DOCSLIB.ORG

Emergency Contraception Krishna K

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Emergency Contraception Krishna K POLICY STATEMENT Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of all Children Emergency Contraception Krishna K. Upadhya, MD, MPH, FAAP, COMMITTEE ON ADOLESCENCE Despite significant declines over the past 2 decades, the United States abstract continues to experience birth rates among teenagers that are significantly higher than other high-income nations. Use of emergency contraception (EC) within 120 hours after unprotected or underprotected intercourse can reduce the risk of pregnancy. Emergency contraceptive methods include oral Children’s National Health System, Washington, District of Columbia medications labeled and dedicated for use as EC by the US Food and Drug Policy statements from the American Academy of Pediatrics benefit Administration (ulipristal and levonorgestrel), the “off-label” use of combined from expertise and resources of liaisons and internal (AAP) and external reviewers. However, policy statements from the American oral contraceptives, and insertion of a copper intrauterine device. Indications Academy of Pediatrics may not reflect the views of the liaisons or the for the use of EC include intercourse without use of contraception; condom organizations or government agencies that they represent. breakage or slippage; missed or late doses of contraceptives, including the Dr Upadhya was responsible for all aspects of revising and writing the policy statement with input from reviewers and the Board of Directors; oral contraceptive pill, contraceptive patch, contraceptive ring, and injectable she approves the final manuscript as submitted. contraception; vomiting after use of oral contraceptives; and sexual assault. The guidance in this statement does not indicate an exclusive course Our aim in this updated policy statement is to (1) educate pediatricians and of treatment or serve as a standard of medical care. Variations, taking other physicians on available emergency contraceptive methods; (2) provide into account individual circumstances, may be appropriate. current data on the safety, efficacy, and use of EC in teenagers; and (3) All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, encourage routine counseling and advance EC prescription as 1 public health revised, or retired at or before that time. strategy to reduce teenaged pregnancy. This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial BACKGROUND INFORMATION involvement in the development of the content of this publication. DOI: https://doi.org/10.1542/peds.2019-3149 Emergency contraception (EC) refers to methods of contraception that are Address correspondence to Krishna K. Upadhya, MD, MPH, FAAP. E-mail: used after sexual intercourse to reduce the risk of pregnancy. Methods [email protected] currently available in the United States are (1) ulipristal acetate (UPA), an oral progesterone receptor agonist-antagonist; (2) levonorgestrel (LNG), PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). an oral progestin; (3) the copper intrauterine device (Cu-IUD); and (4) off- Copyright © 2019 by the American Academy of Pediatrics label use of combined oral contraceptives (Yuzpe method). EC can reduce FINANCIAL DISCLOSURE: The author has indicated she has no financial the risk of pregnancy if used up to 120 hours after unprotected relationships relevant to this article to disclose. intercourse, and hormonal emergency contraceptive pills (ECPs) are more FUNDING: No external funding. 1 likely to be effective the sooner they are used. Use of EC after unprotected POTENTIAL CONFLICT OF INTEREST: The author has indicated she has or underprotected intercourse remains an important strategy to reduce no potential conflicts of interest to disclose. unintended pregnancies among adolescents and women. By the age of 19 years, approximately two-thirds of youth will have To cite: Upadhya KK, AAP COMMITTEE ON ADOLESCENCE. initiated sexual intercourse.2 Most teenagers report first intercourse with Emergency Contraception. Pediatrics. 2019;144(6): e20193149 a steady partner and consensual sex.3 Approximately 11% of US high Downloaded from www.aappublications.org/news by guest on September 26, 2021 PEDIATRICS Volume 144, number 6, December 2019:e20193149 FROM THE AMERICAN ACADEMY OF PEDIATRICS school students report experiencing EC is the only contraceptive method thereby preventing the binding of a forced sexual experience ranging designed to prevent pregnancy after progesterone, and inhibits ovulation. from kissing to forced intercourse.4 intercourse. Indications for the use of Ulipristal, sold under the brand name Sexual assault is 1 factor associated EC include intercourse without use of ella (Watson, Morristown, NJ), is with risk for unintended pregnancy contraception; condom breakage or a single pill containing 30 mg of UPA among adolescents.5 Youth with slippage; missed or late doses of and is indicated for use up to developmental and other disabilities contraceptives, including the oral 120 hours after unprotected may be at even higher risk of contraceptive pill, contraceptive intercourse. It is important for experiencing sexual abuse or assault patch, contraceptive ring, and patients to be counseled that onset of than their peers are.6,7 Improved use injectable contraception; vomiting menses after UPA use may be later of contraception, not declines in after use of