Contraceptives

I am still awaiting the final FDA statement regarding the increased risk of blood clots with the newer low dose birth control pills. The report should be out in December but here is a little more information to hand:

Earlier analysis seems to be backed up by the latest online statements in the British Medical Journal that although there IS a higher venous thromboembolic (VTE) risk carried by the newer forms of progesterone when combined with oral contraceptives containing *30 to *40 μg ethinyl estradiol (synthetic estrogen). However, that risk still remains small, at about 10 in 10,000.The updated analysis included more than 1.2 million non-pregnant 15- to 49-year-old women in Denmark without a history of thrombotic disease.

Progestin -only pills, like the mini pill (low-dose norethisterone or desogestrel alone) or intrauterine devices which released hormones, did NOT have any impact on VTE risk compared with non-users.

Lower estrogen doses were associated with modestly lower VTE risk for oral contraceptives with norethisterone, levonorgestrel, desogestrel or gestodene but NOT with drospirenone.

With the ‘older’, low dose birth control pills (containing levonorgestrel as the type of synthetic progestin) women were still at threefold elevated risk of VTE compared with those not on any hormonal contraception, whereas those on oral contraceptives containing desogestrel, gestodene, drospirenone (Yaz) or cyproterone boosted their risk six to seven times over that of non-users .

For current users of the newer pills, Philip C. Hannaford, MD, of the University of Aberdeen, Scotland, emphasised that the risks appear real and may lead many clinicians to prescribe a combined oral contraceptive with levonorgestrel whenever possible. “It is crucial, however, not to exaggerate the risk — oral contraceptives are remarkably safe and may confer important long-term benefits in relation to cancer and mortality,” Hannaford cautioned.

I’ll follow this issue closely and post again in Dec. or when the FDA releases their latest statement about the risk level of blood clots for users of low dose birth control pills which contain drospirenone (like Yaz).

Primary source: BMJ
Lidegaard Ø, et al “Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9″ BMJ 2011; 343: d6423.

I’m very late with this post due to an awful tragedy in my family which has left me feeling quite unmotivated to do much work but I had to tell you that October is a really special month from a birth control aspect as it is ‘Let’s Talk Month’ at Planned Parenthood. If you are a parent of a teenager or your child is approaching ‘that turning point’ in their sexual awareness and it’s a while, or never, since you had a talk with your son or daughter about their sexual health, help is only a click away. Check out the information on this site

Tools for Parents - there are some really user friendly resources on the Planned Parenthood site, including an online photo flip book with some great comments inside - I like some of ‘the most awkward parent moments’ as well as ‘the best parent moments’ and the video is worth watching too. An online social networking experience will guide you through the steps of developing messages to give your children and helps you to go about having a chat about them all.

As a parent you CAN help your teenager to avoid pregnancy and sexually transmitted infections. Do you REALLY know how sexually active your teenage son or daughter is? Have you done your bit to make sure that if/when they say ‘yes’ they can manage their birth control competently? I hope that you at least have some idea of what’s ‘going on’ in this hugely important sector of your teenager’s development (AND I know how difficult it can be to find out!) but be prepared to be taken aback at what you may discover when you’re honoured with some feedback! Peers and even same sex friends can pass on inaccurate information, myths and half truths when it comes to sharing tales about sexual adventures so take a deep breath if you feel uncomfortable and love your child enough to do this. Your teenager may think that you know nothing about what ‘everybody’s doing’  these days but you can quickly link them up with exactly what they need to be safe sexually and to qualify future partners for nourishing relationships.

Planned Parenthood states ” By the time they’re 19, seven out of 10 teens have had sex. Two thousand teens get pregnant in the U.S. every day and teens have very high rates of sexually transmitted infections.”

We never stop growing up despite how experienced we think we are so before October comes to an end I encourage you to take this opportunity to do the right thing by someone you love, awkward though it may be and give them the best support you can to help them navigate their sexual relationships and ‘contraception career’ safely and with confidence.

If you are not planning to welcome a new little soul into your arms anytime soon, you may wish to join the growing number of women who are forsaking their low dose birth contol pill in favor of a long acting, reversible contraceptive (LARC ) such as an IUD or an implant. A recent bulletin by the American College of Obstetricians and Gynecologists show that today’s much improved IUDs and implants are the most effective forms of reversible contraception.

