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