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Author Topic: 3rd generation birth control pills no better than 2nd
MJ
rabble-rouser
Babbler # 441

posted 08 February 2002 01:49 PM      Profile for MJ     Send New Private Message      Edit/Delete Post  Reply With Quote 
News release from the American Stroke Association conference taking place this weekend:

Click.

quote:
The first major study of ischemic stroke in women taking the latest form of low-estrogen birth control pills finds that they still have about double the stroke risk of women not taking the pill. These findings were reported today at the American Stroke Association's 27th International Stroke Conference. The American Stroke Association is a division of the American Heart Association. In absolute terms, the number of women likely to have stroke from taking "the pill" rises from about three women to six per 10,000 a year, say the Dutch researchers.

The few women still using the first-generation pill were 1.7 times more likely to have a stroke than women not using any oral birth control. Women taking the third-generation pill had an increased stroke risk 2.2 times that of non-pill users. Those taking the second-generation pill formulations had 2.4 times the risk, says senior author Ale Algra, M.D., associate professor of clinical epidemiology at University Medical Center, Utrecht, Netherlands.

Risk factors for stroke - smoking, hypertension, diabetes and high cholesterol - appeared to add to the stroke risk in all pill users in the study.

"Because there is virtually no difference in the risk of stroke in second- and third- generation pills, the balance of the decision whether to use second- or third- generation oral contraceptives should be determined by the risk of venous thrombosis, blood clots deep in the leg," Algra says.


[ February 08, 2002: Message edited by: MJ ]


From: Around. | Registered: May 2001  |  IP: Logged
Trinitty
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Babbler # 826

posted 08 February 2002 02:54 PM      Profile for Trinitty     Send New Private Message      Edit/Delete Post  Reply With Quote 
Yikes.

I noticed an amost bruise-looking thing in my thigh... it's painful... and I worry about blot clots...

Has anyone heard about the "Luna" method? It's a new thing where they test their saliava first thing in the morning... no hormones or these nasty side effects.


From: Europa | Registered: Jun 2001  |  IP: Logged
Myria
rabble-rouser
Babbler # 2122

posted 08 February 2002 04:47 PM      Profile for Myria        Edit/Delete Post  Reply With Quote 
quote:
Trinitty wrote -

"I noticed an amost bruise-looking thing in my thigh... it's painful... and I worry about blot clots..."


That would likely be what it looks like, a sub-dermal hematoma - id est, a bruise - though if you're concerned or are noticing spontaneous bruising you should discuss it with a doctor.

If it is a bruise, that's a very different thing from a DVT (essentially, a blood clot). DVTs occur in the deep veins (thus the 'D' in DVT) not visible from the surface. DVTs are almost invariably asymptomatic, which is one of the reasons they're so problematic. They also rarely occur in the thigh, more typically they occur in the calf. When symptoms do occur they're generally so vague as to be of little use - pains in the calf, for instance, that could be anything from muscle strain to an electrolyte imbalance. The one sign that will sometimes show up that is of some diagnostic use is a swelling in only one calf - a sudden differential in circumference could be worrisome. In some relatively rare instances there are obvious signs, generally caused by return blood flow having been totally cut off or very nearly so. The leg will then swell up and become discoloured - not exactly something you can easily miss.

There are several ways to try and detect a DVT. Recent studies have indicated that MRI may be the best. If discovered, they can be treated, most often with low molecular weight heparin. If you are at risk for a DVT that risk can be monitored somewhat by doing a regular liver panel - specifically looking at the clotting factors. The risk can also be decreased by going to another form of contraception or changing the route of delivery - specifically avoiding orals because of the first-pass effect.

Believe me, this is a matter of great importance to me and I don't downplay its significance lightly. The amount of estrogen/progesterone I take on a daily basis is several orders of magnitude (compare 50mcg to 8mg) above what you'll find in any bi- or tri-phasic OCS, regardless of what generation you're talking about. Consequently, my risk is far higher as the risk is both route and dose dependant, among other things. And yet I've talked to hundreds of people on similar regimens to mine (my list alone has roughly 500 members from all over the world) and I only know of a handful of cases of actual DVTs, all of which were successfully treated. I have heard of only one confirmed case of hormone related death by DVT/PE. It does happen, but even amongst people who have a far higher risk it is still extraordinarily rare.

Just about anything you take carries a risk, that is a given. You do not play around with basic hormonal physiology without consequence, that also is a given. But this thread is somewhat misnamed. The article in question addresses only one of the risk factors - ischemic stroke - and a lesser one at that. Even the magnitude of the risk increase is pretty minute. An increase of 3:10,000? You probably face a higher risk getting in your car every morning.

Anytime you talk about something like OCSs you have to do a risk/benefit analysis. It gets even more complicated because OCSs are commonly used to treat other problems - among them Amenorrhea, Dysmenorrhea, Hypermenorrhea, Endometriosis, Androgenic Alopecia, Androgenic Hirsutism, Hyperandrogenism, and PCS (a mistake, IMHO, but still done) just off the top of my head. And then, of course, their primary usage, no small benefit to many. You have to look at the entire picture, both the nature and magnitude of the risk as well as the value of the benefit to you personally when deciding if taking something like this is for you. As well as, of course, what your other options are. Such a risk/benefit analysis is a very personal thing and depends heavily on how much you value the benefit and how risk averse you are.

Personally I question the shift to C19-Progestogens in the 3G pills, dropping that on top of EE doesn't help. I know why they did it, but it seems to have created more problems than it solved. It seems to me that for now sticking with 2G pills is a good idea. They have a lower DVT risk and that's basically what all of the other major risks derive from.

FWIW...

quote:
Trinitty wrote -

"Has anyone heard about the "Luna" method? It's a new thing where they test their saliava first thing in the morning... no hormones or these nasty side effects."


Salivary hormonal testing has been around for a while, but it's always been somewhat questionable because it claims to measure only "free" hormonal levels and not what is SHBG or Albumin bound (id est, not actual serum level). Something like that might work for some women, it's a relatively gross application, but you would run into a "calibration" problem. Not every woman ovulates when the charts say she should. My sister ran into this problem using salivary testing when she was attempting to get pregnant via artificial insemination and it caused her no end of annoyance and cost because she kept missing the window even though the tests said she was ready. I have to imagine that problem would reduce it's accuracy more than just a little in many other cases as well.

Myria


From: Earth | Registered: Jan 2002  |  IP: Logged
Timebandit
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Babbler # 1448

posted 08 February 2002 05:55 PM      Profile for Timebandit     Send New Private Message      Edit/Delete Post  Reply With Quote 
I have an even better solution -- Use a condom! You can't mess up your dates, and they don't cause any of the side effects (including mood swings and depression) that medications cause. It also brings the male partner into the realm of responsibility....
From: Urban prairie. | Registered: Sep 2001  |  IP: Logged
Secret Agent Style
rabble-rouser
Babbler # 2077

posted 08 February 2002 07:45 PM      Profile for Secret Agent Style        Edit/Delete Post  Reply With Quote 
quote:
I have an even better solution -- Use a condom!

Condoms aren't perfect; they can break or slip off. A lot of people use condoms and the pill at the same time.


From: classified | Registered: Jan 2002  |  IP: Logged

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