Combined contraceptive pill in the context of "Progestogen"

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⭐ Core Definition: Combined contraceptive pill

The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. It is the oral form of combined hormonal contraception. The pill contains two important hormones: a progestin (a synthetic form of the hormone progestogen/progesterone) and estrogen (usually ethinylestradiol or 17β estradiol). When taken correctly, it alters the menstrual cycle to eliminate ovulation and prevent pregnancy.

Combined oral contraceptive pills were first approved for contraceptive use in the United States in 1960, and remain a very popular form of birth control. They are used by more than 100 million women worldwide including about 9 million women in the United States. From 2015 to 2017, 12.6% of women aged 15–49 in the US reported using combined oral contraceptive pills, making it the second most common method of contraception in this age range (female sterilization is the most common method). Use of combined oral contraceptive pills, however, varies widely by country, age, education, and marital status. For example, one third of women aged 16–49 in the United Kingdom use either the combined pill or progestogen-only pill (POP), compared with less than 3% of women in Japan (as of 1950–2014).

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Combined contraceptive pill in the context of Porphyria cutanea tarda

Porphyria cutanea tarda (PCT) is a form of long-term porphyria characterised by fragile skin and sore blisters in areas of skin that receive higher levels of exposure to sunlight, such as the face and backs of the hands. These blisters burst easily resulting in erosions, crusts, and superficial ulcers. There is often associated darkened skin color and extra facial hair growth. Healing is typically slow, leading to scarring and milia, while changes such as hair loss, and alterations in nails may also occur. A slightly purplish tint may be seen around the eyes. Scleroderma-like thick skin may develop over fingers, scalp, behind the ears, at the back of the neck, or in the front of the chest. The urine may appear dark. Unlike other porphyrias, PCT does not cause severe illness.

The disorder results from a deficiency of uroporphyrinogen III decarboxylase, used in the production of heme, a vital component of hemoglobin. It is generally divided into three types; familial, non-familial, and acquired. The condition can be related to liver disease and a history of excessive alcohol consumption. It is a recognised complication of hepatitis C. Other associated conditions include type 2 diabetes, metabolic syndrome, HIV, SLE, and haemochromatosis. Smoking, and the use of estrogen in males with prostate cancer and females on combined contraceptive pill may also trigger PCT. Renal dialysis may cause retention of porphyrins and cause PCT.

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