not watching.”
Those who are very busy, overwhelmed with their problems beyond the roof, can remember about the pills after a few days, or even only in the absence of red days on the calendar. Therefore, the optimal thing for them is something that they stick on, insert, inject, and forget about for a few days/months/years.
The drugs of this group are especially convenient for conductors, flight attendants, for those who constantly travel on business trips, tours, competitions, and at the same time, as I said, manage to have a regular sex life.
It has 5 subgroups:
- Transdermal therapeutic system Evra.
- Vaginal ring NuvaRing.
- Intrauterine devices.
- Contraceptive implants.
- Contraceptive injections.
To the group "For the irresponsible" I placed emergency contraception. Sorry if I offended anyone.
As a rule, they are taken by those who are in search of unearthly happiness, who like to “relax” on holidays and weekends, who lose the remnants of their sanity when heard in their ears with a breath: “Honey, having sex with a condom is like smelling a rose in a gas mask,” and hopes for “maybe.”
Total turned out total 8 subgroups, which we will analyze in order.
Combined oral contraceptives
Combined oral contraceptives (COCs) were invented by men in the 1960s. These were chemist Carl Djerassi, pharmacologists Gregory Pincus and John Rock. And the first oral contraceptive was called Enovid.
What prompted them to this invention, history, of course, is silent. Perhaps they were driven by the desire to save their loved ones from frequent “headaches.”
The first contraceptive contained just horse doses of estrogen and gestagen, so against the background of their use, women began to grow in the wrong places, acne appeared on the body, and some even died from a heart attack or stroke.
All subsequent research was aimed at improving the safety of oral contraceptives and reducing the number of side effects. Doses of estrogen and gestagen were gradually reduced. But it was important not to cross the line when the contraceptive effect was at risk.
This process continues to this day, since the ideal COC has not yet been invented, although colossal progress has been achieved in this direction.
You may have heard of the Pearl Index. This is the failure rate, which shows the number of pregnancies per 100 women using a particular method of contraception.
So that you understand: for modern COCs it is less than one, while for condoms it is 10, for spermicides and lovers of coitus interruptus - 20.
How do combined oral contraceptives work?
- Since there are estrogens in the body (which come from outside), the hypothalamus understands that “everything is calm in Baghdad” and does not give the command to the pituitary gland to produce follicle-stimulating hormone.
- Since follicle-stimulating hormone is not produced, the follicles in the ovaries are in a half-asleep state, they do not produce estrogen, and if they grow, they grow very sluggishly and reluctantly. Therefore, the egg does not mature.
- If the egg cannot reach “coming of age,” it is deprived of the opportunity to leave its parental home and go in search of a soul mate. There is no ovulation.
- Since estrogen levels do not increase, luteinizing hormone is not released, the corpus luteum is not formed, and progesterone is not produced. Why is it needed? After all, it comes from outside.
- This same “foreign” progesterone thickens the mucus produced by the glands of the cervix, and no matter how fast the sperm are, they cannot penetrate the uterus.
- There is another level of protection: since in a woman’s reproductive system, while taking COCs, what should be happening is not happening, the uterus cannot prepare a “cushion” to receive a fertilized egg. The functional layer of the endometrium grows quite a bit. Then it will come out in the form of menstrual-like bleeding. And even if, by some miracle, the egg matures in spite of all its enemies, comes out of the follicle, and the sperm overcomes all obstacles, and they merge in a fit of passion, then the fertilized egg will not be able to settle on the lining of the uterus.
So what happens?
It turns out that when a COC enters the body, the estrogen and gestagen that come in their composition signal the hypothalamus that everything is OK in the body, there are enough necessary hormones, everyone is happy and calm, in general, EVERYONE SLEEP!
And a sleepy kingdom begins in the female reproductive system...
So COC is a deep anesthesia for the hypothalamus, pituitary gland, and ovaries. Deception of nature. Everyone sleeps quietly, snoring and making timid attempts to rehabilitate themselves only on the rare days of a hormone-free interval.
