Contraceptives for mastopathy: mechanism of action and effect

HomeTreatment and preventionEffective treatment of fibrocystic mastopathy - drugs for complex therapy

Every year more and more women are faced with certain diseases of the mammary glands. Many pathologies, in particular breast cancer and mastopathy, have become significantly younger; fibrocystic mastopathy affects more than half of women over 40 years of age. Modern medicine has a wide range of tools to combat these pathological conditions.

Principles of treatment of mastopathy

With the development of nodular mastopathy, surgical intervention is indicated, and to treat the fibrocystic form of the disease, hormonal and non-hormonal drugs are used, the most effective is complex therapy . The main objectives of conservative treatment are to reduce pain in the mammary glands, reduce the size and density of tumors, restore normal hormonal levels, and prevent cancer.

In the presence of gynecological, endocrine and other diseases that contribute to the development of mastopathy, appropriate therapy is prescribed. All modern drugs for the treatment of mastopathy are divided into hormonal (antiestrogens, gestagens, oral contraceptives, androgens, prolactin inhibitors, gonadotropin analogues) and non-hormonal.

The basis of therapy is hormonal agents, since the main cause of the development of the disease is a hormonal imbalance, in particular, a decrease in progesterone levels, an increase in prolactin, and estrogens.

The goal of therapy is not only to relieve the symptoms of mastopathy, but also to eliminate its cause - hormonal imbalance.

However, it should be remembered that hormonal drugs can only be taken as prescribed by the attending physician; self-medication can lead to aggravation of existing pathologies.


Antiestrogens reduce the concentration of estrogen in the body. The use of these drugs can reduce pain in the mammary glands, normalize the cycle, reduce the intensity of the manifestations of premenstrual syndrome, as well as blood loss during menstruation. The result of treatment appears 2-3 months after the start of therapy.

When taking antiestrogens, side effects may occur - nausea, vomiting, dizziness, hot flashes, sweating. The most popular drugs in this group are Tamoxifen and Fareston. The first has a milder effect, but the duration of its use is 3-6 months, the second causes more side effects, but the course of treatment does not exceed 2-3 months.

Oral contraceptives

When treating fibrocystic mastopathy, drugs in this group are prescribed to women under 35 years of age. Oral contraceptives help reduce signs of mastopathy and premenstrual syndrome, restore the menstrual cycle, and prevent pregnancy by suppressing ovulation . Most often, specialists prescribe the following drugs:

  1. Marvelon (Mersilon). A combination drug containing ethinyl estradiol, desogestrel. Suppresses ovulation, reduces blood loss and pain during menstruation.
  2. Femoden. Monophasic agent that contains ethinyl estradiol, gestodene. Helps regulate the menstrual cycle and reduce the manifestations of premenstrual syndrome.
  3. Silest. Combined contraceptive with the main active ingredients ethinyl estradiol, norgestimate. The medication suppresses the production of gonadotropins and prevents the onset of ovulation.
  4. Janine. Contains ethinyl estradiol, dienogest. It is used for various forms of mastopathy and provides an excellent contraceptive effect.
  5. Non-ovlon. Contains ethinyl estradiol and norethisterone. Suppresses ovulation, helps eliminate signs of fibrocystic mastopathy, uterine bleeding. Used to treat functional infertility.

The most common side effects of contraceptives are nausea, vomiting, bleeding, breast engorgement, and weight gain. To avoid such consequences, oral contraceptives (like all other hormonal drugs) must be taken in strict accordance with the regimen selected by the mammologist.

Progesterone preparations

These products help compensate for the lack of progesterone in a woman’s body. An increase in this hormone helps reduce the level of estrogen and prolactin. Normalization of hormonal levels ensures a reduction or complete disappearance of signs of mastopathy.

The most popular synthetic progesterone drug prescribed for fibrocystic mastopathy is Duphaston.

It is indicated for a lack of endogenous progesterone; in addition, this medication reduces the effect of estrogen on breast tissue and helps eliminate pain.

Side effects of the drug are possible weight gain, sweating, dizziness, disruptions in the gastrointestinal tract, heart rhythm disturbances.

The second most popular is Utrozhestan, which contains natural progesterone.

The advantage of this remedy is its naturalness, the disadvantages are the presence of a large number of side effects (lethargy, drowsiness, dizziness, allergies, bleeding during the intermenstrual period).

Most often, these symptoms occur with an overdose of the drug.

Taking Utrozhestan is contraindicated in case of hypersensitivity to the components of the drug, liver failure, epilepsy, bronchial asthma, diabetes, migraine, depression. If side effects occur during treatment with this medication, you should consult your doctor.

Progesterone preparations are available both in tablet form and in the form of gels intended for topical use..

Such products include Progestogel gel, containing micronized progesterone, identical to natural one.

The main advantage of this medicine is that external use minimizes the risk of adverse reactions that occur when taking progesterone drugs orally.

With the help of Progestogel, fibrocystic mastopathy and mastodynia can be treated; the product should be used daily for 3 cycles.

Possible side effects when using the product are fever, nausea, vomiting, bleeding from the genital tract, chest pain.

Progestogel is contraindicated in patients with cancer, nodular mastopathy, and allergies to the components of the drug. It is not advisable to use the gel during pregnancy and lactation.


Androgens are estrogen antagonists, so drugs containing these substances help reduce estrogen levels. They also help reduce the number of cysts in the breast and even out tissue density.

The most famous and popular androgen is Danazol, which reduces the production of gonadotropin hormone and certain enzymes. It also helps increase progesterone levels.

The effectiveness of the drug reaches 60-70%, but it has a number of side effects, so it should be taken with great caution, only as prescribed by a doctor.


