Buzz - Student Health Services Newsletter
(Vol. 5) |
|
Contraceptives
Immunizations, shots, vaccines! These are all words which many
of us dread. However, it is very important to be up-to-date to
prevent some possible side-effects and health complications. Not
all vaccinations are required and not all vaccines are 100% effective.
It is important to discuss this information with your medical provider.
The majority of the information was taken from www.WebMD.com and
also the Centers for Disease Control www.cdc.gov.
Contents
- Ortho Evra and the Nuva Ring
- Other New Products and Research
- Male Contraceptive Demonstrates Efficacy and Safety
Ortho Evra and the Nuva Ring
Choosing the right method of birth control is a decision that
many young women are faced with in today's society. Now, there
are two new options on the market that are offering a simple and
easy-to-use alternative to the methods of the past. These options
are Ortho Evra, the birth control patch and the Nuva Ring.
Ortho Evra
What is it?
 Ortho Evra is a new birth control patch, available through prescription
that has recently been approved by the Food and Drug Administration.
The patch is small (1 ¾" by 1 ¾") and as thin as
a piece of paper making it easy to wear discretely under clothing.
The patch has one sticky side that attaches directly to the skin
and can be applied and removed at home, without the aide of a medical
professional. The patch is made to stay on the body through bathing,
showering and exercising and needs to be changed only once a week.
How it Works
Ortho Evra works in a similar way to the Pill,
but using "patch technology". Patch technology delivers a steady
flow of hormones through the skin and directly into the blood stream
via the sticky side of the patch. The hormones used in the patch
are progestin and estrogen, the same hormones found in the Pill.
In order to prevent pregnancy, the patch works (like the Pill)
in two different ways. The first way it works is in preventing
ovulation. When ovulation is prevented an egg is not released from
one of the ovaries. If the egg is not released the sperm cannot
fertilize it and pregnancy will not result. The second way in which
the patch helps to prevent pregnancy is by thickening the cervical
mucus. This makes it less likely that the sperm will be able to
enter the uterus.
Ortho Evra, like the Pill is 99% effective when used correctly.
Some of the side effects may include breast symptoms, application
site reaction, nausea, upper respiratory infection, menstrual cramps
and abdominal pain. The patch is not made for everyone and anyone
who is considering using it needs to consult with their doctor
or healthcare provider first.
How to Use It
Ortho Evra is the first form of weekly birth
control. The patch is applied once a week for three consecutive
weeks and not reapplied the fourth week. This is the week you will
have your period. The patch can either be started on the first
day of your period or on the first Sunday after your period starts.
The patch should then be changed on the same day each week. The
time of day does not matter as long as it is the same day.
The patch can be worn on four different places of the body: the
buttocks, abdomen, upper torso (not breasts) and upper outer arm.
   
The patch should be carefully applied to clean, dry skin, following
the directions included in the full U.S. Prescribing Information
for Ortho Evra. If the patch seems loose or has come partially
off for less than 24 hours it may be reapplied or a new patch may
be applied without the need for back-up contraception.
Nuva Ring
What is it?
 The Nuva Ring is another hormone based form of birth control.
It is a soft, flexible ring about two inches in diameter that is
inserted into the vagina once a month. The vaginal muscles hold
the Nuva Ring in place where it releases a steady flow of hormones
over three weeks. The fourth week the Nuva Ring is removed and
this is when you have your period. After this seven day break a
new ring is inserted for the next three weeks.
How it Works
The Nuva Ring works in a way similar to the Pill
without having to take a daily pill. The Ring releases a combination
of estrogen and progestin which prevent the ovaries from producing
mature eggs. The hormones are released from the ring when activated
by body temperature. The hormones are then absorbed into the walls
of the vagina and from there distributed into the bloodstream.
The method of delivery gives 99% effectiveness against pregnancy
when used effectively.
The method of delivery also allows for less estrogen than is needed
with the Pill or the Patch. The decrease in the amount of estrogen
means that there is a low incidence of side effects such as headaches,
nausea and breast tenderness. The lower dosage of estrogen combined
with the slow and steady delivery into the blood stream also cuts
down on the amount of hormonal "ups and down" that can be associate
with the Pill and Patch.
