OCP Oral contraceptive pill | CHAPTER 9 | Community Health Nursing

OCP Oral contraceptive pill – This book covers the entire syllabus of “Community Health Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate latest information and topics.

This book is examination friendly setup according to the teachers’ lectures and examination’s questions. At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourished. The unique way of presentation may make your reading of the book a pleasurable experience.

OCP Oral contraceptive pill

Definition of OCP (Oral contraceptive pill)

Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control.

Or

OCP mean Oral contraceptive pill. Hormonal contraceptives used are the most effective spacing methods of contraception. Oral contraceptives of combined types are almost hundred percent effective in preventing pregnancy.

Types of OCP (Oral contraceptive pill)

A. Combined pills:-It is 100% effective, Contain oestrogen and progesterone

B. Mini pill:- It is 97-98% effective, it contain only progesterone

C. Morning after pill

D. It contain only oestrogen.

Advantages of OCP (Oral contraceptive pill)

1. 99% effective low failure rate (0.1/100 wy)

2. Aesthetically – attractive.

3. Sense of well-being.

4. Not interference with sexual act.

5. Reversible.

6. Reasonably cheap & available..

7. It is self-administered.

8. Does not impair subsequent fertility.

9. Some nor-contraceptive advantages eg. protection against:

• Benign breast disease
• Fibroadenoma of breast
• Endometriosis
• Ovarian carcinoma
• PID
• Iron deficiency anaemia
• Dysmenorrhoea
• Premenstrual tension
• Idiopathic hirsuitism.

Disadvantages/Adverse Effect/ Side Effect/Complication of OCP

A. Minor disadvantages:

1. Nausea & vomiting.

2. Weight gain.

3. Break through bleeding or spotting.

4. Reduced menstrual bleeding.

5. Absence of withdrawal bleeding.

6. Others- headache, dizziness, breast tenderness, chloasma, abdominal cramps, emotional changes such as depression.

B. Major disadvantages:

Indications of Oral Pill

A. Contraceptive use.

B. Non-contraceptive uses / benefits:

• To reduce premenstrual tension.
• Dysmenorrhoea.
• Abnormal uterine bleeding
• Dysfunctional uterine bleeding.
• Functional ovarian cyst.
• Benign breast disease.
• Sterility.
• Endometriosis.
• Menopause.

Contra-Indications of OCP

To select a patient for prescribing OCR through history, examination and some investigations are needed to exclude contra-indication

A. Age of the patient is important.

• If she is more than 35 years of age she should be prescribed with caution & regular checkup is needed.
• In smokers it is to be prescribed with caution as it is associated with increased incidence of thromboembolism.

B. Menstrual history is to be taken to exclude pregnancy, undiagnosed uterine diseases etc.

C. Family history of cerebro-vascular disease including hypertension, breast cancer & hyperlipidaemia should be excluded.

D. Medical history regarding thrombo-embolic episodes, jaundice, epilepsy, HTN, DM,
allergic condition, migraine should also be-excluded

E. Examination of breast for any nodule. Blood pressure and weight should be noted.

F. Pelvic examination to exclude fibroid or cervical pathology is manditory.

G. Investigation vaginal cytology if facilities are available.

From the above mentioned examination to screen if it is revealed that the woman is free from any systemic disease and contraindication she is suitable candidate for OCP therapy.

Minipill

Minipill is devoid of oestrogen compound. It contains very low dose of a progestin in any one of the following form-

• Levonorgestril 75mg or Norethisterone 350mg
• Desogestril 5mg, lynesterol 500mg or Norgestril

Mechanism of action :

It works mainly by making cervical mucous thick and viscous, thereby prevents sperm penetration Endometrium becomes atrophic, so blastocyst implantation is also hindered. In about 2% of cases ovulation is inhibited.

How to prescribe minipill :

The first pill hasMo be taken on the first day of the cycle and then continuously. It has to be taken regularly and at the same time of the day. There must be no break between the packs.

Advantages :

• Side effects attributed to oestrogen in combined pill are totally eliminated.
• No adverse effect on lactation
• Easy to take
• It may be prescribe in patient having, hypertension, fibroid, diabetes, epilepsy and H/O thromboembolism.
• Reduces the risk of PID and endometrial cancer.

Drawbacks:

• Acne
• Break through bleeding
• Amenorhoea
• Simple cyst of ovary
• Failure rate 0.5-2 per 100-womenyears of use.

Name of Available OCP

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