CONTRACEPTIVES DRUGS

FEMALE HORMONAL CONTRACEPTIVE MALE HORMONAL ORAL CONTRACEPTIVE CONTRACEPTION WITH

LONG ACTING PROGESTINS

POSTCOITAL CONTRACEPTION

A. COMBINED PILLS Progestin + estrogen Mechanism ?

- Inhibit ovulation by inhibition of secretion of hypothalamic GnRF

- Inhibit implantation by changed endometrial condition

- Inhibit fertilization by increase cervical mucous secretion

Adverse effect ?- GIT disturbances- Oedema, Mastalgia- Headache- Breakthrough

bleeding- Increase weight and

pigmentation- thromboembolism

B. MINI PILL progestin only less effective compare to

combined pill acts by the same

mechanism except that suppression of ovulation is only 50% (via –ve FB of LH)PREPARATIONS

Estrogen : ethinyl estradiol / mestranol

Progestins : norethindrone / norgestrel / ethynodiolADMINISTRATIONStart on the 5th day of menstrual cycle and continued daily for 21 days

Medroxy-progesterone- Given IM

50mg/month @ 150mg/3-4months

- Effective- No significant

danger- Menstrual

irregularities are common

- Infertility may persists for many months after stopping treatment

Progestin implants- Subdermal

capsule containing levonorgestrel

- Long term contraceptive

- Protection for approximately 5yrs

It is a method for contraception which will prevent pregnancy if administered within 72 hrs after unprotected intercourse

Ethinylestradiol + norgestrel tablets within

72hrs followed by 2 doses 12 hrs later

Estrogen alone Ethinylestradiol Twice daily for

5days

Progestin only Norgesterol Twice daily for

a day

Mifepristone Once alone

Mechanism : Both FSH and hight

conc of intra-testicular testerone (+ LH) are essential for spermatogenesis in adult testis

Decrease GnTH decrease effect of FSH on sperm production decrease intratesticular testosterone reversible inhibition of spermatogenesis

Agents used1. testosterone alone- FB inhibition hypothalamus and pituitary inhibition of GnTH release- produce azospermia – oligospermia- does not have 100% contraceptive efficacy- produce side effects of high dose of testosterone2.testosterone combined with progestin- less testosterone dose less side effectIncrease degree of spermatogenic suppression P4 act directly on leydig cells decrease synthesis of testosterone & decrease expression of LH receptors decrease intratesticular testosterone concentration3. GnRH antagonist + testosterone- prevents hypogonadism

CONTRAINDICATIONS Estrogen dependent neoplasm Thromboembolic disease Myocardial infarction Abnormal uterine bleeding Pregnancy Hepatic dysfunction Hyperlipidemia Diabetes Hypertension Migraine Depression and epilepsy