What should I do if I don’t have my period while taking Jess? In this case, you should calm down and not panic. The fact is that the first menstruation when taking Jess may be very different from the menstruation to which you are accustomed.

To identify the cause of the absence of menstruation, it is necessary to understand the principle of operation of hormonal pills.

Jess is a drug containing a low dose of hormones such as drospirenone and ethinyl estdiol. The contraceptive effect is due to several factors:

1. The drug affects the ovaries and suppresses ovulation.
2. The drug thickens the mucus produced by the reproductive system, which prevents the fusion of the sperm with the egg.
3. The drug controls the development of the endometrium, which does not allow even the formed fertilized egg to penetrate the mucous membrane.

The first and third points connect the course of menstruation directly with the effect of the drug. Since the endometrium develops differently while taking the pill, menstruation will also occur differently. Likewise, the effect on the ovaries is an important factor responsible for the appearance of discharge.

When asking what menstruation is normal when taking Jess, you should take into account the woman’s age and her previous menstrual cycle.

Causes of the phenomenon

When taking Jess, most women's periods tend to become scanty. This happens because throughout the entire cycle, the active substance Jess affects the functioning of the ovaries, and this, in turn, interferes with the production of hormones.

The endometrium (the inner lining of the uterus) does not thicken or become porous, as happens if you do not take hormonal medications. All this makes your periods less heavy.

The cycle is individual for each individual woman, but the drug reduces this indicator to a general value. A standard package, designed for a month of use, contains 28 tablets, where the first 24 are active, containing hormones in equal quantities, and the last 4 are inactive, causing withdrawal symptoms. Menstruation occurs during the period of taking inactive pills. The duration of menstruation will depend on the amount of hormones in the blood. On average, this is 3-4 days from the start of taking inactive tablets.

If a woman’s periods were initially light, then it is quite possible that when taking Jess they will stop completely. After all, the drug, as is known, affects the functioning of the ovaries, which provokes the absence of menstruation on certain days.

There is one more thing that worries many girls while taking pills - their periods not only become more scanty, but also change color from red to brown. Also, the discharge becomes viscous, which causes the feeling that menstruation is not “coming”, but simply “smearing”. This is due to the fact that the drug makes the blood more viscous, as a result of which it begins to clot and oxidize faster while inside the vagina. Most often, this effect occurs after a night's sleep or a long period of lying down. Since it is precisely this situation that complicates the movement of secretions.

Factors influencing the absence of menstruation

1. Stress is one of the clear signs of lack of discharge. When a woman drives herself into a corner with thoughts like “I drink Jess, but I don’t have my period,” it is likely that by doing so she can actually affect the functioning of the body and delay menstruation.
2. Alcohol can also contribute to this phenomenon. If the girl is slim, and the amount she drinks exceeds the norm, the level of substances may be reduced, which will lead to the absence of discharge.

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In general, in order for you not to have problems when taking Jess, you should take the tablets strictly according to the instructions, without missing any of them, be they active or inactive tablets.

If the absence of menstruation is just a one-time occurrence, and you have not missed a single active pill during the cycle, you can start a new pack without fear of the consequences. However, if discharge still appears while taking the second package of the drug, then you should think about it and consult a specialist.

Oral contraceptives today are a real salvation for girls. These drugs are used not only to prevent unwanted pregnancy: they help normalize the menstrual cycle and correct the functioning of the endocrine system. Jess tablets are one of the most popular drugs on pharmacy shelves, as this medication is well tolerated by many women, rarely causes side effects and performs its function efficiently. The peculiarity of this OC, like many others, is that it changes a woman’s menstruation. How are Jess and menstruation related, and what should you expect when using the drug?

Jess is a contraceptive containing a low concentration of two hormones: drospirenone and ethinyl estradiol. The drug provides a complex effect; its active components have several targets at once.

The hormones in the drug inhibit the maturation and release of eggs from the follicles, so ovulation in a woman’s menstrual cycle is absent or greatly reduced. The components of the tablets help thicken the cervical mucus, making it much more difficult for sperm to enter the fallopian tubes to reach the egg.

Hormones suppress the thickening of the endometrium, and even if the egg is fertilized, it will not be able to implant in the uterus. Jess reduces the activity of the ovaries - they produce less estrogen, which is what gynecologists use in the treatment of endometriosis or hyperestrogenism.

The drug must be taken when menstruation begins, that is, from the first day of the menstrual cycle.

This is necessary in order to slowly prepare the body for hormonal influences. There are 28 pieces in a pack - this is the standard length of the menstrual cycle. The contraceptive effect appears after menstruation and continues until the end of the course of the drug. The tablets in the package differ in the dosage of active substances, so you need to start strictly from the beginning, and the last 4 pieces are “premenstrual”, they contain a lower concentration of hormones - this will be a signal for the start of menstruation.

When taking Jess, menstruation occurs at the same time every month, so this drug is used not only for contraception, but also to normalize hormonal levels and the menstrual cycle.

Contraindications and side effects

It is important to study this point before using any hormonal drugs, because they contain microscopic doses of substances, but they will be enough to worsen your well-being and health.

Contraindications to taking Jess are the following conditions:

• pregnancy and lactation;
• renal and liver failure;
• migraine, psychiatric disorders;
• hormone-dependent tumors;
• inflammatory diseases of the genital organs;
• diseases of the cardiovascular system (heart attack, stroke, ischemia, heart failure, angina and tachycardia, hypertension);
• diabetes;
• blood clotting disorder.

If these contraindications are ignored, a woman may experience the following side effects of the drug:

Jess and periods

Oral contraceptives are fairly reliable contraceptives, since they correct the functioning of the entire reproductive system, “putting barriers” to pregnancy in 3-4 stages (discussed in the effects of the drug). But when taking them, it is very important to observe regularity - you need to drink one tablet every day at the same time so that doses of hormones enter the body.

If a woman uses Jess indiscriminately, then her risk of becoming pregnant increases significantly, especially in the second half of the cycle, when ovulation should occur under normal conditions.

If you don’t have your period after stopping Jess, you need to wait 2 weeks, and then take a pregnancy test and consult a gynecologist.

What to do if you miss a pill

Skipping at least one tablet when taking oral contraceptives is a dangerous mistake, since stopping the flow of hormones during the day can negate the contraceptive effect of the drug. The thing is that Jess suppresses the synthesis of progesterone in the ovaries, and also slows down the thickening of the endometrium, but when a girl forgets to drink OK, this effect disappears.

To the question: “What should I do if I take Jess and miss a pill?”, the answer can be found in the instructions for the drug. In any situation, the first action is to take the forgotten pill immediately when you remember it, even if you have to take 2 pieces in one day. Further actions depend on the time of the cycle when the contraceptive failure occurred. If a girl missed the white pill, then there is no need to worry, since they do not have a strong contraceptive effect; they help the menstrual cycle to end normally.

Additional measures

If the omission occurred before the 15th day, then the woman can do nothing and calmly continue her sexual life, since ovulation could not occur during this period. If a missed pill occurs after the 16th day of the cycle, then during the next 3-4 days it is necessary to use additional contraceptive measures: condoms or vaginal spermicidal suppositories. This is due to the fact that without the supply of hormones, ovulation can begin - the time for fertilization.

If it still hasn’t started, then you need to take a pregnancy test after 2 weeks and visit a doctor, mentioning the failure while taking the contraceptive.

What reduces the effectiveness of the drug

Sometimes girls on the forums are interested in the question: “Why do I drink Jess and have spotting on the 15-16th day of my cycle?” This phenomenon could be due to the fact that certain facts reduced the effectiveness of the drug, and ovulation occurred - the release of an egg.

A decrease in contraceptive effect may be associated with the following features:

• vomiting, nausea or diarrhea after recently taking the pill (it has not had time to be fully absorbed);
• consumption of alcoholic beverages, cigarettes and drugs;
• taking antibiotics;
• use of anticonvulsants and vasodilators.

When using Jess, it is necessary to take into account the effect of these factors and avoid them so as not to reduce the effectiveness of the drug.

