Prescription Not Necessary
The American College of Obstetricians and Gynecologists (ACOG) and scientists at a non-profit research group recommend that drug regulators make birth control pills available over-the-counter (OTC) to increase women’s access and prevent unplanned pregnancies. Researchers say it is justified because 50 percent of pregnancies are unintended and cost taxpayers 11 billion dollars a year. It is been established as a very effective contraceptive and previous research has shown that the women are more likely to use it when it is OTC and that they make good decisions when weighing the small risk of side effects. One major concern is that if it is OTC, it may be expensive and likely be ineligible for 100 percent coverage under the Affordable Care Act.
Birth Control Pills Still Rule
While the use of intrauterine devices (IUDs) is up in the US, the Pill and condoms are the most popular forms of birth control, says a study from the Guttmacher Institute, a sexual and reproductive health organization in NY. 8.5% of US women using birth control chose an IUD or implant in 2009, up from 4% in 2007. Researchers say that IUDs and implants are the most effective forms of reversible birth control. With IUD’s, it's estimated that between 0.2 and 0.8% of women will have an unplanned pregnancy within a year vs 9% per year for the Pill and condoms. The rise in IUD use may be due to the fact that they’ve been endorsed by the American College of Obstetricians and Gynecologists (ACOG). Also, concerns about pelvic infections, which arose when IUDs first came out, have been dispelled.
Cost May Be Biggest Obstacle
A study involving more than 7,500 women enrolled in the Contraceptive CHOICE project found that hormonal implants placed subcutaneously in the upper arm and intrauterine devices (IUDs) were more effective than the pill and the vaginal ring. Of the 334 pregnancies during the study, almost half related to birth control failure, only 21 were women using IUDs or implants. Women under 21 had twice the risk of an unplanned pregnancy if they were on the pill or using the ring. Researchers speculate that forgetting to take a pill every day and the difficulties in getting a refill add to these numbers. Unfortunately, the initial costs of IUD and implants are expensive which prevent many women from using them and are only used by 5.5 percent of American women who use birth control.
Hormones Hell on the Gut
Results from two studies found that younger women on the pill tripled their risk of Crohn’s disease and post-menopausal women taking hormone replacement therapy were 1.7 times more likely to develop ulcerative colitis. Crohn’s disease results when the lining of the small and/or large intestines becomes inflamed to the point of bleeding. Ulcerative colitis is inflammation of the colon or rectum can lead to diarrhea, abdominal cramps and bleeding of the rectum. Researchers stressed that these studies did not show a cause-and-effect relationship, but the strong association of Crohn’s and the pill do concern them, especially in young women with a family history of the disease. Previous animal studies have demonstrated that estrogen makes the colon more susceptible to inflammation.
New Methods Not Better or Safer
A six year study has shown that Yaz, a newer birth control pill manufactured by Bayer, increases the risk of blood clots by 75 percent compared to other forms of birth control in a cohort of over 800,000 American women. Yaz contains the hormone drospirenone which is made in the lab. The Ortho Evra patch and Nuvaring, which use estrogen and two other hormones, also increase the likelihood of problems. Some health officials are questioning why new drugs that are no better than the older ones and carry a higher risk are being put on the market. A previous study involving over 1,000,000 women from Denmark found that using Yaz doubles the blood clot risk compared to levonorgestrel, an older hormonal birth control pill which is contrary to earlier research showing there was no increased risk.
Affects Left Brain Memory
Results of a new study from the University of California Irvine has shown that the pill reduces a woman’s ability to remember details, providing insight into how men and women remember things and process stress differently. Two groups of women, some on the pill and some not, were shown pictures and told about a car accident involving a mother and her son. Within each group, women were told varying details of the story and took a pop quiz one week later in which they had to recall it. Women on the pill remembered the main points but could not remember details such as objects around the accident scene. Researchers are not surprised since the pill lowers estrogen and progesterone which strengthen “left brain” memory. It is not viewed as a deficit, but as an alteration of the brain.
The Pill. . .For Men
Scientists have tested a drug that inhibits sperm production without decreasing testosterone levels, and therefore libido, in male mice may lead to a birth control pill for men. It prevents retinoic acid, the active metabolite of vitamin A, from binding to the retinoic acid receptor. Retinoic acid is important for such things as eyesight, a healthy immune system and the generation of sperm in men. When the mice stopped taking the drug they were able to make sperm again. No side effects were observed which is important because the safety standard for male contraceptives is higher since the health risks due to an unintended pregnancy are non-existent. Another research team is currently trying to find a drug that will only block vitamin A metabolism in the testes.
Two to Threefold Higher Risk
Bayer’s contraceptive pill, Yasmin, increases the risk of blood clots in the veins, known as venous thromboembolism, by two or threefold in comparison to older pills. The clots can dislodge and travel to the lungs, which can be fatal. The hormone in Yasmin that increases the blood clot risk, drospirenone, was compared to that of women on levonorgestrel. Overall risk of was low, with 30.8 per 100,000 on Yasmin developing the clots compared to 12.5 on the older pill. Studies have not always shown an increased risk, and Bayer believes that results from this study should not be cause for concern even though more warnings were put on the label in Europe last year. Almost 7,000 lawsuits have been filed in the U.S. due to claims of injury due to Yasmin or its generic counterpart known as Yaz.
Yaz Plus Folate
A new birth control pill that prevents parenthood may also reduce the incidence of certain birth defects. A new birth control pill approved by the U.S. Food and Drug Administration, called Beyaz, contains not only estrogen and progestin but a folate, levome folate calcium, a B-vitamin recommended for women of childbearing age. The hope is that women who stop the pill when they want to conceive will decrease the odds of neural tube birth defects linked to a deficiency in folate. The most common side effects were uterine bleeding, nausea, breast tenderness and headache. Blood clots and liver disease were two of the serious side effects. Beyaz is contradicted in women 35 years old and older. It includes the same amount of estrogen and progestin as the birth control pill Yaz.
1 in 5 at Risk on the Pill
Birth control pills are contraindicated in women with congenital heart defects, but 1 in 5 are on it because they were not educated on the risks. A study in Germany of 536 women with heart defects found that 48 percent were not told about the risks of blood clots and hypertension associated with pills containing estrogen and progesterone. Many had “absolute” contraindications such as severe heart failure, defects that impair the circulation of oxygen throughout the body, a history of blood clots and pulmonary hypertension. Managing adults with congenital heart disease is very new and gynecologists may not be aware of the issues that arise in these cases. Other forms of birth control such as condoms and diaphragms eliminate these risks but have higher failure rates.