Contraceptives

Do oral contraceptives cause headaches? The accurate answer is both YES they can and NO, they can actually ‘improve’ them.

Women suffer from headaches and migraines more than men do, this fact may not surprise you, especially if you are a young mother juggling two full time jobs (isn’t rearing children and housekeeping a full time job?) and striving to be the ‘perfect lover of the year’ as well! However, a large majority of women take oral contraceptives and about 20% of them attribute their headaches to the pills.

Stress causes headaches but there was evidence early on, when the pills contained much higher doses of estrogen, of a direct relationship between combined oral contraceptives (containing estrogen and progestin) and headaches in some women. Estrogen seems to be the culprit here so doctors reduced the dose of estrogen but as headaches are caused by all sorts of reasons this did not guarantee success.

There is also evidence that oral contraceptives can ‘ improve’ a woman’s migraines by reducing the attacks or the severity of the migraine, especially if she gets ‘ovulation’ headaches.

Ovulation Headaches

If you are not taking the oral contraceptive pill you may still get headaches with your period or when you ovulate. You may find that taking oral contraceptives will help to reduce the number of headaches you get.

Estrogen Withdrawal Headaches - or Menstrual Migraines - Headaches that occur during the 7 day placebo pill period

For those of you who are sure that the oral contraceptive you are taking causes your headaches, have you noticed if your headache/migraine occurs during the days you are taking the ‘dummy’ pills that do not contain any hormones? Just before you start your period, your natural estrogen level drops. Taking estrogen in your oral contraceptive pill for 21 days then NONE at all for 7 days, causes a sudden fall in estrogen levels during the last week of your menstrual cycle- this sudden drop may trigger a headache or a migraine. A good treatment for this, according to Dr. Rick Jelovsek MD, is Mircette, which has a low dose (10mcgm) of estrogen in each of the 7 day off pills OR…….

Your doctor may be able to prescribe a course of oral contraceptive pills that is ‘active’ every day for 9 weeks, then you take a week’s break of dummy pills. Or he may prescribe a progestin only pill for you.
If you take an oral contraceptive pill and your headaches worsen, you should not continue to use the same pill. Switching to a different pill, with different content, from a different manufacturer, may solve the problem. If not, it is likely that your GP will advise you to stop taking birth control pills completely.

If you have a History of Migraines

Risk profiles for women age 20-44: (www.virginia.edu/studenthealth/OCP%20and%20Migraine%20Headache.pdf)

• A woman with a history of migraine has a 4 fold increase in her risk of stroke compared to her peer who does not have migraines, or 16 to 20 strokes per 100,000 women with migraine per year.
• If the same woman with migraines uses a low-dose estrogen-containing birth control method, her risk for stroke is increased by 7 fold to 28 to 35 strokes per 100,000 women with migraines who use low-dow estrogen-containing birth control pills per year.
• The woman who has migraines, uses an estrogen-containing birth control method, and smokes has a 34 fold increase in her risk of stroke, or 134 to 170 strokes per 100,000 smokers with migraines on birth control pills per year.

For the above reasons, it is strongly recommended that if you have a personal or family history of migraine headaches, you should select non-estrogen methods of contraception. Your doctor should be able to advise you about the alternative options.

It is a case of trial and error - so if one brand of contraceptive pill gives you a migraine, changing to another brand, with your doctor’s approval of course, may not have the same effect. You may just need a pill with a lower dose of estrogen or you may find that your body will only tolerate ‘progestin only’ pills. If the headaches still continue, your health care provider may take you off the birth control pill and suggest that you use another type of contraception.

Headaches can also be a prior warning of an impending stroke or other circulatory disorder. Pay close attention to headaches that are different or more severe than those you had before starting on the Pill.

Are you taking an oral contraceptive ?

Are your teenage hormones raging?

Hormones are chemicals that send information between cells and organs to control our body’s processes. The sex hormones that cause such a ruckus in puberty are crucial to the reproduction process in men and women. The contraceptive pill plays its monthly role in this relay system by tricking the body into thinking it’s pregnant.

Contraceptive pills are one of the most popular types of female contraceptive in use today but do you know HOW and WHY they work? No, I don’t just mean “oral contraceptives stop ovulation” or “they thicken the cervical mucous”, I mean WHAT HAPPENS in various parts of your body, including your pituitary gland, when you swallow a synthetic hormone (present in the contraceptive pill) and HOW does that actually change your body’s normal functions each month to significantly ‘reduce’ the chances of you getting pregnant.

