Hormonal Contraceptives: Types, Mechanisms, and Benefits

Discover a thorough exploration of hormonal contraceptives in this informative PowerPoint presentation. Perfect for students, healthcare professionals, and anyone interested in reproductive health, this presentation covers:

Types of Hormonal Contraceptives: Learn about various methods including oral contraceptives, injectables, implants, patches, and vaginal rings.
Mechanisms of Action: Understand how these contraceptives work to prevent pregnancy by influencing the menstrual cycle, ovulation, and hormonal balance.
Benefits and Side Effects: Get insights into the advantages, potential risks, and side effects associated with each type of hormonal contraceptive.
Recent Advances: Stay updated with the latest developments and research in hormonal contraceptive technology.
Clinical Applications: Explore practical applications and considerations for healthcare providers when prescribing contraceptives.

Whether you’re preparing for an exam, educating patients, or expanding your knowledge, this presentation offers a comprehensive and easy-to-understand overview of hormonal contraceptives.

1. Hormonal Contraceptives By Dhanraj Sethi

2. Introduction to Hormonal Contraceptives Definition : A Method or system that use hormones (estrogen and/or progestin) to prevent pregnancy. Major Mechanism of Actions : Prevent ovulation, thicken cervical mucus, and thin endometrium. Importance - Role in family planning, menstrual regulation, and reducing the risk of certain gynecological conditions.

3. Combined Oral Contraceptives ( COCs ) Examples : Mala-D, Femilon Composition : Estrogen + Progestin Mechanism : Inhibits ovulation, alters cervical mucus, and endometrial lining. Indications: Contraception, dysmenorrhea , PCOS management. Indian Government Program: Mala-D available under government schemes for free distribution.

4. Mechanism of action

5. Side effect and contraindication S ide effect Nausea Breast tenderness Headaches. Mood changes Spotting or breakthrough bleeding Weight changes Increased risk of blood clots Decreased libido C ontraindication History of Thromboembolic Disorders Known or Suspected Pregnancy Severe Hypertension Known or Suspected Breast Cancer Liver Disease Migraine with Aura Major Surgery with Prolonged Immobilization Severe Hyperlipidemia Diabetes with Complications

6. Progestin-Only Pills ( POPs ) Examples : Cerazette, Ovrette Composition : Only Progestin Mechanism : Mainly thickens cervical mucus, inhibits ovulation. Indications : Suitable for breastfeeding women, those who cannot use estrogen.

7. Mechanism of action

8. Injectable Contraceptives Examples: Depo-Provera ( DMPA ), Sayana Press Composition : Medroxy progesterone acetate Mechanism : Same as pop. Use : Effective for 3 months per injection. Indian Government Program: Antara program provides free injectable contraceptives.

9. Advantage and disadvantage Advantages Injections are easy to administer and there is no worry over 'missing pill'. They are long-acting and reversible. The compliance is good and the woman remains under regular medical supervision. DMPA has least androgenic effects among all progesterones . it is best suited for lactating women. Devoid of oestrogenic side effects. The preparations turn out to be more cost-effective for mass usages. DISADVANTAGE Once administered, the side effects, if any, need to be tolerated until the effect of the injection is over. There is a delay in return of fertility, With DMPA , ovulation returns in 5 months. The side effects in the form of weight gain, depression Prolonged DMPA use, by virtue of antioestrogenic action, may reduce bone density mass and induce osteopenia . Contraindicated in women with breast cancer. It does increase LDL but does not adversely affect the blood pressure. It may decrease libido, causes dry vagina.

10. Contraceptive Patch Examples : Ortho Evra Composition: Estrogen + Progestin Mechanism: Transdermal delivery, inhibits ovulation, alters cervical mucus. Use: Weekly replacement, convenient for some users.

11. Vaginal Ring Examples: NuvaRing Composition : Estrogen + Progestin Mechanism: Vaginal delivery, inhibits ovulation, thickens cervical mucus. Use: Worn for 3 weeks, 1-week break for menstruation.

12. Hormonal IUDs Examples: Mirena, Skyla Composition: Progestin-only Mechanism: Thickens cervical mucus, inhibits sperm motility Use : Long-acting (3-6 years), reversible.

13. Mechanism of action

14. Contraceptive Implants Examples: Nexplanon, Implanon Composition: Progestin-only Mechanism: Subdermal implant, inhibits ovulation, thickens cervical mucus. Use : Long-acting (up to 3 years), effective and reversible.

15. ADVANTAGE AND DISADVANTAGE The advantages of implants are as follows: They are long-acting with sustained effect - compliance is good. Coital-independent with no 'nuisance' of daily oral or frequent injection Systemic side effects are few and the first-pass effect on the liver avoided. Return of fertility is prompt (within 4-12 weeks). Can be used by lactating mothers and women older than 40 years. The disadvantages of implants are as follows: Breakthrough bleeding, irregular cycles, amenorrhoea occur as seen with other progesterone only contraceptives Other side effects of progestogens are seen Ectopic pregnancy is reported in 1.3% Local infection at the site of insertion may occur. Requires insertion and removal however, it is a minor surgical procedure. The implants are expensive. Infertility may be seen in a few cases after the removal of implant.

16. Emergency Contraceptives Examples : Plan B, Ella Composition: Higher doses of Progestin Mechanism : Prevents or delays ovulation, alters the endometrium. Use : Post-coital, within 72-120 hours of unprotected intercourse. Indian Government Initiative : chhaya

17. Post Coital contraceptions Levonorgestrel RU486 ( Mifepristone ) Ulipristal Centchroman Copper T IUCD

18. Hormonal Vaginal Gel Example: Phexxi Mechanism : Lowers vaginal pH, creating a hostile environment for sperm. Use: Applied before intercourse.

19. References Shaw's Textbook of Gynaecology www . ncbi . nlm . nih . gov

20. THANK YOU