11 best birth control pills after 30

Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

Hormonal contraceptives are still notorious among Russian women and, oddly enough, among some doctors. In fact, 60 years ago, when such contraceptives first appeared, they contained huge, by modern standards, dosages of hormones and caused many serious complications. But since then, let us recall again, more than half a century has passed. The composition of contraceptive pills has changed, the amount of hormones in the preparations has decreased tenfold, but prejudices have remained.

Meanwhile, modern hormonal contraceptives are not only harmless when used correctly, but can also significantly support women's health. It has been proven that with regular use of birth control pills:

1. the risk of mastopathy decreases,
2. the likelihood of endometriosis decreases:
3. the volume of blood loss during menstruation decreases, and, therefore, the likelihood of developing anemia, from which 10% of Russian women of childbearing age suffer;
4. decreases the severity of premenstrual syndrome,
5. less frequent menstrual migraines
6. the likelihood of developing 'female' inflammation decreases,
7. less risk of ectopic pregnancy
8. the risk of developing cancer of the endometrium, ovaries, colon decreases,
9. in perimenopausal women, the development of osteoporosis is slowed down.

Some birth control pills are able to normalize the normal balance between female and male sex hormones and are successfully used to treat acne (acne) – we will talk in more detail about such means in the relevant sections of the rating.

Overall, in an observational study of 46,000 women over 39 years, regular use of hormonal contraceptives reduced the risk of dying from 'gynecological' cancers by 29%.

For women over the age of 30, there are no particular restrictions on the use of contraceptives: they can be taken until menopause. But the older a woman is, the more diseases she has, and some of them may become a contraindication to taking birth control.

How to choose birth control pills

In popular Russian-language articles, you can often find the statement: in order to choose the right hormonal contraceptives, you need to do a lot of tests, including expensive studies of the hormonal profile.

WHO experts categorically disagree with this opinion, the guidelines of which say that if, according to the anamnesis (translated into Russian – after talking with the doctor) no contraindications have been identified, then any of the modern low-dose and micro-dose contraceptive pills can be safely recommended. Indeed, no analysis, no study of hormonal levels can predict possible side effects or prevent their occurrence. Therefore, the selection of the drug by trial and error (these pills did not fit – let's try others) is a normal practice. Moreover, do not forget that with most contraceptive pills, adverse events decrease after 2 to 3 months of administration.

But since the article is about women over 30 years of age, the age when various chronic diseases begin to appear, it is reasonable to undergo examinations that allow detecting contraindications to the use of hormonal contraceptives:

1. Measure blood pressure, ideally within a week, twice a day, or at least 2-3 times with an interval of several days.
2. Get a mammogram to rule out breast cancer.
3. Get a Pap smear (PAP test) to rule out cervical cancer.

Taking into account modern Russian realities, and the extreme dislike of partners for the barrier method of contraception, we would also recommend taking an analysis for the human papillomavirus, since it increases the likelihood of developing cervical cancer, and against the background of taking hormonal contraceptives, this process accelerates (but COCs themselves , we remind you again, the risks of cancer do not increase).

Otherwise, when choosing birth control pills, it is enough to be guided by common sense and financial capabilities:

1. 'ordinary' women without health problems, with normal skin, can use any modern micro-dose preparation;
2. if there are signs of excess androgens: excessive hair growth, oily hair, oily skin with acne, it is better to choose a remedy with an antiandrogenic effect.
3. if there are contraindications to taking COCs, check if progestin-only contraceptives can be taken and use them.

Proposals on the Internet to divide women into 'estrogenic', 'progestin' and 'balanced' types in appearance and, on this basis, to choose a drug, has nothing to do with modern recommendations for the appointment of hormonal contraceptives.

Pills or spiral

With all the advantages of modern contraceptive pills, they have one significant drawback: you need to remember about taking the medicine every day. In addition, many women are still wary of taking hormones. It would seem that in such a situation an intrauterine device is optimal. But there are also pitfalls here.

A spiral is a foreign body that itself forms aseptic (microbial) inflammation in the uterine cavity. And the slightest infection turns the aseptic process into a septic one – with all the ensuing female problems. That is why the spiral is not recommended for women who often change sexual partners (although how many this change can be considered 'frequent', no methodological manual specifies).

The coil increases blood loss during menstruation. We already mentioned at the beginning of the article. that 10% of Russian women have iron deficiency anemia, and 50% have latent, that is, not yet clinically manifested, iron deficiency. Increased monthly bleeding may well turn this hidden deficit into an obvious one.

And one more unpleasant moment: a foreign body – a spiral – disrupts the normal motility of the fallopian tubes, and therefore increases the likelihood of an ectopic pregnancy.

