Short-acting oral contraceptives
Generally, take 1 tablet (pill) from the fifth day of menstruation for 22 consecutive days. If you accidentally miss it, you should take 1 tablet within 24 hours. Menstruation comes 2 ~ 4 days after drug withdrawal, and then take medicine on the fifth day of menstruation for the next cycle. If you still don't menstruate for 7 days after stopping the drug, you should start taking the next cycle of drugs immediately. The contraceptive effect is satisfactory and the success rate is about 100%. It is the most widely used steroid contraceptive in the world.
The main components are progesterone and estrogen. The principle is to use the normal physiological hormone cycle of women. There are mainly Ma, Te Guler and You Siming.
The levels of progesterone and estrogen in women are at the lowest level during menstruation. After menstruation, the secretion of these two hormones began to increase. The first is the rapid increase of estrogen. Before ovulation, higher estrogen level can promote the pituitary gland to secrete LH directly or through hypothalamus, leading to ovulation (positive feedback).
The so-called long-acting contraceptive, its medical name is short-acting oral contraceptive. Long-acting (short-acting) contraceptives include minocycline, Mafulong, Tejule and Yousiming, which means that they must be taken every day for a long time, and then stopped for 7 days every 265,438+0 days. Progesterone is really used for contraception. Another name for long-acting contraceptives is short-acting oral contraceptives. I have no choice.
Because the contraceptive mechanism of long-term short-acting oral contraceptives is to inhibit ovulation, and as long as there are no eggs, fertilized eggs will not form, so long-term short-acting oral contraceptives can effectively avoid ectopic pregnancy and prevent ovarian cancer to some extent.
There are mainly three-phase contraceptive tablets, compound norethindrone tablets (oral contraceptive 1No.), compound progesterone acetate tablets (oral contraceptive No.2), and contraceptive No.0. The imported drugs are Marvelon and Mindpair. Take three-phase contraceptive tablets on the third day after menstruation, and take 1 tablet every night for 2 1 day. Oral contraceptive tablets 1, 2, 0, taken every night from the fifth day after menstruation, for 22 days; Starting from the first day after menstrual cramps, mafulong and mindingdui were taken 1 tablet daily, for a total of 2 1 day. A few people have early pregnancy reactions such as nausea and vomiting and vaginal bleeding after taking the medicine.
Long acting oral contraceptives
It is gradually released mainly by the long-term action of ethinyl estradiol stored in adipose tissue. Take 1 tablet on the fifth day of menstrual cramps, and take 1 tablet every 28 ~ 30 days thereafter. This medicine is simple and effective. However, side effects such as early pregnancy reaction and leucorrhea are more common.
Contains synthetic progesterone and long-acting estrogen. After the drug enters the human body, it will be stored in adipose tissue, and then released slowly, inhibiting ovulation and playing a long-term contraceptive role. It is suitable for women who can't place intrauterine devices and are unwilling to use other contraceptive methods. There are mainly compound long-acting levonorgestrel oral tablets. Generally, after menstrual cramps, take 1 tablet on the fifth day and 1 tablet after 20 days. Not as effective as short-acting contraceptives. After taking it, some women will have increased leucorrhea, menstrual disorder, early pregnancy-like reaction, and sometimes bleeding, which is difficult to control. Very few people will have allergic reactions.
Long-acting contraceptive injection
Contraceptive needle 1 and compound megestrol acetate injection. For 1 time, 1 time was injected into deep muscle on the 5th and 2nd day of menstrual cycle, and then 1 tablet was injected every month. If amenorrhea occurs after medication, you can inject 1 needle every 28 days; If amenorrhea lasts for two months, injection should be stopped, other contraceptive methods should be used during withdrawal, and injection should be resumed after menstrual cramps. This preparation is simple and effective. The main disadvantage is that large dosage will cause menstrual disorder in some women. Some areas are exploring reducing trials.
