Doctors' Answers to "Frequently Asked Questions" - Contraceptives

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Oral Contraceptives and Headaches [posted 1/11/99]
Question: I have tried several low estrogen oral contraceptives and on each one, I develop severe headaches that last throughout my menstrual cycle. I am researching other forms of birth control, but I am wondering whether they have developed an oral contraceptive with a lower risk of this side effect. Apparently, this is a fairly common occurrence, because I know other people with this reaction as well as reading of it in the literature

Answer: Yeah, very common. Sometimes changing the ratio of estrogen to progesterone will help. Worth a try.

Ortho Tri-Cyclen and Weight Gain [posted 8/5/98]
Question: I am 17 and about to start taking Ortho Tri-Cyclen for my acne. I have heard that the Ortho Tri-Cyclen is known for making its users gain weight. I have also heard that the weight gain is very slight, if any. I am concerned about this and was wondering if you could give me some information about weight gain and this product?

Answer: All birth control pills have the tendency to increase weight in the user. Some seem more, some less. However, they are very individual specific, probably corresponding to individual metabolism as well as response to steroids of any type. Most weight gain is 10-20 pounds over 1 to 2 years.

Oral Contraceptives [posted 7/30/98]
Question: Do all oral contraceptives have the three mechanisms of action - prevention of ovulation, prevention of sperm from reaching the egg and prevention of implantation? Do any have only the first two mechanisms of action?

Answer: Correct, but the relative protection depends on the amount of estrogen , the amount of progesterone type drug and the relative ratio of the two.

Oral Contraceptives
Question: Why is it important to take oral contraceptives at the same time daily? How likely is it to become pregnant if you do not do so?

Answer: It’s not usually not a big deal. However, it depends on the strength of your pill. If you are using a very low dose pill, excess time variation could increase the risk of pregnancy somewhat.

Birth Control Pill
Question: I recently started birth control and I had a major break out what should I do? Should I change my prescription? And do you know of anyway to clear up a complexion fast?

Answer: Acne is caused by relative levels of testosterone. Estrogen is metabolized to testosterone by fat cells which then produce acne as well as affect one's sex drive(usually higher with higher levels of testerone). A different proportion of estrogen to progesterone might work-discuss this with your physician. Topical medications like benzyl peroxide would be the best way to go until this can be accomplished. Oral antibiotics will also help.

Side Effects of Stopping
Question:I have been on few different oral contraceptive and depo shot for the past 5 years. I finally decided to get off the pills and start a family. I have been off them for 2 months now, and my period came 29 days cycle for the first month. Now, I am expecting in any days. Well more like I was expecting few days ago. I have been having so called PMS for past week and a half, cramps and headaches for the most part and it is really bad. My first day of the last period was July 2nd. I tried to find some or any information about after care type of thing about birth control pills, but out of luck and I found you.

Answer: There is no special regimen after stopping birth control pills. Usually, your normal cycle will start with your ovaries and your pituitary gland. There is no reason to wait to get pregnant-stopping the pills will have no effect on the fetus. The length of time-whether 2 months or 5 years doesn't seem to matter. However, periods are often more crampy and with higher flow since the estrogen doses in BCPs are usually lower than your bodies own levels.

Time Frame
Question: I've been on the pill for several years now. Is there a time limit of how long a person should take the pill?

Answer: Doesn't seem to be. There is some increased risk for cardiovascular disease after 35-particularly in smokers. But, if you don't smoke, I wouldn't be too concerned.

Cysts on Ovaries
Question: I am 26 years old. I have been on the pill (Nordet 28) for 11 years. I was put on the pill when I was 15 because I had cysts on my ovaries. As the years passed when I tried to stop taking the pill to have children I have developed cysts. I gave up hope of ever having a child. Then in 1992 I was told that I had didelphic uterus and that I may not be able to carry a child. Well as I sit here I have a seven week old baby girl in my lap!!! I was having very severe panic attacks back in 1994 and was prescribed Paxil. The attacks stopped after about a month but I continued to take the Paxil. I guess my question is has Paxil been associated with decreasing the effectiveness of the pill or was my baby just meant to be? I took the pill every night at 9pm. I took the Paxil at 9am.

Answer: Fortunately, if a child is to be born-statistics don't have a lot to do with it. Cystic ovaries can still ovulate and if the egg implants in the correct part of a congenitally deformed uterus, it will still go to term. This child was destined to be born.


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