IUDs are now considered suitable for the majority of women, including adolescents, women who have had a miscarriage or an abortion, women who have had ectopic pregnancies and also women who have never had any children. HERE is an earlier post with details and a video of a copper IUD insertion.

My earlier post is HERE if you want details of implants but today’s post is just to bring you up to date with the latest increase in popularity of these two low maintenance LARCs.

“IUDs and implants should be considered first-line contraceptives for a majority of women,” says Eve Espey, MD, MPH, an associate professor of obstetrics and gynecology at the University of New Mexico in Albuquerque. Espey also says that available evidence suggests that IUDs do not cause PID (pelvic inflammatory disease) which prevented many doctors recommending them to women who had not had children.

“The majority of unintended pregnancies among contraceptive users occur because of inconsistent or incorrect contraceptive use, and this is where implants and IUDs stand out from the pack. They are maintenance-free, which means there is virtually no margin of error,” she says.

Implanted, contraceptive ’rods’ were approved in 2006. You do need to go to a doctor to have the implant inserted just underneath the skin on the inside of one arm and protection against pregnancy usually lasts for 3 yrs. Yes, you can feel it if you press on the insertion site as seen here http://youtu.be/4TNEtyu1WUU but the idea is to forget about it once it’s in so don’t worry that it’s going to catch on your clothes! These two videos show insertion and removal if you’re interested in the procedure.

INSERTION

REMOVAL- don’t worry about the foreigh language on this video, the procedure is clearly shown.

An IUD can provide 5-10 yrs of protection depending on the type. Paragard is a copper IUD and will protect you for up to10 yrs, while Mirena is a hormonal IUD releasing progestin and will protect you for up to 5 yrs. IUDs also need to be inserted by a doctor.Warning: Neither of these contraceptives will protect you from STIs so condoms come into their own as rescue special ops! Your doctor may or may not offer these two options. Implants and IUDs should not be used if you have been diagnosed with any form of PID, reproductive cancer or Wilson’s disease (too much copper in your body).   If you are a vegetarian did you know that you can buy Vegan/Organic Condoms on this site (search for Sir Richards brand) Undercover Condoms Sales - Click here to view this month’s sale items including Condoms, Lubricants, and more!!Downsides in brief:

• irregular menstrual bleeding, possible acne and weight gain in a few women (no different to other forms of hormonal birth control) and sometimes temporary cramping following an IUD insertion which usually diminishes after a while
• very rarely (1 in 1,000) an IUD pushes through the wall of the uterus and has to be removed
• the contraceptive skin implant may cause a mild insulin resistance in some women 
• initial high cost of several hundred dollars for each type but when averaged out over several years, the monthly cost compares favorably to the cost of a low dose birth control pill

Here are a few more myths about low dose birth control and a link to that extraordinary book I mentioned in the last post.

MYTH 6.  The Pill makes you infertile

No it doesn’t. It can take a few months before your body readjusts itself back to it’s own natural hormone levels but you may believe this myth if you are 30+ and have fewer eggs left which are of a less than ‘prime’ quality.  If you’ve always taken a low dose birth control pill, how do know if you have fertility problems without it?  A low dose birth control pill may actually help you to avoid fibroids, endometriosis and similar uterine conditions so may ‘preserve’ your fertility. 

MYTH 7.  The Pill causes cancer

Not necessarily.  Even a low does birth control pill offers some protection from ovarian cancer and endometriosis. Research shows that if you take a combination birth control pill (estrogen and progestin) you are at a higher risk of cervical cancer but no actual causal link has been found yet.  Please do not increase your risk of cervical cancer further by exposing yourself to the contributing factor, the human papilloma virus , by having unprotectd sex. There is also a slightly higher risk of breast cancer for women on the pill which diminishes after use and disappears altogether after 10 years. Cancer findings here.