Emergency contraceptive pill
Emergency contraception is suitable for cases such as failure to take contraceptive measures in the same room, condom breakage, slipping, failure of in vitro sperm discharge, and accidental injury of women. Taking emergency contraceptive measures within 72 hours after sharing the same room can effectively prevent unintended pregnancy and prevent women from suffering from abortion. From 65438 to 0998, Yuting (scientific name levonorgestrel tablets), the first special emergency contraceptive in China, was jointly developed by the Scientific Research Institute of the National Family Planning Commission, the Contraceptive Service Center of the National Family Planning Commission and relevant manufacturers. It only needs to take one tablet within 72 hours after contraceptive failure and unprotected sex, which can effectively prevent the occurrence of unwanted pregnancy.
1, which can only be used occasionally. Generally, it can only be used once a month at most, not every month.
2. Take one tablet within 72 hours and one tablet every 12 hours, for a total of 2 tablets. The sooner you take the medicine, the better the effect.
If vomiting occurs within 2 hours after taking the medicine, you must take one tablet immediately.
If you have sex after taking emergency contraception, you must take contraceptive measures, otherwise you may still get pregnant.
5. Cardiovascular patients, diabetics, breast cancer patients, women over 40 years old, lactating women within half a year after delivery and those who have been diagnosed as pregnant women are strictly prohibited from using this medicine.
The main component is progesterone. There are mainly Yuting, Mei Dan, Nuoshuang, Baoshiting and Mifepristone Tablets. Generally, the first tablet is taken orally 72 hours after sexual intercourse, and 1 tablet is taken orally after 2 hours. The sooner you take it, the better the effect. The side effects are obvious, such as nausea, vomiting, headache, dizziness, fatigue, breast swelling, bleeding, early or delayed menstruation, etc. Taking emergency contraception is only a remedial measure, not a conventional contraceptive method, and can only be used occasionally. This is because of its large dose and side effects. Generally speaking, experts believe that emergency contraception should not be used more than three times a year.
The principle of emergency contraception after the event is completely different from that of conventional contraception, which uses negative feedback of progesterone. Progesterone is known to inhibit the secretion of progesterone in human body. The progestational hormone content of an emergency contraceptive pill after the event is equivalent to the dosage of six conventional contraceptives, which will suddenly increase the progestational hormone content in the human body to more than six times the normal level, and then suddenly drop to far below the normal level. When progesterone drops far below the normal level, the endometrium will shed and bleed without the support of progesterone, thus making the embryo unable to implant.
Experts believe that the morning-after pill and the birth control pill are not the same concept. Don't take emergency contraception frequently as a contraceptive method, otherwise it will have serious consequences. It can change the normal periodic changes of endometrium, disturb the normal transformation of endometrium, change the histology and biochemistry of endometrium, which is characterized by thinning, poor secretion and rapid atrophy and degeneration, which destroys the synchronization between fertilized eggs and endometrium and is not conducive to implantation of pregnant eggs. Anti-implantation drug is a high-dose progestin, which is not affected by menstrual cycle and can be taken on the day of visiting relatives, so it is also called visiting relatives contraceptive. Diacetylene decarbonyl ester can be used as fetal birth control pill, which has anti-implantation effect, is not limited by menstrual cycle, and does not need to take medicine continuously, but it affects estrogen activity and has great side effects.
There are mainly the following types:
Contraceptive tablets for visiting relatives containing large doses of progesterone
It is a short-term dosage form suitable for couples living apart from each other to visit relatives, and its application is not limited by menstrual cycle. There are two commonly used preparations:
(1) progesterone tablets. Take 1 tablet at noon on the day of visiting relatives (or 8 ~ 10 hours before sexual intercourse), take 1 tablet at night, and take 1 tablet every night thereafter until the next day after visiting relatives.
② Norethindrone tablets. Take 1 tablet every night from the night of visiting relatives and friends. For visiting relatives for more than half a month, take 14 tablets first, and then take 1 or 2 oral contraceptives. Taking it before ovulation can still inhibit ovulation, and some women have similar early pregnancy reaction after taking it, which is generally mild. Menstruation within 1 week after drug withdrawal. Because its application is not limited by menstrual cycle, it is suitable for visiting relatives. oral contraceptive
It has been more than 40 years since the publication of 20 12. As a long-term medication for healthy young women, it is one of the most widely, thoroughly and safely studied drugs for human beings. For most women, this is a very reliable reversible contraceptive method. As long as it is taken correctly, its reliability can reach above 99%, which is comparable to sterilization.
