Contraceptives

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.

Save $5 off any $35 order at Pink Apple - Just for Women. Order massage oils, tampons, female supplements, pregnancy tests, and much more. Enter coupon code PINKSAVINGS in the instructions section of our order form. Offer expires 12/31/2010 and may not be combined with other deals, coupons, and specials at Pink Apple.

Despite the ill winds blowing throughout the global economy at present, lots of fresh breezes have at last rustled things up for the better on the birth control front in America.

So what’s been happening on the birth control front in the last few months?

Major changes in the US -  thanks to the new president.

Read Obama’s top 10 women’s health achievements, a real tonic,  HERE .

also:

• affordable low dose birth control is now available to college students and women on low incomes
• the FDA has approved the over the counter sale of the emergency contraceptive,  Plan B, for 17 year olds - quite rightly, it won’t be as easy as picking up a packet of aspirin though, the pharmacist will verify age prior to dispensing and also monitor the number of prescriptions filled. The pharmacist should also check for any allergies to the non medicinal ingredients in the product
• in some US states, more women are seeking permanent methods of birth control
• the ongoing recession has cost millions of people their jobs. Planned Parenthood and other family planning clinics are seeing more and more people in their waiting rooms. Generally these clinics serve young women between 18 and 24 but now older clients and many without insurance are coming in(CCMC Push journal)
•  the FDA has approved the FC2- a cheaper and improved version of the female condom that is made from synthetic rubber instead of polyurethane
• a small study out of Pittsburgh (only 70 women) may encourage further research into the effects of low dose birth control pills on suppressing the release of anabolic hormones which help build lean muscle mass
• scientists revive dormant gene to prevent HIV transmission

SO….Plan B is now accessible to 17 year olds without a prescription. 17 year olds are, in my opinion, quite capable of taking responsibility for managing their own birth control AND emergency contraception - with support.
If you are 17 years old or younger and sexually active please read on:

• Plan B is for emergency contraception ONLY and should not be used by anybody, regardless of age, as a regular form of birth control

• decide on a long term birth control plan for your own ‘contraception career’, this may mean trialling a few low dose birth control pills until you find one that suits your metabolism or exploring the option of an implant, injection or IUD

•  be brave enough to have intelligent conversations with your parents about birth control if they give you the chance-  if not, take advantage of the ongoing advice, counselling and resources available to you through Family Planning clinics or a health expert you feel comfortable with

• ‘walk in’ and get tested for STDs so you and your friends can brag about being ‘clean’

• have fun with the new female condom if he won’t use his

Plan B does not prevent sexually transmitted infections, such as HIV/AIDS but it is effective in preventing pregnancy if taken within 72 (3 days) hours of unprotected intercourse and certainly within 120 hours (5 days).
Plan B does not contain estrogen and is not a low dose contraceptive - each pill contains 0.75mg of the progestin hormone, levonorgestrel. Two pills need to be taken, each can be taken 12 hours apart or at the same time. Plan B will not interfere with an established pregnancy- it works by preventing ovulation or fertilisation. In medical terms, pregnancy begins when a fertilised egg attaches itself to the wall of the uterus.

I don’t relish advocating medication, synthetic hormones, artificial colouring, preservatives and all the other stuff that is foreign to our bodies but when it comes to assisting young people  through their sexual journey in safety, ie. without catching an STD and without getting pregnant until they are ready,  I believe a ‘duty of care’ must balance the pros and cons. Young people need all the help they can get to access appropriate birth control and to learn to use this synthetic hormone (Plan B) responsibly.

For further information on Plan B visit this earlier post.

Sincere apologies for my absence since Christmas.  Family issues both here and overseas had to take priority but hopefully I shall be able to keep you up to date with low dose birth control information at least one or twice a month from now on and I hope you all enjoyed Valentine’s Day without any ‘unwanted’ follow ups.

 Next post-  update on male contraception methods

This will be my last post before I have a break over Christmas and New year so I thought I would make it a quick ‘reference’ one that could be used in an ‘emergency’ during the holiday.

You could find  yourself in this situation

Great Christmas Eve party and Laura’s bash last night was the best ever BUT….in the cold light of day you suddenly realise that you’ve missed taking 2 low dose birth control pills in a row and you had champagne ‘Christmas’ sex both nights WITHOUT a condom. Sperm can survive up to 5 days inside you so if you have no Plan B to take, what action can you take NOW to reduce your chance of getting pregnant?

