News Highlights
New Birth Control Pill called YAZ® also Treats Acne
YAZ®—a new birth control pill—has been proven effective in treating acne , an unwanted effect of androgens, the hormones the body produces naturally that are responsible for oily skin
Based on the results of a study involving 266 women with moderate acne aged 14-45 years old, taking YAZ for six 28-day cycles, this new pill appears to reduce acne lesions and improve skin clarity. The best results are seen in younger women.
YAZ® contains the progestin called drospirenone, like the popular oral contraceptive called Yasmin®. Both products counteract the effects of androgens and reduce acne. Unlike Yasmin which has 21 active pills and a 7-day pill free interval, Yaz has 24 active pills and only a 4-day interval without pills.
In previous research it has also been shown to alleviate physical and psychological manifestations of premenstrual dysphoric disorder (PMDD), a disorder that is similar to a severe form of PMS and may cause extreme anger, anxiety and depression.
Koltun W, Lucky AW, Thiboutot D, Niknian M, Sampson-Landers C, Korner P and Marr J. Efficacy and safety of 3 mg drospirenone/20 mcg ethinylestradiol oral contraceptive administered in 24/4 regimen in the treatment of acne vulgaris: a randomized, double-blind, placebo-controlled trial. Contraception 2008;77:249-56.
Yonkers KA, Brown C, Pearlstein TB, Foegh M, Sampson-Landers C, Rapkin A. Efficacy of a new low dose oral contraceptive with drospirenone in Premenstrual Dysphoric Disorder. Obstetrics and Gynecology 2005; 106(3): 492-501
Comparing the Pill, Patch and Ring Forms of Combined Contraception
A review of the recent studies on the birth control ring, the patch, and the pill has revealed that the three hormonal methods of contraception—which contain progestin and estrogen—are similar in their effectiveness and their failure rates.
Newer birth control methods like the birth control ring (NuvaRing®) and patch (Evra®) are marketed to women for their convenience, highlighting an increased likelihood of compliance and proper use. The EVRA® patch is applied weekly, and the NuvaRing® is inserted monthly, making both these methods easier to remember than taking an oral contraception pill every day. Most birth control pills are taken on a daily basis for three weeks, followed by one week off or one week of pills with no hormones where the menstrual period occurs.
Some studies found increased compliance with the patch. Women who used the patch also tended to discontinue earlier and have more adverse effects than pill users, including breast tenderness, painful periods, nausea and vomiting.
Women were more satisfied with the vaginal ring than the pill in two studies, though there were similar rates of discontinuation. Ring users reported less nausea, irritability and depression than pill users in a few studies, but they commonly experienced more vaginal discharge and irritation.
Although some differences in compliance and side effects were found between the three different contraceptive methods, they were not large. Every woman responds differently to each method and will prefer a different product.
Lopez LM, Grimes DA, Gallo MF, Schulz KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD003552. DOI: 10.1002/14651858.CD003552.pub2.
FOR HEALTH PROFESSIONALS
Cellulose Sulfate Gel for Contraception in Couples with Low Risk for STIs
Cellulose sulfate gel prevents pregnancy by inhibiting sperm function. After testing the product, more than three-quarters of couples reported that they would purchase the new contraceptive gel if it was available on the market.
Though it is not nearly as effective as other methods of contraception, this product may provide another option for couples who are merely trying to delay pregnancy.
A study that looked at the gels effectiveness involved couples in mutually monogamous relationships who were not trying to get pregnant. The couples used the cellulose sulfate gel as their main method of contraception for six months.
Participants in the study were given the contraceptive gel in the form of single use applicators containing 6% cellulose sulfate gel. The patients were instructed to insert the gel prior to each act of intercourse, and if they did not have intercourse within one hour, they were to insert another dose of the gel prior to sexual intercourse.
The gel was used alone as instructed for more than 75% of episodes of intercourse over the six months, and pregnancy rates over the six months were 13-14% for typical use. Side effects that may have possibly been related to the gel were reported by 29% of the women, most of which were mild. These included yeast infections and bacterial vaginosis, gel reaction, and bladder infection.
Mauck CK, Freziers RG, Walsh TL, Peacock K, Schwartz JL, and Callahan MM. Noncomparative Contraceptive Efficacy of Cellulose Sulfate Gel. Obstetrics & Gynecology 2008; 111(3):739-746.
FOR HEALTH PROFESSIONALS
Emergency Contraception – Which Method is the Best?
