Fertility Control

Question 1

How do pharmacotherapeutic agents modify fertility?

Answer 1

Drugs prevent pregnancy either target:

  A. Menstruation 
  B. Implantation 

Drugs soften out the peaks during hormone cycles

Question 2

What are the different therapeutic agents used to manage contraception?

Answer 2

Hormones

• Oestrogen
• Progestogen

In the form of:

• Combined oral contraceptive
• Progestogen only pills (mini pill)
• Oral emergency contraception (morning after pill)

Question 3

what is a Combined oral contraceptive and MOA

Answer 3

= combined pill with oestrogen and progestogen

 - most effective form of contraception 
 - taken daily 21 o 28 day cycle 

MOA = Suppression of ovulation by inhabitation of GnRH hormone

Question 4

What are the phasic options for COCs?

Answer 4

Monophasic: contain same amount of oestrogen and progestogen throughout each 21 active tablets

Multiphasic: most commonly triphasic (skip periods x3)

Question 5

Contradictions of COCs

people who cannot take

Answer 5

• Less than 6 weeks postpartum (affects breast milk)
• Smoking over 35 and history of VTE
• ischemic heart disease
• breast cancer
• diabetes
• liver tumour

Question 6

Risks with COCs (Adverse effects)

Answer 6

• allergy
• hypertension
• janudice
• VTE
• stroke
• Pancrereatitis

Question 7

Indications for COCs

when cocs should be used

Answer 7

• Benefits outweight risks
• relive menstruation related problems
• prevention of:
  - ovarian and endometrial cancers
  - ovarian cysts
  
  • pelvic inflammatory disease

Question 8

Drug interactions with oestrogen?

Answer 8

Hepatic enzyme (CYP3a4) inducers 
e.g. Rifampicin, phenytoin 

= need high dose of CC

Question 9

What is the progestogen-only pill?

Answer 9

= Mini pill

• only progestogen
• less effective
• taken continuously (no inactive)
• regular withdrawal bleed may not occur
• useful is oestrogen is to be avoided

e.g. Levonorgestrel

Question 10

MOA of progestogen-only pill?

Answer 10

MOA = thickens cervical mucus, makes difficult for sperm to penetrate and reach ovum

Question 11

Indications for progestogen-only pill?

Answer 11

• women who are unable to take oestrogen

- breast feeding (dose not impact breast milk)

Question 12

Adverse effects of progestogen-only pill?

Answer 12

• menstral irregularities
• depression
• weight gain