Hormenal Contraceptives

1 Peripheral Target organs: . 2 Ovaries Gonadotrophin .

3 Anterior Pituitary : : () (F.S.H) . () (L.H.) Ovulation.

Hypothalamus (F.S.H) (L.H) Prolactin (L.H.) . ( ) (F.S.H.) (L.H.) (Corpus Luteum) Progesterone Oestradiole Endomitrium Secretary phase . . Cervical Mucus . . .

1 : 1973 . (F.S.H) (L.H.) .

2 : Implantation . . 3 : . .

1 Progestogen . 19 19- nortostosterone ( ) (1) Oethenyl oestradiel . .

norethindrone& norethyaedrel norethindone Ethynodiol diacetate 15 . norgestril .2 : . Ethenyl Oestradiol 17 Ethenyl Oestradiol 17 Mestranol . Break through . ( ) bleeding & Amenorrhoea . 50 . 20 1 . () Combined . () Sequential . () . : Oestrogen Progestogen . : . Withdrawal Bleeding .

: 2 8% . Break through Bleeding Cilastic Implant Intravaginal Rings .

Combined 2, . (2,% /). . Glycogen . . .

sequential . .

Systemic Effect . . . . :-

. :-1 . 2 . 3 24 . ( 50 ) :-

(1) : : . : Fibroids . Intermenatrual : / . : . : . (2) ( ) Adrenal : 17 17Ketosteroid Aldosterone Cortisol . Thyroid .

Pancreas Diabetes . Pituitary L.R.F. F.S.H. . 2,% Sequental. : Atheroscletosis .

: . .Recurrent Jaundice .

:- 3 100000 . . .

4 : . 5 : Tryptohan Serotinin . . .

: Renin Angiotensin . : Testosterone. (10) .

Ulcerative colifisv . () .

1 . 2 .3 .4 Hyperlipidaemia5 . 1 Depression neurosis 2 Migraine 3 Hypertension4 Epilipsy5

. . .

( ) 1 6090% ( 45% ) 12% ). 2 ( 1/3 ) .

3 . . 50% 1%. 4 ( ) Androgens 80 90% .

5 Hirsutism . 6 Mittelschmerz . 7 50% 40% . 8