7 best contraceptives

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.

Family planning is a very important factor in the harmonious development of modern society. And contraceptives play an important role in this. Modern medicine has a rich arsenal of various contraceptives and methods of protection. In the first place is sterilization, in which, for example, a vasoresection operation is performed in men. This method guarantees a 100% result, but at the same time, having children, alas, in the future is no longer possible.

There are various means of intrauterine contraception, the so-called spirals, there are hormonal injections, barrier methods of contraception. The most famous member of this group is the condom. As you know, its advantage lies in the fact that only it is able to protect not only from fertilization, but also from infections that are sexually transmitted. But if a condom breaks accidentally, a lot of different problems can arise. Many women use the natural calendar method, when sex is possible only during a safe period, but the effectiveness of this method is unlikely to exceed 60%.

Interrupted intercourse is able to protect against fertilization in 80% of cases, but it is associated with known inconveniences, and with constant tension during intercourse. Various agents are also used that destroy spermatozoa – spermicides. They are available in the form of various creams, suppositories and tablets, injected intravaginally and physically destroy male germ cells. The effectiveness of this method also does not exceed 70%.

Therefore, modern women prefer oral contraceptives, namely pill hormonal drugs, and the effectiveness of their use, if indicated, is more than 99%. In terms of reliability, they are in second place after sterilization. Therefore, this rating includes modern drugs from the group of oral contraceptives, which are of high quality and effectiveness, actively prescribed by gynecologists. Prices for drugs are given for the fall of 2018, for pharmacies of various forms of ownership located in large cities of the Russian Federation. It will also cover emergency contraception, injectables and topical products.

Rating of the best contraceptives

Nomination	a place	Name of product	price
Best oral contraceptives	1	Monophasic COCs	956 r
	2	Two-phase COC	529 r
	3	Three-phase COC	267 r
The best emergency contraception	1	Escapel, (Postinor) = levonorgestrel	394 RUB
	2	Mifegin, Agesta, Ginepristone, Zhenale, Mifolian (mifepristone)	310 RUB
The best contraceptives for topical use: creams, rings, spirals	1	Pharmatex (benzalkonium chloride)	237 r
	2	Spiral 'Mirena'	RUB 9 190

Best oral contraceptives

First of all, people without medical education are perplexed by the very name of this group of drugs. Oral contraceptives have nothing to do with oral sex, simply translated from Latin, 'oral' or 'oral' use of any means means application through the mouth. All tablet preparations are administered orally, that is, inside. And contraceptives got a shorter name.

There are several types of these birth control pills. The first large and most popular group is combination drugs, which include two different female hormones – estrogen and progesterone derivatives. They were called COCs, or combined oral contraceptives. If in the composition of the drug there is only an analogue of progesterone, then such contraceptives are called gestagens, and have a second name – mini-pills. They are usually assigned to those women who are breastfeeding.

All medicines also differ in the amount of hormones that are present in them. It is known that a woman's menstrual cycle proceeds with cyclical changes in the concentration of hormones in the blood. In the first phase of the cycle, estrogens predominate, and in the second phase, progesterone. In the event that, regardless of the phase of the cycle, pills with the same hormone content are used, then such a contraceptive is called monophasic. If the amount of hormones in the tablets and their ratio changes in accordance with the day of the menstrual cycle, then such contraceptives are called two – or even three-phase.

The amount of estrogen in the pill is very important. Estrogen is normally secreted by the ovaries and regulates a very large number of various processes in the female body. Therefore, contraceptives are low in estrogen, high in, and with micro doses of this hormone. The latter group of contraceptives is most suitable for young women who have not yet given birth, but drugs with a high dosage of estrogen, for example, 50 mcg per day, are suitable not only as a means of contraception, but also for the treatment of certain diseases.

Consider the most popular and frequently prescribed contraceptive drugs from the group of oral contraceptives. Unlike drugs that are intended for the treatment of diseases, for example, cough suppressants, all the instructions for these drugs are very long, many-page, and contain a lot of very detailed, but extremely important information for the doctor. This is due to the fact that hormones affect almost all stages of metabolism in the female body. Therefore, information about each drug will be given without unnecessary details. Those who are interested in the details should definitely read the official instructions.