These drugs suppress the functions of estrogen (cause inhibition of the gonadotropic function of the pituitary gland) and reduce their effect on the mammary glands.

The results of using these drugs are noticeable several months after the start of therapy.

Gestagens eliminate pain in the chest and prevent pathological tissue proliferation; the use of these medications can increase the effectiveness of treatment by up to 80%.

The most popular gestagens include:

  1. Rotten. The main active ingredient of this medicine is human chorionic gonadotropin. Pregnil has an effect on the woman’s body similar to the effect of luteinizing hormone. It stimulates the production of progesterone in the second half of the menstrual cycle.
  2. Norkolut. Promotes inhibition of the synthesis of gonadotropic hormones of the pituitary gland, accelerates the growth of glandular tissue of the breast and milk ducts.
  3. Orgametril. Normalizes the menstrual cycle, helps fight endometrial hyperplasia, and prevents the formation of lumps in the mammary glands.

The drugs are taken in courses with several breaks. For each patient, the medication regimen is selected individually.

Prolactin production inhibitors

Prolactin inhibitors are prescribed if the cause of mastopathy is an increased level of prolactin. Often such patients experience milk discharge from the nipples.

Prolactin secretion inhibitors help stop lactation, reduce pain, and reduce the size of tumors in the mammary glands.

Also, these drugs normalize the menstrual cycle.

Bromocriptine belongs to this group. This medication stimulates dopamine receptors, which helps stop lactation, eliminate pain, and resolve lumps. The drug is prescribed only in the absence of cancer; side effects from taking it are nausea, vomiting, dizziness, visual disturbances, and convulsions.

The second and third generations of this drug (Norprolac and Cabergoline, respectively) do not cause side effects, since they act only on those dopamine receptors that are responsible for the synthesis of prolactin, but do not affect other receptors.

Another popular prolactin inhibitor is parlodel. This medicine helps to normalize the ratio of progesterone and estrogen in the body, as well as reduce prolactin levels. For cystic mastopathy, the drug promotes the resorption of cysts and lumps.

LHRH gonadotropin analogue

Such drugs are prescribed to patients with severe chest pain. The main indication for use is the ineffectiveness of other methods of hormonal treatment.

Non-hormonal treatment

Complex therapy for mastopathy involves the use of both hormonal and non-hormonal drugs. In order for essential medicines to have the most effective effect on the body, it is necessary to eliminate concomitant diseases and strengthen the immune system . For this purpose, the patient may be prescribed drugs from the following groups:

  1. Adaptogens. These are products that help strengthen the immune system and improve body tone. The most accessible and safest drugs in this group are tinctures of Eleutherococcus, ginseng, and Rhodiola. You need to drink them for 4 months, then it is recommended to take a two-month break and repeat the treatment. The optimal number of courses is 4 or more.
  2. Vitamins and microelements. Taking vitamin complexes containing vitamins PP, E, A, B, C, as well as iodine, helps strengthen the immune system, increase the absorption of hormonal drugs, and reduce side effects from taking basic therapeutic agents. Diseases of the mammary glands occur in the presence of diseases of the thyroid gland, therefore an important stage of treatment is the restoration of normal functioning of the thyroid gland. To maintain the functions of this organ, you should take potassium and iodine preparations (Iodomarin, Iodine-active).
  3. Means that normalize the functioning of the gastrointestinal tract. The development of mastopathy is facilitated by problems with the gastrointestinal tract, in particular constipation. In the presence of these pathologies, the intestines reabsorb estrogens that have already been eliminated from the body. Wobenzym and Duphalac help normalize the functioning of the gastrointestinal tract.
  4. Hepatoprotectors. An increased level of sex hormones has a negative effect on liver tissue, so patients with mastopathy are prescribed medications that normalize liver function - Legalon, Karsil, Essentiale-Forte.
  5. Diuretics. If breast disease is accompanied by tissue swelling, then the patient may be prescribed diuretics, in most cases natural - herbal teas, rosehip decoction.
  6. Calming and sedative drugs. Tinctures of motherwort and valerian, as well as other drugs in this group, are prescribed if mastopathy develops against the background of stress and nervous shock.
  7. Non-steroidal anti-inflammatory and painkillers. Diclofenac and Nise help reduce pain in the mammary glands.

Complex therapy involves the treatment of concomitant gynecological, gastroenterological and endocrine diseases, because these pathologies contribute to the progression of mastopathy.

Homeopathic medicines

In the treatment of mastopathy, homeopathic remedies are widely used, which eliminate the symptoms of the disease, normalize hormonal levels and provide the woman’s body with the necessary vitamins and microelements.

The most popular medicine in this group is Klamin, made from kelp extract. It helps in the fight against fibrocystic mastopathy, activates the removal of excess estrogen from the body, and also reduces the risk of developing cancer.

This drug provides the body with polyunsaturated fatty acids, minerals, potassium, calcium, and iodine. Contraindications to the use of Klamin are hyperfunction of the thyroid gland, allergic reactions to iodine or seafood. Regimen: 2-4 tablets per day, treatment period: 3-6 months. Then you need to take a break and conduct another therapeutic course.

Another popular herbal medicine is Mastodinon. This is a solution that contains iris, twig, cyclamen, iris, lily and other medicinal herbs.

The drug stimulates dopamine receptors, due to which the level of prolactin decreases, the intensity of formation of connective tissue in the mammary glands decreases, and the ducts narrow.

Also, when taking the medicine, swelling and pain decrease.

Novomin. The drug helps cure fibrocystic mastopathy and is a means of cancer prevention and prevents the development of metastases.

Provides the body with vitamins and antioxidants, restores damaged cells, and normalizes the metabolic process. Novomin is taken daily, 1 tablet for a month.

