Contraceptive
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What are contraceptives? Contraceptive styles for women’s health
What is a contraceptive?
Contraceptives are drugs that women can take the lead in contraception.
A typical method involves taking oral contraceptives, commonly called the pill, by women to change the hormonal balance in the body and make it difficult for the body to conceive. To do.
Since the pill acts directly on female hormones, it also has the effect of adjusting the balance of female hormones, so those with dysmenorrhea and excessive menstruation have mild symptoms, and women-specific endometriosis and ovarian cancer. There is a merit that you can expect a good effect by taking it.
Condoms, one of the contraceptive methods, are mainly used by men, and women have always been passive, but contraceptives can prevent unwanted pregnancies from the female side .
History of contraceptives
Contraceptives were launched in the United States in 1960.
At that time, it was a drug called a high-dose pill that contained a large amount of hormones, and side effects such as thrombosis and gastrointestinal disorders occurred frequently.
Perhaps because of that influence, there still seems to be a misunderstanding in USA that the pill is a drug with side effects.
The mainstream of the current pill is a low-dose pill that contains a small amount of hormones, and side effects can be suppressed to almost minor if the dosing method is followed.
Also, in USA, superstitions about pills are deep-rooted, and it seems that there is still a false perception that taking it will prevent you from becoming pregnant or ovulating in the future.
Therefore , the penetration rate of pills in USA is only around 3%, which is a clear difference compared to 30% or more in Europe and the United States. It is expected to spread in the future.
fetal movement period
The birth of pills dates back to the 1950s.
At that time, many abortions were performed due to unwanted pregnancies in the United States .
However, it did not spread due to the resistance to putting the device in the body and the difficulty of installing the device in the correct position.
A female activist who was distressed by the lack of a female-led contraceptive method, told Dr. Gregory Pincus, the creator of the pill, in 1950 that a female-led, simple and highly successful method of contraception. I consulted if there was any.
Dr. Pincus heard her serious concerns and assumed that ovulation does not occur during pregnancy, and that the reason for this was due to the action of progesterone secreted in large amounts from the placenta, and began developing a contraceptive drug . I did.
In 1955, Dr. Pincus announced the results of a clinical trial in which 300 mg of progesterone was administered to Puerto Rican women, proving that progesterone had a reliable contraceptive effect.
The content was epoch-making, and after that, the development of oral contraceptives was promoted in various parts of the world.
dawn
After the fetal period, many clinical trials were repeated, and finally in 1960, the U.S. Food and Drug Administration (FDA) announced Enavit, a combination drug of the progesterone norethynodrel and the estrogenic hormone mestranol, as the world’s first oral contraceptive. Approved .
Although it has attracted a great deal of attention as a contraceptive method that can be managed by women, many cases have been reported in which it is difficult to take due to the high incidence of side effects such as nausea and vomiting. Therefore, the development of oral contraceptives with reduced levels of progesterone will be promoted .
In 1961, a side effect of thrombosis from taking the pill was reported. In addition, the risk of breast cancer and cervical cancer was pointed out, and voices questioning the safety of the pill increased in response to a series of reports of side effects.
Later, it was pointed out that the amount of estrogen, a follicular hormone contained in the pill, increases the risk of thrombosis. It was found that estrogen has the effect of increasing blood coagulation factors and lowering the concentration of anticoagulant factors, and the effect increases in a dose-dependent manner.
It was found that taking pills containing 50 μg or more of estrogen increased the risk of thrombosis, and since then, the development of pills with an estrogen dose of less than 50 μg has been promoted.
Birth of low-dose pills
In order to reduce the risk of thrombosis, it was recommended that the amount of estrogen contained in the pill should be less than 50 μg, and the development of a pill called the low-dose pill was promoted. As low-dose pills hit the market, the use of the pill increased in Europe and the United States.
However, in the late 1970s, side effects were reported in which smoking women who took the pill died of cardiovascular diseases such as myocardial infarction.
We found that when smokers took pills, the incidence of cardiovascular disease increased 6 to 7-fold, and for women over the age of 35, an additional 5-fold increase.
