BACHELOR OF MEDICINE AND BACHELOR OF

SURGERY(MBBS)
(YEAR 2 SEMESTER 2)

PHARMACOLOGY

(Reproductive: Tutorial 2)

Name: Otoh Raya Bin Omar

Matrix No: MBBS 0919237

Lecturer Name’s: Associate Professor Dr. Lim Chin Choon

INTRODUCTION

Oral contraceptives also known as the “Birth Control Pills”, are the most popular method of
contraceptive among female adolescents. The primary mechanism of action is inhibition of
ovulation. In addition, oral contraceptives produce an endometrium that is not receptive to
ovum implantation and cervical mucus that becomes thick and hostile to sperm transport.

Literature Review

There are three types of oral contraceptive pills: combined estrogen-progesterone,

progesterone only and the continuous or extended use pill. The effectiveness of this form of
birth control is referred to as typical and perfect use. (Danielle B. Cooper, Heba Mahdy, Feb
2021).

According to C Miller on his republication on pubmed.ncbi Oral contraceptives pills has

many mechanisms such as inhibition of ovulation by suppressing cyclic follicle stimulating
hormone, reducing sperm penetrability of cervical mucus, rendering the endometrium hostile
to implant and affecting tubal transit time.

Combined oral contraceptives have been associated with an increased of arterial thrombosis
example myocardial infarction or ischemic stroke. However, as these diseases are rare in
young women and as many types of combine oral contraception exist, the magnitude of the
risk and the effect of differential hormonal content of combined oral contraceptives
preparations remain unclear. (Rachel EJ Roach, Frans M. Helmerhorst, Willem M Lifering,
Theo Stijnen, Ale Algra and Olar M Dekkers, August 2015)

Method to use Oral Contraceptive pills

- Initiation of Oral contraceptive pills

Circumstances Progesterone-only pills Combined oral contraceptive

Women with menstrual
cycles
Women are amenorrheric
After breastfeeding
Within 5 days of menstrual
cycle
At any time if it is
reasonably certain she is not
pregnant
Lessthan 6 weeks
pills
Within 5 days of menstrual
cycle
At any time if it is
reasonably certain she is not
pregnant
Not recommended unless
other more appropriate
method available

Oral Contraceptive Pills

Uses Benefits Side Effects
1. Ulipristal Acetate - Avoid an unwanted - Reduced or absence
pregnancy of menstrual
bleeding.
- Dizziness.
- Hot flushes.
- Fatigue.
- Headache.
- Muscle pain.
2. Levonorgestrel - Avoid unwanted - Heavier or ligher
pregnancy menstrual bleeding
- Nausea
- Vomiting.
- Diarrhea.
- Fatigue.
- Dizziness.
3. Azurette (Combined - Avoid unwanted - Nausea
Oral Contraceptive pregnancy. - Vomiting.
Pills) - Headache.
- Bloating.
- Breast tenderness.
- Swelling of ankles or
feet.
- Weight change.

Common problem in uses of OCT.

1. Client did not take the pills based of the right schedule that given by medical
practitioner.
2. Client afraid of the side effects of the OCTs
3. Clients afraid of gain weight.
4. Clients prefer surgical invention than OCTs.
5. Clients afraid if the take OCTs for longer time they might undergoes medical issues.
References.

Roach RE, Helmerhorst FM, Lijfering WM, Stijnen T, Algra A, Dekkers OM.
Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke.
Cochrane Database Syst Rev. 2015 Aug 27;2015(8):CD011054. doi:
10.1002/14651858.CD011054.pub2. PMID: 26310586; PMCID: PMC6494192.

Shearman RP. Oral contraceptive agents. Med J Aust. 1986 Feb 17;144(4):201-5. doi:
10.5694/j.1326-5377.1986.tb128358.x. PMID: 3945219.

Swenson I. Oral contraceptives: a review of the literature. J Nurse Midwifery. 1975

Spring;20(1):7-14. doi: 10.1016/0091-2182(75)90046-4. PMID: 1092815.

Williams RS. Benefits and risks of oral contraceptive use. Postgrad Med. 1992 Nov
15;92(7):155-7, 161-2, 168-71. doi: 10.1080/00325481.1992.11701539. PMID:
1437913.