After this, you need to take a break for 3 months and repeat the treatment.

Fitolon helps eliminate pain and breast engorgement. It also normalizes hormonal balance, accelerates the resorption of cysts and lumps, and provides the body with iodine.

The drug is taken 1-2 tablets 3 times a day, the course of treatment is 1-3 months (after a break, treatment must be repeated).

Phytolon should not be taken in the presence of toxic goiter, hyperfunction of the thyroid gland, or individual intolerance to the elements of the drug.

A natural analogue of the local remedy Progestogel is Api-bust, the main active ingredients of which are plant components and beekeeping products.

This cream stimulates metabolism in breast tissue, thereby ensuring rapid cell regeneration. The ointment is applied to the skin of the mammary glands in a thin layer once a day.

This product has no side substances and is contraindicated only in patients with allergic reactions to bee products.

In addition to the above drugs, there are many other natural remedies for mastopathy on the herbal products market.

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But it should be remembered that it is advisable to take such drugs only as part of complex therapy (that is, simultaneously with hormonal drugs).

Self-treatment with herbal remedies will not provide the necessary therapeutic effect.

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Treatment of fibrocystic mastopathy: how it should be carried out

If you conduct a survey among women diagnosed with fibrocystic mastopathy to find out what they experience, the most frequently used word will not be “pain,” but “fear.” Fear for your own life, fear of the upcoming treatment, fear of the unknown ahead.

Such feelings are associated with the deep-rooted prejudice that mastopathy is a harbinger of breast cancer. And, therefore, sooner or later you will have to go through all the circles of hell: chemotherapy, radiation and... radical mastectomy - breast removal.

But a group of American-Canadian scientists who have studied the mechanism of occurrence and development of mastopathy for more than a decade have come to the conclusion that this disease leads to cancer only in a small number of cases. And only when the patient refused treatment.

Therefore, let's get rid of prejudices and find out what kind of disease this is and what the treatment for fibrocystic mastopathy is.

Causes of the disease

The main cause of mastopathy is disruption of the endocrine system. Since the hormonal “network” is spread throughout the body, malfunctions of the thyroid gland or ovaries gradually lead to a distortion of the overall hormonal background. Mastopathy is the result of the fact that endocrine disorders have become chronic rather than cyclical in nature - hormonal imbalance has become “rooted” in the body.

The most common causes of mastopathy are the following:

  • hyper- or hypofunction of the thyroid gland;
  • ovarian diseases of various etiologies: inflammatory, infectious, etc.;
  • liver disease (the process of utilization of excess hormones is disrupted);
  • chronic diseases of the gastrointestinal tract (the sequence of biochemical processes, which are one of the stages of hormone synthesis, is disrupted);
  • dysfunction of the pituitary gland and hypothalamus;
  • diabetes;
  • history of abortion;
  • obesity;
  • hereditary factors (family cases of mastopathy);
  • smoking;
  • work in hazardous production;
  • unfavorable environmental factors.


If you have any of the following signs, you should contact your doctor to schedule an examination:

  • tension and pain in the chest that occurs in the second half of the menstrual cycle;
  • chest pain that gets worse with compression;
  • breast enlargement, often asymmetrical;
  • compactions of various shapes and consistencies determined by palpation;
  • periodic or constant discharge from the nipples: transparent, slightly yellowish or mixed with blood and pus;
  • In some cases, inflammation and tenderness of the axillary lymph nodes may occur.

Important: obesity is a “double” risk factor: in addition to the fact that excess weight itself leads to metabolic disorders, subcutaneous fat complicates the primary diagnosis of mastopathy. Therefore, weight control is an effective measure both for the prevention of mastopathy and for timely diagnosis.

Mandatory diagnostic procedures for mastopathy are the following:

  • mammography;
  • laboratory blood testing to determine the imbalance of hormones and identify those that will indicate a possible cause of hormonal disorders;
  • Ultrasound;
  • biopsy (sampling of the contents of the seal with a syringe or surgical removal of one of the nodes, followed by histological and cytological examination).

Important: women suffering from mastalgia (cyclical regular chest pain) should be especially attentive to self-examination and preventive examinations with a doctor.

Premenstrual chest pain can effectively mask the real cause - mastopathy that has begun to develop.

And often women, not paying attention to chest pain and considering them symptoms of mastalgia, consult a doctor only when a sufficiently large percentage of glandular tissue is replaced by connective or epithelial tissue.

Treatment of fibrocystic mastopathy

After making a diagnosis, the doctor, together with the patient, considers treatment options for mastopathy. At its core, treatment of mastopathy is divided into two types: conservative and surgical.

Conservative treatment

This type of treatment is carried out without surgery and is aimed at normalizing hormonal levels and reducing the number and size of lumps.

The prescription of drug treatment depends primarily on the reasons why mastopathy developed - since the main causes of mastopathy are hormonal disorders, treatment can be supervised by several specialists at once - an endocrinologist, gastroenterologist, gynecologist.

Hormone therapy

It is a mistake to believe that the hormonal nature of the disease requires treatment with hormonal drugs.

Treatment is primarily aimed at normalizing the functioning of the organ/organs that caused hormonal imbalances.

Thus, if during the examination diseases of the ovaries, thyroid gland, pancreas, etc. were discovered, then the first step would be to stabilize and normalize the functioning of the diseased organ.

In this case, systemic hormonal therapy in the form of oral medications or injections is prescribed strictly on an individual basis and under the supervision of a highly qualified specialist. The following hormonal drugs have shown effectiveness in the treatment of fibrocystic mastopathy:

  • Tamoxifen, Toremifene, Fareston (antiestrogens);
  • Noritesterone, MPA (gesatgens);
  • Danazol (androgen);
  • Bromocriptine, Parlodel (prolactin secretion inhibitor);
  • LHRH preparations (synthetic analogues of gonadotropin releasing hormone).

