Article Sections

Introduction

Contraceptive counseling should be patient-centered and take into consideration patient-specific factors (eg, medical history), the risk/benefit profiles of various contraception methods, and the patient's future fertility desires.

Combined estrogen/progestin oral contraceptive pills (OCPs)

Mechanism of action

OCPs prevent pregnancy through several mechanisms:

  • Ovulation inhibition (primary mechanism of contraception):  The constantly elevated systemic levels of estrogen exert negative feedback on both the hypothalamus and anterior pituitary, which inhibits the release of gonadotropins (LH, FSH).  This suppression prevents the midcycle LH surge required for ovulation.
  • Cervical mucus thickening:  due to the progestin component; the increased cervical mucus viscosity prevents sperm passage.
  • Endometrial changes:  The progestin component thins the endometrial lining, making it less suitable for implantation (this mechanism is also utilized for the management of patients with heavy menses).

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