Discuss the various available hormonal methods of birth control.
Hormones And Birth Control Essay
There are a number of methods available to help prevent pregnancy. Deciding which method is right for you involves considering a number of issues, including convenience, cost, potential side effects, and your future pregnancy plans. (See “Patient education: Birth control; which method is right for me? (Beyond the Basics)”.)
Hormonal methods of birth control (contraception) contain either estrogen and progestin, or progestin only; they are a safe and reliable way to prevent pregnancy for most women. Hormonal methods include an implant, an intrauterine device (IUD), injections, pills, a vaginal ring, and a skin patch.Hormones And Birth Control Essay
This topic discusses the various available hormonal methods of birth control. Nonhormonal methods, which include the copper IUD, barrier methods (eg, male and female condoms), and the cervical cap, diaphragm, and sponge, are discussed separately. (See “Patient education: Long-acting methods of birth control (Beyond the Basics)”, section on ‘Intrauterine device’ and “Patient education: Barrier and pericoital methods of birth control (Beyond the Basics)”.)
When a woman becomes sexually active and fertile, she needs to find ways of preventing pregnancy if she feels that her time to get pregnant has no reached. Birth control refers to the prevention of pregnancy. Today, women have a variety of birth control that they can choose. Different women find different birth control methods that they find comfortable. This paper looks at birth control.Hormones And Birth Control Essay
Discussion
Several birth control methods exist that women can choose. However, the fact that many birth control methods exist, presents a difficult option for women. Women respond to contraceptive pills differently. Some pills work for certain women but do not work for other women. They range from using condoms to contraceptive pills, from IUDs to diaphragms. Birth control work to prevent pregnancy by preventing sperm from coming into contact with an egg.
Because many different methods of birth control exist, contraceptives appear in various categories. These categories include long-term contraceptives, barrier methods, natural birth control, and hormonal birth control. Although certain birth control, options prove inadequate, most of them work effectively. The usage of these birth control methods may impair the effectiveness of using them. They require that one follow instructions carefully.
Hormonal contraceptives help to prevent a pregnancy through imitative forms of naturally occurring hormones to prevent the body of a woman from ovulating. In certain cases, the hormones may also work to thin the lining of the uterus and thicken cervical mucus. Unfortunately, hormones can produce unpleasant side effects including decreased libido. This can cause some women to avoid this birth control option. Examples of hormonal contraceptives include birth control pills, the birth control patch, implanon, birth control ring and IUDs such as mirena.Hormones And Birth Control Essay
Barrier methods prevent the sperm from meeting with the egg. Contraceptives that work this way include diaphragms, cervical caps, the contraceptive sponge and male condoms. Condoms offer another advantage of preventing sexually transmitted disease transmission. However, the use of condoms has proven to fail sometimes. This happens because condoms have the capability of busting when in sexual contact. This may spill sperm on the woman and result in pregnancy.
Another form of birth control method involves the long-term birth control. These methods work permanently to prevent women from getting pregnant. However, women can reverse the long-term birth control methods when they feel the need. Long-term birth control methods include tubal ligations and certain methods of vasectomy. Once an IUD has been inserted, it can stay in place for a period of between five to eight years.
Many women prefer to use the natural birth control methods and hormone free birth control. The fertility awareness methods offer another option for women. This method relies on periodic abstinence. A woman may only engage in active sex during her safe days. Fertility awareness management can involve charting the body of a woman temperature and menstrual circle. It involves noting the changes in the cervical mucus and using the rhythmic method or the newest incarnation, the standard day method. Another rare method of natural birth control involves breastfeeding also known as lactation amenorrhea (LAM).Hormones And Birth Control Essay
Conclusion
Birth control has existed for thousands of years. Today many of the birth control options prove safe, reliable and effective. Women have several options to choose from, when they want to prevent pregnancy. However, they should consult and know the facts about each birth control method. One can learn about birth control methods by consulting physicians or reading information about them. The responsibility for most of the birth control lies with the woman. New methods of birth control come up each time. Therefore, an appropriate method for a couple may change with time, circumstances and bodily changes.
