this presentation gives basic information about the recent advances in hormonal contraceptives, their advantages and disadvantages in a very simplified, short and sweet manner. This presentation saves time and also gives awareness about the newly available contraceptives

1. RECENT ADVANCES IN
HORMONAL CONTRACEPTIVES
M. Aravind
Mbbs II yr
DSMCH

2.  Oral pills- combined pill,
progesterone only pill, post coital pill
 once-a-month pill
 male pill
 Extended cycle oc
 Dogestrel containing oc
 Chewable oc
HORMONAL CONTRACEPTIVES
 Depot (slow release)
formulations
 Injectables
 Implants
 Vaginal rings
 IUDS
 Trandermal patches

3. ONCE A MONTH PILL
 Quinestrol(long acting oestrogen) & short acting progesterone
 Pregnancy rate- too high
 A/E- Irregular bleeding

4. MALE PILL
 Introduced in 1950
 Mechanism of Actions
 Preventing spermatogenesis
 Interfering with sperm storage and maturation
 Preventing sperm transport in the vas
 Affecting constituents of the seminal fluid
 Gossypol – local male contraceptive

5. EXTENDED CYCLE OC
 0, 2, 4 – Hormone free interval (HFI)
 A/Es - Menstrual symptoms (breast tenderness,
bloating, host flushes, headache, bloating, cramping,
hypermenorrhoea)
 Advantages - Reduce withdrawal bleeding
 Did not forget to restart the pill
 Disadv- Excess hormone exposure (endometrial
hyperplasia, thrombosis, breast cancer, future fertility)

6. DESOGESTROL CON OC
 3rd G- dec androgenic effects like hirsuitism, acne
 Disadv- 2 fold increase in venous thromboembolism
 So FDA warned to switch to 2nd G
 Public Citizen’s Health Research Group- 2007
filed a petetion to withdraw these drugs

7. DROSIPERONONE COC
 Disadv- Antimineralocorticoid activity- bloating, breast
tenderness, water retention
 Hyperkalemia due to K+ retention
 Reasons for non compliance
 Physician disagreement with recommendation
 Patient factors
 Health planning barriers

8.  Spear mint flavoured pill
 Cocs with 75 mg ferrous
fumarate
CHEWABLE OC

9. INJECTABLE
 DMPA (Depot Medroxy Progesterone Acetate) 150 mg for 90
days
 NET-EN (Norethisterone enanate) 200mg for 60 days
 DMPA SC 104mg for 60 days

10. IMPLANTS
 Norplant- 6 rods - 216mg of levonorgestrel for 5 yrs
 Implanon- single rod 68mg of desogestrel- biodegradable

11. TRANSDERMAL PATCH
 Ortho evra
 Adv- Weekly application- better compliance
 Easy verification
 Disadv- Site reaction
 60% more exposure to oestrogen – twice risk of VTE
 Public Citizen’s Health Research Group- 2008 filed a petetion to
withdraw these drugs

12. 3RD G IUD
 Levonorgestrol- 5 yrs
 Progestasert- 1 yr

13. VAGINAL RINGS
 Worn in vagina for 3 weeks,
removed for fourth
 Contains levonorgestrol

14.  5o% unintended, 1 in 5 end in abortion
 46% (10,000) had not used contraception
 To avoid unwanted births
 To bring about wanted births
 To regulate interval between pregnancies
 To contol the time of birth to age of parents
 To determine no of children in the family
 41.5% TN 2011 (34%, 6.1%)
 Significant gap in knowledge, practice and preference