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Oral Contraceptive Side Effect Management
Aka: Oral Contraceptive Side Effect Management
- See Also
- Oral Contraceptive-Related Uterine Bleeding Management
- Oral Contraceptive Selection
- Oral Contraceptive
- Management: Nausea
- Take pill at bedtime, or at a meal
- Use Low Estrogen pill (e.g. Loestrin 1/20)
- Management: Fluid Retention
- Change to OCP with the following characteristics
- Low Estrogenic Activity (or low Estrogen dose)
- Examples
- Loestrin 1/20
- Loestrin 1.5/30
- Management: Appetite too active or weight gain
- Change to OCP with the following characteristics
- Low Estrogenic Activity (or low Estrogen dose)
- Low Androgenic Activity
- Examples
- Ovcon 35
- Ortho Novum 1/35
- Management: Hypertension
- Discontinue Oral Contraceptive
- Consider Mini-Pill (Progestin only)
- Management: Major Depression
- See Major Depression Management
- Change to OCP with the following characteristics
- Low Progestin Activity
- Adjunctive Measures
- Pyridoxine 20 mg bid
- Management: Migraine Headache
- See Also Menstrual Migraine
- Do not use Oral Contraceptives in women who have Migraine with Aura (risk of stroke)
- Consider Progestin-only pill (Mini-Pill) or Intrauterine Device as alternative
- Characteristics
- More common during the first cycle of Oral Contraceptives
- More common in women over age 35 years
- Management: General
- Change to OCP with low Estrogenic Activity (or low Estrogen dose)
- Examples
- Loestrin 1/20
- Progesterone only OCP
- Avoid triphasic Oral Contraceptives
- Continuous Cycle or Seasonal Contraception (84 days OCP with 5 days withdraw)
- Indicated for Menstrual Migraine
- Management: Headache during the Placebo week
- Take estradiol 10 mcg orally for 5 of the 7 Placebo days
- Benefit in age over 40 years (unclear if benefit extends to younger women)
- Management: Miscellaneous adverse effects
- Decreased Libido
- Increase Androgenic Activity
- Moodiness
- Lower Estrogenic Activity
- Dry Eyes
- Increase Progestin Activity (Progestin dominant pill)
- References
- Cerel-Suhl (1999) Am Fam Physician 60(7):2073 [PubMed]
- Speroff (1993) Obstet Gynecol 81:1034-47 [PubMed]
- Dickey (1998) Managing Contraceptive Pill Patients