On the other hand, once you put the spiral on, you can forget about it for several years, it can be used during breastfeeding, and it is much more economical at cost, given the long period of use.

	COOK	progestin OK	copper-bearing coil	hormone-containing coil
the likelihood of pregnancy within a year	0.1-0.9%	0.5-3%	0.9-3%	0.1-0.5%
stabilization of hormonal levels	Yes	Yes	Yes	not
stabilization of the menstrual cycle	Yes	Yes	does not affect	Yes
effect on menstrual blood loss	reduce	reduce	enhances	enhances
influence on the possibility of ectopic pregnancy	reduces the likelihood	reduces the likelihood	increases the likelihood	increases the likelihood
systemic side effects	possible	possible	not	possible
drug interactions	possible	possible	not	possible

Rating of the best birth control pills after 30 years

Nomination	a place	Name of product	price
Best combined oral contraceptives	1	Modelle Liebera	RUB 1,162
	2	Novinet	456 r
	3	Logest	RUB 500
	4	Zoely	1 265 rub.
The best antiandrogenic pills	1	Jess	RUB 1,025
	2	Yarina plus	RUB 1,016
The best progestogen contraceptive pills	1	Charosetta	RUB 1,423
	2	Excluton	RUB 3,231
Best emergency contraceptive pills	1	Escapel	402 RUB
	2	Zhenale	412 RUB
	3	Postinor	345 r

Best combined oral contraceptives

Combined oral contraceptives (COCs) are birth control pills that contain synthetic analogues of 2 types of female sex hormones – estrogens and progestins, mimicking the normal hormonal background of a healthy woman. When the active substance of such tablets regularly enters the bloodstream, the body takes it for its hormones and 'lulls' the activity of the ovaries, which produce such substances. At the same time, the egg does not mature and does not leave the follicle, and since there is no egg, then conception is impossible. If you drink combined contraceptive pills strictly according to the instructions, without skipping a dose, then the probability of pregnancy is less than 1%.

It is best to take them in the morning: if for some reason a woman forgets about the pill, she will have another whole day to remember and take the medicine. If the pill was missed the next day, then you need to take two pills at once. In the case when two or more days were missed, you need to drink two tablets and then take one at a time until the end of the package. If this happened with one of the last 7 tablets in the package, then you just need to start a new package, without taking a break for a week. At the same time, the effectiveness of contraception decreases, therefore, if pregnancy is absolutely not needed, an additional method should be used over the next 7 days: a condom, vaginal suppositories or cream.

The traditional scheme of using combined contraceptive pills is 21 + 7, that is, three weeks of continuous use, and a week of cancellation, during which menstrual bleeding occurs. While taking any hormonal contraceptives, real menstruation does not happen, since the ovaries, which regulate the change in women's cycles, 'fall asleep' against the background of the pills and stop producing hormones. Those secretions that appear in the intervals between the cycles of taking pills are in fact only a signal of a sharp decrease in hormonal levels. Therefore, if suddenly during a week of interruption of bleeding, and the pregnancy test is negative, there is nothing to worry about.

It is curious that 60 years ago, the inventor of the contraceptive pill developed such a scheme of use precisely in order to simulate menstruation – he believed that imitating the usual female cycle would present a new type of contraception in a more positive light and, possibly, gain the approval of the Catholic Church (as you know, The Catholic Church prohibits any form of contraception other than the calendar method and coitus, the most unreliable of all options.) The trick failed: Dad did not approve of hormonal contraceptives. But the scheme remained.

Now doctors are gradually moving away from this tradition, not seeing anything wrong with taking COCs for 2-3 months in a row without interruption. Moreover, this method increases the reliability of the contraceptive effect. New drugs appear, initially designed for 3 months of continuous use. In Russia, of such funds, only one has been registered so far, which we will now talk about.

Modelle Liebera

Rating: 4.9

These contraceptive pills appeared on the market relatively recently: the drug was registered in Russia at the end of 2016.

The tool has a non-standard reception scheme. You need to take pills for 84 days in a row. containing 100 mcg of levonorgestrel and 20 mcg of ethinyl estradiol, then within a week – tablets in which there is no progestin levonorgestrel at all, and the amount of estrogen ethinyl estradiol is reduced 10 times. At this time, menstrual bleeding passes.

Such a scheme of use makes the contraceptive effect many times more reliable, even in the case of a one-time missed pill (but it is still not recommended to abuse it). Another advantage is that 'periods', with all their attendant inconveniences, happen only four times a year.