Monophasic COCs: Yarina (Jess, Leia, Midiana, Anabella, Vidora, Delsia, Dimia) = drospirenone + ethinyl estradiol

Rating: 4.9

Usually, in accordance with the standard, each package of any product has a designation according to which scheme the tablets are used. This is important for two-phase and three-phase COCs, since the tablets contain different amounts of hormones, and tablets from these groups are even marked in the same package with different colors. But for monophasic COCs there is no difference which pill and on which day of the cycle to take, because all pills are the same. It is very convenient.

Yarin's drug and its analogs are monophasic COCs from the low-dose group. Yarina and her analogs work by increasing the viscosity of cervical mucus and by suppressing ovulation. You need to use the drug every day for 21 days, and preferably at the same time of day.

The drug begins to be taken strictly on the first day of the cycle – and this is the first day of the onset of menstruation. The package contains 21 tablets. After a woman has completely drunk one package, it is necessary to take a week break. During these seven days, a slight bleeding develops that resembles menstruation, which gynecologists call withdrawal bleeding. This most often happens two or three days after the last tablet has been taken.

A week after the cancellation, you should continue taking the drug by purchasing a new package. If a woman did not have time to start taking this remedy on the first day of the cycle, then she can catch up and start taking the drug on days 2, 3, 4 and even 5 of the cycle. But at the same time, during the first week of admission, it is necessary to use other means of contraception, for example, the use of spermicidal drugs, a condom, or interrupted intercourse. The fact is that the contraceptive effect of all contraceptives does not work immediately.

In the event that a woman missed taking a pill, but this delay was less than 12 hours, nothing bad will happen. But at the same time, it is imperative to make up for the missed dosage, and the next pill is taken as usual. And if a woman simply forgot to miss an appointment, then contraceptive protection will already be significantly reduced. The closer this accidental skip to the end of the course of treatment and to the beginning of the seven-day break, the higher the risk of unwanted pregnancy. As it follows from the above, taking the pills is quite simple, but it is very important to know these prerequisites.

The well-known German manufacturer Schering-Plow produces Yarina's drug, one package containing 21 tablets costs, on average, 970 rubles. But the drug Midiana, which is produced by the Hungarian company Gedeon Richter, will cost from 540 rubles with the same dosage, the number of tablets and decent quality.

Advantages and disadvantages

Yarina's big plus, despite the fact that she is mentioned in the instructions only as a contraceptive, is a pronounced antiandrogenic effect. By reducing the concentration of male sex hormones, Yarina is good at helping with acne, or treating acne. Therefore, this agent can be prescribed as part of complex therapy for the treatment of severe acne. The action of the drug is to reduce the production of sebum, in an antiseborrheic effect. At the same time, Yarina is contraindicated in all thrombosis, in complicated diabetes mellitus, in persons with severe liver and kidney diseases, during breastfeeding.

Biphasic COCs: Anteovin (Bifazil, Sequilar) = Levonorgestrel + Ethinylestradiol

Rating: 4.8

The drug Anteovin belongs to biphasic oral contraceptives. One convolution (blister) contains 21 pills, a box contains three convolutes, that is, 63 pills. Anteovin is presented in white and pink tablets. The white tablet contains the same amount of 2 hormones, and the pink tablet contains fewer gestagens and the same amount of estrogen.

It is necessary to use Anteovin in the evenings, every day, one tablet at a time. For contraception, the ideal start is from the first day of your period, but you can start taking it until the fifth day. For the first 11 days, only white pills are taken, and then pink pills for 10 days. Thus, the entire convolution with 21 tablets is consumed. This is followed by a seven-day break with the bleeding already described, similar to menstruation, and they begin to use the pills from the second convolute. Accordingly, one box of the drug is designed for three menstrual cycles, and approximately corresponds to three months of admission.

