Lesson E6 - Contraceptives Flashcards
The term “oral contraceptive” is usually used to refer to a product containing both an _______ and a _______________
- estrogen
- progestin (progesterone-like compound)
The preparations which contain an ______ and a ______ are the most ___________ developed to date and are also the ___________.
- estrogen
- progestin
- effective contraceptives
- most widely used
What was the first combinations of an estrogen and a progestin?
- Enovid-E
- Developed in 1955, by Pincus and Rock in Puerto Rico
- Became available in Canada in 1961
When are fixed combinations of estrogen and progestin intended to be taken?
- From the 5th to the 25th day of the cycle
- You count day 1 as the onset of menses
Define Multiphasic (biphasic and triphasic) preparations
- Usually contain a fixed amount of an estrogen and variable amounts of a progestin
- The progestin increases from week to week
- Currently the contraceptives of choice
What are the advantages of the Multiphasic (biphasic and triphasic) preparations
- the hormone dose is kept to a minimum and adverse events are believed to be reduced as compared to a fixed-dose combination.
- In addition, the hormonal sequence more closely mimics the pattern of hormones released in the normal ovarian cycle and this may be a further advantage.
- These “phasic” preparations are currently the oral contraceptives of choice.
Define continuous estrogen progestin preparations
- products where an estrogen progestin combination product are taken for 28 days each cycle with no drug free period.
Define the transdermal Contraceptive patch
- These products contain ethinyl estradiol and norelgestromin (progestin) in a patch that is applied to the skin.
- Drug delivered at a constant rate for 7 days (time the patch is worn)
- Three patches are used each cycle.
- The mechanism of action is the same as for combined estrogen-progestin oral contraceptives.
True or False? The mechanism of action of transdermal contraceptive is the same as for combined estrogen-progestin oral contraceptives.
True
Define Low-dose progestin or the mini-pill
- contains a synthetic progestin, e.g. norethindrone.
- A daily dose of progestin is taken as long as the drug is needed.
- Patient acceptability is less than with the estrogen-progestin combinations.
- Breakthrough bleeding (bleeding between periods) is often a problem. Efficacy in preventing pregnancy is also less than with the combination products.
What is often a problem with Low-dose progestin or the mini-pill?
- Breakthrough bleeding (bleeding between periods) is often a problem. Efficacy in preventing pregnancy is also less than with the combination products.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
When are progestin-alone preparations are most suitable ?
- in those individuals where estrogens are contraindicated (should not be used).
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
What though to be the causes of most of the side effects associated with Estrogen-progestin combinations? What did they do to try and prevent this?
- majority of the toxicities were thought to be associated with estrogen
- use the lowest acceptable dose (50 mg/day or less)
- Recently it has been suggested that progestin also plays a role
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
How effective are the phasic preparations?
- Essentially 100% effective
How effective are the phasic preparations?
- Essentially 100% effective
How effective are the phasic preparations?
- Essentially 100% effective
What is a Vasectomy?
- This is a simple operation in which the sperm ducts are tied off so that sperm cannot reach the penis.
- This is considered a permanent form of contraception, except in the odd case where the sperm duct appears to regenerate or the surgery is not done properly.
- New microsurgery techniques have improved the success rate for reversal of the procedure.
How effective are the phasic preparations?
- Essentially 100% effective
Why hasn’t male drug contraceptives taken orally or injected reached the Canadian market? What hormone releasing antagonist is showing promising evidence?
- It is difficult and most of the drugs have had only an 80% infertility rate
- The gonadotropin releasing hormone antagonists, which would block both sperm and androgen production, are showing some promise as a male contraceptive.
How effective are progestin-alone agents?
- About 98% effective
How effective are progestin-alone agents?
- About 98% effective
How effective are progestin-alone agents?
- About 98% effective
How effective are progestin-alone agents?
- About 98% effective
When are progestin-alone preparations are most suitable ?
- in those individuals where estrogens are contraindicated (should not be used).
When are progestin-alone preparations are most suitable ?
- in those individuals where estrogens are contraindicated (should not be used).
When are progestin-alone preparations are most suitable ?
- in those individuals where estrogens are contraindicated (should not be used).
When are progestin-alone preparations are most suitable ?
- in those individuals where estrogens are contraindicated (should not be used).
When are progestin-alone preparations are most suitable ?
- in those individuals where estrogens are contraindicated (should not be used).
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Define the norplant contraceptive
- is comprised of silicone tubes filled with L-norgestrel (a progestin) which are implanted under the skin.
- The drug is released over a period of five years and provides effective contraception during this time.
- The cost of the drug product and surgical placement is approximately $700, which is equivalent to using an estrogen-progestin combination product for three years.
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Is the norplant contraceptive more or less expensive than using a estrogen-progestin combination product?
- Cheaper
- It last 5 years and is the same price as using a estrogen-progestin combination product for 3 years
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
Define the depoprovera contraceptive
- Injectable progestin injected every three months
- provides contraception for about 3 months.
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
True or False? The mechanism of action of estrogen-progestin combination oral contraceptives are essentially the same for the fixed ratio products and the phasic products.
True
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
What is the mechanism of action for Estrogen-progestin combinations?
- The estrogen inhibits the release of GNRH from the hypothalamus. The pituitary is not stimulated to release FSH and LH, and without FSH and LH, follicles do not mature and thus ovulation is inhibited.
- Under conditions in a normal cycle, the secretion of the endocervical glands is a thin watery mucus in the first 14 days when estrogen is present. Under the influence of progesterone, in the last half of the cycle, these secretions are thick and not optimal for sperm migration. The oral contraceptives which contain a progestin render these secretions a thick, scant fluid throughout the entire cycle.
- As the oral contraceptives contain both estrogen and a progestin, the preparation of the endometrium is not optimal for implantation of a fertilized ovum.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
Define the mechanism of action Low-dose progestin and Norplant and DepoProvera
- Progestin inhibits the release of GNRH and thus ovulation.
- The endometrium is not fully developed and is unsuitable for implantation.
- Progestins alter the secretions of the endocervical gland to a scant, thick fluid not optimal for sperm migration.
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
In the last decade, the _____________ have gained popularity and the total dose of exogenous hormone is _______.
- phasic preparations
- reduced
How effective are the phasic preparations?
- Essentially 100% effective
How effective are the phasic preparations?
- Essentially 100% effective
How effective are the phasic preparations?
- Essentially 100% effective
How effective are the phasic preparations?
- Essentially 100% effective
How effective are the phasic preparations?
- Essentially 100% effective