What medicine to drink after an unprotected act. Emergency contraception. Emergency contraception regimen

Sex without protection can happen in the lives of many, but here we will not talk about diseases that can be “picked up”, but about an unplanned pregnancy, when the child is not included in the plans of both partners and panic begins. The first thing to do is to calm down for both, because there are no hopeless situations, and pharmacology suggests the use of birth control pills, which must be taken immediately after the act within 24 hours. They will help to avoid unwanted consequences.

Modern drugs designed to prevent unwanted pregnancies after unprotected intercourse are popular. Some of the most famous means:

• mifepristone.

It is a mistake to think that drugs will be the perfect way to have unprotected sex. These are single use hormonal drugs. They affect the woman's body. Gynecologists say that the maximum allowable intake is two capsules per year. Taking pills by a partner will not affect men's health in any way, but it can deal a critical blow to a woman. To be more precise, not the whole body, but the organs responsible for procreation. Medicines are not kept in home lockers, as they are available at any pharmacy.

Hormonal anti-flight drugs block the process of ovulation, egg implantation. The female body undergoes a severe hormonal failure, so it is better to forget about planning a pregnancy for the next six months. Information is important for both partners if they dream of becoming parents of a healthy baby in the future.

Harm of "emergency" contraceptives

Partners who had joint unprotected intercourse resort to solving the problem without going to the doctors, on their own, fearing that the woman became pregnant. The best option would be to contact a gynecologist to save yourself from the need to use harmful chemical components of drugs. When the decision not to see a doctor is considered and invariable, the couple should carefully read the instructions for the drug, learn about side effects. It should be remembered that there are no harmless drugs in this category.

The body of a woman is exposed to negative effects and even danger. There are several reasons:

• Taking birth control can lead to an ectopic pregnancy;
• The use of the drug is often caused by bleeding from the uterus;
• After using a contraceptive, the likelihood of successful conception is sharply reduced.

Contraceptive pills and other express means are harmful and dangerous for young women who have not given birth. The retribution for intercourse without the use of contraceptives is infertility. Before taking pills, the couple should jointly think over and weigh all the pros and cons, and going to the gynecologist will allow you to choose the compounds that cause the least harm, without greatly loosening the female hormonal system.

The list consists of popular drugs, where postinor is the strongest. The effect is comparable to hitting the female reproductive organs with a heavy object. It is known that taking the drug will prevent pregnancy by 95%, but will call into question the subsequent one. In addition, the remaining 5% leave a chance for conception, but how the pregnancy will proceed, what abnormalities may appear in the fetus after a severe hormonal shock. Statistics say that cases where the drug did not help are solved by the doctors' proposal to have an abortion, since complications are likely for both the mother and the child.

Both grandmothers and mothers know about the drug, all those who found the 1980s of the last century. But not everyone knows what price to pay. The tool consists of a mini-course, the reception is carried out for three days, and each package contains two tablets.

Contraception is not suitable for all women, but if you want to use it, it is important to know the date of the last menstruation. In case of menstrual irregularities, delay, other problems associated with critical days, postinor should be abandoned. Doctors say that after taking heavy prolonged bleeding will appear.

Tablets are not intended for women who have problems and complications associated with the gastrointestinal tract, liver, or suffering from diabetes. It is strictly forbidden to accept young people under 16 years old, as well as those who have not given birth.

Contraception is dangerous for those who are sick:

• tuberculosis;
• thrombosis;
• or other inflammatory diseases of the genitourinary system;
• Botkin's disease;
• Has problems with high blood pressure;
• Oncological diseases;
• Vascular and heart diseases.

The tool is intended for women who do not have health problems, but the pills taken can seriously undermine it. The consequences of admission are manifested:

• In violation of the menstrual cycle;
• The occurrence of vomiting and nausea;
• headaches;
• The development of an ectopic pregnancy;
• In bleeding from the vagina;
• infertility;
• Sudden fainting, itching, swelling, rash;
• Sharp pain in the lower abdomen;

An agent used in a medical clinic to prevent unwanted pregnancy, abortion, when the period does not exceed six weeks. Contraceptives are not sold in pharmacy chains, they are distributed and sold exclusively by prescription. It is used only in the conditions of the blade, so that the doctor can observe and control the process.

Among the contraindications, problems in women with the liver and kidneys are noted. It is necessary to inform the health worker about smoking or drinking alcohol if the patient often indulges in bad habits. The doctor must know if a woman is using, taking the drug with her is unacceptable. Three weeks later, a woman needs to do an ultrasound to make sure that there is no pregnancy, if she is, they have an abortion. A child cannot be born full-fledged, healthy if the person has taken an agesta.

