11 best contraceptive pills after 30 years

Hormonal contraceptives are still notorious among Russian women and, oddly enough, among some doctors. In fact, 60 years ago, when such contraceptives first appeared, they contained huge, by modern standards, dosages of hormones and caused many serious complications. But it has passed since then, we recall once again, more than half a century. The composition of the pill has changed, the amount of hormones in the preparations has decreased tenfold, and the prejudices have remained.

Meanwhile, modern hormonal contraceptives are not only harmless when used properly, but can significantly support women's health. It is proved that with regular use of birth control pills:

1. the risk of mastopathy is reduced,
2. decreases the likelihood of endometriosis:
3. the volume of blood loss during menstruation is reduced, and, consequently, the probability of developing anemia, which affects 10% of Russian women of childbearing age;
4. decreases the severity of premenstrual syndrome
5. menstrual migraines become less frequent,
6. decreases the likelihood of the development of "female" inflammation,
7. less risk of ectopic pregnancy
8. decreases the risk of cancer of the endometrium, ovary, colon,
9. in perimenopausal women, osteoporosis slows down.

Some birth control pills can normalize the normal balance between female and male sex hormones and are successfully used to treat acne (acne) - we will talk more about these tools in the relevant sections of the rating.

In general, according to an observational study that examined the health of 46,000 women for 39 years, regular hormonal contraceptive use reduces the risk of death from "gynecological" cancers by 29%.

For women after 30 years of age there are no particular restrictions on the use of contraceptives: they can be taken before menopause. But the older the woman, the more diseases she has, and some of them may become a contraindication to the use of contraceptives.

How to choose birth control pills

In popular Russian-language articles, one can often find a statement: in order to choose the right hormonal contraceptives it is necessary to do a lot of tests, including expensive research on the hormonal profile.

WHO experts categorically disagree with this opinion, the methodical recommendations of which state that if according to anamnesis (translated into Russian - after a conversation with a doctor) no contraindications have been identified, then we can safely recommend any of the modern low-dose and microdosing pills. Indeed, no analysis, no study of hormonal background can predict the possible side effects or prevent their occurrence. Therefore, the selection of the drug by trial and error (these pills did not fit - we will try others) is a normal practice. While we should not forget that the majority of birth control pills adverse effects are reduced after 2 - 3 months of admission.

But since the article deals with women over 30 years of age, when various chronic diseases begin to manifest themselves, it is reasonable to undergo tests to detect contraindications to the use of hormonal contraceptives:

1. Measure blood pressure, ideally in the week twice a day, or at least 2-3 times with an interval of several days.
2. Complete a mammogram to rule out breast cancer.
3. To pass a Pap smear test (PAP test) to rule out cervical cancer.

Considering modern Russian realities, and the extreme dislike of partners for the barrier method of contraception, we would recommend another test for human papillomavirus, as it increases the likelihood of cervical cancer, and while taking hormonal contraceptives, this process is accelerating (but KOK itself We remind once again that cancer risks do not increase).

For the rest, choosing birth control pills, it is enough to be guided by common sense and financial opportunities:

1. “Ordinary” women with no health problems, with normal skin, you can use any microdosing modern preparation;
2. if there are signs of excess androgens: excessive hair growth, oily hair, oily skin with acne, it is better to choose a remedy with antiandrogenic effect.
3. if there are contraindications to taking COCs, check whether progestin-only contraceptives can be taken and use them.

Internet-based proposals to divide women into "estrogen", "progestin" and "balanced" types in appearance and, on this basis, to choose the drug, has nothing to do with modern recommendations for prescribing hormonal contraceptives.

Tablets or helix

With all the advantages of modern birth control pills, they have one significant disadvantage: you need to remember about taking the medicine every day. In addition, many women are still afraid to take hormones. It would seem that in this situation the intrauterine device is optimal. But there are some pitfalls here too.

The spiral is a foreign body that in itself forms aseptic (germ-free) inflammation in the uterine cavity. And the slightest infection turns the aseptic process into a septic - in all the resulting female problems. That is why the spiral is not recommended for women who often change their sexual partners (although it is not a single manual that explains how often this shift can be considered “frequent”.

Spiral increases blood loss during menstruation. We already mentioned at the beginning of the article. that 10% of Russian women have iron deficiency anemia, and 50% have hidden, that is, while not clinically manifest, iron deficiency. Increased monthly bleeding may well turn this hidden deficit into a clear.

