Extended-cycle birth control a viable optionby Michael BakerPublic Relations Intriguing advertisements for Seasonale, a new birth-control pill, make a simple claim: in addition to preventing pregnancy, the pill allows women to have only four periods each year. While the opportunity to sidestep a major inconvenience of womanhood may draw more women to the product, the pill’s true value lies in its ability to spread awareness of the health benefits of birth control. Melisa Holmes, M.D., associate professor of obstetrics and gynecology, counsels many female patients about contraception and said that despite the novelty of the new drug, its effects aren’t unusual. “Seasonale is the first FDA-approved birth-control pill specifically designed for prolonged use,” she said. “But for years, women have accomplished the same results using typical monophasic birth control pills.” Typical oral contraceptives function on a 28-day cycle. For the first three weeks, the woman takes a pill containing two hormones: estrogen and progesterone. The estrogen prevents follicle formation and helps prevent irregular bleeding, while the progesterone helps prevent ovulation. During the fourth week, the woman takes a placebo pill. She receives no hormones and consequently has her period. Thus, the woman prevents pregnancy without disturbing her menstrual cycle. Seasonale and other monophasic drugs—those with an identical hormone dose in each pill—merely expand upon the original regimen. Instead of a three-weeks-on, one-week-off schedule, the pill provides 11 weeks of daily hormones followed by a week of placebos. The method reduces the menstrual cycle’s frequency, allowing it to repeat only once every three months. The number of periods women experience drops from 13 each year to only four. “Women may see spotting (of blood) before or at the three-month mark, so three-month cycles may not work for all women,” Holmes said. “Yet some may be able to go longer than three months. It’s possible to take the hormone pills continuously until you start to spot; then, take the placebos to allow a period.” Other than the obvious target population, the pill helps women on whom menstruation is particularly taxing. “A lot of women can benefit from extended-cycle birth control,” Holmes said. “Women who get migraines associated with menstruation, who experience heavy, painful periods, or who suffer from any medical condition that gets worse with their periods—depression, for example—can reduce those problems by reducing the number of periods they have.” Furthermore, she said that women who take birth control often reap the advantages of better health. “Long-term studies clearly show that using birth control, because of the hormones involved, does a lot for preventative health,” she said. “Birth control reduces the risk of developing iron-deficiency anemia, osteoporosis, endometrial cancer, and fibrocystic breast disease.” Although researchers aren’t sure why, birth control also reduces a woman’s chance of developing ovarian cysts. More importantly, long-term use of oral contraceptives significantly reduces the risk of ovarian cancer. Aside from the more concrete health benefits, women who take extended-cycle birth control experience lighter, less painful periods. In fact, periods on oral contraceptives tend to have 50 percent less blood loss per cycle. In most cases, the absence of menstruation shouldn’t be cause for alarm. “A woman who takes birth control can stop having her periods without any health risks, because she’s still getting the necessary hormones,” Holmes said. “However, for anyone who isn’t taking birth control, a lack of periods could signal a serious health problem.” Avid female athletes often experience sporadic, extended-cycle periods without taking birth control because their bodies lack enough estrogen. The hormonal deficiency can lead to osteoporosis and stress fractures due to loss of bone density. Physicians often prescribe birth control for such athletes in order to replenish their estrogen levels. As always, Holmes stressed, birth control does not protect against sexually
transmitted diseases. She debunked other myths about birth control as well.
Other side effects may include breast tenderness and nausea, which usually occur when a woman first takes the pill. However, the issues resolve within a few months. Holmes also asserted that no proven long-term risks exist, nor does any relationship between birth control and breast cancer or infertility after going off the pill. Conversely, some evidence suggests that women who stop taking birth control may experience a brief period of hyperfertility immediately after cessation. However, certain women should not take birth control, including those who have a history of breast cancer; experience abnormal blood-clotting (blood that clots too easily) or have had clots in their legs or lungs; have active liver disease; and take certain medications (primarily for seizures). For women concerned with cost, Holmes assured that extended-cycle birth control costs about the same as three packs of typical birth control, an equal supply. Similarly, the co-pay costs three times as much. Cost and side effects aside, most women should be able to take birth control successfully. “There are about 85 pills on the market right now, so chances are, we can find one that works for a patient,” she said. For women who aren’t ready to experience motherhood or for those for
whom menstruation is a test of will and endurance, extended-cycle birth
control may be a viable contraceptive alternative. With a success rate
of 97 percent, it provides a reputedly reliable tool that can prevent pregnancy
and turn a monthly visitor into a minor distraction.
Friday, July 30, 2004
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