VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician
Currently, there are many options for contraception. In today's interview, we decided to focus on the most popular method, i.e. hormonal contraception, about which we discussed with the expert Dr. Tadeusz Oleszczuk.
Patrycja Pupiec: What is the most popular method of contraception?
Tadeusz Oleszczuk:Hormone pills. Each method has its advantages and disadvantages, but the great advantage of the tablets is their availability and simplicity - you can get a prescription from a specialist, buy it, take it, and then take it off. And, for example, you need more work with IUDs, you will also need to see a doctor, but not every woman wants to have something inserted into her uterus. Today, the choice is so large that every woman can find the contraceptive method that best suits her.
Is it advisable to prepare for hormonal contraception?
Of course, certain conditions for the guarantee of he alth must be met. Not every woman can be recommended the same and in the same form or dose. The choice is very wide, ranging from the doses, composition and method of administration. Contraception should be adjusted to the woman individually. But there is one basic condition. Before a woman starts using contraception, she must be he althy, that is, she must not have any hormonal disorders, such as those that cause infertility.
What if I don't choose contraception correctly?
Unfortunately, after discontinuing the pills, it may turn out that nothing has improved and if the woman was taking hormonal contraception for several or several years and was not he althy before starting to use it, e.g. she had hormonal disorders and now wants to get into pregnancy, it may be difficult to do so, but it will not be the fault of the pills, but of previous fertility problems.
What should be done to avoid problems with trying for a baby after stopping contraception?
You need to check the hormonal balance in advance, check if there are any thyroid diseases in the family, take a look at what the weight gain looks like and, before you start taking pills, do an ultrasound of the breast, assess liver parameters,coagulation system to make sure the doctor is okay.
This is enough, because some 16-21-year-old women have hormonal disorders and a gynecologist may prescribe pills to regulate them. Then, after a few months, you should stop taking them and check how the situation has changed, whether the pills really helped, and the cycles without treatment are properly regular.
What are the contraindications for using hormonal contraception?
First of all, it is undiagnosed hormonal disorders, blood clotting disorders, and liver diseases. The situation is individually assessed by a specialist.
What should the appropriate contraception look like?
After taking hormone tests and breast ultrasound, the doctor should do an interview, and then there is no single right answer to this question, because it depends on what the doctor hears in the interview. You have to look at the woman holistically, that is, assess the general state of her he alth. It will be different in the case of problems with the thyroid gland or liver, because then a specialist should assess the work of these organs.
You may find there are cysts in your breasts, so check why. In at least 70 percent. cases, it will be fine, but you need to look at it.
A woman has been taking pills for many years without proper selection and she does not feel well. What to do?
After 3 months of taking the tablets, you can assess how the body reacts to them and how the woman feels while taking them. The tablets act on the endocrine system - they calm it down and lead to balance and stabilization of hormone levels. If a woman complains of poor well-being, frequent headaches, breast pains or increases in body weight, there is no point in getting tired and taking the drug.
Pills are supposed to improve the quality of life, because taking contraception should generate additional advantages, and not be conducive to further ailments. Hormone doses are stable and do not fluctuate.
Exactly, what other advantages of hormonal contraception can we distinguish?
First of all, the big plus is that the ovaries "rest". It has been scientifically proven that hormonal contraception reduces the risk of tumors, cysts or cancer. This is especially important for women who are prone to developing, for example, cysts. But first you have to think about why they appear, is it caused by hypothyroidism, excess prolactin discharge from the pituitary gland, or other factors.problems, and then recommend tablets.
Women using hormonal contraception also visit the gynecologist more often and may report disturbing other symptoms, which allows for earlier detection of possible threats. Other positive effects of hormonal contraception include, first of all, improvement of the skin, weight loss, reduction of painful periods, symptoms of excess testosterone levels, lack of emotional swings.
And the cons?
Sometimes it happens that the level of hormones imposed on the pill in some women can cause a decrease in libido, weight gain, fatigue or spotting. Of course, many factors affect it, but it is precisely such ailments that are the reason for changing the contraceptive to a different, more suitable one, usually from a different group of hormones. Today there are many different preparations with different hormonal compositions and plenty to choose from.
Today, even mothers who are breastfeeding can take hormonal contraception. You can choose tablets depending on what additional goals that improve the quality of life and appearance you want to achieve.
