Contraceptives

2010 will be the 4th year for celebrating World Contraception Day.  September 26th is the day when I encourage you to overcome any embarrassment you may feel and find someone you trust to talk to about your birth control and sexual health.

Well done if you have so far eluded a dose of Chlamydia. On September 26th 2010, World Contraception Day,  make a resolution to ’stay clean’. It doesn’t matter who you are, you must protect yourself from STIs and if you are not ready to take responsibility for bringing up another human being, find someone you feel comfortable with and seriously focus on giving your ‘contraception career’ a thorough health check.

Ask yourself :

• do I have unprotected sex?
• do I talk to my sexual partner about birth control?
• do I know how reliable my method of birth control really is?
• do I believe that ‘withdrawal’ is an effective method of birth control?

It’s never too late to take control. You are being responsible, not promiscuous, in talking about sex. Don’t rely on guesswork or on the potentially inaccurate information from your mates. You will be amazed at the wealth of new facts you will uncover by taking time out to review all your birth control options.  Make World Contraception Day the date on your calendar when you take at least one step forward in managing your ‘contraception career’.

Make another resolution on September 26th 2010 that when you are ready to have a family of your own, YOUR baby will be  well planned and welcomed.

Have the courage to be a leader on World Contraception Day- September 26th 2010 -  talk to someone about low dose birth control, free condom suppliers, emergency contraception or whatever bothers you about sex -  then show your friends how they can do the same. Be be a heroine for a day..

Looking for some safe sex gift ideas?

The latest emergency contraceptive pill, ellaOne has been available on prescription in Europe and the Uk for almost a year. There is still much data to be collected on the safety of ellaOne yet so don’t rush to abandon current emergency contraceptives on the market or think them to be less effective. I have found no evidence which states that this emergency pill is better than the current ones and ellaOne is more expensive. The main point to remember is if you need emergency contraception- ACT AS QUICKLY AS POSSIBLE’.

Anyway, it helps to know what is being stated about ellaOne so here it is:

• emergency contraceptive for occasional use only and not more then once per cycle
• prevents pregnancy up to 5 days after intercourse by preventing or delaying ovulation
• can be taken at any time during your cycle
• if you vomit within 3 hrs of taking ellaOne, take another one
• you can continue your usual hormonal or oral contraceptive after taking ellaOne but since ellaOne may make your regular birth control pill less effective, make sure that you keep using a condom/barrier birth control until your next period
• ellaOne should not be used together with emergency contraceptives containing levonorgestrel such as Plan B One-Step, Next Choice, I Pill, (or doses of Alesse, Levlen, used for emergency contraception)
• it appears that to date, there is a failure rate of 2%
• take a pregnancy test  before using ellaOne if you think you may pregnant
• if you are breastfeeding- feed before taking ellaOne then express enough milk for 36 hours after taking ella One
• ellaOne will not protect you against HIV infection (AIDS) or any other sexually transmitted diseases

Some medications can make ellaOne LESS effective, these include:phenytoin, phenobarbital, carbamazepine ( for treating epilepsy), ritonavir (for treating HIV), rifampicin,(for treating bacterial infections) St.John’s Wort (for treating depression), Omeprazole (for treating stomach ulcers)

Possible side effects - for common, uncommon and rare side effects and further information, - go HERE

Concerns - there is still much monitoring and investigation to be done with this pill, even though the ‘powers that be’ have determined that the benefits outweigh the risks (!!) As with all drugs, think carefully before using it

• could this drug affect the babies of women who become pregnant after taking it?
• are there any possible cancer links?
• if this drug is taken several times during a cycle, or in combination with another emergency contraceptive pill, what would happen (human nature being what it is, we often ignore warnings on the packet)?

The term ‘the morning after pill’ is misleading - implantation occurs about 7 days after fertilisation so you don’t have to take an emergency birth control pill the morning after intercourse for it to work. It is advisable to take an emergency contraceptive pill as soon as possible after intercourse because ALL emergency contracepive pills begin to lose their ability to prevent pregnancy the longer you wait to take them. You have a window of around 72 hours with most brands, (even with ellaOne, I suggest that you do not wait the full 5 days before taking it). If you suffer from asthma let your health professional know.

I’ll post further information on this new emergency contraceptive as it comes to light.

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Is my brand of low dose birth control pill causing my acne? I have been asked this several times so here is an oversimplified answer and explanation which I hope will shed light on this issue and help those of you for whom this is a real problem.

All birth control pills are not equal even though 98% of pills prescribed today are low dose ones. As you know, there are low dose birth control pills that contain a combination of 2 types of synthetic hormones, estrogen and progestin and pills that contain only PROGESTIN (often called the mini pill)

The synthetic estrogen in all birth control pills is of the same type (ethinyl estradiol) so it’s easy to compare doses across brands of BC pills. UPDATE to this post 2011  On May 6, 2010 the Food and Drug Administration approved Natazia as the first ever birth control pill to use estradiol valerate in the United States.

The TYPE and strength (potency) of synthetic progestin varies across brands of birth control pills.

There are 8 types of progestin which vary in strength so 2 diffent brands of pill can appear to contain the same dosage of progestin but if they contain different TYPES of progestin, the strength of the dose will vary and so may the effect it has on your body. Stay with me here because this is where acne enters the picture.

Progestin in a birth control pill helps to prevent ovulation but it can also increase ‘androgenic activity’ which in turn can encourage the devlopment of acne and other side effects reflective of male characteristics.

What is androgenic activity?

