Mini-pill are hormonal nekompensirovanna contraceptive pills and are an alternative to the COC. In the pills contains only progestin component – clean progestins in minimum dosage, so abbreviated a similar oral contraceptives referred to as POCs (pure progesterone contraceptives). Synthetic analogues of progesterone in the minipill is represented by desogestrel, levonorgestrel or norethisterone. The progestin in POCs contained in the minimum dose of 300 to 500 mcg, due to which the tablet was called the mini-pill or low pill.
Unlike KOK mini-pill have fewer contraindications to reception, have a softer effect on the female body, but the likelihood of unintended pregnancy when they are used is somewhat higher than in the use of combined hormonal pills.
The mechanism of action of the minipill
Contraceptive effect due to exposure on the peripheral links of the reproductive system, which explains the lack of systemic side effects. Mini-pill due to the progestin component increase the body’s level of progesterone, creating hormonal balance, which is characteristic of pregnancy.
In the basis of mechanism of action of POCs are:
- reduction of quantity of the cervical mucus, but increasing its density and viscosity, which prevents the promotion of sperm into the uterine cavity;
- suppression of motility of the fallopian tubes, resulting in the ovum after ovulation moving along them slower;
- inhibition of ovulation due to the luteolytic on a yellow body is seen in 25% of women taking minipill;
- creating conditions unfavorable for implantation of the fertilized ovum due to biochemical and morphological changes in the structure of the endometrium.
It is important
Mini-pill often leads to the disorder of the menstrual cycle is the main cause of failure of patients from their use.
How to take chpk
Before taking mini-pill, a woman should consult a gynecologist to exclude pregnancy and possible contraindications to the use of data contraceptive pills. Subject to the rules of admission chpk the chance of pregnancy is 0.3%, which corresponds to 3 pregnancies per 1000 women. In the case of a periodic crossing minipill the risk of unwanted pregnancies increases to 9% or 9 cases per year per 100 women.
Rules of admission chpk:
- To determine the time of taking the pills. The optimal time (should be the same every day) use chpk from 18 to 20 hours before preparing for sleep. Maximum contraceptive action of the minipill develops after 4 to 5 hours after their consumption, hence their desirable evening reception.
- To take the mini-pill every day, until the end of the package (28 tablets). A break in the reception of chpk is not possible, after packing, you need to start taking the following.
- To start receiving chpk is allowed any day of the cycle, but preferably from 1 St to 5th day. In this case, the tablet will begin to provide a contraceptive effect immediately that will not require the use of additional protection measures. At the beginning of the reception mini-drank in other days of the cycle should use barrier contraception (condom) or abstain from sexual contact for 2 to 14 days (the period depends on the particular drug and listed in the instructions).
- Make chpk after a medical abortion or miscarriage, it is recommended the following day. In the case of a delay of receiving mini-pill for a week or more for 2 to 14 days after beginning of their application should use condoms or to observe pelvic rest.
- Go with the COC for the mini-pill is recommended immediately after taking combined contraceptive pills (the pill chpk drink the next day). If the gap between the consumption of COC and start taking mini-pill is 5 days or more, you should use barrier contraception for at least two days.
- To start using the mini-pill after birth, even in the case of stored lactation, it is necessary after 21 – 28 days. If a woman has no menstruation and the child receives only breast milk, the use of additional contraception is not required. In the absence of a menstrual period, but the introduction of complementary foods in the amount of more than 15% of the daily value of nutrition for infants, it is necessary for the first 2 to 14 days of receiving chpk to use barrier contraception or to observe pelvic rest.
- The resulting nausea, vomiting or diarrhea within 4 – 5 hours after ingestion chpk requires abstinence from sexual intercourse or use condoms until 48 hours after the normalization of.
The use of mini-pill as contraception affects the nature of menstruation. The amount of menstrual flow can be reduced, and in some cases (20 – 25%) menstruation disappear. At the termination of menstruation, you must consult a doctor to exclude pregnancy-especially ectopic (risk of ectopic pregnancy increases if the chpk). In the case of her absence continued taking the pills should continue under the scheme.
If the patient forgot to take another pill, but it took less than 3 hours, you must immediately, remembering about the pass, take the missed dose of the drug. Contraceptive effect is saved and additional contraceptive measures are required. In the case of missing the pill more than 3 hours, you should continue taking the drug under the former scheme before the onset of menstruation. The rest of the reception period chpk need to use condoms. It is strictly forbidden to take two pills at once and more if they pass. If the period missed pills occurred sexual intercourse, it is recommended to resort to emergency methods of contraception (Postinor, the introduction of the CPA).