Since they are packaged for three months, these birth control pills may seem relatively expensive – but on a monthly basis they are cheaper than many conventional COCs.

Advantages

• increased reliability;
• low price per month of admission.

disadvantages

• not

Novinet

Rating: 4.6

And these contraceptive pills have been known in Russia for more than 15 years and over the past time have managed to prove themselves well.

Like all drugs in our rating, Novinet is a micro-dosed COC. This means that the concentration of hormones in it is extremely low: 0.02 mg (20 μg) ethinylestradiol and 0.15 mg (150 μg) of the synthetic progestin desogestrel.

The drug is well tolerated with the standard scheme of application 21 + 7, it is not forbidden to take it for 2 months in a row, if for some reason bleeding needs to be avoided. Many women who take it note a decrease in the amount of inflammation on the skin. Of the unobvious but useful bonuses – the tool helps to normalize lipid metabolism, increasing the content of high density lipoproteins ('good' cholesterol) in the blood, which is important for women after 30 years.

Advantages

• improves skin condition,
• low price.

disadvantages

• not.

Logest

Rating: 4.4

Like the previous drug, this one is far from a novelty in our market. Contains: 20 mcg ethinylestradiol and 75 mcg gestodene.

The peculiarity of these contraceptive pills is precisely in gestodene – it has antimineralocorticoid activity. That is, it reduces the effect on the body of the adrenal hormone aldosterone, which causes water retention in the body. Gestodene helps to reduce edema, which means that against its background the likelihood of such side effects as swelling and chest pain, weight gain, increased blood pressure, in fact, edema, is much reduced.

Among the disadvantages, it is worth noting the relatively high cost. Those who cannot afford Logest can use a more budgetary analogue of Lindinet 20.

Advantages

• time-tested remedy
• prevents water retention in the body.

disadvantages

• high price

Zoely

Rating: 4.3

These contraceptive pills appeared in Russia about 6 years ago. Contains 2.5 mg of nomegestrol acetate and 1.55 mg of estradiol hemihydrate. The molecule of estradiol hemihydrate in chemical structure is one of the closest molecules to natural estradiol among the molecules known to date, and nomegestrol acetate is a highly selective gestagen. All this minimizes the likelihood of undesirable phenomena.

The scheme of taking this COC is slightly different from the traditional one. Usually, birth control pills are recommended for 3 weeks in a row, and take a break for a week. Here, the pack contains 24 active pills containing hormones, and 4 placebo pills, which are needed only to make it easier to count the days.

This makes withdrawal bleeding shorter, which replaces menstruation while taking COCs. Often, after six months of use, it disappears completely, which can scare many young women, but, in fact, it is not at all a cause for concern.

Advantages

• the hormone molecule is as close to natural as possible.

disadvantages

• 'menstruation' may disappear,
• high price.

Possible side effects of COCs

In this section of the rating, we have collected only low-dose drugs – that is, tablets containing the minimum amount of hormones. But with all the advantages, contraceptive pills, like any really effective medicine, can cause undesirable effects:

1. pain in the mammary glands;
2. headache;
3. spotting spotting;
4. decreased sex drive;
5. mood swings;
6. cholestasis;
7. swelling;
8. increased fatigue.

It must be said that the side effects when taking COCs are most pronounced in the first month and, as the body adapts to hormones, they subside – usually three cycles are enough for this. This is especially true for smearing secretions. But sometimes the cause of the daub is too low hormone levels. Then you need to look for tablets with a higher content of ethinyl estradiol (but not more than 35 mcg).

In any case, it is highly discouraged to interrupt the use of contraceptive pills in the middle of the cycle, you need to finish the package to the end. But, of course, when it comes to cholestasis, severe migraine or severe allergic reaction, this recommendation does not apply. In life-threatening conditions, which include those listed, you need to stop taking the medication immediately.

Who should not take COCs:

1. pregnant women;
2. lactating;
3. in the first 3 weeks after childbirth, women who do not plan to breastfeed;
4. smoking women over 35;
5. women who have undergone resection of part of the stomach or small intestine (the active substance simply will not have time to be absorbed completely);
6. with arterial hypertension (BP> 140/90);
7. with ischemic heart disease, stroke, complicated valvular heart disease;
8. with intermittent claudication;
9. if an operation is planned for more than half an hour with subsequent long-term restriction of mobility;
10. with a long stay in a wheelchair or paralysis;
11. women suffering from systemic lupus erythematosus with a positive test for antiphospholipid antibodies;
12. with migraines with aura and focal symptoms;
13. women with previous breast cancer or with a mutation in the BRCA1 and BRCA2 genes;
14. women with HIV receiving antiretroviral therapy, as these drugs reduce the effectiveness of COCs;
15. with complicated diabetes mellitus (diabetic angiopathy, neuropathy, retinopathy) or with a disease duration of more than 20 years;
16. with acute viral hepatitis;
17. with complicated liver cirrhosis (ascites, jaundice, encephalopathy, gastrointestinal bleeding);
18. with liver cancer.

