How contraceptives works. In women, the brain releases FSH (follicle
stimulating hormone) which causes the immature eggs in the ovaries to develop and get bigger.
When one follicle gets big enough it bursts, a single egg is released, and is captured in
the Fallopian tube. Woman have some back pain during this ovulation. The follicle
releases estrogen when it bursts. The estrogen from the follicle signals the brain to
quit making FSH and readies (fluffs) the uterus for implantation. FSH decreases and
the ovary quits developing eggs. Normally only one egg is relased. Thus, estrogen
inhibits ovulation because of what it does by reducing FSH. When a woman is taking fertility
drugs (commonly clomiphene citrate injections), the ovary continues to release eggs and
estrogen, which negatively feeds back to the brain to stop FSH production but doesn't
stop the clomiphene citrate already in the bloodstream. Multiple eggs are released
before the clomiphene citrate disappears through liver metabolism3.
During pregnancy much progesterone is released from the pregnancy's
placenta, and elsewhere. Progesterone inhibits the ovaries from ovulation.
All oral contraceptives contain estrogen and progesterone which
together inhibit ovulation. The ratio of estrogen to progesterone, and what kinds of synthetic
hormones, determine what side-effects a woman will have while taking contraception.
Progesterone causes munchies (decrease in glucose tolerance caused by a decrease in insulin),
which can cause a weight gain of maybe 10-20 pounds. Estrogen reverses this effect, thus a
balanced pill for your metabolism will have no weight gain. Too much estrogen, however,
can cause headaches, blurred vision, increased breast size, leg cramps and life-threatening
blood clots.
Surgical Sterilization. Tubal ligation for women costs ~$1300 with
an OB-GYN at a non-catholic hospital plus hsopital charges. The total is around $3000. Sterilization is
99.5% effective; Vasectomies for men cost about $600 total with a Urologist at a non-catholic
hospital, and is 99.85% effective. A vasectomy does NOT effect a man's sex drive. In fact, with
a vasectomy you will worry less and have a better sex drive. Heterosexual men who say they don't
want a doctor touching their scrotum, but ironically don't mind her privates being handled by a
doctor. Contraception is an equal opportunity issue for both parties. Although considered
permanent, vasectomy reversals (about $1500) are more common now.
Quinacrine chemical sterilization. Laparoscopically placed
quinacrine causes chemical scarring of fallopian tubes, inhibiting travel of egg. This is not
available in the U.S.A. About a 10-15% failure with first attempt, but two attempts are made.
The cost is under $10 and great for third world population control for those wanting it. It
used to be an anti-malarial drug.
La Ruda Tea[Legal disclaimer: This
is text on ruta graveolens is not medical advice and is strictly informational for the common
person. This information was gathered from other websites.] This medicinal herb has been
used for decades to "ease" (cause) menstruation, whether the woman's period is late (or she
is pregnant). La ruda (ruta graveolens)
is toxic to the kidneys, liver, and can cause skin rash in the sun (sun sensitivity).
Ruta in sufficient
quantities causes stomach upset, puking, and diarrhea. It and other herbs contain oxytocic chemicals.
Oxytocin, an oxytocic, causes uterine contractions and it will start menstruation. Ruta also
reduces blood flow in the inside of the uterus because of the muscular uterine
contractions on the outside of the uterus, which causes fetal demise because of
reduced blood oxygen if she is pregnant. A few days after fetal demise another dose
of Ruta helps expel the dead pregnancy. Another pharmaceutical oxytocic drug commonly
available is Cytotec (cytoteca, misprostol, "miso"). It has been used in other countries
(Africa and South America) illegally to induce late pregnancies into premature births. It is sold on the internet as ulcer remedy. Herbs of Mexico.com, a distributor of RudaYage.nl, a distributor of RudaAbchomeopathy.com
Spermicides are chemicals (typically nonoxynol-9) that immobilize
the sperm's tail so it can't move and find the egg. It is approximately 70% effective. They are
bitter tasting and care must be taken when oral sex is involved. If the vaginal pill suppository
variety is used, you must wait until the pill has completely melted before having sex or else
possibly stab the penis with the unmelted pill. The foam, jelly (KY with nonoxynol-9) and the
less-messy film varieties (vaginal contraceptive film, VCF's) are quicker acting.