MYTH 8.   It doesn’t matter what time you take your pill each day.  It does if you want to get the maximum protection and efficiency from it so ‘attach’ the pill taking time to a daily routine you already practise well.  MYTH 9.    All birth control pills are the same  Not true.  Low dose birth control pills may all have the same end result of preventing pregnancy but there are many different types, while the estrogen may be identical (ethinyl estradiol) the type of progestin could vary.   Within those, many different brands (including generic brands). Not all pills will suit YOUR body in the same way as your friend’s body so talking to a doctor or family planning professional is the best way to find a ‘match’ that suits your metabolism and medical history. 

NEW ‘must have’ BOOK - You’ll never see your vagina in the same light again

 Now for the link to that remarkable book I mentioned.  I have been waiting awhile to recommend this extraordinary work of art to you- and it is SO much more than that. At a time when women fall victim to media propaganda, when sadly, labiaplasty is growing in popularity and  young girls’  body image is at an all time low, this beautiful book of 164 full colour photographs celibrates and honours the uniqueness and true beauty of every women’s genitals.

Heart of the Flower: The book of yonis is an unflinching exploration of the beautiful diversity of women’s genitals, free of judgement, shame and embarrassment.

To watch a short video about Heart of the Flower book before buying, http://www.youtube.com/watch?v=PztE75RNKbQ

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

New Low Dose Birth Control Pill For 2009

If you’re the sort of girl who likes to review her ‘contraception career’ regularly, you may like to know that a new low dose birth control pill will be coming onto the market in the first few months of next year with benefits that you may welcome. This new low dose birth control pill will be called LoSeasonique and has just been approved by ‘big brother’- the FDA.

If you already use a low dose birth control pill you may be familiar with those brands that reduce the number of withdrawal periods you have, such as Seasonale, Seasonique and Lybrel. These particular low dose birth control pills are termed ‘extended cycle’ or continuous, birth control pills which are 98%-99% effective in preventing pregnancy if taken as directed. Seasonique and Seasonale have been available for some time now, giving four ‘periods’ a year while Lybrel allows no periods at all.

If you’re like me, you’ll want to know how thorough the trials have been on this low dose birth control pill before rushing off for a prescription. Over a 12 month period, over 2,100 female subjects between the ages of 18 and 41 at 56 sites throughout the United States participated in the trial and completed an equivalent of nearly 21,000 28-day cycles of exposure.

LoSeasonique is a low - dose version of Seasonique and, like Seasonique, reduces the number of ‘periods’ you will get from 13 to 4 per year. Yep, it saves on the cost of pain relief and tampons too.

OK. So what’s in this new low dose birth control pill?

LoSeasonique is a combination (progestin + estrogen) birth control pill.
Each pill contains 0.10 mg levonorgestrel and 0.02 mg of ethinyl estradiol (synthetic estrogen) Seasonique contains 0.15mg levonorgestrel and 0.03mg ethinyl estradiol.
Other low dose pills such as Alesse, Mircette and LoOvral contain the same amount of estrogen as LoSeasonique (0.02mg) but with these you will have 13 periods a year.
How do I take it?
LoSeasonique should be taken daily for 84 consecutive days, followed by the 0.01 mg ethinyl estradiol tablets for seven days.

Benefits of the new low dose birth control pill

• you know when to expect your period
• your periods will be light, shorter and less frequent (4 per year)
• you should get relief from PMS and acne
• your risk of ovarian cysts, ectopic pregnancy, benign breast cysts or lumps and ovarian and endometrial cancer will be reduced

Are there any side effects or disadvantages?
Don’t expect any BUT this new low dose birth control pill is likely to affect some women in similar ways to other low dose birth control pills. I’m afraid it’s individual trial every time girls. However, doctors are unlikely to prescribe this new low dose birth pill for you if you smoke, are over 35 years of age or have health problems such as blood clots, breast, uterine, or liver cancers or serious heart problems.

Warning: Please use your own discretion when using any low dose birth control pill. Seasnoque of these brands of low dose birth control pills mentioned above have been used long enough for anyone to say for certain if there any long term negative side effects.

If you hand in your prescription for Yaz at the pharmacy and are offered a ‘generic’ alternative such as Janya, how secure do you feel in accepting the cheaper product- after all this is your family planning at stake here, not some hay fever trial!

