The combined oral contraceptive pill

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.

Frekuensi Hubungan Seksual dan KB Pil Kombinasi terhadap Terjadinya Erosi Portio pada Wanita Pasangan Usia Subur

Portio erosion is a wound or inflammation of the cervix (portio). Inflammation can be caused by hormonal changes, during pregnancy, contraceptive pill use, installation and removal of IUDs, and lack of personal hygien. This erosion can bleed easily and cause bleeding or metrorrhagia. This study aims to determine the relationship between the frequency of sexual relations and the use of the combined oral contraceptive pill to erosion of portion in reproductive women. This research is an analytic study with a cross sectional design with accidental sampling. Data collection was carried out using interviews and direct observation. Data analysis by a cross tabulation with Spearman Rank test through SPSS software. The results obtained are severe portio erosion covering more than 2/3 of the total cervical area of ​​8 women (53%) based on the frequency of sexual intercourse, and mild portio erosion covers less than 1/3 of the total cervical area of ​​10 women (67%) based on the combined oral contraceptive pill. The study concludes that the frequency of sexual intercourse affected the incidence of portio erosion. The use of the combined oral contraceptive pill has affected the incidence of portio erosion in the POSKESDES Binor Paiton Probolinggo. The results of this study are input for women of childbearing age who are sexually active and use combined pill contraceptives to be more aware of the health of their reproductive organs by routinely performing an IVA or Pap smear at least once a year.

Norethisterone-induced cholestasis: A case report

Case presentation: This case report concerns a 49-year-old woman who developed norethisterone drug -induced cholestasis, a progestin contraceptive, which is quite rare complication generally observed with estrogenic component of combined oral contraceptive pill.

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

Background Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don’t use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women, with and without chronic disease, and investigated factors which influenced contraceptive use over time. Methods Using data from 15,244 young women from the Australian Longitudinal Study on Women’s Health (born 1989-95), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results Differences in contraceptive use over time were found for women with cardiac disease, those with autoinflammatory diseases. Compared to women without chronic disease using the pill alone, women with cardiac disease had double the odds of using ‘other’ low efficacy contraception and condoms (OR=2.2, 95% CI: 1.34-3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR=1.39, 95% CI: 1.03-1.89). Women with autoinflammatory disease had increased odds of using LARC and condoms (OR=1.58, 95% CI: 1.04-2.41), using ‘other’ low efficacy contraception and condoms (OR=1.69, 95% CI: 1.11-2.57), and using combined oral contraceptive pill and condom use (OR=1.38, 95% CI: 1.09-1.75), compared to women without chronic disease using the pill. There was little evidence to suggest that contraceptive patterns differed for women with asthma or diabetes from women without chronic disease. Conclusion The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between healthcare providers and women with chronic disease to improve young women’s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.

Access to the Emergency Contraceptive Pill and Women's Reproductive Health: Evidence From Public Reform in Chile

We examine the sharp expansion in availability of the emergency contraceptive pill in Chile following legalized access through municipal public health care centers. We study the period 2002–2016 and a broad rollout of the emergency contraceptive pill occurring between 2008 and 2011. By combining a number of administrative data sets on health outcomes and pharmaceutical use, and using event-study and difference-in-differences methods, we document that this expansion improved certain classes of women's reproductive health outcomes, notably reducing rates of abortion-related morbidity. These improvements were greater in areas of the country where the rollout of the emergency contraceptive pill was more extensive. We also document some evidence that refusal to provide the emergency contraceptive pill upon a women's request was linked with a worsening in reproductive health outcomes. These results point to the importance of contraceptive access as a determinant of women's reproductive health and well-being and relates to a growing body of work documenting the importance of women's autonomy as a determinant of health.

Chronic Administration of Combined Oral Contraceptive Pill Causes Prefrontal Cortical Oxidative Stress in Female Wistar Rats

Combined oral contraceptive pill (COCP) is used by women to prevent ovulation. This study investigated toxicological effects of COCP on the brain of female rats. Fifteen rats were divided at random into three groups (n=5): Normal control, and first and second cycles treated orally with COCP (0.04 μg/kg bwt of ethinyl oestradiol and 2 μg/kg bwt levonorgestrel) daily for 21 and 42 days respectively. Toxicological effect of treatment on the brain was assessed in the prefrontal cortical acetylcholinesterase, sodium/potassium-ATPase (Na+/K+-ATPase), superoxide dismutase and catalase activities, lipid peroxidation and reduced glutathione levels. Histomorphological examination of the prefrontal cortex of the rats in all the groups was carried out. Activities of cortical Na+/K+-ATPase, acetylcholinesterase, superoxide dismutase and catalase were significantly (p<0.05) reduced following chronic administration of COCP. Histomorphological study of the pre-frontal cortex showed large pyramidal neurons, pyknotic pyramidal neurons, condensed nuclei and increased perineural spaces. Results showed that chronic administration of oral contraceptive caused prefrontal cortical oxidative stress by repressing activities of antioxidant enzymes, Na+/K+-ATPase and acetylcholinesterase.