oral contraceptives .... definition, types of oral contraceptives, combines pill, progestin only pill, postcoital pills, indications for oral contraceptives, contraindications, and adverse effects

1. ORAL CONTRACEPTIVES

2. • Oral contraceptive:
• A birth control pill taken by mouth.
• Most oral contraceptives include both oestrogen and progesterone.
• When given in certain amounts and at certain times in the menstrual
cycle, these hormones prevent the ovary from releasing an egg for
fertilization.

3. Types of oral contraceptives:
There are 4 types of oral contraceptive pills….
Combined Pills
Phased pills
Progestin only Pills
Emergency(postcoital) Pills

4. Combined Pills
Widely used oral contraceptive.
• Contains Oestrogen and progestin in a fixed dose…
• Commonly used Progestins – Norethindrone, Levonorgestrel,
Norgestrel
• Commonly used Oestrogen – Ethinyl estradiol
• Third generation progestins
– Desogestrel, Gestodene, Norgestimate are lipid friendly, increase
HDL and reduce atherogenic risk.

5. How it prevents pregnancy:
• Thickens the mucus in the neck of the womb, so it is harder for sperm
to penetrate the womb and reach an egg
• Thins the lining of the womb, so there is less chance of a fertilised egg
implanting into the womb and being able to grow

6. Phased Pills
• Monophasic agents – Fixed amt of oestrogen and progestin in each pill
• Biphasic – Oestrogen is kept constant but progestin varies according to
the phase of the menstrual cycle
• Triphasic – Oestrogen is increased in Mid- Cycle, Progestin increases
in three successive phases of the cycle

7. • Oestrogen content – 20-50 mcg
• Progestin content – 0.15-1 mg
PREPARATIONS:
• Monophasic (Ovcon 50) – Ethinyl Estradiol (50) [EE] +
Norethindrone(1.0) [NE]
•Biphasic – Days 1 to 10 – EE(35) + NE(0.5) (NECON)
(NECON) Days 11 to 21 – EE(35) + NE(1.0)

8. Triphasic (ORTHONOVUM) : Days 1 to 7 – EE(35) + NE(0.5) Days 7
to 21 – EE(40) + NE(0.75) Days 15 to 21 – EE(35) + NE(1.0)
Schedule : One tablet daily from the first day of bleeding till 21 days
followed by 7 days gap.

9. • Progestin Pill
• The progestin-only pill (POP), also called the “Mini-pill,” is a type of
birth control pill that comes in a pack of 28 pills.
• Instead of containing the hormones progestin and estrogen, it only
contains progestin.
• It’s often called the “Mini-Pill” because it doesn’t contain estrogen.

10. How do Progestin-only pills work?
• Progestin is a female hormone that works by preventing the release of
eggs from the ovaries (ovulation) and by changing the cervical mucus
and the lining of the uterus

11. • Types of progestin-only pills:
• All brands contain the same active ingredient – norethindrone, 35
micrograms daily.
• Some Brand Names:
• Camila
• Errin
• Heather
• Jolivette
• Micronor

12. Postcoital Pills
• Levonorgestrel, Ulipristal and Mifepristone
• Schedule: Levonorgestrel 0.75 mg, 2 doses, 12 hrs apart within 72 hrs
of unprotected intercourse
• Ulipristal 30 mg, single dose, within 120 hrs of intercourse
• Mifepristone 600 mg, single dose, within 72 hrs of intercourse

13. Indications
• Avoids unwanted pregnancy
• Dysmenorrhoea and pre menstrual tension.
• Prevents Anaemia by reducing blood loss
• Pelvic inflammatory disease
• Prevents ovarian and endometrial carcinoma
• Benign breast tumours and ovarian cysts

14. Contraindications
• Thromboembolic, coronary and cerebrovascular disease
• HT, hyperlipidaemia
• Hepatoma, jaundice
• Porphyria
• Diabetes
• Smoking

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