Contraceptives: Can all women use them?

Article of the doctor in ONMED.GR

Contraceptives are hormonal preparations that mainly act by preventing ovulation by inhibiting the production of follicle stimulating hormone (FSH) and luteal hormone (LH). They can also make cervical mucus impermeable to sperm and reduce the receptivity of the endometrium during implantation.

What do contraceptives consist of

Contraceptives usually consist of an estrogen and a progestogen. Over the years, significant changes have been made to the formulation to increase safety and reduce any side effects. The most common estrogen in combined hormonal contraceptives is ethinyl estradiol, and based on the dose of estrogen contained, they can be classified as “high-dose” (50 μg or more), “moderate-dose” (30-35 μg) and “low-dose” (15-20 μg) contraceptives. Literature data show greater safety of 20 mcg compared to 25, 30 or 35 mcg of ethinyl estradiol and for this reason, it is usually recommended to start treatment with lower dose estrogen contraceptives. With regard to progestogens, there are several generations of progestogens, with those of the third and fourth generation having less androgenic activity and side effects than those of previous generations.

Are contraceptives for all women?

Hormonal contraception can be safely provided after taking the patient’s medical history and measuring their blood pressure. Important factors to be checked include hypertension, diabetes, thromboembolism, migraine with aura, breast cancer, etc. No additional tests (e.g. thrombophilia testing) are needed in women without underlying diseases. For this reason, it is important that contraceptives are given on the recommendation of the treating physician. https://46d3207e61a6e41bcbb9b8492b6357d0.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

Are there any side effects?

In general, no. However, some women may experience breast tenderness, nausea and bloating at the start of treatment. These symptoms, however, usually resolve quickly within three months. There is no evidence that contraceptives cause weight gain.

Bibliography

Kiley J, et al. Combined oral contraceptives: a comprehensive review. Clin Obstet Gynecol. 2007.

Hee L, et al. Continuous use of oral contraceptives: an overview of effects and side-effects. Acta Obstet Gynecol Scand. 2013 Feb;92(2):125-36

Odwe, et al. Factors influencing satisfaction with oral contraceptive pills and injectables among past users in Kenya.J Biosoc Sci. 2019 Jul;51(4):491-504

Biography

Prof. Dr. Panagiotis Drakopoulos MD, PhD is an obstetrician-gynecologist specializing in the investigation and treatment of infertility and assisted reproduction. She graduated with honors from the Medical School of the University of Athens and specialized in Obstetrics and Gynecology (FMH) at the University Hospital of Geneva (HUG) in Switzerland. He specialised for several years at the Centre for Reproductive Medicine of the University of Brussels (CRG, UZ Brussel), and since 2019 he has been a Professor at the University. He is recognized as a specialist in reproductive medicine by ESHRE (European society of Human Reproduction) and EBCOG (European Board and College of Obstetrics and Gynecology).

Prof. Dr. Drakopoulos has authored more than 80 publications in renowned international journals and is an invited speaker at many international IVF conferences on an annual basis. He contributes as a reviewer to the most important journals in the field of infertility (Lancet, Human Reproduction update, Human reproduction, Fertility and Sterility, etc.) His scientific interest is mainly focused on reproductive endocrinology and strategies to improve the outcome of patients with poor responders. What characterizes him is his focus on the “human being”, his individualized medicine approach and the application of evidence based medicine

Website: drakopoulos-ivf.gr