PRE OPERATIVE USE OF BIRTH CONTROL PILLS

 

MEDICATION: NOR-Q-D (MICRONOR)

 

WHAT TYPE OF MEDICATION IS IT?

NOR-Q-D (Micronor) is a low-dose, progestin-only birth control pill. Because it does not contain estrogen, NOR-Q-D does not increase the uterine lining or have some of the rare but serious side effects associated with combination estrogen-progestin pills.

NORMAL PHYSIOLOGY:

During the normal menstrual cycle the lining (endometrum) of the uterus is built up and prepared to accept and nourish a fertilized egg. During this time an increased blood supply (vascularity) occurs in the pelvic organs as part of the ovulatory changes. When no pregnancy occurs the lining is shed (menstruation).

WHY MAKE CHANGES IN THE MENSTRUAL CYCLE PRIOR TO SURGERY?

Prior to surgery or some procedures (especially hysteroscopy) it is beneficial to keep the endometrial lining to a minimum because:

  1. It is much easier to visualize the uterine cavity if there is very little lining
  2. In surgical procedures, especially those that involve putting dye in the fallopian tubes, a heavy lining may block the tube.
  3. Having a less vascular pelvic cavity makes excessive bleeding less likely and surgery safer.
  4. Lessens the chance of having surgery during an early, undiagnosed pregnancy.

WHEN DO I START TAKING NOR-Q-D?

The medication is usually started during the menstrual period prior to the surgery and taken for a month or less. If the period is expected just prior to the surgery, NOR-Q-D is often given for more than a month and 2 packages will be needed.

The pill is usually begun by the 5th day of the cycle. It is usually preferable to let the flow be firmly established. It should be taken close to the same time each day until the day of surgery.

WHAT ARE THE SIDE EFFECTS?

You might not have any period, due to the thinned uterine lining. You may have a period at the regular time, but it might be lighter than usual. You might have "breakthrough" bleeding. If you take the pill later that 2 hours from your usual time, you often will have breakthrough bleeding. Missing a day's pill will usually result in a flow very much like your menstrual period. It is helpful to carry "mini-pads" or panty liners with you. None of this breakthrough bleeding is harmful, but it is annoying. Even with bleeding, you need to continue taking your pills.