Tag Archives: contraceptive patches

Why Periods? False Hopes, Popes, and the “Grandfathered” Withdrawal Bleed

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The birth control pill and other hormonal contraception are popular. Menstrual periods are not. Hormonal contraception can be used to suppress menstruation — so why isn’t this method, called “continuous contraception,” more popular?

For decades, packets of birth control pills have typically contained 21 “active” pills and seven “placebo” pills. These placebos — sugar pills — trigger bleeding (which most people think of as a menstrual period, even though it’s technically called a withdrawal bleed). Because menstruation is natural, some people think this withdrawal bleed must somehow be healthier. But there are actually no health benefits — and it might also increase risk for pregnancy.

There is no reason to have a period when on the birth control pill — unless you want one.

Last month, British medical guidelines were revised to recommend continuous use of the birth control pill — that is, with no week-long “break” designed to trigger a withdrawal bleed. We could have been skipping our periods since the Pill was introduced in 1960 — so why is it only now that we are coming to see them as optional?

A flurry of recent articles has touted a rather conspiratorial claim: that the monthly bleed was included in an attempt to make the Pill more palatable to the pope. The Telegraph quoted reproductive health expert John Guillebaud: “John Rock devised [the week of placebo pills] because he hoped that the pope would accept the Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.”

Many journalists, pundits, and bloggers have expressed outrage that we’ve been putting up with decades of unnecessary bleeding (and all the attendant pain, headaches, and missed work) just because of an unsuccessful attempt to appease the pope before most women of reproductive age were even born. But the history of the placebo week is more complicated. Continue reading →

Do Birth Control Pills Cause Breast Cancer? The Latest Study

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Last month, you might have seen headlines warning you that hormonal birth control increases risk for breast cancer. This news came from a study that examined the medical records of nearly 1.8 million Danish women — and the huge sample size lent heft to the findings, several of which stood in stark contradiction to commonly held beliefs about modern hormonal contraception.

Some types of hormonal contraception could increase breast cancer risk, while others may not. But the Pill also reduces risk for endometrial and ovarian cancers.

Birth control comes in two “flavors” — hormonal and nonhormonal. Hormonal contraception is among the most effective, and includes birth control pills, hormonal IUDs, the shot, the vaginal ring, the implant, and the patch. Nonhormonal contraception ranges from very effective, including surgical sterilization and the copper IUD, to the not-quite-as-effective, including condoms, diaphragms, and withdrawal. (With the exception of condoms, birth control does not provide protection against STDs.)

Hormonal contraception is one of the greatest achievements in the history of medicine, and offers those wishing to control their fertility an array of effective options. However, as with all effective medications, there is potential for side effects. And, because many forms of hormonal birth control contain types of estrogen, and exposure to estrogen is a risk factor for breast cancer, many people wonder if hormonal birth control might increase users’ chances of developing breast cancer later in life.

Most birth control pills contain a combination of two hormones: estrogen and progestin (synthetic progesterone). Other hormonal methods, such as the ring and the patch, also use combinations of these two hormones.

There are also pills that don’t contain estrogen, called POPs, or progestin-only pills — aka the “minipill.” Additionally, hormonal IUDs, the implant, and the shot are progestin-only methods.

What Previous Studies Have Shown

The connection between hormonal contraception and breast cancer is murky, because the association is difficult to study properly. There are so many different types of hormonal contraceptives, each with different dosages, different chemical formulations, and different ways of entering the body. We can’t tease these differences apart on the one hand, but make blanket statements about hormonal contraception as a whole on the other hand. But we can look at the available evidence and see where it points. Continue reading →

Let’s Talk Contraception: Contraceptive Patches

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Is there a topical birth control available, you ask? No contraceptive cream or ointment has been developed yet, but yes, there is a patch that can be applied to your skin that is almost 99 percent effective at preventing pregnancy.

Patches are easy to use, discreet, and provide excellent birth control.

It’s called a transdermal patch and there is only one available by prescription in the United States. The Ortho Evra patch (or the generic version, called Xulane) is a small, sticky plastic patch that you apply to your skin: one patch each week for three weeks and then no patch for one week before you start the cycle again. While you wear a patch, it releases both a progesterone hormone, norelgestromin, and an estrogen hormone, ethinyl estradiol. This hormone combination is absorbed through your skin and enters your bloodstream to prevent pregnancy, much like oral birth control pills. It is discreet and can be worn comfortably and confidently during bathing, showering, swimming, and exercising without fear of its falling off. As a matter of fact, the patch has been rigorously tested in many situations, and these studies have shown that when applied properly, the patch loosens or falls off less than 2 percent of the time.

Contraceptive patches come in boxes of three for each month. To use a patch, you open a packet and apply one patch to clean, dry, intact (not irritated or injured) skin. It is recommended to apply it to areas on the buttocks, abdomen, upper torso but not breasts, or outer part of upper arm. It should not be applied to areas where it could be rubbed off, such as under a bra strap. Most users apply the patch the first day of their period or the Sunday after the start of their period. When you initially start using the patch, you will need to use a back-up contraceptive method such as a condom for the first seven days. If you are switching to the patch from birth control pills or the vaginal ring, you apply your first patch on the day you would usually start your next pill pack of pills or insert your next vaginal ring. In that case you do not need to use a back-up method of birth control. Continue reading →