The Other Benefits of Oral Con

Most of us think of oral contraceptives as a means of preventing unplanned pregnancies. Oral contraceptives contain progestin and may also contain a synthetic estrogen. With consistent and proper use, oral contraceptives are a highly effective method of contraception.

But did you know that there are several other reproductive health conditions that can be improved or prevented with the use of these hormones? According to American Family Physician's update on oral contraceptives, "The non contraceptive benefits (and favorable side effect profiles) of oral contraceptive pills are so important that some patients use the pills exclusively for those reasons."

The conditions for which the American Academy of Family Physicians endorses the use of oral contraceptives are:

Acne
Acne is associated with excessive androgen levels, and oral contraceptives reduce the amount of androgen that is available. Just how this works depends on the specific hormone combination in a particular oral contraceptive. In a study reported in American Family Physician, 83% of participants who received norgestimate and ethinyl estradiol rated their acne improved after six months. Sales of Ortho Tri-Cyclen have tripled since the results of this study were published, and the FDA gave Johnson & Johnson the right to sell Ortho Tri-Cyclen for the treatment of acne. Estrostep and Yaz are other options.

Breast Pain
Oral contraceptives may be used to treat cyclic breast pain -- that is, pain that is associated with a woman's menstrual cycle.

Dysmenorrhea
While the FDA does not approve of oral contraceptives prescribed primarily for the relief of cramps, women who use The Pill rarely experience menstrual cramps.

Ectopic Pregnancy
According to the Centers for Disease Control (CDC), there is clear controversy about whether oral contraceptives prevent ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg fails to implant itself in the uterus, most often remaining in the fallopian tubes.

Endometriosis
Combined oral contraceptives are an effective treatment for endometriosis. Unfortunately, the side effects of this treatment -- which include irregular bleeding, fluid retention, and depression -- have made this option unbearable for many women.

Functional Ovarian Cysts
These are the most common type of ovarian cyst and usually dissolve within two menstrual cycles without treatment. Oral contraceptives may help prevent this type of ovarian cyst by preventing ovulation.

Hirsutism
Polycystic ovarian syndrome (PCOS) is the most common cause of this excessive hair growth in women. Oral contraceptives can improve or stabilize up to 50% of cases caused by PCOS.

Metrorrhagia
Women who experience abnormal uterine bleeding can often regulate their menstrual cycle with oral contraceptives, if after close medical investigation the abnormal bleeding is not found to be a symptom of a more serious condition.

Mittelschmerz
Oral contraceptives block the surge of hormones that occurs before ovulation, and are often effective for relieving mid-cycle or ovulation pain.

Ovarian and Endometrial Cancer
Women who use oral contraceptives experience these types of cancer at about half the rate of non-users. However, it's important to note that there may be an increased risk of breast cancer and cervical cancer in women who use oral contraceptives for more than five years.

Premenstrual Syndrome
Many women experience fewer symptoms of PMS while using oral contraceptives. However, other treatments and lifestyle modifications that may also provide relief should be considered.

Uterine Fibroid Tumors
According to the National Library of Medicine, oral contraceptives may be an effective treatment for uterine fibroid tumors.

Iron Deficiency Anemia
These drugs may also help improve this problem in women who have very heavy periods.

Oral contraceptives may not be the right choice for everyone. For some women, the side effects of oral contraceptives may be worse than their original symptoms. There is controversy among some healthcare professionals about using synthetic hormones for these purposes when more natural options for many of these conditions exist.

If you think oral contraceptives might be right for treating your reproductive health problems, discuss your personal medical history with your physician.

Source:

AAFP. Benefits and Risks Of OCs Beyond Contraception. http://www.aafp.org/afp/20040501/tips/20.html. Accessed 07/20/09.

AAFP. Update On Oral Contraceptives. http://www.aafp.org/afp/991101ap/2073.html. Accessed 07/20/09.

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Breastfeeding Benefits Mom

Are you pregnant and trying to decide whether breastfeeding is right for you and your baby? You have probably heard all the ways that breastfeeding can benefit your newborn, but breastfeeding provides substantial benefits to the mother as well.

This week I talked to Patricia Ellis RN, MA, IBCLC of Bridgewater/Somerville NJ about the health benefits to mothers who breastfeed.

Q: Please tell me about yourself and your interest in breastfeeding.

A: My interest in breastfeeding began before my first pregnancy, in 1980. I began attending La Leche League meetings to learn about breastfeeding during my pregnancy, and continued to attend for support and information as the baby grew (he's now 21!), and I eventually applied to become a certified Leader, counseling moms and leading the monthly topics at meetings. I was a LLLI Leader for five years, had one more child, and nursed for a total of five years. I lived in Shannon, Ireland for one year and through LLLI contacts there, organized a new group. Breastfeeding was a beautiful experience for me and my sons, in spite of engorgement, sore nipples, and mastitis--even La Leche members get them! However, since that time, much new information has become available and many problems are now more preventable or minimized, especially with the advent of Lactation Consulting as an outgrowth of LLLI.

Subsequently I completed nursing school in 1996 and as I tried to decide which way to go with my degree, maternal and child health became my focus.

Lactation Consulting came about as a field that extended the role of the volunteer leader to a person who had additional specialized training and met specific prerequisites in order to sit for the International Board of Lactation Consultant Examiners annual exam. I became Board Certified in 1999. I have been employed by two hospitals on a part-time basis, and am currently, in addition to my private lactation practice, employed full-time at the hospital with the most births per year in New Jersey as a Lactation Consultant. It is challenging and rewarding work, and I feel honored to be a part of the special process that occurs following childbirth.

Q: What are the health benefits to mothers who breastfeed?

A: Health benefits to mothers who breastfeed are many, including reduced risk of some cancers, reduced risk of osteoporosis, faster return of the uterus to its prepregnant state, steady weight loss based on use of fat deposits laid down during pregnancy for early milk production, slower return of menses which can aid in natural child spacing, and a psychological sense of confidence as the mother provides completed nourishment for her baby.

Q: How does breastfeeding reduce the risk of cancer?

A: To quote Dr. Jack Newman, MD, FRCPC, a Canadian pediatrician regarding the protective factors against cancers conferred by breastfeeding, "There are various theories, but the most common is that women who breastfeed, especially for more than a token few weeks or months, have a different hormonal milieu than women who do not. It is also thought that a woman who has never had children is also at risk for ovarian cancer. In fact, this is the explanation for breast cancer and endometrial cancer as well. It was always well-known that nuns had much higher rates of these cancers than other women.

If we go back to hunter- gatherer societies, sterile menstrual periods are very uncommon. Women in these societies are pregnant or breastfeeding almost continuously from menarche to menopause. This is thought to be the norm for our species and modern society has completely turned this around."

In regard to breast cancer, the risk declines in inverse proportion to the duration of breastfeeding. Also, the mother's age at first full-term pregnancy exerts the strongest influence on reducing the risk; if lactation occurs in early reproductive life, the effect is greatest (Riordan, 1999). I spoke to Alicia Dermer, MD who also agreed and indicated that the low estrogen level during breastfeeding may be the protective factor. The degree of protection is dose-related; that is, the degree of reduced risk is directly related to the duration of breastfeeding

"A 60 percent reduction in the risk of ovarian cancer was found among women who had breastfed as compared with nulliparous women." as stated by A Patrick Schneider II, MD, MPH in the New England Journal of Medicine, 1987.

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