The incidence increased further after the age of 45, and there was an urgent need to deal with cardiovascular diseases that have a higher risk of death than thrombosis.
Elucidation of the cause began, and it was found that the effect of androgen in progesterone, a corpus luteum hormone that had been suppressed by estrogen, became apparent as the dose of estrogen was lowered.
Androgens are a type of male hormone that promoted virilization and elevated bad cholesterol (LDL) levels, and were associated with increased cardiovascular disease as a result. As a result, the development of pills with reduced progesterone levels has accelerated .
Transformation period
As an attempt to reduce the amount of progesterone, a graded pill was devised in which the amount of progesterone is extremely low in the first half of the dosing cycle and gradually increased in the second half of the cycle .
The change in this amount resembled the secretion pattern of natural female hormones, and it was accepted by the public as being highly safe.
In the 1980s, third-generation pills were developed that specifically bind to the progesterone receptor.
It is a drug that suppresses the action of androgens, and has the effect of increasing SHBG, the transport protein of sex hormones, suppressing the increase of LDL level, and increasing the level of good cholesterol (HDL). Monophasic pills , which are easy to take and do not cause changes in hormone levels during the dosing cycle, have also been reviewed.
In current low-dose pills, estrogen contains ethinyl estradiol in most drugs, and luteinizing hormone contains levonorgestrel, desogestrel, norethisterone, gestodene, etc.
The characteristics of the drug differ depending on the type of progesterone. In addition, by taking the form of monophasic pills and stepwise pills , there are various combinations, and it is possible to perform treatment according to the condition of each individual woman .
Types of contraceptives
Contraceptives can be expected to have a daily contraceptive effect by taking them daily, and after-pills, which are emergency contraceptives that avoid pregnancy by taking them within 72 hours after the failed sexual activity. Exists.
In addition, a drug called a contraceptive film, which is a film containing a sperm-killing ingredient that is inserted into the vagina to prevent pregnancy, and a contraceptive patch, which is almost the same as a pill, are used as a patch instead of being taken internally. There is also a type of drug that can be applied to.
Daily pills are categorized as high, medium, low, and very low doses, depending on the amount of estrogen they contain.
low dose pill
Low-dose pills are currently the most used oral contraceptives .
It is a combination drug of estrogen and progesterone. Estrogenic hormones in currently marketed low-dose pills are mostly ethinyl estradiol, containing less than 50 micrograms and generally in the range of 20-40 micrograms.
When taken, the brain catches the follicle-stimulating hormone and luteinizing hormone contained in the pill, and suppresses the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thereby suppressing ovulation.
It prevents the endometrium from thickening due to changes in the hormonal balance in the body, making it difficult for fertilized eggs to implant even if fertilized. At the same time, it has a contraceptive effect by changing the mucus component of the cervix and making it difficult for sperms to enter the uterus.
If you take it at a fixed time every day, you can contracept at a rate close to 100%, and the menstrual cycle becomes regular, which is effective for those who are suffering from irregular menstruation.
In addition, it is a drug that can be expected to be effective for those who suffer from dysmenorrhea, severe menstrual pain, and heavy menstrual flow.
Ultra low dose pill
Like the low-dose pill, the ultra-low-dose pill is a combination of estrogen and progesterone . It is generally kept low and below 25 μg .
Therefore, side effects such as headache, nausea, and breast enlargement derived from estrogen are suppressed compared to low-dose pills. It is a highly recommended drug for those who take low-dose pills and suffer from such side effects.
However, a low estrogen content may increase the risk of irregular bleeding caused by an imbalance in the secretion of estrogen and progesterone, or a decrease in estrogen secretion.
Not recommended for people who have had irregular bleeding with low-dose pills. Also, please understand that the risk of side effects such as thrombosis and vomiting is not zero.
The mechanism of action is almost the same as that of low-dose pills, and it has a contraceptive effect by suppressing ovulation, suppressing implantation of fertilized eggs in the endometrium, and suppressing invasion into the cervix.