The manufacturer indicates that a reliable effect from the use of the drug develops only in the second cycle, that is, when using the second convolute. If you use this remedy regularly and without gaps, then even during the required weekly break, the effect of contraception will be preserved. As in the case of monophasic drugs, if you skip a pill, you need to take it as soon as possible, but if more than 36 hours have passed between doses, the contraceptive effect is greatly reduced. In case of planning a pregnancy, it is necessary to cancel the drug for 3 months, and use already non-hormonal contraceptives.

Advantages and disadvantages

Like many other hormonal drugs, Anteovin is contraindicated in hepatic and renal failure, in malignant tumors, severe vascular diseases, in migraines, and high cholesterol levels. Side effects may develop dyspeptic disorders, headache, decreased libido and increased body weight. But, as a rule, if such side effects occur and the subsequent consultation of a gynecologist, it is quite possible to replace the drug with another, or switch to a monophasic contraceptive. The advantage of a biphasic contraceptive is a milder physiological effect in relation to the development of these effects, since its use in various dosages corresponds to fluctuations in hormones in the body.

Three-phase COC: Tri-regol (Rigevidon, Minisiston) = levonorgestrel + ethinyl estradiol

Rating: 4.7

As a rule, many three-phase oral contraceptives contain the word combination 'three'. In addition to Tri-regola, they include Triquilar, Triziston, and similar names. Unlike two-phase contraceptives, three-phase contraceptives have three types of pills, and in the case of Tri-regol, one package of 21 pills contains pink, white, and dark yellow pills, with different hormone levels.

It is necessary to start taking it in the following sequence: 6 pink tablets, 5 white tablets, 10 dark yellow ones. After the pills run out, you need to take a standard seven-day break, and then start the next cycle by purchasing a different package. All of the above remarks regarding accidental skipping and starting of the first tablet remain valid for this medicinal product. Tri-regol is produced by the Hungarian pharmaceutical company Gedeon Richter, and the cost of one package is, on average, 260 rubles. Such a relatively low price for drugs in this group is due to the need to accurately follow the sequence of taking the pills.

Advantages and disadvantages

A low and affordable price is an advantage of all three-phase oral contraceptives, as well as good tolerance with rare development of side effects. The disadvantage is the need to take pills according to their color, sometimes it is inconvenient. Contraindicated Tri – regol with a high degree of arterial hypertension, gynecological bleeding, with generalized herpetic infection, severe liver and kidney disorders, with a tendency to thrombosis and malignant neoplasms of the mammary glands. It is also contraindicated to take Tri-regola while breastfeeding.

The best emergency contraception

These drugs are not taken before intercourse, but after everything has happened. There are plenty of cases. These are confused days of the cycle, a torn condom, violence made on a woman. The modern pharmaceutical industry produces a rather limited range of these drugs, and currently the most popular are drugs based on levonorgestrel and mifepristone.

Escapel, (Postinor) = levonorgestrel

Rating: 4.9

Escapel contain 1.5 levonorgestrel, and Postinor – half the dosage of a synthetic analogue of progesterone. It has a strong contraceptive effect. This remedy suppresses not only ovulation, but also fertilization. The woman undergoes changes in the endometrium, which can lead to its rejection and prevent the implantation of the egg. In the event that the egg has already been implanted into the myometrium, this drug, like Postinor, will no longer have the desired effect. Therefore, the maximum period after intercourse, when the agent can act, is no more than three days. On the first day, the effectiveness of emergency contraception is 95%, and on the third day it decreases to 60%.

To prevent pregnancy, it is necessary to take one pill orally, and if, after taking the pill, a woman vomited, then another one should be taken, if vomiting occurred no later than 3 hours after ingestion. Levonorgestrel-based drugs can be used on any day of the menstrual cycle. Escapel is produced by the Hungarian pharmaceutical company Gedeon Richter, and the cost of a package with one (!) Tablet is, on average, 415 rubles. Postinor, produced by the same company, costs, on average, 330 rubles, but already for two tablets.

