What is the principle of oral contraceptives? The widely used oral contraceptives for women are synthetic steroid hormones, mainly estrogen and progestin. The main purpose of using synthetic estrogen and progestin for contraception is to inhibit ovulation, change the consistency of cervical mucus, prevent sperm from passing through, and cause the endometrium to develop an atypical secretory phase, which is not conducive to the implantation of a pregnant egg. The two are often used in combination, making it a relatively safe, reliable and popular method of contraception. The contraceptive rate is over 99% when taken as prescribed. There are three main types of oral contraceptives: (1) testosterone derivatives, such as norethindrone, methylnorethindrone. (2) Progesterone derivatives, such as methandrostenolone. (3) Estrogen derivatives, such as ethinyl estradiol. At present, the oral contraceptives taken by women in China are mainly estrogen and progestin combination contraceptives, which are safer, have fewer side effects and are reliable. Are there many women who rely on oral contraceptives? In developed countries, the proportion of women of childbearing age taking oral contraceptives is about 50%. Many women keep the pill in their handbags or bathrooms to make it easier to take it regularly. In China, only about 2% of women use oral contraceptives for birth control. The low acceptance of oral contraceptives among women in China is largely due to the fact that the knowledge of the pill is still 20 years old. Unbeknownst to us, the new third-generation oral contraceptive pill has made significant breakthroughs in reducing side effects. After learning about the benefits of the new oral contraceptive pill, I believe that you can put down your burden, weigh the pros and cons, and make a rational choice for your reproductive health. What preparations should be made before taking oral contraceptives? For those who need to take oral contraceptives for a long time, it is better to go to the gynecological clinic of the hospital for examination, including general examination, such as heart, lung, liver, spleen, breast, blood pressure, etc.; gynecological examination, such as uterus and adnexa; laboratory examination: in addition to blood and urine routine, liver and kidney function, blood sugar and blood lipid must be checked. The doctor will decide whether to take the pill, which pill to take and give a detailed explanation of the method of taking the pill, precautions and possible side effects, etc., based on the results of the medical history, physical examination and laboratory tests. If there is any abnormality while taking the pill, you should go to the hospital for consultation. If you have been taking the pill for more than 1 year, you should go to the hospital for a repeat examination. Are there any contraindications to taking oral contraceptive pills? Women with any of the following conditions should not take oral contraceptives 1. suffering from thrombophlebitis or thromboembolic disease, with a history of deep phlebitis or venous thromboembolism; 2. suffering from cerebrovascular or cardiovascular disease; 3. suffering from hypertension with blood pressure >140/100 mmHg; 4. known or suspected breast cancer; 5. known or suspected estrogen-dependent tumors; 6. suffering from benign or malignant liver tumors. cirrhosis, liver function impairment. or in the active phase of viral hepatitis; 7, suffering from diabetes mellitus with renal, retinopathy and other cardiovascular disease; 8, pregnancy, breastfeeding within 6 months after delivery; 9, abnormal vaginal bleeding of unknown origin; 10, smoking ≥ 20 cigarettes per day. In particular, age ≥ 35 years; 11, with severe migraine; 12, suffering from kidney disease, renal impairment; 13, suffering from asthma, depression; 14, is taking rifampin, barbiturate antiepileptic drugs. Long-term use of antibiotics or drugs that affect the metabolism of liver enzymes. Will oral contraceptives cause infertility? No, it will not. A lot of information shows that most women’s menstruation resumes 6-10 weeks after stopping the pill, and about 70% of women resume ovulation in the first menstrual cycle, and the rate of resumption of ovulation within 3 menstrual cycles can be more than 90%. After stopping the drug, some women experience a rebound of estrogen and progesterone levels higher than the levels before taking the drug, which makes them more likely to conceive. According to some people, 2/3 of the patients who took the drug became pregnant within 1-2 months after stopping the drug, and no fetal abnormalities were found. Ovulation usually resumes in the first cycle after stopping the Pill, while it takes 1-3 months for those taking long-acting contraceptives. How long after stopping the pill is it appropriate to get pregnant? It has been observed that the incidence of twin pregnancies, mainly dizygotic twins, increases by a factor of 1 when conception occurs immediately after stopping the pill. A recent observation of 5500 women taking the pill in the UK found no adverse effects of oral contraceptives on the next generation. There was no significant difference in the rate of malformation and miscarriage. The use of oral contraceptives does not cause genetic disorders. Therefore, the length of time between stopping the pill and conceiving again does not seem to matter. Although it is not always possible to get pregnant soon after stopping the pill, the inhibition of ovulation function is usually lifted in about 5 weeks. However, since there is not enough certainty about the long-term effects of long-term use of the pill on the fetus, most people advocate that it is better to stop taking the pill for six months before conceiving again in order to be cautious, so that the mother can have sufficient time to eliminate the hormonal interference and restore her physiological functions. Are there conflicts between oral contraceptives and other medications? Some medications do affect the effectiveness of oral contraceptives and need to be taken into account. Rifampin, a commonly used anti-tuberculosis drug, can speed up the metabolism of norethindrone and ethinyl estradiol, the main components of oral contraceptives, and reduce the concentration of the drug