And one more unpleasant moment: a foreign body - a spiral - disrupts the normal motility of the fallopian tubes, and therefore increases the likelihood of ectopic pregnancy.

On the other hand, once you put a spiral, you can forget about it for several years, it can be used during breastfeeding, and the cost is much more economical, given the long period of use.

	COC	progestin OK	copper helix	hormone-containing helix
the probability of pregnancy within a year	0,1–0,9%	0,5–3%	0,9–3%	0,1–0,5%
hormonal stabilization	Yes	Yes	Yes	not
stabilization of the menstrual cycle	Yes	Yes	does not affect	Yes
effect on menstrual blood loss	reduce	reduce	reinforces	reinforces
effect on the possibility of ectopic pregnancy	reduces the likelihood	reduces the likelihood	increases the likelihood	increases the likelihood
systemic side effects	are possible	are possible	not	are possible
drug interactions	are possible	are possible	not	are possible

Top Contraceptive Pills Rating after 30 years

Nomination	a place	Name of product	price
The best combined oral contraceptives	1	Model Libera	1 162 ₽
	2	Novinet	456 ₽
	3	Logest	500 ₽
	4	Zoeli	1 265 ₽
The best pills with antiandrogenic effect	1	Jess	1 025 ₽
	2	Yarin plus	1 016 ₽
Top progestogen pills	1	Charozetta	1 423 ₽
	2	Exliton	3 231 ₽
The best pills for emergency contraception	1	Eskapel	402 ₽
	2	Genale	412 ₽
	3	Postinor	345 ₽

The best combined oral contraceptives

Combined oral contraceptives (COCs) are birth control pills that contain synthetic analogues of 2 types of female sex hormones - estrogen and progestin, mimicking the normal hormones of a healthy woman. When the active substance of such pills regularly enters the blood, the body takes it for its hormones and "lulls" the activity of the ovaries, which produce such substances. At the same time, the egg does not mature and does not come out of the follicle, and since there is no egg, then conception is impossible. If you drink the combined birth control pills strictly according to the instructions, without missing a dose, then the probability of pregnancy is less than 1%.

It is best to take them in the morning: if for some reason a woman forgets about the pill, she will have a whole day to remember and drink the medicine. If the skip pill was found the next day, then you need to take two pills at once. In the case when two or more days are missing, you need to drink two tablets and continue to take one by the end of the package. If this happened to one of the last 7 tablets in the package, then you just need to start a new pack, without taking a break a week. The effectiveness of contraception is reduced, therefore, if pregnancy is absolutely not needed, over the next 7 days you need to use an additional method: a condom, vaginal suppositories or cream.

The traditional scheme of use of the combined contraceptive pill is 21 + 7, that is, three weeks of continuous use, and a week of withdrawal, during which menstrual-like bleeding occurs. During the reception of any hormonal contraceptives, these menstruations do not happen, because the ovaries, which regulate the change of female cycles, on the background of pills “fall asleep” and stop producing hormones. Those secretions that appear in the intervals between the cycles of taking pills, in fact, only a signal of a sharp decrease in hormonal levels. Therefore, if suddenly there is no bleeding during the week break and the pregnancy test is negative, there is nothing to worry about.

It is curious that 60 years ago the inventor of the contraceptive pill developed such a scheme of application precisely to simulate menstruation - he believed that imitation of the usual female cycle would allow presenting a new type of contraception in a more positive light and, the Catholic Church prohibits any kind of protection, except for the calendar method and interrupted sexual intercourse, the most unreliable of all options). Focus failed: Dad did not approve hormonal contraceptives. But the scheme remained.

Now doctors are gradually moving away from this tradition, seeing nothing terrible about taking COC for 2-3 months in a row without interruption. Moreover, this method increases the reliability of the contraceptive effect. There are new drugs, originally designed for 3 months of continuous use. In Russia, of these funds, only one has been registered so far, which we will now discuss.

Model Libera

Rating: 4.9

These birth control pills appeared on the market relatively recently: the drug was registered in Russia at the end of 2016.

The tool has a non-standard regimen. 84 days in a row need to drink pills.containing 100 mcg of levonorgestrel and 20 mcg of ethinyl estradiol, then during the week - tablets in which there is no progestin of levonorgestrel at all, and the amount of estrogen of ethinyl estradiol is reduced 10 times. At this time, menstrual bleeding passes.