oral contraceptive pills, than expected and a pregnancy test is sexual activity, has been the most and sexual assault. ECPs include indicated if the patient does not have significant contributor to the decline products labeled and approved by the a period within 3 weeks. UPA is in pregnancy risk among US US Food and Drug Administration currently available by prescription teenagers over the past decade.8 (FDA) for use as EC (levonorgestrel only, regardless of age, and many Pediatricians have an important role and UPA) and the off-label use of pharmacies do not have it in stock. to play in enabling adolescent access combination oral contraceptives (the Progestin-Only Pills to all available contraceptive methods Yuzpe method) that have been to address the Healthy People 2020 described in the literature since Levonorgestrel EC was approved by objective of continuing to reduce 1974.13 Insertion of a Cu-IUD within the FDA in 1999 under the brand adolescent pregnancy in the United 5 days of unprotected intercourse is name Plan B and is currently States.9 an additional method of EC available marketed under several names, in the United States. Insertion of a Cu- including Plan B One Step (Teva The most commonly used methods of IUD is the most effective method of Women’s Health, Woodcliff Lake, NJ), contraception reported by teenagers EC and has the extra benefitof Take Action (Teva Women’s Health), who have had intercourse in the providing ongoing contraception Next Choice One Dose (Actavis United States are the condom, when left in place.1 Pharma, Inc, Parsippany, NJ), and My followed by withdrawal, the oral Way (Gavis Pharmaceuticals, Studies have shown that adolescents contraceptive pill, and ECPs.2 Somerset, NJ). Although are more likely to use ECPs when Condoms are important for levonorgestrel EC originally consisted they have been supplied or protection against sexually 14 of 2 pills, current regimens are prescribed in advance of need. As of transmitted infections (STIs) as well packaged as a single pill with 1.5 mg August 2013, levonorgestrel EC is as pregnancy, and the oral of levonorgestrel. Package labeling approved for over-the-counter sale contraceptive pill can be an effective indicates that levonorgestrel EC throughout the United States to method for pregnancy prevention; 15 should be taken within 72 hours of people of all ages ; however, barriers however, both methods require strict unprotected intercourse; however, to access include cost and availability adherence by the user to be 16 data support that use up to 120 hours in pharmacies. Surveys suggest that maximally effective. Withdrawal is after intercourse may prevent most practicing pediatricians and not recommended because of its pregnancy.23,24 Adolescents should be pediatric residents do not routinely relatively low effectiveness for instructed to take 1.5 mg of counsel patients about EC and do not pregnancy prevention and because it 17–21 levonorgestrel as soon as possible prescribe it. This policy provides no protection against STIs. and up to 120 hours after statement provides updated guidance Although the American Academy of unprotected intercourse. Adolescents on all methods of EC available to US Pediatrics (AAP) and other medical should be aware that the medicine is adolescents (Table 1) and ongoing organizations recommend the use of less likely to be effective when taken policy and access issues. intrauterine devices (IUDs) and at 120 hours when compared with implants as the most effective immediate use. No physical methods for adolescents,10,11 rates of EC METHODS examination or pregnancy testing is use of these methods remain low. The EC Pills required before use. Adolescents are most recent analysis from the Centers advised to test for pregnancy (at for Disease Control and
Load more

Recommended publications
  • Contraception: Choosing the Right Method for You
    Contraception: Choosing the Right Method for You Megan Sax, MD and James L. Whiteside, MD What’s available? Choosing a method of contraception can be overwhelming. The most commonly used methods of reversible contraception in the United States are: hormonal methods the intrauterine device (IUD) the implant barrier methods (e.g. male condom)1 Friends, family, and the Internet are full of stories of failed contraception or bad reactions and these stories can have a big influence that doesn’t always line up with the facts.2 However, knowing these facts is critical to figuring out what type will work best for you. Highly Effective Contraception The best place to start in choosing your contraception is to determine when, if ever, you are planning on starting a family. If you do not wish to become pregnant in the next year, a Long-Acting Reversible Contraceptive (LARC) device may be a good option. LARCs include an implant placed under the skin of the upper, inner arm (brand name Nexplanon) and the IUD. IUDs are placed inside the uterus (see Figure 1). They use copper (brand name ParaGard) or hormones (brand names: Mirena, Lilleta, Skyla, Kyleena) to stop a pregnancy from happening. LARCs are the most effective reversible form of contraception. Less than 1% of users experience unintended pregnancy during the first year of use.3 Currently, the implant Nexplanon is effective for 3 years. The hormonal IUD may be used for 3 to 5 years, depending on the brand. The copper IUD works for 10 years. These devices are inserted and removed by a medical care provider.
