Tag Archives: drug interactions

Will St. John’s Wort Affect Birth Control?

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Herbal remedies are very popular around the world. Many people prefer them to pharmaceuticals because they believe herbs can elicit positive results without serious side effects. However, plants produce a wide variety of chemicals at varying concentrations, and might have a number of effects on your body, both good and bad. Furthermore, since herbal supplements are not evaluated by the FDA for safety or effectiveness, consumers often don’t have ready access to evidence about herbal products. We can’t even be sure that they contain the ingredients that are listed on the label!

St. John’s wort might decrease the effectiveness of birth control pills, and might be unsafe during pregnancy.

One popular herb is St. John’s wort, or Hypericum perforatum. While the scientific evidence is mixed at best, many people believe that St. John’s wort can be used as an antidepressant. However, people often treat themselves with herbal supplements without guidance from a medical doctor or pharmacist — and without knowing whether or not these herbs are safe to use with any medications they might be taking.

Over the millennia, plants have evolved all sorts of powerful chemicals, such as toxins, to defend themselves against insects and other predators. For this reason, we can’t assume that plants only contain inert chemicals that won’t affect us or interact with the chemicals in other drugs and supplements we use. St. John’s wort, in fact, contains chemicals that interfere with other medications. It has been banned in France, and other countries require or are considering warning labels on St. John’s wort products so consumers can be aware of possible drug interactions. Continue reading →

Home Pregnancy Testing 101

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You missed a period. You had unprotected sex. You didn’t take your birth control pills. Are you pregnant? How soon can you know? What are your options to find out?

Approximately every month, most sexually active women of child-bearing years could become pregnant. During ovulation, an egg is released from the ovary and makes its way to the uterus. If it is fertilized by a sperm and implants on the uterine wall, a woman is pregnant. If she is not pregnant, the lining of the uterus sheds (this is your period), and the cycle repeats.

Pregnancy tests are most accurate about one week after a missed period.

When a fertilized egg attaches itself to the uterine wall, the body begins producing a hormone called human chorionic gonadotropin, or hCG. The levels of this hormone rise rapidly in early pregnancy, almost doubling every two to three days. hCG is detectable in urine and blood, and is a sign of pregnancy.

There are different types of pregnancy tests available. Home pregnancy tests, which you can buy in drugstores, test for hCG in urine. Blood tests done in a health provider’s office don’t just test for the presence of hCG, which indicates you are pregnant, but also can tell how much hCG is present. Measuring hCG levels helps a provider determine how far along you are, if you have more than one developing embryo, or if there might be a problem with the pregnancy. Continue reading →

Let’s Talk Contraception: Depo-Provera Injections, Another Progestin-Only Option

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Progestin-only birth control pills (POPs), also called the mini-pill, are good options for those who cannot take estrogen. But for those who have lots of trouble remembering to take a pill every day at the same time, Depo-Provera shots may be the way to go. Depo-Provera is medroxyprogesterone, a hormone similar to progesterone. It is given as a shot in a doctor’s office or a health center such as Planned Parenthood, and lasts for three months to prevent pregnancy. Sometimes it is used to treat other conditions, like endometriosis.

One Depo-Provera shot lasts for three months.

The first shot is given five days after you start your period or, if you do not plan to breastfeed, in the first five days after giving birth. You must not be pregnant when you get the shot because its effects may damage the developing fetus. But it’s OK to use Depo-Provera when breastfeeding, as long as you wait six weeks after giving birth before getting the shot. It’s given in your buttock or upper arm. You need to use a backup method like a condom for seven days after getting your first shot. And if you miss getting your regular 12-week injection by only a few days, you may need to get a pregnancy test before getting your next shot.

While you are on Depo shots, your period may change. You may have spotting, bleeding, or even no bleeding. Fifty percent of people who have been on Depo-Provera for one year have no bleeding at all. After stopping the shots, menstrual bleeding returns. Also, after stopping the shots, it may take nine to 10 months to get pregnant. Continue reading →

Let’s Talk Contraception: The Mini-Pill or Progestin-Only Pill

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Birth control pills usually contain progestin and estrogen, which are both sex hormones. Progestin-only birth control pills (POPs) are sometimes called the mini-pill because they don’t contain estrogen. If you are concerned about taking estrogens because you have high blood pressure, migraines, heart disease, or a history of blood clots, but still would like to take an oral contraceptive, this may be an option for you. It is also a good choice if you are a new mother and breastfeeding.