Hormonal contraception: secrets of medical prescriptions
To be honest, until I delved into this topic, I thought that in order to select a contraceptive, a woman needs to be carefully examined for hormonal status, the presence of malignant tumors, condition, coagulation system, etc.
It turns out there is nothing like that!
The obstetrician-gynecologist questions the woman in detail to determine her health problems, lifestyle, readiness and ability to take pills daily.
The doctor finds out:
- Is the woman breastfeeding her baby?
- How long has it been since your last birth?
- Is there a mass in the mammary gland of unknown origin?
- Is there any damage to the heart valves?
- Do migraines happen? With or without aura?
- Whether there is a ? If so, is it compensated or not?
- Have you had a heart attack or stroke in the past, or is there any ischemic heart disease?
- Isn't it serious problems with the liver and biliary tract?
- Have you had thrombophlebitis or pulmonary embolism in the past?
- Are there plans for a big one in the near future? surgery, which in itself sharply increases the risk of thrombosis and pulmonary embolism?
With love to you, Marina Kuznetsova
Hormonal type, or rather phenotype- this is the structure of the female body depending on the predominance of one or another sex hormone in the body. Having this information, you can better understand the characteristics of your body, select hormonal contraception and calculate it side effects.
In total, 3 female phenotypes were previously identified, but I would still say that there are 5 of them.
Etrogen phentype(type 1), balanced phenotype(type 2), progesterone phenotype(type 3) was previously considered progesterone/androgenic, but based on clinical observations I would single out androgen phenotype in a separate form (type 4). Besides hypoestrogen type allocated to a separate group (with etrogen deficiency).
Estrogen phenotype (i.e. hyperestrogen phenotype): scientific fat type, endomorphic. The predominant hormone is estradiol.
These are women with a “pear” figure type, with pronounced development of the hips and mammary glands, which makes them prone to the phenomena of mastopathy and fibroadenomatosis of the breast. Prone to obesity, with the formation of gallstone disease. They are characterized by good skin, no acne, but a little dry, thin, sometimes curly hair on my head.
Hirsutism (hair growth is active on the face, abdomen, back, thighs) and hypertrichosis (hair growth is more active on the forearms and lower legs) are not typical for them - this applies to Russian women, for women of other nationalities - it depends on the severity of hair growth in the family - constitutional hypertrichosis may be present.
Women of this type are of average height, with a high timbre of voice and a “pretty appearance.” With a tendency to PMS (like “hysteria” and tearfulness). The menstrual cycle is often regular or delays do not exceed 60 days (that is, disorders such as progestron deficiency - hypoluteinism), the cycle can be heavy, with a tendency to endometrial hyperplasia in perimenopause - in the presence of obesity.
Taking Duphaston is well tolerated (they have a “classic type of reaction” to it - with the onset of menstruation 3-6 days after stopping the drug).
By nature, they are more “female lovers”, active (more choleric), in need of constant male attention.
Prone to uterine fibroids, formation follicular cysts And varicose veins veins They get pregnant quickly, but pregnancy can be complicated by a lack of progesterone and threats of miscarriage. COCs with gestodene, desogestrel, levonogestrel (Mikrogynon, Lindinet-20, etc.) are well suited for them. They may have hot flashes for a long time after menopause, sometimes all their lives.
Balanced Phenotype, kind " Ideal woman". Estradiol/progesterone are balanced according to the phases of the cycle.
The body structure is proportional, the skin is clean, with normal moisture and oil content. The hair is thick and dense. Menstruation is regular, PMS is not typical or is only slightly expressed. Soprano voice. Hirsutism is uncharacteristic, there may be slight hypertrichosis - more constitutional. They get pregnant and carry to term without problems.
The most suitable COCs are three-phase COCs with desogestrel and gestodene. (Tri-Mercy, Marvelon, Lindinet-20, etc.)
Progesterone phenotype. Scientifically also called bone, ectomorphic. Progesterone predominates.
These are women with the following body type: both shoulders and hips are developed evenly, “ sports type figure", the distribution of subcutaneous tissue is even, sometimes according to the android (male) type (this is for obesity, that is, the deposition of fat masses in the upper abdomen and back). Oily skin ( oily seborrhea) both the face and the scalp. Acne happens, sporadically.
