It’s hard to surprise anyone with the use of hormonal contraception, uncliding, but it’s easy to get lost in the myths that surround this topic. In the U.S. up to 45% of women 15-44 years old prefer hormonal contraception, while in Russia only 9.5% of women have ever used it. With the help of gynecologist and endocrinologist Valentina Yavnyuk, we looked into how it works, what therapeutic properties it has, whether it poses a danger to a woman’s health, and what feminism has to do with it.

What is hormonal contraception
A hallmark of the modern world is the large-scale movement to liberate the individual from various cultural, religious and social stereotypes. A significant part of this process has to do with women gaining reproductive freedom. This means that a woman regains the right to control her own body: to live the kind of sex life that suits her and to make her own decision about whether to become pregnant or to terminate an unwanted pregnancy. In many ways, it was the emergence and development of hormonal contraception that allowed women to take control of their bodies.

Hormonal contraception is a method of protection against unwanted pregnancy, which a woman can fully regulate herself. At the same time, its effectiveness is higher than all other variants of protection – if the rules of use are followed, of course. Thus, possible pregnancy becomes something that partners can consciously choose. However, such contraceptives do not protect against sexually transmitted infections – here the only way to protect yourself is the condom.

All hormonal contraceptives generally work on the same principle: they suppress ovulation and/or do not allow the egg to attach to the surface of the uterine mucosa. This is done by constantly supplying the body with small amounts of synthetic sex hormones. Suppressing ovulation plunges the ovaries into an artificially induced controlled “sleep”: they shrink in size and the follicles stop releasing eggs in vain.

How Hormones Work
Hormones are substances that actively influence all the functions of the human body. Yes, in most cases they improve skin and hair quality, stabilize weight and have many non-contraceptive benefits. Nevertheless, under no circumstances should you take hormones on your own, without consulting your doctor. Moreover, these drugs should not be prescribed by a cosmetologist or gynecologist without a referral to a gynecologist and endocrinologist.

Sex hormones are biologically active substances of our body, which are responsible for the development of male or female sexual characteristics. We have two types: estrogens are produced by the ovaries and from the beginning of puberty they form the female characteristics of the body, are responsible for libido and menstruation. Gestagens are produced by the corpus luteum of the ovaries and adrenal cortex and ensure the possibility of conception and continuation of pregnancy, so they are called “pregnancy hormones”.

It is these two types of hormones that ensure our monthly cycle, during which an egg matures in the ovary, ovulation occurs (when the egg is released from the ovary) and the uterus is prepared to carry the pregnancy to term. If fertilization does not occur, after ovulation the egg dies and the endometrium, the mucous covering of the uterus, begins to reject, which leads to the start of the period. Despite the opinion that menstruation is a “ruptured egg,” it is actually the rejection of the mucosa that causes the bleeding. An unfertilized egg does come out with it, but it is too small to see.

The main estrogen in the female body is the hormone estradiol, which is produced in the ovaries. A high concentration of estradiol in the blood in the middle of the cycle causes the brain to actively “turn on” the pituitary gland. The pituitary gland triggers ovulation and the production of the main gestagen, progesterone, in case of pregnancy. Hormonal contraceptives work like this: they suppress the ovulatory activity of the pituitary gland, which controls this whole complex process “from above”, and maintain stable levels of the pregnancy hormone progesterone. Thus, the pituitary gland rests from reproductive concerns, and the female body experiences a state of so-called false pregnancy: there are no monthly fluctuations of hormones, the eggs quietly “sleep” in the ovary, so fertilization becomes impossible.

There is another type of hormonal drugs. Gestagens in their composition change the quantity and quality of vaginal mucus, increasing its viscosity. This makes it harder for sperm to get into the uterus, and the altered thickness and quality of its coating excludes the implantation of the egg and reduces the mobility of the fallopian tubes.