Doctors' Answers to "Frequently Asked Questions" - Birth Control (Page 2)

Related Info: Birth Control - Page 1

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.

Ortho-Cyclen [posted 1/13/99]
Question: I have been using ortho-cyclen as my birth control method for the last 5 months. I haven't taken the pill for about a week and was wondering how I should go about starting up again. I always used the "day 1" start method instead of the "Sunday" start. I'm not worried about being pregnant because I haven't had intercourse within this time. I am just concerned about my menstrual cycle getting screwed up. Can you offer a suggestion? And which do you think is best, the "day 1" start or the "Sunday" start?

Answer: Start one week after the start of your menopause more or less, starting in the middle will be ok in a couple of months, but can produce a couple of very weird periods.

Birth Control Pills and weight gain [posted 1/13/99]
Question: I just started taking the pill "phaeva", and am wondering about side affects like weight gain. It is:
gestodene .050 mg., ethinylestradiol .030 mg - for the first 6 days
gestodene .070 mg., ethinylestradiol .040 mg - the next 5 days
gestodene .100 mg., ethinylestradiol .030 mg - the next 10 days
The of course the break of seven days. Is this a big dosage or low? Does same time of day mean within a couple hours of the time, or exactly the same hour you took it? I am in Russia, so it's hard to get this information, though I did go to a doctor at a western-style clinic here. The brand he gave me is French. Also, I've been feeling sort of dreamy since I've started. Sometimes I lose my feeling of concentration, and start writing numbers wrong, etc. I just started taking it 8 days ago. Also, what are the ways of getting oral herpes? Only when there's a breakout? Or at any time?

Answer: Herpes can be transmitted a few days prior to the outbreak and during the outbreak. As to the pills, all birth control pills can cause weight gain.

Birth Control [posted 1/11/99]
Question: I have been taking Ortho Novum 7/7/7 since Janurary 1998. This month I experienced what I thought was breakthrough bleeding, but it started two or three days before I was supposed to take my green "inactive pills." I recently got a new job and moved and I am wondering if the stress made my period begin early? I didn't know if this was possible or not with birth control.

Answer: The lower dose pills will occasionally experience this type of bleeding since they do not slough the uterine lining as completely as higher dosage pills. This occasionally requires extra progesterone at the last week prior to your period to get a complete uterine lining slough.

Stopping Depo and Pregnancy [posted 1/11/99]
Question: I am 34 years old and I recently stopped Depo injections after six years of use. When I stopped, I immediately started taking the pill for 3 months. Currently, I am not using birth control (stopped pill a week ago) in an effort to become pregnant. I realize the amount of time to become pregnant after taking Depo varies and could take a year or so. Why is the average amount of time to get pregnant after stopping the Depo shot significantly longer than stopping the pill and becoming pregnant? Can I assume that the amount of time it will take me to become pregnant is based on when I stopped the Depo shots? Or does the addition and continuation of hormones from the pill play any role in the length of time it takes to become pregnant? Finally, why doesn't the length of time a woman is on Depo affect the amount of time it takes for her to "rid" her body of the hormone?

Answer: The time to rid your body of the hormone is based on your body's metabolism of the drug. It does not build up and once metabolized is gone. When this happens, the pituitary-ovarian cycle begins based on your own biorhythms. This is usually a few months after the depo is gone, but can be one month in some.

Ortho Tri-Cyclen and delaying menstruation [posted 1/11/99]
Question: I have been taking Ortho Tri-Cyclen for slightly under a year with no adverse side effects. In a few weeks, when I will be starting my "inactive" pills, I will be in a situation where it will be extremely inconvenient to have my period. I have heard from a number of sources (medical and otherwise) that I can skip those inactive pills and start right in on my next packet of pills, thus skipping my period for that month. Is this correct, and if so, is there anything about this process that is specific to this type of birth control pills that I should know about? This is not something I would be doing on a regular basis, just for this one unavoidable occasion.

Answer: Yeah, this works, but you should use some type of barrier birth control that month just to be safe.