Are you interested in birth control are know someone who is? Are you stuck or know someone who is stuck in between which birth control to use? Well, being a woman myself I have found that using the birth control Implanon was the best birth control for me only because it is convenient, mess free, and it last for up to three years. People around the world have used birth control methods for thousands of years. These methods include things such as condoms, pills, shots, and many other things that have advanced though out the years. Today, the world has many safe and effective birth control methods available to us, however all birth controls do not work the same for everyone. Birth control which is also formally known as contraception or fertility control are methods or devices used to prevent pregnancy. Birth control methods have been used for many years dating back all the way to ancient times. In fact Egypt has some of the earliest documented birth controls. For example the women there would use honey, acacia leafs and also lent to stuff up their vaginas to block the male sperm from entering.Hormones And Birth Control Essay
Birth Control
Birth Control is defined as various ways used to prevent pregnancy from occurring. Birth Control has been a concern for humans for thousands of years. The first contraception devices were mechanical barriers in the vagina that prevented the male sperm from fertilizing the female egg. Other methods of birth control that were used in the vagina were sea sponges, mixtures of crocodile dung and honey, quinine, rock salt and alum. Birth Control was of interest for a long time, but women did not worry to much about it because child death rates were so high. They felt they needed to have many children just for a few to survive. In the early 1800’s death rates began to drop and people began to show concern for controlling…show more content…
The first method is abstinence or no sex play, this will keep sperm from joining egg. This method is difficult for many people because they have a hard time going without sex for long periods of time and they forget to protect themselves when they stop abstaining. The outercourse method means you will have sex play without vaginal intercourse. This is also difficult for many people and they sometimes forget to protect themselves. The most popular form of birth control in the U.S. among married couples over the age of 30 is surgical sterilization. In the woman this is done by severing and sealing off the Fallopian tubes. The tubes that carry the egg from the ovary to the uterus. The operation is called a tubal ligation. In the male, sterilization is accomplished by severing the two vas deferens. The tubes that carry sperm from the testes to the penis. This procedure is called a vasectomy. Surgical sterilization is relatively easy to accomplish for either sex and is virtually free of known side effects, it is also 100 percent effective. It should be considered a permanent method of birth control. There are several chemical methods of birth control on the market. Oral contraceptives or the pill, are chemicals that work by altering a woman’s normal hormonal patterns so that ovulation does not occur. Their introduction in the late 1950’s revolutionized birth control. The pill is nearly 100 percent effective when taken according to directions.Hormones And Birth Control Essay
Contraceptive methods have been there for thousands of years but in the last fifty years the methods of contraception have increased tremendously. Different contraceptions work in different ways. There are hormonal methods like the pill, barrier method like the cervical cap, Intrauterine devices and sterilization. There is also the emergency pill. Most contraceptives work in different ways such as preventing release of the egg, blocking the sperm from reaching the egg , blocking the functioning of the reproductive organs or ensuring the fertilized egg from implantation (Committee on Contraceptive Development 134). A fertile woman who is sexually active has many options to family planning but should bear in mind that no method is 100% effective against sexually transmitted diseases except abstinence from sex.
There are two types of hormonal contraception.
The differences involve the type of hormone contained, the amount of hormone that is used and how that hormone is administered in the woman’s body. The hormone of use is usually progesterone or estrogen and can be taken orally, injected into the skin, implanted in the body, absorbed from a patch or placed in the vagina (Darney 68). How the hormone is delivered determines how effective it is and if the exposure is continuous or not.Hormones And Birth Control Essay
All the hormonal methods are very effective and reversible but do not protect against sexually transmitted diseases. The pill is made from synthetic hormones and is one of the most effective barrier methods. It comes in two forms one is the combined form which contains estrogen and progestin, it works by preventing the ovaries from reaching maturity interfering with ovulation. When there is no ovulation there is no egg to be fertilsed. The pill is packed in small caps of either 21 days or 28 days.
The second type is the mini pill; it has only one hormone progestin which works by thickening the cervical mucus preventing the sperm from going through the cervix. It also makes the uterine lining less receptive to an egg that has been fertilized and has to be taken every day. The pill cannot protect against sexually transmitted diseases. The pill needs discipline when taking it for it to be effective (Mastroianni 98).Hormones And Birth Control Essay
The mini pill is recommended for women who need to avoid estrogen due to medical reasons such as liver disease and some types of blood clots in the veins. It is also best for nursing mothers since it has no effects on breastfeeding. The pill may lose its effectiveness when taken with drugs like tetracycline. It might also lessen its effects when a woman vomits or diarrhea. Symptoms such as spotting or vaginal bleeding, tender breasts or nausea can be expected within the first three months after use.
Studies show there is no significant weight gain while on the pill contrary to popular belief. Mood swings, pigmented skin, melasma may occur with contraceptives. There is also possibility of amenorrhea which is rare. Using the hormonal pill does not increase possibility of birth defects in babies though a nursing mother should not use combination contraceptives because it can limit the milk and proteins in the milk and the hormone also gets into the breastmilk. Female smokers using pill risk getting a stroke or a heart disease contrary to non smoking females on the pill.
