Barb's Daily Dose

The Birth Control Pill Helps Women

After working in women's health for close to 25 years, I've prescribed thousands and thousands of birth control pills and the NuvaRing to patients for a variety of reasons. With the recent increased focus on the Birth Control Pill, I thought it might be a good idea to review a few facts. In addition to prevent ing accidental pregnancy, which is a good thing, there are a number of other reasons that we prescribe the pill. Before I get to that, let's just do a quick review of some of the hormones and biology that influences a woman's life each and every month. This is by no means an all-inclusive or comprehensive list.

Wait to Start Pill

After mom's give birth, they need to wait at least 3 weeks before re-starting the birth control pill, according to the Centers for Disease Control. This advice is to help decrease the risk of serious complications such as blood clots. I agree, and want to add a bit more information for new moms. I encourage all of my patients to breastfeed their babies for the 6-12 months that's recommended by the American Academy of Pediatrics. For breastfeeding moms, the combination Estrogen + Progesterone pill is not recommended at all because it can decrease milk supply. 

Accidental Pregnancy

Every night in the US, 10 million couples of childbearing age and at risk for pregnancy have intercourse. For those of you doing the math, this includes people having sex before the clock strikes 10. The good  news is that the vast majority are using contraception. In fact over 90% do use some form of protection or birth control. And yet,  it's estimated that over 25,000 couples have condom mishaps and an additional 700,000 are not protected AT ALL.

Pennies for Pause

Our Featured Guest Today is Gina Dillon,

President/Founder of Pennies for Pause

Pennies for Pause (PfP) Concept is Simple:

It addresses unplanned pregnancy in young adults 18-29 by encouraging the use of long-acting reversible contraception (LARCs), life planning and problem solving skills with the use of a reward-based system delivered through social media outlets and an online collaborative website. PfP collects donated merchandise and creates a prize chest of items that can be earned by making responsible choices. Participants are awarded points for choosing to use a LARC, testing for STDs, committing to the use of condoms, participating in online discussions, problem solving and real life challenges. In order to be authentic and engaging, a staff of energetic young adults will operate the program in an edutainment approach.

The Pill Has Other Benefits

I prescribe the birth control pill almost every day that I'm in the office.  We've known for years that there are plenty of non-contraceptive benefits with the birth control pill, including:

• Decreasing menstrual pain
• Helping control acne, and
• Protection against certain cancers. 

I have patients with endometriosis who use the pill to keep the pain at bay.

Click here for an article on this topic that you may be interested in.

Contraceptive Convenience

Have you ever forgotten to take your birth control pill? What about trying to track down a condom and squinting in the dark to make sure it hasn’t expired? What about not having enough time to stop at the drug store to pick up a new pack of pills? And how many times, have you tried to remember the first day of your period so you can try to guestimate if you’re fertile?

Wouldn’t it be nice if we didn’t have to worry about birth control?

You know what? There are 2 options out there that can eliminate the day to day, month to month scrambling.

Mirena IUD – This is method that is great for women who’ve already had a baby. It’s good for 5 years and is over 99% effective. If a woman wants to get pregnant, once the Mirena is removed, she can start trying right away. There’s no delay.

No Periods?

Yes, that's right, women who are on birth control do not need to have a period every month. 

How is this possible, you wonder? Well, as long as there is balance in hormones, then there is no risk of problems. I'll explain a little further.

The menstrual cycle 

If you click on the link above you can learn more about the menstrual cycle, which will make this easier to understand.

Help, I forgot my Birth Control Pill

If I had a nickel for every time that I heard that!  This is a very scary experience, but don't fear, the answers are right here:

If you forgot 1 pill:  

Take it as soon as you remember, and use a back up method of birth control for 3 days to be safe.  You may notice some breakthrough bleeding or spotting for a few days.

If you forgot 2 pills in a row

Take 2 pills as soon as you can, and 2 more the next day to catch up. Use a back up method of birth control for 3 days to be safe. You may notice some breakthrough bleeding or spotting for a few days.

If you're always forgetting pills

Consider switching to another method of birth control.  Stay tuned, we'll talk about the options in the next few weeks.  There's:

NuvaRing

Mirena

Depo-Provera

Implanon

And my favorite, a girl's best friend, Condoms.

  

Birth Control and lowered Libido

I prescribe a lot of birth control pills and many NuvaRings for my patients. As you might imagine most women like their method and have few side effects. Women love the convenience of the NuvaRing and find it easy to use. Many providers, (myself included) like the fact that it has the lowest circulating dose of estradiol (15 mcg). The NuvaRing is a great option for women with menstrual migraines, acne, headaches, & with PMS. 

Within the last month, I have received 3 separate calls from women who wanted to stop using the NuvaRing because of much lower sex drive. One said, that she knows why it's such great contraception, because she has absolutely no interest in sex. Another found that her moods were depressed and she was much more fatigued. Another experienced hot flashes and night sweats on it. 

I searched the literature and the package insert and sure enough lowered libido is one of the side effects. This can happen with any form of hormonal birth control, not just the NuvaRing. Yet, I suspect that the lowered estrogen dose may make this more common in some women. 

The longer I practice, the more I notice individual variation among women. We can all take the exact same dose and yet, each will have a different experience.

Bottom line, if you are having side effects from any medication, give your provider a call and find a better alternative.

Breastfeeding as Contraception?

Recently I was asked whether women who breastfeed need to worry about contraception. 

The answer is:

You sure can.  If you're lucky enough to have the energy and the hots for your partner right now, even though you're probably sleep deprived and craving a little time to yourself. If you're thinking about some cuddling and some intimacy with your partner, then please be sure to use some form of birth control. Although women who are breastfeeding might not have a period, they can still ovulate and get pregnant.

So, play it safe and lubricate, lubricate, lubricate.  Most women who are breastfeeding find that their vaginas are very dry and don't stretch like they used to.  Likewise, their sexual response might be slower. This is a completely natural side effect of breastfeeding.  You see, the hormone prolactin that makes milk, inhibits the hormone estrogen which helps keep our private girl parts moist and able to stretch.  So, no matter what you use for birth control, get yourself some lubricant, and have fun. For more on breastfeeding, see my Personal Guide to Breastfeeding.