A new generation of drugs allows the use of hormones without entering the bloodstream. For example, progesterone preparations, produced in the form of a gel, are applied to the mammary gland affected by fibrocystic mastopathy.

The form of the drug allows progesterone to penetrate into the internal tissues of the breast and at the same time not “clog” the entire body with a hormone that only the diseased organ, the mammary gland, needs. One of the most effective drugs in this group is “Progestogel 1%”.

If the form of mastopathy is not advanced and the patient is under 35 years of age, oral contraceptive drugs may be prescribed. Indications for use are chronic ovarian diseases, for example, adnexitis and polycystic disease, in which the production of estrogens, one of the culprits in the development of mastopathy, increases.

The use of oral contraceptives is prescribed only by the attending physician and does not allow for independent selection of drugs, because the presence/absence of contraindications plays an important role. Monophasic combination drugs are mainly prescribed:

  • Logest;
  • Miniziston;
  • Marvelon;
  • Femoden;
  • Mercilon et al.

As practice has shown, in 70% of women undergoing treatment for fibrocystic mastopathy, by the end of the first month of taking the contraceptive, the pain syndrome is reduced to almost zero.

Drug therapy

Drug treatment of the disease is aimed at reducing pain, relieving swelling in the chest, increasing the body's immunity and resistance, and eliminating other factors associated with mastopathy.

  • if there is significant pain, the patient is prescribed non-steroidal anti-inflammatory drugs - NSAIDs (Indomethacin, Ibuprofen, Diclofenac), which reduce pain - this strategy is aimed not only at pain relief, but also at improving the quality of life: good sleep, stress reduction, etc. Duration of NSAID treatment and dosage determined only by the attending physician;
  • to increase the body's defenses, you should take multivitamin preparations, a complex of microelements, bioactive preparations (tincture of Eleutherococcus, ginseng, etc.);
  • sedatives and antidepressants are prescribed for disorders of the nervous system - insomnia, depression, irritability that accompany mastopathy. Such drugs are often prescribed simultaneously with oral contraceptives, because In the first few days of taking hormonal drugs, a woman may experience mood swings and sleep disturbances. These side effects go away fairly quickly, but your doctor may suggest sedatives to relieve them. You should start taking sedatives with herbal remedies: valerian tincture, motherwort tincture, etc.;
  • taking diuretics is aimed at reducing swelling in the breast tissue. Since lumps in the breast disrupt venous outflow and cause congestion, this disrupts the circulation of blood and lymph (and, accordingly, makes it difficult for drugs to enter the breast tissue), and also increases pain. Diuretics should be taken only when taking potassium and magnesium supplements simultaneously - these microelements, which are responsible for the functioning of the cardiovascular and nervous systems, are excreted along with the urine.
  • Homeopathic remedies (Mastopol, Mastodinon) help increase the body's own defenses aimed at combating mastopathy.

Concomitant therapy

In order for drug treatment to be more effective, doctors recommend using means and methods aimed at normalizing general health.

  • Diet correction has shown excellent results in treatment for fibrocystic mastopathy. Minimizing carbohydrates in the diet accelerates metabolic processes in the body and, accordingly, makes drug therapy more effective;
  • At the initial stage of treatment of this form of mastopathy, it is necessary to take iodine preparations. After some time, they can be replaced with natural products containing iodine: walnuts, seafood, seaweed. Iodine has a beneficial effect on the thyroid gland, which is a regulator of the menstrual cycle and is responsible for the production of sex hormones.


For women undergoing treatment for fibrocystic mastopathy, physiotherapeutic procedures are recommended in isolated cases. This is due to the fact that mastopathy itself is a contraindication to thermal procedures, and the effect of new physiotherapy techniques on mastopathy has not yet been fully studied. The exception is situations when the cause of mastopathy is a disease that can be cured with electrophoresis, mud baths, ultrasound therapy, shock wave therapy and other procedures.

Surgical treatment

Surgical treatment of mastopathy is prescribed mainly for the nodular form, which is difficult to treat with medication.

Indications for surgery are the following cases:

  • fibrocystic mastopathy, aggravated by concomitant diseases that do not allow long-term drug treatment - for example, severe diabetes;
  • rapid growth of tumors;
  • ineffectiveness of other treatment methods;
  • presence of atypical cells in biopsy samples;
  • high probability of transformation of seals into a cancerous tumor;
  • family history of breast cancer in close relatives.

The main percentage of operations in the treatment of fibrocystic mastopathy is sectoral resection (removal of a sector of the mammary gland affected by cysts and nodes). This operation is performed under general anesthesia and lasts about 40 minutes.

Drug treatment after surgery is prescribed as needed: antibacterial drugs are mandatory and additionally as needed. Additional treatment includes medications to normalize the blood count, vitamin and mineral complexes, immunostimulating drugs, etc.

Important: surgical intervention does not eradicate the root cause of the disease, therefore it is necessary to undergo a full course of treatment for cystic fibrous mastopathy, which will be prescribed by the doctor after the operation. This treatment is aimed at preventing relapse of the disease and normalizing the functioning of organs that have become the source of hormonal problems.

And in conclusion, it should be said: treatment of this type of mastopathy should be comprehensive and prescribed by a highly qualified specialist. No matter what miraculous drugs your friends and family offer you, their use is possible only after the approval of the attending physician.


Hormonal contraception. Part II. Mechanism of action

Choosing the right drug for a particular patient can be very difficult. There is no simple way - to see what is missing and fill it up - so we will have to figure out what and where we are introducing in order to ensure not only effective contraception, but also good tolerability.