Side effects are expressed:

• In nausea, vomiting, diarrhea;
• bleeding;
• fainting;
• In violations of the menstrual cycle.

The contraceptive, which must be taken within 24 hours of unprotected intercourse, contains levonorgestrel, a component that prevents pregnancy.

• Violation of menstruation;
• Nausea, vomiting, diarrhea;
• Apathy, headache.

Tablets that prevent a woman's body from unwanted pregnancy after intercourse without protection, containing the substance mifepristone, are a synthetic steroid drug.

The active substances block the effects of progesterone, the pregnancy hormone. In a couple of hours, an environment arises in the uterine region that is negative in relation to the fertilization process. The drug is highly effective.

Side effects:

• In skin rash, itching;
• Nausea, dizziness, vomiting, diarrhea;
• An increase in temperature, a violation of the period of menstruation;
• The appearance of bleeding.

Taking a contraceptive on the first day may not lead to side effects, which cannot be said about using it at a later date. There will be uterine bleeding, you will need immediate medical attention.

Mifepristone

The contraceptive is a means for medical abortion. It is permissible to use contraceptive during the first day after intercourse without protective equipment. When it turns out that the pregnancy has come, mifepristone is used to terminate it.

The appointment of the drug in this period excludes independent use, you must consult a doctor. The uterus will gain tone, accompanied by contractile myometrium, which will lead to miscarriage. The fertilized egg will be destroyed due to the action of the drug that blocks progesterone. Contraindications make up a large list:

• Excluded in renal failure;
• With diabetes;
• Suspicion of an ectopic pregnancy;
• With inflammatory processes of the genital organs;
• Anemia, bronchial asthma;
• Infections, bad habits.

Two days after using the remedy, the woman remains under the supervision of a doctor, and after 14 days she returns to the clinic for an additional health check. The drug is dangerous, sometimes it does not have the desired effect, an abortion will be required. The side effects of the early stages and time after an abortion with the use of a medication are identical.

If a woman does not plan a pregnancy, then birth control pills after the act within 72 hours will help to avoid unwanted conception. This method of protection in medicine is called the method of postcoital, emergency contraception. It is applicable in cases where unprotected intercourse occurs and the woman does not use other methods of contraception (spiral, oral contraceptives).

Emergency contraception and birth control pills after intercourse

Emergency methods are used only when the main options for protection against unwanted pregnancy have failed or unplanned sexual contact has occurred. In this case, birth control pills must be taken within the next 72 hours after an unprotected intercourse. Moreover, the earlier the pill is taken, the higher the likelihood that conception will not occur.

So, taking an emergency contraceptive within 24 hours after an unprotected act provides an effectiveness of about 95%. When using a birth control pill within 48 hours, the chance of conception increases by 10 percent. If a woman takes the drug by the end of the third day, the result will be only 55-60%. That is, the effectiveness of emergency contraception decreases every day, so it is recommended to take the pill as soon as possible (preferably within 24 hours after intercourse).

However, a woman should understand that taking such drugs on a regular basis is unacceptable, since a high concentration of hormones, which forms the basis of drugs, negatively affects not only reproductive function, but also the entire body as a whole. According to WHO recommendations, emergency contraceptives can be taken no more than 2-3 times a year.

At the same time, it is believed that the use of emergency contraceptives is the most gentle alternative to surgical termination of pregnancy (abortion). You just need to know how to properly take birth control pills after intercourse and not abuse these medications.

When do women seek emergency help?

Indications for the use of emergency contraceptives are the following situations:

• unprotected intercourse with an unfamiliar sexual partner;
• the method of barrier contraception used was unreliable (for example, the condom broke, the spiral fell out);
• an oral contraceptive was missed;
• unprotected contact occurred as a result of sexual violence.

In some cases, an indication for taking emergency contraceptives is a course of treatment with drugs (antibiotics, diuretics) that reduce the effectiveness of permanent oral contraceptives prescribed by a woman's doctor.

Contraindications

While modern emergency contraceptives are safer and more effective than first-generation birth control pills, they are not completely harmless. Experts warn that they should be taken no more than once every 3-6 months. More frequent use can cause various gynecological diseases, ectopic pregnancy and subsequent problems with conception. Such funds have an impressive list of contraindications, which must be familiarized with before the first use. Main restrictions for use:

• pathology of the liver and kidneys;
• age up to 16 years;
• varicose veins, venous insufficiency;
• thromboembolism;
• instability of the menstrual cycle;
• uterine bleeding;
• blood clotting disorders;
• period of pregnancy and lactation;
• individual intolerance to the components of the drug;
• severe chronic diseases.

