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[Parenteral contraceptive drugs: depot progestins]
1Universitäts-Frauenklinik Heidelberg, Abteilung für Gynäkologische Endokrinologie.
Wiener Medizinische Wochenschrift (1946)
|November 15, 1987
Summary
Depot progestins offer safe contraception for women with cardiovascular risks, providing options like injectables and implantables. These methods alter cervical mucus for effective birth control, though menstrual irregularities are possible side effects.
Area of Science:
- Reproductive endocrinology
- Pharmacology of hormonal contraceptives
Context:
- Estrogen-progestin contraceptives are contraindicated for women with certain risk factors, such as cardiovascular disease.
- Depot progestin formulations provide alternative long-acting reversible contraceptive (LARC) options.
Purpose:
- To review the mechanisms of action, indications, contraindications, benefits, and drawbacks of various depot progestin contraceptive methods.
- To inform clinical decision-making regarding progestin-only contraceptives.
Summary:
- Injectable depot progestins (medroxyprogesterone acetate, norethistrone enantate) provide 2-4 months of contraception primarily by altering cervical mucus.
- Subdermal implants (levonorgestrel) offer contraception for up to 5 years with lower steroid levels than progestin-only pills.
- Progestin-releasing vaginal rings are under clinical investigation, offering convenient administration and potential for breakthrough bleeding side effects.
Impact:
- Depot progestins provide crucial contraceptive choices for women unable to use combined hormonal methods.
- Understanding the side effect profiles, including menstrual cycle disturbances and amenorrhea, is vital for patient counseling and adherence.
- The development of new delivery systems like vaginal rings expands long-acting reversible contraception options.
Keywords:
AmenorrheaBiologyBleedingCervical Mucus--changesCervixContraceptionContraceptive Agents, FemaleContraceptive Agents, Progestin--pharmacodynamicsContraceptive Agents, Progestin--side effectsContraceptive Agents--pharmacodynamicsContraceptive Agents--side effectsContraceptive Implants--side effectsContraceptive MethodsContraceptive Methods--side effectsDiseasesFamily PlanningGenital Effects, FemaleGenitaliaGenitalia, FemaleHormonesInjectablesMedroxyprogesterone AcetateMenstruation DisordersMetrorrhagiaNorethindrone EnanthatePhysiologyReproductive Control AgentsSigns And SymptomsUrogenital SystemUterus