Even unsuccessfully selected hormonal contraception, if used regularly, will provide the patient with reliable, almost absolute protection from unwanted pregnancy, so individual selection is carried out for the sole purpose of minimizing side effects and obtaining non-contraceptive benefits.

Operating principle and capabilities of COC

Combined oral contraceptives are called combined because they contain two components - estrogen and progestogen. The main purpose of the combination is to prevent ovulation and ensure good cycle control.

With estrogens in COCs, everything is simple. The vast majority of COCs contain the same estrogenic component - EE (ethinyl estradiol). It has been included in contraceptive pills for 50 years and provides ovulation suppression. At the very beginning of the era of contraception, the pills contained huge doses of estrogens, which were gradually reduced and brought to a minimum.

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Today we distinguish three groups of COCs depending on the EE content:

  • high-dose - containing 50 mcg of EE (Non-Ovlon, Ovidon, Anteovin);
  • medium dose - containing 35 mcg of EE (Diane-35, Silest);
  • low-dose - containing 30 mcg of EE (Yarina, Marvelon, Zhanin, Femoden, Belara);
  • micronized - containing 20 mcg of EE or less (Jess, Mercilon, Logest).

High-dose COCs are a thing of history and are no longer used. Medium-dose drugs are prescribed for strict therapeutic indications or in cases where good control cannot be achieved using lower dosages of estrogens.

Doctors traditionally recommend micronized COCs for young girls. At the age of 25+, preparations with 30 mcg of EE are better suited.

Not so long ago, two drugs with estrogens identical to natural ones entered our market - Qlaira and Zoely. Qlaira contains estradiol valerate, and Zoeli contains estradiol hemihydrate. Such drugs significantly reduce the risk of developing estrogenic complications and side effects. “Natural” estrogens are especially good for the older age group of users.

It’s more difficult with the gestagenic component. The gestagens in COCs pretend to work as progesterone, but instead of preparing the endometrium for pregnancy, they control its growth and transformation. They work by connecting to receptors with which progesterone could interact.

It depends on the gestagenic component whether acne will appear or, conversely, disappear, whether the mood will worsen or improve, whether pain during menstruation will disappear or remain, the volume of menstrual bleeding will decrease or remain the same.

If we choose a gestagen with antiandrogenic activity (cyproterone acetate in Diane-35, drospirenone in Jess, dienogest in Janine), then we can expect that the patient’s skin and hair condition will improve and acne will go away.

If we choose a drug with an antimineralocorticoid effect (drospirenone in Jess and Yarina), then we hope that there will be no fluid retention, which means that swelling will not appear, breast enlargement, headaches and PMS will not bother you.

Some gestagens included in COCs retain androgenic activity.

Researchers encountered this problem back in the 1970s and 1980s, when women began to complain en masse of acne, oily skin and hair, and weight gain.

In the world of modern contraception, there are no drugs left that contain such “hard” substances. Gestodene and desogestrel have residual androgenic activity, but in most cases it has no clinical significance.

There are special tables to help gynecologists to clarify the effects of a particular drug.

Activity of steroid receptors of individual progestins*

Progesterone + (+) +
Dienogest +++ ++
Drospirenone + + ++
Levonorgestrel ++ +
Gestoden + + (+)
IPA + + ++
Norgestimate ++ +
Norethisterone +++ +
Cyproterone acetate + +++ +++
Desogestrel + + +

Alas, to individually select a contraceptive combination, it is not enough to simply hold a sign in front of your eyes. What scientists obtained in an experiment does not always coincide with what will happen in the body of a particular patient.

Is it possible to choose a COC “by appearance”?

Attempts to systematize the methodology for selecting COCs based on phenotype have been and are being made. The idea sounds very tempting. Breasts are large and lush - which means there is a lot of estrogen. The bust “takes after my father” means there is not enough estrogen. It would seem that they have already decided which drug to prescribe.

Various phenotypes have been identified in women - with a predominance of the estrogenic, androgenic or progesterone component. Depending on what type the patient belongs to, it is proposed to select the starting dosage of estrogen and the optimal gestagen.

Perhaps this makes some sense (although this point of view does not have serious evidence: all the work was carried out on relatively small groups of patients). But it is much more important for a practicing doctor to understand what exactly a particular drug contains and why a particular patient needs this content.

This is why we have many doctors who prefer to prescribe the same 2-3 drugs. They have studied them sufficiently, are confident in their knowledge and have accumulated decent experience in their own observations.

Selection of a drug based on individual problems

While talking with the patient and conducting an examination, the doctor “catches” small details, problems, features that can be eliminated, smoothed out or leveled out by using a specific drug.

  • If the patient has heavy and prolonged menstruation for no apparent reason (idiopathic menorrhagia), Qlaira is perfect for her.
  • For patients with PCOS, we will offer Yarina or Diana-35, depending on the severity of hyperandrogenism.
  • Jess is perfect for patients with PMS.
  • For patients with endometriosis - Janine.
  • For young girls, it is better to recommend drugs with a minimal estrogen content and a formula that can “withstand the blow” of possible omissions and errors.
  • For women 35+, it is preferable to offer drugs with estrogens identical to endogenous ones (Klaira and Zoeli).
  • If obvious signs of estrogen deficiency are evident, you can try to start with multiphase drugs containing different dosages of hormones.
  • Women under 35 years of age who smoke (and have recently quit smoking) should be offered a drug with a minimum dose of estrogen.
  • If a detailed conversation and examination do not reveal any peculiarities, the drug of first choice should be a monophasic COC with an estrogen content of no more than 30 mcg/day. and low androgenic gestagen.

