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Hormonal contraceptives:, Contraindications of OCP according to WHO…
Hormonal contraceptives:
Hormonal contraceptives can be used
orally(combined oral contraceptive or progesterone only pills) or implants.
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Adverse effects of OCPs
Nausea, mastalgia, breakthrough bleeding and edema
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Cholestatic jaundice, gall bladder disease and incidence of hepatic adenomas are increased with OCP use.
Chances of breast and cervical carcinoma are increased whereas endometrial and ovarian carcinomas are decreased by OCP.
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Combined OCPs may be
Monophasic: content of estrogen and progesterone remain same in all the pills for 21 days.
Biphasic: content of progesterone is different in the pills for first 10 days and that for 11-21 days.
Triphasic: content of progesterone is gradually increased.
It is lowest in first phase 1-6 days,
moderate in second phase 7-11 days and
further increased in third phase 12-21 days.
Biphasic and triphasic pills permit reduction in progesterone content without comprising efficacy.
These pills decrease the risk of breakthrough bleeding.
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On the basis of amount of estrogen, combined OCPs can be classified as
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When should start OCP?
Combined OCPs are started on first day of menstrual cycle and given for 21 days.
To allow withdrawl bleeding, iron tablets are given without hormones for next 7 days.
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OCP - cancer relation
Chances of breast and cervical carcinoma are increased
whereas endometrial and ovarian carcinoma are decreased by OCP use.
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