Gynecology Book

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Oral Contraceptive Selection

Aka: Oral Contraceptive Selection, OCP Selection
  1. See Also
    1. Oral Contraceptive
    2. Oral Contraceptive Side Effect Management
  2. Background: Legend
    1. Progesterone Activity (Progestin/Androgen/Endometrial)
      1. Progestational Activity
      2. Androgenic Activity
      3. Endometrial Activity
    2. Activity Grading
      1. Low: L
      2. Medium: M
      3. High: H
  3. Preparations: Good Monophasic Initial Choices
    1. Ethinyl Estradiol 20 mcg
      1. Loestrin 1/20 (Norethindrone 1000 mcg)
      2. Alesse (Levonorgestrel 100 mcg)
    2. Ethinyl Estradiol 30 mcg (Progesterone Activity: M/M/M)
      1. Loestrin 1/30 (Norethindrone 1000 mcg)
      2. Nordette or Levlen (Levonorgestrel 150 mcg)
      3. Ortho-Cept (Desogestrel 150 mcg)
      4. Lo-Ovral (Norgestrel 300 mcg)
    3. Ethinyl Estradiol 35 mcg (Progesterone Activity: L/L/L)
      1. Ovcon 35 (Norethindrone 400 mcg)
      2. Ortho-Novum 1/35 or Norinyl (Norethindrone 1000 mcg)
  4. Preparations: Good Triphasic Initial Choices
    1. Ethinyl Estradiol 35 mcg (Progesterone Activity: L/M/M)
      1. Ortho Novum 7/7/7 (Norethindrone 500/750/1000 mcg)
      2. Tri-Norinyl (Norethindrone 500/1000/500 mcg)
      3. Ortho Tri-Cyclen (Norgestimate 180/215/250 mcg)
    2. Ethinyl Estradiol 30/40/30 mcg
      1. Triphasil or Tri-Levlen (Levonorgestrel 50/75/125 mcg)
  5. Preparations: Non-Contraceptive Uses of Oral Contraceptive
    1. Dysfunctional Uterine Bleeding
      1. OCP Characteristics
        1. Balanced OCP
        2. High Endometrial Activity
      2. Examples
        1. Demulen 1/35
        2. Loestrin 1.5/30 or 1/20
        3. Brevicon 0.5/35
        4. Modicon 0.5/35
    2. Dysmenorrhea (in DUB or Endometriosis)
      1. OCP Characteristics
        1. High Progestational Activity
      2. Examples
        1. Loestrin 1.5/30 or 1/20
        2. Desogen
        3. Ortho-Cept
        4. Demulen 1/35
    3. Polycystic Ovary Syndrome (Stein-Leventhal)
      1. Ovarian suppression
      2. OCP Characteristics
        1. High Estrogenic Activity (or higher Estrogen dose)
        2. Low Androgenic Activity
      3. Examples
        1. Demulen 50
        2. Ovcon 50
    4. Acne Vulgaris
      1. OCP Characteristics
        1. Low Androgenic Activity
      2. Examples
        1. Demulen 1/35
        2. Modicon
        3. Ortho-Cyclen
        4. Ortho Tri-Cyclen
    5. Endometriosis or Adenomyosis
      1. OCP Characteristics
        1. Low Estrogenic Activity (or low Estrogen dose)
        2. High Progestational Activity
      2. Examples
        1. Loestrin 1.5/30 or 1/20
        2. Desogen
        3. Ortho-Cept
        4. Demulen 1/35
    6. Fibrocystic Breast Disease
      1. OCP Characteristics
        1. Low Estrogenic Activity (or low Estrogen dose)
      2. Examples
        1. Loestrin 1/20
    7. Breast Tenderness or Engorgement
      1. OCP Characteristics
        1. Low Estrogenic Activity
        2. Higher Androgenic Activity
      2. Examples
        1. Loestrin 1.5/30
        2. Nordette
        3. Levlen
        4. Levora 0.15/30
  6. References
    1. Cerel-Suhl (1999) Am Fam Physician 60(7):2073 [PubMed]
    2. Speroff (1993) Obstet Gynecol 81:1034-47 [PubMed]
    3. Dickey (1998) Managing Contraceptive Pill Patients

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