How to Use It
The Nuva Ring is used by squeezing it between the thumb and index
finger and gently inserting it into the vagina. You will know that
the ring is in correctly when it feels comfortable. If you can
feel the ring, simply push it further up. The exact positioning
is not of importance as long as it is comfortable. The ring should
then be left in for three consecutive weeks. At the end of the
three weeks the ring should be removed by simply putting your fingers
into your vagina and pulling the ring out. The ring should be left
out for seven days (while you have your period) and then a new
ring should be reinserted for another consecutive three weeks.
Other Information
More information about Ortho Evra and the Nuva Ring can be found
at the following websites:
More information can also be obtained at St Cloud State University
Health Services. Ortho Evra is available at the SCSU Pharmacy for
$20.25/month and the Nuva Ring is available for $7.95/month.
Back to Contents
Other New Products and Research
SEASONALE Oral Contraceptive
SEASONALE is a relatively new form of oral contraceptive which
will soon become available at the SCSU Student Health Services
. Please ask your provider about this product. We have included
excerpts taken from the SEASONALE website: http://www.seasonale.com
SEASONALE ® tablets are indicated for the prevention of pregnancy.
Women who take SEASONALE ® receive 9 more weeks of estrogen
and progestin every year than with a same-dose 28-day birth control
pill. While this may increase the chance of serious health risks,
current studies have not shown an increased risk.
Risks with SEASONALE ® are similar to those with all birth
control pills. Most side effects are not serious and those that
are occur infrequently. The convenience of fewer planned menses
(4 per year instead of 13 per year) should be weighed against the
inconvenience of increased intermenstrual bleeding and/or spotting.
Serious risks, which can be life threatening, include blood clots,
stroke, and heart attack. Cigarette smoking increases the risk
of serious side effects, especially if you are over 35. Women who
use birth control pills should not smoke. Some women should not
use birth control pills, including women who have blood clots,
certain cancers, a history of heart attack or stroke, as well as
those who are or may be pregnant. If you are a heavy smoker and
over age 35, you should not take SEASONALE ® . Birth control
pills do not protect against HIV infection (AIDS) and other sexually
transmitted diseases.
With SEASONALE ® , while you get the convenience of having
only 4 periods a year, you are also likely to have more breakthrough
bleeding and spotting between periods than with a 28-day birth
control pill.
PLEASE CONSULT WITH YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE
PROFESSIONAL BEFORE USING ANY PRODUCT DISCUSSED HERE OR WITHIN
ANY OF OUR OTHER WEB SITES. Promptly see a qualified healthcare
professional if you have, or suspect that you have, a medical condition.
This site may contain information related to various health, medical,
and fitness conditions and their treatment. However, we do not
offer individualized medical diagnosis or patient-specific treatment
advice. You should not use the information contained herein for
diagnosing or treating a medical condition or disease. You should
always consult a qualified healthcare professional before initiating
use of any medicine or other treatment. Only a qualified healthcare
professional can determine if a product described here, or within
any of our other Web sites, would be appropriate for you to use.
Your qualified healthcare professional is in the best position
to discuss with you the risks and benefits of any treatment, including
prescription drugs, specific to your own medical condition.
FREQUENTLY ASKED QUESTIONS : to read more about
the product go to: http://www.seasonale.com
Choosing SEASONALE ®
Q. Am I a good candidate
for SEASONALE ®?
A. If you are comfortable having your period
just 4 times a year and do not have any risk factors that prevent
you from taking birth control pills, you may be a good candidate
for SEASONALE ® . Only you and your healthcare
professional can make the choice for you to start taking SEASONALE ® .
[Back to Questions]
Q. Is it okay to have only 4 pill periods
a year?
