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Mechanism
  • Synthetic progestins with estrogen
    • suppresses midcycle estrogen and LH surges
    • without an LH surge ovulation does not occur
    • very reliable contraceptive with < 1% failure when used according to directions
  • ↓ risk of endometrial and ovarian cancer
  • ↓ pelvic infections
    • progestins thicken the cervical mucus leading to less bacterial passage
    • consequent ↓ incidence of ectopic pregnancy due to less PID
Indications
  • Contraception
  • Regulation of menses
Toxicity
  • No protection against STDs
  • ↑ triglycerides
  • Depression
  • Weight gain
  • Nausea
  • Hypertension
  • Hypercoagulability
    • seen in any increased estrogen state (OCP use, pregnancy)
    • can predispose to DVT's and increase risk for PE
 

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