Women have a number of emergency contraception (EC) options to choose from to avoid pregnancy within five days of having intercourse. Emergency contraception is not a regular method of contraception—it may be used after intercourse but before pregnancy occurs as a back-up when other methods fail, or for an episode of unprotected intercourse.
A publication reviewed several articles in order to determine what is the most effective, convenient and safe method of emergency contraception. Eighty-one articles were chosen for inclusion based on their quality and content. The medical methods discussed are recommended for use within 72 hours of unprotected intercourse, although they may be used up to five days with decreased effectiveness.
Levonorgestrel, a type of progestin, may be given as two doses of 0.75mg twelve hours apart or as a single dose of 1.5mg. There was no difference in the effectiveness of these two dose regimens. When compared to the Yuzpe method (a combination of an estrogen and progestin), levonorgestrel was twice as effective at preventing pregnancy. Nausea and vomiting are the main side effects of the estrogen and progestin containing methods.
The copper intrauterine device (IUD) has also been used as a form of EC, and has the benefit of providing ongoing contraception once it is inserted. It has also been shown to prevent over 90% of pregnancies, and may be used up to five days after the estimated time of ovulation. It is recommended that women with a high risk of STIs should avoid the copper IUD. One study compared the copper IUD to 50mg of mifepristone and found statistically equivalent results with respect to pregnancy prevention.
Mifepristone, also known as RU486, is an emergency contraceptive that is used in some countries, though it is not available in Canada. Low-dose (less than 25mg) or mid-dose (25-50mg) mifepristone was more effective in preventing pregnancy than levonorgestrel. One of the side-effects of mifepristone is delay in the start of the next menstrual period, and this delay is longer with increased doses.
Learn more about emergency contraception.
Cheng L, Gülmezoglu AM, Piaggio G, Ezcurra E, Van Look PFA. Interventions for emergency contraception. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD001324. DOI: 10.1002/14651858.CD001324.pub3.
Speech enabling Web service gives a whole new meaning to the term “sextalk”
Browsealoud is a new feature on sexualityandu that reads out the words on a web site so you don’t have to. The technology highlights each word as it is read, a useful feature for people looking to improve their literacy skills, and for those with visual impairments.
Click for more information or to download the free software.
Ask Sexualityandu
I heard that drinking alcohol a few hours after taking the pill may cause it to be less effective – is this true?
No. Generally the hormonal contents of the pill are rapidly absorbed. However, if consuming alcohol induces vomiting, this can limit the effectiveness of the pill.
Do I have to be 18 or older to get a test for sexually transmitted infections at a clinic or my doctor’s office?
No. Anyone who is sexually active is eligible and is encouraged to get regular testing for STIs. Although you are encouraged to discuss these issues with your parents, the clinic or doctor has an obligation to maintain patient confidentiality and must not notify your parents or anyone else of your visit or test results without your expressed desire or consent. To learn more about sexual rights in Canada, read Sex and the Law
My husband is allergic to latex. Can I usethe vaginal ring without risking my husband having an allergic reaction?
NuvaRing® is latex free and can be used safely by couples where one or both partners may have a latex allergy. Learn more about the NuvaRing®.
I started a birth control pill a few weeks ago and have been noticing some spotting even since my period finished two weeks ago. Is the pill causing this and should I stop taking it?
One of the potential nuisance side effects associated with taking the pill is breakthrough bleeding or spotting between periods. The good news is that although this is very common, it almost always stops after a few months of being on the pill. Occasionally spotting may also be associated with delays in taking your pill. Other side effects like nausea and breast tenderness are also common when starting the birth control pill but these also usually disappear in the first few months. You do not need to stop taking the pill for this reason and should be optimistic that it will not last.
I have a Mirena® IUS which is working very well for me with no side effects. However, I heard that it does not prevent my body from releasing an egg every month, and I have been told that it causes death of an already formed embryo. Is this true?
The Mirena® thickens the cervical mucus to prevent sperm from reaching the egg, and makes the environment within the uterus inhospitable to sperm if they get that far. The Mirena® does not end an already established pregnancy that has implanted in the uterus. In theory, an embryo that arrives at the uterus after fertilization occurs in the tube could be prevented from implanting. In reality, the primary reason for its contraceptive effectiveness is preventing sperm from reaching the egg. For more information about the Mirena IUS, visit the contraception section of sexualityandu.ca.
