Progestin only oral contraceptives, advantages and disadvantages
Progestin oral contraceptives (POC) – contain a small dose of progestin (mini-pill) and were created as an alternative to COCs. (POC) is used in women to which are contraindicated medications containing estrogen. The use of progestogen on the one hand, allows to reduce the number of complications of hormonal contraception and on the other – reduces the acceptability of this type of contraception. Due to the lack of estrogens that prevent endometrial ability to rejection, while taking POC are frequently observed intermenstrual discharges.
Progestin oral contraceptives are divided in ethynodiol diacetate or Etonogestrel (Implanon, subdermal implant Implanon
vaginal ring NuvaRing, levonorgestrel (28 mini, Follistrel, Microlut, Microlut 35, Microval), lynestrenol (Exluton, Linosun), desogestrel (Arlette – 28, Apri-28, Cyclessa, Desogen, Kariva, Mircette, Ortho-Cept, Reclipsen, Velivet).
Action of Progestin oral contraceptives (POC) cause higher viscosity of cervical mucus, wich lead to creation in the endometrium of unfavorable conditions for the fertilized ovum implantation, decreased motility of the fallopian tubes. The dose of steroids in the mini-pills isn’t sufficient to effectively suppress ovulation. More than half of the women taking the POC, have normal ovulatory cycles, so the contraceptive efficacy of POC is lower than COC’s efficiency, POC Index is 0.6-4.
Currently, only a few women use this method of contraception. This is mainly breastfeeding (Progestin oral contraceptives are not contraindicated during lactation), smokers, women in the late reproductive period with contraindications to estrogen component of combined oral contraception.
Mini-pill contraceptives are taken from the 1st day of menstruation, 1 tablet a day continuously. It should be remembered that the efficiency of Progestin oral contraceptives (POC) decreases while skipping tablet reception more that for 3-4 hours. Such a violation of the regime requires the use of additional methods of contraception for at least 2 days.
By the above contraindications caused by progestins, must be mentioned: ectopic pregnancy in amnesis (progestins slow the egg transport through the fallopian tubes) and ovarian cysts.
Benefits of Progestin oral contraceptives (POC) use:
• Less than in comparation with COC systemic effects on woman body;
• Lack of estrogen side effects;
• ability to use during lactation.
Disadvantages of POC method:
• Less than COC contraceptive efficacy;
• high probability of discarges.
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