Contraceptives

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!

Contraceptives, especially oral pill types, come in hundreds of brand names but what is really important and relevant to YOU is how they are classified. What does this mean and do you care so long as they suit you? Well, I think you’ll find you’ll get much more attention (and gold plated service?) from your health care provider if he/she hears you asking about ‘monophasic’, ‘low dose combined’ and progestin only’ pills when you are considering which contraceptive pill will give you the least side effects.

Oral Pill Types Explained

This is an introductory explanation of the different types of oral contraceptive pills that may help you to select the one that is best for your body and if nothing else will place you in a position of strength during that consultation. 50 years on, we have discovered that the oral contraceptive pill for women still prevents pregnancy if it is made up of much lower doses of estrogen and progestin than in the early days. ‘The Pill’ used to contain 50-100 micrograms of estrogen and today it contains only 20-35 micrograms, with researchers trying to reduce this amount further to reduce side effects. Synthetic hormones (estrogen/ethinyl estradiol and progestin) used in contraceptive pills mimic the natural hormones (oestrogen and progesterone) produced by the ovaries, adrenal gland and liver.

Estrogen’s main job in the contraceptive pill is to prevent ovulation (release of an egg from a woman’s ovary). Progestin in the pill, while it does have some intermittent effect on ovulation (about 50% of the time) is relied on mainly to thicken the mucus around the cervix to stop sperm from getting through to an egg.

Contraceptive Pills come in two basic types: single hormone pills (progestin only) and combination hormone pills (estrogen + progestin) Pills are supplied in two basic packs- 28 day pill packs= 3 weeks of active hormone pills +1 week placebo pills and 21 day pill packs= 3 weeks of active hormone pills with no placebo pills.

PROGESTIN only pills (the ‘mini pill’) do not contain estrogen and only have a small amount of progestin in them. Breastfeeding women are often prescribed these ‘mini pills’ (estrogen may cause a reduction in milk supply) as well as women who cannot take synthetic estrogen for medical reasons. Side effects are less than pills containing estrogen and they are not associated with heart disease, however, irregular bleeding /spotting/mood swings may occur. Progestin only pills MUST be taken at the same time each day and are affected by vomiting or diarrhoea.This type of contraceptive pill is not affected by antibiotics.

COMBINATION PILLS- contain estrogen and progestin and can be further categorized as being Monophasic, Biphasic or Triphasic- so what do these terms mean? Pills are put into these categories according to whether or not the levels of hormones they contain stay the same throughout the first three weeks of a woman’s menstrual cycle (in 28 day pill packs, the pills for the fourth week in the pack are placebo or ‘reminder pills’ that are inactive and do not contain any hormones)

MONOPHASIC Pill- is one that contains the same amount of hormones in every ACTIVE pill so you are less likely to have mood swings as your hormone levels do not vary much throughout the month. Popular monophasic pills include:Alesse,Brevicon,Desogen, Levlen, Levlite, Loestrin, Modicon, Nelova, Nordette, Norinyl,Ortho-Cept, Ortho-Cyclen, Ortho-Novum, Ovcon, Yasmin. In 2003 the FDA approved a new packaging of a monophasic contraceptive pill called Seasonale. This pill is taken for 91 days, during which no periods occur -so in one year, women taking this pill will only have 4 periods (for the first year though, expect the same no. of menstrual days as with a traditional contraceptive pill till your body adjusts)

BIPHASIC Pill- is one that contains different amounts of hormones throughout the pack. These pills alter your hormone levels once during your cycle by increasing the dosage of progestin about halfway through your cycle and are thought to better match your body’s natural production of hormones- they contain smaller doses of hormones in total than monophasic pills. However, insufficient evidence has been gathered to favour these pills over monophasic ones, where much more reliable data is available so monphasic pills are preferred. Breakthrough bleeding has been reported as a side effect with these pills. Popular biphasic pills include : Jenest, Mircette, Necon 10/11, Nelova 10/11, Ortho-Novum 10/11. Attempts to decrease side effects led to the three-phase pill in the 1980s.

TRIPHASE Pill- is one that contains 3 different amounts of hormones in the ACTIVE pills over three weeks, i.e. a change in hormone levels within the body occurs every 7 days for the first 3 weeks.. The dose of estrogen is gradually increased and in some pills, the dose of progestin is also increased. Whether three-phase pills lead to fewer pregnancies than two-phase pills is unknown. Nor is it known if the pills give better cycle control or have fewer side effects. Look for the ‘TRI’ on the label such as:Ortho Tri-Cyclen, Triphasil, Tri-Levlen, Trivora, Tri-Norinyl, Cyclessa, Ortho-Novum 7/7/7.

