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Progestogen-only pills", "Progestin-only pills", and "Progesterone-only pills" are terms each referring to the same class of synthetic hormone medications. The phrase "Progestogen-only pill" is used by the World Health Organization and much of the international medical community. [ 7 ]
During the week of placebo pills, withdrawal bleeding occurs and simulates an average 28-day menstrual cycle. The placebo pills are not required for pregnancy protection, and with any monophasic COCP the placebo pills may be discarded, and the next pack of active pills may be started to prevent the withdrawal bleeding. [10]
Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
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In contrast to other progestins, due to its high endometrial efficacy, the combination of dienogest with estradiol valerate in birth control pills is able to prevent breakthrough bleeding, and is uniquely able to treat heavy menstrual bleeding. [2] The absence of withdrawal bleeding, otherwise known as "silent menstruation", also may occur. [2]
Specific to Progesterone only pills, even if dosing is initiated within five days, backup contraception is suggested in the first 48 hours since the first pill. [24] In the case of dosing initiated after the 5th day from menstruation, effects usually take place after seven days and other contraceptive methods should remain in place until then. [39]
DMPA can affect menstrual bleeding. After a year of use, 55% of women experience amenorrhea (missed periods); after two years, the rate rises to 68%. In the first months of use "irregular or unpredictable bleeding or spotting, or, rarely, heavy or continuous bleeding" was reported. [73]
Various formulations (10-50 μg estrogen (average 20–35) [16] and 0.05–3 mg progesterone [17]) 9% failure rate with typical use (method not used consistently or correctly) 0.3% failure rate with perfect use [7] [18] Meant to be taken at the same time every day (some pills can be taken within 2–24 hours and still be effective) [19]