Oral contraceptive pill

Has the properties of progesterone and is given orally for treating functional uterine haemorrhage. Norethisterone, 19-norelhisterone, m.p. 20I-206°C is one of the progestational steroids used in the contraceptive pill. 

Drug therapy Estrogen-containing oral contraceptive pills Estrogen replacement therapy SERMs HIT... 

A 25-year-old Caucasian woman presents to the university student clinic with complaints of intermittent crampy abdominal pain and four to five loose stools per day. She describes some visible mucus and blood in the stool and states that these symptoms have been present for 6 to 8 weeks. She also has intermittent lower back pain, fatigue, fever, and a 10-lb (4.5 kg) weight loss. The back pain started about the same time as her gastrointestinal symptoms. She denies any sick contacts and has not eaten any take-out or restaurant food over the last 2 months. She takes nonprescription naproxen as needed for aches and pains. She has been using more naproxen recently because of the back pain. She also takes an oral contraceptive pill once daily. She consumes alcohol socially and currently smokes 1/2 to 1 pack of cigarettes per day. 

In addition to preventing pregnancy, there are several noncontraceptive benefits associated with the use of combined oral contraceptive pills. Many of the potential non-contraceptive benefits are highlighted below. 

As an alternative to oral contraceptive pills, which must be taken daily in order to reliably prevent pregnancy, non-oral contraceptives in the form of transdermal, transvaginal, and injectable preparations are available and offer patients safe and effective alternatives to the pills for prevention of pregnancy. These formulations also do not require daily administration, making them more convenient than the pill formulations. 

Like the medical treatment of uterine leiomyomas, danazol, gestrinone, mifepristone, and GnRH-a, with or without add-back therapy, have been proposed for the treatment of endometriosis as well (Olive et al. 2001 Stones et al. 2004), but unlike leiomyomas, oral contraceptive pills, in cyclic or continuous administration, and medroxyprogesterone acetate also seem to be effective (Olive et al. 2001 Stones et al. 2004). A significant benefit in terms of pelvic pain relief also is obtained with the use of nonsteroidal anti-inflammatory drugs (Olive et al. 2001 Stones et al. 2004). 

One potentially serious consequence of enz)rme induction relates to the oral contraceptive pill (OCP), which may be rendered ineffective by induction of its metabolism. The effect of a period of drug administration on circulating... 

Studies on isolation from adrenal cortex and the synthesis of cortisone (in 28 steps), an anti-arthritic hormone, was accomplished in the 1940s by Woodward and others. Cortisone was used as an important military medicine during World War II. Carl Djerassi from Stanford University directed the research at the Syntex Laboratories, which led to the synthesis of the first oral contraceptive pill for women. Koji Mori is very active in the field of the synthesis of pheromones. 

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)... 

The major oestrogen preparations used medically are outlined in Table 1.12, and their chemical structure is illustrated in Figure 1.3. The widest clinical application of oestrogens relate to their use as oral contraceptives. Most such contraceptive pills contain an oestrogen in combination with a progestin (discussed later). 

So far no simple equivalent of the oral contraceptive pill has been developed for men. Relatively large doses of testosterone do inhibit gonadotrophin secretion and hence spermatogenesis, and different schedules are under clinical trial at present. 

The term induction has evolved to include any mechanism that results in increased tissue concentration of catalytically active protein involved in drug metabolism. This increased enzyme activity results in greater systemic clearance and lower bioavailability of extensively metabolized drugs. The resulting lower drug concentrations often result in therapeutic failure. For example, it is well known that oral contraceptive pills become ineffective when rifampin is coprescribed. 

Lehtovirta P, Ranta T, Seppala M. Elevated prolactin levels in oral contraceptive pill-related hypertension. Fertil Steril 1981 35(4) 403-5. 

Peleg R. Abdominal wall pain caused by cutaneous nerve entrapment in an adolescent girl taking oral contraceptive pills. J Adolesc Health 1999 24(l) 45-7. 

Silver EA, Silver AH, Silver DS, McCalmont TH. Pseudoporphyria induced by oral contraceptive pills. Arch Dermatol 2003 139 227-8. 