Unfortunately, before starting to take COCs, it is impossible to predict exactly how a woman’s body will react to a specific combination.

Neither phenotypic tables, nor deep knowledge of biochemistry, biophysics and clinical pharmacology, nor disciplined donation of blood “for all hormones” help.

Armed with knowledge, you can only avoid very serious mistakes and correct them in time by analyzing the tolerability of previously used drugs. Therefore, the reality is that the best person to select COCs is the doctor who knows which 15 combinations were not suitable for the patient.

It is important to understand that this is not about the lack of qualifications of your gynecologist and, of course, no one is experimenting on you. In any case, the doctor tries to find the optimal contraceptive option as soon as possible. And with a high probability, his search will be crowned with success.

Oksana Bogdashevskaya


_____________ Mueck AO, Seeger H, Buhling KJ Gynecol Endocrinol. 2010

Products by theme: Klaira, Zoeli, Yarina, Jess, Diane-35, Janine, Marvelon, Femoden, Belara, Mercilon, Logest


Drugs for the treatment of mastopathy: hormonal and non-hormonal therapy, drug treatment

Mastopathy is a pathological condition of the mammary glands, which is characterized by proliferative growths in their tissues. It occurs regardless of age, but the peak is 30-45 years. The cause of the disease is an imbalance of the hormones progesterone and estrogen, or excessive production of prolactin.

As a treatment for mastopathy, drug and surgical treatment is used, depending on the cause and form of the pathology, and changes in diet and lifestyle.

Drug treatment

For the diffuse type of disease, conservative treatment is used using hormonal and non-hormonal medications.

Therapy is started after consultation with an oncologist, who can exclude the need for urgent surgery.

The first type of treatment is necessary to regulate cyclicity in the hypothalamic-pituitary-ovarian system. This normalizes hormonal levels by affecting breast tissue.

The second type of treatment can be prescribed either in combination or separately. Basically, it stops manifestations in mild forms, and when combined with a healthy lifestyle, it ensures a complete cure.

Non-hormonal therapy for mastopathy

The following drugs form the basis:

  • Vitamins - groups A, B, C, E are especially shown; they improve the functioning of the liver, which is involved in hormone metabolism. According to reviews of patients with mastopathy, after vitamin therapy, the manifestation of symptoms decreased.
  • Medicines containing iodine - Iodine-active, Iodomarin, Klamin.

By regulating the functions of the thyroid gland, they reduce tissue proliferation. However, they have contraindications: autoimmune thyroiditis, hyperthyroidism, so consultation with a specialist and positive reviews are necessary.

Includes iodine and the domestic drug “Mamoklam”, produced on the basis of kelp (algae).

In addition, it contains chlorophyll and omega-3. In combination, the drug relieves pain, regulates the menstrual cycle and hormonal balance, and reduces the process of neoplasms.

In fibrocystic mastopathy, it is prescribed to reduce pain during menstruation, but it is contraindicated in cases of thyroid dysfunction.

  • Enzyme drugs have anti-inflammatory, immunomodulatory, analgesic and decongestant effects (Lidaza, Mulsal, Wobenzym) for fibrocystic mastopathy.
  • NSAIDs for pain quickly relieve it. For example, Diclofenac, Nise, Nimika.
  • Sedatives and sedatives, together with psychotherapy, are indicated for psychological reasons that caused the disease fibrocystic mastopathy. At the initial stage, take tincture of valerian and motherwort.
  • Herbal medicine is used in combination with traditional treatment; it enhances the effect of medications and calms the nervous system.
  • Homeopathic remedies (for example, Cyclodinon, Mastodinon, Remens) reduce the level of prolactin in the blood, thereby eliminating its excess production. The main principle of their use is duration and stability.

Differences between popular homeopathic remedies




Against indication

Features of application

Nature of the remedy

Side effects

Fibrocystic mastopathy; Menstrual irregularities and accompanying pain; Premenstrual syndrome; Infertility due to lack of corpus luteum. Mastodynia (a phenomenon where the breasts become swollen and painful); Premenstrual syndrome; All kinds of menstrual disorders; Fibrocystic mastopathy. Irregular menstrual cycle; Fibrocystic mastopathy; Adnexitis; Endometritis; Menopause syndrome.
The bottle must be shaken before each use. Shake the bottle with drops before use. The bottle must be shaken before use.
1. Pregnancy and lactation; 2. Individual intolerance; 3. Malignant neoplasms of the mammary gland; 4. Children under 12 years old. 1. Pregnancy and lactation; 2. Individual intolerance. Individual intolerance. During pregnancy and lactation, the prescription of the drug is decided strictly individually.
Take 30 drops orally along with a small volume of liquid for 3 months (minimum). The tablet form is taken 1 pc. twice a day. Take 1 tablet orally. or 40 drops 1 time per day along with a small volume of liquid for 3 months. 3 times a day, 10 drops.
Vegetable Vegetable Vegetable
Possibility of allergic reactions Possible skin allergic manifestations Increased salivation is rare

Hormonal therapy for mastopathy

This type of treatment is aimed at stabilizing breast tissue and can be used only after studying the hormonal status. The following drugs are used:

  • estrogen-gestagen contraceptives (oral) - Janine, Marvelon
    They are prescribed to women under 35 years of age in cases where there is no ovulation and the luteal phase is disrupted, using a contraceptive regimen. Their advantage is the normalization of various fluctuations in sex hormones.
  • gestagens are taken in the second phase of menstruation (Progestogel-gel as a breast rub, Norethisterone, Utrozhestan, Duphaston).
    Progestogel contains progesterone, which reduces the symptoms of fibrocystic and other forms of mastopathy.
    It has no side effects due to local application, eliminating penetration into the blood. This is what contributes to its popularity, and positive reviews only cement its fame. Progestogens in tablets also contain progesterone and reduce pain and discomfort in the chest. They are prescribed according to a special scheme.
  • inhibitors of prolactin production are used when excessive secretion of the hormone is detected (for example, Parlodel).