in the blood. It may also cause partial shedding of the endometrium and spot bleeding or dripping, as well as reduce the effectiveness of contraceptive drugs and cause contraceptive failure. Antimicrobials, ampicillin, neomycin, tetracycline, cotrimoxazole, chloramphenicol, furantadine, etc. will affect the absorption of contraceptive drugs in the intestinal tract, resulting in a decrease in the concentration of contraceptive drugs in the blood. Anti-epileptic drugs accelerate the destruction of oral contraceptives, resulting in the failure of contraceptives. Ashwagandha, an antifungal drug, causes contraceptive failure when used in combination with contraceptive drugs. Enzyme enhancers accelerate the metabolism of oral contraceptives and reduce the effectiveness of contraception. If sleeping pills must be used, Valium can be used instead. Therefore, if you need to take any of these drugs while taking oral contraceptives, you should consult your doctor and change the dosage of oral contraceptives, or use other contraceptive methods or other therapeutic drugs. It is important to improve the safety and efficacy of the medication, but also to prevent the pill from failing. Can oral contraceptives really make people fat and get acne? Since the progestin contained in the older generation of oral contraceptives is not highly selective. Because the progestin in the older generation of oral contraceptives is not selective, it has androgenic effects, so some women will gain weight and get acne after taking it. However, the new generation of oral contraceptives (Mafolone, Mildene, and Daing-35) have high selectivity due to the new generation of progestins contained in them. There is no androgenic effect. It is beneficial to the body’s lipid metabolism, so it will not gain weight. They also do not cause acne. Moreover, they are beneficial to the skin, treating acne, seborrheic dermatitis and hirsutism, and making the skin shiny. I heard that oral contraceptives increase the chances of getting breast cancer. Is it true? I have breast enlargement. Should I not take birth control pills? A large number of studies over the past 20 years have reached a consensus that oral contraceptives have no overall effect on the risk of breast cancer. Studies have shown that: (1) women taking oral contraceptives have a slightly increased risk of being diagnosed with breast cancer (relative risk of 1.24), but this risk disappears after 10 years of discontinuing the pill. ②The risk of breast cancer was not related to the duration, dose, or type of oral contraceptive use, and there was no synergistic effect with other risk factors (e.g., family history of breast cancer). ③Women taking birth control pills are more likely to have breast exams and breast cancer is more likely to be diagnosed at an earlier stage of development in the former compared to women who have never taken the pills. It is less likely to spread outside the breast. ④ The use of oral contraceptives does not increase a woman’s lifetime risk of developing breast cancer. In addition, taking oral contraceptives significantly reduces the incidence of benign breast disease, so women with breast enlargement (benign breast disease) can take oral contraceptives. Is it true that oral contraceptives can prevent ovarian cancer and endometrial cancer? Yes, oral contraceptives have an important protective effect on the endometrium and ovaries. The occurrence of endometrial cancer is associated with estrogen overstimulation, and women who take oral contraceptives significantly reduce the risk of endometrial cancer. The risk was reduced by 20% with 1 year of use, 50% with 4 years of use, and 71% with 12 years of use; this protective effect lasted for 15 years after stopping the pill. Oral contraceptives inhibit ovulation, may reduce the incidence of functional ovarian cysts, and have a protective effect against ovarian epithelial cancer. This protective effect is evident when the pill is taken for up to 5 to 10 years, regardless of the formulation used, and can last for more than 10 years after discontinuation. I have heard that oral contraceptives increase the risk of stroke and myocardial infarction, is this true? The incidence of stroke and myocardial infarction. Before 1980, the risk of stroke and myocardial infarction did increase significantly in women taking the older generation of oral contraceptives, but not in non-smokers, women with normal blood pressure, and women under 35 years of age. Nowadays, the new generation of oral contraceptives are low in estrogen and highly selective in progestin, making them quite safe for young women who do not smoke and have no history of hypertension. I am healthy but have a family history of high blood pressure, can I take birth control pills? Older generation oral contraceptives contain high levels of estrogen (≥50 mcg/day), which can cause elevated blood pressure. Newer generation oral contraceptives with low estrogen content (20-30 mcg/day) have no significant effect on blood pressure. However, the older you are, the greater the risk of cardiovascular disease, and the risk of cardiovascular disease in heavy smokers increases accordingly. Therefore, women over 35 years of age and heavy smokers should not take oral contraceptives. You are 26 years old. Your blood pressure is normal and you can take oral contraceptives. Is it true that oral contraceptives increase the risk of venous thrombosis? Yes, the relationship between oral contraceptives and venous thrombosis is related to the dose of estrogen. The annual incidence of venous thrombosis in women taking 30-35 micrograms of estrogen per day is 41,000, compared to 23,000 in young women not taking the pill. The European Medicines Evaluation Agency (EMEA) issued a statement in 1996 that the risk of death from blood clots among women taking combination oral contraceptives would not exceed 2 million-3 million. Over the decades, the incidence of venous thrombosis in users of combined oral contraceptives is decreasing significantly, due to the reduction in estrogen doses. In conclusion: In summary, the choice of new oral contraceptives is safe and effective for healthy women of childbearing age with a need for contraception and no contraindications to using oral contraceptives.