Entries in Hormonal Contraceptive (3)


Study: Birth Control Linked to Heart Attack, Stroke

Michael Matisse/Thinkstock(NEW YORK) -- The decision to use birth control is one that most women face at some point, and today many options exist to help women control whether and when they get pregnant.  But some of these approaches may carry risks -- it has long been known that certain kinds of birth control can increase the risk of clots in the legs and lungs.

Now, a new study by Danish researchers suggests that hormonal contraception also increases the risk of heart attacks and stroke in women.

The overall risk remains low, but the new study, published Wednesday in the New England Journal of Medicine, indicates that these hormonal approaches do indeed boost stroke and heart attack risk in the women who take them.

In the study, researchers looked at more than 1.6 million women over a period of 15 years and tracked all the contraceptive measures they took -- including the pill, the vaginal ring, intrauterine device, subcutaneous implants, skin patches and intramuscular injections, commonly called the "Depo shot."

Women who had already had a stroke or heart attack or who had a clotting disorder were not included in the study, and the researchers also accounted for women who smoked -- a known risk factor for some types of clots.

What they found was that although the absolute risk of stroke and heart attacks associated with the use of contraception was low, the chances of these problems occurring was 0.9 to 1.7 times higher on estrogen at a low dose.  These risks increased to a factor of 1.3 to 2.3 when a higher dose of estrogen was used.

Not all birth control methods contain estrogen, and it was found that progestin-only products, such as the IUD, did not significantly change the risk of having a heart attack or stroke.

While many women taking hormonal birth control may worry about the prospect of having a heart attack or stroke, Dr. Lauren Streicher at Northwestern Memorial Hospital in Chicago said that "pregnancy is far more likely to cause an MI or stroke than hormonal contraception."  This, she said, is because hormone levels naturally change in a woman's body during pregnancy, increasing the risk of clots.

Dr. Jacques Moritz, director of gynecology at St. Luke's-Roosevelt Hospital in New York, agreed, adding that the normal risks associated with pregnancy must be considered alongside those of taking hormonal contraception.

"You throw in ectopic pregnancy and its associated complications and the pill looks good," he said.

Doctors agree that women should talk with their physicians to carefully consider all risks before starting any medication -- and birth control is no exception.

Copyright 2012 ABC News Radio


Birth Control: New Research Gives Boost to IUD Effectiveness

Photodisc/Thinkstock(NEW YORK) -- Twenty-seven-year-old Julie Vonder Haar of St. Louis describes herself as a smart and responsible person, but like many women, she found it difficult to remember taking her birth control pills while juggling four jobs. That was until she discovered the IUD.

"Having it and not having to worry about it, taking that off my plate helped immensely," she said.

As it turns out, Vonder Haar's choice may not only be more convenient but more effective as well. Long-acting reversible contraception like intrauterine devices and progestin implants can prevent unwanted pregnancy up to 20 times better than birth control pills, patches and vaginal rings, according to a study from Washington University School of Medicine, published Wednesday in the New England Journal of Medicine. Of the 3 million unwanted pregnancies in the United States, almost half of those are due to incorrect use of the most commonly prescribed forms of birth control -- pills, patches and rings.

An intrauterine device, or IUD, is a small copper or hormonal implant that is placed in the uterus. The insertion can be done in a doctor's office, and it works for 10 years to prevent pregnancy. Bayer's brand-name IUD Mirena, approved in 2009, is one such device. A progestin implant, meanwhile, is inserted in the upper arm and can prevent pregnancy for up to three years. Merck's Nexplanon is the only such implant currently available in the U.S.

Once in place, these devices prevent unwanted pregnancy as effectively as sterilization, but unlike permanent sterilization, when a woman wants to become pregnant she simply has the device removed.

So why aren't more women using long-acting reversible contraception -- and specifically IUDs?

Cost could be one reason. Since it is not covered by many insurance plans, women might find themselves forking out $700 to buy an IUD and have it inserted. Compare this to $10 to $20 per month for birth control pills, which are generally covered by insurance. Over the long term, however, IUDs are cost-effective; when you break the cost down over a five year period, IUDs cost about $11 a month, the same as birth control pills.

Still, for Vonder Haar, cost was a big factor.

"There was no way I could have gotten the Mirena before the study because I couldn't afford the cost up front," she said.

Dr. Jeff Peipert, one of the study authors and vice chair for clinical research at Washington University, said this big initial cost discourages women, since insurance usually does not cover this type of birth control. In the study he conducted, women were allowed to choose which birth control they wanted, free of charge.

"A major surprise was that many people chose long-acting reversible contraceptive (IUD) when barriers were lifted," Peipert said. "Around 75 percent of women chose a long-acting reversible contraceptive; the hormonal IUD was the most popular."

Women's health experts also said myths surrounding IUDs may keep many women from using this option.

"Many patients have heard bad things about IUDs, such as they cause infertility or infections," said Dr. Kevin Ault, associate professor of gynecology and obstetrics at Emory University School of Medicine in Atlanta. "Careful medical research over the past decade shows these fears are not true."

Dr. Lauren F. Streicher, assistant professor of obstetrics and gynecology at Northwestern Memorial Hospital in Chicago, said some women may have also heard that if they have not yet had children they should not opt for an IUD. While this is untrue, she does recommend having a doctor who is experienced place IUDs in these women as placement can be technically difficult.

And then there is the fact that many women may not know what an IUD is, or that such an option exists. IUDs are not nearly as highly advertised as birth control pills, doctors said -- at least not yet. But as more studies like this most recent one emerge, Streicher said, more women may shift to IUDs in the years to come.

"Very clearly, contraception that is not user-dependent is going to have the lowest failure rates," Streicher said. "Half of unintended pregnancies every year are not 'no contraception,' they are 'failed contraception' such as missed pills, etc."

Vonder Haar, a participant in the study, has now had an IUD for three years, and she said she is grateful to the study for giving her the opportunity to use this method of birth control.

"I have recommended this to everyone," she said. "It has made such a difference; I think every girl should be able to have access to this."

Copyright 2012 ABC News Radio


FDA Approves New Hormonal Contraceptive

Comstock/Thinkstock(WHITEHOUSE STATION, N.J.) – Merck announced on Wednesday that the FDA has approved a new contraceptive, Nexaplanon, for the prevention of pregnancy in women for up to three years.

According to a company press release, Nexaplon is a long-acting, progestin-only single-rod hormonal contraceptive. It is the size of a matchstick and must be inserted under the skin of a woman’s upper arm with a minor surgical in-office procedure.

Merck claims that nexaplanon is effective with less than one pregnancy per every hundred women.

Copyright 2011 ABC New Radio

ABC News Radio