Birth control contraceptives

Rageau, J. Les plantes medicinales de la Nouvelle Caledonie. Trav Doc de Lorstom No 23, Paris 1973. Hilton-Simpson, M. W. Arab medicine and surgery. Oxford Univ Press, Humphrey Milford, London, 1922. Jochle, W. Menses-inducing drugs their role in Antique, Medieval and Rennaissance gynecology and birth control. Contraception 1974 10 425-439. 

The cervical cap birth control device has been available in Europe for many years and in the U.S. since late 1988. It is a small, mbber, dome-shaped device that fits snugly over the cervix. The cervical cap has some advantages over the diaphragm, but has not Hved up to widespread expectations that it would become an overwhelmingly popular method of contraception (100). 

Norplant System. The Norplant System is a long-term system for birth control (see Contraceptives). Investigation of this type of system began ia the eady 1960s, and a patent on the technology was issued ia 1966 (90). 

Women prescribed ampicillin, bacampicillin, and penicillin V who take birth control pills containing estrogen should use additional contraception measures. 

As noted above, many of the AEDs induce hepatic microsomal enzyme systems and thus reduce the effectiveness of hormonal contraceptives. Women taking AEDs that may reduce the effectiveness of hormonal contraceptives should be encouraged to also use other forms of birth control. Due to induction or inhibition of sex hormone metabolism and changes in binding of hormones to sex hormone binding globulin, some AEDs may reduce fertility. For example, valproate has been associated with a drug-induced polycystic ovarian syndrome. Women who experience difficulties with fertility should seek the advice of health care professionals with expertise in fertility. 

As discussed later in this chapter, contraindications exist for various forms of contraception. Patients must be evaluated completely by a health care professional to rule out any medical contraindications to certain contraceptives. The physical examination also will allow health care professionals to determine if there are other medical concerns, such as hypertension, diabetes, or liver disease, that need to be considered when determining the appropriate contraceptive agent. Clinicians also should review family history for potential risks with certain forms of birth control. 

RC, a 22-year-old woman, presents to your clinic requesting information on contraception. You begin to take a history and determine that the patient is currently sexually active and is not using any method of birth control. Her past medical history is significant only for acne, and she takes no medications except occasional ibuprofen for menstrual cramps. On further questioning, you discover that she has a positive family history for hypertension and coronary artery disease. As you begin to discuss various contraceptive options with the patient, it is clear that she has a preference for an oral contraceptive agent. 

Women of reproductive potential prescribed efavirenz should be counseled on its potentially teratogenic effects and the importance of birth control. Additionally, nevirapine, nelfinavir, ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir have been shown to decrease the concentrations of estrogens and/or progestins in oral contraceptives, which could lead to failure.2 For patients prescribed these drugs, barrier forms of contraception are preferred to prevent pregnancy. DepoProvera may be... 

Note Advise patients using oral or other systemic hormonal contraceptives to change to nonhormonal methods of birth control. 

Effective forms of contraception include both primary and secondary forms of contraception. Primary forms of contraception include Tubal ligation, partner s vasectomy, intrauterine devices, birth control pills, and... 

Prescribers are advised to consult the package insert of any medication administered concomitantly with hormonal contraceptives, because some medications may decrease the effectiveness of these birth control products. Patients should be prospectively cautioned not to self-medicate with the herbal supplement St. John s wort because a possible interaction has been suggested with hormonal contraceptives based on reports of breakthrough bleeding while on oral contraceptives shortly after starting St. John s wort. Pregnancies have been reported by users of combined hormonal contraceptives who also used some form of St. John s wort. 

NS normal saline NSAID nonsteroidal antiinflammatory drug NSCLC non small cell lung cancer NSS normal saline solution NYHA New York Heart Association OAB overactive bladder OCD obsessive-compulsive disorder OCP oral contraceptive pill (birth control pills)... 

Prakash, A. O., R. B. Gupta, and R. Mathur. Effect of oral administration of forty-two indigenous plant extracts on early and late pregnancy in albino rats. Probe 1978 17(4) 315-323. Krag, K. J. Plants used as contraceptives by the North American Indians, an ethnobotanical study. Thesis BS Harvard University 196 117 pp Razzack, H. M. A. The concept of birth control in Unani medical literature. Unpublished manuscript of the author 1980 64 pp. 

Carbamazepine induces hepatic cytochrome P450 (CYP) enzymes, which may reduce levels of other medications. Through the mechanism of hepatic enzyme induction, carbamazepine therapy can lead to oral contraceptive failure therefore, women should be advised to consider alternative forms of birth control while taking carbamazepine. Similarly, use of medications or substances that inhibit CYP 3A3/4 (discussed in Chapter 1) may result in significant increases in plasma carbamazepine levels. 

A low dosage of progestin ( mini-pill ) is used, in the form of medroxyprogesterone acetate, which is active at a very low dose. The mini-pill does not inhibit ovulation, but rather interferes with the endometrium and the cervical mucus. The use of this pill prevents most of the side effects of oral contraception, specifically nausea, water retention, and in some cases thrombophlebitis. However, a lower success rate and other frequent side effects have reduced the widespread acceptance of this preparation. Nevertheless, the mini-pill has a role to play in certain specific situations. For example, in an uncommon form of epilepsy called catamenial epilepsy, female patients will experience seizures at particular times during their menstrual cycle, reflecting the fact that seizure focus is stimulated by estrogens but inhibited by progestins. In such women, the mini-pill may afford not only birth control but also improved seizure control. 

Contraceptives and other birth control methods have been used throughout human history. Ancient methods included a plethora of potions, condoms made from animal skins,... 

The next chapter in the use of norethindrone as an oral conception involved Luis Pincus (1903—1967). Pincus was a Harvard researcher whose controversial work on fertility and reproduction forced him to leave Harvard. He moved to Clark University in Worcester, Massachusetts, and while there he helped establish the Worcester Foundation for Experimental Biology. Early in 1950, interest in the use of progesterone as a contraceptive developed as a result of concerns about the burgeoning world population and calls from birth control... 

Although hormonal contraceptives provide an easy and effective means of birth control, their use has been limited somewhat by potentially serious side effects. In particular, contraceptive medications have been associated with cardiovascular problems such as thrombophlebitis, stroke, and myocardial infarction.153 The incidence of these adverse effects, however, seems to depend to a large extent on whether the user has other risk factors associated with cardiovascular disease (smoking cigarettes, hyperlipidemia, hypertension, and so forth).84,120,162 Likewise, cardiovascular risks may be diminished with the newer forms of hormonal contraceptives, which contain relatively less estrogen than their predecessors. 

---