A . Clinical studies to date have shown no increased health risks with SEASONALE ® compared
with a 28-day birth control pill. Periods experienced on birth control pills
(or pill periods) result only because hormones are stopped during the last
7 days of your pill cycle. They do not result because of a need to shed the
built up uterine lining. Taking SEASONALE ® maintains the lining of the
uterus and avoids buildup. Since the lining is thin and does not need to be
shed each month, there is no need for a monthly pill period.
[Back to Questions]
Q. Is it okay to switch
from another birth control pill to SEASONALE ® ?
A. Yes. If you are on another birth control pill, you may switch to SEASONALE ® .
Only you and your healthcare professional, however, can decide if switching
to SEASONALE ® is right for you.
[Back to Questions]
Q. Is SEASONALE ® safe?
A. SEASONALE ® is a combination of low-dose hormones (an estrogen and a
progestin). This combination has been used safely and effectively in a common
28-day birth control pill for more than 20 years. SEASONALE ® has also
been proven safe and effective in a clinical trial. SEASONALE ® is not
for everyone. For information about side effects, see the full Prescribing
Information .
[Back to Questions]
Q. Who should not take
SEASONALE ® ?
A. Birth control pills, including SEASONALE ® ,
are not recommended for women who have experienced heart attack
or stroke; blood clots in the legs, lungs, or eyes; cancer of
the breast or sex organs; or liver tumors. Birth control pills
are also not for women who have chest pain, an inherited tendency
to form blood clots, liver or adrenal disease, or who have yellowing of the
whites of the eyes or skin. Women who smoke, especially those over 35, should
not take birth control pills, neither should women who are pregnant or have
unexplained vaginal bleeding. If you have diabetes, high cholesterol, high
blood pressure, or kidney disease, you should discuss these conditions with
your healthcare professional before taking any birth control pill.
[Back to Questions]
Q. Do birth control pills offer any health
benefits in addition to preventing pregnancy?
A. Birth control pills decrease blood flow during
pill periods. With a lighter flow, your body may lose less iron,
and anemia resulting from iron deficiency may then be less likely
to occur. Birth control pills may also reduce painful periods.
In addition, ovarian cysts, ectopic pregnancy, and noncancerous
lumps or cysts of the breasts may occur less frequently. Birth
control pills may reduce the risk of pelvic inflammatory disease
and may reduce the risk of developing cancers of the ovaries and
the lining of the uterus.
[Back to Questions]
About
SEASONALE ®
Q. How is SEASONALE ® different
from birth control pills I've taken in the past?
A. SEASONALE ® is a birth control pill that extends your cycle. With other
pills, you will have your pill period once every 28 days, or 13 times a year.
SEASONALE ® works like a 28-day birth control pill. Unlike a 28-day birth
control pill, SEASONALE ® extends your cycle.
[Back to Questions]
Q. How does SEASONALE ® work?
A. Just like other birth control pills, SEASONALE ® prevents pregnancy
primarily by stopping your ovaries from releasing an egg. This is called suppression
of ovulation. SEASONALE ® also works in 2 other possible ways to prevent
pregnancy that are similar to other birth control pills. SEASONALE ® thickens
the mucus at the opening of your uterus, to make it difficult for sperm to
reach the egg. SEASONALE ® also changes the lining of your uterus (endometrium)
to make implantation less likely.
[Back to Questions]
Q. How quickly will
I be protected from pregnancy after starting SEASONALE ® ?
A. You should use another method of birth control as a backup (such as condoms
or spermicide) for the first 7 days after you start your first SEASONALE ® Extended-Cycle
Tablet Dispenser.
[Back to Questions]
Q. What is a pill period, and what is the
difference between a pill period and a menstrual period?
A. A pill period is a period that occurs while
you are on a birth control pill. It is different from the menstrual
period of a woman not on a birth control pill. A pill period results
when you stop taking the active pills that contain hormones for
the last 7 days of your pill cycle. A menstrual period occurs when
the lining of the uterus sheds because an egg was not fertilized
and did not implant in the uterus.
[Back to Questions]
Q. If I only get my pill period once every
3 months, what will it be like?
