Many contraceptive drugs have abortifacient (anti-implantation) effects that they are not telling. What has a bad effect on one aspect of the body (prevention of ovulation) will be expected to have other negative effects as well, but this survey is just surprising.

1. CONTRACEPTION DRUGS PROPOSED
UNDER THE PHILIPPINE RH LAW
AND THEIR MECHANISM OF ACTION WITH CITATIONS
May Jennifer Amolat, MD, MPH

2. Cyproterone acetate+ Ethinylestradiol
(Chloe, Althea,Cybelle)
• MECHANISM OF ACTION
Quote: Cyproterone acetate is a progestogen derivative, and the other
ingredient, ethinylestradiol, is a synthetic version of the naturally-
occurring female hormone, oestrogen. The medicine works as a
contraceptive by preventing the ripening and release of eggs from the
ovaries, as well as increasing the thickness of the cervical mucus,
which makes it more difficult for sperm to cross from the vagina into
the womb. It also changes the lining of the womb so that it is less
suitable for any fertilised eggs to successfully implant in.
• REFERENCE http://www.netdoctor.co.uk/medicines/skin-and-
hair/a6558/dianette-cyproterone-acetate-and-ethinylestradiol/
• CONCLUSION Abortifacent

3. Desogestrel + Ethinylestradiol
(Estrelle Plus, Mercilon, Marvelon 28,
Gracial)
• MECHANISM OF ACTION/QUOTE: Combined oral
contraceptives act by suppression of gonadotropins.
Although the primary mechanism of this action is
inhibition of ovulation, other alterations include
changes in the cervical mucus, which increase the
difficulty of sperm entry into the uterus, and changes
in the endometrium which reduce the likelihood of
implantation
• REFERENCE https://www.drugs.com/pro/desogestrel-
and-ethinyl-estradiol.html
• CONCLUSION Abortifacent

4. Drospirenone+ Ethinylestradiol
(Lizonya, Yasmin, Lizelle, Yaz)
• MECHANISM OF ACTION/QUOTE: Since the pill-free interval is only 7 days, in most women the
follicle does not mature to the point of ovulation, and therefore most OCP cycles are anovulatory.
Since the OCP also has a progestin for at least 21 day, the cervical mucus is also altered. With
estrogen alone, the cervical mucus is thin, clear, and copious with Spinnbarkeit noted. Once a
progestin is introduced, the cervical mucus becomes thick, sticky, pasty and scant. It is this
progestin-affected cervical mucus in the combination OCP that produces an environment that
makes it difficult for sperm to enter the uterus. The progestin also alters motility of the uterus and
oviduct as the normal transport of both the ovulated ova traveling down the fallopian tube and the
sperm that are traveling up the fallopian tube to fertilize this ova is interrupted. Progestins also
alter the endometrium, such that the glandular production of glycogen is diminished.
• REFERENCE Bachmann G, Kopacz S. Drospirenone/ethinyl estradiol 3 mg/20 μg (24/4 day regimen):
hormonal contraceptive choices – use of a fourth-generation progestin. Patient preference and
adherence. 2009;3:259- 264. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778416/#b1-ppa-3-
259
• REFERENCE ON “GLYCOGEN (PLAYING) AN IMPORTANT ROLE IN NUTRITIONAL WELFARE OF
PREIMPLANTATION BLASTOCYSTS” p/ 136, para 2 Implantation of the Ovum. Koji Yoshinaga, Roland
K. Meyer, Roy Orval Greep Harvard University Press, 1976, 161 pages
https://books.google.com/books?id=vVzUZpdR_3wC&pg=PA136&lpg=PA136&dq=progestins+and+
glycogen+and+implantation&source=bl&ots=77J_3OpR7e&sig=dMlwnwxPrrsUvlyQTRMc9R1Mtnc&
hl=en&sa=X&ved=0ahUKEwj2jdqC0f3VAhVI54MKHSDpB9QQ6AEIPjAE#v=onepage&q=progestins%
20and%20glycogen%20and%20implantation&f=false
• CONCLUSION Because this decreases glycogen, the mechanism of action is probably/likely
also ABORTIFACENT.

