Oral Progestins (FETT)

Contraceptives

DESOGESTREL

Medroxyprogesterone Acetate (depot)

• Contraception

• Postcoital contraception

• Hypersensitivity to the drug or any ingredient in the formulation.

• Known or suspected pregnancy.

• Undiagnosed abnormal genital bleeding. 

• Diplopia or any ocular lesion arising from ophthalmic vascular disease. 

• Classical migraine. 

• Active liver disease or history of cholestatic jaundice with pregnancy or with prior use of oral contraceptives. 

• Breast-feeding. 

• Thrombophlebitis or thromboembolic disorders. 

• Cerebrovascular disease or CAD (including MI). 

  Severe hypertension. 

• Diabetes with vascular involvement. 

• Known or suspected carcinoma of the breast. 

• Known or suspected estrogen-dependent neoplasia (e.g., carcinoma of the endometrium). 

• Benign or malignant liver tumor that developed during oral contraceptive or other estrogen use. 

• Oral contraceptives containing drospirenone: Contraindicated in women with renal impairment, hepatic tumors (benign or malignant) or hepatic disease, adrenal insufficiency, high risk of arterial or venous thrombotic diseases, undiagnosed abnormal uterine bleeding, history of breast cancer or other estrogen- or progestin-sensitive cancer, and in pregnancy. 

• Most experts state that there currently is no real contraindication to postcoital (emergency) contraception with the recommended regimens and that the benefits generally outweigh any theoretical or proven risk.

Nausea, chloasma or melasma, breakthrough bleeding and/or spotting, breast changes (tenderness, enlargement, secretion).

long-acting progestin-only contraceptive, pregnancy rate 4 %

• Long-term and reversible

• For women who have contraindications for estrogen-containing contraceptives

• A good option for women who may not remember to use short-acting contraceptives consistently.

• Active thrombophlebitis, current or past history of thromboembolic disorders, or cerebrovascular disease. 

• Undiagnosed vaginal bleeding.

• Known or suspected pregnancy. 

• Liver dysfunction or disease. 

• Known or suspected malignancy of the breast. 

• Known hypersensitivity to medroxyprogesterone or any ingredient in the formulation. [ref]

• Use as a pregnancy test. 

Menstrual abnormalities (amenorrhea; frequent, irregular, prolonged, or infrequent bleeding), abdominal pain or discomfort, weight changes, dizziness, headache, asthenia, nervousness. 

• Transforms a proliferative endometrium into a secretory one.

• Androgenic and anabolic effects have been reported; no estrogenic activity reported. 

• At usual IM or sub-Q dosages, inhibits secretion of pituitary gonadotropins, preventing follicular maturation and ovulation and resulting in endometrial thinning.  These actions produce a contraceptive effect. Usual oral dosages do not exhibit these effects.