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--- home:othertreatments:birth_control [07.13.2009] – paulalbert
+++ home:othertreatments:birth_control [05.02.2011] – external edit 127.0.0.1
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+====== Birth control ======
+<relatedarticles> [[home:special:pregnancy|Pregnancy and fertility]], [[home:othertreatments:female_hormones|Female hormone supplementation]] </article>
+Women of childbearing age who are on the MP and sexually active are advised to use adequate contraception measures to avoid an unwanted pregnancy. Note that the MP can increase fertility.
+Because the MP can increase or restore fertility, women of childbearing age who are on the MP and sexually active are advised to use adequate birth control measures to avoid an unwanted pregnancy.
+The doses of hormones found in birth control are low enough that patients need not be excessively concerned with their effect on immune function.
+===== Types of hormones in birth control =====
+  * estrogens – suppresses the body's normal hormonal-driven pattern of producing an egg every menstrual cycle
+  * progestin – works to thicken the cervical mucus, which hinders the movement of sperm and inhibits the egg's ability to travel through the fallopian tubes
+===== Types of birth control =====
+There are two general kinds of birth control: those forms that consist of two synthetic hormones, estrogen and progestin; and those forms that contain progestin alone.
+  * **The combination pill** – Contains estrogen and progestin. Sometimes called the "pill" or the combined oral contraceptive pill (COCP).
+  * **The patch** –  Contains estrogen and progestin. The patch is only applied once per week. Example: Ortho Evra.
+  * **Vaginal ring** – Contains estrogen and progestin. Inserted and removed approximately once per month. Example: NuvaRing.
+  * **The progestin-only pill** – Contains progestin alone. Sometimes called the "minipill."
+==== Adjust to birth control before starting the MP ====
+Women about to begin the MP who have been prescribed birth control medication to use while on the MP should take that medication for one menstrual cycle to ascertain the effect of hormonal changes. They should then start the olmesartan (Benicar) blockade when they are not pre-menstrual, as per guidelines on [[home:starting|starting the protocol]].
+Women should consult with their health care practitioners regarding this suggestion and ask him/her to monitor hormonal levels as they progress on the MP to make sure that the birth control medication continues to prevent ovulation. The physician may advise the use of additional contraceptive measures.
+===== General advice about hormone supplementation =====
+<mainarticle> [[home:othertreatments:hormone_therapy|Hormone and pro-hormone therapy]] </article>
+{{section>:home:othertreatments:hormone_therapy#hormone_and_pro-hormone_therapy&noheader&firstseconly}}
+===== Patients experiences =====
+<blockquote>I used Ortho-lo because I started to get frequent spotting between periods and bad menstrual cramps at random times. It didn't seem to be working right. I switched to NuvaRing, a ring inserted each month and it's been great. No spotting, no cramps whatsoever, the lightest period I have ever had. I'm very happy with it and it SEEMS to be working quite well. It is a possibility that the reason the Ortho-lo wasn't working right had less to do with the MP and more with the low level hormones just not having enough effect. So of course i can't guarantee if NuvaRing is preventing pregnancy, but it seems to be working correctly.
+//**Ames**//</blockquote>
+<blockquote>
+The decision to use the NuvaRing for birth control has really worked out for me. Before starting with it I was having 60-80 days between cycles with really heavy bleeding. I know my whole system was struggling to send the right hormonal signals to all the right places. Now, with the use of the Benicar (and a little hormonal help from the NuvaRing) my cycles are regular, manageable and reasonable.
+//**Joyful**//</blockquote>
+{{tag>Non-MP_therapies Hormone_Supplementation}}
+=====Notes and comments=====
+<blockquote>
+Not sure how good this study is....
+J Am Coll Nutr. 1998 Jun;17(3):282-4.
+The association of oral contraceptive use with plasma 25-hydroxyvitamin D levels.
+Harris SS, Dawson-Hughes B.
+Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts 02111, USA.
+Abstract
+OBJECTIVE: This analysis was conducted to compare wintertime 25-hydroxyvitamin D (25OHD) levels of young women who did and did not use oral contraceptives (OC).
+METHODS: The subjects were 66 Caucasian women aged 20 through 40 recruited from the Boston area. Plasma 25OHD was measured in February or March and again 1 year later. Other measurements included height, weight and vitamin D intake from diet and supplements.
+RESULTS: The initial mean 25OHD level of the 26 OC users was 41% higher than those of nonusers before adjustment for age and vitamin D intake (83 +/- 40 (sd) nmol/L compared with 59 +/- 22), and 39% higher after adjustment (p = 0.003). Five women who discontinued OC use during the year following their initial measurement all had decreases in their 25OHD levels (mean change was -25.5 +/- 17.7 (SD) nmol/L), whereas levels in women whose OC use or non-use was constant did not change.
+CONCLUSION: OC use increases circulating levels of 25OHD, and should be considered when interpreting values obtained for clinical evaluation or nutrition research.
+PIP: This study was conducted to compare wintertime hyroxyvitamin D (250HD) levels among 66 young Caucasian women between ages 20 and 40 years from the Boston area who did and did not take oral contraceptives (OCs). Plasma 250HD was measured within a 2-month period and again after 1 year. Other measurements taken were height, weight, and intake of vitamin D from diet and supplements. The study demonstrated that the 250 HD levels of women who use OCs were as much as 24.1 nmol/l higher than those of non-OC users. This 41% difference decreased to 39% after adjustment for age and intake of vitamin D. All 5 women who discontinued OC use in the year after their initial measurement had reduced 250HD levels, while levels in the women whose OC use or non-use was constant remained unchanged throughout the study period. There were no significant associations between 250HD levels and ethinyl estradiol dosage, type of OC, or duration of use. In conclusion, OC use increases the circulating levels of 250HD of premenopausal adult women and should be taken into consideration when interpreting values obtained for clinical evaluation or nutrition research.
+PMID: 9627916</blockquote>
+EDIT

home/othertreatments/birth_control.txt · Last modified: 01.03.2012 by 127.0.0.1