Blood clots are frequent with low dose oral pills but at a low risk as compared to pregnant women. The pill is not for women with clotting tendencies. Female smokers over 35 years should not be using contraceptives. When a woman experiences cramps in the legs, blurred vision or loss and flashing lights, shortness of breath, pain in the abdomen, coughing blood or swelling in the leg, they should contact a doctor immediately (Darney 123). The benefits of taking the pill apart from being highly effective is that it can influence regular menstruation, it can reduce the menstrual flow and cramps.Hormones And Birth Control Essay
Researchers have evidence that the pill might protect against pelvic inflammatory disease (PID) and anemia. Combination pill can reduce t acne, cysts in breast and ovaries and ectopic pregnancy, uterine and ovarian cyst. Women on the pill are unlikely to develop rheumatoid arthritis and osteoporosis (Committee on Contraceptive Development 102). The patch is worn on the skin on the low part of the abdomen, buttocks or upper part of the body except the breast. It releases estrogen to the blood. One patch can be used for a week and is not worn during menstruation.Hormones And Birth Control Essay
The vaginal ring also releases progestin and estrogen and is worn for about three weeks inside the vagina. It is also taken out during menstruation and a new ring inserted. Emergency contraception is not like the other methods of birth control. It is used after sex if the chosen birth control method fails like a condom burst. The implant also offers a long term protection against and can stay for up to three years and offers no protection from STI’s. It also contains progestin which is released daily and has same effects as the pill. A nurse or a doctor inserts it in the arm and is more effective than the pill due to lack of human error.Hormones And Birth Control Essay
Those opposing hormonal contraceptive use usually argue that is not right, is anti life and not natural. They also say it is the same as abortion and separates sex from its intended purpose of reproduction. This is a problem for Muslims and Christians who believe life starts at contraception. They also argue that hormonal contraception has consequences such as health risk because of the side effects it carries and it also raises many questions among the medical fraternity of how it really works because it allows conception to take place and then makes the uterus a hostile place. Hormonal contraceptives do not prevent sexually transmitted diseases and allows people to have multiple sex partners and also unlike barrier methods offers no protection against these diseases (Darney 67).
They say it gives rise to a dangerous contraceptive culture. Those opposing contraception argue that it is against humanity because potential humans are not born and can be used as eugenic. Sometimes types of hormonal contraception are mistaken for population mass control for certain races. There are also beliefs that contraception leads to depopulation. Some form of contraception like pills are prone to human error and therefore might lack to fulfill the intended purpose of preventing pregnancy.Hormones And Birth Control Essay
Contraception gives rise to a culture of sexual immorality because it makes it easier for unmarried people to have sex and not have children. It allows people to have sex purely for fun. This makes immoral behavior less risky and undermines public view on morality making it easy for people to cheat on their partners and in the process might weaken family ties.
1. Penta Stent
a. MRI Safety
MEDICAL IMPLANTS: PENTA STENT AND ENTERRA 3116 THERAPY SYSTEMIn non-clinical testing, Penta Stent has shown to be MRI safe immediately after its implantation. The MRI test conditions, which have been used to evaluate this stent, are for magnetic field interactions and a static magnetic field strength of 3 Tesla that has a maximum of a spatial gradient of 3.3 tesla/meter magnetic field; that is related to the MRI heating. The maximum whole body averaged a specific absorption rate (SAR) of 2.0 W/Kg a period of 15 minutes of MR imaging.Hormones And Birth Control Essay
However, even though a single stent is expected to produce a temperature increase of 0.6 degree Celsius while remaining intact within its position, the response of stents that are either overlapping or fractured is not yet known. Non- clinical testing have not been conducted to rule out any possibility of stent migration after being exposed to field strengths of more than three Tesla. Findings have also recently shown that the MR image quality will be part of it if the area of imaging is the same exact area (or if it is relatively close) to the position of the stent (Sasao, Hotta & Ogata, 2005).
b. Use for Implant
The Penta Stent is an implant designed to cure atherosclerosis (the hardening and narrowing of the coronary arteries over time) by improving the coronary luminal diameter. The stent particularly used for patients who are suffering from symptomatic ischemic heart disease due to the discrete de novo or the restenosis native coronary artery lesions that have a length of 25mm or less. In this case, the stent corrects vessel diameters that are within the range of 3.0mm and 4.0 mm.
The Penta Stent is also used to treat patients with symptomatic the ischemic heart condition that is brought about by lesions that have a length of 35mm or less in the saphenous vein bypass grafts. It should be in reference to vessel diameters that range from 3.0mm to 4.00 mm. The implant is also applicable to patients who are under treatment for abrupt or threatened abrupt closure in patients who have a failed interventional therapy in lesions that are 35mm or less. It is in reference to vessel diameters that range from 2.5mm to 4.00 mm.Hormones And Birth Control Essay
It is used to reinstate coronary flow in patients who are ailing from acute myocardial infarction with the confirmation by an ST segment elevation or angiographic findings. As long as the patient is presented for treatment within 12hours of the symptom onset while having coronary artery lesions of a length of 35mm or less. It should be in reference to the vessel diameter range of 2.5mm to 4.0 mm (Abbott, 2007).