By 20 12, more than 1 100 million women in the world are taking oral contraceptives, and most of the users in developed countries are 18-30 years old. Oral contraceptives are one of the most widely used contraceptive methods in western developed countries, with a utilization rate as high as 30%-50%. Among German women aged 20-49, 88.9% have used oral contraceptives on average. In Sweden, 90% of women have used oral contraceptives in their lifetime, and one third of women aged 15-44 are taking oral contraceptives. The utilization rate of oral contraceptives in China is less than 3%.
For most healthy women, the advantages of oral contraceptives far outweigh the disadvantages. However, this does not mean that it is suitable for every woman. Before choosing contraceptives, you should make sure that you have no contraindications to oral contraceptives, such as pregnancy, unexplained vaginal bleeding, liver disease, thrombosis or history of thrombosis, hormone-dependent tumors, etc. Women with symptoms such as cardiovascular disease are also not suitable for taking oral contraceptives.
Oral contraceptives are the most reliable for long-term use, at least for several months or years. Even if you may not have sex for a while, you'd better continue to use Marvelon. Because your body needs time to get used to oral contraceptives. And if you insist on taking it and establish your own medication rules, the risk of unintended pregnancy is very, very low.
It's very important not to lend your birth control pills to others, including your friends. Because different brands of contraceptives contain different ingredients. If you suddenly start taking an unused brand, you may feel a little uncomfortable because your body needs to adjust itself to another new hormone level.
If you need surgery or stay in bed for a long time, you need to stop taking oral contraceptives one month before surgery (major surgery or rest). Some operations may increase the risk of thrombosis if they need to lie still for a long time.
Most people will have no problem taking birth control pills, but a few people may have some side effects because of their physical relationship. However, it doesn't matter, they will be safe with a little treatment.
Early pregnancy-like reactions: nausea, vomiting, picky eaters, etc. It occurs after oral contraceptives, which is caused by estrogen in contraceptives stimulating gastric mucosa. This is a temporary phenomenon. When the gastric mucosa adapts to this stimulus, it will become a habit. People with strong reaction need to take some drugs to control this reaction, such as vitamin B6 and anisodamine, or eat some foods rich in vitamin B6, such as lean meat, liver and egg yolk, which can shorten this uncomfortable process.
Menstrual disorder: After taking birth control pills, individual people may have menstrual disorder, and those who are light do not need treatment. Generally, those who have been menopausal for more than two months should switch to other contraceptive measures. At the same time, they should take 50 mg of chlorpheniramine every day for 5 days, then take it for 5 days in the next month, and then take it for 3 months to get better.
Bleeding: Uterine bleeding may occur after missing birth control pills for some reason. If it happens in the first half of menstrual cycle, you can take ethinylestradiol 0.05 ~ 0. 15 mg until you finish taking 22 tablets; If it happens in the second half of the menstrual cycle, you can take 0.5 ~ 1 capsule every night until you finish taking 22 capsules. It is best to eat some iron-rich foods such as animal liver and blood.
Pregnancy spots: Some women will have pregnancy spots after taking birth control pills. In fact, this stain is not unique to pregnancy, and it will also appear when the growth rate of estrogen and progesterone levels in the body is high. For this stain, as long as the contraceptive is stopped, it will gradually fade away. If you can add some fresh vegetables and fruits rich in vitamin C to your diet, such as vegetables, Chinese cabbage, celery, tomatoes, oranges, oranges and so on. The stain will disappear faster.
external contraceptives
Most of them have strong spermicidal effect and are generally made into gels, tablets or suppositories. And put it into the vagina to play a spermicidal role. Such as mercuric phenylacetate, mercuric phenylnitrate, phenyl alcohol ether, etc. The contraceptive effect is not ideal when used alone, but it can be improved when used at the same time.
