••• Chapter 61^ Family Planning and Sterilization^615
❍ True/False. The transdermal patch has a better compliance than OCP?
True.
❍ What is the Seasonale pill?
A 91-day extended cycle OCP. It consists of 84 active pills followed by 7 inactive pills, resulting in 4 withdrawal
bleeds per year.
❍ What is the hormonal component of Seasonale?
The pill contains 30 mg of ethinyl estradiol and 150 mg of levonorgestrel.
❍ What is Seasonique and how does it differ from Seasonale?
Seasonique is also a 91-day extended cycle OCP. It consists of the same 84 active pills followed by 7 pills
containing 10 mg of ethinyl estradiol, which may result in less breakthrough bleeding.
❍ Is the efficacy of Seasonale pill comparable with conventional OCP?
Yes. The Seasonale pill has similar effectiveness to 28-day cycle combined OCP.
❍ Is the breakthrough bleeding more frequent with the Seasonale pill?
Yes. Compared with traditional combined OCP, women who take Seasonale have more unplanned bleeding.
However, it decreases after the fourth cycle.
❍ Do the side effects increase with Seasonale?
No. The side effects and contraindications of Seasonale are similar to other combined OCP.
❍ How does DepoProvera work?
It inhibits gonadotropin secretion, which inhibits follicle maturation and ovulation. Endometrial proliferation is
then inhibited.
❍ What is the effect of progestin on the uterus?
It results in a shallow atrophic endometrium, making it less receptive to implantation. It also thickens cervical
mucus and reduces tubal motility.
❍ What is the “grace” period with DepoProvera?
2 weeks. A 150-mg injection actually provides >3 months protection.
❍ What is the average weight gain per year of use of DepoProvera?
2 to 5 pounds.
❍ What is the expected period of time for return of fertility after DepoProvera?
6 months to 1 year.