Tony Thornton, CEO of Planned Parenthood says about four low dose birth control pills will achieve the same effect as an emergency contraceptive but you should contact a pharmacist before taking more than the recommended dose of your current low dose birth control pill.

Using your low dose birth control pill for emergency contraception is the next best thing if you are really in a desperate situation so below is a dosage guide for some of the popular brands.  If your brand is not listed, check the leaflet in the pack for instructions for ‘emergency use’.   PHONE a 24 hour clinic for advice as well!

Use a barrier method for 7 days as backup protection too (ie. a male or female condom plus spermicide)   Sex without condoms is UNCOOL -  know that you are exposing yourself and your future partners to sexually transmitted diseases.  The percentage of teenagers with Chlamydia is staggeringly high so get tested, stay clean and brag about it!

If Plan B is not available to you the Food and Drug Administration has declared the following brands of low dose birth control pills to be safe and effective for emergency contraception if used in the higher doses as recommended. See RHS of this post for further information on pills mentioned:

Ovral (1 dose is 2 white pills)

Alesse (1 dose is 5 pink pills)

Levlen or Nordette (1 dose is 2 light-orange pills)

Lo/Ovral (1 dose is 4 white pills)

Tri-Levlen or Triphasil (1 dose is 4 yellow pills)

A copper IUD  will also be effective if inserted within 5 days following intercourse but this method of long term birth control should not be rushed into for emergency measures without thorough discussion with a health professional.

Check with a health professional at once if you need emergency contraception and you are breastfeeding - even though there are no actual studies to prove that hormonal contraceptives damage a baby, please be cautious with ALL medications you take. Whatever you swallow is absorbed by your body and eventually passes through your milk and reaches your baby- do you really want your baby to have to cope with huge doses of hormones, alcohol or drugs? Your baby has no ’say’ in the matter so even though you find yourself stressed in this emergency situation, put the baby first and please don’t  panic if you have to include bottle feeds for a while.

Wishing you a very safe and loving Christmas and a New Year that brings you happiness and fulfillment in all you do,

See you in January then,

Kindest regards Carole

Let’s get a few facts clear about Plan B 
Plan B is specifically intended for use by a woman after she has had unprotected intercourse, to avoid a pregnancy –this emergency contraceptive is NOT in the same category as the low dose birth control pill when it comes to the amount of synthetic hormones it delivers into your body.  Plan B delivers much higher doses of hormone than your regular, low dose birth control pill.. Sales of Plan B have soared now that it is easily available over the counter if you are over 18. While it’s good to always have a pack of Plan B in the bathroom cabinet, it should NOT be used more than twice a month and should certainly not be relied upon as your only form of continuous birth control.

Why you may need Plan B

The condom breaks, it was a drunken sex error you regret, you’ve missed a pill, you’re 2 weeks late for your depo shot or heaven forbid, you’ve been raped.  There are many reasons for avoiding an unwanted pregnancy, even though you may well get an unwanted ’something else’ (STI) if you used no condom!

Today’s low dose birth control pills contain much LESS synthetic hormone (20-35mcg) than the first birth control pills of the 1960’s which contained 150mcg of progestin.  I mention progestin and the dosage to impress upon you the HIGH DOSE of hormone you consume when you take Plan B - because Plan B contains a whopping 750mcg progestin (levonorgestrel) and there are associated side effects.  Many types of  low dose birth control pills also contain estrogen, which causes serious side effects in some women so for this reason ‘combined’ birth control pills will never be sold over the counter.

When to Take Plan B

Preferably, within 12-24 hours of sexual intercourse but Plan B is still effective if you take the first dose within 72 hours. After this time you still have the option of having an IUD fitted which will prevent  implantation of a fertilized egg ( this is an issue for those who believe this a form of abortion so counselling may be needed)

Side Effects -  nausea, abdominal pain, fatigue, headache, changes in your period, dizziness and breast tenderness. You may not get all of these but be prepared for the nausea.

If Vomiting Occurs - within one hour of taking the first dose, you may need to repeat the dose so see a doctor. You may also need some anti nausea medication although nausea is less with Plan B than with combined emergency contraception pills that contain estrogen.  Often the nausea will be mild and will disappear after a day or so, do not take more pills than recommended if you have not vomited.