Jess tablets are one of the most effective and at the same time “convenient” contraceptives, since these tablets rarely give side effects and do not negatively affect the girl’s health. Above, answers were given to many questions related to the topics: “I accept Jess. How periods change, why they don’t exist, what to do if you miss a pill, etc.” When using this drug, you must first study the instructions, especially pay attention to contraindications.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Selection of modern means contraception huge. These include chemical agents in the form of vaginal balls and gramicidin pastes, and mechanical agents such as condoms and cervical caps. There is also a so-called natural method of contraception, which involves abstaining from sex directly on “dangerous days”, which are calculated individually for each woman. Today there are many special contraceptive drugs, one of which is a medicine called jess.

General information:

Jess is a completely new low-dose contraceptive intended for oral use. This drug first became known to residents of the United States in 2006. To date, this medicine is registered in more than 40 countries around the world. Compared to other contraceptives, Jesu tends to provide fairly good control of the menstrual cycle, which attracts the attention of a huge number of patients.

Release form and composition:

Available in the form of light pink tablets, which are film-coated. The shape of the tablets is biconvex. On one side of the regular hexagon there is an engraving in the form of the letters “ D.S. " One blister contains 24 active tablets and 4 placebo tablets.
Composition of the drug: active substances – drospirenone and ethinyl estradiol; auxiliary components - magnesium stearate, corn starch, lactose monohydrate, iron oxide, talc, hypromellose, titanium dioxide.

Pharmachologic effect:

The contraceptive property of this drug is due to very diverse factors. One such factor is changes in cervical fluid ( cervical mucus). Cervical mucus is the fluid that is produced from the cervix during menstruation. Jess also tends to inhibit the process of ovulation, namely the phenomenon accompanied by the release of an egg from the ovary into the body cavity due to the rupture of a mature follicle. With its help, it is possible to reduce the severity of bleeding during menstruation, regulate the menstrual cycle and make it less painful. This drug also has an antimineralocorticoid effect, due to which it is possible to prevent an increase in total body weight, as well as the development of any signs indicating fluid retention in the body.

Pharmacokinetics:

When taken orally, fairly rapid and almost complete absorption is observed. drospirenone. After the first dose of the drug, drospirenone dissolves in the blood within 60–120 minutes. Eating does not have any effect on the digestibility of this component, which interacts directly with serum albumin, which is the main protein reserve in the body. With globulin ( blood protein) drospirenone does not interact. Its metabolic products are excreted from the body in urine and feces.

Indications for use:

• contraception ( pregnancy prevention);
• treatment of moderate forms of acne vulgaris ( purulent inflammation of the sebaceous gland and hair follicle);
• treatment of complex forms of premenstrual syndrome ( a whole complex of complex cyclic symptoms that occur 2-10 days before menstruation).

Contraindications for use:

• diabetes mellitus, accompanied by vascular complications;
• benign or malignant liver tumors that are currently present or in history;
• arterial or venous thrombosis or thromboembolism, this also applies to myocardial infarction, deep vein thrombosis, cerebrovascular disorders, pulmonary embolism;
• pregnancy or suspicion of it;
• excessive sensitivity to any substance included in the composition;
• severe or acute renal failure;
• lactation period;
• conditions signaling the development of thrombosis, including angina pectoris and transient ischemic attacks;
• adrenal insufficiency;
• vaginal bleeding of unknown etiology;
• pancreatitis, characterized by severe hypertriglyceridemia;
• pronounced or multiple risk factors for arterial or venous thrombosis ( their list includes atrial fibrillation, smoking and non-compliance with all the rules of a healthy lifestyle over the age of thirty-five, various pathologies of the coronary arteries or cerebral vessels, serious operations accompanied by prolonged immobilization);
• severe liver pathologies or liver failure ( in this case, Jess should not be used until liver tests become normal);
• hormone-dependent malignant diseases, including mammary glands or reproductive organs;
• migraine, characterized by focal signs of a neurological nature.

Use of the drug during pregnancy and lactation:

During pregnancy and breastfeeding, the use of this medication is strictly prohibited. If the fact of conception was detected while taking this contraceptive, then it is immediately canceled. During studies that examined children whose mothers took certain sex steroids, scientists noted that they could not identify any defects. However, there is not much information, which is why it is impossible to draw specific conclusions regarding the effect of this medication on the course of pregnancy, as well as the general health of newborns. It is not recommended to use it during breastfeeding because the components included in the jess tend to reduce the amount of breast milk, as well as significantly change its composition. In addition, a certain amount of sex steroids can enter the child’s body along with milk.

Directions for use and dosage:

Tablets of this drug must be taken every day, following the order indicated on the blister. They should be taken at the same time. Take the tablets with a small amount of liquid. This contraceptive should be taken 1 tablet per day for 28 days. There is no need to take breaks. As soon as the last tablet from the current package is drunk, the very next day you will need to move on to the next package of this drug. Bleeding that resembles menstruation most often begins around the 3rd day after starting placebo pills.

What should you do if you have not used a hormonal contraceptive in the previous month?

In such cases, the first tablet of this drug should be taken on the 1st day of menstruation. You are allowed to take the first pill on the 5th day, but throughout the first cycle you will need to use additional methods of contraception in order to be 100% insured against unwanted pregnancy.

What should you do if only progestogen has been used so far?

In this case, experts recommend starting to take this drug on any convenient day, but during the first 7 days you should use additional methods of contraception.

How to switch from another combined contraceptive to Jess?
It is best to start taking Jess tablets the very next day after taking the previous contraceptive. In this case, the most important thing is not to take a break. If a transdermal patch or vaginal ring was used, then the first tablet of this drug should be taken on the same day that one of these products is removed.

How should I take this drug after childbirth?

Immediately after giving birth, it is recommended to wait until the end of the first normal menstrual cycle, after which we start taking the pills. Some patients are allowed to use the drug earlier, but only as prescribed by a doctor.

How should I take Jess after a spontaneous miscarriage or abortion?

In both cases, it is necessary to obtain specialist advice.

What to do if you missed a pill?

If you missed taking a placebo tablet, then you should simply remove it from the package so as not to prolong the placebo taking phase. If you missed taking one of the active tablets, then you need to adhere to the following instructions:

1. If the delay in taking the active Jess tablet does not exceed 12 hours, then the contraceptive effect of this medication remains the same. In such cases, it is recommended to take the missed pill as soon as the woman remembers. Subsequent tablets from the started package should be taken at the usual time.

2. If the delay exceeds 12 hours, then the contraceptive effect is most often reduced. In this case, it is very important that the total break does not exceed 4 days, since this fact can provoke very strong depression of the hypothalamic system ( parts of the endocrine system).
Given this fact, it is very important to follow the following recommendations:

A) Day 1 – 7th: you need to take the missed tablet as quickly as possible, it is quite possible that it will be 2 tablets at the same time. Then you should continue to take active tablets at the usual time. For the next 7 days, you should use one or another additional method of contraception such as condoms. If there has been sexual intercourse in the previous 7 days, then the likelihood of conception increases. The risk of pregnancy depends immediately on two factors - the number of missed tablets and the period that remains before starting to use placebo tablets.

b) Day 8 – 14th: You should take the missed tablet as quickly as possible, it is quite possible that it will be 2 tablets at once. Then taking the tablets should be continued at the usual time. If the pills were taken correctly during the entire 7 days before skipping, then you don’t have to think about additional contraceptives. If during this period one of the pills was missed, then for the next 7 days after the miss, experts recommend using one of the additional means of contraception.

V) Day 15 - 24th: During this period, missing one of the tablets is especially dangerous, since the contraceptive effect of the drug is reduced quite significantly. In such cases, experts recommend proceeding as follows: take the last missed pill, and then continue taking active pills at the usual time. Placebo tablets should be skipped. As soon as the active tablets from this package run out, we begin taking active tablets from the next package. Most often, this regimen for taking this contraceptive does not cause menstrual-like bleeding until all active tablets from the subsequent package are consumed. During this period, spotting or breakthrough bleeding may occur. There is another option, namely stopping the pills completely if the active pill was missed during this period. Take a break of 4 days, then start taking pills from a new package.

