Managing the side effects of contraception

2021 ◽  
Vol 32 (6) ◽  
pp. 226-231
Author(s):  
Katie Boog
Keyword(s):  
Side Effects ◽  
Hormonal Contraception ◽  
Oral Contraceptive Pill ◽  
Common Reason ◽  
Evidence Based ◽  
Contraceptive Methods ◽  
Mood Change ◽  
Combined Oral Contraceptive ◽  
Free Interval ◽  
Combined Hormonal Contraception

Side effects are the most common reason for the discontinuation of contraceptive methods. Dr Katie Boog summarises the available evidence on how to manage them Although often transient, side effects are the most common reason for individuals to discontinue contraception. The evidence to prove causality is limited, as is evidence-based guidance on how to manage these side effects. This article summarises the available evidence. For individuals who have new or worsening acne on progestogen-only contraception (POC), switching to combined hormonal contraception (CHC) is likely to improve their skin. Continuous or extended CHC use may be beneficial for individuals with premenstrual mood change, and for those who experience headaches in the hormone-free interval. Unpredictable bleeding patterns on POC are common. Injectable users can try reducing the interval between injections to 10 weeks. Implant, injectable or intrauterine system users can be offered a 3-month trial of a combined oral contraceptive pill (COC). CHC and POP users with unpredictable bleeding may benefit from switching to an alternative preparation.

Managing the side effects of contraception

2021 ◽  
Vol 3 (5) ◽  
pp. 184-188
Author(s):  
Katie Boog
Keyword(s):  
Oral Contraceptive ◽  
Side Effects ◽  
Hormonal Contraception ◽  
Oral Contraceptive Pill ◽  
Evidence Based ◽  
Mood Change ◽  
Contraceptive Pill ◽  
Combined Oral Contraceptive ◽  
Free Interval ◽  
Combined Hormonal Contraception

Although often transient, side effects are the most common reason for individuals to discontinue contraception. The evidence to prove causality is limited, as is evidence-based guidance on how to manage these side effects. This article summarises the available evidence. For individuals who have new or worsening acne on progestogen-only contraception (POC), switching to combined hormonal contraception (CHC) is likely to improve their skin. Continuous or extended CHC use may be beneficial for individuals with premenstrual mood change, and for those who experience headaches in the hormone-free interval. Unpredictable bleeding patterns on POC are common. Injectable users can try reducing the interval between injections to 10 weeks. Implant, injectable or Intrauterine system users can be offered a 3-month trial of a combined oral contraceptive pill (COC). CHC and POP users with unpredictable bleeding may benefit from switching to an alternative preparation.

scholarly journals Safety and Efficacy of Levonorgestrel 0.10 mg and Ethinyl Estradiol 0.02 mg plus Ethinyl Estradiol 0.01 mg in an Extended-Cycle Oral Contraceptive Regimen

2010 ◽  
Vol 2 ◽  
pp. CMT.S4661
Author(s):  
Radhika Rible ◽  
Ram Parvataneni ◽  
Angela Chen
Keyword(s):  
Oral Contraceptive ◽  
Ethinyl Estradiol ◽  
Hormonal Contraception ◽  
Pivotal Trial ◽  
Combined Oral Contraceptive ◽  
Free Interval ◽  
Effective Option ◽  
Effective Contraception ◽  
Combined Hormonal Contraception ◽  
Extended Cycle

Extended-cycle combined hormonal contraception has become a common practice among women seeking effective contraception and menstrual regulation. Extended cycle regimens have the benefit of decreasing scheduled bleeding as compared to traditional combined oral contraceptive (COC) regimens containing 21 days of hormones followed by a 7-day hormone-free interval (HFI) by reducing the frequency of the HFI. The newest FDA approved product in this family of contraceptive regimens is a 91-day COC regimen containing 0.02 mg ethinyl estradiol (EE) and 0.1 mg levonorgestrel (LNG) for 84 days followed by a 7-day interval with 0.01 mg EE. This regimen has been evaluated in one pivotal trial and demonstrated to have efficacy and a side effect profile similar to the other currently available FDA approved 91-day extended-cycle regimens. This is the first 91-day regimen formulated with 0.02 mg EE and offers women an effective option for contraception and menstrual cycle control.