Breastfeeding women can take Plan B as it only contains progestin which will not interrupt milk production

There are ‘morning after’ pills that contain estrogen, called the Yuzpe method, but these are not commonly used any more because they have more side effects and are less effective  than Plan B - (57%) compared to the levonorgestrel method (85%)

If Plan B is not available
The FDA has approved some ‘regular’ low dose birth control pills for use in higher doses as emergency contraception.  A list of these low dose birth control pills and the number of pills you need to take can be found on this earlier post. Tony Thornton, CEO of Planned Parenthood in Lubbock said about four birth control pills will achieve the same effect as an emergency contraceptive but you should contact a pharmacist before taking more than the recommended dose of your current low dose birth control pill.

More facts about Plan B.

• plan B does not protect you against STIs or HIV
• if you are already pregnant, Plan B is not an abortifacient (will not abort the fetus)
•  if your period is more than a week late, get a pregnancy test as you should not take Plan B if you are pregnant. If you experience any severe abdominal pain, you could have an ectopic pregnancy which requires immediate medical attention
• there is no need for a medical history to be taken or a physical examination to be carried out before using Plan B

Costs for birth control have risen, sadly, so check to see if you qualify for free or subsided Plan B at your nearest health care clinic or Family Planning Centre. That link again for a good video and for:  Using regular low dose birth control pills for emergency contraception

With the party season fast approaching how about being well prepared to avoid using Plan B with a collection of fun condoms on a stick?  You could go halves in the cost with a friend and hand out these attractive ‘lollipops!

People often confuse Emergency Contraception with Plan B. Plan B is a dedicated emergency contraception product and can be purchased over the counter if you are 0ver 18. –watch this video-

however, higher doses of oral contraceptives also act as emergency contraceptives and a copper IUD  will also be effective if inserted within 5 days following intercourse.

Some pharmacies may not carry Plan B, but most carry oral contraceptives and may provide them as emergency contraceptives. In the unlikely situation that you may not be able to get to a pharmacy or your doctor for the ‘morning after pill’ within 72 hours of unprotected intercourse, here is a list of emergency doses for a popular number of oral contraceptive pills available on line through this website.

The Food and Drug Administration has declared the following brands of oral contraceptives to be safe and effective for emergency contraception:

Ovral (1 dose is 2 white pills)

Alesse (1 dose is 5 pink pills)

Levlen or Nordette (1 dose is 2 light-orange pills)

Lo/Ovral (1 dose is 4 white pills)

Tri-Levlen or Triphasil (1 dose is 4 yellow pills)

Check with your doctor at once if you need emergency contraception and you are breastfeeding- even though there are no actual studies to prove that hormonal contraceptives damage a baby, please be cautious with ALL medications you take. Whatever you swallow is absorbed by your body and eventually passes through your milk and reaches your baby- do you really want your baby to have to cope with huge doses of hormones, alcohol or drugs? Your baby has no ’say’ in the matter so even though you find yourself stressed in this emergency situation please do not panic if you have to include bottle feeds for a while.

Your doctor will reassure you as to what to do next with your birth control regime and your baby will not die of malnourishment.
Precautions to take with the ‘morning after pill’

Just to be sure, it is wise to use an additional method of contraception to prevent pregnancy such as a condom and/or spermicide, especially when your period starts again. Some women find that when they take Plan B (emergency contraceptive) they get their period earlier or later than usual- this means that you are not quite certain when, during that particular cycle, you are at risk of getting pregnant! For the morning after pill to be effective it contains higher doses of hormones than the regular contraceptive pill and may cause noticeable side effects so it should NOT be used routinely.

Do not rely on breastfeeding for emergency contraception unless you fully understand all the criteria required (see separate article on breastfeeding and contraceptives)

Depending on how frequently and for how long you breastfeed a baby determines when your periods return and assume their ‘normal’ cycle. Your hormones swing around all over the place when you have a baby (”don’t I know it!” I hear you say?) so if you wish to continue with birth control after giving birth, take these precautions:

If your breast fed baby is now 6 months old, if you have recently reduced the number of feeds or the length of time you breastfeed your baby or have just introduced some bottle feeds, please take extra caution by using another, non hormonal type of contraceptive.