Hormonal methods

Today is our topic of discussion Hormonal methods

Table of Contents

Definition:

These are methods which alter a woman’s hormonal cycle to prevent fertilization and make cervical mucus thick. These are –

Oral pills (oral contraceptives):

1. Combined pill

2. Progestogen only pill (POP)
3. Post-coital pill (morning after pill)
4. Once-a-month (long acting) pill

5. Male pill

Depot formulations:

1. Injection (Depo-provera”)

2. Subcutaneous implant: Implanon
3. Vaginal rings

Oral Contraceptive Pill

Combined OCP:

It incorporates 21 days of hormone (estrogen & progesterone) containing pills followed by 7 days of iron tablet/placebo or pill free days to allow withdrawal bleeding.

Mechanism of action of OCP:

1. Prevents ovulation by suppressing gonadotropin (FSH & LH) secretiononing abiver

2. Production of viscous cervical mucus that impedes sperm transport

3. Makes the lining of the uterus inhospitable for implantation

Contraindications of OCP:

Absolute contraindications:

1. Pregnancy
2. <6 weeks postpartum if breastfeeding
3. Uncontrolled hypertension
4. Current or history of thromboembolism
5. Ischemic heart disease
6. History of cerebrovascular accidents
7. Valvular heart disease
8. Migraine headache with neurological symptoms
9. Breast cancer
10. Diabetes with complication
11. Severe cirrhosis & liver
12. Smokers of > 35 years

Relative contraindications:

1. Adequately controlled hypertension
2. Migraine headache over the age of 35
3. Symptomatic gallbladder disease

4. Mild cirrhosis

Side effects of OCP:

Abnormal menstrual bleeding
Nausea
Weight gain and increased triglyceride
Mood changes and decreased
Breast tenderness
Headache
Risks:
a. Venous thromboembolismb. Myocardial infarction

c. Stroke

d. Gallstone formation

e. Breast cancer
f. Cervical cancer

Progesterone only pill or ‘minipill’ (POP):

In addition to above three mechanisms, it also reduces ciliary motility in the fallopian tube.

Post-coital pill (morning after pill)/Emergency contraception: First dose as early as possible or at least 72 hours after unprotected intercourse, second dose 12 hours later.

See also :

Stem cell banking pros and cons

Hormonal methods