In my hunt to discover a simple explanation to this question that I could pass onto you, I feared a medically ‘high brow’ (and boring!) answer. However, I found this excellent little animated film that does the job nicely.

If you are interested in really knowing what is going on inside you when you take an oral contraceptive pill, then I think you will find the film below easy to understand. To watch it you will need Flash5 plug in though, which you can get HERE for free if it’s not already installed on your pc.

The information you will discover will also make sense of those side effects that sometimes sneakily accompany the contraceptive perk- not that this makes them any less acceptable but at least you’ll be a ‘know -it-all’ when you next talk to your doctor about birth control! Who knows, you may even find another contraceptive pill suits you better after you’ve been able to ‘take charge’ of the discussion? I cannot emphasize strongly enough though, the need to have a good back up stock of condoms, especially if you have multiple partners, this site is reliable and has quality stock if you wish buy on line.

HOW THE PILL WORKS - The film window is a bit small but there is a zoom button and the option of watching another film on how the female reproductive cycle works too. Just click on the picture when you get to the site.

For detailed information on use and side effects of oral contraceptive pills, here are some popular brands :

ALESSE, DESOGEN, LEVLEN, MIRCETTE, OVRAL and ORTHO TRI-CYCLEN

The very mention of the Dalkon shield contraceptive device sent shudders through the women of America in the 1970’s. At that time, 12 deaths occurred as a result of miscarriage related infections associated with the use of this female contraceptive. Consequently this particular contraceptive was taken off the market in 1975.

Today, that model of contraceptive is widely acknowledged to have had a flawed design, being a multifilament string that served as a channel for infection to a woman’s uterus. Infection could lead to diseases of the pelvic area, infertility and in the worst cases, to the septic miscarriages that first sparked panic.

What is an IUD? An Intra Uterine Device or IUD is a small, plastic or metal/copper device inserted into the uterus that provides years of protection against pregnancy, primarily by interfering with sperm and eggs. For types, use, pros and cons see this easy to follow Handout

Today’s IUDs are one of the most popular types of contraceptive in use and are effective from the time of insertion. Only three IUDs are available in the United States: —the Copper-T 380A (also known as the ParaGard), the Progestasert and a newer one called the Mirena (introduced in the United States in 2001) Effective for a full five years, the Mirena releases a tiny daily amount of levonorgestrel, a hormone similar to progesterone.
No women have died after an IUD ­related miscarriage since 1977 but if a woman has an STD, such as chlamydia, at the time of the insertion of the IUD or soon after, even with the today’s improved design she may be at a higher risk of miscarriage than a nonuser and she may also tend to get more vaginal infections and inflammation of the cervix (cervicitis) .

Neither copper nor hormonal IUDs will protect you against sexually transmitted diseases so please use a condom and spermicide as ‘backup’ if you have more than one sexual partner.

The scientific consensus is that an IUD is safe - even for single women and women who have never given birth (presuming they do not have an active STI at or near the time of insertion). Insertion for women who have never given birth can be a little more difficult though and sometimes the contraceptive device can be more easily expelled so extra vigilance is recommended. If you know that you will constantly be at risk of catching an STI you should NOT have this type of contraceptive fitted.

Use of this type of contraceptive should be discussed with your doctor . The life span (5-10 years ) alone is an important factor for young women to talk about if they wish to have a family at some future date - the IUD does not affect your ability to have children once it is removed- pelvic infections can lead to infertility. For women who have finished having children, this method of contraception may be the answer.
PS. If you are currently using a contraceptive IUD and you think you may be pregnant see your doctor as soon as possible to rule out an ectopic (outside the uterus) pregnancy and have the IUD removed to avoid any risk of a miscarriage.

Future posts on this type of contraceptive and its fitting/insertion will also review the differences between copper IUDs and hormonal IUDs.

Popularity Disparity: Attitudes About the IUD in Europe and the United States

Do you know how spermicides work?

Spermicides kill sperm. A spermicide is a chemical that can be used alone (high failure rate!) but is usually used with diaphragms, cervical caps and condoms. This type of chemical contraceptive can be used without involving a man as it is placed high up inside the vagina, near the cervix. No prescription is required. Spermicides are available over the counter at supermarkets, pharmacies and convenience stores.

