Single Entity Preparation

1. Continuous progestrone
   1. Oral progestrone
      • Norethindone (Norgestril)
   2. Depot
      • IM injection of long acting progestogen.
      • e.g. Medroxyprogestrone acetate (Depoprovera^®)
   3. Subcutanous implant
      • L – norgestril (Norplantâ)

Mechanism: It makes cervical mucus thick, though & hostile and also alter endometrial wall

2. Post coital “morning after” pill

• Oestrogen like Diethyl stilbosterol used within 72 hrs
• Combined oral contraceptive pills can also be used.

Side effects of oral contraceptive: Thromboembolic complication, Weight gain & fluid retention, Menstrual disorder, Breast tenderness & fullness, Skin changes, Nausea & vomiting, Depressed mood, Reduced lactation

Beneficial effects of estrogen /progesterone oral contraceptive

1. Reduced risk of endometrial Carcinoma, ovarian cyst
2. regular Menses, No excessive blood loss
3. Less premenustrual tension and dysmennorrhea
4. Relief of endometriosis

Contraindication: In patients withcardiovascular diseases (hypertension, coronary heart disease).

Thromboemolic disease, breast Cancer, diabetes mellitus, liver disease, women > 35 years (esp. smokers and hypertensives).

Drug interaction:

1. Effect reduced when taken with enzyme inducers like Rifampicin, Phenytoin, Phenobarbitone etc. It may result in unexpected pregnancy and spotting.
2. Oral contraceptive antagonize the effect of Coumarin anticoagulant and some antihypertensives