How should you handle the packaging of this drug?

The packaging of this drug is equipped with a blister that contains 24 active tablets and 4 placebo tablets. In the package you can also find a special self-adhesive appointment calendar, which consists of 7 self-adhesive strips. The names of the days of the week are marked on each strip. If you started taking the pills on Tuesday, then look for the line that starts with " Tue " It is this strip that should be pasted along the top of the package, and in such a way that the designation “ Tue " was located above the tablet to which the arrow is pointing " Start " This will help you keep track of taking each pill day by day.

Stopping the drug:

You can stop taking this contraceptive at any time. When planning a pregnancy, experts advise first to wait for normal menstrual bleeding and only then start trying to conceive. This will help calculate the approximate time of birth of the baby.

Side effects:

From the side of the central nervous system (central nervous system) – deterioration and frequent mood swings, nervousness, asthenic syndrome, decreased or increased libido, headache;
From the reproductive system – engorgement and pain in the mammary glands, hypertrophy of the mammary glands, discharge from the mammary glands, vaginal candidiasis, vaginal discharge, menstrual irregularities;
From the gastrointestinal tract – abdominal pain, vomiting, nausea, diarrhea;
From the skin and subcutaneous tissue – urticaria, erythema multiforme and nodosum, acne, rash;
From the organs of vision – intolerance to contact lenses;
From the immune system – increased sensitivity;
Metabolism c – fluid retention;
Others – decrease or increase in total body weight.

If a woman suffers from hereditary angioedema ( Quincke's edema), the use of this medication may worsen the symptoms of this pathological condition.
Especially often, while taking Jess, arterial or venous thromboembolic events or cerebrovascular disorders make themselves felt. Factors that tend to significantly increase the risk of developing this type of disorder include:

• hereditary predisposition;
• migraine;
• smoking over the age of thirty-five;
• atrial fibrillation;
• age;
• radical surgical interventions;
• long-term immobilization;
• heart valve pathologies;
• serious injuries;
• any surgical interventions on the lower extremities;
• arterial hypertension.

Recommendations for the development of gastrointestinal disorders:

If severe disorders of the gastrointestinal tract occur, incomplete absorption of the components of jess is evident. In such cases, it is necessary to regularly use additional contraceptives. If vomiting occurs within 3 to 4 hours after taking the active tablet, then you should take an additional tablet taken from another package.

Use with caution:

• liver pathologies;
• hereditary angioedema;
• hypertriglyceridemia;
• various pathologies accompanied by peripheral circulation disorders;
• pathologies that first arose or worsened during pregnancy or during a course of sex hormone therapy;
• diseases of the cardiovascular system;
• postpartum period.

Special instructions for use:

Before starting to take this contraceptive, it is important to undergo a full medical examination, during which all warnings and contraindications will be identified. It is recommended that periodic examinations be carried out while taking this medication in order to be able to promptly identify any problems that may occur for the first time while using this drug. Both the frequency and nature of examinations must correspond to the individual characteristics of each patient. Particular attention should be paid to the examination of the abdominal organs, pelvic organs, mammary glands and cervix. In addition, blood pressure levels should be measured regularly. If you have any pathological condition, before starting to use Jess, you should consult with a specialist who can compare the expected benefits and potential risks.

Diseases of the cardiovascular system:

During the research, experts were able to identify a direct relationship between the use of combined contraceptives and an increased incidence of arterial and venous thrombosis, as well as thromboembolism. These conditions occur especially often during the first 12 months of using pharmaceuticals from this group. The risk is especially high if you restart taking the same contraceptive drug. Venous thromboembolism makes itself felt in the form of deep vein thrombosis.

Signs of venous thromboembolism - a local increase in temperature in the area of ​​the affected leg, pain in it, which is especially felt while walking, as well as a change in the color of the skin on the lower limb.

Symptoms of pulmonary embolism - acute chest pain, breathing problems, very severe dizziness, sudden cough, shortness of breath, feeling of anxiety and others.

Arterial thromboembolism can cause a stroke or heart attack. Both of these conditions are life-threatening.
Symptoms of myocardial infarction – irregular or rapid heartbeat, feeling of tightness in the chest, heaviness, pain and discomfort in the same area, cold sweat, dizziness, shortness of breath, nausea, vomiting.
Signs of a stroke – sudden loss of sensation in the upper or lower limbs or face, confusion or loss of consciousness, accompanied by or without an epileptic seizure, severe headache, problems with speech and coordination, dizziness, problems understanding what is happening.

Tumors:

Cervical cancer most often occurs in the presence of persistent human papillomavirus infection. The risk of developing this type of tumor also increases with prolonged use of combined contraceptives. The risk of developing breast cancer is slightly increased. In extremely rare cases, during the use of such contraceptives, the development of both benign and malignant liver tumors was noted. If you begin to experience severe pain in the abdominal area or symptoms indicating the development of intra-abdominal bleeding, then consult a doctor for all necessary examinations.

Other states:

Drospirenone has no effect on the amount of potassium in the blood in patients suffering from mild to moderate renal failure. Hyperkalemia ( increased serum potassium concentration) can develop only if a patient with certain impaired renal function takes this contraceptive along with drugs that tend to retain potassium in the body. To minimize the risk of developing this pathological condition, you should regularly monitor the level of potassium in the blood during the entire first cycle of taking Jess.

Additional information for special categories of patients:

1. Children and adolescents can use this contraceptive only after menarche ( first menstruation);

2. It is strictly forbidden to use this contraceptive after menopause ( complete cessation of menstruation due to cessation of ovarian function);

3. In no case should this medication be prescribed to patients suffering from serious liver pathologies until the function of this organ returns to normal;

4. Women with various kidney problems can use this drug.

How can you change the start time of menstruation or delay it?

If it is necessary to delay the onset of menstruation, then you should continue to take the active tablets from the next pack, while ignoring the placebo tablets from the current pack. If desired, the period of administration can be extended until all active tablets from the next package have been consumed. During this time, spotting or breakthrough bleeding may occur. It is recommended to return to the usual regimen of taking this contraceptive after taking placebo tablets.

If it is necessary to change the day of menstruation, then experts suggest shortening the period of taking placebo pills by the required number of days. The shorter this period is, the greater the likelihood of no menstrual bleeding while using the tablets from the next package.

Overdose:

Accurate information about serious violations during overdose is still not available.
Possible signs of overdose are metrorrhagia or irregular spotting from the uterus, nausea and vomiting.
Treatment: There is no specific antidote, so in case of overdose, symptomatic treatment is carried out.

Reduced efficiency:

• with diarrhea;
• with vomiting;
• when you miss another pill;
• due to drug interactions.

Laboratory tests:

The use of this contraceptive may affect the following laboratory tests:

• indicators of kidney, adrenal, thyroid, and liver function;
• amount of proteins in plasma;
• indicators of carbohydrate metabolism;
• parameters of fibrinolysis and coagulation.

All existing changes in most cases do not exceed the permissible values.

Medical examinations:

If you intend to start or resume taking Jess, then the doctor should initially consider your family history and life history. In addition, you need to undergo a thorough medical examination, during which your body mass index will be determined, your blood pressure will be measured, and your heart rate will be determined. In such cases, a gynecological examination, examination of the mammary glands and cytological examination of cervical mucus are also carried out. Before you start using Jess, you should exclude the fact of pregnancy. As for control examinations, they are recommended to be carried out at least once a year.

Remember! All combined oral contraceptives are not able to protect against HIV infection and other sexually transmitted diseases.

