Types of oral contraceptives.

(2)

(a) Estrogen and progestin combination products. These preparations

are supplied in a package containing 21 or 28 tablets. In that package, 21 of the tablets

contain a combination of estrogen and progestin and seven tablets contain inert

ingredients or iron (25 milligrams of elemental iron per tablet).

(b) Low dose progesterone products. These products contain

progesterone. A tablet is to be taken each day of the cycle.

(c) High dose estrogen (DES). This tablet is taken within 72 hours of

intercourse. High dose estrogen is not a routinely used oral contraceptive. It is only

used in cases of rape and incest.

(3) Side effects. Some significant side effects are associated with the use of

oral contraceptive agents. Some of these are:

(a) Breakthrough bleeding. This side effect is seen in patients taking

low-dose estrogen.

(b) Thromboembolic disease. Symptoms associated with this

particular side effect include severe headache, blurring or loss of vision, flashing lights,

leg pains, chest pains, and shortness of breath.

(c) Candida vaginitis. This is a yeast infection of the vagina. This side

effect is sometimes seen in patients taking high progestin products.

(d) Edema and breast enlargement. This side effect is seen most often

in patients taking high estrogen and/or progestin products.

(e) Nausea and vomiting. This side effect is most often observed in

patients taking high estrogen products.

(f) Skin reactions. Increased pigmentation can be aggravated by

sunlight. This side effect is more common in individuals who have darker skin. This

type of side effect is observed most often in patients who are taking high estrogen

products.

(g) Libido changes. Oral contraceptives sometimes affect the

individual's sex drive.

(h) Rebound fertility. Rebound fertility involves the increased likelihood

of pregnancy. The cause of this side effect is unknown.

MD0807

8-13