09/20/2020
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WARNINGS ABOUT THE USE OF CONTRACEPTIVES

By on 07/28/2020 0
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From the Association we want to inform our members and all women about the use of contraceptives, lately there has been much controversy especially with the withdrawal of Diane 35 in France for several deaths of women who were taking it, and also are doing research on the use of contraceptives like Yasmine, Yasminelle, Yaz containing drospirenone and have caused in young girls DVT (pulmonary venous thrombosis).

An oestrogen, which is always the same of the ethinyl-oestradiol type, participates in the composition of the OCPs. What varies is the amount of it among the different compounds, which is always less than 50 mcg. The way it is processed by the organism is different from one person to another, which explains the variability of side effects. It is metabolized in the liver and is the cause of the thrombotic effect.

On the other hand, we have the gestagens that differentiate the different generations, and whose doses are much lower today:

  • First generation: Cyproterone acetate (diane 35)
  • Second generation: levonorgestrel
  • Third generation: Gestodenum, Desogestrel, Etonogestrel, Norgestimate and Norelgestromine
  • Fourth generation: Drosperidone

What are some of the side effects?

  • Venous thrombosis. Its risk is greater during the first year and is linked to risk factors such as smoking.
  • There may also be some genetic family susceptibility to clotting defects.
  • High blood pressure
  • Acute myocardial infarction, which is intimately linked to tobacco
    Stroke: Smoking and hypertension are risk factors.
    Cervical cancer-but only in women with persistent human papillomavirus infection
    Both doctors and pharmacists comment that the benefits of taking contraceptives outweigh the risks and that these are isolated cases, perfect…isolated cases…but what if it turns out that the isolated case is mine…they don’t take that into account, in my opinion I think that more measures and research should be taken before giving it to women, I also think that the doses of contraceptives should be adjusted to the hormonal profile of each woman, and not give standard doses for all at once.

One of the apparent benefits is the woman’s sexual freedom, the capacity to decide whether or not to have children, and that is very good but at the cost of what? in our case it is worse, many of our associates due to PCOS have high testosterone and have a high libido and taking the contraceptives we have a low libido, so much sexual freedom so that in the end we feel castrated and unwilling? it is a contradiction in terms?

Returning to the topic of the risks of taking contraceptives, our opinion is to look for other less bad alternatives than these, it is clear that in our case they do not give it to us as a contraceptive because we do not ovulate and it is more difficult to become pregnant, they send it so that we have in theory rules and that the layer of the endometrium does not thicken, but there are other things that we can do if we do not want to take them:

1) losing weight promotes more regular cycles, it has been proven that if you lose between 5 to 10% of your body weight, the relationship between the pituitary gland and the ovaries is better, the hormones circulate better and so ovulation can improve, also losing weight helps improve insulin resistance, this makes the androgens also fall, especially those that block the ovary.

2) exercise also helps, diet without exercise does not help

3) If you do not have your period for more than 50 days in a row, you can take natural progesterone such as progefik or utrogestin. They are more natural than progevera (synthetic progesterone), and although they take longer to take effect, their side effects are less than progevera.

4) in case of continuous bleeding, you can consult your gynecologist to get a diu with only progesterone. This diu is also used in case of women who smoke or have a risk of thrombosis and high blood pressure.

And if our doctor insists on taking contraceptives … in this case you have to talk to him, see what the options are and especially not take them before you make a study and analysis to see if you can take or not, it is your health that is at stake and not theirs!

In what cases can’t you take birth control?

If you have or have had a disease that affects the blood circulation, especially those related to thrombosis (formation of clots in the blood) in the legs (deep vein thrombosis), pulmonary embolism, myocardial infarction

You have a history of transient ischemic attack (stroke), or angina

You have a serious or multiple risk factor for arterial or venous thrombosis

You have a history of migraine accompanied by visual symptoms or numbness of any body part

You have diabetes mellitus with vascular involvement (injury to blood vessels)

You have kidney failure or acute kidney failure

You have jaundice or a history of severe liver disease

In case you are taking contraceptives, if you notice the following, go to your doctor:

Unusual severe coughing

Severe chest pain that can reach the left arm

Sudden and unexplained feeling of shortness of breath

Any unaccustomed, severe, and prolonged headache or migraine

Difficulty or inability to speak

Sudden changes in hearing, sense of taste or smell

Dizziness or fainting (if not caused by low blood sugar)

Weakness or numbness of any body part

Severe pain in the abdomen (sudden or continuous)

Severe pain in either leg

Here you have a pdf about the risks associated with taking contraceptives that carry drospirenonadrospirenone bulletin7

As for Diane 35, we were asking at the Spanish Agency of Drugs and this was their answer:

The review of the drug DIANE 35 daily is complete. You can find all the information about the procedure and its result on our website at the following link: http://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/seguridad/2013/NI-MUH_FV_12-2013-ciproterona.htm. In principle it is expected that this opinion will be ratified by the Coordinating Committee for Medicinal Products for Human Use and eventually by the European Commission. A number of additional measures will also be taken, aimed primarily at trying to minimize the risk of VTE, including the distribution of information to both health professionals and patients. Beyond the details you will find in the note, we would like to inform you that the medicine will not be withdrawn from the market.

They mean that in principle they have not found anything abnormal but they are taking measures to minimize the risks of VTE (venous thrombosis), they advise only and exclusively this drug as a treatment for women with hirsutism and acne problems and remind doctors that they should not be taken with other contraceptives because it would double their effect.

In conclusion, if you have no choice but to take them because you consider it to be so, either because you want to have continuous rules, or because they are good for your hair and acne, you must know what their effects are and what you can do to prevent them, demand that before taking them you have analyses done, that you undergo routine checks every few months, and that your blood pressure be controlled periodically.

 

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