Poor control of the menstrual cycle:

While using Jess, it is quite possible to develop irregular bleeding. This is especially common during the first months of using this drug. Given this fact, it is very important to evaluate any irregular bleeding only after the adaptation period has been completed. This period takes about 3 cycles. If bleeding continues to bother you even after this, then it is necessary to conduct a thorough examination to exclude the fact of pregnancy or the presence of a malignant tumor.
In some patients, during a break in taking active Jess tablets, withdrawal bleeding does not occur. This fact should not be scary if the pills were taken correctly all the time. If their intake was irregular, then it is imperative to exclude the fact of pregnancy.

Drug interactions:

When this contraceptive interacts with some other pharmaceutical drugs, breakthrough bleeding is quite possible. In addition, such interaction may cause a decrease in contraceptive reliability. Patients taking these medications should temporarily use additional methods of contraception or choose another method of contraception.

Effect on hepatic metabolism:

The use of medications that synthesize microsomal liver enzymes may cause an increase in clearance ( level) sex hormones. This is possible when using rifampicin, barbiturates, carbamazepine, phenytoin And primidone. There are also assumptions regarding felbamate, oxcarbazepine, as well as medicines that include St. John's wort. HIV protease inhibitors also have an effect on hepatic metabolism. ritonavir.

Effect on enterohepatic circulation:

According to information obtained in the course of separate studies, it was possible to establish that some antibiotic drugs such as tetracycline and penicillin tend to reduce the enterohepatic circulation of estrogen, while reducing the level and ethinyl estradiol.
During the course of therapy with these medications, as well as for 7 days after treatment, it is very important to use additional barrier methods of contraception. When undergoing a course of therapy with medications that have a direct effect on microsomal enzymes, barrier methods of contraception will need to be used for 28 days after their discontinuation.

Impact on the ability to operate dangerous machinery and drive vehicles:

Not found.

Conditions for dispensing from pharmacies:

On prescription.

Storage conditions and periods:

It is recommended to store in a dry place at an air temperature of no higher than 30 degrees. Shelf life - 5 years.
Before use, you should consult a specialist.

One active Jess tablet (pink) contains 20 mcg (0.02 mg) ethinyl estradiol and 3 mg drospirenone.

Jess is a monophasic oral contraceptive, which means that all pink pills contain the same amount of hormones. Inactive tablets (white) do not contain hormones and are pacifiers (placebo).

Jess packaging may contain 1 or 3 blisters (plates) of tablets. One blister contains 28 tablets: 24 active (pink) and 4 inactive (white).

ATTENTION: The drug has contraindications. Do not start using this drug without first consulting your doctor.

Analogs

Preparations Dimia, Jess Plus contain the same doses of hormones as Jess.

Advantages of Jess

Jess birth control pills have an antiandrogenic effect. This means that they reduce the effect of male sex hormones (androgens), which are a common cause of oily facial skin and acne. Therefore, Jess may have a cosmetic effect - eliminate or at least weaken acne (blackheads). Taking Jess to achieve a cosmetic effect is acceptable from the age of 14 (in the absence of contraindications).

Jess tablets, unlike some other OCs, do not retain water in the body, so taking them does not increase a woman’s weight.

How to start taking Jess?

You can start taking Jess from the first day of the menstrual cycle (the first day of your period), or from the first Sunday after the start of your period.

Start on day 1 of your period: Take the first tablet (pink) on the first day of your period and then take one tablet every day at approximately the same time. After finishing the pink pills, take white pills (placebo) from 25 to 28 days. After finishing the placebo tablets, start a new pack of Jess. If you start taking Jess on the 1st day of your period, the contraceptive effect occurs immediately and you do not need to use additional contraception. If you take your pills according to the rules and without misses, then you also do not need to use additional contraception while taking placebo pills (white, inactive pills). If you did not start taking Jess on the first day of your menstruation, you must use additional contraception for another 7 days after starting to take the pills.

Starting on Sunday: You can start taking Jess on the next Sunday after the start of your next menstruation (for example, if your period started on Tuesday, then the first pill should be taken on the next Sunday). However, in this case, you should consider the possibility of pregnancy if you had unprotected sexual intercourse before starting to take OCs. You will also have to use additional contraception for another 7 days after you start taking the pills (until next Sunday).

Jess admission rules

After taking the first Jess tablets, your periods may stop or become less heavy than usual. This is normal and is due to the effects of hormones.

In the first months of taking Jess, you may experience spotting. This is also normal.

The pills are taken every day at approximately the same hour. You can take the tablets regardless of meals.

It is advisable to take the tablets in the order indicated on the package. This is to prevent you from getting confused.

If you accidentally mixed up the numbers of the pills, but only drank pink pills, then nothing bad will happen, because all pink Jess pills contain the same dose of hormones.

If you accidentally mixed up the numbers of the tablets, but instead of taking the active (pink) one, you took the inactive (white) one, then the effect of the tablets may be reduced. What to do in this case, read below, in the section What to do if you miss a Jess pill?

After finishing one blister, the next day you need to take the first tablet from the next blister. There are no breaks between blisters.

Menstruation usually begins at 27-28 tablets from the package. You should start taking a new package even if menstruation has not yet begun or has not yet ended.

When will the Jess effect occur?

If you take Jess from the first day of your period, the contraceptive effect occurs immediately and you no longer need to use it.

If you take Jess from the 2-5th day of your period, or from the next Sunday, then in this case you need to use additional contraception for another 7 days after starting to take the pills.

How to switch to Jess from another OK?

If you have taken other birth control pills in the past month and want to switch to Jess, follow these rules:

If the package of previous OCs contained 28 tablets, then taking the first Jess tablet should be started the day after the end of the previous OCs.

If the package of the previous OCs contained 21 tablets, then taking the first Jess tablet can be started the next day after the end of the previous OCs, or on the 8th day after a seven-day break.

How to switch to Jess from a vaginal ring or hormonal patch?

In this case, the first Jess tablet should be taken on the day when you removed the vaginal ring or removed it, or on the day when you need to put a new vaginal ring on or apply a patch.

How to switch to Jess from an intrauterine device (IUD)?

When switching to Jess from an intrauterine device, the first Jess tablet should be taken on the day the device is removed. Use additional contraception for one week after starting Jess.

How to start taking Jess after an abortion?

After an abortion in early pregnancy (up to 12 weeks), you can start taking Jess on the day of the abortion. If the abortion was late (more than 12 weeks), then taking Jess tablets can be started on the 21st or 28th day after the abortion. In this case, you need to protect yourself for another 7 days. If you had unprotected sex before taking Jess, you can start taking the pills only after you are sure that you are not pregnant.

How to start taking Jess after giving birth?

You can start taking Jess on the 21st or 28th day after birth. In this case, you need to protect yourself for another 7 days. If you had unprotected sex before taking Jess, you can start taking the pills only after you have ruled out a possible pregnancy. If you are breastfeeding, then Jess tablets are contraindicated for you.

What to do if you have vomiting or diarrhea while taking Jess?

If vomiting or diarrhea occurs in the first 3-4 hours after taking the active Jess tablet, then its effectiveness may be reduced. In this case, the same measures should be taken as in the case of missing a tablet (depending on the tablet number).

If vomiting or diarrhea continues, then it is necessary to use additional contraception for the entire duration of the indigestion and for another 7 days after its end.

What to do if you miss a Jess pill?

First of all, look at what pill you missed: if it’s white (inactive), then nothing bad will happen and the effect of Jess will not decrease. Just throw the pill away so you don't accidentally prolong your placebo pills, and continue taking them as planned.

If it was a pink, active pill, then count how late you were in taking it. If it is less than 12 hours, then nothing bad will happen and the Jess effect will not decrease. Take the pill as soon as you remember, and continue taking it according to the schedule at your usual time.

If you are more than 12 hours late with your dose (that is, more than 36 hours have passed since taking the previous pill), then the contraceptive effect of the pills may be reduced. See which pill you missed:

1 to 7 tablets: Take that missed Jess tablet as soon as you remember, even if you have to take 2 tablets at once (yesterday's and today's). Then continue taking the pills as planned at your usual time. Use additional contraception (for example,) for a week after missing a pill.

