contraceptives





1. OCP: Nowadays, low-dose estrogen OCP is available. Due to the low estrogen component, there can be breakthrough bleeding (irregular bleeding). The mechanism of irregular bleeding is that the endometrium gets thinned with low estrogen. so, to prevent that high doses of estrogen can be given during periods of breakthrough bleeding. A common myth is that OCP causes weight gain which is not true. During the initiation of OCP, a person can experience breast tenderness, moodiness, headache, and nausea which subside after some time. OCP also helps to improve acne, and hirsutism in PCOS and decrease the risk of endometrial and ovarian cancer.

Absolute contraindication of combined hormonal contraceptives: 

    a.  migraine with aura

    b. age 35 and above who smoke more than 15 cigarettes /day

    c. coronary artery disease/ stroke

    d. thromboembolic disease

    e. anti-phospholipid syndrome

    f. breast cancer

    g. blood pressure greater than 160/100 mm Hg

    h. diabetes mellitus with end-organ damage

    I. cirrhosis and liver cancer

    j. use less than 3 weeks postpartum

    k. major surgery with prolonged immobilization

combined hormonal contraceptives decreases the risk of ovarian and endometrial cancer. It is not contraindicated if there is a family history of ovarian cancer.

2. Depo-medroxyprogesterone: After discontinuing this, it can take even 1 year to return back fertility. It can be used in adolescent girls as well. Its side effect is that it can cause low bone density which is reversible after discontinuation of depot-medroxyprogesterone and also can cause weight gain.

3. progestin and copper-containing IUD: A common thinking is not to use it in adolescent girls or nulliparous women. This is a myth. It can be used in these groups and in fact, it is preferred in adolescents because of its high efficacy. IUD does not increase the risk of vaginitis and vaginitis is not an indication for its removal. There is also a quick return of fertility on discontinuation.



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