General birth control pill information:
Most pills are of 2 types: monophasic or triphasic. What this simply means
is that the pill is either a continuous dose of medication that is the same all the way throughout the
month(monophasic) or you take pills that are of varying strengths of medication throughout the month (triphasic).
If you are going to take these 'continuously' or without taking a 4th week break for a period, you need to have
monophasic pills. One thing I've heard from some endometriosis sufferers: if you take a pill continuously, it usually
helps to have a 'low dose' (low estrogen dose) pill. There are varying levels of estrogen in pills, and pills are
normally measured by the amount of estrogen compound they have, rather than the progesterone content. Mircette™ or
Mircelon, Alesse (levonorgestrel), LoEstrin and Levlite are 20 mcg pills. Most other prescribed pills are 35 mcg
(or 30) and Demulen, Desogen, Ortho-Cyclen, Ortho-Tricyclen, Ortho-Novum would be an example of these. Most pills with
Tri in them are Triphasics. Remember to take the pill at about the same time each day: there is less chance of
pregnancy and breakthrough bleeding occuring.
Birth control methods:
Don't think that the pill is the only form of birth control around. There are condoms, IUD's, the sponge may come out
again, the rhythem method, abstinence, spermacides, a female condom is in the works also.
Can't pay for the pill?
Prescriptions By Mail or
FemScript are programs that may be
able to help.
RXUSA is a discount store when you can get pills cheap.
Planned Parenthood and other women's clinics have the pill available at low cost or free.
PCO and the pill
A study done over a period of 10 years found
no increase in the
risk of diabetes with pill use.
(Anonymous donor): Demulen 1-35 is good (1.21 androgens) due to the low type of androgens in the pill. Your worst three
are Lo-estrin, Nordette, and Ortho-Tricyclen (or any Tricyclic BCP) by anecdotal evidence. Least androgenic progesterones
to most androgenic are: desogestrel, norgestimate, norethindrone (when combined with higher levels of estrogen),
ethynodiol diacetate, levonorgestrel, norgestrel, norethindrone (when combined with lower levels of estrogen). What you
want to look for is the least androgenic BCP you can get. You might also want to try Mircette or Alesse, lower dose pills
(lower estrogen compounds). Yasmin is made with a derivative of spironolactone,
and this can help with the hirsuit problem and water gain. ARHP has come out with a
androgen paper and a
antiandrogenic and ovulatory benefits paper on the pill.
The pill is NOT a 'cure' for PCO, your symptoms come back with a vengence once you get off of it.
You might want to check out or ask your doctor to read the Journal of Clinical Endocrinology and Metabolism's Vol. 80
no. 11 article on pages 3327-34 about the 'Metabolic effects of oral contraceptives in women with polycystic ovary
syndrome'. This article says that a reduction in insulin resistance happened. Another good article from S. Nader,
M. Riad-Gabriel, and M. Saad on, 'The effect of a desogestrel-containing oral contraceptive on glucose tolerance and
leptin concentrations in hyperandrogenic women' in the Journal of Clinical Endocrinology and Metabolism, Year 1997,
issue 82, pages 3074-307. There are
health benefits of contraception.
I just recently checked out Dr. Leon Speroff's book: A Clinical Guide for Contraception, 2nd edition. (If you are
looking in a medical library, I believe the way to find it is to look for WP 630 5749c 1996 c.1.) He states that
levonorgestrel monophasics have a 'negative impact' or don't work well on those with carbohydrate intolerances. Also that
low doses have small but basically ignorable effects on carbohydrate metabolism and insulin resistance. (Pg 56 - 59.)
Taking the pill continuously for endometriosis:
An unofficial poll showed the most popular pill was Ortho Novum, after that, an Ortho-Cept/Mircette/Desogen
combination. The reasons they changed pills or went to others was due to pain returning and headaches, nausea, etc.
I would also advise that if you are taking thyroid medication, you watch to see if it interferes in that regard.
European pills and PCO:
Diane 35 or Dianette is a good PCOS pill.
Going off the pill: what to expect:
Depends, different people have had different reactions. For some, irregular bleeding, hirsutism, etc. occur.
Is the pill safe?
Yes it appears it is safer than it once was.
Drug interactions and the pill:
drug interactions and the pill aren't a huge worry. Only
one antiobiotic, rarely prescribed, will really interfere with the pill. The information can be found from docs on the
women's health list at obgyn.net.
Emergency contraception:
Previn and the progesterone only pills and other types are listed on
Princeton University's site work.
The pill and problems:
The Pill may increase the risk of breast
cancer is all I can find where there is medical documentation that this may be a problem.
I had a discussion previously with Christine DeZarn, head of PCOSA on the pill
and PCOS. PCOSA does list the pill as a possible treatment of PCOS. When I talked with
her concerning this, the following is an excerpt of what she had to say.
While I am not aware of an oral contraceptive directly causing diabetes, I don't want
people to ever think that PCOSA only lists treatments that carry no risk with them.
All treatments carry both benefit and risk. Some oral contraceptives have been shown
to slightly increase insulin resistance in some studies. Others have not. But a pill
is not a pill is not a pill. There are actually several different types of oral
contraceptives, some of them with entirely different ingredients than others, so this
accounts for the varying results. But no drug is without risk, and all of those listed
as "treatments" for PCOS carry risk as well. Women with PCOS need to educate themselves
about all of the different types of oral contraceptives on the market, and the
research that goes with them, then select the best choice for them.
That being said, endometrial cancer is a much greater risk than a slight increase in
insulin resistance. Even if insulin resistance is slightly raised by an OC, oral
contraceptives irrefutably protect against endometrial cancer - the more immediate
life-threatening risk. What women really need to understand is that they must treat
the insulin resistance *in addition* to protecting themselves against endometrial
cancer. Too many doctors just tell a woman to take the pill and that's it. But that's
not enough. The IR absolutely must be treated. We know that insulin resistance is
treatable with diet, exercise and/or insulin sensitizers. If we are treating the
insulin resistance, then a slight increase in IR from the pill will be addressed
anyway. It's always a balance of benefit and risk, and an educated decision is what is
needed.
In addition, I made this post on the women's health discussion list at obgyn.net. The
original post was made on the pcos medication forum there, so I sent it to another
doctor for an opinion. Search for it on Wed, 15 May 2002 08:56:09 -0500 (CDT),
From: William McIntosh, MD, Subject: Re: Question for doctor
regarding my 14 May
post.