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' meaning 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' pill. This is a pill that is low on estrogen. 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. Want to talk to someone about it? Visit Yahoo!Groups Contraception. Birth control methods:
Don't think that the pill is the only form of birth control around. Ann Rose gives about the best overall, all around treatment of all different types of birth control. There are no only pills, but male and female condoms, the rhythm method, abstinence, and spermacides, just to name a few. You might also want to check out:
What New Contraceptives Are Available
The Journal of the American Medical Association
contraceptive choice list
Utah Med's site
US Medication's site
What a woman should know
Combination Birth Control Pill now available in one-third lower dose
Family Planning and Contraceptive Series
Pill, Birth Control, Oral Contraceptive & health information.
Birth Control Pill resource
Contraceptive Choices Home Page
whats in a Birth Control Pill
Contraceptive Guide Site Contents
A guide to managing contraception
Contraception Online Contraception Report
Mifepristone Shows Promise as Oral Contraceptive Agent
Cyproterone Or OCs Effective For Recurrent Pelvic Pain After...
Class-Action Trial on Third-Generation OC Set in UK
Birth Control - Suite101.com
Biphasic versus monophasic oral contraceptives for contraception
There is a place called Prescriptions By Mail that can help, or there's something called FemScript. It is free or a one time charge of $9.99 that you can pay to really get a cheap rate for a number of different pills. RXUSA is a discount store when you can get pills cheap. You might also want to try the local women's health clinics, like Planned Parenthood. They have them at either a lower price or are free.
As of August 2002, the latest news is that a study done over a period of 10 years found no increase in the risk of diabetes with pill use.
(Anonymous donor): The top 3 pills are Ovacon 1-35 (1.4 androgens), Brevicon (1.7 androgens) and Demulen 1-35 (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). 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, since you are already producing enough androgens. You might also want to try Mircette or Alesse, which are lower hormone dose pills (lower estrogen compounds). There have been several articles published on the androgen part of the contraceptive. Most American pills use ethinyl estradiol as the estrogen part, and change the progesterone component. ARHP has come out with a androgen paper and a antiandrogenic and ovulatory benefits paper on the pill. Don't forget: it isn't the amount of progestin you use to compare with. Its the *type*.
The biggest problems I've heard of are because its not a 'cure' for PCO, your symptoms come back with a vengence once you get off of it, and a higher problem with insulin resistance. Remember, as someone with PCO, you have a higher chance of getting heart problems, etc. due to possible insulin irregularities. The pill may not always help that. Overall the biggest problems are with the triphasic pills. Nausea, headaches, high blood pressure, bad mood swings are some of the symptoms. 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. There is also a 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.) Basically what he means is that while yes, there is a bad effect on your IR from the pill, even in low dose form, it is not significant enough to cause a problem down the road. In addition, the weight gain that you see on the pill subsides after a few months and it can be due to the anabolic response to the sex steroids you have. (Pg 59.) So, be patient and wait out any weight gain and see if it corrects itself. There are few mental disturbances on the pill, but if the estrogen interferes with the tryptophan production (to cause things like depression), it can be reverse with the use of pyridoxine treatment (addition of B6). (Pg 60.)
Contraception for Women With Diabetes
I did an unofficial poll in November 2000 on this subject. The average length of time between the first and second surgeries and taking the pill was 9 months. Most women took Lupron first, then went on the continuous BCP. I got all different kinds of pills tried, but the most popular 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.
Yes. I would check out a highly regarded pill Europeans have that we dont in America, called Diane 35. You can check out the New Zealand Govt.'s information on it. The ladies I've known who've tried it love it!
Depends, different people have had different reactions. Some people have no problem with it, PCOS ladies have had symptoms return like: weight gain, more acne and hirsuitism, and of course, return to irregular periods.
It appears it is safer than it once was. It is safer than ever with the newer low estrogen dose pills that have come out recently. This article talks about the myths about oral contaceptives if you are interested. Of course, smoking and the pill isn't a good thing, so try and cut down or stop smoking (this is a public service announcement from your webmaster). Another article: Oral Contraceptive May Reduce Symptoms of Premenstrual Dysphoric Disorder suggests that the pill is positive. Here are a few URL's that go both ways on the pill: The pill and breast cancer Study finds no link - June 26, 2002
Study suggests 'the pill' doesn't affect weight
New study adds to evidence that taking oral contraception does not increase risk of breast cancer
Low goitre prevalence among users of oral contraceptives in a population sample of 3712 women
Oral Contraceptive Use and Diabetes
The Risk of Cardiovascular Disease With OCs
Oral Contraceptives and Bone Mineral Density in White and Black Women in CARDIA
Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception
Concomitant Use of Fluoxetine, Oral Contraceptives Is Safe
Contraception Study shows OC use by young women does not contribute to weight gain
New low-dose Ortho Tri-Cyclen approved by FDA
Altering the OC regimen
Changing the 21/7 and 28 day pill standard
OCs may not increase cancer threat
Highest Rates of Oral Contraceptive Use Reported in Germany
Third Generation Oral Contraceptives Do Not Raise Risk of Myocardial Infarction
Low-Dose Oral Contraceptive Safe And Effective Treatment For Acne
Effects of two oral contraceptives on plasma levels of nitric oxide, homocysteine, and lipid metabolism
Hormonal contraception: what is new?
Efficacy of a low-dose oral contraceptive containing 20 µg of ethinyl estradiol and 100 µg of levonorgestrel for the treatment of moderate acne
Finally I found a new place listing drug interactions and the pill. The tips page from the women's health discussions mostly only list one antibiotic that is a problem.
There are several pills that you can take in case of accidental unprotected sex. Previn and the progesterone only pills and other types are listed on Princeton University's site. Also for reference: Emergency Contraception.
There has been research done on the low dose pills, much of it favorable.
The Pill may increase the risk of breast cancer
There is no link between the pill and breast cancer.
This was from a post I made in regards to the pill and PCOS on April 29, 2002 on a couple of PCOS forums in regards to misconceptions of the pill: 1) BCP page:
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.
There is also a 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. http://www.arhp.org/betcho.htm
Dr. Leon Speroff's book: A Clinical Guide for Contraception, 2nd edition. (Medical library call number: 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.) Dr. Leon Speroff is a well respected author of ob/gyn and reproductive endocrinology related material.
This article talks about the (http://www.arhp.org/clinical/cpmyths.htm) myths about oral contaceptives if you are interested. 2) Dr. Leon Speroff webpage:
Check out the following pages from his book, "Clinical Gynecologic Endocrinology and Infertility", published 1999 by Lippincott, Williams & Wilkins). 544, 545, 508-9, 898, 899, 46. 3) 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.