After taking emergency birth control pills, side effects may develop. The most common of them:

• nausea, vomiting;
• diarrhea;
• dizziness, headaches;
• painful swelling of the mammary glands;
• weakness, increased fatigue;
• pain in the lower abdomen, menstrual irregularities.

Not uncommon and uterine bleeding, which develops in 10% of women. It is not recommended to prescribe such funds to women after 35 years of age (especially those who smoke). These drugs contain huge doses of hormones that can easily provoke hormonal imbalances. Therefore, this type of protection should be used with extreme caution, and before using it, be sure to consult a doctor and clarify possible contraindications.

Mechanism of action

The principle of action of emergency drugs is based on the inhibition of conception at the initial stage and the impossibility of the development of a fertilized egg. To date, there are 2 types of tablets:

1. preparations based on levonorgestrel (, Eskinor F);
2. contraceptive pills after the act based on mifepristone (Miropristone, Mifegin, Genale).

In general, the effect of drugs with levonorgestrel is that the action of the active substance is aimed at blocking or delaying ovulation (the release of a mature egg from the ovary). Additionally, levonorgestrel changes the composition of cervical mucus, making it thicker and more viscous. Due to this, the process of penetration of spermatozoa into the uterus is significantly hampered. In addition, if fertilization does occur, levonorgestrel prevents the introduction of the egg into the uterine mucosa due to structural changes in the endometrium.

The action of drugs from the second group is largely similar. Contraceptive pills after an act based on mifepristone also inhibit ovulation and exhibit antiprogestogenic activity, that is, they block receptors that respond to the pregnancy hormone (progesterone). As a result, the endometrium of the uterus does not undergo changes necessary for the successful implantation of a fertilized egg. In addition, active substances accelerate the contractile activity of the uterus and contribute to the removal of an unattached egg from its cavity.

Which contraceptive pills are best, how to take them correctly, and which means should be preferred as an emergency remedy after unprotected intercourse? The answer to these questions will help you find an overview of the most popular and sought-after drugs.

Birth control pills after intercourse within 72 hours

When using emergency contraceptive methods, it should be borne in mind that these are strong post-intercourse contraceptive pills with a high content of hormones that cannot be used for the purpose of regular protection. To do this, there are oral contraceptives - contraceptive pills with a low dose of hormones, which should be taken constantly. They have a slightly different mechanism of action aimed at suppressing ovulation.

Emergency contraceptive pills or “next day pills” are quite effective in preventing unplanned pregnancy, but due to the huge dose of active substances, they provoke hormonal imbalance. Therefore, the female body after the use of such funds needs to be restored, it takes a certain time for the reproductive functions to be fully restored. Today, a woman can purchase emergency funds at any pharmacy.

We list the names of birth control pills after the act, which can protect against an unplanned pregnancy:

• Postinor;
• Eskinor F;
• Mifetin;
• Mytholian;
• Genale;
• Ministizon.

It is advisable to take these funds within a day after unprotected intercourse. In addition, in order to prevent conception, you can use combined oral contraceptives, which contain a large dose of female hormones - progestogen, levonorgestrel, progestogen or estrogen.

When using them, you must strictly follow the instructions and observe the indicated dosage, since the action of such medications is aimed at rejection of the endometrium, which, if the dose is exceeded, can cause uterine bleeding. Of the drugs in this group, the following drugs are most in demand:

• Ovidon;
• Regevidon;
• Non-Ovlon;
• Silest;
• Regulon.

Let's take a closer look at the most popular tools and talk about how to use them.

Good and effective birth control pills after the act: a list with names

Postinor

One of the most effective emergency contraceptives that prevent ovulation and fertilization. This tool has been present on the pharmaceutical market for more than a dozen years. The basis of the drug is a synthetically created analogue of the hormone levonorgestrel, the content of which in Postinor is much higher than in planned birth control pills. So, the basis of each tablet is 0.75 mg of levonorgestrel + excipients.

It is recommended to take Postinor after meals (to reduce the gag reflex) with an interval of at least 12 hours. That is, the first tablet should be taken within 48 hours (maximum 72 hours) after unprotected intercourse, and the second tablet should be taken 12 hours after the first. The instruction to the drug notes that with the correct use of the drug, its effectiveness reaches 95%.

However, the longer the time interval between sexual intercourse and taking the pill, the higher the likelihood of pregnancy. So, by the end of the third day, the effectiveness of Postinor decreases to 58%. The tablets can be taken at any stage of the menstrual cycle. If vomiting occurs within three hours after taking the drug, the Postinor tablet should be taken again.