c. Composition
The Penta Stent implant comprise of a pre-mounted 316L stainless steel, which has the components of nickel, iron, chromium, molybdenum stent. It has two radiopaque markers that are located beneath the balloon. These markers fluoroscopically mark the working length of the balloon within which the stent is laced. Two proximal delivery system shaft markers are between 95cm and 105cm from the distal tip. They are to indicate the relative position of the delivery system towards the end of a femoral guide catheter or at the end of a brachial.Hormones And Birth Control Essay
d. Manufacturer
The Guidant Corporation manufactures Penta Stent (NYSE and PCX: GDT). Guidant is a world leader in the management of the coronary artery disease.
e. Wait Period
Penta stent is MRI safe to use immediately after its implementation. There is, therefore, no period necessitated to elapse for a patient to go through MR imaging.
2. Enterra 3116 Therapy System
a. MRI Safety
It is not safe to use MR imaging on a patient who has an implant of Enterra 3116 treatment system. The potential exposure to the electromagnetic fields produced by magnetic resonance imaging may result in a system failure or dislocation of the implanted device. Exposure to MRI may also cause induced voltages in the neurotransmitter or the lead. This induced voltage may result into uncomfortable jolting levels of stimulation on the patient. The magnetic and radio frequency fields produced by MRI also known to change the neurotransmitter settings of the Enterra 3116 therapy implant. As such, it may activate the device and injure the patient.Hormones And Birth Control Essay
b. Use of the implant
The Enterra 3116 therapy system is a neuro-stimulation system used for the treatment of patients who have chronic drug refractory (intractable) nausea, vomiting and malnutrition that is secondary to the gastric paresis of diabetic or idiopathic etiology. The therapy uses mild electrical pulses gently to stimulate and ‘calm’ the stomach for patients aged 18- 70 years old. This electrically induced stimulation helps to control the symptoms associated with gastric paresis such as nausea and vomiting. This implant is however limited to the treatment of patients on which the conventional treatment regimens of drug therapy and diet have failed to control the symptoms of vomiting and nausea. Usually it is due to the possible risks that exist with the implantation of this device.
c. Composition
The Enterra therapy system uses a high frequency and low energy stimulation (HFS) neurotransmitter. The stimulus frequency that it yields is higher than the frequency of the intrinsic gastric wave that is slow at HFS 12 cycles per minute and a pulse of range of 33ms. The implant operates on a pulse generator that is battery powered. The generator is a Medtronic ITREL 3Model 7425 G and 3116 Neurostimulator; the implant is approximately 6cm long (2.5 inches) 5cm wide (2 inches) and 12 mm thick (0.5 inches). The stimulating electrodes are inserted at one centimeter from each other into the stomach wall. Theses leads or electrodes are secured with satures and small silicone discs, and the end of each lead is connected to the stimulator. Adjustments can be done on the electrical stimulation of the gastric tissues with an external programmer system by placing the programmer on the skin over the implanted pulse generator. The pulse generator is set to be on for a period of 0.1 seconds and then off again for a period of 5 seconds depending on how strong the stimulations should be in order to control the symptoms. The pulse generator has a life span of 5 to 10 years, where replacement is through another surgical procedure (Moga & Harstall, 2006).Hormones And Birth Control Essay
CHOOSING A BIRTH CONTROL METHOD
It can be difficult to decide which birth control method is best due to the variety of options available. The best method is one that will be used consistently and does not cause bothersome side effects. Other factors to consider include:
●Efficacy (how well it works to prevent pregnancy)
●Convenience
●How long the drug or device can be used
●Whether and how it affects your monthly period
●Type and frequency of side effects
●Affordability
●Privacy concerns
●Whether or not it also protects against sexually transmitted diseases
●How quickly your fertility will return if you stop taking it Hormones And Birth Control Essay
You should also think about whether you are comfortable remembering to take a pill every day, whether you want to involve your partner(s) in the decision, and whether and when you might want to get pregnant in the future. No birth control is perfect; you must balance the advantages and disadvantages of the different options and decide which method is best for you.
BIRTH CONTROL IMPLANT
The implant (brand name: Nexplanon) is a small rod that contains the hormone progestin. It is inserted under the skin into the upper inner arm by a health care provider (figure 1). It is effective for up to three years, but can be removed earlier if you decide you want to get pregnant or simply prefer not to continue use of the implant. Insertion and removal can be done in an office or clinic.Hormones And Birth Control Essay
The implant is one of the most effective methods of birth control. It provides up to three years of protection from pregnancy as progestin is slowly absorbed into the surrounding tissues. Depending on when during a woman’s cycle the implant is placed, backup birth control (for instance condoms) may be recommended for one week following placement. Irregular bleeding is the most bothersome side effect. Fertility returns rapidly after the rod is removed.