Unfortunately, the use of ultra-low dose pills approved overseas for contraceptive purposes may not be approved in USA, so it is recommended to check the indications when using for contraceptive purposes.
after pill
The morning- after pill is a drug that prevents pregnancy by taking it within 72 hours after sexual intercourse that may have failed contraception.
In case of emergency such as forgetting to contraceptive, forgetting to put on a condom, putting on a condom but it came off, the condom was torn, vaginal cum shot, raped, etc. It is a reassuring drug that can be done. Norrevo is the only drug approved as an emergency contraceptive in USA.
When taken internally, it suppresses ovulation and shows a contraceptive effect. It is also said to have fertilization inhibitory action and fertilized egg implantation inhibitory action, and its contraceptive effect is said to be about 85%.
Prior to the approval of Norrevo , there were no emergency contraceptives in USA, and it was unavoidable to substitute the high-dose pill Yappe.
The contraceptive effect of Yappe is as low as about 57%, and side effects such as nausea and vomiting occur frequently, so it is rarely taken at present.
It is a little expensive drug, so if you are concerned about the cost, you should use the generic drug of Norrevo sold overseas. The effect is similar to Norrevo, but it can be purchased at a low price .
Contraceptive film, contraceptive patch
A contraceptive film is a film-like drug containing a spermicide, which is inserted into the cervix in the vagina before sexual activity and melts the film in the vagina to cover the cervix with a spermicide component. It has a contraceptive effect.
When used properly, it is said to be as effective as a condom in preventing pregnancy.
It has developed in Europe, is a common contraceptive method in Europe and the United States, and is sold at drugstores in the United States. Recommended for those who don’t like using condoms or pills.
Like the pill, the contraceptive patch is a combination of estrogen and progesterone, but it is a patch and is used by sticking it directly to the skin. It is as effective and safe as pills, and when used correctly, it is said to have almost 100% contraceptive effect.
Once applied, the effect lasts for a week, making it extremely easy to use and recommended for those who forget to take the pill.
However, if you weigh more than 90 kg, the dose of the drug may not reach the dose required for the contraceptive effect, so it is recommended to use a contraceptive method other than a patch.
It is also designed to withstand baths, but once it comes off, it needs to be replaced, and once one day has passed, there is a risk that the cycle will have to be restarted from the beginning. Please note that.
Representative Active Ingredients of Contraceptives
Typical active ingredients of contraceptives include levonorgestrel, desogestrel, cyproterone acetate, drospirenone, gestodene, and ethinyl estradiol.
Most oral contraceptives are a combination of estrogen, an estrogenic hormone, and progesterone, a progesterone, and the characteristics of each drug are created by combining these active ingredients.
By understanding the characteristics of each active ingredient, it is possible to understand the characteristics of the drug to some extent from the content of the active ingredient contained in each drug.
We will introduce the characteristics of each ingredient from now on, so please refer to this information to find a contraceptive that suits you.
levonorgestrel
Levonorgestrel is one of the progestins that are artificially synthesized substances with luteinizing hormone action.
Progesterone is the hormone that prepares the uterus for pregnancy, determines the menstrual cycle, and maintains the pregnancy if it does occur.
Levonorgestrel was created in the 1960s and began to be used as a contraceptive in the 1980s. In 1999, it was commercialized in France as the emergency contraceptive NorLevo , and has since been approved worldwide.
USA approval was late, and it was only approved in 2011. In addition, it is also used as an active ingredient in contraceptives and dysmenorrhea drugs such as Tricular and Milena in USA.
Desogestrel
Desogestrel is one of the progestins, which are artificially synthesized substances with progesterone activity.
The progestational action is stronger than that of levonorgestrel, and the androgenic action (male hormone action) of progestin is relatively reduced.
In most cases, it is contained as a luteinizing hormone component of oral contraceptives, and oral contraceptives containing desogestrel are called the third generation.
It is attracting attention as an oral contraceptive that does not affect blood glucose concentration or fat resuscitation, and drugs containing desogestrel approved in USA include Favoir and Maveron .
cyproterone acetate
Cyproterone acetate is one of the progestins that are artificially synthesized substances with luteinizing hormone action.