Height is usually above average (depends more on genetic characteristics), the mammary glands are moderately developed, with a predominance of adipose rather than glandular tissue. Therefore, they are less prone to mastopathy. Menstruation – often scanty, or very. short or long, up to 7 days. PMS happens, but with a tendency to melancholy and tearfulness, swelling.
Taking duphaston (according to indications) can increase manifestations of PMS and swelling. The reaction to Duphaston may be “non-classical” - menstruation does not begin 7 days after the course of the drug (caused by a preliminary lack of estrogen). By nature, they are more sanguine, the type of “woman-mother” - with the need to care for others.
She often shows sexual activity only in the presence of a love object; in her absence, she can be sexually inactive, which distinguishes her from women of the estrogen type. Therefore, the menstrual cycle is often irregular in women of the progesterone type; sometimes there is a tendency that if there is regular sexual intercourse, the menstrual cycle is regular (the production of estrogen is stimulated), if not, the cycle is irregular. Therefore, she does not get pregnant immediately - after a certain time of regular sexual relations, bears without threat (this is, of course, theoretically, based on the activity of the hormone progesterone), but is prone to large weight gains!
Prone to insulin resistance and weight gain, also after childbirth. COCs with dienogest and drospirenone are good options. (Yarina, Jess, Bonade, etc.)
Androgenic phenotype. Muscular or mesomorphic.
A woman's appearance depends on the predominance of androgens ( male hormones) from the ovaries or adrenal glands.
Adrenal hyperandrogenism (dominated by 17-OH progesterone, androstenedione or DHA-S) is tall woman, asthenic (thin), " muscular type", with a poorly developed subcutaneous tissue. “Boyish body type”, the mammary glands are poorly developed, the skin tends to be oily, and acne is not pronounced. An example is modern super-models.
Sexually moderately active, does not get pregnant right away, and carries threats of miscarriage. The menstrual cycle is often irregular. The voice is low.
A woman with a predominance of ovarian androgens (or with mixed secretion, a predominance of total/free testosterone) is short in stature, with a pronounced shoulder girdle, oily skin and acne, hirsutism and hypertrichosis. The mammary glands are moderately developed. The voice is low, mezzo-soprano type. They get pregnant with difficulty and carry threats. Sexually very active (testosterone is the basis of the hormone of sexual activity). We are not prone to PMS, because irregular ovulation, which is the “collateral” of PMS.
If they are obese, often with the phenomenon of hyperinsulenism and impaired carbohydrate metabolism, then they will lose weight well with properly selected physical activity, but there is a risk of “pumping” the muscles. Behavior of women like “their boyfriend”.
An example is women with PCOS syndrome. COCs with cyproterone acetate, drospirenone and dienogest are good options. (Diana-35, Yarina, Klaira... etc.).
Hypoestrogenic phenotype– these are women who are either tall or short (depending genetically), of an infantile structure – small breasts, disproportionately long arms and legs, thin, “parchment” skin, easily tired. PMS is not typical. The menstrual cycle is disrupted up to amenorrhea - delays of up to 6-12 months. Menstruation is painful. Behavior of a “teenage girl”. The voice is high, poor in overtones. Libido is sharply reduced or absent if there is also a lack of androgens. Getting pregnant is problematic. An example is girls with anorexia.
Indicated: hormone replacement therapy, triphasic COCs, COCs with levonogestrel.
A combination of several phenotypes is possible.
By 2011-2015, information appeared that during perimenopause a 6th phenotype can also form: androgen deficiency (according to Apetov S.S.) the level of androgens in the adrenal glands decreases, which also has its consequences - a decrease in muscle strength and endurance, scarcity of axillary and pubic hair , hair loss on the head, gradual disproportionate weight gain in the waist area. A sharp decline libido. Correction of these phenomena may require hormone replacement therapy.
According to information received from clinical trial where 300 women were included - 1 type of women predominates.
*During the writing process, 6 classifications were analyzed.
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