Side effects — The most common side effects of the implant are irregular/unpredictable bleeding.Hormones And Birth Control Essay
IUD WITH PROGESTIN
There are several intrauterine devices (IUDs) that contain a hormone called levonorgestrel (a type of progestin). One is called Mirena (in the United States) and can be left in place for up to five years. A device similar to Mirena (containing the same amount of hormone) is called Liletta and is approved for up to six years. The third and fourth options are called Kyleena and Skyla. These IUDs are somewhat smaller than Mirena and Liletta. Kyleena and Skyla can be left in place for up to five and three years, respectively. All are highly effective in preventing pregnancy.
Side effects — Although irregular bleeding is common initially after progestin IUD placement, bleeding tends to diminish over time. With ongoing use, women using Mirena or Liletta often experience little or no bleeding. Women who use Kyleena or Skyla are more likely to continue having monthly periods.
A complete discussion of the implant and IUDs is available separately. (See “Patient education: Long-acting methods of birth control (Beyond the Basics)”.)Hormones And Birth Control Essay
INJECTABLE BIRTH CONTROL
The only injectable contraceptive currently available in the United States is depot medroxyprogesterone acetate or DMPA (Depo-Provera). DMPA is injected deep into a muscle, such as in the buttock or upper arm, or subcutaneously (under the skin). With either dose, the injection is given once every three months.
DMPA prevents ovulation and thickens the cervical mucus, making the cervix impenetrable to sperm. If you get your first dose of DMPA during the first seven days of your menstrual period, it prevents pregnancy immediately. If you get your first dose after the seventh day of her period, you should use a second form of birth control (eg, condoms) for seven days. DMPA is very effective, with a failure (pregnancy) rate of less than 1 percent when repeat injections are given on time.Hormones And Birth Control Essay
Side effects — The most common side effects of DMPA are irregular or prolonged bleeding and spotting, particularly during the first few months of use. Up to 50 percent of women completely stop having menstrual periods (doctors call this “amenorrhea”) after one year of DMPA use. Monthly periods generally return within six months of the last DMPA injection, although in some women, it may take longer for periods to return. Some women gain weight while they are getting DMPA injections.
In women who get the DMPA shot, there is no increased risk of cardiovascular complications or cancer. Use of DMPA is associated with decreased bone mineral density; however, this effect is mostly reversed after stopping the injections. Studies have not shown an increased risk of bone fractures in women who have used DMPA in the past.
Because DMPA is long-acting, it may not be ideal if you expect to want to get pregnant shortly after stopping the medication. Although most women are able to conceive within 10 months, fertility may not return for up to 18 months after the last injection.Hormones And Birth Control Essay
Benefits compared with birth control pills — There are a number of women who prefer DMPA to the pill, including those who:
●Have difficulty remembering to take a pill every day
●Value the privacy with DMPA use
●Cannot use estrogen
●Also take seizure medications, which can be less effective with combination hormonal contraceptives (see ‘Anticonvulsants’ below)
Additional benefits of DMPA include a decreased risk of uterine cancer and pelvic inflammatory disease.
BIRTH CONTROL PILLS
Most oral contraceptives, commonly called “the pill,” contain a combination of estrogen and progestin. The combination pill reduces the risk of pregnancy by:
●Preventing ovulation
●Keeping the mucus in the cervix thick and impenetrable to sperm
●Keeping the lining of the uterus thin
The pill makes menstrual bleeding more regular, with fewer days of flow and overall lighter flow. Other benefits of the pill include a reduction in:
●Menstrual cramps or pain
●Risk of ovarian cancer or cancer of the endometrium (uterine lining) Hormones And Birth Control Essay
●Acne
●Iron-deficiency anemia (a low blood count due to low iron levels)
One potential downside of the pill is that in order to maximize efficacy, you have to remember to take it every day, ideally at the same time of day (see ‘Efficacy’ below). Some women find this difficult or inconvenient.
Efficacy — When taken properly, birth control pills are a highly effective form of contraception; however, skipping pills or forgetting to restart the pill after the week of your period will decrease efficacy (see ‘When to expect a period’ below). Approximately 9 out of every 100 women who take birth control pills for one year will have an unintended pregnancy.
Missed pills are a common cause of pregnancy. In general, if you forget to take an active pill (containing hormones), you should take it as soon as possible and take the next one at the usual time it is due. If you miss more than two pills, use a backup method of birth control (eg, condoms) for seven days.
Side effects — Possible side effects of the pill include:
●Nausea, breast tenderness, bloating, and mood changes – These typically improve within two to three months without treatment.
●Bleeding between periods – Irregular bleeding, also called “breakthrough bleeding” or “spotting,” is particularly common during the first few months of taking the pill. It almost always resolves without any treatment within two to three months. Forgetting a pill can also cause breakthrough bleeding.Hormones And Birth Control Essay
Taking birth control pills does not cause weight gain.
