The pill is the most used contraception in France. It is a hormonal contraception that prevents the release of eggs by the ovaries. There are several generations. What differences? Contraindications? How to take it? What to do in case of forgetting? What generation to choose? List and guide.
Most pills combine two types of hormones, identical to those produced by women: estrogen and progesteronehormones participating in the woman’s cycle. The different brands of pills contain different quantities of estrogen and progestogen. “”There are Estro -rogestative pillswhich contain low doses of estrogen and progestogen, and Progestive pillswhich contain only progestins“, Details Dr. Philippe Mironneau, gynecologist and obstetrician in Dijon. The pill is prescribed by a doctor or a gynecologistexcept in certain situations, during emergency contraception for example.
The contraceptive pill is completely free for minors aged 15 to 18. In this case, the prescription is confidential and protected by professional secrecy. There is no age to take the pill, she must be mentioned with her daughter when sex life begins. In addition, you have to wait for the rules to start taking it.
The pill replaces the natural cycle of the woman with an artificial cycle. “”The ovaries cease to release eggs, making ovulation and pregnancy impossible. The cervical mucus thickens, blocking the road to the sperm“, Explains Dr. Mironneau. The uterine mucosa becomes thinner, becomes incomplete, making it difficult to fix the fertilized egg to the wall of the uterus. The pill does not protect against sexually transmitted infections (IST).
| Pill names |
|---|
| 1st generation: Triella |
| 2nd generation: ADEPAL, AMANANCE GE, DAILY GE, EVANECIA GE, Evepar, Leeloo GE, LOVAPHARM, LUDEAL GE, Microval, Minidril, OPTIDRIL, OPTILOVA, PACILIA GE, SEASRIE, STEDIRIL, TRINORDIOL, ZIKIALE GeKIALE |
| 3rd generation: Antigone, Carlin, Cerazette, Cilet, Clareal GE, Cycleane, Desobel GE, Desopop, Diamilla, Efezial, Effiprev, Felixita, Harmonet, Holgyeme, Meliane, Melodia, Mercilion, Minerva, Minesse, Minulet, Moneva, Optinese, Phaeva, Sylviane, Tiafemi TRIMINOLET, VARNOLINE, |
| 4th generation: Belanette, Belara, Convuline, Drospibel, Jasmine, Jasmineur, Qlaira, Rimandia, Yaz, Zoely |
“If it is used perfectly, the contraceptive pill is more than 99.7%effective”specifies the specialist. However, different factors can decrease this efficiency: oversights, vomiting, diarrhea or interactions with certain drugs. In doubt, to avoid an unwanted pregnancy, it is imperative to use a condom.
• Estro -rogestative or combined pill
The estro -rogestative pill is one of the methods most often offered to women with no risk factor for its use. Its efficiency approaches 99% provided you take it regularly and correctly. “”Also called combined pill, it contains two hormone which are: an estrogen (often ethinylestradiol) and a progestin. He will not always be the same according to the pills“, Specifies the gynecologist. The estro -rogestative pill is contraindicated in the event of cardiovascular diseases, diabetes accompanied by complications (retinopathy, nephropathy, neuropathy …), obesity, severe blood pressure, headache or migraines accompanied by neurological symptoms, breast cancer, breast cancer, breast cancer The endless or suspected ending, of unexplained vaginal bleeding or liver disease.
• Progestive or micro -rogestative pill
Progesterone is the only hormone used in the micro -rogestative pill. The latter is mainly used for its contraceptive effect when the estro -rogestative pill is contraindicated, but also sometimes in first intention. Taking a micro -rogestative pill must be very rigorous, and must be done every day at the same time, even during the rules. The delay in taking should not, in the vast majority of situations, exceed 3 hours.
According to the progestin used, most of the pills have been divided into several classes or “generations”, there are different generations of pills which are marketed in France depending on the nature of the progestin (s) they contain. The term “generation” refers to the evolution of the composition of contraceptive pills and their estrogen and progestogen dosage over time. Side effects and health risks vary depending on the generations of the pill.
The pills of the pills have 21 or 28 tablets. For platelets with 21 tablets, 7 days are planned to be respected between the two plates. It is during this judgment that the rules arrive, often around the 3rd day of stopping. After 7 days of stopping, it is imperative to start a new brochure on the 8th day.
