Current contraceptives guidelines classify contraceptives primarily according to their hormone content (combined estrogen + progestogen
The sequential regimen means that estrogen (Es) is administered every day and progestogen
(Pr) is used for 14 days (minimum 10 days).
For women with persistent symptoms and no history of estrogen-dependent cancers, low-dose vaginal estrogen therapy is a logical next step and does not require accompanying progestogen
treatment, according to the guideline.
Pills containing one of the newer types of progestogen
hormone - such as drospirenone, desogestrel, gestodene, and cyproterone - are associated with an increased risk of VTE than pills containing older progestogens
such as levonorgestrel and norethisterone, it was found.
Although oral estradiol is inexpensive, women with a uterus also need a progestogen
to protect against uterine cancer.
The tablet is a type of hormonal contraceptive, commonly called 'mini pill' or progestogen
-only pill, that contains the active ingredient norethisterone, which is a synthetic progestogen
, similar to the natural progestogens
produced by the body.
If TSH and prolactin levels are normal, a progestogen
challenge test (Table 2 (3,4)) can help evaluate for a patent outflow tract and detect endogenous estrogen that is affecting the endometrium.
Combined pills have changed the progestogen
ingredient several times and recently changed the oestrogen component.
Certain pharmacists in the city are offering two types of LARCs: * the contraceptive injection which contains progestogen
and is repeated every 12 weeks, and; * the implant - a small rod which is placed under the skin - usually in the upper arm - and slowly releases progestogen
The WHI trial did demonstrate an increase in breast cancer incidence in women treated with estrogen and progestogen
, Premarin, and Provera.
While NAMS limits their discussion to estrogen and estrogen combined with progestogen
therapy, the ES touches on the use of alternative forms of HT such as tibolone and raloxifene, as well as bioidentical forms of HT, such as testosterone and dehydroepiandrosterone.
In the words of Jacques Rossouw, principal investigator of the WHI study: 'The Women's Health Initiative study results tell us that during one year, among 10 000 postmenopausal women with a uterus (as opposed to those who have had the uterus removed) who are taking oestrogen plus progestogen
, 8 more will have invasive breast cancer, 7 more will have a heart attack, 8 more will have a stroke, and 18 more will have blood clot in the lungs and legs, than will a similar group of 10 000 women not taking these hormones.
The study found that women taking pills containing a progestogen
called levonorgestrel (for example, Microgynon) had the lowest risk of thrombosis.
This report focuses on contraceptives that combine estrogen and progestogen
as well as the same combination used in menopause therapy.
Estrogen alone will be referred to as ET and estrogen in combination with a progestogen