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Contraception

Oral Contraceptives

Monophasic OCs contain a constant dose of estrogen and progestin. Phasic OCs alter the dose of the progestin and (in some formulations) the estrogen component with the aim of reducing

Progestins include norethindrone, levonorgestrel, contraception, birth control, oral contraceptive, norplant, IUD, the pill, hormones, postcoital contraception, morning after pill, RU486 norgestrel, norethindrone, and ethynodiol. Two new, less androgenic progestins are norgestimate and desogestrel.

OCs can be used safely until menopause by women who do not have any medical contraindications and who are nonsmokers.

Smoking with OC use increases the risk of myocardial contraception, birth control, oral contraceptives, norplant, IUD, the pill, hormones, depoprovera, depo provera, postcoital contraception, post coital, morning after pill infarction, stroke, and thromboembolic disease, particularly among women older than 35. contraception, birth control, oral contraceptives, norplant, IUD, the pill, hormones, depoprovera, depo provera, postcoital contraception, post coital, morning after pill

Birth Control

Contraindications to Oral Contraceptives

Carcinoma of the endometrium or other known or contraception, birth control, oral contraceptives, norplant, IUD, the pill, hormones, depoprovera, depo provera, postcoital contraception, post coital, morning after pill suspected estrogen-dependent neoplasia

Cerebrovascular or coronary artery disease

Cholestatic jaundice of pregnancy or jaundice with prior pill use

Heavy cigarette smoking (>15 cigarettes per contraception, birth control, oral contraceptives, norplant, IUD, the pill, hormones, contraception, birth control, oral contraceptive, norplant, IUD, the pill, hormones, postcoital contraception, morning after pill, RU486 depoprovera, depo provera, postcoital contraception, post coital, morning after pill Contraception birth control day) in women older than 35

Hepatic adenomas or carcinomas

History of deep vein thrombophlebitis or Contraception birth control thromboembolic disorders

Known or suspected carcinoma of the breast

Known or suspected pregnancy

Undiagnosed abnormal genital bleeding

F. Administration of Oral Contraceptives

1. Most younger patients can be started on Contraception birth control Triphasil-28, LoEstrin 1.5/30, Ortho-Novum 7/7/7, Ortho-Cept, Desogen, Ortho-Cyclen, or Contraception birth control Ortho Tri-Cyclen.

2. ontraception, birth control, oral contraceptive, norplant, IUD, the pill, postcoital contraception, morning after pill, RU486

a. Begin pill on first Sunday after period starts.

b. If missed pill, take forgotten pill as soon as Contraception birth control remembered and take next pill as scheduled.

c. If 2 missed pills, take 2 pills per day for 2 Contraception birth control days, and use backup method for that month.

d. If 3 missed pills, discontinue the pills and Contraception birth control allow withdrawal bleed; resume after 1 week with new pack.

G. Breakthrough Bleeding does not pose a health Contraception birth control threat, but it is the most frequent complaint among OC users. Breakthrough bleeding becomes much less common after 3 months, and it may be caused by missing pills.

1. If bleeding is occurring early in cycle, change to a lower progesterone (Brevicon, Ovcon 35, Ortho Novum 1/50). If bleeding occurs late in cycle, change to lower estrogen (LoOvral, LoEstrin 1/20).

2. If the BTB is prolonged, regardless of where it occurs in the cycle, estrogen (Premarin) 1.25 mg, given daily for a week when the bleeding is present, will reduce bleeding.

H. Acne and Hirsutism. Desogen, Ortho-Cept, Demulen, Ortho-Cyclen, Modicon, Ovcon-35, and Brevicon are useful because they are less androgenic.

I. Weight Gain. Ortho-Cept, Desogen, Ortho-Cyclen, Triphasil, Ortho-Novum 7/7/7 or Jenest 28 may cause less weight gain because they are less androgenic.

J. Headache. Some women experience headaches that usually subside after the first 3 cycles. If headaches persist after 3 months, switching to LoEstrin 1/20, LoEstrin 1.5/30, Ortho-Cept, or Desogen may be useful.

K. Nausea is a common problem. The severity usually declines over the first several months of OC use. Taking the pill at bedtime with food often provides relief. If nausea persists, a preparation with lower progesterone may