A. Your pill period on SEASONALE ® should
not last any longer than what you would experience on a 28-day
birth control pill. And typically, pill periods tend to be lighter
than menstrual periods. [Back to Questions]
Q. Will SEASONALE ® protect
me from HIV infection and other sexually transmitted diseases?
A. SEASONALE ® , like all other birth control
pills, does not protect you from sexually transmitted diseases,
including HIV infection (AIDS). Using a latex condom when you
have sex can reduce the risk of contracting sexually transmitted
diseases. [Back to Questions]
Q. Is it necessary to
take a break every so often from SEASONALE ® ?
A. No. There is no medical reason to take a break from any birth control pill,
including SEASONALE ® . In fact, taking a break from your birth control
pill may increase your risk of unintended pregnancy.
[Back to Questions]
What to Expect...
Q. Without a monthly
pill period, how will I know I'm not pregnant while taking SEASONALE ® ?
A. Just like all birth control pills, when taken daily as directed , SEASONALE ® is
effective in preventing pregnancy. If you think you might be pregnant, especially
if you have missed pills, you should contact your healthcare professional.
[Back to Questions]
Q. What if I don't
get my pill period while I'm on SEASONALE ® ?
A. Some women on birth control pills experience no bleeding during their pill
period. This is called amenorrhea and can happen with many birth control pills.
If you do not get a pill period, contact your healthcare professional to confirm
you are not pregnant.
Q. Are there any risks
associated with taking SEASONALE ® ?
A. Women who take SEASONALE ® receive 9 more weeks of estrogen and progestin
every year than with a same-dose 28-day birth control pill. While this may
increase the chance of serious health risks, current studies have not shown
an increased risk. Risks with SEASONALE ® are similar to those with all
birth control pills. Most side effects are not serious and those that are occur
infrequently. The convenience of fewer planned menses (4 per year instead of
13 per year) should be weighed against the inconvenience of increased intermenstrual
bleeding and/or spotting. Serious risks, which can be life threatening, include
blood clots, stroke, and heart attack. Cigarette smoking increases the risk
of serious side effects, especially if you are over 35. Women who use birth
control pills should not smoke. Some women should not use birth control pills,
including women who have blood clots, certain cancers, a history of heart attack
or stroke, as well as those who are or may be pregnant. If you are a heavy
smoker and over age 35, you should not take SEASONALE ® . Birth control
pills do not protect against HIV infection (AIDS) and other sexually transmitted
diseases.
With SEASONALE ® , while you get the convenience of having
only 4 periods a year, you are also likely to have more breakthrough
bleeding and spotting between periods than with a 28-day birth
control pill.
Q. Will I experience
any side effects with SEASONALE ® ?
A. Side effects associated with SEASONALE ® are similar to those of other
birth control pills. They may include bleeding between pill periods, headache,
nausea, and breast tenderness. These side effects may decrease over time. In
addition, in a 12-month clinical trial, there was no difference in weight change
between women taking SEASONALE ® and women taking a 28-day birth control
pill. A recent review of clinical studies involving different birth control
pills showed no proof that birth control pills actually cause an increase in
weight.
Q. Will I gain weight
with SEASONALE ® ?
A. Change in weight with SEASONALE ® is similar to what you would experience
on a 28-day birth control pill. In a clinical trial, women taking SEASONALE ® did
not experience any noticeable change in their weight. A recent review of clinical
studies involving different birth control pills showed no proof that birth
control pills actually cause an increase in weight. Every woman is different.
Change in weight usually depends on eating and exercise habits.
Q. Will SEASONALE ® help
treat my acne?
A. SEASONALE ® is not indicated for the treatment of acne.
Q. Will I have spotting
or breakthrough bleeding with SEASONALE ® ?
A. SEASONALE ® offers you the convenience of having just 4 pill periods
a year, but you are also likely to have more spotting and breakthrough bleeding
between pill periods than with a 28-day birth control pill. Breakthrough bleeding
may vary from slight spotting to a flow much like a regular pill period. These
side effects are common during early cycles and can happen as your body is
adjusting to hormones. They should decrease over time. Breakthrough bleeding
usually does not indicate any serious problems. Even if you have spotting or
breakthrough bleeding, keep taking your pills as scheduled. If you have bleeding
between pill periods for more than 7 days in a row, contact your healthcare
professional.
