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DRCOG OSCE for Circuit B Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
The risk of pregnancy using the lactational amenorrhoea method is 1-2%. The mother should be advised of alternative forms of postpartum contraception if she wishes the risk to be nil. The progestogen-only pill is safely administered from 6 weeks postpartum in women who breast-feed. The combined oral contraceptive (coc) pill is contraindicated in breast-feeding women as the oestrogen component inhibits the production of breast milk. An alternative form of contraception is the Levonorgestrel-releasing intrauterine system (LNG-IUS), which may be inserted at 6 weeks postpartum in breast-feeding women. The delay in insertion is to avoid the high expulsion rates associated with post-placental insertion. Female sterilization may also be offered but is not recommended at the time of Caesarean section due to higher failure rates associated with oedematous, vascular Fallopian tubes and a higher incidence of regret.
Contraception Across the Reproductive Life-Course
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
The progestogen-only pill comes as either a low-dose pill that must be taken in a very narrow three-hour time frame or a higher-dose formulation that can be taken in a more flexible time frame. It is generally reserved for women who are breastfeeding or who, due to medical conditions such as heart disease, are unable to use a method that contains oestrogen (Faculty of Sexual & Reproductive Healthcare, 2015c).
Common problems in the lactating woman
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
Where possible, breastfeeding mothers should be encouraged to use non-hormonal methods of contraception. The long-term effects of exposing infants, particularly male infants, to female hormones is not known, but the amounts passing into breast milk are small. Oestrogens have the potential to suppress lactation so progestogen-only oral contraceptives are preferred.3 This may decrease the mother’s milk supply briefly, so she may need to offer the breast more frequently for a few days. The progestogen-only pill may be taken from three weeks after the birth.
The influence of hormonal contraception on depression and female sexuality: a narrative review of the literature
Published in Gynecological Endocrinology, 2022
Laura Buggio, Giussy Barbara, Federica Facchin, Laura Ghezzi, Dhouha Dridi, Paolo Vercellini
In the past decades, the relation between HC and depressive symptoms has been investigated in several studies, with controversial results. In 1995, a placebo-controlled double-blind study [67] on 150 asymptomatic women with no risk of pregnancy compared the effects of three different treatments: levonorgestrel (LNG) COC, LNG progestogen-only pill (POP), or placebo. The authors found the lowest incidence of depression in the POP group, although there were no group differences in the depressive mood by the third month. On the other hand, two Swedish nationwide studies [68,69] found teenage girls using POP to be more frequent users of antidepressants compared to non-users of hormonal contraceptives; contrarily, a large cohort Australian study [70] failed to find a significant difference in depressive symptoms in young women assuming oral contraceptive pill vs. non-users.
Management of perimenopause disorders: hormonal treatment
Published in Gynecological Endocrinology, 2021
Libera Troìa, Simona Martone, Giuseppe Morgante, Stefano Luisi
The progestogen-only pill (POP) can be easily suggested to women in their forties and older to minimize VTE risk. The drawback with the low-dose POP is that its mechanism of action relies on very careful administration with only a 3-h window each day. The higher-dose desogestrel POP has two main advantages compared to low-dose POPs: reliable ovulation inhibition in over 99% of cycles and a 12 h intake window. Although ovulation is suppressed, endogenous estradiol levels are maintained within the physiological range. However, the main drawback with any POP is the high incidence of breakthrough bleeding which is particularly problematic in the perimenopause. There is no proven benefit of POPs for cycle-related symptoms and they may induce continuous PMS, typical of progestogenic side effects [14].
Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study
Published in Gynecological Endocrinology, 2019
Francisca Martínez, Jorge Rodriguez-Purata, Dalia Beatriz Rodríguez, Elisabet Clua, Ignacio Rodriguez, Buenaventura Coroleu
Alternatively, suppression of the endogenous LH peak can be achieved by the administration of exogenous progestin, as in the PPOS protocols. The choice of the progestin for these PPOS protocols could be of interest. MPA may lead to stronger pituitary suppression and this may translate in higher total doses of gonadotropins required and longer duration of stimulation compared to that of the conventional stimulation [4]. Utrogestan, a natural progesterone, may interfere with serum progesterone measurements [6]. Dydrogesterone (DYG), at the recommended dose of 10–20 mg does not inhibit ovulation [5]. On the other hand, DSG is a reliable and safe progestogen-only pill [21]. After oral administration, DSG is rapidly metabolized to etonogestrel, a selective progestogen with high affinity for progesterone receptors and low affinity for androgen receptors that at a dose of 75 mcg inhibits ovulation by suppression of the endogenous LH peak [7]. Combining CFT and DSG, a treatment protocol has been specifically designed for OD, with the minimum discomfort, without any apparent deleterious impact [10].