Amenorrhea with mini-pills, fantastic!

2023-07-06 11:01:22

Amenorrhea with mini-pills, fantastic!

Progestogens are synthetic hormonal contraceptives that can be administered through different routes (oral, transdermal and vaginal), whose main mechanism of action is the inhibition of ovulation; which gives them high efficacy, always reversible after discontinuation of treatment.

These birth control pills, even more so in combination with estrogens, in addition to preventing pregnancy, are beneficial to counteract heavy bleeding during menstruation and dysmenorrhea (intense pain in the pelvic-abdominal area).

Progestogens differ in their ability to interact with androgen, glucocorticoid, or mineralocorticoid receptors.

“And among them, cyproterone acetate stands out, which is more antiandrogenic against acne; levonorgestrel, which reduces the possibilities of thromboembolism; and drospirenone, which causes less fluid retention”, explains Dr. Carmen Sala.

The new routes of administration of contraceptives, vaginal and transdermal, have allowed the appearance of preparations with lower doses and side effects, while maintaining safety and efficacy profiles.

In this sense, the treatment is not unique, but there are multiple possibilities of product combinations. In any case, must be completely individualized: a contraceptive for every type of woman.

“Freedom, freedom”, song top of the minipills

“If we take into account different studies, for example the annual surveys on contraception prepared by the Spanish Contraception Society (SEC), around 70% of women in the fertile stage would improve their quality of life if they decided not to have their period,” he says.

To arrive at this observation, the conclusions of the SEC Contraception Survey in 2022 can be analyzed, in which 1,800 women between the ages of 15 and 49 participated, answering 36 specific questions, including sociodemographic variables.

71.2% of the women surveyed admit to having some affectation during this physiobiological period; 45% require pain medication. This percentage rises in women under 25 years of age: 60% between 20 and 24 or 56% in the range from 15 to 19.

37.6% of women have difficulties leading a normal life as a result of pain and/or bleeding. This percentage rises to 52.5% among women between 20 and 24 years of age. In addition, those under 25 are the ones who suffer the most pain and/or bleeding for four days or more.

33.4% of women have ever felt the need to request sick leave or not attend their activity as a result of pain and/or bleeding during menstruation.

In this sense, 53.7% consider that requesting sick leave or not going to work during menstruation can have employment consequences.

“More than half of these women surveyed affirm that they menstruation alters your moodand four out of ten that interferes with their work, studies or sports practice. 16.8% suffer pain that we call absenteeism, that is, the woman has to rest at home“, highlights Dr. Sala.

POP, virtuoso in amenorrhea

“The Progestogen-Only Pill (POP) contraceptive treatment is still not very popular among women who have their period, either because they are not well informed or because it seems strange to them, at least, a vital situation in which they lose menstruation voluntary,” he says.

On the other hand, all women are perfectly familiar with combined contraceptive pills, estrogen and progesterone.

Who among us has not talked with a friend about the well-known 7 days of the period and 21 days of the pill, and so on, with the mandatory breaks!, she points out.

“But the POP of the minipills has come to stay. It is fantastic and phenomenal ”, applauds Dr. Sala, a specialist in women’s quality of life, in her own style.

“It is a contraceptive made only from progestogens that when administered in the form of pills we will do so by taking 1 every day for 28 days, without interruption, and starting again; without rest, ”he describes.

“And if this daily format is not comfortable for you, woman, then there is no problem. You use the Mirena intrauterine device (DIU) that releases hormone progestin… Your ‘gine‘ He puts it on you during the duration of the summer song and amenorrhea triumphs for five long years”, he comments.

Subcutaneous progesterone implants are also offered, usually placed in the upper arm.

And for which women is the treatment that favors amenorrhea intended?

“First, to those who cannot take estrogen. Second, to women who are breastfeeding their baby, since combined hormonal pills are contraindicated. The progestin does not affect breast milk or the development of the baby”, answers the Catalan gynecologist.

In turn, it is indicated for women over 35 and smokers. Also, for obese, hypertensive, diabetic or recurrent migraine women.

And it should be emphasized that the minipills They are easy to use, are sold in pharmacies and do not interrupt a couple’s sexual relations.

In this regard, and according to the SEC survey, 86.5% of women have sexual relations with some frequency; of them, 27.6% one or two days a week; 19.5% three or four times a week; 17.9% between two and three times a month and 3.5% every day.

In comparison, 13.8% practice sex with a partner much less frequently, of which 5.9% never make love.

The SEC also includes data on the average total number of sexual partners that the surveyed women have, which stands at 1.4 partners.

This average rises in women under 30 years of age: from 1.8 couples among those between the ages of 15 and 19 to 1.5 among those between 25 and 29. The average decreases to 1.3 among women of 35 to 39 and goes to 1.1 in the over 45s.

“A marvel of pills; they are prodigious for many women ”, she reiterates.

“This POP treatment removes your period for at least five years, if that is your wish; and, furthermore, it is almost one hundred percent effective against unwanted pregnancy, ”he establishes.

Even so, I must focus on the prevention of infections and sexually transmitted diseases (STIs and STDs), especially in adolescents and young women.

The condom, a barrier method, is synonymous with freedom in couple relationships. It is essential to prevent STIs and pregnancies. It is better to act cold for a few seconds than regret forever.

Love and sexual desire need to apply an infallible method for physical and emotional orgasm: 100% satisfaction with 100% security.

Dr. Carmen Sala Salmerón, gynecologist, obstetrician and pelvic floor expert at the Gine-3 Clinic in Barcelona who always looks you in the eye with a smile to tell you the truth, even if it is uncomfortable