Such a scheme of use makes the contraceptive effect many times safer, even in the case of a one-time skip of taking the pill (but it is still not recommended to abuse it). Another advantage - “monthly” with all the inconvenience that accompanies them occurs only four times a year.

Since the packaging is designed for three months of admission, these birth control pills may seem relatively expensive - but in terms of a month it turns out that they are cheaper than many ordinary COCs.

Novinet

Rating: 4.6

And these birth control pills have been known in Russia for more than 15 years and over the past time they have managed to give a good account of themselves.

Like all drugs of our rating, Novinet is a micro-dosed COC. This means that the concentration of hormones in it is extremely small: 0.02 mg (20 μg) of ethinyl estradiol and 0.15 mg (150 μg) of the synthetic progestin desogestrel.

The drug is well tolerated with the standard application of 21 + 7, it is not forbidden to take it and 2 months in a row, if for some reason you need to avoid bleeding. Many women taking it note a decrease in the number of inflammations on the skin. Of the unobvious but useful bonuses - the tool helps to normalize lipid metabolism by increasing the content of high-density lipoproteins in the blood ("good" cholesterol), which is important for women after 30 years.

Logest

Rating: 4.4

Like the previous drug, this is not new in our market. Contains: 20 µg of ethinyl estradiol and 75 µg of gestodene.

The peculiarity of these birth control pills is in gestodene - it has anti-mineralocorticoid activity. That is, it reduces the effect on the body of the adrenal hormone aldosterone, which causes water retention in the body. Gestoden helps to reduce edema, and, therefore, against its background, the likelihood of side effects such as swelling and chest pain, weight gain, increased blood pressure, edema itself, is much reduced.

Among the shortcomings worth noting is the relatively high cost. Those who cannot afford Logest can take advantage of the more budgetary equivalent of Lindinet 20.

Zoeli

Rating: 4.3

These birth control pills appeared in Russia about 6 years ago. They contain 2.5 mg of nomegastrol acetate and 1.55 mg of estradiol hemihydrate. The molecule of estradiol hemihydrate in chemical structure is one of the closest to natural estradiol among the currently known molecules, and nomegestrol acetate is a highly selective gestagen. All this minimizes the likelihood of adverse events.

The regimen of this COC is slightly different from the traditional. Typically, birth control pills are recommended to drink for 3 weeks in a row, and take a break for a week. Here in the pack contains 24 active pills containing hormones, and 4 placebo tablets, which are needed only to make it easier to count the days.

Because of this, withdrawal bleeding becomes shorter, which replaces menstruation while taking COCs. Often after six months of use, it disappears completely, which may frighten many young women, but, in fact, it is not at all a cause for concern.

Possible side effects of COC

In this section of the ranking, we collected only low-dose drugs - that is, pills containing minimal amounts of hormones. But with all its virtues, birth control pills, like any really effective drugs, can cause undesirable effects:

1. breast pain;
2. headache;
3. spotting;
4. decrease in sexual desire;
5. mood swings;
6. cholestasis;
7. swelling;
8. increased fatigue.

It must be said that the side effects are most pronounced when taking COCs are expressed in the first month, and as the body adapts to hormones, they disappear - usually three cycles are enough for this. This is especially true of spotting. But sometimes the cause of "daub" - too low hormone levels. Then you need to look for tablets with a higher content of ethinyl estradiol (but not more than 35 micrograms).

In any case, it is not recommended to interrupt the taking of birth control pills in the middle of the cycle, you need to finish the packaging to the end. But, of course, when it comes to cholestasis, severe migraine or severe allergic reaction, this recommendation is not applicable. In life-threatening conditions, which are listed, to stop taking the medication should be immediately.

