REVEAL Q3 2017 - Page 30

BC Story irth

By Asia Parham , PharmD
Aviane . Ocella . Jolessa . Apri . No , I ’ m not naming exotic islands I ’ d like to visit . These are just a few of the many birth control names you may have seen or used . If you ’ re like many women , you ’ ve either taken or considered taking some method of birth control . There are so many birth control methods that it can be quite overwhelming to navigate the array of brands and types available .
Which birth control is right for me ? The short answer is that there is no right answer . And it often requires trial and error to determine what option best suits both your body and your personal preferences . Arming yourself with some basic information on contraceptive options may help you in your discussion with your healthcare provider about what option is best for you .
HORMONAL BIRTH CONTROL PILLS Hormonal birth control pills are formulated in one of two ways : estrogen hormone combined with progestin hormone or progestin hormone by itself . Although their effectiveness at preventing pregnancy is comparable , combination estrogen / progestin pills are generally the preferred form of oral birth control . This is because estrogen helps to buffer some of the unwanted side effects of progestin hormone when the two hormones are combined .

What ’ s the big difference between all of these pills ? The type and amount of either estrogen or progestin used varies from pill to pill . Look at the active ingredients in the pills you are choosing to help navigate your search . Combination pills almost always use the same synthetic estrogen form called Ethinyl Estradiol . It ’ s used in concentrations ontrol

between 10 micrograms and 35 micrograms ( and sometimes up to 50 micrograms ). Presently , only one pill offers 10 micrograms — LoLoestrin Fe — for women who are very sensitive to estrogen side effects like breasts tenderness , water retention , or nausea . Many women have off-cycle menstrual bleeding with this because the estrogen hormone is so low . Because of this , estrogen is usually better tolerated at 20-35 micrograms which is the amount in most pills . The progestin hormone used can be one of several and this is where it gets hairy ! But I ’ ll give you the Cliff Notes™ version of the most common progestin hormones included in combination pills .
Norethindrone is found in Loestrin ® and its generics ( Microgestin , Gildess , and Junel ). It ’ s generally well tolerated and found in some of the most commonly prescribed birth control pills . Norgestimate is similar to Norethindrone and is found in brands like Ortho Cyclen ® ( Sprintec and Mononessa ) and Ortho Tri-Cyclen ® ( TriSprintec and Trinessa ).
Drosperinone is found in Yaz ® , Yasmin ® and their generics . It tends to cause the least amount of water retention , bloating and appetite changes . It may be helpful in women who are worried about acne as it is often used to combat oily , acne-prone skin .
Levonorgestrel is the progestin found in Alesse ® ( Aviane and Amethia ) and continuous pack pills like Seasonique ® . This type of progestin has the highest incidence of acne , mood changes , and weight gain but it is generally most helpful in women who have a difficult time regulating their periods or who have painful menstrual cramps .
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PROGESTIN ONLY BIRTH CONTROL These methods are a good option for a select group of patients . They are the only hormonal contraceptives appropriate for breastfeeding women and for women in whom estrogen is not an appropriate choice . This may include women who have a high risk of having a blood clot because of obesity or in women who are greater than 35 who smoke . But because there is no estrogen in these pill formulations , you may see an increase in acne , oily skin , headaches , fatigue , or mood changes .
For all of us who would forget our heads if they weren ’ t attached , there are some great non-oral contraceptives available . The NuvaRing is a combination hormone infused ring inserted into the vagina . It ’ s a good choice for women who want to avoid IUDs but don ’ t want a visible patch on their body .
The Ortho Evra patch is a combination hormone infused patch that is safe to wear in the shower or while swimming or working out . Both methods are typically in place for 21 days , followed by 7 hormone free days .
The Depo Provera shot or the “ depo ” shot is a progestin hormone only injection given once every 3 months . This a great option for women who would prefer a long-lasting contraceptive but it is progestin only and can cause unwanted side effects like weight gain .
INTRAUTERINE DEVICES Intrauterine devices or IUDs are a popular non-oral method of birth control that can be placed by your provider directly into the uterus and stay for 3-5 years . These are progestin hormone only and release a small amount of hormone every day into the