8 to 14 tablets: Take that missed Jess tablet as soon as you remember, even if you have to take 2 tablets at once (yesterday's and today's). Then continue taking the pills as planned at your usual time. If you have taken the pills according to the rules for the last 7 days, then the likelihood of pregnancy is practically excluded. If you also missed pills in the last 7 days or were more than 12 hours late taking your pills, then use additional contraception for a week after missing a pill.

From 15 to 24 tablets: there are two options: 1) you need to take the missed pill Jess as soon as you remember it, even if you have to take 2 pills at once (yesterday’s and today’s). Then continue taking the pills as planned at your usual time. After you have taken the 24th tablet, the next day take the first tablet from the next blister pack (that is, you are not taking white tablets). You do not need additional protection if you took Jess according to the rules 7 days before missing the pill. If not, then you need to take additional protection for 7 days after the pass. 2) throw away this pack and start taking a new pack on day 5. There is no need to use additional contraception.

25 to 28 tablets: These tablets are inactive, so skipping them is not dangerous and you do not need to take any action. Throw away the missed pill to avoid confusion and increase the length of time you take inactive pills.

What should I do if I missed several Jess tablets?

If you missed the white pills, it's not a big deal, because they don't contain hormones. The contraceptive effect of Jess in this case is not reduced. Throw away these pills to avoid prolonging the time you take the placebo pills.

If you miss 2 active tablets in a row in week 1 or 2:

Take two tablets as soon as you remember to skip, and 2 more tablets the next day.

To avoid unwanted pregnancy after missing 2 tablets in a row, use additional contraception for another 7 days after missing.

If you miss 2 active tablets in a row in week 3 or 4:

You may not get your period this month - that's normal. If you don't have your period for 2 months in a row, contact your gynecologist to rule out a possible pregnancy.

If you miss 3 or more active tablets in a row:

If you started taking the very first package of Jess on the first day of your period, then throw away the current package of Jess and start taking a new package of Jess with the first tablet on the same day, as soon as you remembered the omission.

If you started taking the very first pack of Jess on the nearest Sunday after the start of your period, continue to take one tablet a day until the next Sunday, then throw away the current pack of Jess and start a new pack from the first tablet on Sunday.

You need to use additional contraception for another 7 days after the missed period to avoid unwanted pregnancy.

Please note that you have an increased risk of pregnancy, so if you don’t get your period, contact your gynecologist.

If you are not sure what to do in your situation, use additional contraception until you talk to your doctor.

1-2 days after missing the pills, you may experience spotting or breakthrough bleeding, similar to your period. This is not dangerous and is associated with Jess's passes. Continue taking the pills according to the instructions and the discharge will stop.

What should I do if I took several Jess tablets in one day?

Taking 2 tablets in one day is not dangerous. Taking 3 tablets at the same time can lead to symptoms of overdose (nausea, vomiting), but, in principle, is not dangerous.

Bloody discharge while taking Jess

In the first 2-3 months after starting to take Jess, you may experience spotting brown discharge of varying degrees of abundance. It is not dangerous and you do not need to stop taking Jess because of it.

Some women may experience short-term spotting around the middle of the pack while taking birth control pills. This is also normal and you do not need to stop taking Jess because of this.

Bloody discharge may appear if you miss 1 or several Jess tablets. This suggests that Jess's contraceptive effect may be reduced, which means you should use an additional method of contraception (such as condoms) if you have sex.

How to delay menstruation with the help of Jess?

If you need to postpone your period while taking Jess, then after taking 24 tablets from the package (the last pink tablet), the next day start a new blister (the first pink tablet). This way you skip taking the inactive white pills.

With the Jess regimen described above, you may experience symptoms in the middle of the second package, but usually this phenomenon goes away quickly. The next period can come only at the end of the second package (on inactive tablets). The contraceptive effect is retained in full.

Please note: you can postpone your period only if you took Jess at least one month before your unwanted menstruation.

Jess and other drugs

The effect of Jess may be reduced if you are taking the following medications: antibiotics from the group of penicillins, tetracyclines (Doxycycline and others) or Rifampicin, Phenobarbital, anticonvulsant drugs for epilepsy (Phenytoin, Carbamazepine), Griseofulvin, drugs containing St. John's wort (for example, Novo- passit) and some others.

A decrease in the effectiveness of Jess while taking these medications may cause spotting or breakthrough bleeding while taking active tablets. This is not dangerous and you should continue taking Jess on your normal schedule. Use additional contraception for the entire treatment period and for another 7 days after its completion.

Jess and alcohol

Small doses of alcohol do not reduce the effectiveness of Jess tablets. However, the permissible amount of alcoholic drinks depends on your age, weight, metabolism and some other factors. On average, while taking Jess, you are allowed to drink no more than 50 ml of vodka, 200 ml of wine or 400 ml of beer. If you drink more than this amount, you will need to use additional contraception for a week after drinking.

Jess and vomiting, diarrhea

The contraceptive effect of Jess may be reduced by vomiting and diarrhea. Read more about this here:

What should I do if I don’t have my period while taking Jess?

If, after finishing the package, menstruation does not appear, remember if you missed it last month.

If you did, then taking Jess should be postponed until you are sure that you are not pregnant. To do this, you can do or pass.

If last month you took the pills according to the rules, then after finishing the blister, start a new blister. If your period still does not come at the end of the second blister, you need to postpone taking the pills and consult a doctor to rule out a possible pregnancy.

Attention: if in the previous month you have had vomiting, diarrhea, taken large amounts of alcohol, or taken medications that may reduce the effectiveness of Jess, you should consult a doctor to rule out a possible pregnancy. You can read about other reasons for the delay in the article.

What should I do if I get pregnant while taking Jess?

If pregnancy is confirmed, stop taking Jess immediately and consult a gynecologist. If you plan to continue your pregnancy, start taking it as soon as possible.

Taking Jess in the early stages of pregnancy cannot lead to fetal developmental abnormalities and does not affect the health of the unborn child. Therefore, you can safely leave a pregnancy that arose so unexpectedly.

What to do if your period comes while taking active pills?

Against the background of Jess, you may experience bleeding of varying degrees of abundance while taking active tablets: from 1 tablet to 24. Such situations are especially common in the first months of taking Jess.

Such discharge is acceptable; it does not reduce the contraceptive effect of the pill and does not harm your health. Despite these discharges, it is recommended to continue taking Jess as usual - one tablet per day. Do not stop taking Jess if you experience spotting - stopping the pills can significantly increase your periods and lead to the development of uterine bleeding.

Jess' appointment before surgery

If you are undergoing surgery (for any reason), you must stop taking Jess one month (4 weeks) before surgery. This is done to reduce the risk of blood clots. If emergency surgery is required, be sure to notify the anesthesiologist or surgeon that you are taking birth control pills. In this case, your doctor will take additional measures to reduce the risk of blood clots.

You can resume taking Jess 2 weeks after you are able to move independently.

How often should you visit a gynecologist while taking Jess?

Even if nothing bothers you, you need to visit a gynecologist for preventative care at least once a year. If you have any complaints or side effects, contact your gynecologist as soon as possible.

In this article you can read the instructions for use of the drug Jess. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Jess in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Jess analogues in the presence of existing structural analogues. The use of hormonal birth control pills for contraception in women, including during pregnancy and breastfeeding. Side effects (bleeding, headache), withdrawal and use in children and adolescents.

Jess- monophasic oral contraceptive with antimineralocorticoid and antiandrogenic properties.

The contraceptive effect of combined oral contraceptives is based on the interaction of various factors, the most important of which include suppression of ovulation and changes in the properties of cervical secretion, as a result of which it becomes less permeable to sperm.

When used correctly, the Pearl index (the number of pregnancies per 100 women per year) is less than 1. If pills are missed or used incorrectly, the Pearl index may increase.

IN composition of the drug include ethinyl estradiol (in the form of betadex clathrate) and drospirenone.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, painful menstruation is less common, and the intensity of bleeding decreases, which reduces the risk of anemia. In addition, according to epidemiological studies, the use of combined oral contraceptives reduces the risk of developing endometrial and ovarian cancer.

