| |
Additional considerations
Cervical cytology
UK data suggest that the annual incidence of cervical cancer is 9.7 per 100,000 population, with a mortality rate of 3.7 per 100,000 population.15 However, pre-cancerous cervical cells are asymptomatic and may only be detected by population-screening methods. During a woman’s contraception consultation, it may be useful to check that her screening programme is up to date.
Further information.
A Medscape® multimedia presentation entitled: Preventing Cervical Cancer and Other HPV-Related Diseases is available for download here: http://www.medscape.com »
Acne
Acne, greasy hair, and hirsutism are sometimes reported with some progesterone-dominant or older-generation combined oral contraceptive pills. Although these symptoms are not serious, they often cause women to discontinue their pill.
Combined oral contraceptive pills containing newer progestins such as drospirenone appear to cause fewer progestogenic effects. Switching to one of these agents often reduces these androgenic side effects.16,17
Further information.
http://www.cks.library.nhs.uk »
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a hormone imbalance that usually begins during the teenage years. The most common symptoms are:13
- irregular periods
- hirsutism
- acne
- weight gain and/or trouble losing weight
- acanthosis nigricans.
The diagnosis of PCOS is generally made on the basis of these clinical signs and symptoms, but it is important to exclude illnesses that have similar features, such as hypothyroidism, or tumours of the ovary or adrenal glands.13
In women with PCOS, LH levels are already higher than FSH levels at the start of the menstrual cycle. This negates the LH surge which is required for ovulation, and periods become irregular.18 Combined oral contraceptive pills, especially those containing newer progestins such as drospirenone, can counter these effects by correcting this hormone imbalance.19
Further information.
http://www.obgyn.net »
http://www.pcosupport.org »
References
- House of Commons Health Committee. Sexual Health: Third Report of Session 2002-2003. The Stationery Office Limited, June 2003. London. Accessed on 1 April 2005 at: http://www.parliament.the-stationery-office
.co.uk/pa/cm200203/cmselect
/cmhealth/69/69.pdf.
- Leidenberger FA. Klinische Endokrinologie fur Frauenarzte. Berlin, Germany: Springer Verlag, 1998
- Baltzer J, Mickan H. Gynakologie: Ein kurzgefabtes Lehrbuch/Kern. Neuberbeitete Auflage. Stuttgart, Germany, Georg Thieme Verlag, 1985
- Organon. NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) 2001. Available at: http://www.nuvaring.com.
- Ortho-McNeil Pharmceutical Inc. Ortho Evra (Norelgestromin/ Ethinyl estradiol transdermal system) 2001. Available at: http://www.orthoevra.com.
- Ortho-McNeil Pharmaceutical Inc. Ortho Tri-Cyclen Lo tablets (norgestimate/ethinyl estradiol) 2002. Available at: http://www.orthotricyclen.com
- Speroff L, Darney PD. Periodic Abstinence. A clinical guide for contraception. 3rd edn. Philadelphia, PA: Lippincott Williams and Wilkins, 2001
|
|
|
|
|
|
