WARNING

Estrogen and progestin, which are commonly found in combined oral contraceptives (COCs), can provide effective birth control for many individuals. However, it’s important to be aware of potential risks associated with taking these hormones. Here’s a brief overview:

• Blood clots: COCs can increase the risk of blood clot formation, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE). The risk is higher for individuals who smoke, have a history of blood clots, are overweight, or have certain medical conditions that predispose them to clotting.
• Cardiovascular issues: Estrogen and progestin can have an impact on cardiovascular health. Women who smoke and take COCs are at a higher risk of heart disease, stroke, and high blood pressure.
• Hormonal side effects: Some individuals may experience side effects such as breast tenderness, nausea, bloating, and mood changes when taking COCs. These symptoms usually subside over time, but it’s important to discuss any concerns with a healthcare provider.
• Increased risk of certain cancers: Long-term use of COCs may slightly increase the risk of breast and cervical cancer. However, they are associated with a reduced risk of ovarian and endometrial cancers.
• Other potential risks: COCs may have an impact on liver function, and in rare cases, they can cause liver tumors or gallbladder disease. Additionally, they may affect lipid levels and glucose tolerance in some individuals.

It’s crucial to note that the risks and benefits of taking oral contraceptives vary depending on an individual’s health history, lifestyle factors, and specific formulation of the medication. It’s essential to consult with a healthcare provider who can evaluate your personal circumstances and help you make an informed decision about contraception.

Why is this medication prescribed?

Estrogen and progestin, commonly known as oral contraceptives or birth control pills, are prescribed for several reasons:

• Pregnancy prevention: Oral contraceptives are primarily prescribed as a form of contraception to prevent pregnancy. These pills work by suppressing ovulation, which is the release of an egg from the ovaries, thereby preventing fertilization by sperm.
• Hormonal regulation: Estrogen and progestin in oral contraceptives help regulate hormone levels in the body. They can help stabilize the menstrual cycle, reduce menstrual cramps, and decrease the severity of premenstrual syndrome (PMS) symptoms.
• Acne treatment: Certain types of oral contraceptives containing specific progestins are prescribed to treat acne in women. These pills can help reduce the production of androgens (male hormones) that contribute to acne breakouts.
• Polycystic ovary syndrome (PCOS): Women with PCOS often have irregular menstrual cycles and hormonal imbalances. Oral contraceptives can help regulate menstrual periods, reduce androgen levels, and alleviate symptoms associated with PCOS, such as excessive hair growth (hirsutism).
• Endometriosis management: Oral contraceptives may be prescribed to manage symptoms of endometriosis, a condition where the tissue lining the uterus grows outside of it. These pills can help reduce the growth of endometrial tissue, lessen pain during menstruation, and decrease the risk of developing endometriosis-related complications.

It’s important to note that oral contraceptives should only be prescribed by a healthcare professional after a thorough evaluation of an individual’s medical history and individual needs

How should this medicine be used?

The use of estrogen and progestin oral contraceptives should be guided by a healthcare professional. However, here are some general guidelines on how they are typically used:

• Prescription and dosage: Oral contraceptives are available only with a prescription from a healthcare provider. The specific type and dosage of the pill will depend on various factors such as the individual’s medical history, preferences, and any specific conditions being addressed (e.g., acne, PCOS, etc.). It’s important to follow the prescribed dosage and instructions provided by the healthcare professional.
• Start of medication: Oral contraceptives are often started on the first day of the menstrual cycle (Day 1 of bleeding). This provides immediate contraceptive protection. However, there are also options to start on different days of the menstrual cycle, depending on the specific pill type. It’s important to follow the instructions provided by the healthcare professional or read the package insert carefully.
• Daily intake: Oral contraceptives are typically taken once a day, at the same time each day, for 21 to 28 days in a row, depending on the specific type of pill. Some pills contain a combination of estrogen and progestin and are taken for 21 days, followed by a 7-day break or a placebo pill during which withdrawal bleeding (similar to a period) occurs. Other pills are continuous or extended-cycle pills, where active pills are taken continuously for an extended period, such as 84 days, before taking a break.
• Backup contraception: It’s important to use backup contraception, such as condoms, during the first few weeks of starting oral contraceptives. This is to ensure contraceptive effectiveness while the body adjusts to the hormones.
• Missed pills: If a pill is missed or taken late, it’s crucial to refer to the package insert or consult a healthcare professional for specific guidance. The effectiveness of oral contraceptives can be compromised if pills are missed or not taken as directed.
• Follow-up appointments: It’s recommended to have regular follow-up appointments with a healthcare professional while using oral contraceptives. These appointments help monitor the individual’s response to the medication, address any concerns or side effects, and ensure ongoing contraceptive effectiveness.

