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Injectable (prolonged) contraceptives

Injection contraception (IC) is used by more than 18 million women worldwide. The composition of IC includes progestogens of prolonged action, devoid of estrogenic and androgenic activity:

• depot-medroxyprogesterone acetate ("Tsepo-Provera"),

• Norztisterone Enanthate ("NET-EN"). The mechanism of contraceptive action of IC:

• suppression of ovulation (inhibitory effect on the hypothalamic-pituitary system),

• changes in the physicochemical properties of the mucus of the cervical canal (its viscosity and fibrousness increase), which prevent the penetration of spermatozoa,

• violation of the level of enzymes "responsible" for the fertilization process,

• endometrial transformations that prevent implantation.

Contraceptive efficacy of IR - 0.5-1.5 pregnancies per 100 women / year. Regime use of IC: "Depo-Provera-.150" - the first dose of the drug (150 mg / 1 ampoule) is administered in the first 5 days of the menstrual cycle: subsequent injections are made every 12 weeks (3 months + 5 days); "NET-EN" - injection of the drug produced 1 time in 8 weeks (200 mg / 1 ampoule). Shake the vial before administering IC. The drug is injected deep into the gluteus maximus muscle. The injection area is not massaged. Restoration of fertility occurs within 4-24 months after the last injection. Indications:

• the impossibility of regular daily intake of other hormonal drugs, if desired, increase the interval between births.

• late reproductive age (over 35 years),

• contraindications to the appointment of estrogen (a number of extragenital diseases or the presence of estrogen-dependent complications in history),

• lactation period (6 weeks after birth),

• use as a "post-abortion" contraception.

Contraindications:

• pregnancy

• pathological uterine bleeding of obscure genesis,

• planning pregnancy in the near future (especially in patients aged 30 to 40 years),

• malignant diseases of the reproductive system (except for endometrial cancer) and mammary glands,

• NET-EN is not acceptable during lactation. Side effects:

• violations of the menstrual cycle (especially in the first months of contraception),

• galactorrhea,

• dizziness, headache,

• fatigue,

• irritability,

• depression,

• weight gain.

• decreased libido.

Method limitations:

• violations of the menstrual cycle, especially in the first months of contraception (dysmenorrhea, acyclic uterine bleeding, oligomenorrhea, amenorrhea),

• the need for regular injections. Advantages of the method:

• high contraceptive effect,

• simplicity and confidentiality of use,

• low frequency of metabolic disorders (due to the absence of the estrogen component),

• therapeutic effects in endometriosis.
premenstrual and climacteric syndromes, dysfunctional uterine bleeding, algomenorrhea. hyperpolymeneum. endometrial hyperplastic processes. recurrent inflammatory diseases of the internal genital organs.

Recommendations to patients using the PC method: - for two weeks after the first injection of the drug to use additional contraception,

• to inject the drug every 3 months (+5 days) in a medical institution.

• if any complaints appear (especially abundant uterine bleeding, headaches, depression, weight gain, frequent urination) deserve special attention, consult a doctor,

• stop administering the drug several months before the planned pregnancy (it must be borne in mind that fertility is restored after 4-24 months after stopping the injection of the drug),

• for prolonged amenorrhea, consult a doctor to rule out pregnancy.
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Injectable (prolonged) contraceptives

