Hormonal contraceptive Methods

1. HORMONAL
CONTRACEPTIVES
DR A G DHAVALSHANKH

2. DEFINITION
These are the the hormonal preparation used for
reversible suppression of fertility .

4. ORAL CONTRACEPTIVES
1. COMBINED PILLS (Combination of estrogen and
progestin )
Monophasic-each tablet contain fixed amount of E
and P
Biphasic-each tablet contain fixed amount of E
,while the amount of P increases in the second half
of the cycle .
Triphasic – the amount of E may be fixed or
variable ,while the amount of P increases in 3 equal
phases .

5. • In combined pill commonly used
Progestin are - norethindrone ,norgestrel,
levonorgestrel,desogestrel and gestodene
PROGESTIN CONTENT ranges from 0.15mg -1mg
Usual oestrogen – Ethinyl estradiol
OESTROGEN CONTENT ranges from 20-30mcg

7. MEHANISM OF ACTION
• Estrogen and Progesterone causes
feedback inhibition of FSH and LH
secretion from pituitary gland to
inhibit ovulation (Main mechanism )
• Progestin thicken the cervical
mucous and prevent the entry of
sperm
• Make the endometrium less suitable
for implantation
• Causes tubal and uterine contraction
that may interfere with fertilisation

8. PROGESTIN ONLY PILLS(MINIPILL)
These contain low dose of progestin only.
Used as an alternative for women in whom estrogen is
contraindicated.
It is taken daily continuously without any gap.
MOA- 1. by altering the cervical mucus
2.interfering implantation
3.inhibiting ovulation
 AE - 1. Causes menstrual irregularities
2. increased risk of ectopic pregnancy
EFFICACY-96-98%

9. POSTCOITAL PILLS (EMERGENCY PILLS)
These are used for women who are not taking
contraceptive and had a sexual intercourse risking
unwanted pregnancy.
MOA- it interfers with implantation and ovulation
LEVONORGESTREL tablet 0.75mgtwo doses 12 hrs apart
or 1.5mg single dose taken before 72hrs of unprotected
intercourse
ULIPRISTAL 30mg single dose is effective within 120hrs
of intercourse.
MIFEPRISTONE 600mg single dose taken within 72hrs of
intercourse.

11. PARENTERAL CONTRACEPTIVES
 Injectables
• Depot medroxyprogesterone acetate (DMPA) -150mg
deep i,.m once in 3 months.
• Norethindrone enanthate (NEE) – 200mg i.m once in 2
months .
DRAWBACKS
Menstrual irregularities
Headache
Mood change
Weight change
Acne
Decrease in HDL and increase in LDL

12.  Implants
1. Norplant-it is subdermal implant which consist of 6
flexible rods containing 216mg of levonorgestrel.
Effective for 5 yrs
2. Implanon – it is a subdermal single rod containing
68mg of desogestrel. Effective for 3 yrs
SIDE EFFECTS
Infection
Local irritation
Pain at the insertion site