Levonorgestrel ethinyl estradiol

Levonorgestrel

The composition of oral contraceptives, one component of which is levonorgestrel, are regularly reviewed and changed.



Characterization:
Levonorgestrel is a synthetic analogue of the female hormone progesterone.
In combination with estrogens it is used in combined oral contraceptives and in the hormone replacement therapy.

Pharmacological action
More often levonorgestrel is used as a component of combined oral contraceptives.
It inhibits the release of luteinizing hormone (LH) in the anterior pituitary, resulting in ovulation does not occur. Under the action of the levonorgestrel the mucus changes in the cervix. It becomes denser, which makes the penetration of sperm into the uterus.
Together with estrogen levonorgestrel prevents the physiological process of preparing the endometrium for implantation of a fertilized egg. Levonorgestrel is a synthetic progestin contraceptive with action. It influences on gonadotropic pituitary function, reducing the peak FSH and LH. It causes temporary atrophic changes in the endometrium that lead to disruption of implantation. Increases the viscosity of cervical mucus that impedes the progress of sperm. After S / 6 capsules for implantation, the contraceptive effect is achieved after 24 hours in the Levonorgestrel intrauterine device has a direct local effect on the endometrium (reducing its implantation function), fallopian tubes, the viscosity of cervical mucus, which increases the efficiency and duration of the Navy, without suppression of ovulation.

Contraindications:

Capsules and intrauterine devices: pregnancy, acute and subacute inflammation of the internal and external genitalia, malignant tumors of the body and cervix, metrorrhagia of unknown origin, congenital anomalies of the body and cervix of the uterus, endometriosis, uterine fibroids, chronic endometritis and oophoritis, cervical erosion , ectopic pregnancy (in history), nulliparous women, pregnancy steatosis (in history), acute liver disease, Dubin-Johnson syndrome, rotor syndrome, breast cancer, herpes, and thrombosis of arteries and veins, thromboembolism (history), bleeding of unknown etiology (history), disorders of fat metabolism. Tablets: liver and bile ducts, jaundice (including history).

Precautions:
You should avoid repeated use of the drug inside during the same menstrual cycle due to the possible violation of the menstrual function. You may not use oral lekformy as a means of regular and continuous contraception, as this leads to a lower efficacy and more frequent adverse reactions. At a delay of menstruation for more than 5-7 days after an emergency postcoital contraception is necessary to exclude pregnancy, and in case of uterine bleeding, pelvic examination is recommended.
For adolescents under 16 years of application for emergency postcoital contraception is possible only in exceptional circumstances (including the rape), and only after consulting a gynecologist.

Before installing the Navy to carry out general medical and gynecological examination, include examination of the pelvic organs and breasts, and smear of the cervix, the woman must be re-examined 4-12 weeks after IUD insertion, and then – once in a year or more frequently if clinically indicated. Navy remains effective for five years. You should consult a doctor who has experience with this well-trained Navy or the implementation of this procedure.

Some studies have recently shown that women taking contraceptives containing only progestin, may increase the risk of venous thrombosis, but these results are not definite. However, if symptoms of venous thrombosis appear, you should immediately take appropriate diagnostic and therapeutic measures.

After removal of the IUD fertility is restored in 50% of women after 6 months, at 96.4% – 12 months.

Application
• Levonorgestrel is a part of combined oral contraceptives in a strict dose. Tablets must be taken within three weeks of each day at the same time. This is followed by a seven-day break, after which reception is resumed. During a break, there is menstrual bleeding.

• As the main component of progesterone drugs, which include only levonorgestrel, estrogen available, it should be taken daily at the same time (difference of three hours). Seven-day break is absent. Compared with the combined contraceptive this type of contraception is more effective.

• As a post-coital contraception – contraceptive method based on taking large doses of hormones (estrogen and levonorgestrel) within 72 hours after sexual intercourse without contraception.

• Currently, there is another method of postcoital contraception in which a woman takes only levonorgestrel at a higher dose (750 mg) than in a single tablet progesteron contraceptive.

• As part of hormone replacement therapy (HRT) – estrogen in combination with levonorgestrel used to correct the deficiency of hormones during menopause, accompanied by high tides, frequent obesity. In addition, HRT is the prevention of osteoporosis, cardiovascular disease and Alzheimer’s disease.

• As an intrauterine (IUD) – helix becoming more popular. They are highly effective, but their duration is up to five years. Using the spiral is not accompanied by an increased risk of inflammatory diseases of the pelvic organs.

• Heavy menstruation – intrauterine spirals are used not only for contraception but also to reduce the intensity of menstrual bleeding. Reduced blood loss is achieved by releasing small doses of levonorgestrel, acting on the endometrium.

Dose and administration:

Inside, immediately after the first coitus 1 tablet, with multiple additional 1 tablet at 8 h after the first. You can also receive no more than 4 tablets per month. Capsules of 6 pieces, implanted p / c in the inner part of the shoulder by the original method of surgery, for a period of 5 years. IUD is recommended to enter at 4-6 days of the menstrual cycle after induced abortion or immediately after the next menstrual period. After uncomplicated spontaneous delivery it should be taken no earlier than 6 weeks.

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