Effective contraception is supposed to protect against unwanted pregnancies. But it is not everything. Contraception can help prevent he alth problems. We talk to the gynecologist Dr. n. med. Jacek Tulimowski.

  • Is there an ideal method of contraception in all respects that can be recommended to all women?
  • Jacek Tpimowski, MD, PhD : There are many methods, but such an ideal one has not yet been developed. Anyway, it all depends on what we expect from these measures. If a woman only cares about protection against unplanned pregnancy, then the most effective method should be sought. When he expects other benefits, it is necessary to choose a preparation or form of contraception that will meet such expectations.

  • Perhaps natural contraception would be the best?
  • J.T .: I am not an opponent of natural methods, although I believe that modern women, especially those overworked and under stress, may be disappointed with them. If a couple decides to perform birth control, e.g. with the Billings method based on the observation of cervical mucus, the undoubted benefit for a woman will be that she will get to know her cycle, her sexuality. It is similar with globules and foams. These can be helpful for women who suffer from vaginal dryness for various reasons. However, natural family planning methods fail as effective contraception.

  • And comfort, a sense of security in your sex life?
  • J.T .: Of course. The hormonal IUD allows a woman to get rid of the fear of an unplanned pregnancy for 5 years. If she is planning a baby in less than 5 years, she may choose hormone injections, which are taken once every 3 months. Hormone patches are another solution, because you have to remember about them 3 times a month.

  • Painful periods are a problem for many women. Can contraceptives help to eliminate these ailments?
  • J.T .: Yes, but before hormonal contraception is recommended, because it is effective in such cases, you need to find out the causes of the pain. Period pains are normal, physiological phenomena, but difficult to accept for many women. Treatment of symptoms, i.e. primary painfulmenstruation, by administering antispasmodics and analgesics is sometimes not enough. The administration of drugs that inhibit the production of prostaglandins (prostaglandin synthesis inhibitors) is not successful in every woman. Estrogen-progestogen contraception gives very good results. But one more thing needs to be emphasized. If the cause of painful menstruation (called secondary) is due to a malformation or a medical condition, no hormone pill will help. In such a situation, it is necessary to eliminate the cause, i.e. surgical correction of anatomical defects, treatment of inflammations, endometriosis, removal of fibroids.

  • And how does "analgesic" hormonal contraception work?
  • J.T .: Under its influence, the synthesis of prostaglandins in the uterus decreases, and thus the pain caused by the overactivity of this organ is reduced.

  • Heavy menstrual bleeding is also a great nightmare for women. Their effect is not only difficult hygiene, but also anemia.
  • J.T .: Indeed, in practice about 40 percent. women using hormonal contraception choose it because of the relief of symptoms related to bleeding. The healing effect of the pills is, among others, on the fact that the endometrium grows less. As a result, bleeding is scanty, short-lived and overall blood loss is significantly reduced. What's more - even the so-called withdrawal bleedings (in the break between packets of pills) are less heavy than those that accompany the normal cycle. If they are still strong, you can reduce the frequency of their occurrence, e.g. once every 2-3 months - then you should take 2-3 tablets of the contraceptive continuously, one after the other.

  • This possibility gives rise to the idea of ​​limiting the onset of menstruation to several times a year.
  • J.T .: It is possible. The use of the pack to pack method, i.e. packaging by packaging, is widely recognized by doctors as a safe method of deciding (even independently) about the time of bleeding. However, a lot depends on the type of pills and the he alth of the woman. After all, there are funds available in packages of 90 pieces. The recipient woman can therefore only have a period four times a year. Some say that a he althy woman can take the pill continuously for 6 months, i.e. menstruate twice a year, without harming her he alth or fertility.

    Fears that the lack of menstruation disrupts the body is unfounded. In women who systematically use contraceptive pills, it does not work according to its own biological clock, but according to the dictation of the pills. The whole cycle is not natural as there is no ovation. Membranethe lining of the uterus is constantly less supplied with blood. When you stop taking the pills, your hormone levels drop quickly and your blood vessels constrict. There is bleeding that is not a period. If it doesn't happen once in a while, the mucosa won't flake off, but nothing bad will happen. The same thing happens during pregnancy.