The following medications are less commonly taken:

  • androgens (Methyltestosterone) have many side effects, so they are prescribed extremely rarely to women over 45 years of age with fibrocystic mastopathy.
  • antiestrogens must be used continuously for 3 months (Fareston, Tamoxifen).
  • Gonadotropin-releasing hormone antagonists reduce the level of sex hormones in the blood - the so-called artificial reversible menopause, characterized by the reverse development of changes in mastopathy in the mammary glands. These drugs include Zoladex, Buserelin.

Features of estrogen-gestagen contraceptives

This group of drugs has made it possible to radically change the treatment of many pathological conditions and preserve the quality of life and reproductive health of women.

It has a positive effect on various levels of adaptation (mental, social, physical), is used as a measure for the prevention of psychological trauma and gynecological and non-gynecological diseases, and is also a conscious contraception and therapy for anovulatory infertility.

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Oral contraceptives are in demand as a treatment for fibrocystic mastopathy, endometriosis and ovarian cancer. This is due to their protective effect, the ability to cause anovulation and suppress endometrial secretion.



Against indication

Side effects

Features of application

1. Contraception; 2. Mastopathy. 1. Contraception; 2. Change in the period of menstruation; 3. Mastopathy. 1. Contraceptive; 2. Underdevelopment of the uterus; 3. Uterine bleeding of various nature; 4. Fibrocystic mastopathy; 5. Functional infertility.
Pregnancy, lactation, diabetes, migraine, smoking, thrombosis of various natures and others. Similar to the entire group of contraceptives. Threatened abortion and pregnancy, hepatitis and cirrhosis of the liver; thromboembolism and the risk of its development; otosclerosis.
Irregular bleeding. Bleeding, nausea. Nausea, weight gain, breast engorgement.
For 21 days, use 1 tablet per day. Use according to the regimen strictly prescribed by the doctor. Used from the 5th day of the menstrual cycle according to a special regimen as prescribed by a doctor.

Thus, if fibrocystic mastopathy is detected, estrogen-progestin contraceptives are prescribed only by a doctor, due to their unsafety, possible side effects and contraindications.


Mastopathy is a pathology of the mammary gland that occurs regardless of a woman’s age, and we will answer the question that we have already heard more than once - yes, mastopathy can be treated and quite successfully if you consult a doctor in a timely manner.

Before treatment, it is necessary to examine the hormonal status, then the mammologist prescribes treatment: surgical for nodular forms and medication for the fibrocystic type.

The second treatment option involves the use of hormonal and non-hormonal drugs that affect the production of lactin and regulate the balance of estrogen and progestogen. The main principles of treatment are:

  • Normalization of hormonal levels;
  • Elimination of stressful conditions;
  • Local therapy of glandular tissue;
  • Hormonal and non-hormonal drugs.

A necessary measure is a special diet that limits the intake of chocolate, coffee, cocoa and tea, fatty and smoked foods. The patient's diet should consist mainly of vegetables and fruits, vitamins A and E.

It is important to consider that the risk group is nulliparous women over 25 years of age. The possibility of developing mastopathy up to 25 in people with one child is much lower.


For mastopathy, contraceptives

Home » Mastopathy » For mastopathy, contraceptives

A disease such as mastopathy is the most common ailment in women. The disease is caused by the fact that pathologies develop in the mammary gland in the form of cystic and fibrous neoplasms.

Mastopathy mainly occurs due to diseases associated with the internal genital organs or the endocrine system. However, many girls and women wonder whether it is possible to take contraceptives during the period of mastopathy.

And the question also arises, which birth control pills can be taken in order to avoid unwanted pregnancy.

Taking contraceptives

As a rule, hormonal contraceptives for women who have mastopathy are strictly contraindicated. But you can take contraceptive pills under the supervision of a gynecologist, and only after a thorough diagnosis of the disease.

Before prescribing oral contraceptives, the gynecologist recommends undergoing the following examinations:

  • Get an electrocardiogram.
  • Consult an oncologist and mammologist.
  • Palpate the mammary glands.
  • Perform an ultrasound examination of the glands.
  • Get examined by a gynecologist.
  • Do an ultrasound of the internal genital organs.
  • Take a blood test to check for the presence of sex hormones in it.
  • Consult a general practitioner.

In addition, if a woman uses hormonal contraceptive pills, she should be under the supervision of a specialist in the field of mammology. This is necessary so that the doctor constantly examines the mammary glands for the presence of tumors. In addition, a woman should undergo ultrasound and mammography examinations every 3 menstrual cycles.

The use of hormonal contraceptives significantly increases the risk of mastopathy. And those women who intensively use contraceptives, their chance of developing diseases such as fibrous and cystic mastopathy increases significantly.

To reduce the likelihood of mastopathy, many experts strongly recommend reducing the use of hormonal birth control pills to twice every three months. That is, such drugs can be taken, but when taking it, it is necessary to take certain breaks.

Hormonal contraceptives

As you know, birth control pills are divided into two types: the combined type and the “mini pill”. Combined contraceptives contain several hormones, often estrogen and progesterone. And the so-called mini-pills contain only one hormone (most often progesterone).

Combination drugs are also divided into the following classes:

  • With a mini-dose of hormones.
  • With a low dose of hormones contained.
  • With an average dosage.
  • With a large dose of hormones.

And the so-called mini-pill contraceptive drugs are considered the safest of hormonal drugs. They can be taken by almost all women. However, if you have individual intolerance, you should not take this drug.

