Extended Use Of Combined Oral Contraceptive Pills

Posted by e-Medical PPT Tuesday, May 22, 2012
Combined Oral contraceptive pill (COCP) formulations have included a standard 21-day active regimen followed by a 7-day placebo or hormone-free week.
Both physicians and women faced off-label manipulation of this regimen for years, for example, to minimize days of bleeding or to treat other medical conditions.

Extended use of COCPs has been used for many years to treat:
1- Endometriosis
2- Dysmenorrhea
3- Menstruation-associated symptoms
4-Menorrhagia
5-Simple Ovarian cysts
6-Androgen excess conditions: reduction in acne lesions and hirsutism
7-Prevent Non Chlamydial pelvic inflammatory disease
8-Reduced risk or slower progression of   rheumatoid arthritis
9-Reduced conditions appearing during menses,
   seizures, and asthma
10-Personal preference (most common )

Side effects
Extended use of COCPs or non oral combined hormonal contraceptives carries the same risk of side effects and medical risks as traditional COCP use.
loss of sex drive (libido), headaches, acne, weight gain, vaginal (fungal)infections, and depression.
Serious risks of COCPs that can be life threatening include blood clots, stroke, and heart attack.  These risks are increased in women who smoke cigarettes.
With all extended-cycle COCPs, breakthrough bleeding is the most common side effect, especially in the first 3-6 months of use although it tends to decrease over time. In a 12-month study of a continuous COCP regimen, 59% of women experienced no bleeding in months six through twelve and 79% of women experienced no bleeding in month twelve

Contraindications
Combined oral contraceptives are generally accepted to be contraindicated in women with pre-existing cardiovascular disease, in women who have a familial tendency to form blood clots (such as familial factor V Leiden), women with severe obesity and/or hypercholesterolemia (high cholesterol level), and in smokers over age 35.
COC are also contraindicated for women with liver tumors, hepatic adenoma or severe cirrhosis of the liver, and for those with known or suspected breast cancer.

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