Remember, the information provided here is a general overview, and it’s essential to consult with a healthcare professional for personalized guidance on the use of estrogen and progestin oral contraceptives.

Other uses for this medicine

Estrogen and progestin, besides their use as oral contraceptives, have several other medical applications. Here are some additional uses:

• Hormone replacement therapy (HRT): Estrogen and progestin can be prescribed to alleviate symptoms associated with menopause, such as hot flashes, vaginal dryness, and mood swings. HRT can also help prevent osteoporosis in postmenopausal women.
• Polycystic ovary syndrome (PCOS): Oral contraceptives can regulate menstrual cycles, reduce excess hair growth, and improve acne in individuals with PCOS.
• Endometriosis management: Estrogen and progestin can be used to treat endometriosis, a condition where the tissue lining the uterus grows outside of it, leading to pain and fertility issues. Oral contraceptives can help alleviate symptoms by suppressing the growth of this tissue.
• Menstrual disorders: In cases of heavy, prolonged, or irregular menstrual bleeding, oral contraceptives can help regulate the menstrual cycle and reduce excessive bleeding.

What special precautions should I follow?

Special precautions for the use of estrogen and progestin oral contraceptives include:

• Medical history evaluation: Before prescribing oral contraceptives, healthcare professionals typically evaluate an individual’s medical history, including any pre-existing conditions, such as blood clotting disorders, liver disease, high blood pressure, or a history of breast or uterine cancer.
• Side effects and risks: Oral contraceptives can have potential side effects, such as nausea, breast tenderness, changes in mood, and breakthrough bleeding. They also carry a small risk of serious complications, including blood clots, stroke, heart attack, and liver problems. The overall risks and benefits should be considered and discussed with a healthcare professional.
• Contraindications: Oral contraceptives are contraindicated in certain conditions, such as pregnancy, breastfeeding, undiagnosed vaginal bleeding, active liver disease, and a history of blood clots or certain types of cancer. It’s crucial to inform the healthcare professional about any pre-existing conditions or medications being taken.
• Interactions with other medications: Some medications, such as certain antibiotics, antifungal drugs, anticonvulsants, and St. John’s wort, may interact with oral contraceptives and reduce their effectiveness. It’s important to inform the healthcare professional about all medications, including over-the-counter and herbal supplements, being taken.

It’s important to remember that the use of estrogen and progestin oral contraceptives should always be prescribed and monitored by a healthcare professional who can assess individual risks, benefits, and provide personalized guidance.

What special dietary instructions should I follow?

There are no specific dietary instructions that need to be followed when taking estrogen and progestin oral contraceptives. However, it’s generally recommended to take the pills with or after a meal to help reduce the likelihood of stomach upset or nausea. If you have any concerns or specific dietary restrictions, it’s advisable to consult with your healthcare professional.

What should I do if I forget a dose?

If you forget to take a dose of your oral contraceptive, the specific instructions for what to do can vary depending on the type of pill and where you are in your pill pack. Here are some general guidelines:

1. Combination pills (estrogen and progestin):
   • If you miss one active pill: Take the missed pill as soon as you remember, even if it means taking two pills in one day. Continue taking the remaining pills at the usual time. No backup contraception is needed.
   • If you miss two or more active pills: Take the most recent missed pill as soon as you remember, and discard the other missed pills. Continue taking the remaining pills at the usual time. Backup contraception (e.g., condoms) is recommended for the next seven days. If the missed pills occurred in the third week of the pack, start the next pack immediately without taking the placebo pills.
2. Progestin-only pills (mini-pills):
   • If you miss a progestin-only pill: Take the missed pill as soon as you remember, even if it means taking two pills in one day. Take the next pill at the usual time. Backup contraception is not typically needed unless you are more than three hours late in taking a progestin-only pill.