    Important

    Preventing pregnancy with hormones is not a lockpick that opens all doors to he alth. For every woman, the form of contraception or hormone therapy must be selected after collecting an interview about her and her family's he alth.

  • But it's probably not only a convenience. Long breaks between bleeding are also a method of treating certain medical conditions.
  • J.T .: Extending the menstrual cycle with contraceptive pills is used in the treatment of many diseases, not only gynecological ones. By giving them, you can, for example, protect women against excessive iron loss, i.e. anemia. The same procedure is recommended for the diagnosis of endometriosis, uterine fibroids or functional ovarian cysts. In this case, the long-term use of contraception is also a treatment leading to the disappearance of endometriosis foci. Managing your period helps you avoid PMS.

  • Can contraception improve my complexion?
  • J.T .: Contraception is not a cosmetic. Admittedly, only 5 percent. young women have complexion problems, but as much as 95 percent. thinks he has them. Therefore, for most female patients in their 20s and 25s, the greatest added benefit of the hormone pill is that it improves the appearance of the skin. Today, the contraceptive pill is expected not only to be effective, but also to be effective. non-contraceptive action. And the drospirenone tablet not only does not make you gain weight, but also radically improves your complexion. Hypertrichosis is reduced in patients taking gestagens.

  • Many women avoid using hormonal contraception because it is believed that it causes cancer.
  • J.T .: It's true. I often hear, "I don't want hormones, that's what cancer is for." When women are so convinced, I do not advocate the use of these measures. But the truth is different. Hormonal contraception reduces the risk of ovarian cancer, endometrial cancer, cancer of the lower colon, endometrial cancer. Women in their 50s and 60s most often develop these types of cancer. age. Research shows that hormonal contraception used in the age of 20-25 reduces the risk of developing the disease in middle age. This theory is confirmed by the fact that women who did not give birth to children, did not breastfeed and were not pregnant, are more likely to suffer from these tumors than women,who have had interruptions in their periods.

  • But there is no such certainty in the case of breast cancer.
  • J.T .: It's true. Discussions on this are still ongoing, but neither theory is convincing. However, it is believed that the increased risk of breast cancer (regardless of the family cancer burden) applies only to young women, before the first birth, who use hormonal contraception for a long time, for 7-10 years.

  • Increasingly, it is also said that hormonal contraception can counteract water retention in the body.
  • J.T .: Indeed, this property of the contraceptive pill is important in an individual's tendency to retain water and the resulting increase in body weight, as well as in severe premenstrual symptoms. This effect is demonstrated by modern contraceptive pills containing a progestogenic component called drospirenone. It effectively reduces breast tension and pain, the feeling of body swelling and heaviness. It also prevents retention, i.e. water retention in the body, and sometimes allows you to reduce weight.

  • The pill can be used as part of hormone therapy in mature women?
  • J.T .: Irregular menstrual bleeding begins in mature women, which can be reduced with pills, patches or an intrauterine device, e.g. with levonorgestrel. Thanks to this, women avoid the dangers of endometrial hyperplasia. There is an opinion among endocrinologists that even women who have not used contraception should think about it in their forties. With age, the level of estrogens in the blood decreases, and this determines low self-esteem or lack of interest in sex. Taking estradiol changes these situations. The woman gains energy, feels attractive.

  • Mature women, however, are afraid of hormones because they have a negative effect on the circulatory system or increase the level of bad cholesterol.
  • J.T .: This is a simplification. There are various forms of contraception and pills with different compositions on the market. Thus, the method, dose and type of hormone can be individually selected. A progestogen can lower HDL (i.e. good) cholesterol in the blood and raise LDL (bad) cholesterol. But estrogens do the opposite and so are protective. Drospirenone does not raise blood pressure as it does with other hormones. It does not provoke thromboembolism. As for cardiovascular diseases, it is known that with age, the concentration of estrogens in a woman's body naturally decreases, which protect the heart, e.g. against a heart attack. When they are missing, he alth problems arise.But providing a well-chosen hormone reduces them.

  • So contraception is good for everything?
  • J.T .: Contraception can solve many he alth problems of a woman, make life easier and more attractive. But it's not an effective method for everything.

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