Barrier methods. Condoms for men and vaginal condoms for women are
approximately 70% effective because of User-error usually. They're available as lubricated,
flavored, textured, rubber/'sheep skin'/polyurethane varieties. With male condom one must pull
out after climax before penis gets soft, or else risk semen leaking out of the condom onto the
labia, or falling off inside the vagina, and causing pregnancy. There are also diaphrams for
women. Diaphrams (cervical caps) are rubber-like and must be used with spermicide on each use.
Insert prior to intercourse. Remove at least 2+ hours after sex. Wash diaphram and put away.
Approximately $50-60/diaphram. See Lea's Shield.
Cervical Sponge. (Barrier method) This is a vaginally inserted
sponge pre-filled with spermicide. They are wetted with tap water, then vaginally inserted before
sex and left inside several hours after sex. Taken off market in U.S. but still available in
Canada or on-line. They became available again 5-19-2009. It is now called
Today Sponge.
Withdrawal Method. This method involves pulling the penis out
just before ejaculation. This is a method used by those who want to be a parent because it
doesn't prevent anything, neither STD's nor pregnancy. Before the penis is pulled-out of the
vagina during sex, the man's pre-ejaculate has enough sperm in it to cause pregnancy.
Rhythm method. (Also known as "Natural Family Planning".)
Not a reliable method despite what Catholic church says. The woman calculates when she
is ovulating and avoids sex five days before and after ovulation time. This requires the unlikely
self-control of the man. The problem is that sperm can viably last up to 5 days inside the
vagina and possibly longer inside the uterus and once ovulated the egg survives for about 5 days.
Sex during the end of menstruation or just before menstruation could still get a woman pregnant!
If used without any other birth control method, you will be pregnant within a year in our opinion.
Abstinence (not having sex). Difficult. If it was easy, you wouldn't
already be here.
Oral and anal sex, and mutual masterbation are always an option to
penile-vaginal sex and less likely to cause pregnancy. You can Google them up yourself.
Male-only contraceptives are still in the testing phases.
(excerpted from, "Male contraceptives show some promise", by Chistopher Edling, Editorial Writer,
the Daily Trojan, published in Vol. 150, No. 41 (Thursday, October 23, 2003), on page 8,
(reply to: dtrojan@usc.edu): -- Oral Contraceptives: Synthetic hormone capsules can reduce sperm counts to levels that are
unlikely to cause pregnancy. A clinical test in Italy confirmed the pill's effectiveness when used
in collaboration with another method of rising popularity. -- Testosterone Enanthate Injections: Weekly injections by themselves have also proven very
effective in lowering men's sperm counts. Four hundred men in nine countries were given weekly
injections of testosterone that reduced their sperm counts dramatically. Some levels dropped to
zero. A monthly or tri-monthly version of the injection, a combination of TE and the Depo-Provera
progestin depot-medroxyprogesterone acetate (DMPA), is also in the works. -- Implants: In essence, an arrangement of time-release rods placed under the skin that distribute
testosterone enhancers similar to those described above. -- Battery-Powered Capsules: And you thought the implants sounded harsh. For those of you who
were too busy giggling (or, in my case, laughing hysterically) during sex education, there is a
tube that connects the testicles to the prostate called the "vas Deferens" (or, as I like to call
it, "The Sperm Super-Highway"). In this method, capsules are implanted into each tube to immobilize
passing sperm with low-level electrical emissions."
1 Yaz misleads us by implying that their pill exclusively has those beneficial
effects but is not true since it was compared against NO birth control pill. It also misleads
us when they say in bold letters it helps reduce (...is indicated for...) PMDD (premenstrual
dysphoric disorder, severe PMS) but in smaller print they acknowledge it hasn't been proved to
help the lesser PMS (!?). All pills lessen hormonal emotional fluctuations (of PMS and PMDD),
not just Yaz. It's like advertising that OUR car is the only car proven by a panel of experts
to have four wheels and a steering wheel. Yaz also claims that there is less bloating because of
their progestin's diuretic (pissing) properties but that effect is minimal, being one-fourth the
amount prescribed to reduce edema (bloating) and one-eighth the amount prescribed to reduce acne
(facial oiliness) and hirsutism (extra hair you don't want).
