Hormonal contraceptives

 Gender puberty  in a woman will manifest development secondary signs and the onset menstrual menstrual cycle cycle. All changes which _ complete his picture they are conditioned fluctuating by the secretion of  estrogens  and  gestagens  from the ovaries.

 Endocrine function ovaries  is controlled regular cyclical by washing out pituitary hormones : FSH ( follicle stimulating hormone ) and LH ( luteinizing hormone ). Macroscopically it is for beginning cycle considered menstruation ( bleeding ) conditional peeling upper ones layers uterine mucous membrane. 6th day rises secretion of FSH. Under his influence is running out starting up maturation follicle in the ovaries. Thecal cells follicles they produce estrogens. In the middle cycle they rise also LH levels. A follicle it snaps and releases egg into the cavity abdominal to near the fallopian tube. Cavity the follicle fills up blood and fluid ( corpos haemorhagicum ) later the cavity will fill proliferating cells theca (corpus luteum). At the same time rises production progesterone.

Endometrium in the first phase under the influence estrogens considerably proliferates ( phase proliferative ), after ovulation with an increase progesterone are increasing glands and the mucous membrane is ready for nidation eggs ( stage secretory ). If fertilization does not occur separation occurs _ upper endometrial layers - menstrual bleeding.

Estrogens
{{ Edit article| Estrogens } } { {: Estrogens }}

Progestogens
{{ Edit article| Progestogens } } { {: Progestogens }}

History contraception

 * Effort separate sexual life from conception the child is old like humanity itself - legendary biblical Onán - " anytime ". entered the woman, let out seed on the earth , that it should not beget offspring " ( Genesis 38.9 ) - mentioned biblical the hero does so stood inventor never masturbation , but the oldest contraceptive methods –  intermittent intercourse .
 * Advice old ones Egyptians : to introduce into the vagina different substances before intercourse : Petri 's papyrus, crocodile paste dung, elephant dung , oxen bile ,… Method established on principle killing sperm to this day used in contraceptives suppositories ( of course does not contain given substances ).
 * History modern contraception : 1921 – Haberlandt ( Austria ) si noticed that _ ovarian extracts _ pregnant women animals they can be used like contraception . To obtain doses for one however, the user would was 80 thousand needed ovaries.
 * Synthesis artificial ones of hormones - American chemist Russel Marker from the proceeds sure Mexican plants.
 * 1960 – on market first contraceptive tablet Enavid 10 - high content hormones - in one tablet estrogens for 10 days and progestogens on the 20

Intermittent have intercourse – coitus interruptus

 * Method it isn't too much reliable - up to 20% failure for year . Causes failure :
 * to escape sperm can milk even without a male orgasm ;
 * expulsion sperm outside vagina can be also source pregnancy ;
 * Mon ejaculation remains in the urinary tract tube a small amount sperm and at repeatedly have sex in the vagina few always gets.
 * The method should remain emergency a solution reserved for situations when _ already really nothing another available _ is not.

Method Ogino – Knausova

 * Counting fertile and infertile days . Method requires regular menstrual cycle and is recommended to monitor ovulation by measurement basal temperature.

Condom

 * He allegedly used it and famous Jacomo Casanova (1725–1798). Before the second world war with them only produced in the USA more than half past one millions annually . Today's world production is on level of 8.5 trillion pieces.
 * It is relative reliable and cheap protection . To a great extent measure protects and before transmission sexual diseases, therefore it is recommended mainly to those who they don't have constant partner.

Cervical pessary

 * bowl-shaped semicircular formation of plastic mass that is deployed _ on the cervix. Must have reasonable size which _ will recommend doctor . With us it isn't power taken.

Chemical contraception

 * Spermicidal creams and suppositories are introduced before have sex They are though medically harmless, harmless and light available , however relatively little reliable . They require experienced user and is more suitable like supplement others contraceptives methods to increase reliability.

Intrauterine bodies

 * Effective, long-term , comfortable and cheap method . Already in use many years and still doing well he doesn't know how exactly it works . She is suitable mainly for women who _ already gave birth . It isn't suitable for those who they have strong menstruation or often changes partners.

Two-phase hormonal contraception

 * Estrogen alone would not be enough, because it would grow mucous membrane uterus and irregular would occur bleeding and increased risk cancer . That's why to end cycle adds progestogen to prevent growth uterine mucosa and at the same time closed the cervix. Administration progestogens after the whole time is advantageous because _ mucous membrane uterus does not grow , the cervix is closed - it is double protection and so is possible reduce dose estrogens.

Single phase hormonal contraception

 * Each tablet contains dose estrogens with admixture progestogens.

Contraceptive patches

 * They are founded on the same principle like combined contraceptive pills . They don't increase risks vascular diseases and their effect they do not disturb antibiotics . They are however still Relatively expensive and technical imperfect . It is, however very perspective method with large the future.

Minipills

 * They are estrogen -free contain only small doses progestogens . They are suitable for breastfeeding women . They are used without a weekly allowance pauses and they can cause irregularity cycle . They report lower effectiveness.

Injections and Implants

 * They work on principle maintenance levels gestagens in the body.
 *  Depot injection  – po the skin is straightened suspension microcrystals that slowly _ _ they dissolve and secure so constant level progestogens on three months.
 *  Subcutaneous implants  – hollow rods which _ will ensure level progestogens in the body on several years.
 * It exists sure suspicion on increase risks osteoporosis, they destroy cycle.

Intrauterine contraceptive complex

 * Combination intrauterine body and implant . Highly effective method.

Postcoital contraception or Morning after pill

 * 1) Shocking filing increased doses hormones . That means 4 contraceptives tablets within 72 hours after intercourse and after 12 hours another 4. (It is a possibility administration of 8 tablets at once, but it is almost sure the lady would _ she refuted ).
 * 2) Submission higher doses progestogens . If was powder submitted within an hour after intercourse, one would be enough tablet . In the opposite the case after 12 hours follows the second

Mechanism effect
Combined preparations acts several mechanisms – the  primary  is inhibition ovulation,  secondary ' effects you can partition to " pre- implantation " ( they slow down motility fallopian tubes and cilia epithelium in them ),  periimplantation  ( it prevents by affecting the endometrium nidation ) and " post-implantation " ( will not prevent alone nidation , but maintenance pregnancy ). All described three second secondary effects they are post- fertilization, i.e. & nbsp ; abortive & nbsp ;- occurs at them to  death already fertilized eggs . Yet they weren't performed studies more precisely quantifying share secondary effects on final action hormonal preparations.

Toxicity
Toxicity contraceptive is important for the long term usage contraceptive during of life women.

Thromboembolic events
Main danger use contraceptive. Especially in detail they are described  thromboembolic events  (AIM, CMP, pulmonary embolization ) in the elderly women smokers, as familiar load thromboembolic malfunctions. Today is a risk occurrence these complications during therapy smaller compared to incidence _ during in pregnancy.

Carcinogenic effect
They exist convincingly evidence that _ these substances  reduce  the incidence of endometrial carcinoma and ovaries. Results in cancer breast are unconvincing. Carcinoma uterine suppository is probably unaffected. Risk was high in the elderly preparations with a higher content estrogens.

Different risks
Nausea, tension breasts , pain heads , pigmentation skin ,  acne , hirsutism. Undesirable effects they are substantially lower at use modern ones preparations with low content estrogens ( less than 50 μg /day).