The Best Pill to Take? All contraceptive pills are effective if taken correctly, with combination pills (containing estrogen and progestin) being more effective than the low dose ‘mini pill’. Monophasic pills may be the best to start with- they are cheaper and those with lower amounts of estrogen may have fewer side effects (but more breakthrough bleeding)

Always use back up (a condom or diaphragm) for the rest of the month if you miss a pill. Trial and error, side effects and talking to your doctor should help you to find a contraceptive pill that suits your body. Pregnancies occur mainly when women forget to take a pill or take them incorrectly, vomit, get diarrhoea or, in the case of the mini pill, do not take pills at the same time each day. It is very easy to start a pill packet late if you just forget or if you don’t have the next new packet on hand. The most dangerous time to miss a pill is at the end or beginning of a packet because it lengthens the pill free interval beyond seven days which means that you may not have absorbed sufficient synthetic hormones to prevent you from ovulating in the next month.

Phew! Well, that was a marathon read but at least you have some reference information and a few brand names to discuss with your doctor- not all of these brand names will be available in each country but there will be some generic brands that will be a ‘match’ for the types of contraceptive pill explained above.  Good luck!

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

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

WHEN contraceptives actually work in your body could make all the difference as to how you feel about selecting one- especially where religious tolerances are concerned and ‘abortion’ in the purest sense of the word is a real issue for you.

We use contraceptives mainly to ensure that we don’t get pregnant. “Getting pregnant” means that his sperm has fertilized your egg and a baby is on the way right? Well, that all depends on WHEN you believe a new life has begun. Is it at fertilization or a bit later- before, during or after the fertilized egg has implanted itself into the wall of your uterus?

Selecting a method of contraception may be more confusing and stressful for you if your religion has certain beliefs around when a new human life begins. Seek counseling and accurate information on this issue so that you can be satisfied that the type of contraceptive you eventually choose does not conflict with what you personally believe. I acknowledge that if you are against abortion you may also be against methods of birth control that are not ‘natural’. I list options below for information only.

Family planning professor, John Guillebaud has examined many sources of information on contraceptives and WHEN they work regarding fertilization and implantation and, as this site aims to address all aspects of contraceptives, I thought it wouldn’t hurt to summarise some of his study findings to help those of you who face this dilemma. Professor Guillebaud’s personal view is that implantation is the biological event that separates family planning from abortion. If you are unsure about the physiological changes that oral contraceptives cause within the uterus itself, I strongly recommend that you also read the whole of this post- it may just help you make the final decision.

Let’s look at WHEN Oral Contraceptive Pills Work

The active ingredients in the combined oral contraceptive pill prevent ovulation and therefore prevent fertilization so there is nothing to implant. For this reason they are not classed as ‘abortifacients’. Their capacity to activate their ‘back up mechanism’, that of obstructing implantation of a fertilized egg, is what puts oral contraceptives into the ‘gray’ area of the purist abortion debate.

The progestin only pill sometimes acts after fertilization (with the exception of Cerazette) because in some women it permits ovulation to happen therefore an egg could be fertilized. However, if taken correctly and on time, it is scientifically proved that these pills also act prior to fertilization and do not have to ‘use their back up mechanism’ to block implantation.

Obviously if you regularly forget to take your combined oral contraceptive pill, (particularly a low dose one) you risk ovulating.

It is the lengthening of the pill free period that causes pill failure pregnancies and ‘near misses’- NOT forgetting to take a pill at other times. Even if ovulation does occur without subsequent pregnancy, it does not follow that the pill acts post-fertilization: the hormones in the oral contraceptive thicken the cervical mucus and block the sperm’s journey to the egg.

Professor Guillebaud states “Most experts believe that if sufficient pills were missed to cause the mucus mechanism to fail as well, there still wouldn’t be any interference beyond fertilisation; the anti-implantation effect (being the COCP’s weakest contraceptive effect) would fail also, leading to conception. Of course, one couldn’t be certain of this over many years of forgetful pill-taking. Still, we are talking about a forgetful pill-taker taking one of the weakest available pills.”

Depo-Provera

This type of contraceptive prevents ovulation and is delivered by an injection given ‘on time’ every 3 months. If you are worried about possible fertilization happening (and implantation subsequently being disrupted) you can opt to have the injection every 10 weeks instead of every 12 weeks. This will ensure that ovulation is always blocked and (for you) the unacceptable back-up mechanism is never used.

