Progestinnegative effect in hypothalamic pituitary ovarian axis LH suppression

Progestinnegative effect in hypothalamic pituitary

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Progestin—negative effect in hypothalamic pituitary ovarian axis (LH suppression) cause atrophy of endometrium & prevent implantation Estrogen—FSH release suppression; cycle control Goal of Tx Safest, best-tolerated, most effective method that pt desires GI illness (diarrhea, vomiting): need to use backup method for at least 7 days Rational Drug selection Start w/ absolute contraindication d/t pre-existing health issue & age Then delivery method: Fine tune based on bleeding pattern, side effect profile Consider patients need for discretion; timing of subsequent pregnancy Patient variables: thorough person, family history, performing physical examination, and labs for patients age will identify if OCs shouldn’t be prescribed Other benefits Decreased dysmenorrhea, menstrual irregularities, and menstrual blood loss Lessening of acne and hirsutism Fewer ovarian cysts Significantly reduced endometrial and ovarian cancer risk Lower incidence of benign breast conditions such as fibrocystic changes and fibroadenoma Increased bone density
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Suppression of endometriosis for women who do not currently desire pregnancy ADRs & contra- indication Risk factors (3-10 times higher) for DVT are inherited clotting disorders, strong family history of inherited clotting disorders, being older than 35 years, smoking more than 10 cigarettes per day, or obesity (BMI 30) levonorgestrel combined w/ low dose of estrogen as safe option cholestatic jaundice, benign hepatic neoplasms, myocardial infarction, stroke, and neurological migraines Dosing regimens Traditional: 21 days active drug + 7 days inactive tablets with withdrawal bleed during inactive tablets Seasonale (extended cycle): 84 days of active drug then 7 days off (withdrawal bleed once every 3 mo
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  • Spring '14
  • Henrikson,J
  • progesterone, Hormonal contraception,  Third-generation

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