Oral Conceptives Flashcards
In the scheme of 21 active and 7 placebo tablets taken with COC, is it possible for ovulation to occur?
No
Menses can occur though
When are progestogen-only oral preparations (mini-pills) indicated?
When oestrogen is contradicted
When the women is lactating (oestrogen can prevent lactating while progestogen can’t)
How does oestrogen prevent pregnancy?
Inhibits FSH release
May or may not inhibit LH
What is levonorgestrel used for apart from the OCP?
Morning after pill
HART
What are the two oldest synthetic progestogens?
Norethisterone
Levonorgestrel
What is a major drawback of the newer synthetic progestagens?
They are more expensive
How does progestogen treatment prevent pregnancy?
Creates an unfavourable environment for implantation
Changes the mucous and interferes with the coordinated contractions of the tube and uterus
(Can negatively feedback on LH at high doses)
Which tissues produce oestrogen?
Ovaries
Placenta
Adrenal Cortex
Testes
What type of oral contraception is most effective?
Combined preparation (COCs) - A mixture of oestrogen and progestogen in a fixed ratio of doses
What is ethinyloestradiol?
A synthetic oestrogen
How are doses varied with sequential preparations?
The ratio of doses varies to correspond approximately to changes in endogenous oestrogen and progestogen in an attempt to mirror the normal fluctuations of hormone throughout the menstrual cycle
Name a potent anti-androgen
Cyproterone
What are the other benefits of COCs?
Decreased risk of endometrial cancer
Decreased incidence of ovarian cancer and ovarian cyst formation
Reduction in risk of colorectal cancer
Reduction in risk of bone fractures
What are the major adverse effects of COCs?
Hypertension
Venous thromboembolism
Cancer - Breast, cervical and uterine cancer
Others: Nausea/vomiting
Dizziness
Flushing
Breast discomfort
Headache
Weight gain - fluid retention? Anabolic effect?
What is a major drawback of cyproterone?
It has a high thromboembolic risk