Birth Control Pill [posted 1/7/99]
Question: Which BCPs have the lowest doses of hormones? I've been on the pill in the past, Ortho Novum 777 and TriPhasil, but had problems with the latter. I can't remember how my experience with 777 was, but I'm thinking of taking those again. I'm concerned with circulatory problems since I have a number of spider veins in my legs and arms and I'm only 28. Can these be spurred on by the pill? I'm also concerned with lowered sex drive, headaches, which I already have, and breast cancer. I recall hearing that some studies linked breast cancer with early use of oral contraceptives, and I began taking the pill at 14.

Answer: Well, there are different mixtures. Depending on your medical condition and what else is trying to be achieved. There are lots of choices depending on some extra medical history. Check with your doctor.

Birth Control [posted 1/6/99]
Question: I have been taking ortho novum for about 5 years and every couple months I spot instead of having my period for two days. Is this normal for someone that has been on the pill for so long? My doctor said if I take my pill every day at the same time there should not be a problem. I also have breast tenderness every so often. Is that normal? It usuallyednipens about a week and a half before I have my period.

Answer: Pretty normal, especially with the lower dosage types of medications. Breast tenderness is usual with birth control pills.

Birth Control Pill [posted 1/5/99]
Question: When on the pill for most of 15 years I had no problems (norinyl and loestrin I believe). On the occasions I would go off, I would experience hair loss, PMS, and pelvic pain. Laproscopy showed no sign of endometriosis. After having been off the pill for 3 years, I was prescribed zoloft for depression. I believe my depression is actually PMS due to time of month it occurs, but zoloft does help. I also was on pill for a year (ortho-novum 1/35), but my hair still fell out. Now I have thin hair and am wondering if I should go back on a different pill than Ortho 1/35 at 38 years old to help with hair loss and PMS. I no longer smoke. How old can you be and still take the pill? I've never had children. Does progesterone help prevent hair loss?

Answer: Wouldn't be recommended after late 30s. Topical rogaine would be effective for the thinning of the hair. Progesterone may help/hurt the problem, depending on your weight and how much gets metabolized to testosterone in your fat cells.

Birth Control - Ortho Novum [posted 1/5/99]
Question: I have been taking Ortho Novum 777 for 5 years. I usually suffer from depression 1 or 2 days in the days before I start menstruating and have some water gain, but I have learned to accept these side effects in order to reap the benefits. Since I have been on the pill, I have had no surprises and have always been on a perfect cycle. However, recently I discovered that I will be menstruating during my honeymoon and the depression and water gain will hit on my wedding day. I was wondering if it is possible to change my cycle by taking an extra week's pills or taking another pill pack or by going off the pill for a month? All my options do not seem like healthy choices, but I have to do something.

Answer: You can always add a week in sequence and change your period. However, you cannot guarantee whether the anti-fertility aspect is successful while shifting. If you are going to do this, do it a couple of months before your wedding and use alternative methods for 1-2 months while shifting.

Getting Pregnant After Being on the Pill for a Long Period [posted 12/10/98]
Question: I started the birth control pill, Ortho-Novum 1/35, when I was fifteen years old. I am now twenty-four years old.  I have never stopped taking the pill at any period of time in that nine  years. In a couple of years I will be getting married. My question is: Will I have a hard time getting pregnant as I have been on the pill for so long? A friend of mine couldn't believe my doctor has let me stay on the pill for so long. This has really been worrying me and I have been thinking of stopping the pill altogether. Your response would be greatly  appreciated.

Answer: Won't be a problem. Your fertility will revert to what it would have been without the pill. Many women have difficulty getting pregnant and this issue has been raised often, but, without any major substantiation.

Can Birth Control Pill Cause Skin Discoloration [posted 12/02/98]
Question: I am a 23 yr old and have been taking ortho tri-cyclen for 1yr and a half. Within the past month I've noticed a skin discoloration above my upper lip. It's an orange color (almost like a fake tan). Could this be the result of my birth control? If so, why now?? I also (within the past 3 months) moved to a sunny state. Could this be the change? What can I do to get rid of my perpetual u.v ray look?

Answer: Possible;but, unlikely. I'd see a dermatologist.

Starting the Pill as Birth Control   [posted 11/25/98]
Question: I just started Tri-Phasil 28 this month. I was told I should start the pills within the first 24 hours of my period. since then, I have been reading things that suggest that i should have started a week after my period started. Did I do this right? Will this make my period start earlier later? When will this be an effective means of birth control?

