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Updated: Oct 14 2017

Combined Oral Contraceptive Pill (COCP)

  • 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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