Class oral contraceptives

this class is in brief for under graduate understanding ans examination purpose

1. ORAL
CONTRACEPTIVES

2. Birth control pills (oral contraceptives) are prescription
medications that prevent pregnancy.
Birth control (contraceptive) medications contain
hormones(estrogen and progesteroneor progesterone
alone).
Birth control pills may also be prescribed to reduce
menstrual cramps or prevent anemia.
Some women experience various levels of side effects of
birth control pills.

3. Hormonalbirth control medications preventpregnancy
through the following ways:
Byblockingovulation(releaseof an egg from the ovaries),
thus preventing pregnancy
Byalteringmucusin thecervix,which makes it hard for
sperm totravel further
Bychanging theendometrium(liningof theuterus)so
that it cannot support a fertilized egg
Byaltering the fallopiantubes sothat they cannot
effectively move eggs toward the uterus

5. Birth control(contraceptive) medications contain
hormones(estrogen and progesteroneor progesterone
alone).
The medications are available in various forms, such as
pills, injections (into amuscle, topical(skin) patches,
and slow-release systems (vaginal rings, skin implants,
and contraceptive-infusedintrauterinedevices

6. Estrogens- Ethinylestradiol-30 micro grams
Mestranol-50 micro grams
ProgesteronesNorethindrone-1mg
Norethindroneacetate
Norgestimate
Desogestrel150 micro grams
Norgestrel-0.5mg
Levonorgestrel150 micro grams

7. Combinationcontraceptives, that is, contraceptive
medications containing both estrogen and progesterone,
are the most effective means for contraception with the
exception of surgical sterilization.
Severaltypes of combination birth control pills exist,
includingmonophasicpills, biphasic pills,triphasicpills,
and 91-day-cycle pills.

8. Monophasicpills have a constant dose of both
estrogen andprogestinin each of the hormonally
active pills throughout the entire cycle (21 days of
ingesting active pills).
Severalof the brands listed above may be
available in several strengths of estrogen or
progesterone, from which doctors choose
according to a woman’s individual needs.

9. Biphasicpills typically contain 2 different progesterone
doses. The progesterone dose is increased about halfway
through the cycle.
Ethinylestradiol 35 micro gram+Norethindrone0.5mg
(day1 to day 10)
Ethinylestradiol 35 micro gram+Norethindrone1mg
(day12to day21)

10. Triphasicpills gradually increase the dose of
progesterone and provides higher dose of estrogen
Three different increasing pill doses are contained in
each cycle
Ethinylestradiol 35 micro gram+Norgestrol0.05mg
(day1 to day6)
Ethinylestradiol 35 micro gram+Norgestrol0.075 mg
(day 7to day11)
Ethinylestradiol 35 micro gram+Norgestrol0.125 mg
(day12to day21)

11. Two tablets of progestinlevonorgestrolcontaining 1500mg
Or single 1500mcg tablet taken as soon as possible after
unprotected intercourse (up to 72 hours after)
Preferably within 12 hours, no later than 72 hours
Ethinylestradiol50micro gram+levonorgestrol250 micro
gram. Two such tablets are to be taken with in 72hrsof
unprotected sex
Ulipristal(SPRM-Selective Progesterone Receptor
Modulator)
single dose 30mg effective with in 120hrs/5days

12. Non steroidal estrogen receptor antagonist-serm
Centchroman-30mg twice in a week for first 3month and
once in a week subsequently as long as the contraception
is preferred
Reversible in 6 months
It is potent competitive antagonist at peripheral estrogen
receptors andsupressesproliferative stage of
endometrium
It accelerates ovum transport, without affecting ovulation
No risk ofteratogenesis
C/I-hepatic dysfunction, polycystic ovarian disease,
cervical hyperplasia, tuberculosis, renal disease

13. Depotmedroxyprogesterone acetate(Depot-Provera)-DMPA
Thefirst injection is given within 5 days following the onset of
menstruation.Afterthat, an injection is needed every 11-13
weeks.
Sideeffects:Sinceprogesterone is the only hormonal ingredient,
estrogen-related side effects are avoided.
A side effect unique to this method of birth control is that most
women eventually stop having their periods.
Depo-Proveramay last in the body for several months in women
who have used it on a long-term basis and can actually delay the
return tofertilityafter stopping the drug.
Otherside effects include weight gain and depression.