Drospirenone contained in the drug Jess has an antimineralocorticoid effect. Prevents weight gain and the appearance of edema associated with estrogen-induced fluid retention, which ensures very good tolerability of the drug. Drospirenone has a positive effect on premenstrual syndrome (PMS). Jess has been shown to be clinically effective in relieving symptoms of severe PMS, such as severe psycho-emotional disorders, breast engorgement, headache, muscle and joint pain, weight gain and other symptoms associated with the menstrual cycle.

Drospirenone also has antiandrogenic activity and helps reduce acne, oily skin and hair. This action of drospirenone is similar to the action of natural progesterone produced by the body.

Drospirenone does not have androgenic, estrogenic, glucocorticoid or antiglucocorticoid activity. All this, combined with antimineralocorticoid and antiandrogenic effects, provides drospirenone with a biochemical and pharmacological profile similar to natural progesterone.

When combined with ethinyl estradiol, drospirenone demonstrates a beneficial effect on the lipid profile, characterized by an increase in HDL.

Pharmacokinetics

Drospirenone

When taken orally, drospirenone is rapidly and almost completely absorbed. Unmodified drospirenone is excreted only in trace amounts. Drospirenone metabolites are excreted in feces and urine in a ratio of approximately 1.2:1.4.

Ethinyl estradiol

After oral administration, ethinyl estradiol is rapidly and completely absorbed. Concomitant food intake reduces the bioavailability of ethinyl estradiol in approximately 25% of subjects, while no such changes were observed in other subjects. Ethinyl estradiol is practically not excreted unchanged. Ethinyl estradiol metabolites are excreted in urine and bile in a ratio of 4:6.

Indications

• contraception;
• treatment of moderate forms of acne (pimples) (acne vulgaris);
• treatment of severe premenstrual syndrome.

Release forms

Tablets (28 tablets per pack).

Jess Plus - film-coated tablets 3 mg + 0.03 mg + 0.451 mg (additionally contains calcium levomefolinate).

Instructions for use and dosage regimen

The tablets should be taken in the order indicated on the package, at approximately the same time every day, with a small amount of water. The tablets are taken without interruption. You should take 1 tablet per day consecutively for 28 days. Each subsequent package should be started the day after taking the last tablet from the previous package.

Withdrawal bleeding usually begins on the 2-3rd day after starting to take inactive tablets and may not yet end before the next pack is started.

Start taking the drug

If you have not taken any hormonal contraceptives in the previous month

The drug should be taken on the 1st day of the menstrual cycle (i.e. on the 1st day of menstrual bleeding). It is possible to start taking it on the 2-5th day of the menstrual cycle, but in this case it is recommended to additionally use a barrier method of contraception during the first 7 days of taking the tablets from the first package.

When switching from other combined oral contraceptives, vaginal ring or contraceptive patch

It is preferable to start taking the drug the day after taking the last active tablet from the previous package, but in no case later than the next day after the usual 7-day break (for drugs containing 21 tablets) or after taking the last inactive tablet (for drugs containing 28 tablets per package). Taking Jess should begin on the day the vaginal ring or patch is removed, but no later than the day when a new ring is to be inserted or a new patch is applied.

When switching from contraceptives containing only gestagens (mini-pills, injectable forms, implant), or from a gestagen-releasing intrauterine contraceptive (Mirena)

A woman can switch from taking the “mini-pill” to Jess on any day (without a break), from an implant or intrauterine contraceptive with gestagen - on the day of its removal, from an injectable contraceptive - on the day when the next injection is due. In all cases, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills.

After an abortion in the 1st trimester of pregnancy

A woman can start taking the drug immediately. If this condition is met, the woman does not need additional contraceptive measures.

After childbirth or abortion in the 2nd trimester of pregnancy

It is recommended to start taking the drug on the 21-28th day after childbirth or abortion in the 2nd trimester of pregnancy. If use is started later, it is necessary to use an additional barrier method of contraception during the first 7 days of taking the pills. However, if a woman has already been sexually active, pregnancy should be excluded before taking Jess or she must wait until her first menstruation.

Taking missed pills

Skipping inactive tablets can be ignored. However, they should be thrown away to avoid accidentally prolonging the period of taking inactive tablets. The following recommendations apply only to skipping active tablets.

If the delay in taking the drug is less than 12 hours, contraceptive protection is not reduced. A woman should take the missed pill as soon as possible and take the next pill at the usual time.

If the delay in taking the pills is more than 12 hours, contraceptive protection may be reduced. The more pills you skip and the closer the missed pills are to the inactive pill phase, the higher the chance of pregnancy.

In this case, you can be guided by the following two basic rules:

1. taking the drug should never be interrupted for more than 4 days;

2. To achieve adequate suppression of the hypothalamic-pituitary-ovarian axis, 7 days of continuous pill use are required.

Accordingly, if the delay in taking active tablets is more than 12 hours (the interval from the moment of taking the last active tablet is more than 36 hours), the following can be recommended:

From 1st to 7th day

A woman should take the last missed pill as soon as she remembers, even if this means taking two pills at the same time. She continues to take her next pills at the usual time. In addition, over the next 7 days it is necessary to additionally use a barrier method of contraception (for example, a condom). If sexual intercourse took place within 7 days before missing a pill, the possibility of pregnancy should be taken into account.

From 8th to 14th day

A woman should take the last missed pill as soon as she remembers, even if this means taking two pills at the same time. She continues to take her next pills at the usual time.

Provided that a woman has taken her pills correctly for the 7 days preceding the first missed pill, there is no need to use additional contraceptive measures. Otherwise, as well as if you miss two or more tablets, you must additionally use barrier methods of contraception (for example, a condom) for 7 days.

From the 15th to the 24th day

The risk of reduced reliability is inevitable due to the approaching phase of taking inactive tablets. A woman must strictly adhere to one of the following two options. Moreover, if during the 7 days preceding the first missed pill, all pills were taken correctly, there is no need to use additional contraceptive methods. Otherwise, you must use the first of the following regimens and additionally use a barrier method of contraception (for example, a condom) for 7 days.

1. A woman should take the last missed pill as soon as she remembers (even if this means taking two pills at the same time). The following tablets are taken at the usual time until the active tablets in the pack are gone. The four inactive tablets should be discarded and the next pack of tablets should be started immediately. Withdrawal bleeding is unlikely until the active tablets in the second pack are gone, but spotting and breakthrough bleeding may occur while taking the tablets.

2. A woman can also stop taking pills from the current package. Then she should take a break of no more than 4 days, including days of missing pills, and then start taking the drug from a new package.

If a woman has missed active pills and there is no withdrawal bleeding while taking inactive pills, pregnancy must be ruled out.

In severe gastrointestinal disorders, absorption may be incomplete, so additional contraceptive measures should be taken.

If vomiting occurs within 4 hours after taking an active tablet, you should follow the recommendations for skipping tablets. If a woman does not want to change her usual dosing regimen and postpone the onset of menstruation to another day of the week, an additional active tablet should be taken from a different package.

How to change menstrual cycles or how to delay the onset of menstruation

To delay the onset of menstruation, a woman should continue taking tablets from the next pack of Jess, skipping the inactive tablets from the current pack. Thus, the cycle can be extended, if desired, for any period until the active tablets from the second package run out. While taking the drug from the second package, a woman may experience spotting or breakthrough uterine bleeding. Regular use of Jess is then resumed after the end of the inactive pill phase.

To postpone the onset of menstruation to another day of the week, a woman should reduce the next phase of taking inactive pills by the desired number of days. The shorter the interval, the higher the risk that she will not have withdrawal bleeding, and will continue to have spotting and breakthrough bleeding while taking the second pack.

Additional information for special categories of patients

Jess is indicated for children and adolescents only after menarche.

After menopause, Jess is not indicated.

