Contraceptives essential

Exposure to sexually transmitted diseases (STDs) is also a concern for women who are sexually active. It is estimated that 15 million people in the United States become newly infected annually with an STD.5 Given that not all methods of contraception protect the user adequately against STDs, the provision of proper patient education by health care professionals regarding this risk is absolutely essential. 

Data from Hatcher RA, Trussel i Stewart F, et at. Contraceptive Technology, 8th ed. New York Ardent Media, 2004 Dickey RP. Managing Contraceptive Pill Patients, 12th ed. Dallas, IX Essential Medical Information Systems, 2004. 

Tone, Andrea, and Elizabeth Watkins, eds. Medicating Modem America Prescription Drugs in History. New York NYU Press, 2007. This history of medicine in America covers eight of the most influential and important drugs antibiotics, mood stabilizers, hormone replacement therapy, oral contraceptives, tranquilizers, stimulants, statins, and Viagra. Each chapter describes how the drugs become such an essential part of medical care and change the way Americans think about disease. 

There are some circumstances in which it is prudent to avoid using oral contraceptives, or in which frequent control of the state of the breasts is essential. These include (a) very long-term use before the first full pregnancy (b) prolonged use of high-dose formulations (c) uninterrupted use in women with a family history of breast cancer or with a personal history of fibroadenoma. 

In some cases, the simple modification of a drug structure can essentially modify the biological activity profile, whilst preserving some part of the original activity. Drospirenone (see Chapter 11-17), an orally active progestin contraceptive with antimineralcorticoid properties, is an example of an analogue-based drug discovery process that started from the diuretic spironolactone. 

The pill should be taken about the same time (to within 12 hours) every day to establish a routined The monthly bleeds that occur 1-2 days after the cessation of active hormone administration are hormone withdrawal bleeds not natural menstruation. They are not an essential feature of oral contraception, but women are accustomed to monthly bleeds and they provide monthly reassurance of the absence of pregnancy. 

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