Progestin-only pills don’t contain estrogen, making them a good option for some people.

POPs are used in the same way as other birth control pills. They come in packs of 28 pills. You take one pill at the same time each day and after the last pill in the pack is taken, you start a new pack the next day; there is no skipping days. Because there is a slightly greater risk of becoming pregnant on progestin-only pills, you must be very careful to take each pill at the same time each day and never miss a day. If your period is late and you missed one or more pills or took them late, you may need to take a pregnancy test.

The effects of POPs are easily reversible and after stopping these pills your chances of getting pregnant should not be delayed. Continue reading →

Let’s Talk Contraception: What’s the Difference Between Generic and Brand-Name Birth Control?

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Oral contraceptives (birth control pills) have been around for decades, and many are now available as generics. In general, generics cost less than brand-name medications. Despite saving money, some users question whether generic birth control pills are as “good” as brand-name pills. To confuse the situation, new brand-name birth control pills have been developed that specifically claim other benefits in addition to protection from pregnancy, such as treatment of acne. The cost of these brand-name pills is much higher. To understand the generic vs. brand-name debate, it is first important to understand how drugs are developed.

Clinical evidence doesn’t support the idea that generic birth control pills have different failure rates or side effects than their name-brand counterparts.

When a drug is first discovered and developed it goes through a drug review process. This involves many steps: chemistry experiments to discover the active chemical structure of the drug, manufacturing and testing the chemical drug product, inspections of the manufacturing process, and many other developmental studies. Then there are animal studies to check safety and efficacy — and if the drug works without major side effects. Finally, clinical studies are conducted in people; these studies test to assure bioavailability (the amount of time it takes for the body to absorb the drug). These last tests, in animals and people, show bioequivalence. Bioequivalence means the drug must enter the body, be absorbed in the same time frame, and work in the body the same way consistently.

When a new drug is finally approved by the FDA, it has met strict standards regarding its strength, purity, quality, potency, safety, and clinical effectiveness. New drugs are awarded patents for 20 years, but by the time they come to market, much of that time has run out due to all of the testing requirements. Generics are usually less expensive — manufacturers do not need to repeat discovering the drug, nor must they redo animal and human studies to assure the drug is safe and works as intended. The generic companies also do not need to spend as much money on advertising, marketing, and promotion. Continue reading →

Let’s Talk Contraception: Taking Birth Control Pills Properly

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Failure to take birth control pills properly can cause a lot of anxiety, and even lead to pregnancy. For best results, follow the manufacturer’s directions.

Oral contraceptives (also known as birth control pills or BCPs) are used to prevent pregnancy. Taken properly, they are about 99 percent effective in preventing pregnancy. They are even more effective when used in combination with other birth-control methods, such as condoms.

There are many different brands of birth control pills. Most contain a combination of the two female hormones estrogen and progesterone, but there are some BCPs that only contain progesterone. These different brands may need to be taken in slightly different ways and may have different benefits and risks, but whichever type you use, it’s very important to take them properly to get the most benefit.

You cannot take a birth control pill only when you remember to or just after you’ve had a sexual encounter — they must be taken daily.

First of all, it’s important to know which oral contraceptive you are taking. These pills usually come in packs of 21, 28, or 91 tablets and need to be taken daily.

  • Packs of 21: Take one pill each day until all 21 are gone, then don’t take a pill for seven days — this is when you should have your period. After seven days off, start a new pack of 21 pills.
  • Packs of 28: Take one pill each day, and when you finish with the pack start a new pack the next day. Sometimes these packs have pills with different colors that contain different doses of the hormones or inactive ingredients, vitamins, or minerals. They must be taken in order.
  • Packs of 91: The 91-tablet pack is larger and may contain three trays — take one pill each day until all 91 pills have been taken and then start the new pack of 91 pills the next day. Continue reading →