Contraceptive care

New pill changes perception of birth control

New pill changes perception of birth control

December 19, 2005|By KRISTIN WILSON

Across generations, time zones, political boundaries and cultures, women of childbearing ages share one inalienable truth: once a month, they will get a period.

Such a truth, however, has been turned on its head with the discovery in the gynecological world that women, at least some women, do not need to menstruate on a monthly basis.

Two years ago, the first U.S. Food and Drug Administration-approved extended-cycle oral contraceptive hit the market, giving women the choice to reduce the number of periods they experience to four a year.


This concept continues to catch on among Tri-State area women interested in contraceptives, says Dr. V. Ashok Rangnath, a gynecologist and obstetrician at Women's Health Center at Robinwood Medical Center near Hagerstown.

The new birth-control pill is called Seasonale. Instead of the standard birth-control pill packs that come with 28 pills, a prescription of Seasonale includes 91 pills and provides three continuous months of contraception before a woman has a period.

While the product and concept is revolutionary to many women, it is nothing new for gynecologists.

"We have been doing continuous contraception in gynecological offices for many, many years," Rangnath says. "You can actually do the continuous method with any birth-control (pill) that is on the market."

Gynecologists learned years ago that women could postpone periods by taking a hormone pill continuously. This was often prescribed for women who had difficulties associated with menstruation, including endometriosis and chronic pelvic pain.

But for women today, it is entirely possible to choose when and how frequently they menstruate.

"Now women can postpone their cycles," Rangnath says. "Previously there was nothing you could do about it. It is very nice from a convenience perspective."

Brad Imler, president of the American Pregnancy Association, says the concept of Seasonale is attractive to many women.

"In observations the idea of the absence of periods is appealing. The concern that women do have as they consider taking that route is, 'If I'm changing my cycle that much, what potential risk is there?'" he says.

Women still have many questions and concerns about altering natural menstruation when considering a continuous contraception method, Rangnath adds.

"A lot of people say, 'Is it safe for me to not have a period for three months?'" Rangnath says. "For a select group of women, the answer is yes"

"What the continuous birth-control pill does is keep the lining of the uterine wall very, very thin," Rangnath explains. That means that there is not much material to be shed during a period. "There are many female gynecologists who put themselves on continuous contraception for six months," he adds, pointing out a show of confidence in the medication.

In fact, birth-control research is looking into the possibility of offering a pill that would extend time between periods to longer than once every three months, Imler says.

"I think that in the future you'll be able to postpone your cycle for six months, one year or longer," Rangnath adds.

Seasonale is just one form of birth control that is offering new choices to women.

In 2001, the FDA approved the first contraceptive vaginal ring. Called Nuvaring, it is a transparent ring that is inserted into the vagina. The ring stays in place for three weeks, releasing a continuous dose of estrogen and progestin to keep a woman from ovulating.

A contraceptive product called Implanon is still being researched. Implanon is a single, plastic rod inserted under the skin in the upper arm. The rod keeps a woman's body from ovulating for as long as three years.

New products are constantly being tested and developed to increase options for women's reproductive health and to improve efficacy.

The innovation is largely striving to make birth control more convenient for women, says Rangnath and Tammi Spangler, a family planning clinician with the Washington County Health Department.

"I think most of it is that we want to give the minimal amount of hormones to the client that is going to produce the least amount of side effects and is going to prevent against pregnancy. The thing is too, what's more convenient for the woman," Spangler says.

Ortho Evra, the birth-control patch, debuted in 2002 and continues to grow in popularity in the Tri-State region, doctors and women's health advocates say.

However, in November, the FDA released findings that users of the patch are exposed to 60 percent more estrogen than if they were using a "typical birth-control pill" containing 35 micrograms of estrogen, according to information from the FDA.

"The concern is that the higher the estrogen, the higher the risk of certain side effects," explains Rangnath. Common side effects include breast tenderness, nausea and abdominal cramps. More serious, but rare complications could include blood clots, stroke or heart attack.

The FDA warning states that "it is not known whether women using Ortho Evra are at a greater risk of experiencing these serious side effects."

All forms of hormone-based birth control have similar potential side effects. With all of the choices available to women, it is best to talk with a health-care provider about what is best for individual patients.

How it works

Seasonale reduces the number of periods a woman has in one year from 12 or 13 to four.

Preventing pregnancy

Every year there are 60 million American women of childbearing ages. Sixty-four percent of those women use a form of contraception, according to the American Pregnancy Association.

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