Side effect

The following most common adverse reactions are reported in women using Jess for the indications “Contraception” and “Contraception and treatment of moderate acne (acne vulgaris)”: nausea, pain in the mammary glands, irregular uterine bleeding, bleeding from the genital tract of unspecified origin. These adverse reactions occurred in more than 3% of women. In patients using Jess for the indication "Contraception and treatment of severe premenstrual syndrome", the following most common adverse reactions were reported (in more than 10% of women): nausea, pain in the mammary glands, irregular uterine bleeding.

Serious adverse reactions include arterial and venous thromboembolism.

Also note:

• migraine (headache);
• mood swings, depression/depressed mood;
• decreased or absent libido;
• venous or arterial thromboembolism;
• nausea;
• pain in the mammary glands;
• irregular uterine bleeding;
• bleeding from the genital tract of unspecified origin.

The following are very rare adverse reactions that are thought to be associated with oral combination drugs.

Tumors

• The incidence of breast cancer diagnosis in women taking combined oral contraceptives is slightly increased. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women taking combined oral contraceptives is small relative to the overall risk of this disease;
• liver tumors (benign and malignant).

Other states

• erythema nodosum;
• hypertension;
• conditions that develop or worsen while taking combined oral contraceptives, but their relationship has not been proven: jaundice and/or itching associated with cholestasis, formation of gallstones, porphyria, systemic lupus erythematosus, hemolytic uremic syndrome, Sydenham's chorea, herpes of pregnancy, hearing loss associated with otosclerosis;
• in women with hereditary angioedema, taking estrogens may cause or aggravate its symptoms;
• liver dysfunction;
• changes in glucose tolerance or effects on insulin resistance;
• Crohn's disease, ulcerative colitis;
• chloasma;
• hypersensitivity (including symptoms such as rash, urticaria).

Contraindications

Jess should not be used if you have any of the conditions listed below. If any of these conditions develop for the first time while taking the drug, the drug should be discontinued immediately:

• thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction), cerebrovascular disorders;
• conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history;
• migraine with focal neurological symptoms currently or in history;
• diabetes mellitus with vascular complications;
• multiple or severe risk factors for venous or arterial thrombosis (including complicated lesions of the valvular apparatus of the heart; atrial fibrillation; cerebrovascular or coronary artery disease; uncontrolled arterial hypertension; major surgery with prolonged immobilization; smoking over the age of 35 years) ;
• pancreatitis with severe hypertriglyceridemia currently or in history;
• liver failure and severe liver disease (until liver tests return to normal);
• liver tumors (benign or malignant) currently or in history;
• severe renal failure, acute renal failure;
• adrenal insufficiency;
• identified hormone-dependent malignant diseases (including genital organs or mammary glands) or suspicion of them;
• vaginal bleeding of unknown origin;
• pregnancy or suspicion of it;
• breastfeeding period;
• hypersensitivity to any of the components of the drug Jess.

Use during pregnancy and breastfeeding

Jess is not prescribed during pregnancy and breastfeeding.

If pregnancy is detected while taking Jess, the drug should be discontinued immediately. However, extensive epidemiological studies have not shown any increased risk of developmental defects in children born to women who received sex steroids (including combined oral contraceptives) before pregnancy, or teratogenic effects when sex steroids were taken inadvertently in early pregnancy.

Existing data on the results of taking the drug Jess during pregnancy are limited, which does not allow us to draw any conclusions about the effect of the drug on the course of pregnancy, the health of the newborn and the fetus. There are currently no significant epidemiological data on the drug Jess.

Taking combined oral contraceptives may reduce the amount of breast milk and change its composition, therefore, their use is not recommended until breastfeeding is stopped. Small amounts of sex steroids and/or their metabolites may be excreted in breast milk.

special instructions

If any of the conditions/risk factors listed below currently exist, the potential risks and expected benefits of combined oral contraceptives should be carefully weighed on an individual basis and discussed with the woman before she decides to start taking the drug. If any of these conditions or risk factors worsen, intensify, or appear for the first time, a woman should consult her doctor, who may decide whether to discontinue the drug.

Diseases of the cardiovascular system

The results of epidemiological studies indicate a relationship between the use of combined oral contraceptives and an increased incidence of venous and arterial thrombosis and thromboembolism (such as deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular disease) when taking combined oral contraceptives. These diseases are rare.

The risk of developing venous thromboembolism (VTE) is greatest in the first year of taking such drugs. An increased risk is present after initial use of oral contraceptives or resumption of use of the same or different combined oral contraceptives (after a dosing interval of 4 weeks or more). Data from a large prospective study involving 3 groups of patients suggest that this increased risk is predominantly present during the first 3 months.

The overall risk of VTE in patients taking low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола), в 2-3 раза выше, чем у небеременных пациенток, которые не принимают комбинированные пероральные контрацептивы, тем не менее, этот риск остается более низким по сравнению с риском ВТЭ при беременности и родах. ВТЭ может угрожать жизни или привести к летальному исходу (в 1-2% случаев).

VTE, manifested as deep vein thrombosis or pulmonary embolism, can occur with the use of any combined oral contraceptives.

It is extremely rare that when using combined oral contraceptives, thrombosis of other blood vessels occurs, for example, hepatic, mesenteric, renal, cerebral veins and arteries or retinal vessels. There is no consensus regarding the relationship between the occurrence of these events and the use of combined oral contraceptives. Symptoms of deep vein thrombosis (DVT) include: unilateral swelling of the lower extremity or along a vein in the leg, pain or discomfort in the leg only when standing or walking, localized warmth in the affected leg, redness or discoloration of the skin on the leg.

Symptoms of pulmonary embolism (PE) include: difficulty or rapid breathing; sudden cough, incl. with hemoptysis; sharp pain in the chest, which may intensify with deep inspiration; sense of anxiety; severe dizziness; fast or irregular heartbeat. Some of these symptoms (eg, shortness of breath, cough) are nonspecific and may be misinterpreted as symptoms of other more or less severe events (eg, respiratory tract infection).

Arterial thromboembolism can lead to stroke, vascular occlusion, or myocardial infarction. Symptoms of a stroke: sudden weakness or loss of sensation in the face, arm or leg, especially on one side of the body, sudden confusion, problems with speech and comprehension; sudden unilateral or bilateral vision loss; sudden disturbance in gait, dizziness, loss of balance or coordination; sudden, severe or prolonged headache for no apparent reason; loss of consciousness or fainting with or without an epileptic seizure. Other signs of vascular occlusion: sudden pain, swelling and slight blue discoloration of the extremities, acute abdomen.

Symptoms of myocardial infarction include: pain, discomfort, pressure, heaviness, a feeling of squeezing or fullness in the chest, arm, or chest; discomfort radiating to the back, cheekbone, larynx, arm, stomach; cold sweat, nausea, vomiting or dizziness, severe weakness, anxiety or shortness of breath; fast or irregular heartbeat.

Arterial thromboembolism can be life-threatening or fatal.

The risk of developing thrombosis (venous and/or arterial) and thromboembolism increases:

• with age;
• in smokers (with increasing number of cigarettes or increasing age, the risk increases, especially in women over 35 years of age);
• for obesity (body mass index more than 30 kg/m2);
• if there is a family history (for example, venous or arterial thromboembolism ever occurred in close relatives or parents at a relatively young age). In the case of a hereditary or acquired predisposition, the woman should be examined by an appropriate specialist to decide on the possibility of taking combined oral contraceptives;
• with prolonged immobilization, major surgery, any leg surgery or major trauma. In these situations, it is advisable to stop using combined oral contraceptives (in the case of planned surgery, at least four weeks before it) and not resume use for two weeks after the end of immobilization;
• with dyslipoproteinemia;
• with arterial hypertension;
• for migraines;
• for diseases of the heart valves;
• with atrial fibrillation.

An increase in the frequency and severity of migraine during use of combined oral contraceptives (which may precede cerebrovascular events) may be grounds for immediate discontinuation of these drugs.

Biochemical indicators indicating a hereditary or acquired predisposition to venous or arterial thrombosis include: resistance to activated protein C, hyperhomocysteinemia, antithrombin III deficiency, protein C deficiency, protein S deficiency, antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).

