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Birth control: hormonal methods. Boris Delić Mentor: A. Žmegač Horvat. Introduction. several different hormonal methods , according to: 1. the type of hormone 2. the amount of hormone 3. the way the hormone enters a woman's body hormones can be estrogen and/or progesterone
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Birth control:hormonal methods Boris Delić Mentor: A. Žmegač Horvat
Introduction • several different hormonal methods, according to: • 1. the type of hormone • 2. the amount of hormone • 3. the way the hormone enters a woman's body • hormones can be estrogen and/or progesterone • the mode of delivery determines whether the hormonal exposure is continuous or intermittent • do not protect against sexually transmitted infections
Oral contraceptives: the pill • 97%-99% effective if used properly • available since 1960 • more than 10 million American women currently use birth-control pills • two types of birth-control pills available: • 1. the combination pill • 2. the minipill
The combination pill • contains the hormones estrogen and progestin • the eggs in the ovaries do not mature and the woman does not ovulate • the 21-pill pack has pills for 21 "on" days and no pills for the seven "off" days that follow • the 28-pill pack has active pills for the first 21 "on" days and seven inactive (placebo) ones
The minipill • contains one hormone, progestin • thickens the cervical mucus, making it more difficult for sperm to pass through the cervix • makes the lining of the uterus less receptive to the implantation of a fertilized egg • recommended for women who have medical reasons for which they must avoid taking estrogen hormones • there are no "on" or "off" days with the minipill
taking it at varying times of the day can significantly impair its effectiveness in contraception • if a woman misses one pill, she should take it as soon as she remembers • The pill may partially lose its effectiveness if a woman vomits or has diarrhea • sedatives and some antibiotics such as penicillin and tetracycline may reduce the effectiveness of the pill
side effects: severe headache, leg cramps, change in vision, pain, chest pain, shortness of breath, coughing up blood, leg swelling or pain • women who smoke and take the pill are at increased risk of heart disease and stroke • contraindications: clotting tendencies, coronary heart disease, stroke, breast lumps, vaginal bleeding, breast cancer • benefits: regularize a woman's menstrual cycle and reduce her menstrual flow and menstrual cramps
protect against cancer of the ovary and uterus as well as pelvic inflammatory disease and iron deficiency anemia, reduce acne, the risk of an ectopic pregnancy, noncancerous breast cysts and ovarian cysts, arthritis and osteoporosis • the combination pill confers no long-term risk of breast cancer
Injected contraceptive: depot medroxyprogesterone acetate • synthetic long-acting form of the hormone progesterone • acts by preventing the release of the egg from the ovary (ovulation) and by promoting thick cervical mucus that impedes the sperm's progress • effectiveness close to 100% • DMPA must be injected by a health-care professional every three months
available both as intramuscular or subcutaneous injections • after two years of use, 70% of women will have no menstrual bleeding common side effects of DMPA injections are irregular menstrual cycles, cessation of menstrual periods, and weight gain greatly reduces the risk of developing uterine cancer
Contraceptive patch: Ortho-Evra • hormonal contraception through the skin, known as transdermal delivery system • the patch is about the size of a half-dollar and can be worn on the arm, abdomen, or buttocks • a woman wears the patch for a week and then replaces it with a new patch • contains both estrogen and progesterone
suppresses ovulation and has the advantage of improved compliance and convenience • associated with a greater risk of negative side effects, such as blood-clotting problems important to ensure that the patch makes good contact with the skin • some women may experience skin irritation at the site of the patch
Vaginal ring (NuvaRing) • ring-shaped device that contains the hormones estradioland etonogetrel (a progestin) placed in the vagina • remains in place for three weeks continuously • then removed for one week to allow for a menstrual period
about 99% effective • incidence of side effects similar to those seen with other hormonal contraceptive methods
Contraceptive implants (Implanon) • provide contraception by the slow release of the progestin etonogestrel over a period of three years • a thin rod that is inserted in the upper arm under local anesthesia • fertility rapidly returns after removal of the rod • generally well tolerated and effective in preventing pregnancy • irregular bleeding a possible side effect