After cautiously clearing Yaz for continued use Thursday, an FDA Advisory Panel Friday addressed post-marketing data showing similarly increased blood clot risks among users of the contraceptive patch. The committee, after having been clearly quite extensively briefed, heard testimony from Ortho Evra’s manufacturer and experts in epidemiology, gynecology and hematology. They also heard moving testimony about a young woman who died from a massive pulmonary embolism while using the Nuvaring, whose parents argued that not only the Patch, but most of the newer methods carry an increased clot risk that no woman should be allowed to take without being adequately informed.
The committee ruled that despite limitations of the data, the patch most likely carried a 1.5 times relative risk of blood clots compared to 2nd generation levonogestrel pills, but not necessarily higher than that of newer pills containing 3rd and 4th generation progestins and drosperinone. With a few dissenters, the committee voted to allow the Patch to stay on the market, but asked for Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
image from www.blisstree.com
It depends on the method and whether the mother plans to breast feed. Ideally, it is recommended that women abstain from sexual relations for at least 4 to 6 weeks after having a baby to reduce the risk of developing vaginal infections and of course, becoming pregnant.
Pregnant women have an increased risk of developing blood clots because of hormonal changes. This is commonly referred to as a hypercoagulable state. Birth control pills that contain both estrogen and progestin (aka combination pills) are not recommended for the first 42 days after the delivery because they increase the risk of blood clots in the legs (Deep Venous Thrombosis, aka DVT) and also decrease breast milk production. The vaginal ring and patch are also not recommended. However, birth control pills that only contain progestin are safe to take immediately after delivery because they don’t increase the risk of developing blood clots nor do they reduce the amount of breast milk production. The Depo- Provera injection may also be given as well because it is a progestin-only product. What women are at increased risk for developing a DVT? Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
Ask any third-year medical student how hormonal contraception prevents pregnancy, and they’ll probably tell you it prevents ovulation. What they won’t tell you is that this effect is variable and dose-dependent, and if we depended on it alone, hormonal contraception would be much less effective.
That’s because of the very important, and in my opinion, much under-appreciated effect of hormonal contraception on cervical mucus.
A Cervical Mucus Primer
Fertile cervical mucus — which forms under the influence of rising estrogen levels in the first half of the menstrual cycle and is maximal around ovulation –- is thin, watery, clear and easy for sperm to traverse.
Non-fertile mucus — which forms after ovulation and also in pregnancy under the influence of progesterone –- is the exact opposite: Thick,tacky, non-distensible and impossible for sperm to penetrate. (It’s not called the mucus plug for nothing.) Read more »
*This blog post was originally published at tbtam*