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Smoking is major factor in choice of contraception

Clinical Update - Contraception: Many of the earlier contraceptive pills had much higher dosages than the more recently introduced pills on the market. The newer pills have very low doses of oestrogen and different types of progesterone.

The aim is to produce progesterones which are effective contraceptives with minimal side effects.

In selecting a method of contraception, smoking is a major factor in assessing the risk of thrombosis. The pill increases the risk of a thrombotic event above that of the background population, but the absolute risk of thrombosis occuring is still low — only a small number per 100,000 people.

“In this context, smoking significantly increases the risk of getting a clot. In a woman who is a non-smoker, I have no problem using any of the pills – including the combined pill – up to the menopause,” said Dr Richard Horgan, Clinical Research Fellow and Specialist Registrar in Obstetrics and Gynaecology at Cork University Maternity Hospital.

The combined pill also has a protective effect against ovarian cancer. The modern combined contraceptive pill inhibits ovulation.

Many steroid hormones have similar properties and common pathways and often an enzyme reaction converts one into another. There are different orders of progesterone. “Some are more thrombogenic, some are more androgenic (they may lead to acne and hair growth),” said Dr Horgan.

The progesterone-only pill can cause irregular bleeding as one of its side effects. Weight can also be added when using the combined oestrogen/progesterone pill.

For Dr Shirley McQuade, Medical Director of the Dublin Well Woman Centre, the combined pill is still the standard oral contraceptive. The combined pill gives a regular cycle and a withdrawal bleed once a month.

A lot of women will have minor side effects when put on any pill. Progesterone can cause fluid retention, headaches, breast tenderness and bloating.

People who continue to have fluid retention- type problems usually are better if they use treatments such as Yasmin (Yasminelle is a lower dose version) or Yaz, which was released this year. Drospirenone is the progesterone that is in Yasmin.

Posted in Genito-urinary on 20 November 2009
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abortion, accupuncture, ACE inhibitors, acne, ADHD, alcohol, allergies, Alzheimer's, anaemia, anaethesia, anorexia, antibiotics, antidepressants, antihistamine, anxiety, appetite control, arthritis, ASCOT, aspirin, asthma, atherosclerosis, autism, autoantibodies, back pain, beta carotene, beta-blockers, bipolar disorder, birth, bleeding, blindness, blood pressure, body dysmorphic disorder, body mass, breast cancer, breast feeding, bronchitis, Caesarean section, calcium, cancer, carcinogens, carcinoma, cardiac syncope, cardiolgy, cataracts, cervical cancer, chemotherapy, child psychiatry, children, cholesterol, clinical trial, clopidogrel, Clostridium difficile, cognitive behavioural therapy, colectomy, colic, colorectal cancer, complementary and alternative therapies, contraception, COPD, coronary care, coronary stents, Crohn's, cystic fibrosis, defibrillator, dementia, depression, dermatology, diabetes management, diet, disability, DNA, Down's syndrome, eating disorders, echinacea, ECT, eczema, elderly people, endoscopy, epilepsy, erectile dysfunction, euthanasia, exercise, fat, fertility, fitness, flu pandemic, fluoxetine, folic acid, food labelling, fracture, fragile X syndrome, general surgery, genetics, gerontology, GIK infusion therapy, GORD, gout, haemodialysis, hearing, heart attack, heart disease, heart failure, heart health, hepatitis, HIV, hospital care, HPV, HRT, hyperglycaemia, hypertension, hypoglycaemia, IBD, ICU, incontinence, infant, infant mortality, infection, inflammatory bowel disease, influenza, invasive candidiasis, IQ, Irish Heart Foundation, irritable bowel syndrome, keyhole surgery, kidney disease, laser, learning difficulties, leukaemia, liver disease, lumbar disk herniation, lung cancer, lung disease, lymph nodes, macular degeneration, macular oedema, magnetic resonance imaging (MRI), malaria, malnutrition, Marfan syndrome, media, medical ethics, medical research, medication, meningitis, mental illness, metabolic syndrome, migraine, miscarriage, mortality rate, MRSA, multiple sclerosis (MS), NCHDs, nephrology, neurology, OAB, obesity, obstetrics, occupational health, ocular medicine, omega-3, opthalmology, oral cancer, organ transplantation, orthopaedics, osteoporosis, otolaryngology, ovarian cancer, paediatrics, pain management, pancreatic cancer, panic, Parkinson’s disease, patient safety, patient-physician communication, personality disorders, physiotherapy, plastic surgery, polio, practice, pre-eclampsia, pregnancy, preventative health care, probiotics, prostate cancer, psoriasis, psychiatric admission, psychiatry, psychotherapy, PTSD, public health, quality of life, radiology, radiotherapy, rectal cancer, reproductive health, research, resuscitation, rheumatoid arthritis, rheumatology, rhinitis, salt, SARS, schizophrenia, screening, seizures, self harm, sexual abuse, sexual health, sexually transmitted infections, SGA, sinusitis, skin cancer, sleep disorders, smoking, smoking ban, spinal injury, sports medicine, statins, stress, stroke, substance abuse, suicide, supplement, surgery, syncope, technology, teenagers, testosterone, thoracic surgery, thrombosis, thyroid cancer, tonsillectomy, tonsillitis, Tourette's syndrome, toxicology, travel medicine, tuberculosis, tumour angiogenesis, type 1 diabetes, type 2 diabetes, ulcer, ulcerative colitis, urinary incontinence, vaccine, vitamins, weight, WHO, women's health, World Health Assembly

«Previous article | Next article»

Smoking is major factor in choice of contraception

Clinical Update - Contraception: Many of the earlier contraceptive pills had much higher dosages than the more recently introduced pills on the market. The newer pills have very low doses of oestrogen and different types of progesterone.

The aim is to produce progesterones which are effective contraceptives with minimal side effects.

In selecting a method of contraception, smoking is a major factor in assessing the risk of thrombosis. The pill increases the risk of a thrombotic event above that of the background population, but the absolute risk of thrombosis occuring is still low — only a small number per 100,000 people.

“In this context, smoking significantly increases the risk of getting a clot. In a woman who is a non-smoker, I have no problem using any of the pills – including the combined pill – up to the menopause,” said Dr Richard Horgan, Clinical Research Fellow and Specialist Registrar in Obstetrics and Gynaecology at Cork University Maternity Hospital.

The combined pill also has a protective effect against ovarian cancer. The modern combined contraceptive pill inhibits ovulation.

Many steroid hormones have similar properties and common pathways and often an enzyme reaction converts one into another. There are different orders of progesterone. “Some are more thrombogenic, some are more androgenic (they may lead to acne and hair growth),” said Dr Horgan.

The progesterone-only pill can cause irregular bleeding as one of its side effects. Weight can also be added when using the combined oestrogen/progesterone pill.

For Dr Shirley McQuade, Medical Director of the Dublin Well Woman Centre, the combined pill is still the standard oral contraceptive. The combined pill gives a regular cycle and a withdrawal bleed once a month.

A lot of women will have minor side effects when put on any pill. Progesterone can cause fluid retention, headaches, breast tenderness and bloating.

People who continue to have fluid retention- type problems usually are better if they use treatments such as Yasmin (Yasminelle is a lower dose version) or Yaz, which was released this year. Drospirenone is the progesterone that is in Yasmin.

Posted in Genito-urinary on 20 November 2009
Tags: