What is the effect of Progestogen Only Pills?
Correct Answer: All of the above
Description: (D) All of the above[?]Progestogen-Only Pill (POP)oCommonly referred to as 'minipill' or 'micropill'.oIt contains only progestogen, which is given in small doses throughout the cycle.oCommonly used progestogens are norethisterone and levonorgestrel.oProgestogen-only pills never gained widespread use because of poor cycle control and an increased pregnancy rate.oHave a definite place in modern day contraception.oCould be prescribed to older women for whom the combined pill is contraindicated because of cardiovascular risks.oMay also be considered in young women with risk factors for neoplasia.oProgestogens may lower the high-density lipoproteins may be of some concern.oEffectiveness of progestogen-only pills is almost as good as that of the combination products.oIn large family planning programmes, the effectiveness and continuation rates are usually lower than in clinical trials.oEffectiveness may also be affected by certain drugs such as Rifampicin, Phenobarbital & Ampicillin.[?]Mode of Action of Mini-PillsoCerazette suppresses ovulation in 97-100%, whereas other progesterone only pills suppress ovulation in only 40%.oIt forms a thick plug of mucus in the cervical canal and acts as a barrier to sperms.oIt increases tubal peristalsis and fertilized egg reaches the uterine cavity too early for implantation.oCerazette containing 75 meg desogestrel has the following advantages over other POPs:-Stringent time compliance not necessary, as it suppresses ovulation in 97%, through pituitary hormone suppression.-No androgenic effects like acne.-No ectopic pregnancy, no effect on carbohydrate or lipid metabolism.-Failure rate only 0.21 per 100 woman years. It acts through metabolite etonogestrel which binds to progesterone receptorsoComplications of desogestrel are:-Deep venous thrombosis-Pulmonary embolism, breast cancer, liver disease apart from common other complications of progestogensoIncidence of PID is reduced, though it does not reach the same low level as seen with the barrier method. This effect is due to the thick cervical mucus caused by progestogen, preventing the organisms entering into the uterine cavity.oReduced incidenceEFFECTS OF OESTROGEN & PROGESTERONE ON THE FEMALE GENITAL TRACTOrganOestrogenProgesterone*. BreastsDuctal/stromal growthAlveolar growth*. VaginaSuperficial cells with glycogenIntermediate cells*. CervixAbundant mucus thin, viscous, penetrable to spermsThick tenacious mucus, impenetrable to sperms*. UterusMyohyperplasiaMyohyperplasia*. EndometriumProliferative endometriumSecretory endometrium*. Fallopian tubeSecretionIncreased peristaltic movements*. OvaryNo actionNo actionoProgestogen-only pills/Progestin-only Pills (POP)/Morning after pills:-Contraceptive pills-Contain only synthetic progestins & doesn't contain estrogen.oMechanism:oMucus thickening in neck of womb:-Penetration of sperm to reach egg and womb becomes difficult.
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