How do hormonal contraceptives (birth control pills) work?

The mission of such contraceptives is to prevent the onset of pregnancy. And this happens under the influence of synthetic hormones or combined oral contraceptives (COCs), which in microdoses either “put to sleep” the eggs or increase the viscosity of mucus in the vagina and suppress the function of ovulation, which is controlled by the pituitary gland. He also maintains an average level of progesterone, which is necessary for carrying a baby. The pituitary gland has paused the reproduction of offspring, eggs are not thrown out of the ovary unnecessarily, so fertilization becomes impossible.

What kind of examination should be done before starting to use COCs?

Before the doctor understands the complete picture of your health based on the tests, share as much information as possible about your lifestyle, hereditary and chronic diseases.

For example, for girls who smoke, oral contraception is banned. Taking these drugs can affect the blood circulation process and thicken the blood, significantly increasing the risk of cardiovascular diseases and venous pathologies in combination with nicotine.

Biochemical blood analysis is considered desirable (COCs are contraindicated in diabetes mellitus, liver, and kidney diseases), urine analysis, ultrasound of internal organs and pelvic organs, mandatory examination by a doctor.

It will be ideal if you take a blood test to check the level of progesterone, estrogen, prolactin, LH – a luteinizing hormone, and FSH –follicle-stimulating hormone estradiol androgen steroid hormone, which, in addition to male organs, is present in the ovaries. All of these items affect the overall condition of the reproductive system.

But, the quality of the female body depends not only on the functioning of the female genital organs. Thyroid derivatives also help to ensure a harmonious existence, which, if possible, is also desirable to pass.  These are TSH, T4 free, T3 free – they affect general well-being, nervous system, blood pressure, skin and hair condition, carbohydrate metabolism, and weight.

This is the perfect picture. But, most often, the doctor prescribes contraceptives, guided by minimal information, which is sometimes enough. To undergo examinations or not is a matter of the patient’s consciousness, but not a mandatory doctor’s appointment.

How to choose hormonal contraceptives

They are divided into 2 types:

  • combined pills (COCs) and
  • mini-pills.

As you can understand, the combined ones consist of two components; the mini-tablets are based on one.

Differences between KOK and mini-pili

They differ not only in their composition but also in their effect on the body.

Mini-pills, as a rule, consist of gestagens in microdose. Their clinically confirmed effectiveness is lower than that of the combined ones, but there is a plus – they are suitable for breastfeeding and 1.5 months after childbirth. Because the drug contains one low-dose component, it affects only the endometrium without affecting the main functions of the reproductive system. So, their reception makes the attachment of a fertilized egg impossible, and pregnancy does not occur.

This principle of operation of the mini-peel gives an undeniable advantage over the COC – reducing side effects to a minimum. The doctor also chooses in favor of a mini-peel when the patient has severe reasons for prohibiting the use of combined OK – arterial hypertension, chronic liver diseases, diabetes, migraines.

COC has a more massive effect than the previous version because the contraceptive impact occurs through the pituitary gland. Combined are divided into three more types:

  • Monophasic – each pill in the package contains the same dose of hormones, does not cause an increase in pressure, does not provoke an increase in body weight, does not retain fluid, does not have a significant effect on the liver.  Diana, Silest, Marvelon, Silest, Lactinet, Logest.
  • Biphasic – contain different doses of hormones: the first majority have estrogens; in the remaining ones, progestogens are connected to estrogens. This approach simulates the natural fluctuation of hormones in a girl at different cycle periods. Drugs of this group are not prescribed often. Antiovin, Regevidon, Minisiston, Adepal
  • three-phase – contain different doses of hormones, but in total – the smallest or microdose – compared to previous drugs. They are considered the most modern and most naturally imitating the cycle. Triziston, Tri-regol, Tri-mercy, Trinovium.

Pros and cons of COC

Suppose the issue of choosing contraceptive pills is on your schedule. In that case, it should be understood that even a full-fledged examination, a thorough consultation with a gynecologist, and an investigation will not be able to give entirely favorable forecasts regarding the use of hormonal pills. Each lady’s body is individual, as is the selection of funds.


  • They are considered the most effective way to prevent unwanted pregnancy
  • They have “pleasant bonuses” in clean skin, getting rid of acne and acne, lack of oily skin, weight loss, reduction of pain during menstruation and elimination of PMS, breast enlargement.
  • Additionally, they have a preventive and curative effect on the female reproductive system, are convenient and easy to use, reduce the risk of developing cancerous tumors of the ovaries, endometrium, and cervix


  • Will not protect against vaginal infections and fungi, dangerous diseases
  • Require strict discipline reception, at the same time every day
  • Can cause unwanted side effects: headaches, nausea, fluid retention, increased appetite, mood swings
  • Complete recovery of fertility in a woman recovering from 2 to 6 months
  • Not combinable with certain medications (anticonvulsants and anti-bacterial), and lifestyle (even periodic consumption of alcohol and Smoking)

How to take hormones correctly.

All contraceptives are available with 21 active tablets in a blister or 28.

Carefully read the instructions follow all the manufacturer’s instructions.

It would be best if you drank pills from the 1st to the 5th day of the beginning of menstruation. If this is a pack with 21 tablets, then after taking the last one, a break is made for 7 days, and after that, it is essential to proceed to the next pack, regardless of the day on which menstruation began. If there are 28 birth control pills in a package, no breaks are needed. After the last pill, immediately start the next one. In this case, menstruation occurs from the 21st to the 28th day.

Control the reception time every day! (strict reception at the same time concerns the mini-peel since its effect is short-lived and being late even for 2-3 hours reduces the contraceptive effect to zero)

In the first week of using the drug, it is recommended to use additional protection methods against unwanted pregnancy.

With the sudden appearance of nausea, vomiting, diarrhea after drinking a pill, you should immediately stop taking hormones and try to pick up other drugs and methods.

When skipping the contraceptive, follow the manufacturer’s instructions

If, for some reason, there is no withdrawal bleeding (expected monthly), do not interrupt the reception and consult a gynecologist


Among the strict contraindications for these types of contraceptives are:

  • malignant and benign tumors of various locations
  • diabetes mellitus
  • thrombosis
  • pancreatitis
  • liver and kidney
  • pathology heart and vascular pathology


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