Who should not take COC:

1. pregnant women;
2. lactating;
3. in the first 3 weeks after birth, women who are not planning to breastfeed;
4. smoking women over 35 years old;
5. women who have undergone resection of a part of the stomach or small intestine (the active ingredient simply will not be completely absorbed);
6. with arterial hypertension (BP> 140/90);
7. with coronary heart disease, stroke, complicated valvular heart disease;
8. with intermittent claudication;
9. if you plan an operation lasting more than half an hour, followed by a long-term restriction of mobility;
10. during prolonged stay in a wheelchair or paralysis;
11. women suffering from systemic lupus erythematosus with a positive antiphospholipid antibody test;
12. in migraines with aura and focal symptoms;
13. women with previous breast cancer or mutations in the BRCA1 and BRCA2 genes;
14. women with HIV receiving antiretroviral therapy, as these drugs reduce the effectiveness of COCs;
15. with complicated diabetes mellitus (diabetic angiopathies, neuropathies, retinopathies) or with a disease duration of more than 20 years;
16. in acute viral hepatitis;
17. with complicated liver cirrhosis (ascites, jaundice, encephalopathy, gastrointestinal bleeding);
18. in liver cancer.

As can be seen, most contraindications are related to the ability of COCs to increase the likelihood of arterial thrombosis. But such a completely natural condition as pregnancy increases the likelihood of thrombosis 10 times, and in the first three weeks after birth, it increases to 100 times, while modern COCs increase 2–4 times.

The best pills with antiandrogenic effect

All KOCs somehow have an anti-androgenic effect - the ability to reduce the effect of male sex hormones on the body, creating a completely artificial hormones. But some of them neutralize the effect of androgens more actively than others. It is these pills that are recommended for conditions of pronounced hormonal imbalance: increased hair growth (hirsutism), acne, polycystic ovary syndrome. Of course, they are much more in demand among young women, and adolescents with severe forms of acne or excessively heavy periods are often prescribed in the absence of sex. But KOC with antiandrogenic effects are also necessary for mature women, so we included them in the rating.

Jess

Rating: 4.8

These birth control pills compare favorably with other antiandrogenic agents with a low content of ethinyl estradiol: 0.02 mg. Among the drugs with a similar effect, the second one with such a small amount of estrogen simply does not exist - at least in Russia at the time of the creation of this rating.

Another positive point: the substance drospirenone is used as a progestin in a dosage of 3 mg. Drospirenone is one of the relatively new substances that has not only antiandrogenic, but also antimineralocorticoid effect. That is, not only does not cause weight gain, which is often feared by women who start taking COCs, but may also contribute to its reduction. In addition, drospirenone contributes to the normalization of the lipid profile of the blood serum, which, again, is useful after 30 years of age.

Among the shortcomings should be noted the high price. Cheaper products with a similar composition - Dimia, Model Trend.

Yarin plus

Rating: 4.5

This drug is very similar to the previous one - similar active ingredients, but slightly higher amount of estrogen (0.03 mg versus 0.02 mg in Jes). On the one hand, it can increase the frequency of undesirable phenomena, on the other hand, it is precisely such means, with a slightly higher content of ethinyl estradiol, that can be indispensable for women in whom microdosing preparations cause spotting in the middle of the cycle. But the main feature of Yarina Plus is not this.

The main advantage of these birth control pills is the addition of folic acid, a vitamin that is responsible for blood formation in adults and for the formation of the brain and spinal cord in the fetus. Usually, on the background of long-term administration of COC, the amount of folic acid in the body is disturbed, and before planning a pregnancy it is recommended to drink a course of vitamins. With this drug, you can become pregnant immediately after taking the pill.

We did not include such a well-known drug as Diane 35 because of the large amount of ethinyl estradiol (0.035 mg or 35 mcg) compared to other drugs: for many years these contraceptive pills have been remembered for more modern, low-dose and effective it makes no sense about him.

Top progestogen pills

These hormonal contraceptives contain only analogues of the female hormone progesterone. They are no less effective than KOC, but they are much more demanding on the regularity of reception: a delay of even 3 hours in relation to the usual time of use requires additional measures of protection for at least 2 following days. When using pure progestins much more often than when using COCs, intermenstrual discharge appears, and the cycle itself becomes difficult to predict: there are 28 tablets in a package that you need to drink without interruption, and somewhere in this period of time a menstrual-like reaction comes - or not .

On the other hand, due to the lack of estrogens, which cause the most side effects when taking COCs, progestins are safer. They can even be taken during lactation and often this becomes the only available way to avoid too little interruption between births.

Charozetta

Rating: 4.7

Sodarjit 0,075 mg (75 mkg) desogestrel. This is a synthetic analogue of gestagens - hormones that are produced during pregnancy. It does not affect the activity of lactation and very little penetrates into breast milk, so these birth control pills can be used during lactation. Women over 30 years old may find the drug useful when it is impossible to take combined contraceptives containing both progestins and estrogens - the latter have much more contraindications.

