Contraceptives

Do you participate in one of today’s highest risk activities- taking oral contraceptive pills and smoking, especially if you are over 35 years of age, babies are off the agenda but you enjoy a great sex life AND your ciggies?

Why does your heart beat faster and faster? Why do your blood vessels get narrower?

We all know that smoking is bad for your lungs and can cause cancer and it is also a fact that taking contraceptive pills and smoking does place women at a much higher risk of developing heart disease or having a stroke than taking oral contraceptive pills and NOT smoking. So, yes, smoking is the major villain here and in case you didn’t come top of the class in Health Ed. but you’re still a little bit interested in what happens inside your circulatory system (the arteries and veins that carry the blood throughout the body) when you smoke, take a look HERE at this easy to read explanation from JAMA (Journal of the American Medical Assocn). If you do, you’ll feel like a ‘know it all’ and and I’ll feel better that I gave you the option as ‘back up’ to your ‘contraception education’.

I have never smoked so it’s easy for me to recommend which activity to give up if you love your baby free, happy sex life and are up for a challenge - maybe after reading the JAMA page you’ll learn to love your throbbing pink circulatory system more than those deathly white cancer sticks (ouch) Contraceptive pills and smoking just ain’t good bedfellows!

Low Dose Birth Control Pills Minimize Side Effects

Today’s oral contraceptive pills,  called ‘new generation contraceptives’,  contain much lower doses of synthetic hormones than in the 1960’s when ‘The PILL’  (with 50 micrograms of estrogen) first went onto the market. “So how does that benefit me?”, you may be saying to yourself - here’s some information about low dose oral contraceptive pills that may help you to talk to your doctor if you’re not happy with the oral contraceptive that you are currently taking.

Trial and error with different pill types is likely to be ahead of you -bearing in mind that oral contraceptives are still not the perfect method of birth control for everyone. If you are on the ‘right pill’ to suit your body, you should feel exactly the same way as you do normally, if not a little better. Some women cannot tolerate the estrogen in combined oral contraceptive pills so are prescribed progestin only pills.  Estrogen seemed to be the main culprit where side effects were to blame so low dose  birth control pills were developed to minimise these.

Changing hormone levels within your body can result in side effects which vary for every individual. Keeping hormones at  a consistent level in your body is the job of an oral contraceptive so that you do not ovulate, your uterine lining thins and your cervical mucous thickens. These three events work together to prevent pregnancy.

Pills such as ALESSE and MIRCETTE are called ultra low dose birth control pills as they contain only 20mcg of estrogen. These oral contraceptives are effective at preventing pregnancy but some women find that they have more spotting and breakthrough bleeding with them than with pills containing 30 or 35 micrograms (considered the norm today) of estrogen. Spotting and breakthrough bleeding often disappear after a few months on a low dose birth control pill.

Women who prefer ALESSE and MIRCETTE say they reduce headaches, mood swings, breast tenderness and bloating. These two brands also may be better for ‘first timer pill users’ as a ‘low estrogen start’ to introducing synthetic hormones into their bodies.

Progestin only pills or ‘mini pills’

These oral contraceptives are 90-95% effective at preventing pregnancy compared to the 99% efficacy rate of combination pills.  However,  they do not cause the common side effects of estrogen pills such as nausea, breast tenderness and cramps. The risk of developing deep vein thrombosis and cardiovascular disease is lower with progestin only pills. Nursing mothers can use progestin only pills a few weeks after giving birth as progestin does not affect milk supply like estrogen does. ‘Mini pills’ must be taken every day at the same time with no break.  If you miss just one pill or take it more than three hours past the regular time, you need to use a backup method of birth control for 48 hours after taking the late pill.

Disadvantage of the ‘mini pill’ - apart from irregular spotting and breakthrough bleeding, is that it can increase the risk of ovarian cysts and ectopic pregnancy.

Latest Update

Low-dose birth control pills may increase risk for heart attack or stroke, especially in women who suffer from polycystic ovary syndrome (PCOS) or metabolic disorder. However, this risk disappears when you stop taking the pill (according to a Virginia Commonwealth University study published in the July issue of the Journal of Clinical Endocrinology and Metabolism).

PCOS is a condition that can affect a woman’s menstrual cycle, fertility, hormones, insulin production, heart, blood vessels and appearance.

“Despite the doubling of risk associated with the pill, the absolute risk for a cardiovascular event in an individual woman taking the pill is low - Women using the pill are not going to automatically have a heart attack,” states John Nestler, M.D., professor and chair of the Division of Endocrinology and Metabolism in the VCU School of Medicine. “However, our findings do raise the issue of whether oral contraceptives are optimal therapy for certain groups of women who are at baseline risk or who are taking the pill for a longer time, such as women with PCOS.”   Source: http://www.medicalnewstoday.com

So if you don’t have PCOS and you think a low dose birth control pill may suit you better, read more about Alesse and Mircette before asking your doctor which brand would ’suit’ your own medical history. Don’t forget to tell him/her which other medications you are also taking. The suppliers I have recommended on line are accredited and also offer the best prices.

