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hormonal contraception

Hormonal methods of contraception for women. Includes: 1) oral contraceptives 2) transdermal hormonal patches, Ortho-Evra 3) intramuscular hormonal injections, Depo-Provera 4) prostestin implant 5) intra-vaginal devices that release hormones, Nuva Ring Indications: - see oral contraceptive Contraindications: - women > 35 years of age who smoke > 15 cigarettes daily should not be prescribed estrogen-containing contraceptives [6,7] - progrestin-only contraceptives for women > 35 years of age who smoke [6,7] - avoid estrogen-containing contraceptive in women with migraine with aura (further increases stroke risk) [6] - avoid estrogen/progrestone contraceptives in womwn with breat cancer, venous thromboembolism, uncontrolled hpertension, liver disease Adverse effects: - see estrogen, progestin, oral contraceptive, Ortho-Evra, Depo-Provera, Nuva Ring - associated with new-onset depression [10] - accelerates HIV progression [3] - increases risk of acquiring & transmitting HIV1 infection - 2-fold risk - injectable forms account for most of the increased risk [4] - women living with HIV or at high risk of HIV can safely continue to use hormonal contraceptives to prevent pregnancy [5] - small increase in risk of breast cancer [11] - 68 vs 55 breast cancers per 100,000 person-years Drug interactions: - anticonvulsants carbamezepine, oxcarbazepine, phenytoin & topiramate inactivate many forms of hormonal contraception [6] Notes: - healthy women of reproductive age generally do not require pelvic examination or other studies prior to hormonal contraception [6] - Oregon & California to allow pharmacists to prescribe hormonal contraceptives to women over age 18 [9]

Interactions

drug adverse effects of hormonal contraception

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contraceptive

General

contraception

References

  1. Prescriber's Letter 13(8): 2006 Hormonal Contraception ... Detail-Document#: 220809 (subscription needed) http://www.prescribersletter.com
  2. Prescriber's Letter 15(5): 2008 Hormonal Contraception in Older Women Detail-Document#: 240508 (subscription needed) http://www.prescribersletter.com
  3. Stringer EM et al HIV disease progression by hormonal contraceptive method: Secondary analysis of a randomized trial. AIDS 2009 Jul 17; 23:1377. PMID: 19448528
  4. Heffron R et al Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study The Lancet Infectious Diseases, 4 October 2011 PMID: 21975269 http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2811%2970247-X/abstract - Morrison CS and Nanda K Hormonal contraception and HIV: an unanswered question The Lancet Infectious Diseases, 4 October 2011 PMID: 21975268 http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2811%2970254-7/fulltext
  5. News Release: Feb 16, 2012, World Health Organization (WHO) WHO upholds guidance on hormonal contraceptive use and HIV http://www.who.int/mediacentre/news/notes/2012/contraceptives_20120216/en/index.html
  6. Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2015 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  7. ACOG Committee on Practice Bulletins-Gynecology. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2006 Jun;107(6):1453-72. PMID: 16738183
  8. Prescriber's Letter 20(3): 2013 COMMENTARY: Hormonal Contraception CHART: Comparison of Oral Contraceptives and Non-Oral Alternatives Detail-Document#: 290322 (subscription needed) http://www.prescribersletter.com
  9. Physician's First Watch, Jan 4, 2016 Oregon Pharmacists Can Prescribe Hormonal Contraception. David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org - Malara M. UPI Home/Health News Oregon greenlights pharmacist-prescribed birth control. http://www.upi.com/Health_News/2016/01/02/Oregon-greenlights-pharmacist-prescribed-birth-control/3031451743659/
  10. Skovlund CW, Morch LS, Kessing LV, Lidegaard O Association of Hormonal Contraception With Depression. JAMA Psychiatry. Published online September 28, 2016. PMID: 27680324 http://archpsyc.jamanetwork.com/article.aspx?articleid=2552796
  11. Morch LS, Skovlund CW, Hannaford PC et al Contemporary Hormonal Contraception and the Risk of Breast Cancer. N Engl J Med 2017; 377:2228-2239. Dec 7, 2017 PMID: 29211679 http://www.nejm.org/doi/full/10.1056/NEJMoa1700732 - Hunter DJ. Oral Contraceptives and the Small Increased Risk of Breast Cancer. N Engl J Med 2017; 377:2276-2277. Dec 7, 2017 PMID: 29211666 http://www.nejm.org/doi/full/10.1056/NEJMe1709636
  12. Peachman RR Weighing the Risks and Benefits of Hormonal Contraception. JAMA. Published online February 28, 2018. PMID: 29490363 https://jamanetwork.com/journals/jama/fullarticle/2673941