Oral Contraceptives and Related Conditions

Opill is a progestin-only oral contraceptive pill containing norgestrel 0.075mg, approved by the FDA for OTC use on July 13th, 2023. It's a mini-pill, meaning it doesn't contain estrogen. This makes it useful for individuals who can't take estrogen, like breastfeeding mothers.

Opill's effectiveness is reduced by certain medications, including phenytoin, carbamazepine, barbiturates, rifampin, efavirenz, and Saint John's Wort. These medications can interfere with the pill's ability to work effectively.

Opill needs to be taken at the same time every day for maximum effectiveness, as missed doses can reduce its ability to prevent pregnancy. It's also crucial to use backup contraception for the first 48 hours after starting Opill, and anytime vomiting or diarrhea occurs within four hours of taking a dose.

When using Opill, it's essential to remember that it does not protect against sexually transmitted infections (STIs). It's still crucial to practice safe sex and use condoms to prevent the spread of STIs.

Progestin-only contraceptives, like Opill, should not be used by those with current or past breast cancer, suspected pregnancy, or unexplained vaginal bleeding. These conditions require further evaluation and may make progestin-only contraception unsuitable.

A common vaginal infection caused by Candida albicans, often leading to itching, burning, and white, cheesy discharge.

VVC is most common after menarche, with 50% of women experiencing at least one episode by age 25.

Pregnancy, high-dose estrogen contraceptives, and estrogen replacement therapy can increase the risk of VVC by elevating glycogen levels.

While VVC is often linked to poor glycemic control, broader antibiotic use, immunosuppression, and sexual activity, it can also occur without a known cause.

VVC treatment aims to relieve symptoms, eradicate the infection, and restore normal vaginal flora. It's usually managed with a single course of therapy.

Self-treatment for VVC is appropriate for infrequent episodes, previous medical diagnosis, mild-to-moderate symptoms, and a vaginal pH below 4.5.

Pregnancy, individuals under 12 years old, concurrent symptoms like fever or pain, certain medications, and recurrent infections are all reasons why self-treatment is not recommended.

Over-the-counter antifungal medications like clotrimazole, miconazole, or tioconazole are commonly recommended for self-treatment of VVC.

An antifungal medication used for treating vaginal yeast infections (VVC). It is available in both cream and suppository forms.

A vaginal antifungal used to treat yeast infections. Available in both cream and suppository forms.

An infection caused by an overgrowth of Candida yeast in the vagina. Symptoms include vaginal itching, burning, white discharge, and sometimes swelling.

The vaginal environment's pH level helps differentiate between VVC and other vaginal infections. A pH above 4.5 with symptoms suggests VVC.

Vaginal yeast infections may cause itching, burning, and irritation. Applying antifungal products helps alleviate these symptoms.

Douches, tea tree oil, gentian violet, boric acid, and lactobacillus preparations may be used to manage VVC. These are complementary therapies to direct antifungal treatment.

Insert the applicator as far into the vagina as comfortable, then push the inside piece to release medication.

Start using vaginal antifungal medication at bedtime for optimal absorption. Wash and dry the vaginal area before applying medication.

FDA-approved imidazole-based products without a prescription are the initial treatment recommendation for vaginal yeast infections.

Imidazole vaginal products like creams, suppositories, and tablets are available for treating yeast infections, providing patients with choices based on their preferences.

Studies show similar effectiveness (80-90%) for various imidazole products in treating vaginal yeast infections.

One-dose butoconazole and seven-day miconazole treatments have demonstrated non-significant differences in effectiveness, indicating both options are viable choices.

Miconazole treatments, regardless of whether they last one, three, or seven days, show comparable outcomes in treating yeast infections.

The timing of dosage, either daytime or bedtime, does not seem to affect the effectiveness of imidazole treatments for yeast infections.

Mycelex-3 Cream, Gyne-Lotrimin 7 Cream, Mycelex-7 Cream, Mycelex-7 Combination Pack, Gyne-Lotrimin 3 Cream, Monistat 1 Combination Pack, Monistat 1 Daytime Ovule, Monistat 3 Cream, and Monistat 3 Combination Pack are common brands containing various imidazole medications for yeast infections.

Dosage and frequency of application vary between imidazole products. Check the instructions of each specific product for proper usage.

Levonorgestrel is a synthetic hormone that works by preventing ovulation, the release of an egg from the ovary. It can also interfere with fertilization and implantation, and thicken cervical mucus.

If a woman's BMI (Body Mass Index) is 26 or greater, the effectiveness of nonprescription emergency contraceptive products might be reduced. However, it's important to remember that these products should not be withheld based on BMI alone.

Common side effects of levonorgestrel include nausea, vomiting, breast tenderness, abdominal pain or cramping, headache, menstrual changes, tiredness, diarrhea, and dizziness. Nausea and vomiting are more common with oral contraceptive tablets, so an antiemetic can be taken before the first dose.

Levonorgestrel is effective for up to 120 hours (5 days) after unprotected intercourse, but is most effective within the first 72 hours. If a patient vomits within 1-2 hours after taking the initial dose, a repeat dose should be taken.

Ulipristal Acetate (Ella) is a prescription-only emergency contraceptive that can be taken within 120 hours (5 days) after unprotected sex or contraceptive failure. It functions as both a progesterone agonist and antagonist and carries a pregnancy category X designation, meaning it is contraindicated in pregnancy. It's often debated whether it should be considered a medication similar to RU-486 due to its progesterone-related action.

Emergency contraceptives, including levonorgestrel and ulipristal acetate, are not intended for regular birth control. Levonorgestrel is most effective within the first 72 hours after unprotected intercourse, but ulipristal acetate can be used up to 120 hours after. Both options can be used in case of contraceptive failure, but they do not protect against HIV/AIDS or other sexually transmitted infections.

Pharmacists are increasingly involved in prescribing hormonal contraceptives, which often requires a consultation and assessment of the patient's medical history and risk factors. They must also provide adequate counseling on the use, side effects, and potential risks involved with these medications.

Emergency contraception, which includes options like levonorgestrel and ulipristal acetate, is a valuable tool for preventing unintended pregnancies. It is important to understand the mechanisms of action, appropriate usage, effectiveness window, and potential side effects of these contraceptives to make informed choices for contraception and reproductive health.

A condition where urination is painful, burning, or frequent, and may be accompanied by other symptoms like cloudy urine, blood in urine, strong odor, or lower back/abdomen pain.

A medication used to relieve pain, burning, urgency, and frequency of urination related to lower urinary tract irritation.

A combination of methenamine and sodium salicylate, used for pain relief from urinary tract discomfort.

Painful menstruation, often occurring in adolescence.

Painful menstruation that has a known underlying medical cause, like endometriosis, pelvic inflammatory disease, or fibroids.