    [Show full text]
  • Preven Emergency Contraceptive
    9/1/1998 1 Rx Only PREVENÔ Emergency Contraceptive Kit consisting of Emergency Contraceptive Pills and Pregnancy Test Emergency Contraceptive Pills (Levonorgestrel and Ethinyl Estradiol Tablets, USP) and Pregnancy Test The PREVENÔ Emergency Contraceptive Kit is intended to prevent pregnancy after known or suspected contraceptive failure or unprotected intercourse. Emergency contraceptive pills (like all oral contraceptives) do not protect against infection with HIV (the virus that causes AIDS) and other sexually transmitted diseases. DESCRIPTION The PREVENÔ Emergency Contraceptive Kit consists of a patient information book, a urine pregnancy test and four (4) emergency contraceptive pills (ECPs). The pills in the PREVENÔ Emergency Contraceptive Kit are combination oral contraceptives (COCs) which are used to provide postcoital emergency contraception. Each blue film-coated pill contains 0.25 mg levonorgestrel (18,19-Dinorpregn-4-en-20- yn-3-one, 13-Ethyl-17-hydroxy-, (17a)-(-), a totally synthetic progestogen, and 0.05 mg ethinyl estradiol (19-Nor-17a-pregna-1,3,5, (10)-trien-20-yne-3,17-diol). The inactive ingredients present are polacrilin potassium, lactose, magnesium stearate, hydroxypropyl methylcellulose, titanium dioxide, polyethylene glycol, polysorbate 80 and FD&C Blue No.2 Aluminum Lake. MOLECULES TO BE ADDED The Pregnancy Test uses monoclonal antibodies to detect the presence of hCG (Human Chorionic Gonadotropin) in the urine. It is sensitive to 20 – 25 mIU / mL 9/1/1998 2 CLINICAL PHARMACOLOGY ECPs are not effective if the woman is pregnant; they act primarily by inhibiting ovulation. They may also act by altering tubal transport of sperm and/or ova (thereby inhibiting fertilization), and/or possibly altering the endometrium (thereby inhibiting implantation).