If you are taking the pill, tell your health care provider right away if you experience abdominal pain, chest pain, severe headaches, eye problems, or severe leg pain. These could be symptoms of several serious conditions including heart attack, blood clot, stroke, and liver or gallbladder disease.
Potential complications — When the pill was first introduced in the 1960s, the doses of both hormones (estrogen and progestin) were quite high. Because of this, cardiovascular complications occurred, such as high blood pressure, heart attacks, strokes, and blood clots in the legs and lungs.
The pills prescribed today have much lower doses of progestin and estrogen, which has decreased the risk of these complications. As a result, birth control pills are now considered a reliable and safe option for most healthy, nonsmoking women. While there is a very small risk of blood clots, this risk is actually lower than the risk in pregnant women or those who have recently given birth.Hormones And Birth Control Essay
Experts have studied the possible association between taking the pill and the risk of breast cancer. While these studies have had mixed results, there is some evidence that women who take the pill do have a slightly higher risk of getting breast cancer later in life than women who do not. However, if there is an increase in risk, it is very small, especially in younger women. It’s important to balance this against the benefits of the pill, which include not only pregnancy prevention but a reduction in the risk of ovarian and endometrial cancer (see above).
Who should not take the pill? — Because of an increased risk of complications, you should not take the pill if you:
●Are 35 or older and smoke cigarettes (as this puts you at high risk for cardiovascular complications such as blood clots or heart attack)
●Are pregnant
●Have had blood clots or a stroke in the past (as this increases your risk of blood clots while taking the pill)Hormones And Birth Control Essay
●Have a history of an “estrogen-dependent” tumor (eg, breast or uterine cancer)
●Have abnormal or unexplained menstrual bleeding (in which case the cause of the bleeding should be investigated before starting the pill)
●Have active liver disease (the pill could worsen the liver disease)
●Have migraine headaches associated with certain visual or other neurologic symptoms (eg, aura), which increases your risk of stroke
Some women may take the pill under certain circumstances, but need close monitoring. Talk with your doctor or nurse if you:
●Have high blood pressure – You may experience a further increase in blood pressure and should be monitored more frequently while on the pill.
●Take certain medication for seizures (epilepsy) – In this case, the pill may be slightly less effective in preventing pregnancy because the seizure medicines change the way it is metabolized. (See ‘Anticonvulsants’ below.)
●Have diabetes mellitus – Women with diabetes and kidney disease or vascular complications from diabetes should not use the pill.
Medication interactions — The pill may not work as well to prevent pregnancy if you also take certain other medications.Hormones And Birth Control Essay
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Anticonvulsants — Some anticonvulsants, including phenytoin (sample brand names: Dilantin, Phenytek), carbamazepine (sample brand names: Carbatrol, Tegretol), barbiturates, primidone (brand name: Mysoline), topiramate (sample brand name: Topamax), and oxcarbazepine (sample brand name: Trileptal), decrease the effectiveness of birth control pills, as well as the patch and vaginal ring. As a result, women who take these anticonvulsants are advised to avoid hormonal birth control methods (with the exception of depot medroxyprogesterone acetate [Depo-Provera] and intrauterine devices [IUDs] with progestin). (See ‘Injectable birth control’ above and ‘IUD with progestin’ above.)
Other anticonvulsants do not appear to reduce contraceptive efficacy, including gabapentin (sample brand names: Gralise, Neurontin), lamotrigine (sample brand names: Lamictal, Subvenite), levetiracetam (sample brand names: Keppra, Roweepra), tiagabine (brand name: Gabitril), and valproic acid (brand name: Depakote). However, there is some concern that oral contraceptives may reduce the effectiveness of lamotrigine, potentially increasing the risk of seizures.
If you take any anti-seizure medications, it’s important to talk with your health care provider about possible interactions before starting the pill or another hormonal birth control method.Hormones And Birth Control Essay
Antibiotics — Rifampin, which is sometimes used to treat tuberculosis, can decrease the efficacy of hormonal birth control. As a result, women who take rifampin are advised to avoid most hormonal birth control methods, with the exception of depot medroxyprogesterone acetate (Depo-Provera) and IUDs with progestin (see ‘Injectable birth control’ above and ‘IUD with progestin’ above). Other alternative options include an IUD, condoms, or a diaphragm, or tubal ligation (permanent birth control).
Contrary to popular belief, other (more commonly used) antibiotics do not affect the efficacy of hormonal birth control methods. Backup contraception is not needed when you take these antibiotics.Hormones And Birth Control Essay
St. John’s Wort — St. John’s wort, an herbal supplement sometimes taken to treat depression, may reduce the effectiveness of birth control pills, and possibly the patch and ring. (See “Patient education: Depression treatment options for adults (Beyond the Basics)”.)
Starting the pill — Ideally, you should start taking the pill on the first day of your period. This provides protection from pregnancy beginning immediately.
