this class is in brief for under graduate understanding ans examination purpose

1. ORAL
CONTRACEPTIVES

2. Birth control pills (oral contraceptives) are prescription
medications that prevent pregnancy.
Birth control (contraceptive) medications contain
hormones (estrogen and progesterone or progesterone
alone).
Birth control pills may also be prescribed to reduce
menstrual cramps or prevent anemia.
Some women experience various levels of side effects of
birth control pills.

3. Hormonal birth control medications prevent pregnancy
through the following ways:
By blocking ovulation(release of an egg from the ovaries),
thus preventing pregnancy
By altering mucus in the cervix, which makes it hard for
sperm to travel further
By changing the endometrium(lining of the uterus) so
that it cannot support a fertilized egg
By altering the fallopian tubes so that they cannot
effectively move eggs toward the uterus

5. Birth control(contraceptive) medications contain
hormones (estrogen and progesterone or progesterone
alone).
The medications are available in various forms, such as
pills, injections (into a muscle, topical (skin) patches,
and slow-release systems (vaginal rings, skin implants,
and contraceptive-infused intrauterine devices

6. Estrogens- Ethinyl estradiol-30 micro grams
Mestranol-50 micro grams
Progesterones Norethindrone- 1mg
Norethindrone acetate
Norgestimate
Desogestrel 150 micro grams
Norgestrel -0.5mg
Levonorgestrel 150 micro grams

7. Combination contraceptives, that is, contraceptive
medications containing both estrogen and progesterone,
are the most effective means for contraception with the
exception of surgical sterilization.
Several types of combination birth control pills exist,
including monophasic pills, biphasic pills, triphasic pills,
and 91-day-cycle pills.

8. Monophasic pills have a constant dose of both
estrogen and progestin in each of the hormonally
active pills throughout the entire cycle (21 days of
ingesting active pills).
Several of the brands listed above may be
available in several strengths of estrogen or
progesterone, from which doctors choose
according to a woman’s individual needs.

9. Biphasic pills typically contain 2 different progesterone
doses. The progesterone dose is increased about halfway
through the cycle.
Ethinyl estradiol 35 micro gram+ Norethindrone 0.5mg
(day1 to day 10)
Ethinyl estradiol 35 micro gram+ Norethindrone 1mg
(day12 to day 21)

10. Triphasic pills gradually increase the dose of
progesterone and provides higher dose of estrogen
Three different increasing pill doses are contained in
each cycle
Ethinyl estradiol 35 micro gram+ Norgestrol 0.05mg
(day1 to day 6)
Ethinyl estradiol 35 micro gram+ Norgestrol 0.075 mg
(day 7 to day 11)
Ethinyl estradiol 35 micro gram+ Norgestrol 0.125 mg
(day 12 to day 21)

11. Two tablets of progestin levonorgestrol containing 1500mg
Or single 1500mcg tablet taken as soon as possible after
unprotected intercourse (up to 72 hours after)
Preferably within 12 hours, no later than 72 hours
Ethinyl estradiol 50 micro gram+ levonorgestrol 250 micro
gram. Two such tablets are to be taken with in 72 hrs of
unprotected sex
Ulipristal (SPRM-Selective Progesterone Receptor
Modulator)
single dose 30mg effective with in 120hrs/5days

12. Non steroidal estrogen receptor antagonist-serm
Centchroman- 30mg twice in a week for first 3month and
once in a week subsequently as long as the contraception
is preferred
Reversible in 6 months
It is potent competitive antagonist at peripheral estrogen
receptors and supresses proliferative stage of
endometrium
It accelerates ovum transport, without affecting ovulation
No risk of teratogenesis
C/I- hepatic dysfunction, polycystic ovarian disease,
cervical hyperplasia, tuberculosis, renal disease

13. Depot medroxy progesterone acetate (Depot-Provera) -DMPA
The first injection is given within 5 days following the onset of
menstruation. After that, an injection is needed every 11-13
weeks.
Side effects: Since progesterone is the only hormonal ingredient,
estrogen-related side effects are avoided.
A side effect unique to this method of birth control is that most
women eventually stop having their periods.
Depo-Provera may last in the body for several months in women
who have used it on a long-term basis and can actually delay the
return to fertility after stopping the drug.
Other side effects include weight gain and depression.