    [Show full text]
  • Reseptregisteret 2013–2017 the Norwegian Prescription Database
    LEGEMIDDELSTATISTIKK 2018:2 Reseptregisteret 2013–2017 Tema: Legemidler og eldre The Norwegian Prescription Database 2013–2017 Topic: Drug use in the elderly Reseptregisteret 2013–2017 Tema: Legemidler og eldre The Norwegian Prescription Database 2013–2017 Topic: Drug use in the elderly Christian Berg Hege Salvesen Blix Olaug Fenne Kari Furu Vidar Hjellvik Kari Jansdotter Husabø Irene Litleskare Marit Rønning Solveig Sakshaug Randi Selmer Anne-Johanne Søgaard Sissel Torheim Utgitt av Folkehelseinstituttet/Published by Norwegian Institute of Public Health Område for Helsedata og digitalisering Avdeling for Legemiddelstatistikk Juni 2018 Tittel/Title: Legemiddelstatistikk 2018:2 Reseptregisteret 2013–2017 / The Norwegian Prescription Database 2013–2017 Forfattere/Authors: Christian Berg, redaktør/editor Hege Salvesen Blix Olaug Fenne Kari Furu Vidar Hjellvik Kari Jansdotter Husabø Irene Litleskare Marit Rønning Solveig Sakshaug Randi Selmer Anne-Johanne Søgaard Sissel Torheim Acknowledgement: Julie D. W. Johansen (English text) Bestilling/Order: Rapporten kan lastes ned som pdf på Folkehelseinstituttets nettsider: www.fhi.no The report can be downloaded from www.fhi.no Grafisk design omslag: Fete Typer Ombrekking: Houston911 Kontaktinformasjon/Contact information: Folkehelseinstituttet/Norwegian Institute of Public Health Postboks 222 Skøyen N-0213 Oslo Tel: +47 21 07 70 00 ISSN: 1890-9647 ISBN: 978-82-8082-926-9 Sitering/Citation: Berg, C (red), Reseptregisteret 2013–2017 [The Norwegian Prescription Database 2013–2017] Legemiddelstatistikk 2018:2, Oslo, Norge: Folkehelseinstituttet, 2018. Tidligere utgaver / Previous editions: 2008: Reseptregisteret 2004–2007 / The Norwegian Prescription Database 2004–2007 2009: Legemiddelstatistikk 2009:2: Reseptregisteret 2004–2008 / The Norwegian Prescription Database 2004–2008 2010: Legemiddelstatistikk 2010:2: Reseptregisteret 2005–2009. Tema: Vanedannende legemidler / The Norwegian Prescription Database 2005–2009.
    [Show full text]
  • F.8 Ethinylestradiol-Etonogestrel.Pdf
    General Items 1. Summary statement of the proposal for inclusion, change or deletion. Here within, please find the evidence to support the inclusion Ethinylestradiol/Etonogestrel Vaginal Ring in the World Health Organization’s Essential Medicines List (EML). Unintended pregnancy is regarded as a serious public health issue both in developed and developing countries and has received growing research and policy attention during last few decades (1). It is a major global concern due to its association with adverse physical, mental, social and economic outcomes. Developing countries account for approximately 99% of the global maternal deaths in 2015, with sub-Saharan Africa alone accounting for roughly 66% (2). Even though the incidence of unintended pregnancy has declined globally in the past decade, the rate of unintended pregnancy remains high, particularly in developing regions. (3) Regarding the use of contraceptive vaginal rings, updated bibliography (4,5,6) states that contraceptive vaginal rings (CVR) offer an effective contraceptive option, expanding the available choices of hormonal contraception. Ethinylestradiol/Etonogestrel Vaginal Ring is a non-biodegradable, flexible, transparent with an outer diameter of 54 mm and a cross-sectional diameter of 4 mm. It contains 11.7 mg etonogestrel and 2.7 mg ethinyl estradiol. When placed in the vagina, each ring releases on average 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinyl estradiol over a three-week period of use. Ethinylestradiol/Etonogestrel Vaginal Ring is intended for women of fertile age. The safety and efficacy have been established in women aged 18 to 40 years. The main advantages of CVRs are their effectiveness (similar or slightly better than the pill), ease of use without the need of remembering a daily routine, user ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring, in comparison with oral contraceptives.