Contraindications for admission are conditions such as thrombosis, hypertension, bleeding disorders, liver and kidney diseases, oncological and cardiovascular pathologies, hypersensitivity to the drug, pregnancy and lactation.

With extreme caution, Postinor should be prescribed for diseases of the biliary tract and inflammatory lesions of the bladder. Among the side effects are the occurrence of uterine bleeding, nausea, abdominal pain, migraine, menstrual irregularities, and allergic reactions. The cost of Postinor tablets (2 pcs in a pack) is from 350 rubles.

The basis of the drug is the same active ingredient - levonorgestrel, but unlike Postinor, its dosage is doubled. Each Escapel capsule contains 1.5 mg of the active ingredient, so a single tablet intake is sufficient within 72 hours after unprotected intercourse.

Contraindications and side effects for Escapel and Postinor are almost identical. In addition, Escapel cannot be used for jaundice (even if the woman has already had jaundice in the past) and Crohn's disease. This means of postcoital contraception can be used in any phase of the menstrual cycle. If after taking the drug there is an attack of vomiting or diarrhea appears, the tablet should be repeated.

Taking these drugs (Escapela and Postinora) does not affect the fetus. That is, if you unknowingly took the drug when you were already pregnant, there is no need to have an abortion. These contraceptives do not have a negative impact on the development and formation of the child. Escapela price (1 piece) - from 300 rubles.

A contraceptive based on the active substance mifepristone, which blocks the action of the pregnancy hormone (progesterone). It is a steroidal antiprogestogen drug that is effective within 72 hours after intercourse. To achieve the maximum contraceptive effect, it is necessary to refrain from eating 2 hours before taking the Ginepristone tablet and not to eat for another 2 hours after drinking the drug.

Contraindications to the use of contraceptives are acute and chronic renal and hepatic failure, long-term use of glucocorticosteroids, blood clotting disorders, cardiovascular pathologies, hypertension, hypersensitivity.

Of the side effects, systemic reactions from the digestive, nervous system, manifestations of allergies, as well as menstrual irregularities and the appearance of bloody discharge from the genital tract are possible. The price of the drug (1 pc) - from 180 rubles.

This remedy differs from other postcoital contraceptive pills in that it can be used for medical abortion. This means that, like other means, a Mifepristone tablet can be drunk within 3 days after an unprotected act, or used to terminate a pregnancy that does not exceed 6 weeks.

The action of the drug is based on blocking progesterone receptors and increasing the tone of the uterus. 1 tablet of Mifepristone contains 200 mg of the active substance of the same name + auxiliary components. Each package of the drug contains 3 or 6 pieces of light yellow tablets. This tool has an extensive list of contraindications and side effects, so it should be taken after consulting with your doctor.

Termination of pregnancy in the early stages should be carried out in a medical institution under the supervision of doctors. To do this, a woman should drink three tablets at once 1.5 hours after a meal, drinking the drug with a sufficient amount of water. Mifepristone is a potent drug, so it is released from pharmacies only by prescription.

Ovidon (Non - Ovlon, Rigevidon, Silest) and other combined contraceptive pills after the act.

You should start taking birth control pills no later than 72 hours after unprotected contact. Such oral contraceptives are intended for continuous use (1 tablet per day), but in emergency cases it is allowed to use them as an "ambulance" in order to prevent unwanted pregnancy. The main thing is to correctly calculate the required dose in such a way as to achieve the desired effect without harming the body.

Consequences of taking postcoital contraceptive pills

Before starting the use of emergency contraception, every woman should be aware of the negative consequences of their use. Taking birth control pills with a high concentration of hormones can lead to the following complications:

• uterine bleeding;
• menstrual irregularities;
• the risk of developing an ectopic pregnancy;
• violation of reproductive function (infertility);
• violation of hemostasis, leading to the formation of blood clots;
• bowel disease (Crohn's disease).

In addition to dangerous complications, a woman, while taking such drugs, encounters unpleasant side reactions - swelling and soreness of the mammary glands, nausea, bouts of vomiting, pulling pains in the lower abdomen, migraines. In addition, in the reviews, many mention allergic reactions and emotional instability, expressed in increased irritability and hysteria.

Therefore, before deciding to take postcoital pills, every woman should find out possible contraindications and take into account the likely risks from using high-dose oral contraceptives.

Sometimes during sexual intercourse such an unpleasant event as a rupture of a condom can occur, which will entail the ingress of seminal fluid into the woman's body. Also, during sex, partners may forget use a contraceptive. And some couples even have sex without a condom, while using coitus interruptus as a method of contraception.