5. Estradiol Valerate + Dienogest (Olaira)
• MECHANISM OF ACTION/ QUOTE: The progestin
component prevents the luteinizing hormone surge
required for release of the ovum. It also serves to thicken
cervical mucus and decrease tubal motility, creating a less
facile passage for sperm. In addition, the progestin acts to
thin the endometrium, resulting in tissue less receptive to
implantation.
• REFERENCE Kiley, Jessica W, and Lee P Shulman. “Estradiol
Valerate and Dienogest: A New Approach to Oral
Contraception.” International Journal of Women’s Health 3
(2011): 281–286. PMC. Web. 12 Sept. 2017.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163658/
• CONCLUSION Abortifacent

6. Etonogestrel
(Implanon, Implanon NXT)
• The contraceptive effect of IMPLANON is
achieved by suppression of ovulation,
increased viscosity of the cervical mucus, and
alterations in the endometrium.
• REFERENCE Prescribing Information.
Mechanism of Action, p. 24.
http://www.merck.com/product/usa/pi_circular
s/i/implanon/implanon_pi.pdf
• CONCLUSION Abortifacent

7. Etonogestrel+ Ethinylestradiol
(Nuvaring)
• Although the primary effect of this action is inhibition
of ovulation, other alterations include changes in the
cervical mucus (which increase the difficulty of sperm
entry into the uterus) and the endometrium (which
reduce the likelihood of implantation)
• REFERENCE Prescribing Information. Mechanism of
Action, p. 16.
http://www.merck.com/product/usa/pi_circulars/n/nu
varing/nuvaring_pi.pdf
• CONCLUSION Abortifacent

8. Gestodene + Ethinylestradiol
(Sophia,Meliane, Gynera)
• Femodene tablets contain two active ingredients, ethinylestradiol and gestodene.
These are synthetic versions of the naturally occurring female sex hormones,
oestrogen and progesterone. Ethinylestradiol is a synthetic version of oestrogen
and gestodene is a 'third generation' synthetic form of progesterone.
• Combined oral contraceptives like Femodene work by over-riding the normal
menstrual cycle. In a woman's normal menstrual cycle, levels of the sex hormones
change throughout each month. The hormones cause an egg to be released from
the ovaries (ovulation) and prepare the lining of the womb for a possible
pregnancy. At the end of each cycle, if the egg has not been fertilised the levels of
the hormones fall, causing the womb lining to be shed as a monthly period.
• The daily dose of hormones taken in the pill work mainly by tricking your body into
thinking that ovulation has already happened. This prevents an egg from ripening
and being released from the ovaries each month.
• The hormones also increase the thickness of the natural mucus at the neck of the
womb, which makes it more difficult for sperm to cross from the vagina into the
womb and reach an egg. They also change the quality of the womb lining
(endometrium), making it less likely that a fertilised egg can implant there.
• REFERENCE Femodene. http://www.netdoctor.co.uk/medicines/sexual-
health/a6712/femodene-ethinylestradiol-and-gestodene/
• CONCLUSION Abortifacent

9. Levonorgestrel (Mirena)
• Studies of Mirena and similar LNG IUS prototypes have
suggested several mechanisms that prevent pregnancy:
thickening of cervical mucus preventing passage of
sperm into the uterus, inhibition of sperm capacitation
or survival, and alteration of the endometrium.
• REFERENCE Prescribing Information. Mechanism of
Action, p. 19.
https://labeling.bayerhealthcare.com/html/products/pi/
Mirena_PI.pdf
• CONCLUSION Abortifacient

10. Levonorgestrel + Ethinylestradiol
(Juliiane, Nordette, Lady, Denise,
Minipil,Seif, Logynon 21)
• Combination oral contraceptives act by suppression of
gonadotrophins. Although the primary mechanism of
this action is inhibition of ovulation, other alterations
include changes in the cervical mucus (which increase
the difficulty of sperm entry into the uterus) and the
endometrium (which may reduce the likelihood of
implantation).
• REFERENCE http://www.rxlist.com/levora-
drug/patient-images-side-effects.htm
• CONCLUSION Abortifacient

11. Levonorgestrel+ Ethinylestradiol +
Ferrous fumarate
(Protec, Famila 28F, Femme, Ruby,
Trust Pill, Charlize)
• The mechanism is the same as above. Ferrous sulfate is simply
added as an iron supplement.
• Combination oral contraceptives act by suppression of
gonadotrophins. Although the primary mechanism of this action is
inhibition of ovulation, other alterations include changes in the
cervical mucus (which increase the difficulty of sperm entry into the
uterus) and the endometrium (which may reduce the likelihood of
implantation).
• REFERENCE http://www.rxlist.com/levora-drug/patient-images-
side-effects.htm
• CONCLUSION Abortifacient