14. Norelgestromin/ethinylestradiol
The topical patch may be applied to clean,onthe shoulders,
upperarms, buttocks or abdomen. Thepatch may be less
effective in women weighing more than 198 pounds (90 kg).
Use:Anew patch is applied on the same day of the week, each
week for 3 weeks in a row.
Thefirst patch is applied either on the first day of the
menstrual period or on the Sunday following menses.
On the fourth week, no patch is applied.
This4-week period is considered 1cycle.
Another4-week cycle is started by applying a new patch
following the 7-daypatch-freeperiod.

15. Side effects are similar to other birth control agents
containing both estrogen and progesterone.
Effects include menstrual irregularities, weight gain,
and mood changes.
Other specific side effects include a skin reaction at
the site of application and problems with contact
use

16. NorethindroneProgesterone-onlypills (POPs), also known as
mini-pills. Lessthan 1% of users of oral contraceptives use them
as their only method of birth control. Those who use them
include women who arebreast feedingand women who cannot
take estrogen.
Use:POPsare ingested once daily, every day.
POPsmay be started on any day, and there are no pill-free
days or different-colored pills to track.Sinceprogesterone is
the only hormonal ingredient, estrogen-related side effects are
avoided.However, since POPs do not include estrogen, they
have a higher failure rate.
Usersmust take this pill at the same time daily for greatest
effectiveness.

17. Womenwith the following conditions should not use estrogen-
containing birth control medications:
to any component of the product
History ofblood clottingdisorders
History ofstroke or heart attack
heartvalve disease with complications
Severehypertension
Poorlycontrolled diabetes
Recentmajorsurgery withprolonged bed rest
Breast cancer, Liver cancer(orliver disease)
Uterine canceror other known or suspected estrogen-dependent
cancers
jaundiceduring pregnancy or jaundice with prior hormonal
contraceptive use

18. The effectiveness of oral contraceptives, Progesterone
Only Pill and post coital pill will be reduced by
interaction with drugs that are enzyme inducers
Drugs that may cause this effect include: many
antibiotics (e.g.,cephalosporins, chloramphenicol,
macrolides,penicillins, tetracyclines, sulfas),
aprepitant,bexarotene,
Broad spectrum antibiotics may reduce effectiveness
of OCPs by altering the bacterial flora of the bowel

19. Nausea, breasttenderness,fluidretention,weight gain,
acne, breakthroughbleeding,missed periods,headaches,
depression, change in vision, othermood changes, and
lower sexual desire.
Additionally, the following more serious side effects may
occur:thromboembolism(bloodclots)
Breastcancer, cervical cancer
Benign liver tumors
Diabetes

21. Smoking cigarettes while using this medication increases
your chance of having heart problems.
Do not smoke while using this medication.
The risk of heart problems increases with age (especially
in women greater than 35 years of age) and with
frequent smoking (15 cigarettes per day or greater)
If overdose is suspected, contact your local poison
control center or emergency room immediately.
Symptoms of overdose may includenausea and
vomiting.
Mayexperiencevaginal bleeding.

22. 1.Menstrual Bleeding Disorders
2.Dysmenorrhea
3.Symptoms ofAndrogenisation(Seborrhea, Acne, Hirsutism,
Alopecia)
4.Premenstrual Syndrome (PMS) and PremenstrualDisphoric
Disorder(PMDD )
5.OvarianCysts
6.Endometriosis/Adenomyosis
7.Pelvic Inflammatory Disease (PID)
8.Multiple Sclerosis
9.Menstrual Migraine
10.Endometrial Hyperplasia
11.Benign Breast Disease
12.Prevention of Ovarian Cancer
13.Endometrial Cancer
14.Colon Cancer