    [Show full text]
  • Mycophenolate: OB-GYN Contraception Counseling Referral
    Current as of 6/1/2013. This document may not be part of the latest approved REMS. OB/GYN CONTRACEPTION COUNSELING LETTER Reference ID: 3194413 Current as of 6/1/2013. This document may not be part of the latest approved REMS. Letter to Ob/Gyn Contraception Counseling ((Date)) ((Recipient’s Name)) ((Recipient’s Address 1)) ((Recipient’s Address 2)) ((City, State, ZIP)) In reference to: My patient ((Patient’s Name)) Reason for the referral: Contraception counseling Dear Dr ((Recipient’s Last Name)): I am writing to you in reference to the above-named patient who is under my care for ((diagnosis)) and ((insert drug information such as drug name, when patient will begin taking the drug, if treatment has already begun, etc)). This medication contains mycophenolate, which is associated with an increased risk of first trimester pregnancy loss and congenital malformations. It is important that this patient receive contraception counseling about methods that are acceptable for use while taking mycophenolate. Prescribers of mycophenolate participate in the FDA-mandated Mycophenolate REMS (Risk Evaluation and Mitigation Strategy) to ensure that the benefits of mycophenolate outweigh the risks. The following table lists the forms of contraception that are acceptable for use during treatment with mycophenolate. Acceptable Contraception Methods for Females of Reproductive Potential Guide your patients to choose from the following birth control options: Option 1 Intrauterine devices (IUDs) Tubal sterilization Methods to Use Patient’s partner had
    [Show full text]
  • Delaying Menstruation During Holidays. Norethisterone 5Mg Tds
    Delaying menstruation during holidays. Norethisterone 5mg tds, started 3 days before the expected menses can be used for the postponement of menstruation and is often prescribed prior to a holiday. The effectiveness of the delay varies between individuals. So what is the problem? A review article in the Journal of Family Planning and Reproductive healthcare ( Mansour 2012) highlighted that owing to the specific structure of norethisterone, it is partly metabolised to ethinyl oestradiol. Chu et al 2007 suggested that a daily dose of norethisterone 5mg tds might be equivalent to taking 20-30mcg combined oral contraceptive pill. Therefore, prescribing therapeutic doses of norethisterone for women with significant risk factors for venous thromboembolism ( VTE) may therefore be inappropriate. Who shouldn’t be given norethisterone? Obese Personal h/o VTE Strong FH of VTE Immobile/wheelchair bound Carriers of thrombophilia Any other condition predisposing to VTE If my patient can’t take norethisterone, what are the alternatives? The metabolism to ethinyl oestradiol occurs with doses of norethisterone 5mg and over and therefore, the concern does not apply to or other progestogens or contraceptive pills containing norethisterone. Mansour suggested Medroxyprogesterone ( MPA ) 10mg three times a day to reduce heavy menstrual bleeding. Dr Sarah Grey (personal communication) recommends 20mg medroxyprogesterone to be taken daily, starting 3 days before the expected onset of menses. However, (MPA) is not licensed for this use and the prescriber should follow the rules of off label prescribing. References Safer prescribing of therapeutic norethisterone for women at risk of venous thromboembolism. Mansour JFPRHC July 2012 Formation of ethinyl oestradiol in women during treatment with norethisterone acetate.
    [Show full text]
  • Vaginal Administration of Contraceptives
    Scientia Pharmaceutica Review Vaginal Administration of Contraceptives Esmat Jalalvandi 1,*, Hafez Jafari 2 , Christiani A. Amorim 3 , Denise Freitas Siqueira Petri 4 , Lei Nie 5,* and Amin Shavandi 2,* 1 School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK 2 BioMatter Unit, École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue F.D. Roosevelt, 50-CP 165/61, 1050 Brussels, Belgium; [email protected] 3 Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, Belgium; [email protected] 4 Fundamental Chemistry Department, Institute of Chemistry, University of São Paulo, Av. Prof. Lineu Prestes 748, São Paulo 05508-000, Brazil; [email protected] 5 College of Life Sciences, Xinyang Normal University, Xinyang 464000, China * Correspondence: [email protected] (E.J.); [email protected] (L.N.); [email protected] (A.S.); Tel.: +32-2-650-3681 (A.S.) Abstract: While contraceptive drugs have enabled many people to decide when they want to have a baby, more than 100 million unintended pregnancies each year in the world may indicate the contraceptive requirement of many people has not been well addressed yet. The vagina is a well- established and practical route for the delivery of various pharmacological molecules, including contraceptives. This review aims to present an overview of different contraceptive methods focusing on the vaginal route of delivery for contraceptives, including current developments, discussing the potentials and limitations of the modern methods, designs, and how well each method performs for delivering the contraceptives and preventing pregnancy.