Sources: Centers for Disease Control and Prevention, Dr. Elizabeth Silverman,  obstetrician-gynecologist at Scripps Memorial Hospital in La Jolla. Dr. Pamela Deak, obstetrician-gynecologist at the University of California San Diego Medical Center.

It’s a good idea to start your ‘contraception career’ with a hormone check up first so that you and importantly, the person who will write your contraceptive pill prescription, knows exactly what state your body and its hormones are in. I thought I’d pass on this information from a doctor’s newsletter I subscribe to (link to Dr. Pete below) as it is relevant to anyone who is thinking of taking oral contraceptives AND also to those who aren’t.

OK. Let’s say you are NOT on the pill- if you suffer from painful, heavy or irregular periods, irritability and mood changes, (yes, I did say NOT on the pill!) poor memory, fatigue, lack of motivation, craving sugar and chocolate, fluid retention, bloating, night sweats, hot flushes,… it could be that your hormones are out of balance. If you haven’t seen a health professional about these symptoms maybe you should- especially if want to use any type of hormonal contraceptive.

Many of us know first hand the impact that a hormone imbalance can have on every breathing moment of your waking life AND how it is maddeningly and frustratingly underestimated by ‘himself’ and the kids! Taking oral contraceptives and hormonal replacement therapy (HRT) can be beneficial in adjusting hormone levels and reducing symptoms. However, some women find that they then replace one set of side effects with another so getting a hormone check before you start down that path will place you and your doctor in a position to make the most sensible and appropriate choice to trial first.

The ingredients (synthetic hormones) in contraceptive pills are often prescribed to alleviate painful periods and other symptoms rather than to prevent pregnancy. We in the western world are having fewer children on average and experiencing approximately 400 periods during our reproductive life. Even if we only have one painful day each cycle (you wish!) that equates to an average of 400 days, or more than ONE YEAR OF PAIN. According to Dr. Pete, if you accept that 90% of women experience period pain, this has the potential to create a significant health
and socioeconomic issue.

IN SUMMARY Dr.Pete states:

Hormone Imbalance causes:Period Pain, Premenstrual Syndrome, Endometriosis, Fibroids, Poly Cystic Ovarian Syndrome (PCOS) and Menopause.

What Interferes with Hormone Balance?

• “oestrogen dominance”, associate with fertility problems- this is where high or relatively high (compared to progesterone) levels of oestrogen

activity cause increased tissue activity in oestrogen-sensitive tissues, such as the lining of the uterus, ovaries and breasts

• poor liver detoxification, which is often due to allergies, food intolerances or toxins, results in a build up of harmful oestrogen break down

products

• many environmental chemicals such as pesticides

Get to know your hormones and hopefully they’ll behave themselves for many years - Having a check up at the doc’s could save you a few prescription ’swaps’ in the long run and help you to successfully manage those controlling little juices.

If you would like to join Dr. Pete’s newsletter here is the LINK

The first oral contraceptives on the market contained much higher doses of hormones than those prescribed today and weight gain and fluid retention are two ‘associated ’side effects’ that seem to have lingered on. An average of five pounds gain in weight was estimated to be the result of taking oral contraceptives. Studies have concluded that overall, today’s low dose oral contraceptives do not cause weight gain. Before you jump up and down with a ‘Look at me, I’ve gained 2 kgs!’, it is a fact that those women who got nauseous on the pill actually LOST just as much weight

as others (who didn’t get nauseous) gained. However, there will still be some women who have certain factors in their bodies that respond even to today’s low dose pills and this may account for their weight gain when they take oral contraceptive pills.

One of the active ingredients in the contraceptive pill is estrogen, which in high doses is known to cause weight gain due to fluid retention. The fluid retention in turn causes increase in salt (sodium) retention. With the lower dose pills of today, this problem has been greatly reduced.

Do oral contraceptives increase your appetite?

They could do if they raise your insulin level - known as ‘insulin resistance’. Insulin levels rise in response to
carbohydrates and drive all energy into the fat cells and essentially prevent weight loss even with dieting. Not all women are susceptible to ‘insulin resistance’, therefore not all women will gain weight when they take oral contraceptives. This ‘condition’ can be diagnosed by a doctor and if you have it- it causes your blood insulin levels to be chronically higher which stops your fat cells from giving up their energy stores to let you lose weight.

Oral contraceptives can affect your metabolism- what does this mean?

Your metabolism or metabolic rate is the rate at which your body burns the fuel (food) that you put in it to ‘run’ it and give you energy - like putting petrol into a car. Not everyone has the same ‘metabolic rate’ or ‘metabolism’ - the heavier you are, the higher is your metabolic rate.

Many women complain about gaining weight when they start taking oral contraceptives. Did you ever notice that when you weren’t on the pill you also put on extra weight in the latter half of your menstrual cycle? This is quite normal and is due to the change in hormone levels.

Other medications can also cause weight gain, including pills for depression so it can be unfair to blame only the contraceptive pill. An honest conversation with a health care provider about weight gain as a side effect of taking an oral contraceptive and maybe a change of pill type may reduce the anxiety over this sensitive ‘image’ issue.

Are oral contraceptives less effective in overweight or obese women?

