Dysfunctional Uterine Bleeding (DUB) is an outdated term that used to refer to abnormal uterine bleeding that occurs in the absence of recognisable pelvic pathology, systemic disease, or pregnancy. It is typically caused by hormonal imbalances, particularly those involving the hypothalamic-pituitary-ovarian axis, leading…
Hormone replacement therapy (HRT) is used to relieve moderate to severe vasomotor symptoms and urogenital symptoms, and to prevent osteoporosis. It replaces oestrogen and progesterone, which are no longer being produced. Progestogens are included in patients with a uterus to prevent endometrial…
Intrauterine contraception is a long-acting reversible method of preventing pregnancy. Small T-shaped pieces of plastic coated with either copper or progestogen-releasing compounds (intrauterine devices or IUDs) are inserted into the uterus transvaginally. Intrauterine contraceptives Intrauterine device Description Levonorgestrel-releasing intrautrine systme…
Contraceptive implants are rod-shaped subdermal devices that slowly release progestogens. They can provide contraception for up to 3 – 5 years. Implant Description Levonorgestrel subdermal implant (Jadelle) 2-rod progestin implant. Approved for 5 years Etonorgestrel subdermal implant (Implanon, Nexplanon) Single-rod progestin…
Combined oral contraceptive pills contain oestrogen and progestogen components. Both monophasic and multiphasic pills are in a 21-day supply, with a 7-day break to allow withdrawal bleeding. They are one of the most popular methods of contraception. COCPs Description Monophasic…
The progestogen-only pill (’mini-pill’) contains a synthetic version of progesterone.
Contraceptive injections are a progesterone-only method. Injectable progestins are 99% effective at preventing pregnancy. Injectable progestin Description Depot-Medroxyprogesterone Acetate (DMPA, Depo-Provera) This is the most common preparation of injectable progestin. It is administered every 90 days (3 months) via intramuscular route. Adverse effects…
Contraceptive patches are analogous to combined oral contraceptives and have a similar adverse effect and contraindications. Patch Description Norelgestromin/Ethinyl estradiol (Ortho Evra Patch): Applied for three weeks then taken off
Barrier methods of contraception prevent the sperm from reaching the egg and provide additional protection from sexually transmitted infections. Male condoms are 98% effective when used correctly, while female condoms are 95% effective when used correctly
Emergency contraception is a post-coital method of preventing pregnancy. These methods prevent ovulation, fertilisation, and/or implantation. They do not alter the embryo after implantation. Emergency contraceptive Description Pregnancy rate if taken within 120 hours Levonorgestrel (LNG) Progesterone-only emergency contraception (POEC).…
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