The minimal diuretic side-effect of the drospirenone is loss of sodium
(good) and increase in potassium (usually good) but adds a warning. If you are taking any
other potassium-increasing medicine, have any renal problems, or use NSAIDs like ibuprofen
regularly, you should NOT use this birth control because they can increase your potassium level.
They have added to their warnings that if you don't do a potassium level blood test after 30 days
and get re-evaluated they are not responsible. Too much potassium can give you a heart attack!
Thus, if the diuretic effect is as good as they say, one must be careful about too much potassium.
If the diuretic effect is minimal, then too much potassium is not a problem. Which is it? They
cannot claim both good diuresis and unlikely potassium problems.
2 These items are metabolized through the liver's
cytochrome P450 enzymes. Under 3A4 and 3A5, some macrolide antibiotics through antihistamines
are similar enzymatic substrates, whereas anti-seizure medicines, Dilantin, phenobarbital and
Tegretol, are inducers of the 3A4 and 3A5 enzymatic substrate. Some macrolide antibiotics and
grapefruit are actually inhibitors of 3A4 and 3A5. Under CYP1A2, caffeine through theophylline
are similar enzymatic substrates, whereas broccoli through tobacco are inducers of the enzymatic
substrate. All substrates and inducers can cause estrogen to indirectly and directly metabolize
quicker. Also, see Professor Flockhart's Cytochrome
for reference.
3 "CYP2D6 is Primarily Responsible for the Metabolism of Clomiphene",
Cyrus GHOBADI, Anne GREGORY, H. Kim CREWE, Amin ROSTAMI-HODJEGAN and Martin S. LENNARD,
Drug Metabolism and Pharmacokinetics, Vol. 23, No. 2, pp.101-105, (2008).
Krattenmacher R.,"Drospirenone: pharmacology and pharmacokinetics of a unique progestogen",
Berlex Laboratories, 300 Fairfield Road, 07470, Wayne, NJ, USA.
rolf_krattenmacher@berlex.com:
"The pharmacology and pharmacokinetics of drospirenone, a unique
progestogen, are reviewed in this paper. Unlike other progestogens, drospirenone,
an analogue of spironolactone, has biochemical and pharmacologic profiles similar to endogenous progesterone,
especially regarding antimineralocorticoid and antiandrogenic activities. Drospirenone counteracts
the estrogen-induced stimulation of the renin-angiotensin-aldosterone system and blocks
testosterone from binding to androgen receptors. Because of these characteristics, it
has the potential to reduce body weight, blood pressure, and low-density lipoprotein levels and to
enhance high-density lipoprotein levels. [color and underlining by this editor, MJP]
As a combination oral contraceptive, drospirenone with ethinyl estradiol is effective and has
positive effects on weight and lipid levels. Additionally, it relieves menstrual-related
symptoms (e.g., negative affect and water retention) that are commonly observed with other
combination oral contraceptives. Based on the biochemical and pharmacodynamic data, drospirenone
appears to be a viable alternative to the currently available progestogens."
Female Patient magazine,
April 2002,
A 3mg dose of drospirenone is equivalent to approximately 25mg of spironolactone, which is one
eighth of the spironolactone dose used to treat hirsutism or acne. (Oelkers W, Berger V, Bolik
A, et al. "Dihydrospirorenone, a new progestogen, with antimineralocorticoid activity: effects on
ovulation, electrolyte excretion, and the renin–aldosterone system in normal women", J Clin
Endocrinol Metab.1991; 73:837-842.)