Advantages and disadvantages

There is no need to talk about the advantages of these drugs. The situation is urgent, and the side effects that may occur occur, and quite often. Despite all the admonitions of gynecologists, these drugs have always been used, and will be used, although they are far from harmless. Their action is based on a shock dosage of hormones, which not only prevent unwanted pregnancy, but can also significantly harm the female body. Most often, after using these drugs, symptoms such as various bleeding occur, and the cycle may not be restored for a long time. Also, a woman may experience allergic side effects, vomiting quite often occurs, which makes her take a second pill. Perhaps, this is precisely the advantage of Postinor over Escapel, since there are two tablets in the package. After taking these drugs, there may be a delay in menstruation, pain in the lower abdomen and other unpleasant symptoms appear. Naturally, you can be advised to avoid situations that may lead to the need to use these funds.

Mifegin, Agesta, Ginepristone, Zhenale, Mifolian (mifepristone)

Rating: 4.8

Mifegin, and its analogs containing mifepristone, are an amazing example of dialectics in pharmacology. The remedy serves both for the destruction of life and for its appearance. What does it mean? The action of this agent is associated with the blockade of progesterone receptors, and therefore the abortion occurs, but already at the stage of formation of the ovum. That is why Mifegin and its analogs are not effective for 3 days, like Postinor or Escapel, but up to 42 days of absence of menstruation.

But these drugs have a second indication for use. They also help induce labor in a full-term pregnancy. Under the influence of this drug, the excretion of the fetus from the mother's body is induced, only not in the form of an early miscarriage, but in the form of normal childbirth. Therefore, it should not be surprising that these drugs are prescribed for women in the later stages.

It is necessary to take the drug for abortion under special conditions. Indeed, at such a late date, a woman is already going to provoke a miscarriage. Termination of pregnancy is carried out in the presence of a doctor, and within 2 hours after a woman has taken 3 tablets of Mifegin, 200 mg each, she should be under nursing control within 2 hours. Not later than two days later, it is necessary to perform a control gynecological ultrasound of the uterus. After follow-up, a chorionic gonadotropin test is performed to confirm mifepristone-induced miscarriage.

Mifegin is produced by the French company Laboratory Macros, and this tool is the most expensive – it is an original drug and a high-quality substance. A pack of 3 tablets can be purchased at a price of 3650 rubles. Cheap analogues, which have the name Ginepristone and Zhenale, can be purchased for about 420 rubles. per package in one tablet, but the dosage will not be 200 mg, but 100 mg. Since a woman needs to take 6 tablets at once, this will require an amount of 2520 rubles. As you can see, the difference in price is only one thousand rubles, but the difference in quality between the original and local generics can be colossal. And with such indications, you cannot save money, this is not the choice of a plaster for gluing a finger.

Advantages and disadvantages

The colossal and indisputable advantage of mifepristone is the ability to terminate a pregnancy up to 42 days after fertilization. But there are also serious contraindications. This is the use of corticosteroid hormones, significant impairment of liver and kidney function, decreased blood clotting, and the presence of inflammatory gynecological diseases (colpitis, cervicitis) in the acute stage. These contraindications are due to the fact that a woman will have to endure a miscarriage, and it will always be accompanied by bleeding.

This remedy is also categorically contraindicated if there is a suspicion of an ectopic pregnancy. You can not use this drug if pregnancy is not confirmed and proven by taking an analysis for hCG and using ultrasound. There are other, special contraindications, but this topic is so complex and responsible that in each specific situation the obstetrician-gynecologist will determine them and prescribe something.

The best contraceptives for topical use: creams, rings, spirals

This section of the rating includes funds with very different activity. These are spermicides that destroy sperm and are introduced into the vagina in the form of capsules, tablets, as well as in the form of suppositories or cream. The effectiveness of these drugs is slightly lower than that of hormonal contraceptives, and is about 70%. Therefore, it is desirable to use them in conjunction with other methods of contraception. The use of a special hormonal ring, which is also presented in the ranking, is considered highly effective. Finally, women use intrauterine contraceptives (IUDs), colloquially called coils, which are also sources of hormones that are released in micro doses. The use of intrauterine devices is a separate large topic, but since, nevertheless, these devices are also used locally, the spiral is placed in the rating of contraceptives in this section, although with the same right both the spiral and the ring may be in the list of hormonal drugs.

