Hormonal contraceptives

1. Hormonal
Contraceptives
Alternative name:
Birth-control pills

2.  World wide used
 Convenient method
 Inexpensive
 Reversible
 Easy and simple to use with minimum side effects
 Readily available
 Can be administered by non-healthcare personnel.
 Pills are safe and effective when taken properly
 Pills are over 99% effective

3. Types of hormonal methods of contraception
There are several different types hormonal methods of birth
control. The differences among them involve
 the type of hormone,
 the amount of hormone, and
 the way the hormone enters a woman's body.
 The hormones can be estrogen and/or progesterone. These
hormones may be taken orally (taken by mouth), implanted into
body tissue, injected under the skin, absorbed from a patch on
the skin, or placed in the vagina. The mode of delivery
determines whether the hormonal exposure is continuous or
intermittent.

4. Oral Contraception
 Combined oral
contraception
(COC)
 Progestogen
only pill (POP)
 Emergency
Hormonal
Contraception
(EHC)

5. Combined Oral Contraception
 Contains oestrogen and
progestogen
 Take one tablet daily
for 21 days (28 for ED)
followed by a 7 day pill
free period
• Most effective
preparation for
general use
• With optimal use,
> 99% effective

6. Combined Oral Contraception
 Monophasic
 fixed amount of an oestrogen and a progestogen
in each active tablet
 Biphasic/Triphasic
 varying amounts of the two hormones according
to the stage of the cycle
 ED (every day)
 includes 7 days of placebo tablets

7. Combined Oral Contraception
How does it work?

8. Oral Contraception
 Combined oral
contraception
(COC)
 Progestogen
only pill (POP)
 Emergency
Hormonal
Contraception
(EHC)

9. Progestogen only pill
 Contains one active ingredient -
progesterone
 Taken continuously – no break
 Offers an alternative when oestrogens
are contraindicated
 Efficacy dependent on the
meticulousness of the user

10. Oral Contraception
 Combined oral
contraception
(COC)
 Progestogen
only pill (POP)
 Emergency
Hormonal
Contraception
(EHC)

11. Emergency Hormonal Contraception (EHC)
 Levonelle 1500 (one step)
 Contains high dose progesterone
(levonorgesterel)
 One 1500mcg tablet taken as soon as
possible after unprotected intercourse
(up to 72 hours after)
 Preferably within 12 hours, no later
than 72 hours

12. Emergency Hormonal Contraception
 Taking the dose as soon as possible increases
efficacy
 Available from:
 A & E
 GP
 Walk in Centres
 Family Planning Clinics
 Sexual Health Clinics
 Community Pharmacies

13. When is EHC indicated?
 Unprotected sexual intercourse
 Reduced efficacy of other forms of
contraception:
 Torn, leaking condom
 Missed pills
 Late implant or injection
 Detached contraceptive patch

14. How does EHC work?
 Dependent on point in the menstrual
cycle
 Either prevents or delays ovulation,
prevents fertilisation or prevents
implantation of the fertilised egg into
the uterus.
 Clinical opinion is that EHC is not an
abortifacient (a substance that induces
abortion)

15. Side effects
 Nausea, vomiting
 stomach cramps or bloating
 diarrhea
 constipation
 gingivitis (swelling of the gum tissue)
 increased or decreased appetite
 weight gain or weight loss
 brown or black skin patches
 acne
 hair growth in unusual places
 bleeding or spotting
between menstrual periods
 changes in menstrual flow
 painful or missed periods
 breast tenderness,
enlargement, or discharge
 swelling, redness, irritation,
burning, or itching of the
vagina
 white vaginal discharge

16. Severe S/E
 severe headache
 severe vomiting
 speech problems
 dizziness or faintness
 weakness or numbness of an arm or
leg
 crushing chest pain or chest heaviness
 coughing up blood
 SOB
 leg pain
 partial or complete loss of vision
 double vision
 bulging eyes
 severe stomach pain
 yellowing of the skin or eyes
 loss of appetite
 extreme tiredness, weakness, or lack
of energy
 fever
 dark-colored urine
 light-colored stool
 swelling of the hands, feet, ankles,
or lower legs
 depression, especially if you also
have trouble sleeping, tiredness, loss
of energy, or other mood changes
 unusual bleeding
 rash
 menstrual bleeding that is unusually
heavy or that lasts for longer than 7
days in a row

17. Hormonal Contraceptives and Cancer Risk
（Research done by National Cancer
Institute ）
Lifetime Risk of Reproductive Cancers in All Women
Type of Cancer Risk of
Contracting
Risk of Dying Added Risk with
Hormonal
Contraceptives
Breast 1 in 8 (12%) 1 in 34 (3%) Increased
Cervical 1 in 142 (0.7%) 1 in 434 (0.2%) Increased
Ovarian 1 in 71 (1.4%) 1 in 91 (1.1%) Decreased
Uterine/
Endometrial
1 in 41 (2.5%) 1 in 190 (0.5%) Decreased

18. References
 http://www.contracept.org/hormonal.php
 http://www.medicinenet.com/hormonal_methods_
of_birth_control/page2.htm