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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 slowing down of egg migration through the fallopian tube;
d. "central factor" - in 50% of patients, MPs suppress ovulation (19-nortestosterone derivatives 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 norethisteron Femulen, SEARLE, USA 0.5 mg ethynodiol diacetate Ovret, WYETH GROUP, H. 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 birth, 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 preparation,
• 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 in 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 that arose 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 contraceptives are one of the types of hormonal contraception that was created due to the need to exclude the estrogen 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
A mini-mind map is an embryonic mind map. Although it is called “mini”, the applications that this type of intelligence card finds are truly enormous. In order to practically perform the exercises offered below, you will need colored felt-tip pens and either a notebook for mind maps, or an illustration on page 61, or simply blank sheets of large-format paper.
- STERILIZATION BY MINI-LAPAROTOMY
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- Exercise on drawing up a mini-intelligence card using images
This exercise, recommended for those who wish to practice their “mental muscles” in terms of images, is similar to the exercise with the word “happiness” described in the previous chapter. The difference is that a graphic image is placed in the center, and over each of the ten branches departing from it, images are drawn that are the first associations that come to mind. By doing
- Hormonal contraception - general information
The first oral contraceptives appeared at the turn of the 50s - 60s. this century. The first oral contraceptive "Enovid" (1959) contained 0.15 mg of mestranol and 10 mg of noretinodrel. Subsequently, the method of hormonal contraception underwent significant improvements, among which it is necessary to highlight the following: • firstly, in combined OK, the doses of hormones significantly decreased during
- Chapter Overview
• Expanding the range of associations • Exercise In this chapter, the process started in chapter 6 from the exercise on developing a mini-intelligence card with the word “happiness” as the central one continues. Moving further, in this chapter, you will come very close to the complete intellect map, learning how to expand the mini-intellect map to any desired
- Training 5
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- TABLE OF CONTENTS
INTRODUCTION 9 Chapter 1. HISTORY OF CONTRACEPT 12 Chapter 2. MODERN METHODS OF CONTRACEPT 30 2.1. Hormonal contraception 33 Combined hormonal oral contraceptives (CEC) 34 Prolonged contraception 96 Oral hormonal contraceptives containing only progestogen (pure progestin tablets, or mini-pill) 110 Hormonal
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- Biological methods
Biological agents include hormonal drugs, namely injection and oral contraceptives (OK). The most popular around the world 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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- Abortion up to 12 weeks
During the operation, the woman is on the gynecological chair. Before surgery, hair is removed in the area of the pubis, the bladder and intestines are emptied, and the external genitals are treated with a disinfectant solution. Anesthesia is performed using intravenous or inhalation anesthesia. Abortion up to 5 weeks (pregnancy tests, ultrasound) - mini-abortion - maybe