Dear Emily,

Please accept my deepest apology for this delayed reply to your email query. I have been o/seas and out of ‘the online ether’ for a while, attending to family affairs in the UK.

You have probaly solved your problem by now but FYI I thought I would pass on information that you may find helpful for future reference. There seems to be a link between types of synthetic progesterone in different BC pills and the various reactions women have. Every woman responds differently to the progestin dose and strength or androgenicity (male hormone effect),

Many women love Yaz/Yasmin because of its reduced side effects (its progestin type has anti water retention properties, hence less apparent weight gain) but everyone’s metabolism and medical history is unique so despite the brand name of a BC pill, the same pill can affect diffent women in different ways. It is a case of trial (approx. 3 months) and error I’m afraid and sadly for those women with a tendency to blood clotting, gall bladder weakness/disease, acne and other conditions, taking an oral contraceptive cocktail can result in a bad outcome. Careful screening and consultation with a doctor is really the only way to find compatible and effective options for birth control.

Have you considered hormone free alternatives such as an IUD ? Condoms still need to protect you from STIs as you know.

In regard to minimising weight gain, the pills with the lowest estrogen and progestin strength are usually recommended so this is probably why your doctor suggested Yaz. Alesse is another popular low dose pill.

In relation to minimising acne, if you are prone to this condition, the pills higher in estrogen and lower in androgen strength are recommended. These include: Yasmin, Ortho Tri-Cyclen and Mircette (see appropriate pages here)

I wish you the best of luck in your trials and well done for researching as much as you can. Don’t let anyone intimidate you for asking questions!

Kind regards carole

Dear Denny,
I understand your challenges with all these issues (I am no longer the owner of a uterus -due to large fibroids) The acne is a very visible and distressing problem that needs dealing with asap but you’re probably worried that fibroids complicate your birth control issue if you use hormones. Fibroids are rich in estrogen receptors and so react to hormones estrogen and progesterone, which is why symptoms often disappear at menopause. Taking high doses of estrogen could make your fibroids grow but there is no evidence that the low doses in any form do. However, if I were you, I would get my hormone levels checked out first (urine, blood or saliva test, easy) A 3-4 month trial with any low dose BCP that suits your metabolism could be combined with a check to see if your fibroids increae in size. It’s likely that they won’t and it’s likely that your acne will be reduced too. If you prefer natural approaches try eating more whole grains and beans - which are said to change the body’s estrogen/progesterone ratio for the better and shrink fibroids.

Are you taking any antifibrinolytic medicines (which help blood to clot)? If so you should NOT use other hormonal contraceptives like Depo shots, implants, vaginal ring or BCPs without approval from your doctor as this could increase your risk of blood clots, stroke or even heart attack. I would not be recommending an IUD in your case (possible bleeding problems aggravated) Are you squeamish about using a diaphragm as an alternative to condoms, it’s not quite as reliable though and may be less so if your fibroid is pressing down on your vagina and distorting it?

If your fibroids are severe, there are now several options for treating fibroids, including hysteroscopic resection, uterine embolization, myomectomy and suprecervical hysterectomy but hang on to your ovaries if you can. If you do not want children, ever, Essure is a birth control method that would give you a permanent solution but it won’t do a thing for your acne or your fibroids.

Your decision may be to avoid all types of hormonal birth control and deal with the acne via consultation with a dermatolgist, Denny, it does sound chronic and it may be a big ask to expect a low dose birth control method to clear it up completely which is why I am reluctant to suggest any brand in particular. Good luck, best wishes to you.

Dear Brandy,

I sympathise with your situation, watching your daughter go through this is awful and taking that step to put her on the pill is also a milestone in her life that can attract its own issues. It sounds as though you have tried everything else to relieve your daughter’s cramps and acne and that the ‘pill’ is your last resort. If you have talked to your doctor about this I bet the pill has been one of the first solutions suggested. I understand your reluctance to start your daughter on synthetic hormones at her age though. Many young girls rave about Yasmin for acne and other pills work for many too.

What you eat also affects your skin and diet can be just as sensitive a topic with a teenager as the appearance of their skin. Can you persevere a bit longer with treating two conditions separately while a young body adjusts itself to womanhood?

Dysmenorrhea (the technical name for severe period cramps) is a separate issue from acne, a low dose birth control pill often solves both problems it’s true. If it was my daughter, I would explore every other option before putting her on the pill, which is a mix of artificial hormones that may have its own side effects.

Pain is a sign that something in your daughter’s body is out of balance, no prizes for guessing at her age, that its’ probably her hormones and the fact that she now also ovulating regularly. The earlier periods start, the more common the pain seems to be. Suppressing ovulation with the ‘pill’ can relieve this pain and reduce acne.

Pain killers such as Nurofen may work better than panadol for this type of pain as they stop/reduce the release of prostaglandins, hormones used by the uterus as it contracts to expel its lining.

Natural medicines work really well to correct imbalances in our bodies, they find the CAUSE and address it. If you are open to finding a good naturopath you may be surprised at the results and it may buy your daughter more time off the pill. You’ll have peace of mind that you did try alternatives first.

If nothing works after all this, a low dose birth control pill will probably be recommended by your doctor but again she will go through a period of trial and error until she finds one that suits her metabolism.

Topical acne treatments should be well researched if your doctor has not prescribed a suitable one as many over the counter products can strip oils from the skin causing the glands to secrete even MORE oil to harbour dirt and bacteria and keep the cycle going. Teenagers will do ANYTHING to get rid of those spots and are very vulnerable consumers.

It’s tough growing up but use this ‘opportunity’ to be a ‘good friend’ and talk through all the options with your daughter without any judgement about the ‘pill’ and its implications. This will stand both of you in good stead for those ‘puberty blue’ years ahead of you and lay the foundation for open dialogue between you on your daughter’s sexual health issues.

All the very best Brandy, your daughter is fortunate to have such a caring mum who is willing to get on board and help her,

Thank you for your enquiry

You do not state your age or whether or not acne is also a problem for you so as you have commented under this post perhaps Yasmin may be a pill you could trial initially? A doctor will advise you once your medical history has been determined so do not be afraid to ask.

BUT- If you are looking for long term contraception only or have decided NOT to get pregnant again during your reproductive life, please talk to a health professional about alternatives to a contraception pill such an IUD, an implant or an injection (Depo shot lasts 3 months). You may have ruled one of these out already if you are uncomfortable about the ‘process’ of administration but you can’t beat a face to face conversation with someone who cananswer your specific questions and assess your personal circumstances. These birth control options mentioned will not, however, protect you from sexually transmitted diseases but if you are now with one sex partner and intend to remain with him, this may not be an issue for you. If you intend to have multiple sex partners a condom can be used as well.

The IUD and implant will prevent pregnancy for several years and both have a high success rate. Once fitted you can ‘forget’ these types of contraceptive as they just keep on working without you having to remember to do anything more until you wish to become pregnant or have emerged from menopause!

If you choose an injection, this will have to be administered every 3 months, which is not as often as remembering to take a pill every day and there is less risk of ‘missing’ a pill. There are too many warnings surrounding the ‘patch’ for me to encourage you to consider this particular method of contraception. Good Luck and let me know how you get on.