Continuing with the ‘How To’ series on the basics of using contraceptives, here is another doctor’s patient handout, this one contains tips for using spermicides. You will find facts about effectiveness, use, the different types of spermicides and information about side effects.
Please also read my earlier post about the warning related to Nonoxynol 9.

If you are using an oral contraceptive pill, hormone injection, implants or an IUD (intra uterine device) for your method of birth control and have found some changes in your menstrual bleeding patterns, this useful patient handout may reassure you. It explains some of the ways in which different contraceptives can affect your menstrual cycle and when you should consult your doctor. Usually no action is needed but being informed often allays unnecessary fears.

Most menstrual bleeding changes while using contraceptives are to be expected and are not harmful.

The handout also explains about breakthrough bleeding or spotting between periods.

If you have concerns about your menstrual changes with your contraceptive, don’t
stop using it without talking to your clinician. Often nothing is needed but your health care provider can assess the situation and provide treatment if necessary. Some clinicians suggest using a menstrual diary or calendar to record menstrual changes so that you can have an objective record. The diary will help you remember what changes have occurred so you can tell your clinician.

If you need a reminder about where the menstrual bleeding comes from each month this video will explain.

Using barrier contraceptives? Are you spinning your cap, girls? Yes, you need to do this to improve the seal but if you don’t know what this means read carefully through this simple fact sheet on How to use Contraceptives properly- this time we review the Cervical Cap.

Similar to the diaphragm, the cervical cap is also made of latex rubber and covers the cervix (neck of the womb). Like the diaphragm and the condom, this is a ‘barrier’ method of birth control which works by stopping those little swimmers from entering the vagina and swimming off in search of that egg. Spermicides are used with cervical caps - these are chemicals that kill sperm on contact. If you use Nonoxynol 9 please read this warning, you may wish to change brands!

No hormones so no side effects- this is one benefit of using this particular contraceptive, unless you are allergic to spermicides or latex as some people are. Women who cannot use a diaphragm (those with uterine prolapse or vaginal relaxation) often find the cervical cap does the job nicely.

You do need to be fitted for a cervical cap as they come in four different sizes and then refitted again if you have a baby. If used correctly and consistently, this type of barrier contraceptive is effective though the success rate is not as high as hormonal contraceptives.

The handout shows clear diagrams for insertion of the cap and correct placement over the cervix. Risks and benefits are included alongside care and storage tips so if you are using this type of contraceptive or considering an option to your diaphragm please make sure you read through the details HERE.

Using contraceptives for the first time can be daunting and stressful. Before you rush out for those contraceptives ask yourself “Am I really ready for sex?” You only lose your virginity once.
Running through these few questions with a simple YES or NO answer may help you to be really sure:

• Is someone putting the hard word on you to have sex, especially your boyfriend?

• Do you want to have sex before marriage or before living with someone?

• Are you forcing the sex issue with your partner?

• Do you know the person you are considering having sex with really, really well?

• Are you absolutely certain that your intended sex partner doesn’t have (or has never had) a sexually transmitted disease (STD), or even HIV/AIDS? No it won’t just ‘go away’.

• Are you sure that YOU don’t have an STD that you could pass on? Almost 30% of sexually active teens contracted a new STD within a mere six months, even among condom users (Archives of Pediatrics and Adolescent Medicine, Sept 1995)

• If this relationship does not last, will I be glad that I had sex with this person?

• If I do get pregnant, (it only takes one sperm!) am I ready to be a single parent and can I afford it on my own?

• If I can’t face becoming pregnant right now, can I go through with an abortion or give my baby up for adoption?

Any ‘NO’s in there? Or maybe you have doubts about continuing to be sexually active? If so, stand tall and take charge of your life at this point. It is responsible and sensible to wait till the timing is better for YOU. Just because ‘you’ve done it a few times already’ doesn’t mean you can’t stop for a while now (hopefully you aren’t pregnant yet and you don’t have an STD)

If you have been sexually active, just pop into a clinic and get checked out. There are plenty of places and people to talk to these days if you are confused about your relationship or sexual habits.

Trust your intuition- if it doesn’t feel right- it ISN”T- you don’t have to know why in your head.

Abstinence is practised by some young people so the use of contraceptives is not an issue for them yet ( if you want to try it- make it easier for yourself by avoiding situations where your hormones are at an unfair disadvantage, like the back seat of a car or a bedroom at a friend’s party!)