What side effects can this medication cause?

Estrogen and progestin oral contraceptives can cause side effects in some individuals. It’s important to note that not everyone will experience these side effects, and the severity and occurrence can vary from person to person. Common side effects of estrogen and progestin oral contraceptives may include:

• Nausea: Some individuals may experience mild to moderate nausea, especially when starting a new pill or during the first few cycles. Taking the pill with food or before bed can help alleviate this side effect.
• Breast tenderness: Breast tenderness or enlargement can occur, but it is usually temporary and resolves on its own.
• Headaches: Some individuals may experience headaches or migraines while taking oral contraceptives. If the headaches become severe or persistent, it’s advisable to consult a healthcare professional.
• Breakthrough bleeding or spotting: In the initial months of starting oral contraceptives, irregular bleeding or spotting between periods may occur. This is usually temporary and resolves as the body adjusts to the hormonal changes.
• Mood changes: Some individuals may experience mood swings, irritability, or changes in mood while taking oral contraceptives. If these symptoms persist or become severe, it’s important to consult with a healthcare professional.
• Changes in menstrual flow: Oral contraceptives can cause changes in menstrual flow, including lighter periods, shorter periods, or even the absence of periods (amenorrhea). This is a common effect of the hormones in the pills.
• Weight changes: While some individuals may experience slight weight fluctuations, studies have not consistently shown a direct link between oral contraceptives and significant weight gain.
• Decreased libido: In some cases, oral contraceptives can contribute to a decrease in sexual desire or libido. However, this effect is not experienced by all users.

It’s important to remember that these side effects are generally mild and temporary. Most women tolerate oral contraceptives well, and the benefits of pregnancy prevention and other therapeutic uses often outweigh the potential side effects. If you experience severe or persistent side effects or have any concerns, it’s recommended to consult with a healthcare professional for further evaluation and guidance.

What should I know about storage and disposal of this medication?

1. Storage: Follow the instructions provided by your healthcare provider or the medication’s packaging for proper storage. Generally, it is recommended to store oral contraceptives at room temperature, away from direct sunlight, moisture, and heat. Avoid storing them in the bathroom or any area prone to temperature fluctuations.
2. Disposal: It is essential to dispose of unused or expired medications safely to prevent accidental ingestion or environmental contamination. Here are some common guidelines for medication disposal:
   • Check the medication packaging or consult your pharmacist for specific disposal instructions.
   • Do not flush oral contraceptives down the toilet or pour them down the drain unless specifically instructed to do so.
   • If no specific instructions are provided, you can mix the medication with an undesirable substance (e.g., coffee grounds, cat litter) in a sealed bag or container before throwing it in the trash. This helps prevent accidental ingestion by people or animals.

In case of emergency/overdose

• Contact emergency services: Call your local emergency number (e.g., 911 in the United States) or the relevant emergency services in your country.
• Inform medical professionals: Clearly communicate the details of the situation, including the name of the medication (estrogen and progestin oral contraceptives), the strength or dosage you took, and the quantity. If possible, provide the healthcare professionals with the original packaging or prescription information.
• Follow medical advice: The medical professionals will provide appropriate guidance based on the severity of the situation. It may involve monitoring your vital signs, administering certain treatments or antidotes, or other measures deemed necessary.

What other information should I know?

• Proper usage: Follow the prescribed instructions for taking oral contraceptives, including the recommended dosage, timing, and duration. It is important to be consistent in taking them at the same time each day to maintain their effectiveness.
• Possible side effects: Oral contraceptives may cause side effects such as nausea, breast tenderness, changes in menstrual bleeding, mood changes, or headaches. If you experience any concerning or persistent side effects, contact your healthcare provider.
• Drug interactions: Some medications, including certain antibiotics and anticonvulsants, may interact with oral contraceptives and reduce their effectiveness. Inform your healthcare provider about all the medications, supplements, or herbal products you are taking.
• Effectiveness: While oral contraceptives are highly effective in preventing pregnancy when used correctly, they do not provide protection against sexually transmitted infections (STIs). If STI protection is needed, consider using additional barrier methods such as condoms.

Remember, it is always best to consult your healthcare provider or pharmacist for specific instructions and guidance regarding storage, disposal, emergencies, and any concerns related to estrogen and progestin oral contraceptives.