As you can see, most of the contraindications are associated with the ability of COCs to increase the likelihood of arterial thrombosis. But such a completely natural state as pregnancy increases the likelihood of thrombosis by 10 times, and in the first three weeks after childbirth, it increases up to 100 times, while modern COCs – 2-4 times.

The best antiandrogenic pills

All COCs somehow have an antiandrogenic effect – the ability to reduce the effect of male sex hormones on the body, creating a completely artificial hormonal background. But some of them neutralize the influence of androgens more actively than others. It is these pills that are recommended for conditions of severe hormonal imbalance: increased hair growth (hirsutism), acne, polycystic ovary syndrome. Of course, they are much more in demand among young women, and adolescents with severe acne or excessively heavy menstruation are often prescribed in the absence of sexual activity. But COCs with an antiandrogenic effect are also necessary for mature women, so we included them in the rating.

Jess

Rating: 4.8

These contraceptive pills compare favorably with other antiandrogenic drugs with a low ethinyl estradiol content: 0.02 mg. Among the drugs with a similar effect, there is simply no second with such a small amount of estrogen – at least in Russia at the time of this rating.

Another positive point: the substance drospirenone at a dosage of 3 mg is used as a progestin. Drospirenone is one of the relatively new substances that has not only antiandrogenic, but also antimineralocorticoid effect. That is, not only does it not cause weight gain, which is often feared by women who start taking COCs, but can also contribute to its reduction. In addition, drospirenone helps to normalize the serum lipid profile, which, again, is useful after 30 years of age.

Among the shortcomings, it should be noted the high price. Cheaper funds with a similar composition – Dimia, Model Trend.

Advantages

• low hormone content,
• prevents fluid retention,
• can promote weight loss.

disadvantages

• high price.

Yarina plus

Rating: 4.5

This drug is in many ways similar to the previous one – similar active ingredients, but the amount of estrogen is slightly higher (0.03 mg versus 0.02 mg for Jess). On the one hand, this can increase the frequency of undesirable effects, on the other hand, it is precisely such drugs with a slightly higher content of ethinyl estradiol that can be indispensable for women in whom microdosing drugs cause spotting spotting in the middle of the cycle. But this is not the main feature of Yarina Plus.

The main benefit of these birth control pills is the addition of folate, a vitamin that is responsible for blood formation in adults and the formation of the brain and spinal cord in the fetus. Usually, against the background of a long intake of COCs, the amount of folic acid in the body is disturbed, and it is recommended to drink a course of vitamins before planning a pregnancy. With this drug, you can get pregnant right after you stop taking the contraceptive pill.

Advantages

• replenishes folic acid deficiency.

disadvantages

• high price.

We did not include such a well-known drug as Diane 35 in this rating because of the large, in comparison with other drugs, the amount of ethinyl estradiol (0.035 mg or 35 μg): these contraceptive pills have been around for many years and in the presence of more modern, low-dose and effective COCs, remember there is no point about him.

The best progestogen contraceptive pills

These hormonal contraceptives contain only analogues of the female hormone progesterone. They are no less effective than COCs, but much more demanding on the regularity of taking: a delay of even 3 hours in relation to the usual time of use requires additional protection measures for at least 2 next days. When using pure progestins, intermenstrual discharge appears much more often than when using COCs, and the cycle itself becomes difficult to predict: there are 28 tablets in the package that you need to drink without interruption, and somewhere in this period of time, a menstrual reaction occurs – or does not come at all .

On the other hand, due to the lack of estrogens, which cause most of the side effects of COCs, progestins are safer. They can even be taken while breastfeeding and is often the only available way to avoid having too little time between births.

Charosetta

Rating: 4.7

Sodargite 0.075 mg (75 mcg) desogestrel. It is a synthetic analogue of gestagens – hormones that are produced during pregnancy. It does not affect the activity of lactation and very little penetrates into breast milk, therefore, these contraceptive pills can be used during breastfeeding. For women over 30 years old, the drug can be useful in the case when it is impossible to take combined contraceptives containing both progestins and estrogens – the latter have much more contraindications.

Of the shortcomings, it is traditionally necessary to indicate a high price. Cheaper analogs: Laktinet, Diamilla, Model Mam.