scholarly journals Clinical features of migraine with onset prior to or during start of combined hormonal contraception: a prospective cohort study

2021 ◽  
Author(s):  
Gabriele S. Merki-Feld ◽  
Peter S. Sandor ◽  
Rossella E. Nappi ◽  
Heiko Pohl ◽  
Christoph Schankin
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Natural Cycle ◽  
Free Interval ◽  
Migraine Frequency ◽  
Combined Hormonal Contraception ◽  
Migraine Onset

AbstractMany studies have described the features of menstrually related migraines but there is a lack of knowledge regarding the features of migraine in combined hormonal contraceptive users (CHC). Hormone-withdrawal migraines in the pill-free period could differ from those in the natural cycle. Gynaecologic comorbidities, like dysmenorrhea and endometriosis, but also depression or a family history might modify the course of migraine. A better understanding of migraine features linked to special hormonal situations could improve treatment. For this prospective cohort study, we conducted telephone interviews with women using a CHC and reporting withdrawal migraine to collect information on migraine frequency, intensity, triggers, symptoms, pain medication, gynaecologic history and comorbidities (n = 48). A subset of women agreed to also document their migraines in prospective diaries. The mean number of migraine days per cycle was 4.2 (± 2.7). Around 50% of these migraines occurred during the hormone-free interval. Migraine frequency was significantly higher in women who suffered from migraine before CHC start (5.0 ± 3.1) (n = 22) in comparison to those with migraine onset after CHC start (3.5 ± 2.1) (n = 26). Menstrually related attacks were described as more painful (57.5%), especially in women with migraine onset before CHC use (72%) (p < 0.02). Comorbidities were rare, except dysmenorrhea. The majority of migraine attacks in CHC users occur during the hormone-free interval. Similar as in the natural cycle, hormone-withdrawal migraines in CHC users are very intense and the response to acute medication is less good, especially in those women, who developed migraine before CHC use.

Starting oral contraceptives – which, when and how?

1992 ◽  
Vol 30 (11) ◽  
pp. 41-44
Keyword(s):  
Oral Contraceptive ◽  
Sexual Activity ◽  
Medical History ◽  
Oral Contraceptives ◽  
New Products ◽  
Oral Contraceptive Pill ◽  
Oral Contraception ◽  
Planned Parenthood ◽  
Combined Oral Contraceptive ◽  
Free Interval

About one quarter of women in Britain aged 18–44 use oral contraceptives,1 and almost half of those aged 20–29.2 Many will use more than one type during their years of sexual activity. Changes will occur as new products are introduced and new risks identified or in response to unwanted effects. Decisions may also be prompted by the need to restart oral contraception after a break as part of planned parenthood. Oral contraception is chosen chiefly because it is reliable and does not interrupt spontaneous sexual activity. Whether a combined oral contraceptive pill (COC) or a progestagen-only pill (POP) would be the more appropriate depends mainly on the woman’s medical history, smoking habits and age. Most women will want good cycle control, and a few will prefer to take an inactive pill for a few days in each cycle rather than have a pill-free interval. This article discusses the choice when starting, restarting or switching oral contraception.

scholarly journals Birth Control: A Review of Pharmacological and Non-pharmacological Modalities, Associated Pros and Cons, and Their Effectiveness

2021 ◽  
pp. 225-232
Author(s):  
Maryam Fairag ◽  
Malak ALGhamdi ◽  
Abdulaziz Baghlaf ◽  
Bader Alallah ◽  
Turki Alharbi ◽  
...  
Keyword(s):  
Family Planning ◽  
Birth Control ◽  
Control Method ◽  
Hormonal Contraception ◽  
Multiple Birth ◽  
Control Methods ◽  
Contraceptive Methods ◽  
Advantages And Disadvantages ◽  
Pros And Cons ◽  
Combined Hormonal Contraception

