Birth Control Pill and Patch, how safe are they?
June 3 2017
by Ray Sahelian, M.D.
The risk of side effects from newer birth control pills
may be higher than previously thought. Some newer birth control pills carry
a much higher risk of dangerous blood clots as older contraceptives. These, which include several made by Barr Pharmaceuticals Inc. and Akzo
Nobel NV unit Organon BioSciences, are also no better than some older ones,
according to Public Citizen, which filed a petition filed with the Food and Drug
Administration.
Millions of prescriptions have been filled for birth
control pills, which includes Johnson & Johnson's Ortho-Cept and Watson
Pharmaceuticals Inc.'s Reclipsen. The petition also mentioned Barr's Mircette,
Velivet, Kariva as well as Organon's Desogen. Generic birth control
pills containing desogestrel were also cited. Older oral contraceptives contain
estrogen and progestin hormones, but newer ones sold in the United States --
so-called "third generation" -- contain a different type of progestin called desogestrel. "By banning third-generation oral contraceptives, the FDA will
potentially save hundreds of young women a year from developing venous
thrombosis and its disabling and sometimes fatal consequences," said Public
Citizen.
Q. What is your take on birth control
contraception pills. I was born at the beginning of the 1970s and I clearly
remember woman's magazines clearly praising how wonderful they are basically
solving any problems form PMS syndrome to bad acne. At the same time i do not
remember at the time ANY young women under 40 to have to worry about breast
cancer or ovarian cancer or any other cancers that i seem to hear more and more
appearing in girls even around age 20. I took the pill for a very short period
of time in my twenties. I could not obviously tie the two together but at the
same time i also had extreme mood-swings and gained a lot of weight. I got off
of them. Since than i was not taking them (especially after about 10 years ago
an old school mate of mine died at the age of 24 after giving birth to her first
child and returning to the pill), lost the weight, got over most of the
emotional stuff. Recently however it became obvious to me that i would need to come up with a fairly reliable contraceptive method. I
heard new pills are "safer" than the old ones 10-15 years ago, but somehow i
have hard time trusting it. Nowadays these drugs are handed out like vitamins
and that makes me very uncomfortable. What is your take on the birth control
contraception pills?
A. I don't like introducing hormones into women's or men's bodies
at any age, particularly at a young age, unless absolutely required.
Birth control pill side effect and long term danger - increased risk for
breast cancer
The most serious birth control pill side effect is a
blood clot. The blood clot
can occur throughout the body and dislodge to block blood flow to the lungs and
other crucial organs. Those that contain the hormone drospirenone must now carry
a warning. Other common side effects of birth control pills include:
Bleeding or spotting between menstrual cycles. Nausea. Tender breasts. Gaining
weight or retaining water. Darkened spots on the skin. Moodiness.
Postmenopausal women who use combination hormone replacement
therapy (HRT) containing estrogen and progestin have an increased
risk of breast cancer if they also have a history of birth control pill use.
The use of a combination oral estrogen-progestin birth control
pills by otherwise healthy young women increases the prevalence of carotid and
femoral artery plaques by 20% to 30% for every 10 years of use.
Women who take birth control pills run a higher risk of developing
cervical cancer, but this risk is transient and reverts to normal about 10 years
after they stop.
Oral contraceptives behave differently in the bodies of obese women
than in normal-weight women, they may not work as well in preventing pregnancy.
Contraception, 2009.
Newer forms of the birth control pill -- brands such as Yaz, Yasmin and Desogen -- are more likely to cause blood clots than older versions.
Hum Reprod. 2013. Heparanase procoagulant activity is elevated in women using oral contraceptives.
Risk of blood clot
Thrombotic risk is associated with the estrogen dose and type of progestin in
combined oral contraceptives. Studies published since 1990 show that
third-generation progestins have larger risk to contribute to thrombosis
development than the second-generation.
Birth control patch carries
higher side effect risk
The risk of blood clots in the legs and lungs may be
higher for women using the birth control patch. The label on the Ortho Evra
birth-control patch has been updated to reflect the results of a study that found women using
the birth control patch faced twice the risk of clots than did women on the pill. However, a
second study found no difference in risk between the two forms of birth control.