Pharmatex (benzalkonium chloride)

Rating: 4.9

This is a classic example of a spermicidal drug whose active ingredient is benzalkonium chloride. It immobilizes and destroys male reproductive cells, and is used in capsules, tablets, in the form of a cream and in the form of vaginal suppositories, or suppositories. In addition to the contraceptive, the drug has a moderate antiseptic effect.

The woman herself chooses which form to use, but certain conditions will be required. Both tablets and capsules, cream and suppositories are inserted deep into the vagina 10 minutes before the expected sexual intercourse. Only candles can be used 5 minutes before intercourse. In this case, the duration of protection is different. The use of capsules and suppositories protects for 4 hours, the tablets act for three hours, and the cream works for up to 10 hours. This is due to the fact that the cream is injected using a special dispenser, and very well lubricates the entire surface of the vagina, as well as the structure of the cervix. In the event that a second intercourse is planned, then, despite the fact that the protection time has not yet ended, it is necessary to reapply the drug.

Pharmatex is produced by the French company Innotech, and the cost of a pack of 10 capsules, a suppository is 500 rubles, a pack of 12 tablets is 340 rubles, a tube of cream weighing 72 g costs 500 rubles, and a pack of 6 vaginal capsules can be purchased for 400 rubles.

Advantages and disadvantages

Pharmatex, as well as other topical spermicides, has a large number of both advantages and disadvantages. A big plus will be the ability to use them if a woman has contraindications to the appointment of hormones, or to the setting of a spiral. Pharmatex is very useful for rare sexual intercourse, when it is not necessary to load the body with the constant use of hormones. Spermicides work at any age, as well as during breastfeeding, there are no contraindications for use. Cream and suppositories help to significantly moisturize the surface of the mucous membranes, and facilitate intercourse. Spermicides are good to use if a woman constantly uses combined oral contraceptives, but accidentally missed a pill, and this omission came close to the planned withdrawal period, and then this second method reduces the chances of unwanted pregnancy.

The disadvantages of Pharmatex and other spermicides can be considered a gross psychological defect: sexual intercourse must be planned, and spontaneous intimacy, which is born of desire, is impossible. A woman is forced to refuse her partner for at least 5 or 10 minutes, and during this time a lot can happen, and then intimacy may not take place at all. The second disadvantage is the possible development of local allergic reactions. This is the appearance of irritation or itching on the mucous membrane of the female genital organs, and even on the surface of the partner's penis. But such reactions are rare, and therefore it is safe to recommend these safe drugs, especially for combined contraception.

Vaginal ring Novaring (ethinyl estradiol + etonogestrel)

Rating: 4.8

Novaring is a representative of hormonal drugs, but only applied topically. Therefore, it could be described in the section on hormonal contraceptives. The conditions of use, schemes and all kinds of terms remain very similar, as with KOC. After all, the vaginal ring, made of plastic, is impregnated with hormones, almost the same that are part of combined oral contraceptives. The ring is colorless, smooth and transparent. It works in the same way as pill oral contraceptives – it suppresses ovulation.

A woman can independently insert this ring to herself, after squeezing it with her fingers, and straightening it inside the vagina. The ring should be firmly held inside, and the position of the ring is not of great importance for contraception. After the introduction, a rather long period is required for the hormones that the ring secretes to have a contraceptive effect. This period is 3 weeks. After the expiration of this time, it is necessary to remove the ring, and on the same day of the week when it was delivered. The exact time must also be observed. For example, if a woman put the ring on Monday at 6 pm, then it must also be removed on Monday, at 6 pm exactly 3 weeks later. This is followed by a weekly break, and then at the same time on Monday at 6pm a new ring is introduced and the cycle repeats.

During the week, while the ring is gone, there is the same bleeding, similar to menstruation, which occurs with a planned omission in taking combined oral contraceptives. There are many subtleties and peculiarities (switching to the use of a ring after stopping oral contraceptives, postpartum period), but all this should be explained at the reception of the attending physician – gynecologist.

The well-known company Organon produces the Novaring vaginal ring, and you can purchase a set of three rings designed for use within 3 months at an average cost of 3240 rubles. You can also buy packaging with just one ring. This is justified for a short period during which such a method of contraception is planned, for example, associated with the planned cancellation of pill contraceptives. The average cost of a package containing one ring is 1230 rubles.

