Contraception (birth control) browsing by tag


Should you be worried about the blot clot risk with newer birth control pills?

Monday, November 21st, 2011

You might have read the news that YAZ and Yasmin, two newer birth control pills, are riskier to take than older contraceptives due to higher potential for blood clot formation.

But it’s important to put this into perspective. No matter what birth control pill you use, blood clots are a possibility, if an uncommon one. What you might not know is that blood clots are even more common in pregnancy. Fortunately, the vast majority of the millions of women who get pregnant and give birth each year don’t suffer blood clots. Just as millions of women take birth control pills with no such side effects.

So, is there a unique problem with YAZ? Yes, but not the one identified in the headlines. The problem is in the marketing.

YAZ was promoted to women as a pill for bloating and acne in addition to its contraceptive effects. While that might be a good marketing strategy, it’s not a good medical one. Contraceptives are for birth control, and the best one for you, based on your medical history, might have nothing to do with acne. People shouldn’t pick their birth control the way they pick their toothpaste—on the basis of consumer advertising. You should consult your doctor who will look at your history and decide what form of contraception meets your needs. If your family has a history of strokes, blood clots, or thrombophlebitis (a blood clot that causes swelling in a vein), your doctor will almost certainly order advanced testing due to the possibility that any birth control pill—YAZ, Yasmin, or older medicines—might be inappropriate for your condition.

But if your doctor has already determined that YAZ or Yasmin is a safe bet, and you’re on one of these now? Keep taking it unless your doctor says otherwise. The alternative could be unintended pregnancy. And pregnancy, ironically enough, is more likely to cause a blood clot than your birth control pills.

– Yvonne S. Thornton, MD, MPH

Overweight or Obese? Don’t Count On Your Birth Control Pills.

Wednesday, July 14th, 2010

Since the pill first appeared on the scene, about 50 years ago, women have felt secure knowing that they had an almost foolproof way to avoid unwanted pregnancies. And that’s been mostly true.

But maybe not for all women.

If you’re overweight or obese, recent studies suggest that birth control pills might not be as effective for you as they are for more slender women:

“In one study of oral contraceptive pills, women with a body mass index (BMI) in the overweight range (a BMI of 25 or more) had a higher risk of pregnancy that those in the normal weight range. In another study of contraceptive skin patches, higher body weight — not higher BMI — was associated with higher risks of pregnancy.”

In addition to the sobering news about the lessened effectiveness of hormonal birth control, these birth control methods are thought to slightly increase a woman’s risks of heart disease, high blood pressure and other conditions. When you consider that overweight and obese women are already at increased risk of heart disease, diabetes and other ills, and that pregnancy is a riskier venture, overall, for obese women and their babies, you have a new incentive for getting your weight down.

I know it isn’t easy. I’ve struggled with weight myself and can attest to the fact that it’s a constant battle. But it’s a battle we must fight – and win. And now, we have one more reason to do it.

– Yvonne S. Thornton, MD, MPH

Why it’s essential to offer kids comprehensive sex education

Monday, August 31st, 2009

In a recent study, about half of teens surveyed admitted to sexual activity. It’s a fact of life that adults have to face squarely.

And adults probably would be naïve to assume that the only ones having sex are the ones who are willing to admit to it.

But there’s another factor to consider: kids without access to comprehensive sex education may not know enough to call the sex that they’re having “real” sex.

Consider this finding from another survey, this one of ninth graders, that appeared in the journal Pediatrics in April 2005:

Adolescents evaluated oral sex as significantly less risky than vaginal sex on health, social, and emotional consequences.

That study found that, because of their assumptions about it being less risky, considerably more ninth-graders were having oral sex than were having vaginal sex.

Clearly, we’re failing our children if they believe that oral sex is less dangerous to their health. Oral sex can expose teens to the same sexually transmitted diseases — herpes, Chlamydia, gonorrhea, and HIV — as “real” sex. The only risk they’re avoiding by having oral-genital or anal-genital intercourse instead of genital-to-genital contact is pregnancy.

So why don’t kids know the risks?

Because we adults are not providing them with frank, comprehensive sex education.

We all want to keep children safe and preserve their innocence. But think for a minute — would you hand over the car keys to a child who’s never had a driving lesson? Teens are exposed to a more powerful drive than the one to get behind the wheel. Those raging hormones of adolescence are a biological imperative. We ignore that irrepressible drive at our children’s peril.

As an Ob-Gyn, I see the consequences of inadequate sex education. After years of decline, STDs are on the rise among adolescents. So is pregnancy.

We need to be honest with our children about sex, not because we expect them to be sexually active any more than when we expect them to crash the car when we tell them to buckle up. We must do it to protect them. We would be negligent not to. And, we need to discuss sexual intercourse and all the attendant risks along with the responsibilities before they are teenagers.

Age-appropriate sex education must be available to all youngsters. It must be comprehensive, and include detailed information about homosexuality, heterosexuality, anal-genital intercourse, oral-genital intercourse, and sexually transmitted diseases, as well as abstinence. We must tell our youth the entire story, without flinching or sugar-coating. A child’s future fertility, even his or her life and quality of life can be at stake. If that doesn’t merit giving them the truth, I can’t imagine what does.

– Yvonne Thornton, MD, MPH

Pregnancy and the pill

Tuesday, June 16th, 2009

For many women, taking the pill is more a matter of delaying pregnancy until the time is right rather than preventing it all together.

So, the big question becomes, how long after you stop taking the pill can you expect to become pregnant? No two women are alike but, generally speaking, pregnancy is possible the next time you ovulate. You may ovulate within two weeks after finishing up your last package of birth control pills. So, theoretically, you could become pregnant almost immediately. However, as we all know, there are many variables. Some couples try for years to become parents without success.

It almost seems an unfair trick of the heavens that it’s sometimes the women who don’t want to become pregnant who easily do.

That means, if you’re dead set against pregnancy, and you stop the pill, you need to begin another form of contraception immediately. I actually recommend that my patients begin using an alternate contraceptive before getting off the pill so they get into the habit of using it.

Otherwise, you may have to get into the habit of changing diapers.

– Yvonne Thornton, MD, MPH

Can you use the “morning after” pill as your main form of contraception?

Wednesday, May 20th, 2009

Some women wonder whether, since the morning after pill (a.k.a. “Plan B”) can prevent pregnancy, they can take it whenever they have intercourse and skip other forms of contraception.

Here’s the short answer: No.

Okay, now for the longer answer. Plan B delivers a wallop of hormones – at least twice the amount that you’d get in a high dose birth control pill. We doctors just don’t know what effect such a massive dose of hormones might have on a woman’s body over time, including an increase in the risk for blood clots and strokes. That’s because there have been no studies done on using the morning after pill as anything but a one-shot emergency contraceptive.

If you try to use Plan B as ordinary contraception, you will be, in effect, going into the “do-it-yourself” research business, with yourself as chief guinea pig. You’ll be risking your health while not developing a responsible approach to birth control. There are plenty of effective, tested contraceptives on the market. Use this medicine only for the purpose it was intended to serve.

– Yvonne S. Thornton, MD, MPH