Special case: continuous pills. For platelets with 28 tablets, they take themselves without interruption. In some cases, the latest tablets will not be the same color and the rules will arrive at that time. The first time we take the pill, you have to start the first day of the rules.
In case of forgetting, the procedure depends on the type of pill. Taking a micro -rogestative pill must be very rigorous, and do yourself every day at the same time, even during the rules. The delay in taking should not, in the vast majority of situations, exceed 3 hours.
In case of forgetting of pill and unprotected report, a pregnancy can be avoided by taking the next day pill, also called an emergency pill. This next day pill is strongly dosed in progesterone.
The following undesirable effects are common to all of the oral oral procurement contraceptives (1st, 2nd, 2nd and 3rd generation) and depend on each woman: acne, weight gain, nausea, heavy legs, drop in libido, mastodynia (united or bilateral breast pain), dysmenorrhea (difficulty in the flow of rules), amenorrhea, bleeding (Meno-fees and spottings). THE Progestive pills Can cause amenorrhea, spottings (bleeding outside the rules) and poor cycle control. Please note, side effects can be specific to a pill brand : In this case, it is necessary to talk to your doctor about it. This can offer another pill brand containing different dosages or a change of contraceptive method.
Pill and rules
The combined pill makes ovulation disappear. The bleeding is less intense and less painful. When no break is made during the pill, the rules do not arrive. With the pill, ovulation is not deleted so the rules occur regularly, approximately every four weeks.
A woman who takes a pill, including a combined pill, does not ovule and does not have a real menstrual cycle. Continuous (non -sequential) micro progestogen pills (non -sequential) Do not always prevent ovulation.
Contractive pills are only available on prescription, except the so -called “emergency pill of the next day”. All oral contraceptives are registered on list 1, can be issued for a period of 3 months, and their prescription may have a duration of 12 months. The pharmacist can provide the pill for an additional period of 6 months maximum provided that:
- the period of validity of the order is expired;
- All of the prescribed contraceptives have been issued;
- The prescription dates from less than a year.
The nurse can renew the prescriptions of oral contraceptives under the same conditions. In total the duration of the pharmacist and/or nurse renewal cannot exceed 6 months. “In no case can a pharmacist refuse the issuance of contraception in the name of his moral or religious convictions. The pharmacist can recall the existence of an alternative of care also anonymous and free in planning or family education centers2 (CPEF)” recalls the High Authority for Health.
There are two types of oral contraceptives: Progestatives alone or cripprogestatives.
Progestatives alone (Lévonorgestrel, Déogestrel) : these pills have the advantage of having few contraindications Absolute: an evolutionary venous thromboembolic accident of less than 6 months, severe liver pathology, breast or uterus cancer, genital hemorrhage not explained. They can be used during breastfeeding.
Cripprogestatives: The pills of 3rd generation containing deogestrel or gestodene, and 4th generation containing Drospirenone, expose to a Increased risk of thromboembolic accidents Compared to pills containing Lévonorgestrel; They should not be used as a first intention. Cripprogestative pills present more contraindications Whether progestogen pills: venous or arterial thromboembolic accident (current or history), high blood pressure uncontrolled, diabetes with vascular complications, smoking after 35 years, Migraines with aura (whatever the age), estrogen-dependent tumors, liver tumors and severe hepatopathies. They must not not be used in principle during breastfeeding and are contraindicated during the first 3 weeks of postpartum.
Tobacco consumption is not recommended with taking a hormonal contraceptive.
The price is not the same for all pills. Social security distinguishes 1st, 2nd and 3rd generation pills. For the first two, the pill is reimbursed up to 65 % of the social security agreement rate when prescribed by a doctor for women over 18 years of age (from 15 to 18 years old, it is 100 % covered). For the 3rd and 4th generation, most are not reimbursed despite a medical prescription. From January 1, 2022, the pill will be reimbursed 100% for women until the age of 25 according to declarations by Olivier Véran on September 9, 2021.
An exception, a list of around twenty references. Find out with your pharmacist. Generally, it costs between 2 and 15 euros for a month.
Source: Oral hormonal contraception: dispensation in pharmacies. Updated in July 2019. Has been
Thank you to Dr. Philippe Mironneau, gynecologist and obstetrician in Dijon.