Answer:  Either would work, as to effective birth control, most physicians recommend two complete cycles before protection is assured.

Birth Control That Will Not Affect Mood  [posted 11/25/98]
Question:  I am currently taking Ativan 1mg 3x per day and Prozac 20 mg 2x per day and Lipitor 20 mg 1x day. I recently experienced a severe depression episode because I started the Depo-Provera shot. Is there any birth control method (other than a diaphram) that I can use that will not increase my depression.

Answer: IUD.

Planning a Pregnancy & the Pill [posted 11/24/98]
Question:  When should I stop taking Triphasil-28 if I would like to have a baby? I have heard it may take up to a year to get pregnant and I will be 25 years old this year. I do not want to delay getting pregnant for too long but I do not feel that I am ready immediately to have a child, what should I do? 

Answer: You are theoretically able to become pregnant the month after you stop birth control pills. 

Varicose Veins & the Pill [posted 11/19/98]
Question: I've been taking birth control pills (desogen) for the past 3 years. After taking them for a year and a half, I noticed that I started to get spider veins in my legs. The condition seems to be getting worse. I'm wondering if this may being caused by the pill. I am not "high risk" for varicosities: not overweight, exercise every day, only family history is a grandmother on my father's side. If the pill is causing this (I have read some information which suggests it might) will these minor varicosities vanish when I get off the pill? Thanks for your time

Answer: Probably the pill, it increases these type of markings in about 10-20% of women. They may not may not vanish;but, you might do better with a lower estrogen formatted pill.

Birth Control Pill Effectiveness & Prescription Medication [posted 11/19/98]
Question:  How long after taking a prescription medication that affects birth control will its effectiveness return?

Answer: Usually a couple of months is safe, some recommend 3 cycles.

How Long Should You Take the Pill [posted 11/10/98]
Question: Is there a time limit to taking the birth control pill? I heard that you are supposed to switch pills every three to five years or your body will develop an immunity.

Answer: There is no tolerance that develops to the blocking of pregnancy. There is an increased risk of coronary disease with increasing age.

Should I Expect Side Effects When Stopping the Pill [posted 11/10/98]
Question: Should I expect any side effects after discontinuing the pill (Triphasil)? I was on it for two years and finally couldn't stand the side effects anymore.

Answer: Not usually.

Period Shifting [posted 11/10/98]
Question: If anyone can help me with this question, I would really appreciate it! I need to change the week of my menstrual period. I take birth control pills, and the nurse I talked to said I could immediately start a new pill pack as soon as I was done with the previous one but that It most likely would not work.

Answer: Well, it will work to shift your period,but, you may get pregnant while shifting. A better way is to take the second week out of a pack and repeat it after the second week of your current pack. You should use other protection while doing this since it could increase your risk of pregnancy ;but,works.

Problems Encountered While Attempting to Change Period Due Dates [posted 11/5/98]
Question: Recently, I inquired to my doctor's office about changing the date I start my period. I am currently on Triphasil 28, and I was told to throw away the placebos/inactive pills and start a new pack of pills. I was then told I would miss my period for the next month and should start one week earlier than I normally would have in following month. But in the middle of the next month, I started my period. I contacted my doctor's office again, and asked them why this happened when I was told I would miss my period for the month of July. They stated that this sometimes happens when you alter your pill schedule and should be of no concern. The reason that I am concerned is that it is now 8 days later and I am still having a period. I have never had one this long before and it has been pretty heavy the entire 8 days. Should I be concerned? Should my period start normally the following month, or is it possible that I will continue to be on it through. If not, what can my doctor do to "get me back on track"?

Answer: Usually when you do this shifting, you will have irregular periods for 2-3 cycles and then return to normal. Occasionally, extra progesterone is necessary the last week to ensure uterine sloughing during your period. This would depend a great deal on the type of BCP you are taking.

Tri-Norinyl vs. Tri-Levlen Birth Control Pills [posted 11/4/98]
Question: I am doing some research on Tri-Norinyl. I used to take Tri-Levlen about a year and a half ago and now I am going back on the pill. The prescription plan that I have doesn't cover the Tri-levlen so I would have to pay full price. I get a big discount with Tri-Norinyl. Any information that you would have on it would be much appreciated. The norethindrone is what I was concerned about. Which is better tolerated - levonorgesterol or norethindrone? I know all women are different but is Tri-Norinyl commonly prescribed and would I find a difference in it? I used to take Lo-Ovral and Nordette and Tri-levlen with no problem. I just hope Tri-Norinyl doesn't cause me any problems. If you have any info, I would appreciate it.