Please note: According to Alison Edelman, M.D., an assistant professor of obstetrics and gynecology at Oregon Health Sciences University, in Portland, Depo can delay fertility for up to a year and a half (the average is six months) With the other hormonal methods, including the Pill, it’s possible to become pregnant within one to three months.Intrauterine contraceptive devices (IUCs or IUDs)

IUDs contain copper or Levonorgestrel. Copper is toxic to sperm. Devices containing Levonorgestrel act as contraceptives by thickening cervical mucus to block sperm from traveling to the egg. Both types also keep the uterus lining thinner than normal to make implantation difficult. Using this type of contraceptive, which also acts after fertilization, could be a dilemma for you if you believe that life begins at fertilization, not at implantation.

If you believe that blocking implantation is abortion and you are also a hopeless pill taker, here is a list of contraceptive options that you may wish to consider:

• Male and female sterilization- vasectomy, tubal ligation or Essure insertion

• a combined oral contraceptive pill such as Mircette or Ortho Tricyclen (but do not lengthen the pill free period)

• shorten the pill free period of your combined oral contraceptive pill to 4 days instead of 7 and/or use a tri cycle regime-in which the pill free interval is eliminated usually for four, three or sometimes two monophasic pill cycles (for better bleeding control) and then also shortened after each run of packets.

Implanon prevents ovulation and is a contraceptive device that is inserted underneath the skin on the inside of a woman’s upper arm. The hormone content and actions are very similar to Cerazette. Implanon should be replaced every three years. Implanon acts prior to fertilisation and does not have to ‘use the mechanism’ to block implantation.

Full breast-feeding - combined with the ‘mini pill (progestin only) or the Depo-Provera injections. During weaning there is a risk of ovulation so back up contraceptives should be used.

Coitus interruptus- also known as ‘withdrawal’ or ‘being careful’, is better than using no manufactured contraceptive but is not the most effective method of birth control. Even those little sperm in that first drop of fluid swim very fast into the uterus and are up into the Fallopian tubes before you know it!

Natural fertility management- charting your temperature and checking the thickness of your cervical mucus helps you to estimate your ‘infertile days’ when there is little risk of pregnancy.

Male and female barrier methods and spermicides- including condoms, the diaphragm and the cervical cap.

The home pregnancy test kit

This kit measures a hormone in a woman’s blood called hCG (human chorionic gonadotrophin) If hCG is present the test shows a positive reading BUT hCG only shows up AFTER IMPLANTATION (which occurs six to twelve days after fertilization) of the fertilized egg into the wall of the uterus. hCG (nor any other embryo-specific substance) does not show up while contraceptives are in use. This means that any method of contraception linked with the presence of serum hCG would be off-limits to someone requiring a contraceptive that only operates BEFORE fertilization.

Source: www.cmf.org.uk

Oral contraceptives and risks-  alarming headlines can often be misleading when it comes to oral
contraceptive research so it pays not to assume anything on first ’skimming’. Rather, investigate a bit more deeply if it’s something that is likely to affect you and your body and your own future management of contraception.  A whisper about ‘new’ evidence on oral contraceptives, either positive or negative,  can generate mass over reaction and exaggeration.  Find out for yourself as much as you can before allowing the results of studies and ‘findings from the latest research’ influence any decision you are about to make about a specific contraceptive you are considering.

One of the agreed benefits of taking combined oral contraceptives that emerged from many global studies over the years,  is that they reduce the risk of ovarian cancer.  It now seems that they may also slightly reduce the risk of colon cancer .  According to lead researcher Dr. Geoffrey C. Kabat, of Albert Einstein College of Medicine in New York it’s too soon to leap ahead and conclude this yet but in a study of nearly 90,000 Canadian women aged 40- 59, it was found that those who had ever used contraceptive pills were 17 percent less likely to develop colon cancer over the next 16 years.  Interestingly, this was NOT the case for women on HRT (hormone replacement therapy)

These results regarding oral contraceptives were published in the International Journal of Cancer after a breast cancer screening study was carried out on 89,835 Canadian women over a period of 16 years. Studies with smaller groups have also been done in Italy between 1985 and 1996 with similar results.

It seems to me that there are so many other factors to be considered such as lifestyle, weight, medical history of family for colon cancer and not least the various doses of hormones in all the different types of oral contraceptives,  so I think it will be quite a while before any firm statement will be made on this one.