As long as you are sure you are not pregnant (which can be confirmed with a urine pregnancy test), it is also an option to start the pill as soon as your doctor prescribes it, regardless of where you are in your menstrual cycle. This is called the “quick start” method. If you do this, you will need to use a backup form of birth control (eg, condoms) for the first seven days after the quick start.Hormones And Birth Control Essay
Many women start taking the pill on the first Sunday after their period starts (because most pill packs are arranged for a Sunday start). If you do this, you will also need to use some form of backup contraception (eg, condoms) for the first seven days after the Sunday start.
When to expect a period — Traditionally, the pill is taken on a 28-day cycle that includes 21 days of hormone pills followed by 7 days of placebo pills (“no hormone pills”) that do not contain hormones. Newer formulations have a longer duration of hormone pills (eg, 24 days) and fewer days of placebo pills (eg, 4 days). It is not necessary to take the placebo pills as they do not contain any active ingredients, but many women find it easier to stay on schedule when they continue to take a daily pill throughout the entire 28-day cycle.
Your period should arrive during the fourth week of the pill pack (ie, the week that you are taking placebo pills or no pills). However, some women have irregular breakthrough bleeding or spotting in the first few months. (See ‘Side effects’ above.)Hormones And Birth Control Essay
Continuous dosing — Some women prefer to take hormone-containing birth control pills continuously, without the week of no pills or placebo pills. This allows you to control whether and when you have a monthly period. This regimen often works well for women with painful periods, endometriosis (a condition that causes abdominal pain), or bothersome premenstrual symptoms, including mood changes.
Traditional birth control pill packs can be used in continuous dosing. To do this, you take the first three weeks of a pill pack, then immediately start a new pack the next day (without taking a break or taking the placebo pills). This can be continued for as long as desired.
A pill called Seasonale was specifically designed for continuous dosing. You take an active pill every day for 12 weeks, followed by seven days of placebo pills; with this regimen, you only get your period once every three months. Seasonique is a different option that contains seven days of low-dose estrogen pills instead of the placebo pills; this is intended to reduce breakthrough bleeding and possibly other symptoms such as mood changes and headaches. Both Seasonale and Seasonique are also available as generics that work in the same way.Hormones And Birth Control Essay
Over time, using continuous-dosing regimens results in fewer periods per year (or no periods at all); however, many women experience unpredictable breakthrough bleeding when starting a continuous-dosing regimen. Breakthrough bleeding is inconvenient but does not mean that the pills are less effective (assuming you are taking them at the same time each day and not skipping any active pills).
Progestin-only pills — Some pills contain only progestin (sometimes called the “mini pill”); these may be an option for women who cannot or should not take estrogen. This includes women who are breastfeeding or who have worsened migraines or high blood pressure with combination contraceptive pills. Progestin-only pills are as effective as combination pills when taken at the same time every day, but have a slightly higher failure rate if you are more than three hours late in taking it. A backup method of birth control should be used for seven days if you forget a pill or are more than three hours late in taking it.Hormones And Birth Control Essay
Progestin-only pills are available in 28-day packs. Two types of progestin-only pills are available in the United States. For one type (containing norethindrone), all 28 pills contain hormone (ie, there is no “placebo week”). For the second type (containing drospirenone), each pack includes 24 hormone pills and 4 placebo pills. Breakthrough bleeding or spotting is common with progestin-only pills.
VAGINAL RING
This is a flexible plastic ring (figure 2) that contains estrogen and a progestin; the ring is inserted into the vagina, and the hormones are slowly absorbed into the body. This prevents pregnancy, similar to the pill. You keep the ring in your vagina for three weeks then leave it out for one week, during which you will get your period. The following week, you insert a new ring or reinsert the previous one (one type of ring is reusable for approximately one year, while the other type needs to be discarded and replaced each month). The ring’s position inside the vagina is not important.Hormones And Birth Control Essay
You can start using the vaginal ring anytime during your menstrual cycle. If you start it more than seven days after the first day of your last period, or if you’re not sure when your last period started, you should use a backup method of contraception (eg, condoms) for the first seven days of inserting the ring.
Most women cannot feel the ring while it is in place, and for most women, it is easy to insert and remove. It may be removed for a short time if desired (see below) but should be left in during intercourse. The ring is not usually felt by the sexual partner. You should check before and after sex to confirm the ring is in place. If the ring is left out for more than a few hours, you may be able to put it back in, or you may need to discard it, depending on which type of ring you use and (for NuvaRing) where you are in your menstrual cycle.Hormones And Birth Control Essay
If you use the ring that gets replaced each month (NuvaRing):
●During the first two weeks of your cycle, you can reinsert the ring and continue with the usual schedule. The ring should be rinsed in cool or warm (but not hot) water, without soap or detergent, before it is reinserted.