Often the doctor will indicate on your script that a generic product is optional too, if one is available but what if you wish to buy online for convenience and save a few dollars in the process? I’m not taking a legal or scientific stance here, just explaining simply for the average consumer, what the term ‘generic’ means so that you can confidently make a decision about this option for your contraceptive pill if one is available.

Generic options may not be offered to you for all contraceptives but when they are, they are usually cheaper than the original, patented drug and for an item that can occupy a regular spot on your shopping list for YEARS, those significant dollars you save may well relieve the budget elsewhere.

First, a bit about what a ‘drug’ is…

Any drug that requires a doctor’s prescription is made up of chemical compounds. Compounds are made up of molecules containing atoms that are joined together in various configurations or patterns, depending on the type of compound. When a drug company comes up with a chemical substance they wish to market as a drug, they know the configuration of the atoms in the molecule and that configuration usually dictates what the name of the substance should be.

How is the Janya (or Gianvi®) contraceptive pill classified as being the ‘generic’ equivalent of Yaz/Yasmin?

I reluctantly take a drug to lower my high cholesterol (yes I’ve tried all the other non chemical, detox, diet related solutions in vain!) -its chemical name is atorvastatin which the company Pfizer patented so that no one else could make or sell it for the term of the patent ‘life’. Pfizer called the drug Lipitor, which they registered as a trademark so again, no one else can use this name.
When we use the term, ‘generic’ we are usually talking about an alternative drug that is cheaper than the brand but does the same thing. While the patent is in force, for any particular drug, there will be no generic alternative. You can check the patent expiration date on line for a drug you are interested in. Patents are country specific too so if your drug is not registered in another country, you may find its generic equivalent is available in that country. Costs to develop new contraceptive pills are high and a company that manufactures that same contraceptive pill after a patent expires does not incur these costs so can produce the same contraceptive pill cheaper and therefore sell it on at a lower price than the original. Most of us call these cheaper products ‘generic’ and they are often made by the same company as the patented version.

No doubt you’ve bought ‘generic’ baked beans at your supermarket and been disappointed with the quality, especially if you’re a Heinz fan but when the term ‘generic’ is applied to a drug used in such an important product as a contraceptive pill, ingredients and quality are much more regulated. These medicines ‘do the same job’ in the body as the patented ones do and are required by law to contain ‘comparable’ or identical active ingredients and be functionally equivalent to the original. I believe that the FDA requires the generic brand to fall within 20% of the named brand in relation to its absorption properties. For this reason generics are generally accepted to have exactly the same medicinal or contraceptive effectiveness as the original brand name drug.

Janya (Yasmin/Yaz) for example, contains active compounds -3 mg of drospirenone and 0.02 mg of ethinyl estradiol, however, some generics contain different ‘fillers’ or colours and human bodies being what they are, these may affect women differently from those used in the name brand. One common filler is lactose/milk sugar so if you happen to be  lactose intolerant and were on a non lactose BC pill and you unknowingly swap to a generic brand with a lactose filler then its possible that you may experience slight tummy upsets. 

Next time you have a prescription to fill, you can confidently speak to your pharmacist (yes, even for on line orders) about generic options that may be available for your contraceptive pill. If you happen to be using Yasmin or Yaz, check out the prices for the generic product, Janya HERE as I believe this supplier has the best on line price and you may get volume discount. 

PS. July 2011 update: I am watching for the results of the FDA study of 800,000 women using Yaz to see whether the ingredient ‘drospirenone’ significantly increases the risk of blood clotting.

More information on this site

I realize that this post will only apply to a few women but hey, if 3 years supply of free contraceptives interests you, read on. A Contraceptive Choice Project is beginning at the Washington University School of Medicine and if you live in the St. Louis area, you may be one of 10,000 women who will be accepted for participating in a study AND reap considerable benefits along the way. The goal of the Contraceptive Choice Project is to better understand contraceptive choices.

As well as the free birth control for three years, you’ll also get free testing for sexually transmitted disease, free STD treatment and the satisfaction of helping others learn about contraceptive choice.

As far as I’m concerned, the more we can keep this topic in the limelight, the more funds may be spent on improving contraceptives, developing new types of contraceptives to provide a wider range of birth control options and very importantly, making sure that women are much more knowledgeable about what goes into contraceptives and their effects on the body- especially the hormonal ones.

