Paper II
2025 March (Supplementary) (2010 Scheme)

Question

Combination of Oestrogen and Progesterone in Oral contraceptive pills

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Answer

Estrogen and progesterone act on complementary points of the hypothalamic-pituitary-ovarian axis to reliably prevent conception: estrogen suppresses FSH release, preventing follicular development, while progesterone suppresses the LH surge, preventing ovulation, and additionally thickens cervical mucus (impeding sperm penetration) and produces an endometrium unfavorable to implantation. Combining both gives more reliable, redundant suppression of fertility than either hormone alone, and progesterone’s cycle-stabilizing effect on the endometrium controls breakthrough bleeding — allowing a lower, safer estrogen dose than would be needed with estrogen alone.

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