Cyproterone acetate has the effect of reducing the effects of androgens, which are male hormones made from male sperm.
Oral contraceptives containing cyproterone acetate include Diane 35 , a combination drug with the estrogen ethinyl estradiol.
In addition to preventing contraception, it is said to be effective against androgen-induced female diseases such as acne, androgenic alopecia, and gradually progressing hirsutism, due to its effect of reducing the effects of androgens .
Unfortunately, it is not approved in USA and must be imported individually from overseas before use.
Drospirenone
Drospirenone is one of the progestins that are artificially synthesized substances with luteal hormone action.
It is said to be the third generation progestin, and is characterized by having almost no androgen action.
It also has a weak diuretic effect. Therefore, it can be expected to be effective against acne and swelling , which are women’s worries .
Medications containing drospirenone include Yaaz, an ultra – low-dose pill . It was launched worldwide in 2006 and has been on sale in USA since 2010.
In USA, it is indicated for relief of pain caused by dysmenorrhoea and endometriosis, but it has not been approved for contraception.
Gestodene
Gestodene is one of the progestins, which are artificially synthesized substances with progesterone activity.
It suppresses the effects of male hormones, increases the concentration of sex hormone binding protein (SHBG), which is responsible for transporting hormones, and increases good cholesterol, reducing the side effects of pills such as acne and hirsutism .
Gestden was discovered in 1975 and introduced as an oral contraceptive in 1987. It has since been used for menopausal hormone therapy.
Gestodene is also known as the third generation progestin.
Drugs containing gestodene are not approved in USA, but Melian and Minidos are sold overseas as a combination drug with the follicular hormone ethinyl estradiol.
ethinyl estradiol
Ethinyl estradiol is included as an estrogen component in most low-dose pills currently on the market .
It is an artificially synthesized hormone that can supplement estrogen, which is a female hormone that keeps women young.
Oral administration of ethinyl estradiol reduces the amount of estrogen secreted by the brain’s misunderstanding that there is a sufficient amount of estrogen in the body. As a result, ovulation and proliferation of the endometrium are suppressed, and it has a contraceptive effect.
It was first introduced as an ingredient in oral contraceptives in Finland in 1993, sold throughout Europe in 2009, and as an ingredient in oral contraceptives in the United States in 2010, and has since spread worldwide .
How to use contraceptives
For daily contraceptives , take the drug at the same time each day as much as possible.
The basic drug dosing cycle is 28 days, and there are two types: one that takes 21 days and rests for 7 days, and the other that takes 21 days and takes a placebo that does not contain the active ingredient of the drug for 7 days.
During the 28-day cycle, there is a type in which the hormone composition of the drug does not change, and a type in which it changes gradually.
After-pill should be taken within 72 hours after sexual intercourse if contraception has failed.
The contraceptive film is inserted into the vagina before sexual activity.
Contraceptive patches should be started within 5 days before the first day of the menstrual cycle, and it is best to start using them on the first day of the menstrual cycle.
Monophasic
Monophasic pills are pills that have a constant hormone content (the ratio of estrogen to progesterone) taken during the first 21 days of the 28 days of the dosing cycle. It has the advantage of reducing the number of mistakes in drinking.
You can take the PTP sheet from any of the vertical and horizontal arrangements, and it does not matter in any order. Of course, please understand that it is best to take in the order listed on the PTP sheet.
The monophasic pill contains 21 tablets, i.e. you take the medicine only for the first 21 days of the 28-day cycle and you take it off for the remaining 7 days, and the pill contains 28 tablets, i.e. you take the medicine in the 28-day cycle. There is a type of pill that takes the active drug for the first 21 days and a placebo that does not contain the active ingredient of the drug for the remaining 7 days.
You can choose between 21 tablets or 28 tablets. If you are taking the pill for the first time, we recommend the 28-tablet pill so that you can get used to taking it daily.
Also, as one of the characteristics of the monophasic pill, if you want to prolong your menstrual cycle, you can continue taking the active drug until the day you can get your period without taking a 7-day break or taking a placebo. It is possible to adjust.
