Combined hormonal pills in contemporary women

The daily stress influences the health and social wellbeing of contemporary women. Combined hormonal pills (CHP) can help in some specific situations: health hormonal correction, maintenance of reproductive potential, avoidance of unwanted pregnancy, treatment of gynecologic diseases and infertility, harmonious aging. In polycystic ovarian syndrome (PCOS) all hormonal methods can be prescribed. The benefice of CHP in mild hirsutism and acne, is explained by the antigonadotropic action with no cardiovascular risk, no changes in metabolism and coagulation. In moderate and severe hirsutism, cyproterone acetate should be prescribed, due to decreasing of testosterone level. Ovarian functional cysts need to be treated by hormonal contraception. In these cases, CHP block the development of follicule and establish a balance in estrogen/progesterone level. CHP and progestin-only birth control pills should be very well chosen in uterine myoma. The combination of estradiol valerate and dienogest is prescribed in heavy menstrual bleeding in submucosal myoma. Another optimal method is the intrauterine device with levonorgestrel (IUD-LNG), especially in submucosal nodules. CHP (ethinyl estradiol + drospirenone) is the mandatory method of contraception in endometriosis and the first line treatment in painful syndrome and postoperative recurrences. CHP can be associated with nonsteroidal anti-inflammatory drugs. Other hormonal methods used to treat the endometriosis are: gonadotropin-releasing hormone agonists which decrease estrogen level, induce endometrial atrophy and amenorrhea; IUD-LNG which decrease pelvic pain and dysmenorrheal. The implant with etonogestrel contributes to the decreasing of symptoms too. The importance of CHP as birth control method and treatment choice in gynecologic pathology, is explained by: hypothalamic-pituitary-ovarian axis inhibition, decreasing of menstrual bleeding and decreasing of pain.