Oral Contraceptive Pill

by **puan akmal** Fri 29 May 2009, 2:41 am

estrogen

�3 major naturally estrogen:estradiol,estriol,estrone

�Functioning as primary
female sex hormone

�Use as oral contraceptives,hormone replacement therapy

�Estrogen is produce
primarily by developing follicles in the ovaries;smaller amounts in liver,adrenal glands and the breasts(especially important
in postmenopause
women)

�Estrogen levels vary
through menstual
cycle ,highest before ovulation.

�

by **puan akmal** Fri 29 May 2009, 2:47 am

Mode of action

�Estrogen

estrogen inhibit production of GnRH

↓

low FSH & LH

↓

inhibit ovulation

�Progesterone

1.Cervival
mucus become
hostile to spermatozoa

- Thick ,viscous,scanty

- Resistant for penetration

2.Endometrial changes become hostile for
implantation

- Thin & hypoplastic

3. Inhibit tubal transport for ovum

- Progesterone relaxes its smooth muscle
-

by **puan akmal** Fri 29 May 2009, 2:51 am

Contraindication

�Absolute
1.History of thromboembolic
disease

2.Impaired hepatic
function

3.Putuitary dysfunction

4.Hormone dependent tumour

5.Undiagnosed irregular
vaginal bleeding

6.Potential drug
interaction

7.Focal migraine

8.Severe hypertension

�Relative
1.Hypetension

2.Generalized migraine

3.Diabetes mellitus

4.Uterine fibroids

5.Epilepsy

6.Benign breast cancer

7.Gallbladder disease

8.History of cholestatic
jaundice of pregnancy

9.Lactation

10.Heavy smoking

11.Sickle cell anemia

by **puan akmal** Fri 29 May 2009, 2:54 am

The effectiveness of
various methodshttp://www.netdoctor.co.uk/sex_relationships/facts/contraceptivepills.htm

Contraceptive method	Effectiveness
Vasectomy	Almost 100 per cent
Female sterilisation	Almost 100 per cent
The Pill	Almost 100 per cent
Contraceptive injection	Almost 100 per cent
IUS (Mirena)	98 to 99 per cent
IUD (the coil)	97 to 98 per cent
The mini-Pill	Around 98 per cent
Male condom*	90 to 98 per cent
Female condom*	90 to 98 per cent
Diaphragm with spermicide	90 to 96 per cent

by **puan akmal** Fri 29 May 2009, 2:57 am

Contraception efficacy comparison chart

Method	Average pregnancy rates per woman-yr
Oral monophasic combination
<30 mcg ethinyl estradiol(EE)	0.75
35~49 mcg EE	0.27
50 mcg EE	0.16
Oral multiphasic combination	0.33
Oral progestin only
Age 25~30 yr	3.1
Age 30~34 yr	2.0
Age 35~39 yr	1.0
Age >/=40 yr	0.3
Lactating	0.3

by **puan akmal** Fri 29 May 2009, 3:04 am

IUS in blue book

�mirena�,A*

�Levonorgestrel Releasing Intrauterine System

�Indication
:Contraception (Initial release rate of 20 mcg/24 hours)

�Dosage:One unit intrauterine device to be inserted into
the uterine cavity within 7 days of the onset of menstruation or immediately
after first trimester abortion. Postpartum insertion should be postponed until
6 weeks after delivery. One unit IUD is effective for 5 years

by **puan akmal** Fri 29 May 2009, 3:06 am

IUD in
blue book

�Multiload MLCu �,B

�Copper 375 mm2(or 250 mm2
) Intrauterine Device

�Indication :contraception

�Dosage:One unit intrauterine device to be inserted into
the uterine cavity on the last day of the menstrual flow or in the first days
afterwards. It is advised that the Multiload Cu 375 devices are replaced every 5 years

by **puan akmal** Fri 29 May 2009, 3:10 am

Side effect

1. Cardiovascular complication

-thromboembolism

-hypertension

2. Metabolic effect

-estrogen has anti-insulin effect

-↑peripheral resistance to insulin

3. Hepatic function

-stone formation

-hepatocellular adenoma(rare)

4. Carcinogenic effect

-↑risk of breast and cervical CA

5.↓volume &quality of milk

6. Ectopic pregnancy (progesterone only pill)

7. Other

-skin pigmentation

-GIT manifestation

-fluid retention

-irritability

-depression

by **puan akmal** Fri 29 May 2009, 3:14 am

hehehhe...ok la kengkawan dah ngantok ni....esok la aku sambung lagi pasal OCP nih....ada bnyk lagi ni......tdo dulu la....to be continue........... Sleep

by **puan akmal** Fri 29 May 2009, 7:50 am

dan selamat pagi kawan2 semua sunny

mulakan pagi anda dgn sesuatu yang mampu menceriakan hari anda. jom minum dulu....... minum

by **puan akmal** Fri 29 May 2009, 7:53 am

hari ni dlm sejarah...aku sampai awal kat tmpt keja....hehehehhe.....jadi org pertama...mesti semua x percaya lepas ni...

