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When to choose combined hormonal contraception over progestin only contraception?

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Combined hormonal contraception (CHC) is preferred over progestin-only contraception when the benefits outweigh the risks, especially considering thromboembolic risks. CHC, including oral contraceptives, patches, and vaginal rings, are highly effective but come with an increased risk of thromboembolism, both venous and arterial . On the other hand, progestin-only pills are considered safer in terms of thromboembolic risk, making them suitable for women who cannot use CHC due to contraindications . However, recent studies suggest that progestin-only contraceptives, while associated with a slight increase in breast cancer risk, are still a viable option for many women, with similar risks to CHC . Therefore, the choice between CHC and progestin-only contraception should be based on individual risk factors, preferences, and overall health considerations.

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Journal Article•DOI [The Thromboembolism Risk with Combined Hormonal Contraceptives: Current Status and Prescribing Practice]. Dorothea Wunder 01 Mar 2023-Praxis 1 Citations	When benefits outweigh thromboembolism risk factors like age >35, obesity, smoking, and positive family history, combined hormonal contraception may be chosen over progestin-only contraception for suitable candidates.
Open access•Journal Article•DOI Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis Danielle Fitzpatrick, Kirstin Pirie, Gillian K Reeves, Jane Green, Valerie Beral - Show less +4 more 01 Mar 2023-PLOS Medicine 4 Citations	Choose combined hormonal contraception over progestin-only when considering breast cancer risk, as both show similar slight increases. Benefits and age should guide decision-making for premenopausal women.
Journal Article•DOI Progestogen-only pills: which progestogen would be ideal. Christian Egarter 20 Jul 2021-Hormone Molecular Biology and Clinical Investigation 3 Citations	When considering thromboembolic risk, choose progestin-only pills over combined hormonal contraceptives, especially for women ineligible for the latter. Modern progestogens like drospirenone may offer additional benefits.
Journal Article•DOI [Combined Hormonal Contraception - Which Pill for Which Patient?] Philipp Quaas 01 Mar 2023-Praxis 1 Citations	Combined hormonal contraception is preferred over progestin-only when a tailored approach is needed, considering individual thromboembolism risk. CHC offers varied estrogen and progestin options for personalized prescribing.
Open access•Journal Article•DOI Use of progestogen‐only pills for oral contraception Jenny Kitson 01 Jun 2023-Prescriber	When combined hormonal contraception is unsuitable, progestogen-only pills (POPs) are a safe and effective option for women preferring oral contraception, as outlined in the paper.

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The weight gain or lost is a syntom of the hormonal contraceptives?4 answersWeight gain is commonly associated with hormonal contraceptives, particularly among users of depot-medroxyprogesterone acetate, where weight gain may occur, especially in overweight or obese adolescents at initiation. However, evidence suggests that combination contraceptives like oral pills or patches are not causally linked to weight gain. In contrast, progestin-only contraceptives, such as medroxyprogesterone, may lead to modest weight gain over time. The fear of weight gain can deter women from using hormonal contraceptives, impacting their contraceptive choices and adherence. Providers play a crucial role in reassuring women about the limited association between hormonal contraceptives and weight gain, offering guidance based on available evidence to alleviate concerns and ensure informed decision-making.

What are health benefits of combined oral contraceptives?4 answersCombined oral contraceptives (COCs) have several health benefits. They are effective in preventing unwanted pregnancies and reducing the risk of diseases associated with premature pregnancy, especially in teenage girls. COCs can also be used to treat polycystic ovarian syndrome (PCOS), menstrual disorders, hirsutism, and acne vulgaris. Additionally, COCs have been shown to have a positive impact on women's health by reducing the risk of colorectal cancer, ovarian cancer, and endometrial cancer. They can also effectively suppress hypothalamic-pituitary-ovarian axis excitability after abortion and prevent neural tube defects in the case of pregnancy after withdrawal of COCs. However, it is important to constantly learn about the topic and minimize the risk of adverse side effects associated with COC use.

Is a combined hormonal contraceptive patch less thrombotic than a pill?5 answersThe transdermal patch provides an effective and convenient option for hormonal contraception, with similar efficacy and tolerability to combined oral contraceptives (COCs). However, studies show that the risk of developing venous thromboembolism (VTE) is about twice as high with the patch compared to COCs. The risk of VTE is also increased with other non-oral routes of administration, such as the vaginal ring. Combined hormonal contraceptives containing desogestrel, gestodene, drospirenone, or cyproterone acetate are associated with a higher risk of VTE compared to those containing levonorgestrel. In contrast, progestin-only contraceptives do not confer an increased risk of VTE. Therefore, it can be concluded that the combined hormonal contraceptive patch is more thrombotic than a pill containing levonorgestrel, but progestin-only contraceptives are not thrombotic.

Do combined oral contraceptives compete with thyroid hormones?5 answersCombined oral contraceptives (COCs) can impact thyroid hormones. COCs containing estrogen can increase liver proteins such as thyroid-binding globulin (TBG), sex hormone-binding protein (SHBG), and coagulation factors, leading to elevated levels of thyroxine (T4) and triiodothyronine (T3). COCs containing ethinyl estradiol and dienogest can increase serum concentrations of TBG, total T3, and total T4, while free T4 remains unchanged. COCs do not interfere with thyroid metabolism per se, but they can affect thyroid hormone levels, particularly TT4 and FT4I, which are significantly raised in women on COCs compared to control women. COCs containing desogestrel and ethinyloestradiol do not alter thyroid function, but they can increase serum thyroxine, free thyroxine index, and thyroxine-binding globulin. DNG-containing and LNG-containing low-dose COCs can increase T3, T4, and cortisol levels due to elevated binding to serum globulins, while the free proportion of the hormones is not significantly changed.

In which forms can progesterone alone or in combination with estrogen be used in females?10 answers

In which type of pill both estrogen and progestin are present in nearly the same amount?8 answers

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