Combined oral contraceptive pills

Combined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pillsCombined oral contraceptive pills

1. COMBINED ORAL CONTRACEPTIVE PILLS DONE BY: ALI NAJAT JABBAR KIRKUK MEDICAL COLLAGE

2. INTRODUCTION The combined oral contraceptive pill (COCP), often referred to as the birth control pill Is a type of birth control that is designed to be taken orally by women. It includes a combination of an estrogen (usually ethinylestradiol) and a progestogen (specifically a progestin) I t alters the menstrual cycle to eliminate ovulation and prevent pregnancy. Have many formulations include monophasic, diphasic and triphasic.

3. MECHANISM OF ACTION Estrogen and progesterone have negative feedback effect which decrease the pulse frequency of gonadotropin-releasing hormone (GnRH) release by the hypothalamus, which decreases the secretion of follicle-stimulating hormone (FSH) and greatly decreases the secretion of luteinizing hormone (LH) by the anterior pituitary. Decreased levels of FSH inhibit follicular development, preventing an increase in estradiol levels. Progestogen negative feedback and the lack of estrogen positive feedback on LH secretion prevent a mid-cycle LH surge. Inhibition of follicular development and the absence of an LH surge prevent ovulation.

4. Contraceptive use Combined oral contraceptive pills are a type of oral medication that is designed to be taken every day, at the same time of day, in order to prevent pregnancy. There are many different formulations or brands, but the average pack is designed to be taken over a 28-day period, or cycle. For the first 21 days of the cycle. The last 7 days of the cycle are hormone free days (placebo pills). Effectiveness the estimated risk of getting pregnant is 0.3%, or about 3 in 1000 women on COCPs will become pregnant within one year.

5. MEDICAL USES Used in treatment of: PCOS Endometriosis Adenomyosis Acne

6. DRUG INTERACTIONS Some drugs reduce the effect of the pill and can cause breakthrough bleeding, or increased chance of pregnancy. These include drugs such as rifampicin , barbiturates , phenytoin and carbamazepine . In addition cautions are given about broad spectrum antibiotics, such as ampicillin and doxycycline .

7. SIDE EFFECTS Nausea, vomiting, headache, bloating, breast tenderness, swelling of the ankles/feet (fluid retention), or weight change may occur. Vaginal bleeding. I ncrease the risk of venous thromboembolism (including deep vein thrombosis (DVT) and pulmonary embolism (PE)). I ncrease the risk of ischemic stroke and myocardial infarction at high doses. I ncrease in breast cancer risk. Depression (decrease of serotonin levels). Hypertension (increase bradykinin breakdown).

8. CONTRAINDICATION C ardiovascular disease (such as valvular heart disease or ischemic heart disease), history of thromboembolism or pulmonary embolism, cerebrovascular accident, migraine with aura, a familial tendency to form blood clots (such as familial factor V Leiden), and in smokers over age 35. A dvanced diabetes, liver tumors, hepatic adenoma or severe cirrhosis of the liver. B reast cancer, endometrial cancer. Pregnancy. W omen who are breastfeeding are also advised not to start COCPs until 4 weeks after birth due to increased risk of blood clots. Severe hypercholesterolemia and hypertriglyceridemia.

9. THANK YOU