by **puan akmal** Fri 29 May 2009, 7:54 am

ok la kengkawan....aku nak persiapkan diri utk bekerja dulu.....nanti CT kata aku mengular lagi kang....heheheh....
CT gurau je la...hehehee

by **tam** Fri 29 May 2009, 8:45 am

avatar aku tu gambar aku 2 minggu lepas masa party kat rumah
pengarah..... ok kah banding dulu..... gambar badan kurang 15 kg dari
masa di kolej...hehehehe.....mau jaga badan juga wooo.... ye lah usia
makin bertambah......

steady lah bapak..... kishishishi...

by **tam** Fri 29 May 2009, 8:48 am

ya la bah...aku tersilap info tu..sob sob..maklumla aku ngah sakit
perut time tu..otak ndka register,,mau2 lagi org dlm tv tu ckp
orgputih..
MIS INTERPRETE ja...ya la menang la BACHA kamu..hehehhee

kishishishis... bukan bacha ler... barca....... kishishishishsi....

by **hannajr** Fri 29 May 2009, 8:50 am

kak mai bgs la tu ari jumaat yg mulia ni ada org insaf skit..awal p krja..x mengular..tp jap lg mst ada jgk dia muncul tu kan kakkkkk maiiii...menaga jak.. Twisted Evil

by **hannajr** Fri 29 May 2009, 8:51 am

kak mai bgs la tu ari jumaat yg mulia ni ada org insaf skit..awal p krja..x mengular..tp jap lg mst ada jgk dia muncul tu kan kakkkkk maiiii...menaga jak.. Twisted Evil

by **tam** Fri 29 May 2009, 8:56 am

wey kwn kwn..meh la kita berconference malam ni..boleh bincang open table pasal reunion ni...

cam bosan tahap dewa dah ko nix.... kishishishis... ilek lah..... x online tuh ada la sbbnya....

by **hannajr** Fri 29 May 2009, 8:58 am

tp kan aku x puas ati btl dgn kak mai ni tau.... Penyek

aku pnya la tgu dia post kan resepi pau dia smlm..smpikan aku trtdr2 dan mimpi mkn pau dia x htr jgk..nnt ko kakk maii..aku htr ni tuk akak d pg jumaat yg mulia ini tembak

..

by **tam** Fri 29 May 2009, 9:03 am

nix ko jgn buruk sngka tau sama reputasi aku tu...rupanya aku dpt 1
positive votes..sbb tu reputation aku jdk cmtu..wat suspension jak drg
ni..ingtkan aku dah trbabas cakap ka..

oh yeker aku baru tau.... terer jugak la ko ni ct... dpt undian... aku dah lama pon masih lagi kocong..... kalo dlm af ko la yg paling atas .. paling byk dpt undian.....

tapi napa nixie jadi negatif arrr reputasi dia.....

by **tam** Fri 29 May 2009, 9:06 am

huhuhu...x sabar nya nak tunggu bulan 11 ni...tadi dah survey
tiket....airasia dr miri ke KK rm6.50 ja one way...hehehe...kalau dah
konfirm ni boelh terus beli

biar betik...... rm6.50 jew.... murah giler... mana aci camtuh...
KL-KK rm107 pegi balek.... jauh beza tuh....
camni aku pindah swak la....

by **tam** Fri 29 May 2009, 9:10 am

bagus mai.....ko ker yang bagi tau kat diana....terkezut juga aku bila
dia sms kat aku... apa tak nyer dia cakap aku ni diana....dah lah aku
kenal ramai diana.... nasib baik dia cerita pasal reunion kalau tak
cofirm aku tak kenal..........

kalo dia x cite psl reunion apa akan terjadi..... aku tertanya2 ni bapak... lol!

by **hannajr** Fri 29 May 2009, 9:12 am

yelah pak tam bru aku perasan ko ckp..nixie nyer jd -ve..aku tgk kat profile aku smlm..tgk kat statictic..mgkn ada org bg negative votes kat nixie kot..kejam btl la..tp x penting pun..jgn kena halau dr umah sdh..

by **hannajr** Fri 29 May 2009, 9:14 am

pak tam ko nak pndh srwk ek..bkn sal tiket tu..ntah2 rndu awek lama kot Laughing

by **tam** Fri 29 May 2009, 9:23 am

kureng asem cilagi tul ct nih.....

by **tam** Fri 29 May 2009, 9:24 am

ct ko xda keje kah ni... sian pt tuh tggu lama .....

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