Of the disadvantages traditionally have to specify the high price. Cheaper analogues: Lactinet, Diamilla, Model Mom.

Exliton

Rating: 4.2

Another contraceptive pill that has proven itself for at least a decade. Contain 0.5 mg lynestrenol.

The tool has a lot of good reviews and it is well tolerated, but the picture is spoiled by a very high price (almost 3,000 per package) in the absence of cheaper analogues.

Like COCs, progestins can also cause adverse effects:

1. irregular cycle;
2. nausea;
3. weight gain;
4. acne;
5. headache;
6. mood swings.

Contraindications to the use of progestin-only contraceptives:

1. pregnancy;
2. arterial thrombosis in the acute phase;
3. coronary heart disease;
4. stroke;
5. systemic lupus erythematosus with a positive test for antiphospholipid antibodies;
6. breast cancer, including in remission;
7. decompensated liver cirrhosis;
8. malignant tumor of the liver;
9. of obscure vaginal bleeding;
10. taking some anticonvulsant, antiretroviral drugs (you need to consult instructions), rifampicin.

The best pills for emergency contraception

These birth control pills contain fairly high doses of hormones, so they cannot be used for contraception all the time. But they are indispensable in emergency situations, such as a torn condom, an error during interrupted sexual intercourse, rape.

Technically, in such cases, conventional progestin or combined contraceptive pills containing levonorgestrel can be taken - only a few pills at once, so that the total dose of the hormone reaches 1.5 mg. But if you use for this COC, it will be extremely high and oz-estrogen, which can provoke thrombosis and other dangerous complications. Therefore, it is better not to risk and buy 1 pill.

The most effective emergency contraceptive pills in the first 3 days after unprotected contact, but you can use them for 5 days, although the probability of an unwanted pregnancy will increase significantly.

Eskapel

Rating: 4.1

These tablets can not be used constantly as contraceptives in any case. This means for emergency contraception, situations where unprotected sexual intercourse for some reason happened, but pregnancy and childbirth are not included in the plans.

Contains a high dose of hormones: 1.5 mg of levonorgestrel. For comparison: the Model Libera mentioned at the beginning of the rating contains 0.1 mg of levonorgestrel, that is, 15 times less. This amount of hormones is needed to slow down ovulation (the release of the egg from the ovary), if the contact occurred in the first half of the cycle, or to make the uterine lining unsuitable for implantation of the egg. But it is with this high content of hormones that a rather large number of side effects are associated:

1. vomiting
2. headache,
3. dizziness
4. lower abdominal pain
5. bleeding.

The tool can not be taken with severe liver failure and adolescents under 16 years.

Genale

Rating: 4.0

These birth control pills do not contain an analogue, but a gestagen antagonist: mifepristone at a dosage of 10 mg. The result after application is similar: if ovulation has not yet occurred, it is blocked, and in case the egg has already left and fertilization is possible, the drug causes rejection of the uterine lining (approximately the same process occurs during normal menstruation), after which the fertilized egg is not implanted can.

On the Internet, you can find the opinion that the drug is not hormonal and therefore safer than Eskapel, but this is fundamentally wrong - hormone antagonists change the normal background in the same way as their counterparts.

In general, reviews of these birth control pills are not bad, undesirable effects are rare.But somewhat more often in comparison with drugs based on levonorgestrel, there are reviews of the ineffectiveness of the drug, even if it is correctly taken.

Possible side effects:

1. abdominal pain,
2. nausea,
3. vomiting
4. diarrhea,
5. exacerbation of "female" inflammations,
6. headache,
7. weakness.

Contraindications:adrenal insufficiency, renal or hepatic failure, use of glucocorticoteroids, anemia,

porphyria, bleeding disorders.

Possible analogues: ginepristone

Postinor

Rating: 3.9

Rating: 3.9.

The active substance is similar to the active substance Eskapela, but its quantity is exactly two times less. And if Escapel is enough to take once, then Postinor will have to drink twice, and the second pill - exactly 12 hours after the first, which can be extremely uncomfortable. Or, ignoring the instructions, take two tablets at the same time, remembering the dosage of similar drugs.

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Attention! This rating is subjective, is not advertising and does not serve as a guide to the purchase. Before buying, you should consult with a specialist.