Before using vaginal contraceptives, you should clean the vulva, then wash your hands, and use your index finger to penetrate the membrane into the vagina until you reach the posterior fornix. 10 minutes later, the drug film is completely dissolved and sexual intercourse can be achieved. If there is no sexual intercourse within 30 minutes after placing the medicated membrane, 1 medicated membrane should be placed again to improve the contraceptive effect. If you have sex again after an interval of 1 hour, you should put 1 piece of spermicide again, otherwise it is easy to get pregnant.
If you find that the film is hard (which is easy to happen in cold weather), you can reuse it by heating it with your palm a little. Generally, the film can be preserved for two years under moisture-proof conditions, and can be used as long as it does not expire.
A few women are allergic to external contraceptive membranes. If there are some adverse reactions such as pruritus, burning, redness and swelling of vulva, stop using it.
Contraceptive drugs
Animal experiments have proved that gossypol acetate, a male contraceptive, can destroy sperm, sperm cells and spermatocytes in seminiferous tubules of testis, inhibit spermatogenesis and make semen lack of sperm. After short-term administration and drug withdrawal, the fertility of animals can be restored. The clinical trial results show that the effective rate of this product is over 99%. However, about 1% of drug addicts have hypokalemic myasthenia during taking the drug, so it cannot be popularized.
Male contraceptives are safer and more effective.
Male contraceptives will be 100% effective and bring fewer side effects to users. Anderson, a researcher on human reproduction at the University of Edinburgh in Scotland, said: "We have conducted a series of tests and found that male contraceptives do not have many side effects like female contraceptives. The side effects of female contraceptives include mood swings, blood clots, dizziness, nausea and headache. The side effects of male contraceptives should be few, which will only lead to a slight increase in the weight of consumers at most. "
Some experts pointed out that another advantage of male contraceptives is that male contraceptives are not as difficult to recover as vasectomy, because men can recover their reproductive ability as long as they stop taking contraceptives 16 weeks.
Chinese scientists have made great efforts to tackle the problem and found that male testosterone heptanoate injection, supplemented by incubation, has a good contraceptive effect. This contraceptive method is especially suitable for Asian men. Testosterone heptanoate is an ideal contraceptive for men. Testosterone heptanoate is a kind of hormone ester, which can inhibit pituitary gland and promote gonad release, thus reducing endogenous testosterone secreted by leydig cells of testis and finally achieving the purpose of blocking spermatogenesis. Clinical trials also show that the effect of testosterone heptanoate contraceptive on Asian men is significantly higher than that of western whites. In this study, although there is no racial difference in the rate of sperm reduction, Asians are more sensitive to hormone-induced sperm production inhibition than whites. More than 95% of Asians can achieve azoospermia, while only 40% to 70% of whites become azoospermia.
Male contraceptives can work in the following different ways:
(1) Long-term and large-scale use of gonadotropin-releasing hormone can reduce the secretion of pituitary gonadotropins (follicle stimulating hormone and luteinizing hormone) and inhibit spermatogenesis.
(2) Blocking the effect of follicle stimulating hormone and luteinizing hormone with corresponding antibodies. However, because both hormones contain the same A subunit and are the same as the A subunit of thyrotropin, when the function of antibody can not specifically antagonize this hormone, it may cause unnecessary side effects.
All the above drugs interfere with spermatogenesis by inhibiting hypothalamus-pituitary-gonad axis. Drugs are expensive and inconvenient to use, and at the same time inhibit the function of leydig cells in testis, leading to the decrease of testosterone level, libido or sexual dysfunction, which needs further study. Although testosterone can also inhibit the function of interstitial cells, its substitution does not affect sexual function, so it has a good application prospect.
(3) Gossypol, a drug that selectively inhibits seminiferous epithelium, was first discovered by China scholars, and a lot of research and clinical trials have been conducted in China. This research has attracted international attention. It is a kind of male contraceptive pill, which is cheap and easy to use, but it also has some side effects.