When assessing the risk-benefit ratio, it should be taken into account that adequate treatment of the relevant condition may reduce the associated risk of thrombosis. It should also be taken into account that the risk of thrombosis and thromboembolism during pregnancy is higher than when taking low-dose oral contraceptives (< 50 мкг этинилэстрадиола).

Tumors

The most significant risk factor for developing cervical cancer is persistent human papillomavirus infection. There are reports of a slight increase in the risk of developing cervical cancer with long-term use of combined oral contraceptives. The connection with the use of combined oral contraceptives has not been proven. Controversy remains regarding the extent to which these findings are related to screening for cervical pathology or to sexual behavior (lower use of barrier methods of contraception).

A meta-analysis of 54 epidemiological studies found that there is a slightly increased relative risk of developing breast cancer diagnosed in women currently taking combined oral contraceptives (relative risk 1.24). The increased risk gradually disappears within 10 years of stopping these drugs. Because breast cancer is rare in women under 40 years of age, the increase in breast cancer diagnoses in women currently or recently taking combined oral contraceptives is small relative to the overall risk of breast cancer. The observed increased risk may be due to earlier diagnosis of breast cancer in women using combined oral contraceptives, the biological effects of oral contraceptives, or a combination of both factors. Women who have used combined oral contraceptives have clinically less severe breast cancer than women who have never used them.

In rare cases, during the use of combined oral contraceptives, the development of benign, and in extremely rare cases, malignant liver tumors, which in some cases led to life-threatening intra-abdominal bleeding, was observed. If severe abdominal pain, liver enlargement, or signs of intra-abdominal bleeding occur, this should be taken into account when making a differential diagnosis.

Tumors can be life-threatening or fatal.

Other states

Clinical studies have shown no effect of drospirenone on serum potassium concentrations in patients with mild to moderate renal failure. There is a theoretical risk of developing hyperkalemia in patients with impaired renal function with an initial potassium concentration at ULN who are simultaneously taking medications that lead to potassium retention in the body. However, in women at increased risk of developing hyperkalemia, it is recommended that plasma potassium concentrations be determined during the first cycle of taking Jess.

Women with hypertriglyceridemia (or a family history of this condition) may have an increased risk of developing pancreatitis while taking combined oral contraceptives.

Although slight increases in blood pressure have been described in many women taking combined oral contraceptives, clinically significant increases have rarely been reported. However, if a persistent, clinically significant increase in blood pressure develops while taking combined oral contraceptives, these drugs should be discontinued and treatment of arterial hypertension should be initiated. Taking combined oral contraceptives can be continued if normal blood pressure values ​​are achieved with antihypertensive therapy.

The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives, but their relationship with taking combined oral contraceptives has not been proven: jaundice and/or pruritus associated with cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; Sydenham's chorea; herpes during pregnancy; hearing loss associated with otosclerosis. Cases of Crohn's disease and ulcerative colitis have also been described during the use of combined oral contraceptives.

In women with hereditary forms of angioedema, exogenous estrogens may cause or worsen symptoms of angioedema.

Acute or chronic liver dysfunction may require discontinuation of combined oral contraceptives until liver function tests return to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of combined oral contraceptives.

Although combined oral contraceptives may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetic patients using low-dose combined oral contraceptives (< 50 мкг этинилэстрадиола). Тем не менее, женщины с сахарным диабетом должны тщательно наблюдаться во время приема комбинированных пероральных контрацептивов.

Chloasma can sometimes develop, especially in women with a history of pregnancy chloasma. Women prone to chloasma should avoid prolonged exposure to the sun and ultraviolet radiation while taking combined oral contraceptives.

Laboratory tests

Taking combined oral contraceptives may affect the results of some laboratory tests, including liver, kidney, thyroid, adrenal function, plasma transport protein levels, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes usually do not go beyond normal values.

Drospirenone increases plasma renin and aldosterone activity, which is associated with its antimineralocorticoid effect.

Medical examinations

Before starting or resuming the use of the drug Jess, it is necessary to familiarize yourself with the woman’s life history, family history, conduct a thorough general medical examination (including measurement of blood pressure, heart rate, determination of body mass index) and gynecological examination (including examination of the mammary glands and cytological examination of cervical mucus), and exclude pregnancy. The scope of additional studies and the frequency of follow-up examinations are determined individually. Typically, follow-up examinations should be carried out at least once a year.

The woman should be warned that combined oral contraceptives do not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Reduced efficiency

The effectiveness of combined oral contraceptives may be reduced if pills are missed, vomiting or diarrhea occurs, or due to drug interactions.

Poor control of the menstrual cycle

While taking combined oral contraceptives, irregular bleeding (spotting or breakthrough bleeding) may occur, especially during the first months of use. Therefore, any irregular bleeding should be assessed only after an adaptation period of approximately three cycles.

If irregular bleeding recurs or develops after previous regular cycles, careful evaluation should be performed to rule out malignancy or pregnancy.

Some women may not develop withdrawal bleeding during a pill-free break. If combined oral contraceptives are taken as directed, the woman is unlikely to be pregnant. However, if combined oral contraceptives have not been taken regularly before or if there are no consecutive withdrawal bleeds, pregnancy should be ruled out before continuing to take the drug.

Impact on the ability to drive vehicles and operate machinery

Not found.

Drug interactions

Interaction of oral contraceptives with other drugs (enzyme inducers, some antibiotics) may lead to breakthrough bleeding and/or decreased contraceptive reliability. Women taking these drugs should temporarily use barrier methods of contraception in addition to Jess, or choose another method of contraception.

The use of drugs that induce microsomal liver enzymes can lead to an increase in the clearance of sex hormones. Such drugs include phenytoin, barbiturates, primidone, carbamazepine, rifampicin; There are also suggestions for oxcarbazepine, topiramate, felbamate, griseofulvin and preparations containing St. John's wort.

HIV protease inhibitors (eg, ritonavir) and non-nucleoside reverse transcriptase inhibitors (eg, nevirapine) and combinations thereof also have the potential to affect hepatic metabolism.

According to individual studies, some antibiotics (for example, penicillins and tetracyclines) may reduce the enterohepatic circulation of estrogens, thereby lowering the concentration of ethinyl estradiol.

While taking medications that affect microsomal enzymes, and for 28 days after their discontinuation, you should additionally use a barrier method of contraception.

While taking antibiotics (such as ampicillins and tetracyclines) and for 7 days after their discontinuation, you should additionally use a barrier method of contraception. If the period of using the barrier method of contraception ends later than the tablet in the package, you need to move on to the next package of Jess without the usual break in taking the pills.

The main metabolites of drospirenone are formed in plasma without the participation of the cytochrome P450 system. Therefore, the effect of inhibitors of the cytochrome P450 system on the metabolism of drospirenone is unlikely.

Oral combination contraceptives may affect the metabolism of other drugs, resulting in increased (eg cyclosporine) or decreased (eg lamotrigine) plasma and tissue concentrations.

Based on in vitro interaction studies, as well as in vivo studies in female volunteers taking omeprazole, simvastatin and midazolam as markers, it can be concluded that the effect of drospirenone 3 mg on the metabolism of other medicinal substances is unlikely.

There is a theoretical possibility of increased serum potassium levels in women receiving Jess concomitantly with other drugs that may increase serum potassium levels. These drugs include ACE inhibitors, angiotensin 2 receptor antagonists, some anti-inflammatory drugs, potassium-sparing diuretics, and aldosterone antagonists. However, in studies evaluating the interaction of drospirenone with ACE inhibitors or indomethacin, there was no significant difference in serum potassium concentrations compared with placebo. However, in women taking drugs that may increase serum potassium levels, it is recommended that serum potassium concentrations be determined during the first cycle of dosing.

To identify possible interactions, you should read the instructions for use of the relevant medications.

Analogues of the hormonal drug Jess

Structural analogues of the active substance:

• Dailla;
• Dimia;
• Midiana;
• Yarina.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.