Without being careful, all this can lead to unwanted pregnancy, which is a serious problem for both partners.

What is emergency contraception within 72 hours

One of the methods of emergency contraception is special pills for unwanted pregnancy, which you need to accept a woman within 72 hours. This medical method is aimed at suppressing the chances of getting pregnant through unprotected intercourse.

These are medications that contain a huge dose of the female steroid hormone - gestagen (progestogen), which suppresses ovulation by affecting anterior pituitary gland. Also, gestagen thickens the cervical mucus, which makes it difficult for the sperm to move towards the egg.

If fertilization has occurred, then under the action of steroid female hormone the endometrial layer regresses, thereby making it impossible for the zygote to attach to the fallopian tube.

In other words, the principle of action of these drugs is based on artificial stimulation of menstruation in women. A uterine contraction occurs, resulting in the egg is washed out.

Thus, emergency contraceptive pills can stop pregnancy at conception within 72 hours.

Name of drugs for emergency contraception

Nowadays, medicine provides a fairly large selection of pharmacological therapy for unwanted pregnancies.

Postinor- a contraceptive drug that includes the substance levonorgestel - a synthetic progestogen. The medicine prevents pregnancy in about 85% of cases. The drug must be taken within 72 hours of unprotected intercourse.

Ginepriston- the active component of mifepristone. Accept within 72 hours.

Escapelle- the drug contains the same substance as the previous one. Accept within 72 hours.

Jenale- the active substance mifepristone is a synthetic steroid antiprogestogen. Causes inhibition of ovulation, prevents the implantation of a fertilized egg. Take the drug within 72 hours of having sex.

Such a drug as regulon not suitable as emergency contraceptive, but with long-term use, regulon provides a contraceptive effect.
Regulon is a combined contraceptive drug. Its pharmacodynamics is inhibition of the effect of gonadotropin, inhibition of ovulation and prevention of sperm penetration into the cervical canal.

Rules for the use of tablets

It is important to take emergency contraceptives early after unprotected intercourse, preferably within the first 12 or 24 hours. The deadline is 72 hours, after which the contraceptive will not work. Remember, the sooner emergency contraception is used, the greater the chance of successful drug action.

But this type of contraception is an extreme method. Emergency contraceptives can be used only twice a year due to the huge consequences for the body in kind of hormonal imbalance, which is very dangerous for women's health and can lead to a long range of diseases.

Side effects

• menstrual irregularities;
• headache;
• nausea;
• vomit;
• loss of consciousness;
• rashes;
• swelling of the limbs and face;
• aching, pulling pains in the lower abdomen;
• ectopic pregnancy - a complicated pregnancy when a fertilized egg attaches itself outside the uterine cavity. This is a medical emergency, a life-threatening condition;
• mastopathy - pathological fibrocystic changes in breast tissue. In the mammary gland, the formation of painful fine-grained seals occurs. This is a good education. However, there is a high risk of their malignancy and transition to a malignant tumor process;
• uterine bleeding is a serious condition that also requires emergency medical care. Life threatening;
• infertility (emergency contraception is especially dangerous for women who have never given birth);
• thrombosis - hormonal drugs can provoke thrombosis, which in turn can lead to pulmonary embolism, strokes;
• Crohn's disease - hormonal drugs increase the risk of Crohn's disease by 3 times;
• emotional lability.

It is worth noting that the choice of the drug is best done with a specialist doctor. Do not rush to take the first contraceptive that comes across without first consulting a gynecologist. Improper use of hormonal drugs is very dangerous for both health and life. The doctor will select a drug that is more suitable for you, tell you the risks that you can expect after taking the drug. Under the supervision of a specialist, the effects of taking these drugs are significantly reduced.

If for some reason you still cannot go to a gynecologist, then carefully read the instructions before taking the drug. This is important not only for the correct application of the pharmacological action, but also for your health.

After taking hormonal drugs, within two weeks, it is advisable to consult a doctor, even if you feel well and do not show any complaints.

Contraindications

For girls under 16 years of age, taking emergency contraception is contraindicated, since they have not formed ovulation and menstruation cycles. This can lead not only to infertility, but also to irreparable health problems. Other

Do not under any circumstances take oral contraceptives for confirmed pregnancy, there is a high risk of ectopic pregnancy.
The use of hormonal contraceptives is excluded in case of pathology of the liver, biliary tract, liver failure. In case of impaired glucose absorption or lactose intolerance, the use of these drugs is also prohibited.

It is forbidden to use drugs at the stage of breastfeeding. Don't breastfeed your baby for a day if the drug was taken.