“But we don’t go all the way”

If you are having oral sex you can catch an STD.
If you are engaging in mutual masturbation, sperm from hands can get into the vagina then they swim like hell so you CAN get preggers this way AND the little devils can get through clothing too,
that’s why condoms are made of non porous, non woven material!
If you think anal sex is safe- guess what? Those little spermies can spill over into your vagina then off they swim in search of your egg. These and other similar practices mean you ARE having sex so don’t kid yourself that you’re abstaining! You are also still at risk of pregnancy and/or sexually transmitted diseases.

If he is ‘putting it in’ halfway, pulling out before ejaculating or even if you are letting him ‘put it in’ for a second- you are having sex and you can get pregnant or catch a disease that, if untreated, could cause permanent damage to your reproductive system or even death in severe cases.

If you are absolutely determined to have sex, then find out all you can about birth control options and please BE SMART - not reckless with your sexual habits.
Dying of AIDS can be agonising and bringing up a child alone is a huge responsibility.

If you wish to use an oral contraceptive pill (such as Alesse, Desogen, Levlen, Mircette, Ortho Tricyclen or Ovral) as well as condoms, (because if it’s not on, ‘it’s not on!’ right?) then please read the information about the various types and their side effects (see sidebar headings on the RHS of this site) before discussing what’s best for YOU with your doctor.

Knowledge is power- ASK QUESTIONS and don’t be intimidated, it’s your body and you’re the one who will have to cop the consequences of your decisions, possibly for the rest of your life.

When the time is right- enjoying a great sex life with a great partner is wonderful but…you are a goddess- be smart, be safe and be choosy! Here are 3 easy to read books for more help.

Continuing the series on ‘How to use’ different types of contraceptives, today is the guy’s turn and we’ll start with an obvious one, the condom. You may think that there is not much to learn about condoms, girls, - you wish ‘he’ would use one without being reminded, you know what they are for, that they are easily available, that you can blow them up like balloons and that if they tear or slip off, oops- your health and entire future could be affected! OK but there’s a lot more to condoms than this.

Do you know?

• which type of condom to use if your partner is allergic to latex
• which condom is best-one with/without a nipple at the end
• is it OK to use petroleum jelly as a lubricant with latex condoms
• that your wallet is NOT a good place to carry condoms

Sexually Active Guys and Gals should carry condoms - if they are used correctly, one of the most important things about condoms is that they provide good protection against STD’s. I know you’ve heard it all before but it IS important for you to talk to your partner and have a birth control PLAN, which may mean using more than one type of contraceptive. Agreeing to a contraceptive solution that is workable for both of you will enrich those spontaneous moments and reduce the worry of ‘catching something’!

There is a short video in the videos category on this site too, on how to a put a condom on but first, here is the link to some clear instructions and dias. on How To Use a Condom and please read the warnings on this site about using Nonoxynol-9 as a lubricant with condoms or other contraceptives.

I think the best and most reliable site for more information and for buying condoms and other ‘goodies’ on line is Condom Man

If you are looking for a fascinating bedtime read with a difference, check out Andrea Tone’s book, Devices and Desires: A History of Contraceptives in America and you’ll be riveted by some amazing facts on early types of contraceptives and their use.

Did you know, for instance that:

• condoms were first invented by a down-and-out sausage-casing worker who turned surplus animal intestines into a million-dollar condom enterprise?
• inventors fashioned cervical caps out of watch springs
• a mother of six kissed photographs of the inventor of the Pill

The book begins with the criminalization of the birth control business and ends with today’s contraceptives, (including Depo-Provera and Norplant). Andrea looks at the benefits of chemical prophylaxes kits for World War I soldiers, the Lysol antiseptic douche and the disastrous 1973 Dalkon Shield.

I found this interesting review for Devices and Desires: A History of Contraceptives in America

Andrea Tone provides valuable new insights into what it was like to make, sell, buy, and use contraceptives in a period when contraception developed from an illicit trade to a big business. Her account challenges the conventional view that contraceptive history is a tale of progress in which bad, over-the-counter, contraceptives were replaced by good, medically prescribed methods.”
–Carole R. McCann, author of Birth Control Politics in the United States, 1916-1945
With a few surprises tucked in here and there, the book is fun to read and takes us on a journey from an illicit trade located in basement workshops and pornography outlets to one of the most successful legitimate businesses in American history.

Author
Andrea Tone, an associate professor of history at the Georgia Institute of Technology, is the author of The Business of Benevolence and the editor of Controlling Reproduction: An American History.