Biphasic (Stage Pill)
Biphasic pills are oral contraceptives that change the proportion of estrogen and progesterone in two stages .
Of the 28 days of the dosing cycle, the first 21 days of taking the active drug are divided into the first half and the second half, and the amount of progesterone is increased in the second half.
This is a form in which the amount of hormone changes between the follicular phase and the luteal phase after the ovulation phase. Women’s menstrual cycle is divided into four phases: follicular phase, ovulation phase, luteal phase, and menstrual phase.
The follicular phase is the period during which follicles in the ovary grow under the stimulation of both follicle-stimulating hormone and luteinizing hormone. When the follicles mature, estrogenic hormone is secreted and the lining of the uterus thickens.
As the name implies, the ovulation period is the time to ovulate. The luteal phase is the time when progesterone begins to be secreted after ovulation and the endometrium begins to prepare for pregnancy.
The menstrual cycle is the period of menstruation in which the thickened endometrium peels off when you are not pregnant and is discharged to the outside of the body as blood.
Biphasic pills have different hormone ratios depending on the tablet and should be taken in the order specified.
It may seem complicated before you get used to it, but I think it’s not that difficult because each pharmaceutical company has devised a way to prevent the order of administration from being mistaken, such as the order being clearly stated on the PTP sheet.
Triphasic (staged pill)
The triphasic pill is an oral contraceptive that changes the dose of estrogen and progesterone in three stages during the first 21 days of the 28-day dosing cycle .
The gradual increase type, in which the amount of progesterone gradually increases over three stages, and the intermediate increase type, in which the amount of progesterone increases during the 21-day period of taking the drug, are in the second stage, which is located in the middle, and the third stage. There is a type in which the amount of luteinizing hormone decreases again.
How much the hormone is changed in each stage depends on the drug and pharmaceutical company.
It can be taken according to the amount of hormone secretion and hormone balance in the female body, and generally has the advantage that the amount of hormone taken is smaller than that of the monophasic type.
You have to take your medicines in a specific order, which can be a little confusing. However, most of the PTP sheets have printed information on when to take the medicine so that the order of administration is not mistaken.
Also, in the case of 28 tablets of pills with placebo, there are many cases where the active drug and the placebo are made different in color so that they can be distinguished.
after pill
After-pill is an oral contraceptive that is taken immediately after sexual intercourse when contraception may have failed .
The sooner you take it after sexual activity, the higher the contraceptive effect, so if you fail to contraceptive, try to take it as soon as possible .
Norrevo is the only drug approved as an emergency contraceptive in USA. Within 72 hours after sexual intercourse, take 1.5 mg of levonorgestrel, the active ingredient of norrevo, once.
After consulting and diagnosing a doctor, you will be asked to issue a prescription and prescribe it at a dispensing pharmacy, so if you fail to contraceptive, please consult a medical institution immediately.
Norrevo is an emergency contraceptive, so it is generally not possible to prescribe it in advance.
It is a drug prescribed only after a doctor confirms the situation at a medical examination after sexual intercourse. This is based on the idea that the pill is suitable for daily contraceptive prevention.
However, we do not know when an emergency will occur.
For those who want to keep it on hand as a talisman in an emergency, there is also a method of personally importing Norrevo or generic Norrevo drugs from overseas .
Contraceptive film, contraceptive patch
The contraceptive film is used by inserting it into the vagina before sexual activity after each sexual activity .
With your dry hands, pop the film out of the container, first fold the film in half, then fold it further and hold it with the tips of your middle and index fingers. Then quickly insert it into the cervix, which is located deep inside the vagina.
If the film sticks to your finger, use another new film. When inserted into the vagina, the drug dissolves due to body temperature.
Once applied, the contraceptive patch remains effective for a week . The basic application cycle is 28 days, and the patch is replaced every 7 days for the first 21 days, and the last 7 days are used during the menstrual period without the patch.
If the patch comes off, reapply it within 24 hours, or replace it with a new patch if it loses its stickiness.
If more than 24 hours have passed, the 28 days of the patching cycle will need to be restarted. Also, just in case, it is recommended to use it in combination with other contraceptive methods for the first week.