An interesting fact is that in the body of a breastfeeding mother, the hormone prolactin is secreted, which, under certain conditions, practically excludes pregnancy for a woman at this time.

Hormonal contraceptives are contraindicated if a woman has had an ectopic pregnancy in the past, with tumors, with increased blood clotting, or with long-term use of corticosteroids, with anemia, Crohn's disease.

Any pathology on the part of a woman's body can cast doubt on the use of hormonal contraceptives. You should think twice before taking these drugs, weighing the pros and cons.

Each organism is individual, and especially female. It is difficult to say how a healthy body will react to a hormonal surge. In some cases, the consequences after taking oral emergency contraceptives do not appear, or they appear slightly, while in other cases, taking hormones can lead to serious consequences for a woman's health. There is a big risk that not only the reproductive system will suffer, but the whole organism as a whole.

Unwanted pregnancy can lead to social problems, especially at a young age. To prevent unwanted consequences, before taking emergency contraceptives, it is better to consult a gynecologist who will prescribe you a more gentle medicine.

One of the main causes of many gynecological diseases and infertility is abortion. Particularly high risk of complications and injuries of the genital organs are characterized by abortion, which is accompanied by instrumental dilation of the cervix, vacuum aspiration and, especially, curettage.

Termination of pregnancy with pills in the early stages of gestation avoids mechanical trauma to the cervix and uterine body, significantly reduces the risk of bleeding and acute and chronic inflammatory processes, which often complicate surgical abortions. In addition, medical abortion completely eliminates the risks associated with anesthesia and significantly reduces the degree of psychological trauma.

Medications for medical abortion

The drug technique is based on the use of drugs belonging to different groups that affect the function of the luteal (yellow) body and increase the contractility of the uterine myometrium. These include:

1. Synthetic derivatives of prostaglandins.
2. Progesterone antagonists (antiprogestins).

Derivatives of prostaglandins

This group includes the only drug registered in Russia, Misoprostol, available in tablets at a dose of 200 mcg, it can also be under the trade name Mirolut. It is a synthetic analogue of prostaglandin E 1 . Misoprostol initiates contractions of smooth muscle fibers, which not only facilitates the opening of the cervical canal and stimulates contractions of the myometrium, but also increases the strength and frequency of contractions of the uterus, which leads to the expulsion of the contents of its cavity.

The mechanism of action of misoprostol is explained by the fact that, like oxytocin, it binds to a specific receptor apparatus of the muscle cells of the uterus, as a result of which calcium ions are released from the endoplasm of the latter, which increase the contractile activity of smooth muscle fibers. In addition, it enhances the transmission of impulses in the presynaptic membrane of adrenergic nerve endings, which leads to an increase in their release of norepinephrine.

Progesterone antagonists

The synthetic analogue of prostaglandin E 1 misoprostol is used in combination with the antiprogestin mifepristone. The name of the abortion pills for this group is Mifepristone, Pencrofton, Mifolian, Mifegin, Mifeprex. All these products, equally effective, contain 200 mg of mifepristone as an active ingredient.

The latter is a synthetic steroid drug intended for oral administration. Tablets for termination of early pregnancy, containing mifepristone, are characterized by a high degree of its affinity for progesterone receptors. By binding to them, it leads to a specific blocking of the effects of progesterone on the corresponding receptors located in the endometrium and myometrium. Mifepristone also causes a significant decrease in blood levels, which may be due to the destructive effect on the corpus luteum and its ability to reduce the content of human chorionic gonadotropin in the blood.

All this, in turn, causes:

• inhibition of the development of cells of the nutrient layer (trophoblast) of the embryo and necrosis of the fetal egg;
• hypoplasia and necrosis of the transformed functional layer of the uterine mucosa (decidual membrane of the embryo) with its subsequent rejection;
• the occurrence of uterine contractions and the development of bleeding, similar to menstrual bleeding or slightly exceeding it in terms of blood volume, which (clinically) is the essence.

In addition, mifepristone increases the sensitivity of the muscular layer of the uterus to the effects of endogenous (own) and exogenous (additionally administered in the form of misoprostol) prostaglandins. Thus, drugs for early termination of pregnancy, when used simultaneously, act as synergists.

The main regimen for the use of mifepristone and misoprostol

It consists in a single dose of three tablets (600 mg) of mifepristone in the presence of a gynecologist, after which, after 36-48 hours, the prostaglandin misoprostol is prescribed at a dose of 2-4 tablets (400-800 mcg). After taking the latter, a woman is observed by a doctor for 2 to 4 hours. A re-examination by a gynecologist with an ultrasound examination is carried out at the end of the second or at 3 weeks (14 days) after taking mifepristone.