Advantages and disadvantages

This method of contraception has both pros and cons. For example, the 'enter and forget' situation is a plus. For a month, the woman does not need to take any pills. The use of the ring may remain a mystery to the partner as the ring is not felt by the man. Finally, hormones practically do not enter the woman's body, and they all act locally, and their dosage is minimal. The ring also helps to normalize the menstrual cycle and makes menstruation less painful.

But still, it does not do without drawbacks. Some women physically cannot tolerate a situation when a foreign body exists inside their body, and this leads to neuroses. Also, a minus is a rather high price, contraindications, the list of which is long. These are all those diseases for which oral contraceptives are prescribed: thrombosis, decompensated diabetes mellitus, migraine, inflammatory diseases of the female genital organs, vaginal defects associated with its overstretching, prolapse of internal organs, when the ring simply does not hold and falls out. But in the event that a woman tolerates Novaring well, it will be an excellent way, and not only of contraception, but also the treatment of some endocrine gynecological diseases.

Spiral 'Mirena'

Rating: 4.8

In common parlance, this type of contraception is called a spiral or even a 'spiral'. In fact, it is a modern, high-tech intrauterine therapeutic system that allows the release of the hormone levonorgestrel in a precisely dosed amount – 20 micrograms per day. This hormone has a local effect and is not absorbed into the bloodstream. Mirena is a low-dose contraceptive, which is very important.

The Mirena spiral leads to a decrease in the sensitivity of hormonal receptors, and the inner surface of the uterus ceases to respond to the signal of estradiol, and therefore becomes unable to proliferate and to implant an egg. In addition, the cervical secretion becomes more viscous, which makes it difficult for sperm to penetrate inside and fertilization does not occur. In addition to contraception, the Mirena intrauterine device is used for various painful and heavy periods (menorrhagia), as well as for prophylactic purposes, when a woman is prescribed a large amount of estrogen for indications, and it is necessary to prevent hyperplasia, or significant growth of the endometrium.

The Mirena intrauterine device, once inserted inside, has its effect for 5 years. The system is installed by a specialist doctor who is trained in the installation technique, has experience with this type of contraception, so it will not be discussed here how the spiral is installed. For several months (1 – 2) following the installation of the spiral, the body reacts to it through heavy periods. This is normal and there is no need to be afraid of it. The Finnish division of the pharmaceutical company Bayer Schering Pharma produces the Mirena spiral, and its cost will be the highest of all the drugs that took part in the rating. The minimum price at which you can purchase a spiral is 10,900 rubles, and the average retail price in pharmacies of all forms of ownership is 13,000 rubles.

Advantages and disadvantages

Perhaps the most important advantage of the spiral is the local effect: the hormone does not affect any other organs, does not have a systemic effect, and does not enter the bloodstream. Contraceptive properties persist for a long time, and the degree of protection is high. After the spiral is removed, after almost one or two months, the woman restores the ability to conceive and pregnancy. The price of a spiral seems incredibly high, but if you decompose it into 5 years of use, then every day it will cost only 7 rubles. In addition, the use of Mirena makes it possible to prevent the occurrence of malignant neoplasms of the uterus and endometriosis, reduces pain during menstruation, and in the presence of myomatous nodes in the uterus, it stops their increase.

But still, there are downsides. Some women simply cannot afford to give such a large amount at once. If a woman often changes sexual partners, then the presence of any foreign body in the uterus (including the IUD) significantly increases the risk of inflammation, and then it will be necessary to remove the coil early. This spiral does not protect against sexually transmitted infections. You should definitely trust the installation of the spiral to an experienced specialist, because if the spiral is set incorrectly, then there may be a feeling of soreness and bleeding. Of course, there are contraindications, which include acute and chronic inflammatory diseases of the uterus and vagina, cervical dysplasia, chronic liver diseases, congenital heart defects and other conditions that must be determined by a specialist. But the Mirena intrauterine therapeutic complex is a modern and very effective means for preventing unwanted pregnancy, if all indications and contraindications are taken into account.

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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.