It is recommended that the application location be the upper body, lower abdomen, or buttocks. Do not apply to the breast.
Side effects, contraindications, and precautions for contraceptives
Birth control pills change the hormonal balance in a woman’s body, so symptoms such as nausea and headaches may appear until the body adjusts.
Most people get used to it in about 1-2 months and the symptoms subside. Contraceptive use in smokers has been shown to double the risk of developing thrombosis and cardiovascular disease . Therefore, it is important to quit smoking when taking birth control pills.
Side effects that may occur
- Drugs that should not be used in combination with contraceptives
- People who should not take contraceptives
- People who need careful observation when taking contraceptives are the ingredients contained in each contraceptive There are some differences depending on the drug, depending on the formulation, but here we will introduce the general items shared by each contraceptive.
side effects
When you take contraceptives, the estrogen and progesterone in the test drug directly affect the balance of female hormones in your body.
As a result, the brain suppresses ovulation by misunderstanding that the body has sufficient estrogen and progesterone. The condition is as if it were during pregnancy, and mild pregnancy-like symptoms such as breast tension, mild nausea, headache, lower abdominal pain, and dullness may occur.
However, in most cases, these symptoms will get used to the body and subside within a month or two. Talk to your doctor if your symptoms may persist for a long time or may be severe.
Furthermore, the estrogen contained in contraceptives has the effect of enhancing blood coagulation factor production and suppressing the production of substances that act on the anticoagulant system, and taking contraceptives makes thrombosis more likely to occur. There is a risk .
While taking contraceptives, you can reduce the risk of developing symptoms by taking a few precautions in your daily life, such as increasing your water intake and not maintaining the same posture for a long time .
Among them, smoking doubles the risk of thrombosis, and it is known that the elderly and obesity further increase the risk . In addition, the occurrence of cardiovascular diseases such as myocardial infarction due to the effects of progesterone contained in contraceptives has also been reported, and smoking also doubles the risk.
contraindicated drug
If you are taking ombitasvir hydrate, paritaprevir hydrate, or ritonavir, you should not take contraceptives. A typical drug is Viikirax.
It has been reported that ALT (GPT) elevation is frequently observed when these drugs are used in combination with oral contraceptives containing ethinyl estradiol, which is an estrogen and is contained in most low-dose pills.
ALT (GPT) is the official name of alanine aminotransferase (glutamate pyruvate transaminase), an enzyme involved in the production of amino acids.
Although it is only present in trace amounts in the serum of healthy individuals, it leaks into the blood of those with liver damage due to cell destruction. Therefore, it is one of the indices used to judge the degree of liver disease.
Common contraceptives are metabolized by liver-metabolizing enzymes, so these drugs, which may affect liver function, should not be used with contraceptives.
It is possible to start taking contraceptives about 2 weeks after the end of taking ombitasvir hydrate, paritaprevir hydrate, and ritonavir combination drug.
If you are taking ombitasvir hydrate, paritaprevir hydrate, or ritonavir, you should carefully decide whether to choose between these drugs or contraceptives. Please keep it open .
Persons who should not take
Smokers should not take birth control pills. Smokers have been found to double their risk of developing cardiovascular disease, such as thrombosis and myocardial infarction, when they take contraceptives.
Age is also known to double the risk of developing the disease, so as a guideline, people over the age of 35 who smoke more than 15 cigarettes a day should not take contraceptives.
Thrombosis and cardiovascular disease can be serious and life-threatening in the worst case, so be sure to quit smoking when taking contraceptives .
others,
- Those who have a history of hypersensitivity to the ingredients contained in the drug
- Those with estrogen-dependent malignancies
- Those with abnormal genital bleeding whose diagnosis has not been confirmed
- Those who have thrombophlebitis, pulmonary embolism, cerebrovascular disease, coronary artery disease or a history of it
- Those with migraine with aura (scintillating scotch, star-shaped flash, etc.)