All OCs reduce levels of free testosterone and other androgens, resulting in beneficial effects
on acne and hirsutism. (Van der Vange N, Blankenstein MA, Kloosterboer HJ, et al. "Effects of
seven low-dose combined oral contraceptives on sex hormone binding globulin, corticosteroid binding
globulin, total and free testosterone", Contraception. 1989;41: 345-352), and (Thorneycroft IH,
Stanczyk FZ, Ballagh SA, et al. "Effect of low-dose oral contraceptives on androgenic markers
and acne." Contraception. 1999;60:255-262.)
"Concomitant use of nonsteroidal anti-inflammatory drugs with drospirenone/EE
has not been shown to increase hyperkalemia risk in women with normal renal and hepatic function."
"As drospirenone simultaneously reduces androgen levels, blocks androgen receptors, and does not
attenuate the estrogen-mediated increase in SHBG, its therapeutic effects in this area have the
potential to be greater than those of traditional OCs. Comparative trials will determine whether
drospirenone/EE is more effective than other OCs in this respect, and whether women who are being
treated for acne and/or hirsutism with a combination of spironolactone and an OC might do well
with drospirenone/EE alone."(Berlex Laboratories. Data on file.)
http://www.rxlist.com/cgi/generic/spiron_ids.htm
"Edema in adults (congestive heart failure, hepatic cirrhosis, or nephrotic syndrome). An initial
daily dosage of 100 mg of Aldactone [spironolactone] administered in either single or divided
doses is recommended, but may range from 25 to 200 mg daily."
"Essential hypertension. For adults, an initial daily dosage of 50 to 100 mg of Aldactone
administered in either single or divided doses is recommended."
"Hypokalemia. Aldactone in a dosage ranging from 25 mg to 100 mg daily is useful in treating a
diuretic-induced hypokalemia, ..."
[Thus, the diuretic effect of the 3mg drospirenone (25mg equivalent spironolactone) in Yaz is
on average equivalent to ¼ of the 100mg amount required for diuretic results and the amount
required for hirsutism or acne. Editor, MJP.]
Yaz website "Fatigue, Bloating, Moodiness, Acne*"
"*Treats moderate acne in women who choose the Pill for contraception." [versus no oral contraceptive pill, editor, MJP]
"YAZ is also indicated for the treatment of symptoms of premenstrual dysphoric disorder
(PMDD) in women who choose to use an oral contraceptive as their method of contraception."
[versus no OCP, editor, MJP]
"YAZ has not been evaluated for the treatment of premenstrual syndrome (PMS)." [but it was evaluated for the more extreme PMDD?! This is probably because the hormonal controlling effect only is slight]
"Who shouldn't take YAZ? YAZ contains a different kind of hormone, drsp®, which may increase
potassium. Therefore, you should not take YAZ if you have kidney, liver, or adrenal disease
because this could cause serious heart and health problems. Tell your doctor if you are on daily
long-term treatment for a chronic condition such as cardiovascular disease or chronic
inflammatory disease. Women who take certain drugs (see safety information) should have their
potassium level checked in the first month of taking YAZ." [or else they cannot be held liable. editor added bolding, and underlining]
"What are some examples of cardiovascular or chronic inflammatory drugs that may increase
potassium? NSAIDs-ibuprofen (Motrin®, Advil®), naproxen (Naprosyn®, Aleve®, and others)
when taken long-term and daily for arthritis or other diseases or conditions, Potassium-sparing
diuretics (spironolactone and others [Hydrochlorothiazide, HCTZ, a common generic for
high blood pressure, MJP]), Potassium supplementation, ACE inhibitors (Capoten®, Vasotec®,
Zestril®, and others [lisinopril a common generic for high blood pressure]),
Angiotensin-II receptor antagonists (Cozaar®, Diovan®, Avapro®, and others), and Heparin."
pmdd.factsforhealth.org
PMDD is not just a new name for premenstrual syndrome (PMS), a condition [PMS] that affects
as many as 75% of menstruating women. It is, however, considered to be a very severe form of
PMS that affects about 5% of menstruating women. Both PMDD and PMS share symptoms in common
that include depression, anxiety, tension, irritability and moodiness. What sets PMDD apart
is its severity.
[Editor, MJ Pederson, Central Family Medicine, Kansas City, KS 66101.3546.]