Initial results of the two studies were made public in February by the patch's
manufacturer, Ortho Women's Health & Urology. The Raritan, N.J.-based company is
owned by Johnson & Johnson. In 2005, an investigation by The Associated Press, citing federal death and
injury reports, found higher rates of blood clots in women using the patch. In November,
2006 the FDA updated the label on Ortho Evra to alert women that using
the birth control patch exposes them to about 60 percent more estrogen than using
birth-control pills. Ortho Women's Health & Urology reported in filings made in
August 2006 that Ortho Evra sales have
declined significantly following the previous label revision and a spate of
media coverage of the clot issue. Since the birth control patch went on sale in 2002, more
than 4 million women have used it.
The company also disclosed that approximately 500 people have filed lawsuits or
made claims related to injuries they allegedly suffered from the Ortho Evra
patch.
The investigation by The Associated Press found that patch users die and suffer
blood clots at a rate three times higher than women taking the pill. About a
dozen women died in 2004 from blood clots believed linked to use of the patch. Dozens more suffered strokes and other clot-linked problems.
Bone mass while weight lifting
Young women who use oral contraceptives may not get as much out of their
weight-lifting routine as women who are not on the pill. Chang-Woock Lee, from
Texas A&M University in College Station identified a potential new factor that
may be independently associated with the characteristics and variability of
muscle responses to a controlled resistance exercise training program. Chang-Woock
Lee did a study with 73 healthy women between 18 and 31 years old. They
participated in whole-body resistance exercises three times a week for 10 weeks.
Thirty-four of the women used oral contraceptives and 39 did not. The women were
encouraged to eat enough protein to promote muscle growth. There were marked
differences in lean muscle mass gains between the two groups. Lean muscle
increased by just 2.1 percent in birth control pills users compared with 3.5
percent in non users. Blood levels of three muscle-building hormones were lower
and one muscle-breaking hormone was significantly higher in oral contraceptive
users than non users. The findings were presented at the American Physiological
Society meeting, 2009, in New Orleans.
Ortho Evra Contraceptive
Transdermal Patch
2008 - The label on the Ortho Evra Contraceptive Transdermal Patch will need to
include the results of a study in women aged 15-to-44 indicating a higher risk
of clots than for women using birth control pills. These could
potentially lead to a lung embolism.
2013
The so-called morning-after pill, an emergency contraceptive, is going
over-the-counter, with the U.S. Food and Drug Administration announcing that it
has approved unrestricted sales of Plan B One-Step.
Supplements and interactions, combination with herbs
and vitamins
Q. I am wondering if you have any information or know of any research done on
using supplements to assist in mood swings related to hormonal birth control. I
have been told that both Calcium and B-6 can help if taken daily.
A. It is difficult to say which supplements will for a particular
person, but in general you may wish to discuss some of the options mentioned on
the page on depression such as 5-htp or fish oils or kava or passion flower,
etc. with your doctor.
Q. I'm an currently on birth control pill, will the
Passion Rx affect the birth control pill taking? How often should I take Passion
Rx? Just whenever or when I am about to have sex that day?
A. Many sex herbs work better on the second day of use, therefore
it may be better to take Passion Rx the day before and perhaps a smaller amount
the day of sexual activity. If you have sex let's say on the weekends, you could
skip taking Passion Rx during the week and just take it on Friday and Saturday.
These are general guidelines and each person through trial and error will find
the best time and dosage for them.
Q. I was wondering if maca herb interferes with birth
control at all. I am on ortho tri cyclin and i do not want to take anything that
would make it less effective.
A. We have not seen any studies that have looked at the interaction
of maca herb with birth control pills. We doubt a maca supplement would
interfere with birth control pills, but we can't be sure since we are not aware
of medical studies combining the herb and the hormone.
Q. I am 55 years old. In my mid 40's I started getting
horrible migraines once a month when I would go off the pill. I was still on
birth control pills at the time and my woman gynecologist told me to take the
pill for two months and then I would only have a migraine once every two months
when I went off for a cycle. What a crock. I didn't even try that. I read your
book on pregnenolone so I started taking 30 mgs a day and went off the birth
control pill. I had no more migraines to this day and I have been through
menopause with ease.
A. Thanks for writing and I am very glad you were helped. Since
writing my book on pregnenolone I have realized that this hormone is much more
potent than I thought and now my dosages recommendations are a fraction of what
I had mentioned before. So, use the least amount that works for you.
Can I take maca herb while I am on birth control?
We can't specifically assure that any herbal and hormonal
combination is safe in any one person, but thus far we have not had any reports
of untoward reactions with maca and this combination.