Introduction: Family planning importance is increasing progressively and is regarded as an essential part in every couple’s life. Family planning has a lot of benefits for the whole family as it provides a better control over the period between each pregnancy leading to a better balance over the personal, financial, and societal life. There are multiple birth control methods, from which couples can choose from with the assistance of their physicians since each method has its own advantages and disadvantages. Furthermore, some contraceptive methods may be more suited for a certain couple or situation than another one. This review of current methods aims to shed the lights on the various contraception options along with their advantages and disadvantages to aid providers in taking care of their patients. Methodology: A thorough search was carried out on PubMed using the most suitable keywords representing the aim of the present study. A total of 120 were found and based on whether they are suited to achieve the aim of the study, 28 were selected. Discussion: There is a great variety of birth control methods, and each has its associated advantages and disadvantages. Barrier contraceptive methods, most common of which are male condoms, are extremely popular in Western countries. Combined hormonal contraception methods which are available in the form of pills, patches, and rings. Progestin only contraception either in the form of a pill, injection or an implant is the most commonly used type among breastfeeding women. Furthermore, intrauterine devices are another effective contraceptive method which may be copper-based or hormonal-based. Conclusion: Contraception is an integral part of family planning, which can be achieved through a variety of methods. Each birth control method has its own pros and cons that should be explained to the couple clearly, so they can choose the method that is most suited for them.

scholarly journals Ethinyl Estradiol/Drospirenone for the Treatment of the Emotional and Physical Symptoms of Premenstrual Dysphoric Disorder

2007 ◽  
Vol 3 (4) ◽  
pp. 395-408 ◽  
Author(s):  
Andrea J Rapkin ◽  
Michelle McDonald ◽  
Sharon A Winer
Keyword(s):  
Premenstrual Syndrome ◽  
Ethinyl Estradiol ◽  
Oral Contraceptive Pill ◽  
Premenstrual Dysphoric Disorder ◽  
Physical Symptoms ◽  
Severe Form ◽  
Steroid Production ◽  
Combined Oral Contraceptive ◽  
Free Interval ◽  
Affective Symptoms

A combined oral contraceptive pill containing 20 μg of ethinyl estradiol and 3 mg of the progestin drospirenone in a novel dose regimen (24 active pills followed by 4 placebo pills), has demonstrated efficacy for the symptoms of premenstrual dysphoric disorder, a severe form of premenstrual syndrome, with an emphasis on the affective symptoms. Drospirenone has progestagenic, anti-androgenic and anti-aldosterone properties, which differ from earlier generations of progestins, and reducing the hormone pill-free interval allows for better suppression of ovarian steroid production.

scholarly journals Efficacy of Acupuncture versus Combined Oral Contraceptive Pill in Treatment of Moderate-to-Severe Dysmenorrhea: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Intira Sriprasert ◽  
Suparerk Suerungruang ◽  
Porntip Athilarp ◽  
Anuchart Matanasarawoot ◽  
Supanimit Teekachunhatean
Keyword(s):  
Randomized Controlled Trial ◽  
Oral Contraceptive ◽  
Side Effects ◽  
Controlled Trial ◽  
Oral Contraceptive Pill ◽  
Open Label ◽  
Intention To Treat ◽  
Combined Oral Contraceptive ◽  
Randomized Controlled ◽  
Pain Scores

This open-label randomized controlled trial was designed to compare the efficacy of acupuncture and combined oral contraceptive (COC) pill in treating moderate-to-severe primary dysmenorrhea. Fifty-two participants were randomly assigned to receive either acupuncture (n= 27) or COC (n= 25) for three menstrual cycles. Mefenamic acid was prescribed as a recue analgesic drug with both groups. The statistical approach used for efficacy and safety assessments was intention-to-treat analysis. By the end of the study, both treatments had resulted in significant improvement over baselines in all outcomes, that is, maximal dysmenorrhea pain scores, days suffering from dysmenorrhea, amount of rescue analgesic used, and quality of life assessed by SF-36 questionnaire. Over the three treatment cycles, COC caused greater reduction in maximal pain scores than acupuncture, while improvements in the remaining outcomes were comparable. Responders were defined as participants whose maximal dysmenorrhea pain scores decreased at least 33% below their baseline. Response rates following both interventions at the end of the study were not statistically different. Acupuncture commonly caused minimal local side effects but did not cause any hormone-related side effects as did COC. In conclusion, acupuncture is an alternative option for relieving dysmenorrhea, especially when COC is not a favorable choice.

