Contraception and infertility - Drugs
26 important questions on Contraception and infertility - Drugs
COC monophasic: 24 active combined/2 EE/2 inactive w iron
(very low dose estrogen used= 10 mcg)
COC extended cycle: 84 days of EE + LNG followed by 7 placebo days
COC extended cycle: 84 days of EE + LNG followed by 7 days of low dose EE
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Progestin only "mini pill"/POP: fixed dose of norethindrone
Progestin only "mini pill" approved for use without Rx
What do POPs require?
Why are POPs sometimes used for migraine prophylaxis and safe in women who have migraines with aura?
Why do patches have an even higher risk of thromboembolism?
Weight considerations with patches
Decreased efficacy: Twirla
With extended cycle COCs, how often does period occur?
Dose of estrogen and progestin in monophasic COC
Which COCs mimic the estrogen and progesterone levels during the menstrual cycle?
Progestin with highest clot risk
Other progestins with low anti-androgenic activity
How do hormonal contraceptives work?
Also alter cervical mucus, which stops sperm from penetrating egg.
Even though reducing estrogen dose can reduce risk of side effects, what can happen if the dose is too low?
Recognizable symptoms of clots (DVT, PE)
Abdominal pain that is severe- mesenteric or pelvic vein thrombosis
Chest pain- SOB can indicate PE (clot in lungs)
Headaches- sudden/severe with vomiting or one side weakness can indicate stroke
Eye problems- blurry vision, flashing lights, partial/complete vision loss can indicate clot in eye
Swelling or sudden leg pain- can indicate DVT (clot in leg)
Why can drospirenone NOT be used with kidney, liver or adrenal gland disease?
Injectable depo-provera can cause what?
Antibiotics that can decrease efficacy of hormonal contraceptives
After rifampin has been stopped, how long is a back-up contraception needed?
Can antifungals decrease efficacy of hormonal contraceptives?
Misc. Drugs that decrease efficacy of hormonal contraceptives
Smoking tobacco
Ritonavir-boosted PIs
Colesevelam
Return to fertility for injectable medroxyprogesterone (depo-provera)
Daily recommendation with injectable medroxyprogesterone
Return to fertility for COC, POP, IUD and implants
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