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Oral Contraceptives
Oral contraceptives, or birth control pills, constitute a class of synthetic steroid hormones that suppress the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior lobe of the pituitary gland in the female body. Known collectively as gonadotrophic hormones, FSH and LH stimulate the release of progesterone and estrogen from the ovaries; all these hormones are responsible for modulating the menstrual cycle.
Ovulation is believed to be related to a mid-cycle release of LH, which can be effectively suppressed or blocked by the systematic administration of synthetic hormones. There are many commercial preparations of oral contraceptives, but most of them contain a combination of an estrogen (usually ethinyl estradiol) and a progestin (commonly norethindrone).
In general, oral contraceptives are taken in a monthly regimen that parallels the menstrual cycle. Protection from pregnancy is often unreliable until the second or third drug cycle, and during this time certain side effects such as nausea, breast tenderness, or bleeding may be evident. More serious side effects, including blood clots and a rise in blood pressure, are possible, especially in women over 34 years of age. However, the incidence of side effects from oral contraceptives has been significantly reduced by decreasing the amounts of estrogen and progesterone in the preparations. Normal ovulation usually commences two to three months after the drug is stopped.
Progestin-only preparations (the so-called Minipill) thicken the mucus lining the cervix and make it more acidic, thereby rendering it hostile to spermatozoa. Progestin-only preparations are somewhat less reliable than the combination preparations but produce fewer side effects. Under certain circumstances, the progestin may be administered as an intramuscular deposit that gradually releases the hormone over the course of one to three months.
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