●During the third week, you can insert a new ring and begin a new cycle immediately. If the ring was previously in place for at least seven days in a row, you can also choose to leave the ring out for up to a week (during which you may get your period) and then insert a new one.
●Regardless of where you are in your cycle, if the ring is left out for more than three hours, you should use a backup method of birth control (eg, condoms) for the next seven days. Any backup method other than the female condom or diaphragm can be used.
If you use the reusable ring that gets reinserted each month (Annovera), the instructions are the same regardless of where you are in your menstrual cycle:
●If the ring is out for two hours or less, you can reinsert it. Before doing so, wash the ring with mild soap, rinse with water, and gently dry.Hormones And Birth Control Essay
●If the ring is out for more than two hours, either continuously or cumulatively (eg, if you take it out two separate times that add up to more than two hours), you should also clean and insert the ring. However, you also must use a backup form of birth control (eg, condoms) for the next seven days.
As with the pill, in addition to being an effective method of preventing pregnancy, the vaginal ring also has other potential benefits. These include a reduction in menstrual cramps, iron-deficiency anemia, and the risk of certain cancers. (See ‘Birth control pills’ above.)
Risks and side effects are also similar to those of oral contraceptives. (See ‘Side effects’ above and ‘Potential complications’ above.)
BIRTH CONTROL SKIN PATCH
Birth control skin patches (sample brand name: Xulane) contain estrogen and progestin, similar to oral contraceptives. The patch is similar to the pill in terms of efficacy in preventing pregnancy, although the failure rate of the patch may be higher for women who weigh more than 198 lbs (90 kg). Some women prefer the patch because it does not require remembering to take a pill each day; on the other hand, some women do not like having a visible patch on their skin.Hormones And Birth Control Essay
The patch is worn for one week on the upper arm, shoulder, upper back, abdomen, or buttock (figure 3). After one week, you remove the old patch and apply a new one; this is done for three weeks. During the fourth week, you do not apply a new patch; you will get your period during this time.
The patch is ideally started on the first day of your period. This approach provides protection from pregnancy immediately. If you prefer, you can also start using the patch on the day it is prescribed, regardless of where you are in your menstrual cycle (called “quick start”). If you do this, you will need to use a backup form of birth control (eg, condoms) for the first seven days.
As with the pill, in addition to being an effective method of preventing pregnancy, the patch also likely has other potential benefits, although studies are limited. These include a reduction in menstrual cramps, iron-deficiency anemia, and the risk of certain cancers. (See ‘Birth control pills’ above.)
While efficacy is similar to the pill, the patch may deliver a higher overall dose of estrogen. Some studies found that this was associated with an approximate doubling of the risk of blood clots compared with women using oral contraceptives (the pill). However, other studies found no increase in risk compared with women using the pill. Further study is needed to define this risk.Hormones And Birth Control Essay
PREGNANCY AFTER HORMONAL BIRTH CONTROL
The length of time it takes to become pregnant after use of a hormonal method of birth control depends upon which method was used, as well as some individual factors.
Most women return to their normal level of fertility within a cycle or two. For some, it may take several months before ovulation becomes regular and the woman can become pregnant, especially if her periods were irregular before starting birth control. However, hormonal birth control does not increase the risk of infertility. In general:
●Women who use the pill, skin patch, or vaginal ring usually start ovulating regularly again within one to three months of stopping birth control.
●With injectable depot medroxyprogesterone acetate (DMPA or Depo-Provera), return of fertility can be delayed. Approximately half of women who want to be pregnant are pregnant within 10 months of stopping DMPA. However, some women will not get their periods back for up to 18 months. (See ‘Injectable birth control’ above.)Hormones And Birth Control Essay
●Women who get an implant (eg, Nexplanon) or an intrauterine device (IUD) usually begin to ovulate again within one month after the device is removed.
EMERGENCY CONTRACEPTION
If you have unprotected sex (eg, did not use birth control or missed taking a dose), you can take a “morning after” pill to reduce your risk of pregnancy. This should be taken as soon as possible after sex, ideally within 120 hours. A copper intrauterine device (IUD) is another option for emergency contraception. More information about this is available separately. (See “Patient education: Emergency contraception (morning after pill) (Beyond the Basics)”.)
WHERE TO GET MORE INFORMATION
Your health care provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.Hormones And Birth Control Essay
Patient level information — UpToDate offers two types of patient education materials.
The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.
Patient education: Hormonal birth control (The Basics)
Patient education: Choosing birth control (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Ovarian cysts (The Basics)
Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (The Basics)
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Barrier and pericoital methods of birth control (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Depression treatment options for adults (Beyond the Basics)Hormones And Birth Control Essay
Patient education: Emergency contraception (morning after pill) (Beyond the Basics)
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Hormones And Birth Control Essay