Studies have found that a female with a body mass index (BMI) of 25 to 29.9 who is on oral contraceptives has a 60% greater risk of pregnancy than a woman of normal weight (BMI 18.5 to 24.9). The percentage rises to 70% if she is has a BMI of over 30. Why is this? The reason is still not clear and there are probably many reasons but it could be that since the hormones in oral contraceptives are soluble in fat, they dissolve in the fat of an overweight person rather than entering the bloodstream.

The higher metabolism of an overweight person also reduces the ‘lasting effect’ of medications.
Your liver helps to metabolise the hormones in oral contraceptives. If you are overweight, the enzymes in your liver increase so you metabolise or ‘burn’ up the hormones in oral contraceptives much faster than normal. Today’s oral contraceptive pills contain much lower doses of hormones than they used to so if you are overweight they could quickly become ‘burned’ up hence their effect in your body could be of a shorter duration and thereby increase your risk of becoming pregnant.

What can you do if you have weight gain on the pills?

Use the lowest possible estrogen containing birth control pill - this should minimize weight gain and swelling from water retention. Two of the current 20 mcgm pills which are the lowest estrogen doses available are: Alesse and Mircette.

You’re probably wondering, ‘What on earth can a cup of cottage cheese have to do with me taking oral contraceptives? If moodiness is a side effect you suffer from- you need to read this. Personally, I am not a pill popper and much prefer to use ‘natural’ products whenever possible, including good quality, non synthetic supplements that have not been tested on animals. At the end of this post I have provided some links to an on line, direct supplier for this type of supplement, this source also has natural skin care products, shampoos, weight loss products and yes, even a ‘natural libido booster’ if life is a little ‘quiet’ for you right now!

Did your doctor tell you that oral contraceptives can increase your hunger (so you eat more and gain weight!) and also that they can deplete your body of certain essential nutrients? As though refined foods and sugary treats weren’t enough!

Have you been taking an oral contraceptive for more than 7 years? If so, it is likely that you are deficient in some nutrients and should be taking a supplement. Research has shown that the B group of vitamins are the most commonly depleted nutrients when taking oral contraceptives. Vitamin B is critical to keeping your nerves healthy (hence they are often sold as executive ’stress’ vitamins)

A high-potency, B-complex vitamin (with at least 50 -100mg of B6, 1,000 meg of B12, and 800 meg of folate) should be taken alongside contraceptive pills. An increased need for vitamins C (1-3g, yes, not mg), E,(400-600 IU’s) and K may also result from the use of birth control pills- Vit C especially can help to reduce the chance of vaginal infections.

Cells that are replaced frequently, like those in the mouth and gut can become ulcerated if folate is depleted.
Folic acid is a relative of Vit B and is important for brain health as well as cell repair and development.

You may never have heard of Tyrosine but you’ve probably heard of amino acids. Tyrosine is an amino acid which has many ‘jobs’ in your body but one is to keep your thyroid healthy. Low tyrosine can also contribute to depression. Depletion of tyrosine is one of the reasons ‘the pill’ is often associated with weight gain and moodiness. AH! Is that a penny dropping? OK , next time you pop out to collect your prescription for Alesse or other oral contraceptive pill, grab a tub of cottage cheese from the supermarket as this is the highest food source of tyrosine: 1 cup provides 1.5 g. (or you can take a supplement -1.5 g daily), particularly during the second half of your menstrual cycle.

It is likely that we are all slightly short of magnesium anyway so women who take oral contraceptives can become even more depleted. deficiency often shows itself as muscle cramps, weakness, insomnia, kidney stones, bone loss, depression, nervousness, anxiety and high blood pressure. Take 500 mg at bedtime in a liquid or powdered form for easy absorption.

Copper levels in the blood may be increased by the use of oral contraceptives which can lead to depression and
emotional problems. Limit supplement to 1mg. Whole grains, nuts, seeds, and vegetables will ensure that copper requirements are met.

If you normally take an iron supplement you may not need it if you take oral contraceptives. Iron levels may increase when you are on the pill as there is often less blood loss. Iron needs are probably reduced from the usual 18 mg. to around 12-15 mg per day. However, if your periods are heavy or you have anemia then you may need a different dose of iron. Check with your doctor first.

Zinc is another essential mineral depleted by oral contraceptives and is important for wound healing and combatting depression; supplement with 20 to 50 mg daily, which will also help to reduce copper levels.
“As if I don’t have enough side effects to worry about!”- well, at least a quick blood test will show you exactly where you stand with your body’s nutrients and you never know- that tub of cottage cheese may be just the thing to banish those monthly moods!

Source: Nutrition and Vitamin Therapy, Michael Lesser, M.D

Elson M. Haas M.D. Staying Healthy with Nutrition
Better Nutrition

Here are the links to the natural products I mentioned. Be kind to your body, be kind to earth, Vegetarian, chemical free, addictive free and All Natural- what more could you want?

Multi Vitamin Supplements
Get nature’s wholesome goodness of whole food ingredients with a combination of powerful nutrients, with Life Multi Complete a multivitamin and mineral combination.

Natural Skin Care products

Libido Booster

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.