    [Show full text]
  • Recommendations for Contraceptive Use, 2013 Adapted from the World Health Organization Selected Practice Recommendations for Contraceptive Use, 2Nd Edition
    Morbidity and Mortality Weekly Report Early Release / Vol. 62 June 14, 2013 U.S. Selected Practice Recommendations for Contraceptive Use, 2013 Adapted from the World Health Organization Selected Practice Recommendations for Contraceptive Use, 2nd Edition Continuing Education Examination available at http://www.cdc.gov/mmwr/cme/conted.html. U.S. Department of Health and Human Services Centers for Disease Control and Prevention Early Release CONTENTS CONTENTS (Continued) Introduction ............................................................................................................1 Appendix A: Summary Chart of U.S. Medical Eligibility Criteria for Methods ....................................................................................................................2 Contraceptive Use, 2010 .................................................................................. 47 How To Use This Document ...............................................................................3 Appendix B: When To Start Using Specific Contraceptive Summary of Changes from WHO SPR ............................................................4 Methods .............................................................................................................. 55 Contraceptive Method Choice .........................................................................4 Appendix C: Examinations and Tests Needed Before Initiation of Maintaining Updated Guidance ......................................................................4 Contraceptive Methods
    [Show full text]
  • ESTROSTEP Fe (Norethindrone Acetate and Ethinyl Estradiol Tablets, USP and Ferrous Fumarate Tablets*) *Ferrous Fumarate Tablets Are Not USP for Dissolution and Assay
    ESTROSTEP Fe (Norethindrone Acetate and Ethinyl Estradiol Tablets, USP and Ferrous Fumarate Tablets*) *Ferrous fumarate tablets are not USP for dissolution and assay. ESTROSTEP® Fe (Each white triangular tablet contains 1 mg norethindrone acetate and 20 mcg ethinyl estradiol; each white square tablet contains 1 mg norethindrone acetate and 30 mcg ethinyl estradiol; each white round tablet contains 1 mg norethindrone acetate and 35 mcg ethinyl estradiol; each brown tablet contains 75 mg ferrous fumarate.) Patients should be counseled that this product does not protect against HIV infection (AIDS) and other sexually transmitted diseases. DESCRIPTION ESTROSTEP® Fe is a graduated estrophasic oral contraceptive providing estrogen in a graduated sequence over a 21-day period with a constant dose of progestogen. ESTROSTEP Fe provides for a continuous dosage regimen consisting of 21 oral contraceptive tablets and seven ferrous fumarate tablets. The ferrous fumarate tablets are present to facilitate ease of drug administration via a 28-day regimen, are non-hormonal, and do not serve any therapeutic purpose. Each white triangle-shaped tablet contains 1 mg norethindrone acetate [(17 alpha)-17- (acetyloxy)-19-norpregna-4-en-20-yn-3-one] and 20 mcg ethinyl estradiol [(17 alpha)-19- norpregna-1,3,5(10)-trien-20-yne-3,17-diol]; each white square-shaped tablet contains 1 mg norethindrone acetate and 30 mcg ethinyl estradiol; and each white round tablet contains 1 mg norethindrone acetate and 35 mcg ethinyl estradiol. Each tablet also contains calcium stearate; lactose; microcrystalline cellulose; and starch. The structural formulas are as follows: Each brown tablet contains ferrous fumarate, mannitol, povidone, microcrystalline cellulose, sodium starch glycolate, magnesium stearate, sucralose and spearmint flavor.
    [Show full text]
  • 1 Effects Ethinyl Estradiol Ethinyl Estradiol & Its Effects On
    1 Effects Ethinyl Estradiol Ethinyl Estradiol & Its Effects on Cardiovascular Health Mary Eilert Lourdes University Spring 2019 BIO 490 Section A Dr. Anjali Gray 2 Effects Ethinyl Estradiol ABSTRACT Combined hormonal birth control regulates the menstrual cycle in women by manipulating the hormonal level. Combined hormonal contraception utilizes progestin and Ethinyl estradiol, which are synthetics of progesterone and estrogen. These synthetic hormones help regulate ovulation in women and in turn menstruation. Venous thromboembolism (VTE), stroke, and myocardial infarction are all risk factors when taking combined hormonal contraception due to the chemical composition of Ethinyl estradiol. Ethinyl estradiol’s binding mechanism to an estrogen receptor causes clots and therefore a risk for cardiovascular disease. The dosage of Ethinyl estradiol is related to an increased risk for VTE, stroke, and myocardial infarction. Due to the increased threat to cardiovascular health, physicians should screen patient health history carefully when prescribing combined hormonal birth control. Analyzing the risk Ethinyl estradiol poses to cardiovascular health in women can be used to determine if combined hormonal birth control is the ideal choice for contraception. 3 Effects Ethinyl Estradiol INTRODUCTION Birth control, a contraceptive, is frequently prescribed to women of varying ages throughout the United States. Birth control can be used for its primary use as a contraceptive or prescribed as a means of lessening symptoms of reproductive diseases, such as endometriosis. Birth control comes in various forms and methods. Intrauterine devices (IUDs) and birth control implants are forms which are implanted into the women and rely on the release of hormones to regulate the menstrual cycle (Planned Parenthood).