12. Lynestrenol (Exluton, Daphne, Leila)
• In 10 women taking 0.5 mg lynestrenol for oral contraception
endometrium biopsies were carried out in several consecutive cycles
between the 21st and 25th day of each cycle. In addition pregnandiol
excretion in the urine was measured in one of the last three treatment
cycles always on the 10th and 21st day of cycle. During treatment of a
characteristic, monomorphic microscopical endometrium picture was
observed with hardly distinct endometrium glands and only slight
decidualike transformation of cellular elements of the stroma. From these
histological pictures it is concluded that oral application of 0,5 mg
lynestrenol produces endometrium changes characterized by insufficient
transformation so that nidation of a blastocyte becomes impossible.
• REFERENCE Gerber E, Koch P; [Effects of low doses of lynestrenol on
endometrium and nidation (author's transl)]. Med Klin 71 (2): 51-5 (1976)
https://www.ncbi.nlm.nih.gov/pubmed/1246215?dopt=Abstract
• CONCLUSION Abortifacient

13. Medroxyprogesterone acetate
(Depo-gestin, Depofemme, Depotrust,
Lyndavel, Protec)
• Results of studies conducted using medroxyprogesterone
acetate for marketed indications showed it to be a potent inhibitor of
gonadotropins 1-3 and that it was slowly absorbed from the injection
site resulting in prolonged activity. Furthermore, continued use of the
drug results in endometrial suppression producing an environment
hostile to nidation.
REFERENCE Schwallie, P. and Assenzo, JR. Contraceptive use efficacy
study utilizing Medroxyprogesterone acetate* administered as an
intramuscular injection once every 90 days.” Fertility and Sterility. 25
(5): 331 (1973).
http://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-
S0015028216396698/first-page-pdf
• CONCLUSION Abortifacient

14. Nomegestrol acetate+ Estradiol (as
hemihydrate) (Zoely)
• The contraceptive effect of birth control pills derives primarily from
the progestin component, while the estrogen component
contributes cycle control and potentiates contraceptive efficacy.
The progestin contraceptive effects of NOMAC include
antigonadotropin activity (suppression of the luteinizing and
follicle-stimulating hormone surges that lead to follicle
development and ovulation); thickening of cervical mucus; and
thinning of the endometrium .
• REFERENCE Burke, Anne. “Nomegestrol Acetate-17b-Estradiol for
Oral Contraception.” Patient preference and adherence 7 (2013):
607–619. PMC. Web. 14 Sept. 2017.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702550/#__sec2t
itle
• CONCLUSION Abortifacient

15. Norethisterone Enanthate + Estradiol valerate
(Norifam)
Norethisterone+ Ethinylestradiol (Micropill)
Norethisterone+ Ethinylestradiol + Ferrous
fumarate (Micropill Plus)
• The principal distinctions between DMPA and NET-EN are their durations of effectiveness and the
incidence of drug-induced amenorrhea, and little else typically determines prescriptive practice.
Nonetheless, given slight differences in the steroid derivation of the two drugs, experience of
different side-effects with the two methods (e.g., weight gain or hirsutism), cannot be ruled out;
however, most comparative data show few clinical differences other than duration of action…
Current formulations of injectable contraceptives are highly effective. One injection of DMPA
inhibits ovulation for 14 weeks, suppressing both FSH and LH. Cervical mucus is thickened,
decreasing sperm penetration, the endometrium is atrophied with inactive glands, and there is
decreased tubal motility. Pregnancies due to method failure are consistently low, with cumulative
life-table rates of 0-0.1 percent at 12 months. NET-EN is also highly effective. When given at 60-day
intervals, the cumulative lifetable rates are 0.4% at 12 months, and 0.4% at 24 months.
• REFERENCE Injectable Contraceptives for Women. Adapted from: d'Arcangues C, Snow R. Injectable
contraceptives. In: Rabe T, Runnebaum B, eds. Fertility Control-Update and Trends. Springer-Verlag
Berlin 1999: 121-149. http://www.gfmer.ch/Endo/Course2003/Injectable_contraceptives.htm
• CONCLUSION Same as medroxyprogesterone acetate (DPMA); abortifacient

16. Copper Intrauterine Device
(Securit-T)
• All IUDs induce a local inflammatory reaction that disturbs the
functioning of the endometrium and myometrium and changes the
microenvironment of the uterine cavity. Moreover, these effects
alter signaling between uterus and ovary. The entire genital tract
seems affected, at least in part because of luminal transmission of
fluids accumulating in the uterine lumen. Copper or progesterone-
releasing IUDs may attenuate or accentuate the inflammatory
response, disturb the physiology of the gametes in the female
genital tract, or destroy the viability of the embryos or endometrial
receptivity to implantation.
• REFERENCE Ortiz ME1, Croxatto HB, Bardin CW. Mechanisms of
action of intrauterine devices. Obstet Gynecol Surv. 1996 Dec;51(12
Suppl):S42-51.
https://www.ncbi.nlm.nih.gov/pubmed/8972502
• CONCLUSION Abortifacient