Spector TD, Hochberg MC. The protective effect of the oral contraceptive pill on rheumatoid arthritis an overview of the analytic epidemiological studies using meta-analysis. J Clin Epidemiol 1990 43(ll) 1221-30. 

Kendall MJ, Quarterman CP, Jack DB, Beeley L. Metoprolol pharmacokinetics and the oral contraceptive pill. Br J Clin Pharmacol 1982 14(l) 120-2. 

Hughes BR, Cunliffe WJ. Interactions between the oral contraceptive pill and antibiotics. Br J Dermatol 1990 122(5) 717-8. 

Watson KJR, Ghabrial H, Mashford ML, Harman PJ, Breen KJ, Desmond PV. The oral contraceptive pill increases morphine clearance but does not increase hepatic blood flow. Gastroenterology 1986 90 1779. 

Suzuki R, Matsumura Y, Kambe N, Fujii H, Tachibana T, Miyachi Y. Erythema multiforme due to progesterone in a low-dose oral contraceptive pill. Br J Dermatol 2005 152 370-1. 

There has been a resurgence of interest in vaginal contraception methods as a result of recent concerns about the prolonged use of oral combined contraception. The issue of compliance is also a major stumbling block for the contraceptive pill. Although the theoretical effectiveness of the pill is close to 100%, various studies have demonstrated that the real life pregnancy rate is almost 8 per 100 women during their first year of use [154,155],... 

Pymar HC, Creinin AID. The risks of oral contraceptive pills. Semin Reprod Med. 2001 19 305-312. 

Sedee AGJ, Beijersbergen van Henegouwen GMJ. Photochemical decomposition of contraceptive steroids a possible explanation for the observed (photo)allergy of the oral contraceptive pill. Arch Pharm (Weinheim) 1985 318 111-119. 

Meanwhile, the currently marketed CYP3A4 inducers can profoundly affect the pharmacokinetics of coadministered CYP3A4 substrates, e.g., rifampin on midazolam (139) or triazolam (140). Clearly, the most frequent outcome is a loss of efficacy, which is perhaps less serious than inhibition interactions, although the consequences of coadministering rifampin with the oral contraceptive pill can lead to contraceptive failure (141-143). 

The current consensus is that the contemporary low-dose preparations pose minimal risks in women who have no predisposing risk factors and, in fact, may provide certain beneficial health effects (e.g., protection against endometrial and ovarian cancer). Oral contraceptive pills have been associated with increased risk for myocardial infarction, stroke, and venous thromboembolism. However, studies have been published that suggest that these risks are minimal in appropriately chosen low-risk women. 

Stroke is a very uncommon event in childbearing women, occurring in approximately 11 per 100,000 women over a 1-year period of time. Therefore, even a doubling of this risk with oral contraceptive pills would have minimal effect on attributable risk. The estimated risk of myocardial infarction associated with oral contraceptive pill use in nonsmokers is 3 per million women over 1 year. The estimated risk of venous thromboembolism attributable to oral contraceptive pills is less than 3 per 10,000 women per year. However, the risk may be increased in women who smoke or have other predisposing factors to thrombosis or thromboembolism. In fact, it should be emphasized that the risk of serious cardiovascular side effects is particularly marked in women over 35 years of age who are heavy smokers (e.g., more than 15 cigarettes per day). Additionally, the literature suggests that there may be an increased risk of breast cancer associated with long-term oral contraceptive pill use in women under the age of 35. However, because the incidence of breast cancer is so relatively low in this population, the attributable risk of breast cancer from birth control pill use is small. 

In November 2000, drospirenone in combination with ethinylestradiol was introduced by Schering AG to the drug market in Germany as a contraceptive pill under the tradename Yasmin . Today, it is available almost worldwide, and is considered to be the most successful oral contraceptive of the past decade. 

The ovulation-inhibiting component of many oral contraceptive pills is a compound known as ethynyloestradiol, and this compound too is made by an alkynyllithium addition to the female sex hormone... 

Warn the patient that the antibiotics may interfere with the combined oral contraceptive pill (COC), as she is taking this. She should use condoms for one week after completion of the antibiotic course, and the next COC pill pack should be started without a break and thus omitting the pill-free week. 

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