Don’t be shy or embarrassed about getting involved in a study about contraceptives, maybe you could get together some girlfriends and all do it as part of your ‘further education’? This is your chance to do your bit for all the goddesses out there and the money that you would have spent on 3 years supply of contraceptives? Well, an extra $700 or $800 in the kitty isn’t to be sneezed at is it, girls?

NO RISK

Oh, and in case you’re wondering if this study is going to increase your risk of getting pregnant- only if you do not continue to use your contraceptives correctly and consistently as you do now, yes? This study is about contraceptive CHOICES, not effectiveness. Check out the study at 314-747-0800,

OR you can read the PDF on line

You know that I will not and have never recommended the contraceptive patch on this site, except to warn you about the risks if you really want to use it. A Public Citizen petition has just been filed demanding withdrawal of the contraceptive patch from the market within six months. If by chance you are still using a contraceptive patch, I’m making a personal plea to you now not to continue using it, even for another six months. “When in doubt, leave it out” girls, as there are many more types of contraceptives to choose from with lesser risks. Why take a risk, even for another six months, with a contraceptive that has had so many negative reports from users, bad publicity and law suits attached to it? The package should come with its own red flashing light and siren sound - not just an amended warning label!

Is the FDA (or more correctly, Johnson and Johnson) using women as lab rats?

When a packaged food item in a product batch is tampered with or suspected of placing consumers at risk, it is recalled immediately and supermarkets sweep it off their shelves. In the case of the contraceptive patch, it could not be confirmed that the level of estrogen was consistent in each batch! The FDA agreed that further studies needed to be done on a product that they knew (2 years ago) affected blood clotting and could place women in danger of strokes. Was the product swept off the shelves? No. The FDA just kept amending the label warning (3 times!) and left women to make a decision about its risks without providing them with the full facts.

It’s not as though the patch is the best or only contraceptive in the world. What is the FDA waiting for, further ‘free’ evidence and possibly more deaths while the window of opportunity remains open for lawyers to advertise their services to women with problems? Shameful!

I accept that one of the main birth control ‘benefits’ of using the contraceptive patch is the convenience of not having to remember to take a pill each day but if you still believe that this advantage outweighs the potentially high risk to your health, consider changing from this type of contraceptive to an IUD like Mirena or Paragard or at the very least, discuss some alternative birth control methods with your doctor.

6 months phase out of the contraceptive patch-why ?

Why is a phase out period for the contraceptive patch needed at all? Because the powers that be are worried that we women may not immediately replace the patch with another form of birth control- Hello!-we panic if we miss one pill or throw up! OK, so you need time to have a chat with your health care provider about another type of contraceptive but is a short spell of ‘playing safe’ with condoms too big an ask for an empowered, responsible, modern young woman who successfully manages her ‘contraception career’? (that’s why you visit this site yes?) Why refill a prescription, even for six months, when that last round of patches could leave you with one of the biggest regrets of your life?

The patch releases high doses of estrogen into a women’s body creating an unacceptable risk to her health so suggesting that in 6 months time it is pulled off the shelves does little to reduce the problem today. Six months gives time for more lawsuits to arise and with them the inevitable toll on unfortunate women.

“Women deserve a level of risk at least comparable to or less than the pill for their hormonal contraceptive. The absence of any evidence of a unique benefit combined with the considerable safety problems of high-dose, variable estrogen exposure in Ortho-Evra tips the balance of risks and benefits against its availability as a contraceptive.” ……Dr. Sidney Wolfe, director of the Health Research Group at Public Citizen.

Come on girls, this is no time for apathy, if you still have a contraceptive patch in the pack I strongly urge you to leave it there. A lower dose of estrogen in a contraceptive pill may not seem attractive to you right now but for tonight’s protection go grab some trendy condoms then head off to see the doc!

There’s detailed information about different types of contraceptive pills on this site and I’ve found the cheapest on line suppliers for the brand names listed on the RHS of this page, including Alesse, Desogen, Levlen, Mircette, Ovral, Ortho Tricyclen and Yaz/Yasmin.

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!