Advantages

• few contraindications,
• can be used while breastfeeding.

disadvantages

• high price.

Excluton

Rating: 4.2

Another contraceptive pill that has proven itself for at least a decade. Contains 0.5 mg of linestrenol.

There are many good reviews for the tool and it is perfectly tolerated, but the picture is spoiled by a very high price (almost 3 thousand per pack) in the absence of cheaper analogues.

Advantages

• can be taken by nursing
• good tolerance

disadvantages

• high cost.

Like COCs, progestins can also cause side effects:

1. irregular cycle;
2. nausea;
3. weight gain;
4. acne;
5. headache;
6. mood swings.

Contraindications to the use of progestin-only contraceptives:

1. pregnancy;
2. arterial thrombosis in the acute phase;
3. cardiac ischemia;
4. stroke;
5. systemic lupus erythematosus with a positive test for antiphospholipid antibodies;
6. breast cancer, including in remission;
7. decompensated cirrhosis of the liver;
8. malignant liver tumor;
9. vaginal bleeding of unknown origin;
10. taking some anticonvulsants, antiretroviral drugs (you need to check the instructions), rifampicin.

Best emergency contraceptive pills

These birth control pills contain fairly high doses of hormones, so they cannot be used continuously for contraception. But they are irreplaceable in emergency situations, such as a broken condom, a mistake during interrupted intercourse, rape.

Technically, in such cases, you can take conventional progestin-only or combined contraceptives containing levonorgestrel – just a few tablets at once, so that the total dose of the hormone reaches 1.5 mg. But if you use COCs for this, the oza of estrogen will also be extremely high, which can provoke thrombosis and other dangerous complications. Therefore, it is better not to risk it and buy 1 required pill.

Emergency contraceptive pills are most effective in the first 3 days after unprotected contact, but you can use them within 5 days, although the likelihood of unwanted pregnancy will increase significantly.

Escapel

Rating: 4.1

These pills cannot be used constantly as contraceptives in any case. This is a means for emergency contraception, situations when unprotected sexual intercourse for some reason happened, but pregnancy and childbirth are not included in the plans.

Contains a high dose of hormones: 1.5 mg of levonorgestrel. For comparison: the Model Libera mentioned at the beginning of the ranking contains 0.1 mg of levonorgestrel, that is, 15 times less. This amount of hormones is needed to slow down ovulation (release of an egg from the ovary), if contact occurred in the first half of the cycle, or to make the uterine lining unsuitable for egg implantation. But it is with this high content of hormones that a rather large number of side effects are associated:

1. vomiting
2. headache,
3. dizziness
4. lower abdominal pain
5. bleeding.

The drug should not be taken in severe liver failure and adolescents under 16 years of age.

Advantages

• protects against unwanted pregnancy,
• a small number of contraindications.

disadvantages

• high probability of undesirable phenomena.

Zhenale

Rating: 4.0

These birth control pills contain not an analog, but a progestogen antagonist: 10 mg mifepristone. The result after application is the same: if ovulation has not yet occurred, it is blocked, and in case the egg has already left and fertilization is possible, the drug causes rejection of the uterine mucosa (approximately the same process occurs during normal menstruation), after which the fertilized egg cannot be implanted can.

On the Internet, you can find the opinion that the drug is not hormonal and therefore safer than Escapel, but this is fundamentally wrong – hormone antagonists change the normal background in the same way as their counterparts.

In general, the reviews about these contraceptive pills are not bad, undesirable effects are rare. But somewhat more often, in comparison with drugs based on levonorgestrel, there are reviews about the ineffectiveness of the drug, even if taken correctly.

Possible side effects:

1. abdominal pain,
2. nausea,
3. vomiting
4. diarrhea,
5. exacerbation of 'female' inflammation,
6. headache,
7. weakness.

Contraindications for use: adrenal insufficiency, renal or hepatic insufficiency, the use of glucocorticosteroids, anemia,

porphyria, a blood clotting disorder.

Possible analogs: ginepristone.

Advantages

• prevents unplanned pregnancy.

disadvantages

• may not work.

Postinor

Rating: 3.9

Rating: 3.9.

The active substance is similar to the active substance of Escapel, but its amount is exactly two times less. And if it is enough to take Escapel once, then Postinor will have to be drunk twice, and the second pill – exactly 12 hours after the first, which can be extremely inconvenient. Or, ignoring the instructions, take two tablets at the same time, remembering the dosage of similar drugs.

Advantages

• protects against unwanted pregnancy.

disadvantages

• side effects often occur.

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Attention! This rating is subjective and does not constitute an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.