Description of Hormonal Contraceptives
Session 35: Description of Hormonal Contraceptives
Methods
Total Session Time: 60 minutes
Prerequisites
Learning Tasks
By the end of this session students are expected to be able to:
Resources Needed:
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation/
2 05 minutes Indications of Hormonal Contraceptives
Buzzing
Presentation/ Contraindications of Hormonal
3 10 minutes
Brainstorming Contraceptives
Dose, Dosage and Course of Hormonal
4 20 minutes Presentation
Contraceptives
Presentation/ Side Effects and Adverse Effects of Hormonal
5 05 minutes
Brainstorming Contraceptives
Interactions and Precaution of Hormonal
6 05minutes Presentation
Contraceptives
7 05 minutes Presentation Key Points
8 05 minutes Presentation Evaluation
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STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing.
STEP 2: Indications of Hormonal Contraceptives (5 minutes)
Activity: Buzzing (5 minutes)
ASK students to pair up and buzz on the following question for 2 minutes
WRITE their response on the flip chart/board
CLARIFY and SUMMARIZE by using the content below
o Combined oral contraceptives) COCs)
o Progestogen Only Pills (POPs)
o Alleviating menopausal symptoms
o In women with early natural or surgical menopause
o Primarily for prevention of conception
o Treatment of dysfunctional uterine bleeding,
o Treatment of dysmenorrheal
o Treatment of endometriosis.
o In management of Menorrhagia
o Treatment of premenstrual symptoms
o Post Coital Contraception (―morning-after pill‖)
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STEP 3: Contraindications of Hormonal Contraceptives (10 minutes)
Activity: Brainstorming (5 minutes)
Ask students to brainstorm on the following question:
ALLOW few students to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
o Thrombophlebitis
o Thromboembolic phenomena
o Cardiovascular and
o Cerebrovascular disorders or a past history of these conditions
o Treat vaginal bleeding when the cause is unknown
estrogen-dependent neoplasm
o Liver disease
o Pregnancy
o Severe headaches especially associated with visual disturbances
o Numbness or paresis of extremities
o Unexplained chest pain or shortness of breath
o Severe leg pains
STEP 4: Dose, Dosage and Course of Hormonal Contraceptives
(30 minutes)
intradermal
o Combined Oral Contraceptive (COP)
The use of COP in contraception
In pack of 28 pills, first 21 have hormone and the last 7 have no hormone
Take one pill each day until the pack is empty
o Menopausal symptoms with uterus
Give one tablet of combined oral contraceptive daily
o Menopausal symptom and osteoporosis prophylaxis (with progesterone for 12-14
days per cycle in women with intact uterus)
10-50 micrograms daily for 21 days repeated after 7 days tablet free period.
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o Female hypogonadism
10-50micrograms daily
o Post Coital Contraception (―morning-after pill‖)
The method is applicable mostly after rape and unprotected sexual intercourse
where pregnancy is not desired
Within 3 days (72 hours) of unprotected sexual intercourse, give
Combined oral Contraceptive 100 microgram ethinylestradiol and 500
micrograms levonorgestrel (2 high dose COC tablets)
Or
When this preparation is not available, use 3 tablets each containing 30-35
micrograms ethinyloetradiol and 150-250 microgram levonorgestrel (3 low dose
COC tablets)
o Norethisterone (Primolut N) 5mg 12hourly for 10 -14 days
COC (E+P) Combined oral contraception 2-3 cycles
o This type is suitable for lactating mothers or women with mild or moderate
hypertension. Start 6 week after birth
o Use of POP in contraception
o Take one tablet every daily at the same time
o Use of POP in management of dysmenorrhea. Give POP 5mg three times daily by
mouth from day 5 to 24 for 3-4 cycles
o Use of POP in management premenstrual syndrome. Give POP 5mg 2-3 times
o This type is suitable for lactating mothers or women with mild or moderate
hypertension
o Depo Provera 150m intramuscular after every three month
o Deep intramuscular into buttock of 5-10mg daily for 5-10 days until 2days before
onset of menstruation
o Levonorgestrel in six plastic capsules is implanted in the left upper arm made under
local anesthesia
o Levonorgestrel is effective for five years and is recommended for women who have
completed their family or not ready for sterilization or those not able to take estrogen
containing contraceptives
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STEP 5: Side Effects and Adverse Effects of Hormonal Contraceptives
(20 Minutes)
Activity: Brainstorming (5 minutes)
Ask students to brainstorm on the following question:
ALLOW few students to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
o Nausea and vomiting, abdominal cramps and bloating, weight changes
o Breast enlargement and tenderness
o Premenstrual-like syndrome
o Changes in libido, depression, mood changes, headache, migraine, dizziness,
o Leg cramps (rule out venous thrombosis)
o Headache has been reported
o Premenstrual like syndrome which includes; bloating, fluid retention, breast
tenderness
o Weight change, nausea, headache, dizziness, insomnia
o Drowsiness, depression, change in libido
o Skin reactions including urticaria, pruritus, rash, and acne)
o Hirsutism and alopecia
o Jaundice and anaphylactic reactions
o Menstrual disturbances
STEP 6: Interactions and Precautions of Hormonal Contraceptives
(5 minutes)
contraceptive methods:
o Hypnotic/sedatives anti-migraine medication, barbiturates, chloral hydrate, diazepam
o Antacid: Aluminium hydroxide, magnesium hydroxide, magnesium trisilicate
o Anti TB as rifampicin
o Antiretroviral as Nevirapine and Ritonavir
o Certain antibiotics as Ampicillin and other Penicillins and Tetracyclines
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consider increasing the doses of the following drugs, known with careful monitoring:
o Anticonvulsant
o Ant diabetic agents
o Anticoagulants
o Antihypertensive agents (methyldopa)
o Corticosteroid
o Hypnotics, sedatives or other CNS depressants
Step 7: Key Points (5minutes)
problems
implants
cramps and bloating, weight changes
antiretroviral
corticosteroids, anticonvulsants and anticoagulants
STEP 8: Evaluation (5minutes)
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References
Pharmacotherapy: A Pathophysiologic Approach (9th ed.). New York, McGraw-Hill
Education.
Ministry of Health and Social Welfare. ( 2013). Standard Treatment Guidelines & National
Essential Medicines List Tanzania Mainland (4th ed.). Dar es salaam, Tanzania
government printers.
Sally S.R., Jeanne C.S. (2000). Introductory Clinical Pharmacology (6th ed) New York,
Lippincott Williams and Wilkins.
School of Pharmaceutical sciences. (2011). Tanzania Pharmaceutical Handbook (2nd ed.).
Dar es Salaam, ARDHI University press.
The Royal Pharmaceutical Society of Great Britain. (2007). Martindale: The Extra
Pharmacopoeia (5TH ed). London, pharmaceutical press.
The Royal Pharmaceutical Society of Great Britain. (2009). British National Formulary
(59th ed). London, BMJ Group and RPS Publishing.
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