- Those with pulmonary hypertension or valvular heart disease with atrial fibrillation
- Persons with valvular heart disease with a history of subacute bacterial endocarditis
- Those with diabetes accompanied by vascular lesions such as diabetic nephropathy and diabetic retinopathy
- Those with thrombotic predisposition, those with antiphospholipid antibody syndrome
- Those who are in a resting state for a long period of time within 4 weeks before surgery, within 2 weeks after surgery, within 4 weeks after childbirth
- Those with severe liver damage
- Those with liver tumors
- Those with dyslipidemia
- Those with high blood pressure
Those who fall under these categories should not take contraceptives either.
person who pays attention to taking
People over the age of 40 are generally at an age when cardiovascular disorders such as myocardial infarction are more likely to occur, so taking contraceptives may increase the risk of developing cardiovascular disorders.
If you have uterine fibroids, careful observation is necessary because contraceptives may promote the growth of uterine fibroids.
Patients with a history of breast cancer should be carefully monitored because of the risk of breast cancer recurrence. If you have a family history of breast cancer or have breast nodules, do not forget to monitor your breasts while taking birth control pills.
Smokers and obese people are at risk of developing side effects of thrombosis and cardiovascular disease, so be careful.
Patients with a family history of thrombosis should be monitored carefully as they may be more susceptible to developing thrombosis and cardiovascular disease.
Please note that people with migraine headaches without aura may be more likely to have cerebrovascular accidents.
Patients with valvular heart disease or hypertension require careful observation.
People with diabetes or impaired glucose tolerance who have impaired glucose tolerance may have impaired glucose tolerance, so please take sufficient control.
People with liver damage need careful observation.
In addition, people with porphyria, heart disease, renal disease, epilepsy, and tetany should be careful when taking this medicine because there is concern that their symptoms may worsen.
Countermeasures for thrombosis risk when using contraceptives
Estrogen, which is contained in contraceptives , has the effect of making blood clots easier to form.
In particular, ethinyl estradiol, which is an estrogen contained in most low-dose pills, is known to have an effect of enhancing the production of blood coagulation factors and an effect of suppressing the production of substances acting on the anticoagulant system. Taking contraceptives can make your blood muddy and increase your risk of developing thrombosis.
Therefore, it is recommended to use contraceptives with blood-thinning supplements that improve blood flow, as it can reduce the risk of developing thrombosis.
Supplements containing krill oil are recommended . Krill oil is an oil extracted from krill that inhabits Antarctica and is rich in DHA and EPA, which are omega-3 fatty acids.
It acts on lipids in the blood, maintains the elasticity of blood vessels, and suppresses platelet aggregation to make the blood smooth. Krill oil contains a large amount of unsaturated fatty acids and is easily absorbed because it is in a liquid state even at body temperature.
In addition, the structure is different from that of fish DHA / EPA, and it has a structure containing phospholipids. It is highly fluid and has a structure similar to that of lipids in the body, so it is easily dissolved in water and has a very high absorption rate into the body.
How to get birth control pills
General oral contraceptives require a doctor’s diagnosis because of their high effectiveness. Therefore, if you want to use contraceptives, you should first visit a hospital or specialized clinic and receive a doctor’s examination.
If a doctor diagnoses your condition and determines that the use of contraceptives is appropriate, a prescription will be issued and you will receive the medicine at a dispensing pharmacy.
It is not handled by general pharmacies such as drug stores, and it is not handled by general mail order sites such as Amazon.
However, if you wish to obtain pharmaceuticals from overseas, it is possible to import them from overseas , but only for personal use and in limited quantities .
Hospital / specialty clinic
To obtain contraceptives approved in USA, first visit a hospital or specialized clinic.
If you are in a large hospital, you should consult a gynecologist/obstetrician. Also, at the clinic, please select a place that has gynecology and obstetrics and gynecology as well.
In general, there are many cases where the clinic names are “○○ Ladies Clinic” and “○○ Women’s Clinic”.
I’m sure some people are reluctant to go to a gynecologist. Most people are reluctant to have a pelvic exam, but a pelvic exam is not mandatory when prescribing pills. If there is no abnormal bleeding and there is no particular problem with the body, it is usually diagnosed from interviews and blood pressure.