Answer: Very, very individual, but, most women don't have major differences.

Tri-phasic Pill Availability in Mexico [posted 11/10/8]
Question: I have been taking Triphasil-28 for a few years, but then I moved to Mexico, and have been unable to find this drug or, for that matter, any other tri-phasic birth control pill. I'm now taking Ortho-Novum 1/35, which is doing it's job to prevent pregnancy, but has also all but stopped me from having periods at all. Are single-phasic pills dangerous? Is there some other one I should take or any health issues I should be aware of? Do you have any idea whether tri-phasic pills are available in Mexico, or how I could find out? Thanks.

Answer: Most triphasic pills are available in Mexico, if you have a Rx. There is no major advantage to either, save side effects.

Concerns About Birth Control Pill While on NSAIDS [posted 10/28/98]
Question: I would like to know whether NSAIDS like Cataflam will influence the working of contraceptive pills like Triphasil?

Answer: Not usually.

Considerations for Stopping the Birth Control Pill (BCP) [posted 10/28/98]
Question: I am 19 years old and sexually active. My boyfriend and I were previously virgins and we've been together for a year and a half. Recently I went to the gynecologist and she prescribed Desogen to me. I started it on the first day of my period and have now taken it eight times. I am worried about side effects even though I don't have a high risk of blood clots, etc in my family. But, I feel as though I am already gaining weight, feeling nauseous and moody, and have a decreased sex drive. Is it possible that I could have these side effects so quickly or am I just feeling paranoid? How can I tell if I have a blood clot? Also, if I decide to stop taking this pill (and not use any other oral contraceptive) when should I do this - can I stop at any time or should I wait until the month is over? What will happen when I stop? Thank you so much for your time in answering my questions. I greatly appreciate any information you can give me.

Answer: All the birth control pills imitate a pregnancy to your body. Hence, further ovulation is stopped(or implantation). All the symptoms of pregnancy can and do occur on BCPs including nausea, decreased sex drive, weight gain breast enlargement etc. Blood clots are pretty easy to stop. Usually in the leg and there will be swelling, redness, pain etc. These are usually not subtle. Different formulations of BCPs can change some of the side effects. Stop the pills after the last pill of a month. Other methods of birth control are available, double barrier is probably the one with the least side effects(diaphragm using spermicidal jelly and a condom). But, not as conducive to spontaneous sex. After you stop, your system will start usual ovulation in one or two months.

Difference Between Light Period & Missed Period [posted 10/23/98]
Question: I've been taking low-dose BC pills for several months now, and while skimming over the little pamphlet that comes with each refill, I noticed the paragraph that discusses missed periods. Assuming that one takes all their pills correctly, it says to continue as normal, and to get checked out if you miss 2 periods in a row. So, do "lighter- than-what- one-is-used -to -on-the -pill" periods count as "missing a period"? I have heard that such is counted as a miss, and I have also heard that any bleeding you get providing that it is at the correct time and you haven't missed any pills or taken any late, or not had any other situations that would have hampered the effectiveness, can be considered a period. In other words, the only time a miss would "count" is if a period was COMPLETELY skipped. My pill packet insert isn't really clear on this.

Answer: Even a very light period counts as a period. What they are referring to is the tendency to build up uterine lining on the "light" pills. This may occasionally need extra progesterone to completely slough the lining of the uterus.

Ok to Take Dexatrim While on the Pill [posted 10/21/98]
Question: I was wondering if it would be safe to take regular dexatrim with ortho-cept. I've been on the BCP for 6 months and my eating habits have sky-rocketed.

Answer: Usually.

Will the Pill Help Control Acne [posted 10/21/98]
Question: Is there a particular Oral Contraceptive (OC) that improve acne problems? Is there any significance to clots noticed in menstrual blood?

Answer: Most of the OC will improve acne. There are three classes which have different amounts of estrogen to progesterone. Sometimes, one needs to try different classes to see which is best.

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-stoppr Bathe 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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