    [Show full text]
  • Drospirenone and Ethinyl Estradiol
    YASMIN 28 TABLETS (drospirenone and ethinyl estradiol) PHYSICIAN LABELING Rx only PATIENTS SHOULD BE COUNSELED THAT THIS PRODUCT DOES NOT PROTECT AGAINST HIV INFECTION (AIDS) AND OTHER SEXUALLY TRANSMITTED DISEASES. DESCRIPTION YASMIN® provides an oral contraceptive regimen consisting of 21 active film coated tablets each containing 3 mg of drospirenone and 0.03 mg of ethinyl estradiol and 7 inert film coated tablets. The inactive ingredients are lactose monohydrate NF, corn starch NF, modified starch NF, povidone 25000 USP, magnesium stearate NF, hydroxylpropylmethyl cellulose USP, macrogol 6000 NF, talc USP, titanium dioxide USP, ferric oxide pigment, yellow NF. The inert film coated tablets contain lactose monohydrate NF, corn starch NF, povidone 25000 USP, magnesium stearate NF, hydroxylpropylmethyl cellulose USP, talc USP, titanium dioxide USP. Drospirenone (6R,7R,8R,9S,10R,13S,14S,15S,16S,17S)-1,3',4',6,6a,7,8,9,10,11,12,13, 14,15,15a,16-hexadecahydro-10,13-dimethylspiro-[17H-dicyclopropa-6,7:15,16] cyclopenta[ a]phenanthrene-17,2'(5H)-furan]-3,5'(2H)-dione) is a synthetic progestational compound and has a molecular weight of 366.5 and a molecular formula of C24H30O3. Ethinyl estradiol (19-nor­ 17α-pregna 1,3,5(10)-triene-20-yne-3,17-diol) is a synthetic estrogenic compound and has a molecular weight of 296.4 and a molecular formula of C20H24O2. The structural formulas are as follows: CLINICAL PHARMACOLOGY PHARMACODYNAMICS Combination oral contraceptives (COCs) act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increases the difficulty of sperm entry into the uterus) and the endometrium (which reduces the likelihood of implantation).
    [Show full text]
  • Emergency Contraception
    Need more information? State of Illinois This document provides some very basic information about emergency Illinois Department of Public Health contraception and how it works. If EC is something you want to know more about, ask the hospital emergency personnel about their policy on EC or ask the sexual assault advocate for assistance in getting this information. Local Support/Assistance: What You Should Know About Emergency Contraception For more information, contact ILLINOIS DEPARTMENT OF PUBLIC HEALTH 535 W. Jefferson St. Springfield, IL 62761 217-782-5750 Women’s Health-line 888-522-1282 TTY (hearing impaired use only) 800-547-0466 www.idph.state.il.us Developed by the Illinois Department of Public Health in cooperation with the Illinois Coalition Against Sexual Assault Printed by Authority of the State of Illinois IOCI 0041-1 Illinois law provides that victims of sexual assault are entitled to If I am already pregnant, medically and factually accurate information about emergency contra - ception (EC) when they receive emergency care in a hospital. Under will EC hurt the fetus? the Sexual Assault Survivors Emergency Treatment Act (410 ILCS There is no evidence that EC causes birth defects. However, there 70/2.2), Illinois hospitals are required to have a policy in place regarding have been no studies specific to taking birth control at this dosage. emergency contraception. Individual hospital protocols must ensure What is known is that babies born to women who continue taking that each victim of sexual assault will receive medically and factually birth control pills before finding out they are pregnant do not have accurate written and oral information about emergency contraception; higher rates of birth defects.
    [Show full text]