Main non-contraceptive benefits of oral contraceptives: (To first part of the material)
- Dysmenorrhoea – painful menstruation. All oral contraceptives have an effect on dysmenorrhea because they suppress proliferation and hypovascularization (increased endometrial vessels) of the endometrium due to its effect on ovulation inhibition. In anovulatory cycles (those not preceded by ovulation) in women who do not use hormonal contraceptives and menstruation itself is slightly painful.
- Polymenorrhea – abundant menstruation. Hormonal contraceptives keep the mucous membrane low, resulting in sparse genital bleeding. They are suitable for young girls in the first years after the onset of menarche (the first menstruation). Because of their immaturity in the hypothalamus-pituitary-ovary axis, often the first and subsequent menstruations are very abundant and may lead to anemia. Treatment lasts for three to six months and, if necessary, longer.
- Periovulatory (around ovulation) and postmenstrual uterine bleeding. They are observed in women around the age of 35 and may be due to estrogen deficiency, yellow body deficiency that forms at the site of the broken follicle and produces progesterone, and the presence of anovulatory cycles – menses (pseudo-menstruation) without prior ovulation. When combined oral contraceptives are administered, a balanced amount of estrogens and gestagens are delivered, resulting in treatment of the condition. The result of hormonal contraceptives in this case is achieved in the second month of intake.
- Sterility . When the hypothalamus-pituitary-ovary axis of hormone tablets is suppressed for at least three months, a “turbulent” reaction is sometimes seen when they are stopped, sometimes with more than one Graaf follicle and a possibility of a bipolar pregnancy. This shows that hormonal contraceptives are also suitable for the treatment of certain forms of sterility.
- Premenstrual syndrome. Most of the complaints are due to retention (fluid retention) of the body, headaches, swelling, mastodynia (chest pain), depressive states. Some contraceptives contain 17 alpha spironolactone derivatives, which, in addition to having close effects to those of natural gestagens, also have diuretic action.
- Polycystic ovarian disease. Women with polycystic ovarian disease have less than eight real menstrual cycles per year, because of the polycystic ovarian disease they do not ovulate. In addition, the disease is often associated with acne, seborrhea, hypertrichosis (increasing the lumbago – mossy hair on the body), and oral hormonal intake reduces these symptoms, due to the available gestagen component. After stopping the tablets, the blocking effect on the synthesis of the endogenous hormones of the woman, which leads to a violent response to hormone synthesis, ovulation and the desired pregnancy occurs.
- Endometriosis . Oral contraceptives are used when the endometrial outbreak is low, or a combination of medication and surgical treatment at a larger outbreak. Treatment with oral contraceptives alone is not sufficient in these cases, but it is sure to significantly reduce the endometrial focus. There is also an accumulation effect, that is, the longer the hormonal contraceptives are used, the better the effect on endometriosis.
- Functional ovarian cysts. In women who tend not to “break” the follicle and persist in the form of a functional (follicular) cyst, the use of hormonal contraceptives is very useful because of suppression of follicular growth and blockade of ovulation.
- Ectopic pregnancy. This is a pregnancy that develops outside the uterus. When using an intrauterine pessary as a contraceptive method, the risk of ectopic pregnancy is not reduced, whereas when using hormonal contraceptives, ectopic pregnancies are more of a medical exotic.
- Endometrial carcinoma . There are many studies that prove that women using or using hormonal contraceptives are less likely to have endometrial cancer. This is due to a decrease in the number of mitosis, especially in the proliferative phase of the endometrium, and this leads to prevention of endometrial atypical hyperplasia, which is the root of endometrial cancer.
- Ovarian carcinoma. Lack of ovulation prevents ovaries from developing ovarian cancer. It has been found that the “weakness” of the ovary and the place where the malignant process can develop is precisely where the follicle is concerned. Reducing the number of ovulation during the woman’s fertile age reduces this risk. The risk of developing ovarian carcinoma is lower in the case of lactating women and is based on the same principle – the lack of ovulation.
- Benign breast diseases. The elevated estrogen level in women with anovulatory cycles – for example polycystic ovarian disease, creates a prerequisite for ductal hyperplasia of the mammary gland. The use of combined oral contraceptives introduces a balanced amount of hormones into the female organism and this has some prevention of these diseases.
One of the most serious negatives of combined oral contraceptives is that they increase the risk of vessel thrombosis due to a decrease in the amount of the coagulation inhibitor antithrombin 3. Therefore, they are not given to women after 35 years of age, or they are written but under stricter control than younger patients. The risk of thrombosis is reduced to that before taking the tablets about a month after cessation.
When using estrogen-only hormone therapy, the risk of endometrial cancer as well as breast cancer increases. Therefore, women who have entered menopause early in the 40-year-old and post-accidental syndrome (surgical or gonadal removal of ovaries) are recommended to use combined hormonal agents with estrogen and gestagen to have a protective action. The choice and dosage of hormonal contraceptives is individual for each patient. When side effects appear to be relatively uncommon in new hormonal contraceptives, the medication may be changed or a different method of contraception may be initiated, but after consultation with a gynecologist.