[Parenteral contraceptive drugs: depot progestins].
Depot progestins as injectables, implantables or vaginal rings are suitable for contraception in those female patients, in which risk factors (e.g. cardiovascular risk) exclude the use of estrogen-progestin mixtures. In this paper the mode of action, indications, contraindications, advantages and disadvantages of the various methods using depot-progestins are discussed. Injectables contain either medroxyprogesterone acetate or norethistronenantate; both steroids are released slowly within a limited time interval (2 to 4 months) out of a depot. The major effect is a change of the cervical mucus. Side-effects are disturbances of the menstrual cycle (e.g. breakthrough bleedings) as well as an amenorrhea after frequent use (up to 50% of all cases). The subdermal implantables (Norplant 2 or 5) release levonorgestrel out of a depot over a time period of at least 5 years. Steroid plasma levels are lower than in those patients using a progestin-only pill. Side-effects of implantables are disturbances of the menstrual cycle (e.g. breakthrough bleeding); in patients who desire to conceive a child or suffer from undesirable side-effects the implantables can be removed at every time. The progestin releasing vaginal rings are in a stage of controlled clinical trials. The advantages depend on ethe easy mode of administration (implantation or removal). Side-effects are also breakthrough bleedings.
Rabe
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Universitäts-Frauenklinik Heidelberg, Abteilung für Gynäkologische Endokrinologie.
Runnebaum
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B
D000282:Administration, Intravaginal; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations; D004343:Drug Implants; D005260:Female; D006801:Humans; D007267:Injections; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D017258:Medroxyprogesterone Acetate; D008597:Menstrual Cycle / Q000187:drug effects; D009640:Norethindrone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011247:Pregnancy
D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D004343:Drug Implants; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone; C024319:norethindrone enanthate; D009640:Norethindrone
Parenterale empfängnisverhütende Präparate: Depotgestagene.