Side effects and complications

When conducting a medical abortion in 2-10% of cases, the following side effects and complications of the combined use of these drugs are possible:

• chills and fever (sometimes to high values), which usually lasts no more than 2 hours;
• general malaise and weakness;
• dizziness, headache, fainting;
• a feeling of discomfort and minor pain, mainly in the lower abdomen, associated with spastic uterine contractions (sometimes, in 5-15%, the pain can be quite intense, requiring the use of analgesic and/or antispasmodic drugs);
• bloating, nausea (50%), vomiting (30%), diarrhea (less than 25%);
• allergic reactions in the form of skin rashes (rarely);
• incomplete abortion, due to the insufficient effectiveness of the effects of drugs - the longer the gestational age, the higher the risk of incomplete abortion;
• bleeding after taking abortion pills.

Bleeding is the most serious and dangerous complication. As a rule, this bleeding is longer and more pronounced than menstrual bleeding. At the same time, it does not lead to a decrease in the level of hemoglobin in the blood. However, in about 0.2-2.6% it can be quite intense. In these cases, it may be necessary to carry out hemostatic therapy, surgical stop of bleeding by holding or curettage, transfusion of blood substitutes, blood plasma, erythrocyte mass.

Terms of use of tablets

In the instructions for Misoprostol and Mifepristone, registered in the Russian Federation, their use for medical termination of pregnancy on an outpatient basis indicates a time limit for use of 42 days without menstruation. At the same time, the World Health Organization limits this period to 63 days. In addition, the safety and high degree of effectiveness of these funds are noted.

In this regard, the period of 63 days of absence of menstruation is accepted as a normative one. Preparations for terminating pregnancy in the later stages can be used only in the conditions of a stationary gynecological department with the possibility of providing medical care in the required amount. It should be remembered that the longer this period, the lower the degree of effectiveness of the drugs.

Contraindications for use

Absolute contraindications are:

1. Individual intolerance to one of the drugs or their auxiliary components.
2. Presence assumption.
3. Long-term use of glucocorticoid drugs due to certain comorbidities, and/or chronic adrenal insufficiency.
4. Chronic renal or hepatic insufficiency.
5. Violation of pigment metabolism, accompanied by an increased level of porphyrins in the blood (hereditary porphyria).
6. Severe concomitant extragenital pathology, as well as the presence of glaucoma, arterial hypertension, chronic obstructive pulmonary disease, severe bronchial asthma.
7. Hormone-dependent tumor formations, as well as impaired functioning of the endocrine glands, including diabetes mellitus.
8. Exhaustion.

Relative contraindications:

1. Absence of menstruation (with confirmed pregnancy) for more than 63 days. The need for misoprostol and mifepristone in longer pregnancy requires hospitalization in the gynecological department.
2. The presence of a significant size, which is a risk factor for bleeding. The use of drugs is possible with the size of the dominant myomatous node up to 4 cm and the absence of deformation of the uterine cavity by myomatous nodes.
3. The initial content of hemoglobin in the blood is less than 100 g / l, which increases the risk of even more pronounced anemia due to possible blood loss.
4. Blood clotting disorders, including taking anticoagulants and non-steroidal anti-inflammatory drugs, which dramatically increases the risk of blood loss.
5. Acute inflammatory processes of the female genital area (despite the fact that medical abortion does not increase the risk of developing an ascending infection, however, the simultaneous use of antibacterial agents is desirable).
6. Smoking women over 35 years of age, as they are at risk for cardiovascular disease. Prior to the appointment of the above drugs, it is necessary to conduct an examination by a therapist.
7. breastfeeding period. It must be canceled for 7 days from the day you took mifepristone and 5 days from the day you took misoprostol.
8. The development of pregnancy against the background of the use of an intrauterine contraceptive. The IUD must be removed before taking mifepristone and misoprostol.
9. Long-term use of oral hormonal contraceptives, which increase the risk of bleeding disorders. Although this contraindication is relative, nevertheless, a preliminary study of the coagulogram is necessary.

The implementation of an abortion in the early stages using these drugs is characterized by longer bleeding and, often, a longer pain syndrome, compared with surgical abortion. However, complications from medical abortion are much less common. In addition, it is psychologically tolerated much easier.

It is practically impossible to buy pills for medical termination of pregnancy in pharmacies, especially without a prescription. They should be used only under the supervision of a gynecologist, and are issued mainly to specialized private medical institutions or gynecological inpatient departments that have official permission to perform abortions and have the ability to carry out not only infusion and transfusion therapy, but also provide emergency gynecological and surgical care or , in extreme cases, the emergency delivery of a woman to the appropriate medical institutions.