Can we talk about treatment with hormonal contraception? You can certainly fight troublesome ailments that the use of hormones inhibits, e.g. painful menstruation. For what else do doctors recommend this type of contraception?
The most common disorders of the menstrual rhythm in young women. The doctor notices that menstruation is irregular, which is caused by hormonal disorders, so he recommends certain tests and taking contraception for 3 or 4 cycles. The girl takes them and after this time the cycles usually normalize.
The tablets can be used for acne problems, reducing the amount of blood during menstruation or just getting rid of the painful periods you mentioned. Young women often ask for pills before vacation. And that's good - it's better to prepare than to worry later why her period is late, so she takes pills during the holidays and then takes them off.
Many women fear hormonal contraception for fear of reduced or even loss of fertility, so how does contraception affect fertility when used long-term?
If, before taking birth control, the tests show that everything is fine and the woman is fertile, her hormone levels are normal, ultrasound shows that everything is fine, contraception will not take it away. The tablets will keep your ovaries “resting” while you are taking them. After the hormones are discontinued, it can go into very quicklypregnancy. Especially in the first few months after weaning.
On the other hand, if a girl had fertility problems before and took pills, but the problem was never diagnosed, then he may speak up after stopping them, because this is how this mechanism works - you can turn off the problem, but when it is not fixed then he will not disappear. Therefore, you should get tested and make sure everything is okay before you start taking the pills.
Plans change a lot these days, so what if a woman who takes hormonal contraception wants to stop and get pregnant in the next few months?
Pills do not change fertility. Simply, a woman, after discontinuing hormonal contraception, finds the same area that she left before starting taking. It may even improve, you can eliminate certain disorders, stabilize the hormonal balance, but if there are fertility problems, you need to do research and find the cause.
Often this problem is in the thyroid gland or in the prolactin level. If a woman is planning a pregnancy, she should take folic acid beforehand or use preparations for pregnant women. For example, if she wants to get pregnant in June, she should start taking certain supplements in March or switch her diet exclusively to organic products.
There are measures that eliminate the negative effects of contraception …
In fact, with each type of medication, there are extra pills. Manufacturers are looking for gaps, so if someone takes a preparation because his joints hurt, other drugs are produced to protect, for example, his gastrointestinal mucosa against the side effects of anti-inflammatory drugs. Instead of using these types of things, I would suggest taking care of yourself, that is, eat better, do not harm yourself and limit sugar in your diet. The easiest and, in the end, the cheapest is eating only organic.
So these recommendations, for example, for drugs for the liver when taking pills, are not relevant?
This is a bit of a strange way of thinking, since I am already taking some pills that the liver has to metabolize, why further limiting this effect … Instead of taking additional measures, it may be better to think about an IUD so as not to tire the liver anymore. It is very comfortable and, in fact, the cheapest.
Often women take medications that lower sugar levels, and when I ask them what they eat, it turns out that they consume huge amounts of sugar, but take preparations to lower it, to avoid the consequences of poor nutrition.It is better and easiest to eat right, and if there are liver problems, change the type of contraception to the IUD to avoid the gastrointestinal tract.
What disrupts hormonal contraception? In particular, grapefruit juice is discouraged.
This is true because grapefruit acts on metabolism using the same metabolic pathways and can block the metabolism of many drugs.
Is there an age limit for contraception?
There is no strict limit, but the first menstruation that should occur by the age of 16 is important. They most often appear between the ages of 11 and 13. If everything is fine after your medical history and tests, you can start taking hormonal contraception in a timely manner. The young woman will receive other funds than the older one.
Natural estrogens are usually used in women over the age of 35 because hormone levels decline with age. There are also preparations that imitate the natural changes in the monthly cycle.
If a woman is taking hormonal contraception, should she pay more attention to her he alth?
It would be good to stop smoking if a woman smokes, because it affects blood flow and when taking pills, the risk of thrombosis increases, and as I mentioned - a he althy ecological diet and possible additional supplementation. Of course, you should also remember about regular examinations.
Are there any times when a woman should take tablets, e.g. better in the morning or better in the evening?
You have to remember to take hormonal contraception at regular times. It doesn't even have to be the exact same time. If you accidentally forget a tablet, it is important that you take the forgotten tablet within 12 hours from the time you were supposed to take it. The time will not matter as it is not an antibiotic that has to be taken within an exact time frame.
gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones".
www.tadeuszoleszczuk.pl
fb.com / drtadeusz
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