levonorgestrel+-+contraception

=Levonorgestrel=

How it works
//When used as contraceptives, progestogens thicken cervical mucus to impede the passage of sperm and change endometrium reducing the potential for implantation. They act on hypothalamus and suppress pituitary luteinising hormone surge and may inhibit ovulation. Depot injection and implant reliably suppress ovulation; oral progestogen-only contraceptive suppresses ovulation in <50% of women.//

Questions to Ask
What medications? - medical conditions? - allergies?

Use after 3 weeks post-partum (as can cause heavy, irregular bleeding)

Preferred for breastfeeding as it does not inhibit lactation
 * Candidates for a progestogen-only pill**

How to take
30 micrograms daily beginning on the first day of menstruation or day 21 postpartum. //If changing from a COC//, start on the day after taking the last active tablet in the pack.

Take pills at the same time every day. Choose a time when you are most likely to remember, and keep to it. Use additional contraception for 48 hours if starting after first day of menstruation. Must be taken continuously; there are no inactive (sugar) pills or 7-day break as with the combined pill. If you forget to take a pill, take it as soon as you remember and take the next pill at the usual time. If the pill is more than 3 hours overdue, you are not protected. Resume normal pill taking, but use another contraceptive method, eg condoms, for the next 48 hours. If unprotected intercourse has occurred, emergency contraception should be used. Vomiting, very severe diarrhoea, a forgotten pill (more than 3 hours late) and other medications may stop the pill from working. Effective contraception will be assured 48 hours after restarting the pill; use another contraceptive method in the meantime.

Side effects
menstrual irregularity, prolonged bleeding, spotting, amenorrhoea, breast tenderness, depression, acne, weight changes nausea, vomiting, headache, dizziness, lethargy
 * Common**
 * Infrequent**

Other advice?

 * less effective than the COC
 * if started on the first day of a period, no additional contraception is required; if started at any other time, it is not effective until after 48 hours; in this case, use additional contraception for the first 2 days of pill taking
 * consider the possibility of ectopic pregnancy in cases of contraceptive failure; progestogen-only contraceptives do not reliably inhibit ovulation and therefore offer less protection against ectopic than intrauterine pregnancy (in trials for 1 brand up to 10% of pregnancies were ectopic)

CMI
Microlut [|AMH]