hormonal contraceptive
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Indications
Contraindications
- estrogen-containing contraceptives contraindicated in women with migraine with aura due to increased risk of stroke[15]
Adverse effects
- due to estrogens
- increased risk of thromboembolism
- risk 9-18/100,000/year[5]
- increases risk 14-fold with air-travel[4]
- risk higher for oral contraceptives also containing progestin[10]
- risk higher for drospirenone than levonorgestrel (OR=2.4-3.3)[9]
- increased risk of stroke (RR = 1.5-2.2) & myocardial infarction for estrogen-containing contraceptives*[11][15] (RR = 1.3-2.3) (RR for 30-40 ug of ethinyl estradiol)[11]
- increased risk of coronary artery disease
- increased risk of MI with 2nd generation agents[1]
- risk is minimal with 3rd generation agents[1]
- increased risk of stroke
- increased frequency & severity of migraine headaches
- increased risk of hepatic adenoma
- post-pill amenorrhea
- due to progestins
- other
- nausea/vomiting
- weight gain
- depression
- may increase risk of cervical cancer[2]
- NO increase risk of breast cancer[3]
- may increase risk of urinary incontinence[6]
- accelerates HIV progression[7]
- increased risk of glioma[12]
- RR=1.5, RR=3.2 with progestin-only contraceptive[12]
- no increase in mortality; may confer benefit[8]
* progestin-only contraceptives an option?[11]
Drug interactions
- anticonvulsants carbamezepine, oxcarbazepine, phenytoin & topiramate inactivate many hormonal contraceptives[15]
Notes
- estrogen-containing contraceptives increase serum 25-OH vit D 20%[13]
- use of newer combination hormonal contraceptives associated 34% reduced risk for ovarian cancer[14]
More general terms
More specific terms
- ethinyl estradiol/norelgestromin transdermal patch (Ortho Evra,Xulane)
- ethinyl estradiol/segesterone acetate (Annovera)
- Lunelle
- NuvaRing (etonogestrel, ethinyl estradiol)
- oral contraceptive (OC)
- progestin-only contraceptive
References
- ↑ Jump up to: 1.0 1.1 1.2 Journal Watch 22(3):21-22, 2002 Tanis BC et al Oral contraceptives and the risk of myocardial infarction. N Engl J Med 345:1787, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11752354
- ↑ Jump up to: 2.0 2.1 Journal Watch 22(9):74, 2002 Munoz N et al Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case-control study. Lancet 359:1093, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11943256
Moreno V et al Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet 359:1085, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11943255 - ↑ Jump up to: 3.0 3.1 Journal Watch 22(15):120-21, 2002 MarchBanks PA et al Oral contraceptives and the risk of breast cancer. N Engl J Med 346:2025, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12087137
Davidson NE & Helzlsouer KJ Good news about oral contraceptives. N Engl J Med 346:2078, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12087145 - ↑ Jump up to: 4.0 4.1 Prescriber's Letter 11(2):8 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200203&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 5.0 5.1 Prescriber's Letter 12(9): 2005 Ortho Evra and the Risk of Thromboembolism Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210902&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 6.0 6.1 Townsend MK et al Oral contraceptive use and incident urinary incontinence in premenopausal women. J Urol 2009 May; 181:2170. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19296979
Jackson SL and Fihn SD Exogenous estrogen and urinary incontinence. J Urol 2009 May; 181:1989. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19286197 - ↑ Jump up to: 7.0 7.1 Stringer EM et al HIV disease progression by hormonal contraceptive method: Secondary analysis of a randomized trial. AIDS 2009 Jul 17; 23:1377. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19448528
- ↑ Jump up to: 8.0 8.1 Hannaford PC et al. Mortality among contraceptive pill users: Cohort evidence from Royal College of General Practitioners' Oral Contraception Study. BMJ 2010 Mar 11; 340:c927. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20223876 <Internet> http://dx.doi.org/10.1136/bmj.c927
- ↑ Jump up to: 9.0 9.1 Jick SS and Hernandez RK Risk of non-fatal venous thromboembolism in women using oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel: case- control study using United States claims data BMJ 2011; 342:d2151 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21511805 <Internet> http://www.bmj.com/content/342/bmj.d2151
Parkin L et al Risk of venous thromboembolism in users of oral contraceptives containing drospirenone or levonorgestrel: nested case-control study based on UK General Practice Research Database BMJ 2011; 342:d2139 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21511804 <Internet> http://www.bmj.com/content/342/bmj.d2139
Dunn N The risk of deep venous thrombosis with oral contraceptives containing drospirenone BMJ 2011; 342:d2519 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21511807 <Internet> http://www.bmj.com/content/342/bmj.d2519.extract
FDA Safety Alert: Posted 05/31/2011 Birth Control Pills Containing Drospirenone: Possible Increased Risk of Blood Clots http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm257337.htm - ↑ Jump up to: 10.0 10.1 Lidegaard O et al Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9 BMJ 2011; 343:d6423 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22027398 <Internet> http://www.bmj.com/content/343/bmj.d6423.full
Hannaford PC The progestogen content of combined oral contraceptives and venous thromboembolic risk BMJ 2011; 343:d6592 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22028481 <Internet> http://www.bmj.com/content/343/bmj.d6592.extract - ↑ Jump up to: 11.0 11.1 11.2 11.3 Lidegaard O et al Thrombotic Stroke and Myocardial Infarction with Hormonal Contraception N Engl J Med 2012; 366:2257-2266June 14, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22693997 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1111840
Petitti DB Hormonal Contraceptives and Arterial Thrombosis - Not Risk-free but Safe Enough N Engl J Med 2012; 366:2316-2318June 14, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22694003 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1204769 - ↑ Jump up to: 12.0 12.1 12.2 Andersen L et al Hormonal contraceptive use and risk of glioma among younger women a nationwide case-control study. British Journal of Clinical Pharmacology. Jan 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25345919 <Internet> http://onlinelibrary.wiley.com/doi/10.1111/bcp.12535/abstract
- ↑ Jump up to: 13.0 13.1 Harmon QE, Umbach DH, Baird DD Use of Estrogen-Containing Contraception Is Associated With Increased Concentrations of 25-Hydroxy Vitamin D. J Clin Endocrinol Metab 101: Aug, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27490916 <Internet> http://press.endocrine.org/doi/pdf/10.1210/jc.2016-1658
- ↑ Jump up to: 14.0 14.1 Iversen L, Fielding S, Lidegaard O et al Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study. BMJ 2018;362:k3609 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30257920 Free full text https://www.bmj.com/content/362/bmj.k3609
- ↑ Jump up to: 15.0 15.1 15.2 15.3 Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022