Combined hormonal contraceptives

Contraception gynecologist Munich

Your gynecologist practice for combined hormonal contraception Munich

In the developed world the most common method used to prevent pregnancy from occurring is “the pill”. All combination pills contain two hormones, oestrogen and progestogen. In new combination contraceptives, the classic oestrogen (ethinylestradiol) has been replaced by a more natural form of oestrogen.

Combined hormonal contraceptives are not only available as a pill, but also come in the form of a contraceptive ring (vaginal ring) or a contraceptive patch.

Combined hormonal contraceptive methods may not be suitable for all women. For example, the pill may not be suitable for women who suffer from any of the following conditions: high blood pressure, s/p thromboembolism, s/p deep vein thrombosis, migraines with focal neurological symptoms, known thrombophilia, lipid metabolism disorders or liver disease. It is also not the most suitable method for smokers over the age of 35, for anyone who will be immobile for an extended period of time such as being on bed rest after a serious operation and should not be used while breastfeeding.

When used correctly, this method of birth control can be very effective and has a rating of <= 1 on the Pearl Index. However, this method can occasionally “fail”, particularly if not used correctly or due to interaction with other medications.

Medications that may decrease the effectiveness of combined hormonal contraceptives:

Tuberculostatics (rifampicin), antifungals(griseofulvin), antidepressants (imipramine), St. John’s wort, antihistamines (cimetidine), antiepileptics (carbamazepine, phenobarbital, primidone, phenytoin, oxcarbazepine, felbamate, topiramate)

and the following antibiotics

  • Penicillin (amoxicillin, piperacillin, benzylpenicillin, phenoxymethylpenicillin, flucloxacillin, clavulanic acid, tazobactam)
  • Tetracycline (doxycycline, minocycline, demeclocycline, lymecycline, tigecycline)
  • Cephalosporin (cefaclor, cefazolin, cefuroxime, cefamandole, cefotaxime, ceftriaxone, cefixime, ceftibuten, cefpodoxime, ceftazidime, cefprozil, cefepime, ceftobiprole)
  • Chloramphenicol
  • Sulfonamides (sulfadiazine, sulfamethoxazole – cotrimoxazole, sulfasalazine)
  • Nitroimidazoles (metronidazole, ornidazole, tinidazole)
  • Potentially macrolide antibiotics (azithromycin, clarithromycin, erythromycin, roxithromycin, spiramycin)

Other factors that my decrease the effectiveness of oral contraceptives (not applicable to the vaginal ring and contraceptive patch): gastritis, enteritis, Crohn’s disease, cystic fibrosis, diarrhoea, vomiting.