14. Norelgestromin /ethinyl estradiol
The topical patch may be applied to clean, on the shoulders,
upper arms, buttocks or abdomen. The patch may be less
effective in women weighing more than 198 pounds (90 kg).
Use: A new patch is applied on the same day of the week, each
week for 3 weeks in a row.
The first patch is applied either on the first day of the
menstrual period or on the Sunday following menses.
On the fourth week, no patch is applied.
This 4-week period is considered 1 cycle.
Another 4-week cycle is started by applying a new patch
following the 7-day patch-free period.

15. Side effects are similar to other birth control agents
containing both estrogen and progesterone.
Effects include menstrual irregularities, weight gain,
and mood changes.
Other specific side effects include a skin reaction at
the site of application and problems with contact
use

16. Norethindrone Progesterone-only pills (POPs), also known as
mini-pills. Less than 1% of users of oral contraceptives use them
as their only method of birth control. Those who use them
include women who are breast feeding and women who cannot
take estrogen.
Use: POPs are ingested once daily, every day.
POPs may be started on any day, and there are no pill-free
days or different-colored pills to track. Since progesterone is
the only hormonal ingredient, estrogen-related side effects are
avoided. However, since POPs do not include estrogen, they
have a higher failure rate.
Users must take this pill at the same time daily for greatest
effectiveness.

17. Women with the following conditions should not use estrogen-
containing birth control medications:
to any component of the product
History of blood clotting disorders
History of stroke or heart attack
heart valve disease with complications
Severe hypertension
Poorly controlled diabetes
Recent major surgery with prolonged bed rest
Breast cancer, Liver cancer (or liver disease)
Uterine cancer or other known or suspected estrogen-dependent
cancers
jaundice during pregnancy or jaundice with prior hormonal
contraceptive use

18. The effectiveness of oral contraceptives, Progesterone
Only Pill and post coital pill will be reduced by
interaction with drugs that are enzyme inducers
Drugs that may cause this effect include: many
antibiotics (e.g., cephalosporins, chloramphenicol,
macrolides, penicillins, tetracyclines, sulfas),
aprepitant, bexarotene,
Broad spectrum antibiotics may reduce effectiveness
of OCPs by altering the bacterial flora of the bowel

19. Nausea, breast tenderness, fluid retention, weight gain,
acne, breakthrough bleeding, missed periods, headaches,
depression, change in vision, other mood changes, and
lower sexual desire.
Additionally, the following more serious side effects may
occur: thromboembolism(blood clots)
Breast cancer, cervical cancer
Benign liver tumors
Diabetes

21. Smoking cigarettes while using this medication increases
your chance of having heart problems.
Do not smoke while using this medication.
The risk of heart problems increases with age (especially
in women greater than 35 years of age) and with
frequent smoking (15 cigarettes per day or greater)
If overdose is suspected, contact your local poison
control center or emergency room immediately.
Symptoms of overdose may include nausea and
vomiting.
May experience vaginal bleeding.

22. 1. Menstrual Bleeding Disorders
2. Dysmenorrhea
3. Symptoms of Androgenisation (Seborrhea, Acne, Hirsutism,
Alopecia)
4. Premenstrual Syndrome (PMS) and Premenstrual Disphoric
Disorder (PMDD )
5. Ovarian Cysts
6. Endometriosis/Adenomyosis
7. Pelvic Inflammatory Disease (PID)
8. Multiple Sclerosis
9. Menstrual Migraine
10. Endometrial Hyperplasia
11. Benign Breast Disease
12. Prevention of Ovarian Cancer
13. Endometrial Cancer
14. Colon Cancer