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Mini-pili (MP) contain only microdoses of progestogens (300-500 mcg), which is 15-30% of the dose of progestogen in combined estrogen-progestin preparations.
The mechanism of contraceptive action of MP consists of several factors:
a. "cervical factor" - under the influence of MP, the amount of cervical mucus decreases, its viscosity increases, which reduces the penetrating ability of spermatozoa in the peri-ovulatory period;
b. "uterine factor" - the use of MP leads to changes in the endometrium, preventing implantation;
c. "Tubular factor" - MP cause the slowing of egg migration through the fallopian tube;
d. "central factor" - in 50% of patients, MPs suppress ovulation (derivatives of 19-nortestosterone compared with derivatives of 17a-hydroxyprogesterone have a more pronounced inhibitory effect on the hypothalamic-pituitary system).
Contraceptive efficacy of MP - 0.3-9.6 pregnancies per 100 women. Below are the main drugs class "mini-pili". Continuin (Kontinuin), GEDEON RICHTER, Republic of Hungary 0.5 mg ethynodiol diacid Micronor, CILAG, USA 0.35 mg noremtisterone Femulen, SEARLE, USA 0.5 mg ethynodiol diacetate Ovret, WYETH, 22 Norgestrela Exluton (Exluton), ORGANON, The Netherlands 0.5 mg Linestrenol MP Dosage: The drug is taken continuously, at the same time, starting from the 1st day of the menstrual cycle.
• older reproductive age,
• lactation period (4-6 weeks after delivery, as MPs do not affect lactation), - the presence of contraindications to the appointment of estrogen (a number of extragenital diseases) or estrogen-dependent side effects in history,
• active smoking over the age of 35 years. Contraindications:
• high risk in case of unwanted pregnancy,
• malignant tumors of the reproductive system and mammary glands,
• irregular menstrual cycle (if the period from the moment of menarche does not exceed two years),
• an ectopic pregnancy in history,
• heavy menstruation,
• a history of idiopathic jaundice during pregnancy,
• abnormal liver function
• thromboembolic diseases,
• lesion of cerebral vessels. Side effects:
• irregular menstruation (10.6%),
• nausea, vomiting,
• weight gain,
• headache, dizziness,
mammary glands. Method limitations:
• less contraceptive efficacy compared with OK,
• the need for strict adherence to the regimen of drug administration (at the same time),
• the risk of developing functional ovarian cysts and ectopic pregnancy increases (the frequency of the latter against the background of MP-2 intake per 100 women / year),
• menstrual irregularities of intermenstrual bleeding (caused by the underdevelopment of the spiral arteries and the expansion of venules of the endometrium), shortening of the menstrual cycle to 25 days or less (25%), the appearance of uterine bleeding "breakthrough".
Advantages of the method:
• low content of progestogen and the absence of estrogen in the drug,
• in comparison with OC, a lower risk of developing diseases of the cardiovascular system and cerebrovascular disorders (1.8–2.9 and 0.9, respectively);
• MPs do not affect carbohydrate metabolism and blood coagulation system,
• in comparison with OK, MP suppress the hypothalamic-pituitary system to a lesser extent,
• MPs have a therapeutic effect on algomenorrhea, premenstrual syndrome, ovulatory pain, inflammatory diseases of the internal genital organs, a relatively rapid restoration of fertility (already within 3 months after discontinuation of the drug),
• simplicity and availability.
Recommendations for patients receiving MP:
1. during the first 7 days of taking the drug should use an additional method of contraception,
2. strictly observe the regimen of administration of the drug; in case of an erroneous missed pill for more than 3 hours, it is necessary to resort to an additional method of contraception within 48 hours,
3. if 1 tablet was missed, it is necessary to take it as soon as possible and take another pill as usual at the usual time; in case of missing 2 tablets - a double dose should be taken within two days and at the same time use an additional method of birth control.
4. when menstruation is delayed for more than 45 days, you should consult a doctor to exclude pregnancy,
5. when intermenstrual bleeding from the genital tract appears in the first months of administration, continue the usual dosage of the drug, and if they increase, consult a doctor,
6. for diarrhea, it is recommended to use additional contraception,
7. stop taking MP for 3 months before the planned pregnancy (during a specified period, resort to another method of contraception),
8. if you have any complaints arising while taking the MP - consult a doctor.
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- ORAL HORMONAL CONTRACEPTIVES CONTAINING ONLY PROGEDAGEN (PURE PROGESTIC TABLETS OR MINI PIL)
Pure progestin-only contraceptives are one of the types of hormonal contraception that was created due to the need to eliminate the estrogenic component that causes the majority of metabolic disorders: hypertension and, especially, thromboembolic states. Pure progestin-only contraceptives include: • oral contraceptives containing only progestagen (pure
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- Exercise to create a mini-intelligence card
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- STERILIZATION BY MINI-LAPAROTOMY
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- Hormonal contraception - general information
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- Chapter Overview
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- Training 5
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Biological agents include hormonal drugs, namely injection and oral contraceptives (OK). The most popular worldwide are OK - birth control pills. • Oral contraceptives It is difficult to overestimate the role of a small pill that allows millions of people to enjoy the pleasures of sex without the danger of conception. Operating principle
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