scholarly journals Ultra-low-dose oral contraceptive pill: a new approach to a conventional requirement

2017 ◽  
Vol 6 (2) ◽  
pp. 364
Author(s):  
Meenakshi Ahuja ◽  
Pramod Pujari
Keyword(s):  
Side Effects ◽  
Low Dose ◽  
Oral Contraceptive Pill ◽  
New Approach ◽  
Breakthrough Bleeding ◽  
Free Interval ◽  
Dose Oral ◽  
Hormonal Fluctuations ◽  
Reversible Method ◽  
Dose Oral Contraceptive

Combined oral contraceptives (COCs) offer a convenient, safe, effective, and reversible method of contraception. However, their use is limited by side effects. Several strategies have been suggested to make COC use more acceptable among women. Reduction in the dose of estrogen is a commonly accepted approach to reduce the side effects of COC. Use of newer generation of progestins, such as gestodene, reduces the androgenic side effects generally associated with progestogens. Furthermore, reduction in hormone-free interval, as a 24/4 regimen, can reduce the risk of escape ovulation (hence preventing contraceptive failure) and breakthrough bleeding. It also reduces hormonal fluctuations, thereby reducing the withdrawal symptoms. A COC with gestodene 60 µg and ethinylestradiol (EE) 15 µg offers the lowest hormonal dose in 24/4 treatment regimen. This regimen has been shown to offer good contraceptive efficacy and cycle control. With the progress of treatment cycles, the incidence of breakthrough bleeding reduces. Gestodene/EE low dose 24/4 regimen was associated with lower incidence of estrogen-related adverse events, such as headache, breast tenderness, and nausea. Furthermore, COCs containing low dose of estrogen have not been associated with any adverse effect on haemostasis in healthy women. Ultra-low-dose COCs can be considered in women who are at risk of developing estrogen-related side effects.

The combined oral contraceptive pill

2022 ◽  
pp. 175573802110598
Author(s):  
Laura Patterson
Keyword(s):  
Oral Contraceptive ◽  
Side Effects ◽  
Health Risks ◽  
Best Practice ◽  
Oral Contraceptive Pill ◽  
Contraceptive Pill ◽  
Combined Oral Contraceptive ◽  
Risks And Benefits ◽  
Long Acting ◽  
Health Risks And Benefits

The combined oral contraceptive pill (COCP) has been a popular choice of contraception since it was first introduced in 1961. There are numerous varieties of COCP and tailored regimes allow patients more choice and opportunities to adapt contraception to suit individual needs. The pandemic has made it more difficult for patients to access long-acting reversible contraception support and many have been using interim methods of contraception, including the COCP. In this article we explore which pill to prescribe, developments in tailored regimes, guidance about changing pills when side effects arise, health risks and benefits, as well as best practice for remote assessments and prescribing.

scholarly journals Update on male hormonal contraception

2019 ◽  
Vol 10 ◽  
pp. 204201881983484 ◽  
Author(s):  
Giulia Gava ◽  
Maria Cristina Meriggiola
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Contraceptive Method ◽  
Hormonal Contraception ◽  
Active Role ◽  
Hormonal Contraceptives ◽  
Contraceptive Methods ◽  
Men And Women ◽  
Male Contraceptive ◽  
The World

Despite increases in female contraceptive options, 40–45% of pregnancies across the world are still unplanned. While several effective female contraceptive methods have been developed, contraceptive choices for men are still limited to the male condom with its high failure rates and to vasectomies, which are invasive and not reliably reversible. Several studies have demonstrated a great interest among men and women for effective, reversible, and safe male contraceptive methods. Over the years, numerous studies have been performed to develop male hormonal and nonhormonal safe and effective contraceptives. A variety of new molecules are under development as oral or transdermal hormonal contraceptives for men demonstrating few side effects. In our overpopulated world, the development and commercialization of a male contraceptive method that will allow both men and women to take an active role in family planning is mandatory and further research on this topic is required.

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