  1. INJECTION CONTRACEPTION
    In recent years, research in the field of the development of hormonal contraceptives has mainly focused on ensuring that the dosage forms offered to the consumer have high contraceptive efficacy and at the same time do not have an undesirable effect on metabolic rates, do not increase the risk of complications and adverse reactions and acceptable. According to
  2. HISTORY OF INJECTION CONTRACEPTION
    Depot medroxyprogesterone acetate (DMPA) in the early stages was applied in medicine as a remedy for the treatment of oncological diseases, threatened miscarriage, endometriosis. The first clinical trials of the drug as a contraceptive began in 1963. For the first time, a report on contraceptive efficacy was published in 1966. Based on the results of the study, scientists concluded
  3. Injectable contraceptives
    Contraceptives used as injections are progestins of prolonged action. Medroxyprogesterone acetate (DMPA) and norethindrone enanthate (NET-EN) are currently used for this purpose. The mechanism of contraceptive action of long-acting progestins (in the form of a depot) is based on the blockade of ovulation, changes in the mucus of the cervical canal and transformation
  4. Prolonged stress
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  5. PROLONGED CONTRACEPTION
    Modern effective contraceptive methods began to be applied only in the 20th century, with special progress in fertility planning taking shape with the start of the use of pain 30 years ago combined estrogen-gestagenic oral contraceptives (COCs). According to the WHO, at present, oral contraception is the most popular method of family planning worldwide (Prilepskaya V.N.,
  6. Principles for the selection of oral contraceptives
    The purpose of oral contraceptives should be differentiated, taking into account the peculiarities of somatic and gynecological status, sexual activity, initial hormonal background, history data, the possibility of adverse reactions. When selecting drugs, preference should be given to low-dose contraceptives containing third-generation progestogens. Main
  7. Use of prolonged contraceptive regimens for therapeutic purposes
    Endometriosis Endometriosis is manifested by pains in the pelvic area, menometer, dysmenorrhea, dyspareunia, infertility. The clinical manifestations of endometriosis are largely dependent on the level of estrogen, therefore, the suppression of ovarian production of steroids leads to a decrease in the severity of symptoms. In endometrioid tissue, expression is reduced, type 2p-hydroxysteroid dehydrogenase,
  8. Combined estrogen-progestin contraceptives
    Preparations of this group are called "oral contraceptives" (OK). Each OK tablet contains estrogen and progestogen. As an estrogen component, it is mainly used ethinyl estradiol, less often - mestranol. Ethinyl estradiol is slightly more active than mestranol. The progestogen component is represented by derivatives of the 19-nortesto-Sterone: noretinodrel (1st generation);
  9. COMBINED HORMONAL ORAL CONTRACEPTIVES (COC)
    Combined oral contraceptives (COCs) are among the most common methods of birth control and contain estrogen and gestogenic components. Synthetic estrogen ethinyl estradiol (EE) is used as an estrogen component of COC, and various synthetic progestogens are used as a progestogen. Currently, KOC is enjoying a large
  10. ORAL HORMONAL CONTRACEPTIVES CONTAINING ONLY PROGEDAGEN (PURE PROGESTIC TABLETS OR MINI PIL)
    Pure progestin-only contraceptives are one of the types of hormonal contraception that was created due to the need to eliminate the estrogenic component that causes the majority of metabolic disorders: hypertension and, especially, thromboembolic states. Pure progestin-only contraceptives include: • oral contraceptives containing only progestagen (pure
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  13. Oral contraceptives - modern approach
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  14. Lecture. Family Planning, 2011
    Family planning. Abortion. Contraception. Barrier contraceptive methods. Rhythmic method of contraception. Intrauterine contraception. Oral contraceptives - a modern approach. Injectable (prolonged) contraceptives. Subcutaneous implants as a method of contraception. Principles for the selection of oral contraceptives. Voluntary surgical sterilization. Contraception - principles
  15. Hormonal contraception - general information
    The first oral contraceptives appeared at the turn of the 50s - 60s. this century. The first oral contraceptive "Enovid" (1959) contained 0.15 mg of mestranol and 10 mg of noretinodrel. Subsequently, the method of hormonal contraception underwent significant improvements, among which it is necessary to highlight the following: • firstly, in combined OK, the doses of hormones significantly decreased during
  16. Hormonal contraception
    Hormonal contraception is currently the most common method of protection from unwanted pregnancy. And although more than forty years, intensive research has been conducted on this problem (since the development of the first contraceptive drug, the Enovid, Pincus tablets, in 1959, by the American physiologist G. Pinkus and obstetricians and gynecologists)
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