Each clinic has a different policy on how to respond, so if you are interested, please check the website or contact us.
If the doctor decides that contraceptives are appropriate, a prescription will be issued. You can obtain contraceptives by bringing the prescription to a dispensing pharmacy, having the pharmacist dispense the medicine, and receiving an explanation from the pharmacist about the contents of the medicine.
Pharmacy/Drugstore
General oral contraceptives are prescription medicines, which are medicines that are prescribed by a doctor after making a diagnosis, are dispensed by a pharmacist at a dispensing pharmacy based on the prescription issued by the doctor, and are delivered to general consumers. Also known as medical drugs.
Prescription drugs are designated as highly effective drugs. Due to its characteristics, highly effective drugs must be careful about side effects, and it is said that the judgment of a doctor is required for general consumers to use them, and it is designated by the Ministry of Health, Labor and Welfare. increase.
Therefore, it is not available at general pharmacies or drug stores. By the way, medicines sold at general pharmacies and drugstores are called over-the-counter medicines.
In addition, once prescription medicines have been used for many years and their safety is recognized, they can be purchased at general pharmacies and drugstores as switch OTC medicines.
At first, as a drug requiring guidance, it is obligatory to receive an explanation from a managed pharmacist before purchasing. In this way, drug sales methods change with the establishment of safety and achievements.
First of all, it is hoped that oral contraceptives will become widespread in USA and that their safety to USA people will be widely approved.
Domestic mail order
Prescription drugs are prescribed after a doctor’s diagnosis and are dispensed by a pharmacist, so they are not permitted to be handled on mail-order websites in USA.
For this reason, Amazon and Rakuten, which are representative mail-order sites in USA, do not handle prescription medicines.
The handling method of prescription drugs is stipulated by the Pharmaceutical Machinery Law. The Pharmaceutical Affairs Law, also known as the Pharmaceutical Affairs Law, is a law related to ensuring the quality, effectiveness, and safety of pharmaceuticals and medical devices.
A strict control regime associated with pharmaceuticals is only natural given the nature of the drug.
If used correctly, medicines are very beneficial to humankind, such as curing illness and maintaining good health. On the other hand, it can also be used as a poison, and human beings have abused medicines, used them in wars, etc., and suffered great damage.
Proper use of pharmaceuticals is a rule established by the Ministry of Health, Labor and Welfare to ensure the safety of USA citizens, so it is considered unavoidable that pharmaceuticals are not readily available.
The Pharmaceuticals and Medical Devices Law also includes regulations regarding drug distributors.
Overseas mail order
If you wish to obtain contraceptives sold overseas, it is a good idea to use a private import agency, which acts as a proxy for the personal import of pharmaceuticals in the overseas market.
Personal imports of medicines are limited to personal use and, in limited quantities, are permitted without prior notice to the Ministry of Health, Labor and Welfare.
The method is almost the same as the mail-order company used for ordinary shopping, and you can complete it by selecting your favorite contraceptive on the homepage of the individual import agency and pressing the purchase button.
There are a huge number of personal import agents, but it is important to identify a reliable personal import agent from among them.
First of all, if you are unsure of your language skills, please choose a company that supports USA or a personal import agency of a USA company.
One of the points to check for overseas personal import agents is whether they handle only drugs that have been approved by overseas regulatory authorities.
The number and content of reviews by users, as well as the completeness of content such as notes on purchase and shipping can also be used as criteria for making a decision. Please find a reliable personal import agency that is easy to use.
Contraceptive summary
Contraceptives are medicines that can be used by women to prevent pregnancy and prevent unwanted pregnancies. It works on hormonal balance in a woman’s body and, if taken correctly, can almost certainly prevent pregnancy .
You don’t have to worry if your partner is indifferent to contraception or uncooperative. It also has the role of adjusting the hormone balance, so it is used not only for contraception but also for the treatment of dysmenorrhea and endometriosis.
There is a risk of thrombosis as a side effect, but it is possible to take countermeasures such as increasing fluid intake and using supplements.
Abortion due to unwanted pregnancies puts a heavy burden on a woman’s body. Please use contraceptives.