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The latest buzz on Contraception

Be in the know-learn about recent developments in natural and artificial birth control methods.

By Sonia Javelosa-Silos, M.D.

New pill on the block

The pill has truly come a long way. Dr. Janice Bernal-Lacuna, an OB-Gyne specializing in reproductive endocrinology at the University of Perpetual Help Medical Center in Las Piñas City, explains the first generation pills had high estrogen levels of about 50 micrograms, causing doctors and users to worry about side effects like clotting and cardiovascular complications.

It was eventually pulled out of the market. “Second and third generation pills have a lower hormonal content. They have been available for a long period of time and have been found to be safe and effective,” she adds.

Most oral contraceptives today are combination pills, which mix estrogen, specifically ethinyl estradiol, and progestin. The most recent addition to the pill family, approved by the U.S. Food and Drug Administration last May, is a combination oral contraceptive, which uses estrogen estradiol valerate for contraception for the first time.

This new pill, produced by Bayer Healthcare Pharmaceuticals, Inc., is also the first quadriphasic contraceptive in the market. Conventional monophasic oral contraceptives deliver the same dose of hormones in every pill. For this new drug, each pill contains varying doses of hormones that are taken during specific days in a 28-day cycle. Dr. Bernal-Lacuna has this to say. “Theoretically, there should be better control of the menstrual cycle, the side effects of progesterone should be decreased … [side effects] like weight gain, increased blood pressure, and breast tenderness. Headaches and mood changes should also be less likely as these are commonly caused by the sudden drop in estrogen in conventional monophasic pills.

A longer regimen

Another fairly new option is the extended-cycle and continuous-use oral contraceptives. Instead of taking pills for the usual 21 days and having seven pill-free days, they lengthen the pill-taking to 24 days, 84 days, even up to a whole year. The advantage for this is much, much lighter periods in the case of the 24-day pills; period comes every three months for the 84-day pills; and no period at all for those taking pills continuously. For women who want to lessen the frequency of their menstruation, this is a novel way to do it.

A more durable vaginal ring

Much research has also gone into the development of better vaginal rings. Remember that a vaginal ring acts much like a birth control pill by releasing a combination of hormones. The standard vaginal ring is put in place for three weeks and then removed for one week to allow menstrual bleeding to occur.

Newer vaginal rings that can be left in place for a year are now in the works. This has been targeted for developing countries to induce better compliance. Other vaginal rings that are being studied are those that carry only progestins which would be beneficial for breastfeeding women to use.

Despite having been in the U.S. since the 1990s, vaginal rings are not yet available in our shores.

Through your skin

Transdermal contraception is also another option for birth control. The hormones are delivered through the skin. A patch is worn on the shoulder, abdomen, or buttocks for a total of three weeks, changing the patch once every seven days. The fourth week is patch-free to allow for menstruation.

A patch-less, spray-on option is currently being developed that delivers fast drying hormones through the skin. This spray contraceptive contains only progestins and is targeted for breastfeeding women.

"[Vaginal ring and patches are] best for busy, career women who don't want to be bothered by the daily intake of a pill, but want an easily reversible form of contraception while maintaining their regular cycle," Dr. Bernal-Lacuna explains.

The techie way

A more sophisticated way of identifying the fertile period is with the use of electronic fertility computers. Available in Europe and the U.S., one model measures and stores basal body temperature readings, and predicts fertility based on these measurements. Another model requires the use of urine sticks that measure the amount of hormones to determine the fertility. A fertility computer benefits those women who have long or irregular cycles, and is especially helpful in postpartum women. The main disadvantage of this method though is the cost of the computer.

Down to your choice

Hormonal contraception has a much higher effectiveness rate compared to the natural fertility-awareness methods or FAM. But it may also carry side effects. Dr. Bernal-Lacuna says there are many things to consider when choosing a family planning method. "Age, religious beliefs, convenience, and existing medical illnesses are all considerations in picking out a birth control method." In the end, the choice of what birth control method to use ultimately lies with the user.


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