The principle of action of hormonal contraceptives

Contraceptives are usually made from synthetic hormones that are as similar as possible to female hormones. In women, such hormones are actively produced during the period of bearing a child.

That is, the female hormones progesterone and estrogen significantly slow down the production of other substances that are responsible for the maturation of follicles, which, in turn, cause ovulation.

Based on this, a small dose of a combined contraceptive drug effectively slows down the maturation of the egg, which subsequently prevents pregnancy. It is on this principle of action that a large number of combined contraceptives have been created.

The effect of the drugs disappears immediately after stopping the drug. After 2-3 months, a woman’s reproductive function is fully restored, and she can become pregnant if desired.

The effect of hormonal oral contraception prevents pregnancy with a 99.8% probability, but only if the conditions of use are met.

Birth control pills can control the menstrual cycle, eliminate pain in women and bleeding during menstruation.

The newest oral contraceptives eliminate the premenstrual cycle, reduce the likelihood of developing cancer pathologies, and slow down hair growth.

Side effects from using hormonal drugs

The main disadvantage of contraceptive pills is the negative impact on the body, which includes:

  • Spotting bloody discharge from the vagina. Most often occur during the first use of the drug. But after the body gets used to the pills, this effect often disappears.
  • The hormones contained in the drug can provoke bloating of the gastrointestinal tract, cause swelling of the legs, and also retain fluid in the woman’s body. In addition, the contraceptive drug may cause high blood pressure and occasional headaches.
  • Progestins included in the composition can provoke nervousness, the appearance of acne on the face, as well as weight gain.
  • When using some hormonal contraceptive pills, the use of alcohol and tobacco products is contraindicated, as this may cause a risk of heart attack or ischemic stroke.
  • If you often take combined contraceptive pills, there is a risk of urolithiasis, and subsequently the formation of new stones in the bile ducts.
  • Negative consequences may arise from the use of oral contraceptives and the concurrent use of other medications.

Contraceptives for mastopathy

The use of oral contraceptives for diseases of the mammary glands can have a beneficial effect on this organ.

This is due to the fact that the synthetic hormones that are part of the drug can suppress the growth of tumors in the mammary glands. In order for hormonal contraceptives to have a beneficial effect on the mammary gland, it is necessary to use a contraceptive drug with a minimum estrogen content and a large amount of gestagens.

However, it is worth considering that it is advisable to use hormonal pills mainly for women under 30 years of age. Doctors recommend taking a contraceptive drug for mastopathy for no more than 3 menstrual periods.

From the start of using the drug, patients experienced improvement in the condition of the mammary glands within forty days of using hormonal contraceptives.

And complete normalization of the breast condition is achieved from 10 months to 2 years of treatment with this method.

Side effects from taking contraceptives for breast disease

Cancerous tumors in a woman’s breast are an unacceptable indicator for hormonal contraception. That is, the use of hormonal contraceptives can provoke the growth of cancerous tumors, if any.

In addition, if cancer is suspected, contraceptives are strictly contraindicated.

Only after removal of tumors can you use hormonal contraceptives under periodic ultrasound examination and supervision of a specialist in the field of mammology.

It is possible to take contraceptives for mastopathy, but this must be done quite carefully. This is due to the fact that these types of drugs can provoke unstable hormone levels. Therefore, it is best to consult your doctor before starting use.

  • We recommend reading:


Oral contraceptives for mastopathy: myths and truth about taking them

Benign diseases of the mammary glands occur in every fourth woman after 35 years. Despite the fact that in 99% of cases they do not degenerate into a malignant pathology, mastopathy can become a background for its development.

How can women with similar breast diseases protect themselves from pregnancy correctly and without harm to their own health? There is still an opinion that taking contraceptive drugs increases the risk of developing cancer, including breast cancer.

Is it possible to use oral contraceptives for mastopathy with health benefits?

The influence of hormones on mastopathy

The mammary gland is the target organ for estrogens, androgens and gestagens, hormones of the pituitary gland and some other parts of the endocrine system. That is why breast pathology is the first signal of a malfunction of the body. The mammary gland is most sensitive to sex hormones. Violation of their balance leads to the development of mastopathy and its unpleasant manifestations.

The main influence on the development of benign breast diseases is exerted by estrogens, progesterone and prolactin. An imbalance leads to uncoordinated tissue growth and the emergence of pathological lesions.

Estrogens predominate in the hormonal background in the first phase of the cycle. They stimulate the growth and reproduction of breast cells. Progesterone to some extent limits the influence of estrogens and reduces the sensitivity of tissues to them.

It promotes the differentiation of newly formed structures. Prolactin enhances the secretory properties of mammary gland cells. Normally, it exerts its significant influence only during pregnancy and breastfeeding.

When its level increases in the normal state, the sensitivity of breast cells to estrogen increases.

Most often, women develop conditions that lead to an excess of estrogen and a lack of progesterone. As a result, breast cells are formed in unlimited quantities, their growth is disrupted - cysts, fibroadenomas, etc. appear.

Thyroid hormones play a significant role in the functioning of the organ. With hypothyroidism, an autoimmune lesion in the mammary glands, signs of pathological growth appear in response.

Taking into account all these nuances, the doctor, competently and adequately prescribing oral contraceptives for mastopathy, gives a chance to improve the condition of the breast.

Many people believe that in the presence of benign diseases of the mammary glands, taking contraceptive drugs is not allowed. And this is associated with an increased risk of developing breast cancer.

However, numerous studies in this area have proven the absence of any relationship between these processes.

And even vice versa: hormones can be used to prevent the progression of mastopathy.


Contraceptives for mastopathy: mechanism of action and effect Link to main publication
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