Genetic and Cultural Factors to Consider when Prescribing Contraceptives

2
Levonorgestrel
Your Name
Subject and Section
Professor's name
Date
Levonorgestrel
Genetic and Cultural Factors
Genetic
Khialani et al. (2020) state that oral contraceptives (OCPs) typically increase the risk for venous thrombosis. However, genetic factors contribute to increased morbidity. Notably, mutations in Factor V Leiden (F5 rs6025) or Prothrombin (F2 rs1799963) heightens the risk for coagulative disorders compared to women who do not take the drug. It applies to the majority of OCPs, especially those with combined hormones. However, the researchers also revealed that drugs containing only levonorgestrel have the lowest risk of bleeding in women with inherited thrombophilia.
Aside from vascular diseases, prenatal exposure to levonorgestrel may also affect brain tissues and induce autism-like symptoms. It is secondary to the suppression of estrogen receptor beta (Erβ), the primary estrogen receptor expressed in the brain, particularly in the amygdala. One of the principal functions of Erβ in the brain is to mediate anxiety, fear responses, and locomotor activity, which has been observed in mice brain activity. The diminished expression of Erβ in the middle frontal gyrus also indicates that this is probably responsible for autism spectrum disorder (ASD) development. Another factor contributing to the development of ASD is the suppression of estrogen-related receptor alpha (ERRα) and superoxide dismutase (SOD2) because Erβ stimulates the release of these two. Hence, it results in SOD2 suppression-mediated oxidative stress that contributes to the breakage of the brain tissues' deoxyribonucleic acid (DNA) (Zou et al., 2017).
Cultural
Patient preferences should also be considered when choosing OCPs, which are highly influenced by cultural factors that result in health barriers. An example of this culture is that follows the directives of the Catholic Church, which discourages women from availing of artificial contraception while encouraging the use of natural family planning methods (Haeger et al., 2018).
Mechanism of Action
The drug belongs to the class of second-generation synthetic progestogens. The androgen and progesterone receptors induce the release of gonadotropin-releasing hormone from the hypothalamus, and this drug inhibits this action. Thus, it inhibits...