Oestrogen-progestogen combined oral contraceptive

Levonorgestrel is a progestogen derivative. It is found either in combined oral contraceptives coupled with an oestrogen derivative or alone in progestogen-only contraceptives. 

The combined oral contraceptive pill contains both oestrogen and progestogen. 

Q7 Combined oral contraceptives contain synthetic oestrogens and progestogens which inhibit FSH and LH release. These compounds inhibit both ovulation and the secretory phase of endometrial growth. Since they are inhibitors of ovulation, they are able to diminish the symptoms of dysmenorrhoea and premenstrual syndrome, which both appear to be related to the menstrual cycles in which ovulation occurs. 

Since the development of the oral contraceptive steroids in the 1960s, various steroids and procedures have been used. Synthetic steroids are now used since their half-hves in the body are longer than the natural steroids. Combined oestrogen-progesterone contraception involves taking one piU each day which contains a synthetic progestogen plus an oestrogen. The pill is taken for 21 dyas, with a break for... 

Hormonal contraceptives, which use oral oestrogen and/or progesterone, such as combined hormonal contraceptives and progestogen-only contraceptives. 

Q10 When choosing an oral contraceptive, a preparation with the lowest oestrogen and progestogen content that can control the cycle is selected. In older women or women with a history of venous thrombosis who require contraception, a progestogen-only preparation may be more suitable than the combined hormonal type, but unfortunately this is not a suitable choice for Shabana s problem. 

Combined oestrogen/progestogen oral contraceptives may both suppress and enhance cancers (see pp. 719, 723). 

Combined oestrogen-progestogen oral contraceptives have been extensively used since 1956. The principal mechanism is inhibition of ovulation (4, above) through inhibition of gonadotrophin secretion from the h3 othalamus. In addition the endometrium is altered, so that implantation is less likely (7, above) and cervical mucus becomes more viscous and impedes the passage of the spermatozoa (5, above). 

The oral contraceptives are of two main types the combined hormonal contraceptives containing both an oestrogen and a progestogen (monophasic, biphasie, triphasie, or sequential), available as tablets or a patch, and the progestogen-only contraceptives, which are available as tablets (sometimes ealled mini pills), parenteral preparations (implants, depot injections) and intrauterine devices. 

Combined oral preparations are most usually taken for 21 days, followed by a period of 7 days during whieh withdrawal bleeding occurs. Some of them include 7 inert tablets to be taken at this time so that the daily routine of taking a tablet is not broken. The eombined patch is applied weekly for 3 weeks followed by a patch-free week. The oestrogenic and progestogen-ic components of these contraceptives aet together to consistently suppress ovulation. 

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