ORAL CONTRACEPTIVES 2 main types: Combined oral contraceptives
(Progestogen and Oestrogen) Progestogen-only contraceptives
(Mini-pill or POP)
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COMBINED ORAL CONTRACEPTIVES One of most commonly used methods
of contraceptives Currently available CHCs contain a synthetic
oestrogen (ethinylestradiol or mestranol) and a progestogen Eg:
Microgynon (30microg ethinylestradiol and 150mg levonogestrol)
Loestrin (20 microg ethinylestradiol and 1mg noresthisterone)
Dianette (25mcg ethinylestrodiol and 2mg cyproterone acetate)
Yasmin (30microg ethinylestradiol and 3mg drospironone) Logynon
Binovum Brevinor Cilest
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HOW DO THEY WORK? Primarily by preventing ovulation through
inhibition of hypothalamo-ovarian-pituitary axis Also cervical
mucus Endometrial changes
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HOW ARE THEY TAKEN? 28 pills (21 active 7 placebo) First 7
inhibit ovulation Next 14 maintain anovulation
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WHEN TO START? Any time as long as sure not pregnant Immediate
contraceptive cover if started on day 1-5 of cycle If starting
after day 5, extra protection required for 7 days
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QUESTION A 25 yr old woman phones for advice. She has missed
two pills in a row. Today she would be taking the 19 th pill of the
packet. There have been no other missed pills during the packet.
She has been having regular UPSI during the weekend. You have
already told her to take two of her pills as soon as possible. What
next? 1. Needs EC + use condoms for 7 days + skip the break 2. Use
condoms for 7 days + skip the break 3. Needs EC + skip the 7 day
break 4. Needs EC + use condoms for 7 days 5. Use condoms for next
7 days
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WHAT TO DO IF YOU MISS A PILL... 1 pill missed Take asap then
carry on, no additional protection required 2 or more missed pills
Take latest missed pill then use extra protection for next 7 days
In week 1- consider EC if had UPSI in the last 7 days or pill free
period In week 2- No need for EC (as long as has had 7 consecutive
pills in 1 st week) In week 3- No need for EC. Finish the pills in
her current pack, skip the break
Slide 10
QUESTION A 25 yr old woman phones for advice. She has missed
two pills in a row. Today she would be taking the 19 th pill of the
packet. There have been no other missed pills during the packet.
She has been having regular UPSI during the weekend. You have
already told her to take two of her pills as soon as possible. What
next? 1. Needs EC + use condoms for 7 days +skip the break 2. Use
condoms for 7 days + skip the break 3. Needs EC +skip the 7 day
break 4. Needs EC + use condoms for 7 days 5. Use condoms for next
7 days
Slide 11
QUESTION A 25 yr old woman phones for advice. She has missed
two pills in a row. Today she would be taking the 19 th pill of the
packet. There have been no other missed pills during the packet.
She has been having regular UPSI during the weekend. You have
already told her to take two of her pills as soon as possible. What
next? 1. Needs EC + use condoms for 7 days +skip the break 2. Use
condoms for 7 days + skip the break