March 28, 2023

Learning Outcomes:

Foreign contraception is defined as a deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse hormonal contraception is when hormones are used by different modalities to achieve contraception the hormones used in contraception are estrogen estrogen mainly suppresses follicular stimulating hormone from

The pituitary and thereby prevents folliculogenesis which means it does not allow the follicles to develop in the proliferative phase of the endometrium or follicular phase of the ovary and it also prevents recruitment of the follicle for ovulation in effect it disrupts ovulation and the woman becomes anovulatory when she is using estrogens progesterone also makes

The endometrium unresponsive to nidation which means that the embryo cannot get embedded in the endometrial cavity it also has an additional advantage of making the cervical mucus thick visage scanty and impervious flows from transport so with the during the time of sexual intercourse the sperms cannot get into the uterine cavity it also inhibits tubal peristalsis

And makes the cube unable to transport the ovum from the ovary to the endometrial cavity the types of oral contraceptives the combined oral contraceptives as their called as coc is the most commonly used the package contains 28 tablets of which 21 contain same strength or dose of estrogen and progesterone followed by seven inner tablets which contain iron or

Vitamins periods occur when the active tablets are completed and when inert star blitz are started so the courses are taken continuously even during menstruation in some instances the pack contains only 21 active or hormone containing tablets here a seven day gap is given after the 21 tablets are over the regimen is called three weeks on and one week off there

Is also another regimen called the extended regimen which is not commonly used here in our country but more used in europe where all 28 tablets in the pack are active tablets containing hormones and this is particularly meant for women who do not want to have periods at all here of course the courses have to be taken continuously without any interruption to avoid

Menses the first generation of oral contraceptive pill contained more than 50 micrograms of ethyl easter dayal which is a common estrogen that is used in the oral contraceptive pill the second generation contain different types of all progesterons levo not gestural nor justimate nor ethistron family all of them are added to ethanol easter day all but the dose of

Ethanol easter dayal was reduced to 20 30 or 35 microgram to reduce the side effects of estrogen the third generation contained disogestral gaston plus ethanyl again the dosage of only 20 25 or 30 so you can see that the dose of the easter dial was reduced gradually to keep a minimum dose mainly to avoid side effects of estrogens the fourth generation that is being

Used now contains progesterone called ross perinone and dinogest and also nor gestural these are added to ethnalists today all the same dosage when ethanol easter dial is the dose is less than 50 micrograms in the pill it is called a low dose oral contraceptive pill the ethyl easter dayal has been a constant constituent in the pill but the dose has become lower

As i showed in the previous slide the progestins have evolved to improve tolerability benefits and to reduce the side effects the earlier progestins were derived from 19 north testosterone and so there was certain amount of androgenic side effects of the oral contraceptive pill to reduce the androgenic side effects of 19 north testosterone the fourth generation

Of oral contraceptive pills contain drosperinone which is derived not from testosterone but from spironolactone which is a diuretic diesel gestural and knowledge estimate are still being used because they are lipid friendly and so the risk of atherosclerosis is minimal when these oral contraceptives are used for a long time there are certain non-controceptive

Benefits of oral contraceptive pills the best benefit of course is the failure rate is very very low it is 0.1 per 100 woman years this formula is calculated as perl index about which we will discuss a little later the non-contraceptive benefits of oral contraceptives are there is relief of mana regia and dysmenorrhea excessive bleeding during periods reduced

Almost up to 50 percent and the pain during periods is reduced to almost 40 percent it also decreases the risk of premenstrual tension syndrome and middle smurfs metal smurfs is pain during ovulation it decreases the chance of iron deficiency anemia mainly because the bleeding is less during periods it also helps in regression of conditions like endometriosis

Fibroids and functional ovariances it improves hirsutism acne and polycystic ovarian syndrome where the main problem is hyper antigenism

Transcribed from video
OBGYN for Undergrads lecture "Hormonal Contraception" by Dr. Narayanan Raghavan By DigiNerve