Hormonal Contraceptives part IV

II.6. Effectiveness of Hormonal Contraception in Preventing Pregnancy

 The effectiveness of combination preparations of all existing stocks of contraceptive pills, the dosage of the most effective combination monofasiklah prevent pregnancy and its ability almost like tubectomy. However, it remains difficult for experts to determine with certainty the effectiveness of each type of hormonal contraception. In 1930 Raymond Pearl's formula makes the value of the effectiveness of a contraceptive. The formula is:

        Pearl/100 index in women

 Effectiveness sequential preparations

As noted above, that the workings of different preparations sequential monophasic combination preparations. Therefore, the failure rate will be relatively high. In 1965 found the Pearl Index 1.12, even ever found even higher, namely 7.1. in order to obtain a low Pearl index, estrogen dose should be increased. However, this is difficult because it can cause many side effects.

II.7. Changes Occurring In Over Body Use of Hormonal Contraception

All organs of women who are under the influence of sex hormones on its own would be affected by hormonal contraceptives. On these organs will be certain changes, the occurrence is highly dependent on the dose, type of hormone, and long use. Organs of the most under the influence of hormonal contraception is the endometrium, myometrium, cervix and breast.

Effect of Hormonal Contraception Against Endometrium

On endometrial secretory changes and these changes are not only caused by oral contraceptives containing estrogen and progesterone, but also by preparations containing progesterone alone as depot preparations and minipil. Changes in the endometrium only the functional layer. Whereas the basal layer was not influenced by the hormone contained in the pill.

Secretory changes that occur depend on the type of hormonal contraceptive use. Does the type or types of sequential monofosik. On the combined pill because early secretory changes early. However, secretory changes that occur not as if influenced by the gestagen only. On the type of sequential administration, the changes in the endometrium resembling normal female menstrual cycle changes. Neither the provision of a combination or sequential administration can prevent the occurrence of endometrial hyperplasia. The use of long-term monophasic combination pills can cause atrophy endomtrium, the arteries (spiral) do not grow anymore, and the blood vessels that had been widening will be covered by thrombus. In general it can be said that the combination preparations cause the endometrium is inactive.

Effect of Hormonal Contraception Against Menstrual Cycle

Provision of hormonal contraceptives may cause changes in sex steroid secretion from the ovaries so that complaints arising before or diving menstruation as menstrual pain (dysmenorrhoea), premenstrual syndrome (PMS) and mestodini (breast pain) can be treated by administering hormonal contraceptives.

At the end of the contraceptive pill provision generally will be bleeding. Bleeding that occurs can not be regarded as menstrual blood in the strict sense, that is going from a normal endometrium (secretory phase). On the provision of a combination pill lucut bleeding, but bleeding that occurs not from a normal endometrium as gestagen has been around since the beginning of the proliferative phase. As is known, that menstruation is normal due to the decreased levels of progesterone, whereas the use of combination pills, menstruation which occurs a result of declining levels of estrogen and progesterone or synthetic result of declining hormone levels. Period that occurs after the use of combination pills or pill is said to be sequential rather pseudo menstruation. The positive thing is the use of the contraceptive pill menstruation became regular, the amount of menstrual blood comes out normal, and lost or reduced menstrual pain.

Effect of Hormonal Contraception Total  Menstrual Blood

The amount of menstrual blood comes out during use of the contraceptive pill will be reduced to 50-70%, especially on the first and second. These properties are very clearly visible on the use of pills containing gestoden. After long term use, the amount of blood that came out less well and sometimes even up to amenorrhoea can occur.
The amount of blood that comes out is very dependent on the dose used hormonal contraceptives. The smaller dose of estrogen and progesterone, the more blood coming out.

Effect of Hormonal Contraception Against The duration of bleeding.

With the reduced amount of blood loss, duration of bleeding is usually also be changed. On the use of multilevel pill bleeding duration ranged from 3-5 days. Changes to the duration of bleeding is generally caused by the gestagen component in the preparation of these hormonal contraceptives. On certain women, changes to the length of bleeding during the use of the contraceptive pill is a nuisance, so they often ask for treatment. They need to be explained, that it is not a disorder that does not need to do any act, let alone replace it with another type of pill.

Hormonal Contraceptive Effect Of Cycle duration

The use of oral contraceptives, especially the type sekusnsial make regular menstrual cycles. On the use of monophasic combination pill types obtained nearly 90% lucut regular bleeding.

Hormonal contraceptives may affect to not Perdahan Lucut occurrence.
Sometimes found in some women not bleeding lucut on use of contraceptive pills. On this the first time to think about is the woman is pregnant or not. Absence of menstruation after using birth control pills known as amenorrhea, or the term Anglo-American pascapil is silent menstruation or amenorrhoea on the pill. The cause is not the duration of ovarian function too depressed by hormonal contraceptive for amenorrhea endomerium generally occurs in the use of pills with high doses of gestagen or gestagen depot to use. This type of preparation lead to atrophy endomerium. Because the stratum basalis of the endometrium does not atrophy, amenorrhea occurring reversible.

Absence of menstruation due to the lack of effect of estrogen on endomerium inadequate, so profiferasi endometrium less than perfect. As a result gestagen contained in the pill does not have sufficient ability to remove the endometrial tissue.

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