Androgenic ( ‘andros’ meaning man + genein meaning to produce). Androgenic activity begins in puberty, when androgen (male hormone) is produced by the testes (between 12 and 14 yrs in men) and the adrenal glands. Both men and women produce androgens and androgenic activity can be higher in some women than others, resulting in side effects such as excessive body hair and other male characteristics, including acne.

So depending on the type of progestin in my birth control pill, my acne could get worse? This is a possibility if your adrenal glands are producing a higher than normal level of androgen. Combine this tendency with a low dose birth control pill high in androgenicity and you can see the consideration needed as to which brand of birth control pill will suit you best. If your low dose birth control pill is one that contains a type of progestin with high androgenic activity and a low estrogen content you may wish to ask your doctor about switching to a pill with a lower androgenic activity and a higher estrogen content. I bet that will impress! Talk to a health care professional if you think your type of acne is hormonal, since a change of birth control pill may only be part of a combined treatment type of treatment for you. You may be prescribed anti -androgen drugs to reduce oil production so it’s vital that if you also prefer to use oral contraceptives as your birth control that you let your doctor ‘mix the cocktail’ for you. Examples of pills that may make your acne worse would be those at the bottom of the list below but I stress that these brands DO NOT cause acne in women with normal levels of androgen.

Low dose birth control pills with a low androgenic activity and a higher doses of estrogen help to reduce the side effects related to androgenic activity. What the effect may be on blood clots, we have yet to discover. It is swings and roundabouts and the merry - go -round of trialing low dose birth control pills can be a test of endurance.

Yaz/Yasmin

Low dose birth control pills such as Yaz/Yasmin contain a unique type of progestin (drospirenone) to all the others and also has low androgenic activity in the body which probably accounts for this brand’s popularity and success with many acne sufferers.

Low dose birth control pills listed according to androgenic activity (low to high)

A. Androgen activity based on Methytestosterone mg/28 days

B. Ortho Tri-Cyclen (Norgestimate): 0.15 and Mircette (0.15 Desogestrel) Levlen (0.15 Levonorgestrel)

C. Ortho-Cept or Desogen (Desogestrel): 0.17

D. Modicon (Norethindrone): 0.17

E. Ortho-Cyclen (Norgestimate): 0.18

F. Demulen 1/35 (Ethynodiol Diacetate): 0.21

G. Ortho-Novum 777 (Norethindrone): 0.25

H. Triphasil (Levonorgestrel): 0.29

I. Alesse (Levonorgestrel): 0.31

J. Ortho-Novum 1/35 (Norethindrone): 0.34

K. Nordette (Levonorgestrel): 0.46L. Lo-Ovral (Norgestrel): 0.46

M. Estrostep (Norethindrone Acetate): 0.53

N. Loestrin 1/20 (Norethindrone Acetate): 0.53

O. Loestrin 1.5/30 (Norethindrone Acetate): 0.80

Be aware that if you also have an issue with weight gain or suffer from other medical conditions such as endometriosis for instance, this will most likely have been taken into consideration when your doctor prescribed the type of progestin that would be most suitable for you. I hope that understanding the link between progestins, androgen activity and acne will help you to manage your low dose birth control much better. Hormonal birth control does not have to be part of everyone’s contraceptive career, however, so don’t be afraid to explore something different, ask lots of questions and be optimistic about finding the right solution for YOU. Hormones are not to messed with so a DIY approach to treating your acne just by changing your low dose birth control is not a good idea- talk to your doctor.

References:A. Cerel-Suhl (1999) Am Fam Physician 60(7):2073B. Speroff (1993) Obstet Gynecol 81:1034 C. Dickey (1998) Managing Contraceptive Pill Patients

Frederick R. Jelovsek MD, MS

http://www.fpnotebook.com/Gyn/Pharm/PrgstnAndrgncActvty.htm

You cannot buy it yet but if the next phase of trials is successful, you may soon be able to forsake your low dose birth control in favor of a no dose birth control. A NON HORMONAL intravaginal ring may soon be available to women. 3 months of ‘Guinea pig’ scuttling from one brand of oral contraceptive to another and coping with side effects from synthetic hormone absorption may be a thing of the past if a new barrier contraceptive device proves itself.

OVAPRENE is the name of this non hormonal contraceptive ring by Ovatech, a women’s health-focused company that has just announced a successful completion to a Phase 2 clinical study with 85 women. Apparent bonuses with this ring, apart from the obvious ones, are that ‘one size fits all’ and once inserted, it contraceptive effect lasts for 4 weeks. Maybe the only slightly tricky part is that you have to insert it at the end of your period and remove it at the start of your next period. The ring can be left in place after sexual intercourse. How does the ring work?Ovaprene is made from organic silicone and continuously releases a non drug substance which kills sperm and virtually paralyzes the energetic attempts of the rest so they can’t move! Once correctly inserted, the ring is safe for both sexual partners during sexual activity.Is it tolerated by men too?Of course the issue of tolerance is there, as with all things foreign to the body but so far the trials indicate that the non hormonal ring is well tolerated by both women and men. While it’s always good to discuss birth control with your partner, you don’t need their approval or participation to use this female controlled contraceptive barrier device.

 “Ovaprene is designed to be a whole new paradigm for birth control,” said John A. Williams, President and CEO of Ovatech. “We look forward to starting our Phase 3 pivotal trial as soon as possible.”

We shall be following your progress with interest and anticipation John, in the meantime lassies, keep safe Undercover Condoms Sales - Click here to view this month’s sale

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