Contraceptives

Is Low Dose Birth Control less effective than High Dose Birth Control?

If you are feeling a bit anxious about the effectiveness of today’s low dose birth control pills, relax, most of the ones prescribed today are classified ‘low dose’ and are just as reliable for preventing pregnancy as the earlier, higher dose birth control pills. You may protest that two headache pills work better than one but with birth control ingredients, it’s not a case of, the higher the dose, the more protection you will get. Many other factors determine how effective ANY birth control pill will be and how risky it may be to use it.

Did you know that the first oral contraceptive pill did NOT contain any estrogen?

When the first oral contraceptive pill was tested in the 1950’s, it contained only progestin, a synthetic form of progesterone that was very effective in preventing pregnancy. However, when it was discovered that progestin only pills caused irregular bleeding, estrogen was added to the oral contraceptive to combat this particular side effect and to create ‘regular’ menstrual cycles.  The amount of estrogen added in the 1960’s was 150mcg, compared to the 20-35mcg found in today’s low dose birth control pills. The estrogen component in all ‘combination’ birth control pills sold in the USA is the same - ethinyl estradiol- but the progestin component can vary, depending on the manufacturer.

SIDE EFFECTS and TRIAL and ERROR (groan)

Since the 1960’s, after estrogen was found to cause other side effects such as nausea, (surprise, surprise) researchers embarked on a ‘balancing act’ to fine tune/lower the estrogen content to minimize the side effects.  Today, 20mcg of estrogen seems to be the ‘hover’ point for low dose birth control pills but ‘breakthrough’ bleeding or spotting can still be experienced by some women.  In these cases a doctor may prescribe a birth control pill that contains a higher level of estrogen (50mcg.) If you experience nausea on a low dose birth control pill  containing 35mcg of estrogen, then ask your doctor about decreasing the estrogen dose to 20mcg.  Your friend may find that a dose of 35mcg of estrogen suits her perfectly.Trial and error is really the only way to find out which low dose birth control pill is best for you and your body metabolism. Usually it takes 3 months for your body to adjust to a different estrogen level and for side effects to disappear. Once you’ve found the ‘right’ p low dose birth control for you, you feel ‘normal’ like you did pre pill.

OK, so now we have a low dose birth control pill that overall causes minimal side effects (was that a derisive snort I heard?)  regulates monthly bleeding and reduces PMS but be fair, this is not a headache pill we are taking here. A low dose birth control pill affects our hormones and in turn, one of the major systems in our body, our reproductive system, which begs the question, how can ONE type of medication ideally be perfect for millions of different hormone systems, different metabolisms, extremes of body mass, very different medical histories, inherited genes/health issues and all the other stuff that makes us UNIQUE?  The short answer to this is-  it can’t.

This is why there are many brands of low dose birth control pills, containing from 20 mcg to 35mcg of estrogen and yes, the generic ones are just as effective as the brand names. You may find that the triphasic ones, that ‘mimic’ your natural hormone levels and release varying amounts of estrogen throughout your cycle, suit you better than the  monophasic ones which release equal amounts of estrogen for 21 days, then no estrogen for 7 days (this sudden estrogen ‘drop’ gives some women headaches)  Again, I’m afraid it’s a case of trial and error.

RISKS with low dose birth control pills- you will have read or been told by now that smoking and ANY TYPE of hormonal contraceptives are bad bedfellows due to the increased risk of clots and heart attack/strokes. Studies continue to look at the effectiveness of hormonal contraceptives in obese women and also in black skinned women. There are so many factors that determine if a woman gets cancer that I’m including this link for now,  for further information on “Oral Contraceptives and Cancer Risk”.

BOTTOM LINE

YOU are responsible for that birth control pill doing its job in your body - regardless of brand name, generic alternative, combination or ‘progestin only’ birth control pill, monophasic or multiphasic,  if you don’t follow the instructions and take your birth control pill as directed, it will not deliver the amount of estrogen you need each month to protect you from getting pregnant ….. so you and your partner will end up playing ‘nursery roulette’!

May Madame Luck be on your side!

ALESSE and MIRCETTE contain only 20mcg of estrogen and I think I’ve found the cheapest on line supplier. if you prefer triphasic pills try Ortho TriCyclen Lo