The use of mini-pill as contraception can cause the emergence of a number of side effects:
- disorders of the menstrual cycle: the emergence of intermenstrual bleeding, prolonged menstrual periods, cessation of menstruation (the drug is not cancelled);
- formation of functional ovarian cysts (disappear on their own after discontinuation of the chpk for 1 – 2 months);
- exacerbation of chronic vulvovaginal candidiasis;
- the appearance of engorgement and soreness of the breast;
- the occurrence of nausea, vomiting, diarrhea;
- the emergence or strengthening of headaches, dizziness;
- increase of body weight;
- edema of the lower extremities;
- the weakening of sexual desire;
- the appearance of age spots, especially under the action of ultraviolet light;
- hirsutism (very rare);
- improve oily skin and acne;
- the occurrence of skin rashes and itching;
- increasing blood clotting;
- the changes in emotional state: nervousness, irritability, depression.
It is important
It is urgent to consult your doctor with the appearance of intense pain in the abdomen, profuse and prolonged bleeding or if mnogodnevki of menstruation.
Advantages of reception of chpk
Mini-pill have the following advantages:
- soft effect on the body of the patient;
- rapid restoration of fertility after discontinuation of the drug (for 1 – 3 months);
- quick contraceptive effect birth control maximum effect develops after 4 hours after taking the pill;
- no effect on lactation and quality of breast milk;
- minimal risk of side effects (headache, nausea, rise in blood pressure) even at the beginning of the reception;
- the absence of the probability of occurrence of thrombosis and thromboembolic complications;
- the possibility of using breastfeeding;
- low the risk of reducing libido;
- no effect on the psychoemotional status of the patient;
- the improvement of the skin (the disappearance of acne) and hair;
- relief of symptoms of premenstrual syndrome;
- pain relief during menstruation;
- the possibility of taking before surgery;
- providing therapeutic effects for endometriosis;
- reducing menopausal symptoms;
- reducing the risk of development of inflammatory processes of the uterus and appendages.
The shortcomings of the reception chpk
The disadvantages of the use of data of the pill include:
- the need to respect the self – discipline minipill require regular ingestion;
- less efficient in comparison with combined hormonal contraceptives;
- the probability of change in weight of the patient (decreasing or increasing);
- the lack of protection from sexually transmitted infections;
- increased risk of ectopic pregnancy and functional ovarian cysts;
- the risk of violations of the cycle (intermenstrual allocation, elongation, or the absence of menstruation).
It is important
Chpk contraceptive effect is reduced with simultaneous use with anticonvulsant drugs (petitoin, phenobarbital, carbamazepine), drugs St. John’s wort, antiviral drugs (antiretroviral), antibiotics (rifampicin, amoxicillin, rifabutin, doxycycline, tetracycline).
Who recommended the acceptance of the chpk
To use the mini-pill gynecologists recommends that those patients who have contraindications to COC:
Prohibits the use of mini-pill in the following cases:
- breast cancer;
- severe liver pathology (tumors, active hepatitis, cirrhosis);
- severe kidney disease;
- hypertension with an increase in the pressure above 160/100;
- moved resection of the stomach;
- taking anticonvulsants and some antibiotics;
- bleeding from the genital tract of unknown origin;
- a ban on the carrying of pregnancy (only surgical sterilization);
- intense itching;
- ectopic pregnancy in the past;
If the patient has previously experienced an allergic reaction to medications, severe headaches, which were accompanied by loss of consciousness and nausea, the mini-pill are appointed with care after the doctor’s consultation and further assessment.
List of drugs
The most popular mini-pill:
- microlut – contains 300 mcg of levonorgestrel (Germany);
- exluton – contains 500 mcg of lynestrenol (Netherlands);
- charozetta – comprising 75 µg desogestrel (Netherlands);
- Lachine – contains 75 mcg desogestrel (Hungary);
- micronor – consisting of 350 µg norethisterone (Germany);
- will Bret – contains 0.075 mg norgestrel (Germany);
- continuin – contains 500 mcg of desogestrel (Germany);
- orgametril (lynestrenol) – in the 0.5 mg of lynestrenol (Netherlands);
- primolut-nor in the composition of 0.5 mg of norethisterone acetate (Germany).
Sozinova Anna Vladimirovna obstetrician-gynecologist