Typically, contraception entails the use of a procedure or a device to prevent conception following sexual activity. Notably, oral contraceptive pills refer to hormonal-based tablets mainly used to avoid pregnancy occurrence. Before any test is carried out, the physician must collect a detailed history, particularly family medical history and hereditary diseases, to assess the history of cardiovascular illnesses. Tests or examinations that a physician should perform before prescribing an OCP regimen include:
The physician should conduct a gynaecological exam, including a pap smear, if sexually active, to assess the patient’s cervical health. Consequently, the physician should conduct a physical examination, including blood pressure monitoring, weight, and a pregnancy test. Consequently, the physician should conduct a baseline lab assessment for heart diseases such as triglycerides and cholesterol. Also, urine tests and blood tests should be performed to determine if the patient has sexually transmitted infections. Lastly, there should be accurate blood pressure monitoring.
The three contraceptive regimes that could be chosen for the patient include Balziva 28, combined agent hormonal therapy- Estrogen and progestin, and Single-agent hormonal therapy-Progestin Only. Balziva 28 contraceptive regimen consists of Ethinyl estradiol tablets ( 0.035mg) and norethindrone 0.4mg.Besides, it contains hormones progestin and estrogen. Moreover, the packet has about 21 active and seven inactive tablets (Marks et al., 2020). It is recommended that a patient should take a tablet once daily. The hormone medication prevents pregnancy by preventing the release of the egg during the menstruation period. Besides, it makes the vaginal fluid thicker and prevents fertilization. It decreases the risks of ovarian cysts and treats acne.
More importantly, it decreases blood loss and also prevents painful periods. However, this regimen makes one’s period more regular. The only problem with this medication is that it fails to safeguard partners from STDs such as gonorrhoea and HIV. In combined agent hormonal therapy- Estrogen and progestin, the treatment inhibit the pituitary glands from releasing FSH and L.H. This, in turn, inhibits ovulation as well as the development of a dominant follicle (Bastianelli et al., 2020). It also increases the cervical mucus viscosity, thereby impairing sperm transportation. It is advantageous in that when taken appropriately. The failure rate is less than one per cent. Other additional benefits are reduced endometriosis risk, premenstrual syndrome, endometrial and ovarian cancers. Lastly, Single-agent hormonal therapy-Progestin contains a low dosage of progesterone. Besides, it changes the endometrial and cervical mucus environments (Busund et al., 2018). .It is highly recommended for a patient with high B.P. and those unable to tolerate estrogen-containing doses or are aged over 35. Consumption of such medication makes the cervical mucosa change in 2-4 hours after being administered. The declining impact is usually after twenty-two hours. It is recommendable that a backup form of contraception is used if the pill dose is taken three hours later.
Mainly, all medications have various risks associated with their consumption. From the case study given, the physician must explain to J.L. the side effects of those medications to help her choose the appropriate oral contraceptive. The side effects of Balziva 28 include bloating, breast tenderness, headache, vomiting, swelling of feet, weight changes, and nausea. Moreover, vaginal bleeding occurs predominantly during the first few months of use. Allergic side impacts may also arise following hypersensitivity towards progesterone. Combined agent hormonal therapy’s side effects include weight gain, increased acne, adverse effects on lipid metabolism, blood clots, heart attack, breast or liver cancer, and stroke (Bastianelli et al., 2020). Lastly, side impacts of single-agent hormonal therapy are related to progestin-only contraceptives such as breast tenderness, irregular periods, dizziness, headaches, acne, and increased hair growth. In this case, it is appropriate that J.L. receives the contraceptive regimen’s administration with fewer side effects that will not cause harm to her.
Bastianelli, C., Farris, M., Bruni, V., Brosens, I., & Benagiano, G. (2020). Pharmacodynamics of combined estrogenprogestin oral contraceptives: 4. Effects on uterine and cervical epithelia. Expert review of clinical pharmacology, 13(2), 163-182.
Busund, M., Bugge, N. S., Braaten, T., Waaseth, M., Rylander, C., & Lund, E. (2018). Progestin?only and combined oral contraceptives and receptor?defined premenopausal breast cancer risk: The Norwegian Women and Cancer Study. International journal of cancer, 142(11), 2293-2302.
Marks, D. H., Okhovat, J. P., & Senna, M. M. (2020). Medical Treatments for Androgenetic Alopecia. In Hair Transplant Surgery and Platelet Rich Plasma (pp. 9-28). Springer, Cham.