How often, in a fit of passion, we forget about prudence and lose our heads! Most passionate hugs in the morning end with the thought: "I can get pregnant." No need to panic! the site talks about the best means of postcoital contraception.

After unprotected sex a huge number of images fly through your head related to the family, unnecessary marriage, difficult childbirth, etc. First of all, you should not panic.

You should wash yourself with warm water and douche (rinse the vagina with warm water or a spermicidal solution). In this case, you need to be very careful, since inept douching can easily injure the delicate vaginal mucosa, as well as upset the balance of microflora.

Of course, these measures will not help to avoid pregnancy, but it is still possible to slightly reduce its likelihood (according to statistics, douching reduces the chance of getting pregnant by only 10-15%).

Of course, the main methods of so-called post-coital (after sexual intercourse) contraception are much more complex methods.

Modern medicine offers several options for contraception after unprotected intercourse to protect a woman from an unwanted pregnancy.

Gestagens and antigestagens - which is safer?

Hormonal contraception

Contraception

The body of a woman is such that her entire reproductive system is subject to hormones - substances of a special structure produced in different organs.

Modern doctors have "tamed" hormones by learning to control them. This is what emergency contraception is based on.

Fertilization occurs within a few days after intercourse, so it is so important to influence this mechanism already in the early stages.(the first 72 hours the effectiveness of the drug is high, then it decreases sharply).

It is best to take the drug within the first 12-24 hours after unprotected intercourse.

The probability of getting pregnant after unprotected intercourse when taking hormonal drugs is approximately 1-2%, and these drugs are relatively easily tolerated.

Reproductive function is restored already in the next cycle, the drug has practically no effect on the hormonal background as a whole with a single use.

Preparations do not protect partners from infections, since hormones have no effect on viruses and bacteria.

This way not used for permanent contraception, because in this case it can disrupt the hormonal system.

Complications

If you are worried about symptoms such as vomiting, nausea, abdominal pain, severe bleeding from the genital tract, dizziness, then consult a doctor, he will help you cope with poor health.

To hormonal postcoital contraception include progestogens and antiprogestogens.

Post-coital protection with... IUD!

Gestagens and antigestagens

Contraception

Gestagens

In postcoital contraception high doses of the hormone progesterone are used, which affects changes in the inner surface of the uterus (endometrium).

Progesterone also blocks ovulation (the release of a mature egg from the ovary), if it did not occur before intercourse, and, accordingly, there will be nothing for spermatozoa to fertilize, pregnancy will not take place.

Progesterone is also used in oral contraceptives, but in much smaller doses. This hormone is found in preparations:

"Postinor"
1 tablet after intercourse within 48 hours, but no later than 72 hours. 12 hours after the first dose, you need to take another 1 tablet.
"Postinor" can be used on any day of the menstrual cycle.

"Escapel"
1 tablet within 96 hours of intercourse. A new generation drug, safer than Postinor.

These drugs contain very high doses of the hormone progesterone, which, if used frequently, can impair ovarian function.

In a pharmacy, these funds are sold without a doctor's prescription, but you need to monitor your well-being and, if necessary, immediately contact the clinic.

Antigestagens

They do not use high doses of the hormone progesterone, but small doses of antiprogesterone, which is a more effective method of preventing unwanted pregnancy.

Such a modern postcoital drug is "Ginepriston" ("Agest"). It also inhibits ovulation and prevents the implantation of a fertilized egg.

The drug is used 1 tablet inside for 72 hours after unprotected intercourse. "Ginepriston" can be used in any phase of the menstrual cycle.

Intrauterine device (IUD)

Contraception

This method is applicable to women who have had childbirth and abortion in the past.

Especially setting a spiral is dangerous for women who already had a history of inflammatory diseases (inflammation of the appendages, vagina and uterus), as well as those with chlamydia, mycoplasmas or viruses.

If an unforeseen situation happened to you, do not panic. Calculate your menstrual cycle - you may not be able to get pregnant on this day.

With a regular cycle, "risky" days are 7-9 before ovulation and 1-2 after ovulation (ovulation occurs on day 14 with a 28-day cycle). We repeat that this method is effective only with a regular cycle.

If these are still fertile days, use the above methods. Unfortunately, all of them only prevent unwanted pregnancy, but do not protect against sexually transmitted infections.

Therefore, if the intimacy did not occur with a permanent partner, it is recommended that you definitely visit a gynecologist and check for infections - pass smears and tests. In addition, the gynecologist will evaluate the correctness of therapy, monitor your menstrual cycle and, if necessary, correct it.

Daria VOLKOVA,
gynecologist