Dwi  Indria  Anggraini

Faculty  of  Medicine  Lampung  University  

 Drugs  are  available  that decrease fertility by
impairing  
interfering  with  
prevention  ovulation gametogenesis  or  
gestation
gamet  maturation

The  most  common  pharmacologic  

intervention:
Interference  with  ovulation
Two  types  of  preparations   are  used  for  oral  contraception:
• (1)  combinations   of  estrogens  and  progestins
• (2)  continuous  progestin  therapy  only
The  combination  agents  are  further  divided  into  
• Monophasic  forms
• Biphasic  or  triphasic  forms
SC  Implant
• Norgestrel/etonogestrel
IM  Injection
• Large  doses  of  medroxyprogesterone
 Postcoital  
contracep
Progestin  
tion
implant
Progestin  
pill

Combina
tion  pill
 produce  a  change  in  
Combinations  of   selective  inhibition  of  
the  cervical  mucus,  
pituitary  function  that  
estrogens  and   results  in  inhibition  of  
uterine  endometrium,  
motility  and  secretion  
progestins ovulation
in  the  uterine  tubes

The  continuous  use   decrease  the  likelihood  

does  not  always  inhibit  
of  progestins   ovulation
of  conception  and  
implantation.  
alone:
• Nausea,  mastalgia,   • Breakthrough   • Thromboembolism
breakthrough   bleeding • MCI
bleeding,  and   • Weight  gain • CVD
edema • Increased  skin   • Gastrointestinal  
• Changes  in  serum   pigment. Disorders
proteins  and   • Acne (cholestatic  
endocrine  function   jaundice)
• Hirsutism
• Headache  is  mild   • Endometrial  and  
• Ureteral  dilation
and  often  transient ovarian  cancer
• Vaginal  infections
• Withdrawal  
bleeding • Amenorrhea
The  progestin  implant  are  extremely  effective,  and  last  for  5–6  years  
(Norplant)  or  2–4  years  (Implanon).  

The  low  levels  of  hormone  have  little  effect  on  lipoprotein  and  carbohydrate  
metabolism  or  blood  pressure.  

The  disadvantages  include  the  need  for  surgical  insertion  and  removal  of  
capsules  and  some  irregular  bleeding  rather  than  predictable  menses.  

An  association  of  intracranial  HT.  Patients  experiencing  headache  or  visual  

disturbances  should  be  checked  for  papilledema.

Contraception  with  progestins  is  useful  in  patients  with  hepatic  disease,  
hypertension,  psychosis  or  mental  retardation,  or  prior  thromboembolism.  

The  side  effects  include  headache,  dizziness,  bloating  and  weight  gain  of  1–2  
kg,  and  a  reversible  reduction  of  glucose  tolerance.