Health Conditions

Combination oral contraceptives (COCs) contain both an estrogen (usually one called ethinyl estradiol) and a progestin. Different brands may have varying amounts of estrogen and the progestin may be different. In general, lower doses of estrogen cause fewer side effects, so most currently-available COCs contain smaller amounts of estrogen than earlier versions. In addition, the products may have constant or varying amounts of the progestin component - making the pills either monophasic, biphasic, or triphasic. Monophasic COCs have the same amount of the estrogen and the same amount of the progestin in each pill throughout the cycle. Biphasic pills have the same amount of the estrogen, but have two different doses of the progestin at different parts of the menstrual cycle. Triphasic COCs, which are made to mimic the natural changes in hormone levels, have a constant dose of the estrogen with three different amounts of the progestin. Most COCs are prepackaged in compact-like cases that contain either 21 or 28 pills. Women who use the 21-day packs do not take a pill during their menstrual periods. The 28-day packs contain 21 active pills and seven inactive placebo (sugar) pills that are included as reminders so that the individual taking the pills does not forget to start a new pack on time.

A newly-approved COC (Seasonale) introduces a new dosing schedule that is more convenient for women using it. Intended to be taken daily for 12 weeks, the ?extended-cycle? COC is then discontinued for one week. As a result, the user has only four periods a year instead of one a month.

Estrogen containing drugs may increase your chances of developing heart disease. This is especially true if you are a smoker, have diabetes, high cholesterol, or a history of heart disease in your family. A recent study found that even low dose estrogen containing oral contraceptives can increase a woman?s risk for a heart attack or stroke. You should always talk with your physician to see if a particular form of birth control is right for you.

Contraceptive patches release hormones through the skin. One patch is applied by the user each week for 3 weeks every month, skipping the fourth week ? usually the week that menstruation occurs. They are convenient for women who cannot remember to take pills.

Injectable estrogen and progestin combinations are given into a muscle of the arm, thigh, or buttock by a qualified health care professional. They must be injected once a month between days one and 5 of the menstrual cycle. Injectable combination hormonal contraception offers another effective alternative for women who may have difficulty remembering to take pills. Unfortunately, injectable estrogen and progestin combinations are no longer available in the U.S.

Vaginal rings are inserted by the user. After releasing hormones for 3 weeks, they are removed and discarded. A new vaginal ring is then inserted ? possibly during the menstrual period. Similar to hormonal injections or patches, vaginal rings provide an alternative for women who have difficulty remembering to take pills.

Injectable progestin has been used for contraception since the 1960's, even though it was not FDA-approved for contraception until 1992. Given by injection into an arm or buttock muscle, it must be administered by a health care professional. It is given once every 3 months between days one and 5 of the menstrual cycle. A very effective long-term contraceptive, progestin injection may be an especially good choice for women who are breast-feeding, who have a history of seizures, who should avoid estrogens, who may forget to take pills, or who do not want to use other methods.

Intrauterine devices (IUDs) are small "T"-shaped devices, which may be filled with a progestin. In addition to releasing a progestin, IUDs are believed to cause minor uterine inflammation, change the chemical environment of the uterus, and ? possibly ? interfere with sperm movement. All these effects may destroy the egg or sperm and they may also prevent implantation. IUDs are inserted through the vagina by a qualified health professional. Good candidates for an IUD are women who have a history of seizures, who should avoid estrogens, who have trouble remembering to take pills, who do not want to use other methods, or who want long-term contraception that is not permanent. However, women who use IUDs may have higher risk for both pelvic inflammatory disease (PID) and ectopic pregnancy (a fertilized egg that has implanted outside the uterus).

Progestin-only pills, also called "POPs" or "minipills" offer an alternative to COCs for women who are breast-feeding, smokers over the age of 35, women who have or who have had breast cancer, and other women who cannot take estrogens. They must be taken every day with no breaks during periods. To be as effective as possible, progestin-only pills need to be taken at the same time each day.

Progestin-only implants are not currently available in the United States, although they are used commonly in other parts of the world. They consist of up to six small tubes that contain a progestin. Inserted under the skin on the inside part of the upper arm, the tubes release a constant amount of medication. Their insertion and removal are minor surgical procedures that must be done by a doctor with special training. Insertion is usually done between days one and 7 of the menstrual cycle or after a negative pregnancy test. Progestin-only implants may be removed at any time over a period of one to 5 years depending on the brand and the number of tubes that are inserted.

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.