Q. What is breakthrough bleeding?
A. Breakthrough bleeding is vaginal bleeding, other than during your menstrual
or pill period, that requires sanitary protection (a pad or tampon). It is
common and often occurs as your body is adjusting to any birth control pill,
including SEASONALE ® . If you are concerned, contact your healthcare
professional.
Q. What is spotting?
A. Spotting is light vaginal bleeding, other than during your menstrual or
pill period, that does not require sanitary protection (a pad or tampon).
It is common and often occurs as your body is adjusting to any birth control
pill, including SEASONALE ® . If you are concerned, contact your healthcare
professional.
Q. When should I call my healthcare professional?
A. While taking SEASONALE ® , call your healthcare professional if you
experience any symptom that causes you concern. Call right away if you experience
any of the following: sharp chest pain, coughing up blood, sudden shortness
of breath, calf pain, sudden severe headache or vomiting, dizziness or fainting,
vision or speech disturbances, numbness in an arm or leg, breast lumps, or
severe stomach pain. If you have missed pills and think you may be pregnant,
contact your healthcare professional.
Q. What if I want to get pregnant?
A. SEASONALE ® is a reversible form of birth control, so once you stop
taking SEASONALE ® , ovulation should start again. There may be some delay
in becoming pregnant after you stop using any birth control pill, including
SEASONALE ® , especially if you've had irregular menstrual cycles before
using a birth control pill. Birth control pills, including SEASONALE ® ,
do not cause infertility.
Taking SEASONALE ®
Q. How do I start taking
SEASONALE ® ?
A. Take your first pink active pill on the Sunday after your period starts,
even if you are still bleeding. If your period begins on Sunday, start taking
SEASONALE ® that same day. You should use another method of birth control
as a backup (such as condoms or spermicide) for the first 7 days of your
first Extended-Cycle Tablet Dispenser.
Q. How often should
I take SEASONALE ® ?
A. You should take 1 pink active pill every day for 84 days in a row. Then
take 1 white inactive pill every day for 7 days. You should take SEASONALE ® at
the same time every day to most effectively prevent pregnancy. This may also
reduce the chance of spotting or breakthrough bleeding.
Q. Do I need to take
SEASONALE ® at
the same time every day?
A. Yes. It's important to take SEASONALE ® at the same time every day.
This makes sure you are most effectively protected from pregnancy. It may also
help lessen the chance of spotting and breakthrough bleeding.
Q. How can I remember
to take SEASONALE ® every
day?
A. The best way to remember to take SEASONALE ® every day is to make it
part of your daily routine. Pick a time that's easy for you to remember, and
take SEASONALE ® at that time every day. For example, take SEASONALE ® with
your breakfast every morning, with your daily vitamins, or right after you
brush your teeth at night.
Q. What if I forget to take 1 pink pill?
A. If you miss 1 pink active pill, take it as soon as you remember. Take the
next pill at your regular time. This may mean you will take 2 pills on the
same day.
Q. What should I do if I miss 2, 3, or more
pink pills?
A. If you miss 2 pink active pills, take 2 pills on the day you remember. Take
2 pills the next day. Then take 1 pill a day until you finish your pack. If
you miss 3 or more pink active pills, do not remove the missed pills from your
pack. You are not going to take them. Instead, keep taking 1 pill every day
until you have finished your pack. You may experience bleeding during the week
following your missed pills. You must use another method of birth control (such
as condoms or spermicide) as a backup for 7 days after you miss 2 or more pink
active pills.
Q. What if I forget to take a white pill?
A. Your white pills are inactive (placebo) and do not contain any hormones.
If you miss 1 or more white pills, skip them and keep taking your white pills
as scheduled. When you start taking your white pills, it is a good time to
refill your SEASONALE ® prescription to make sure you don't miss any
of your pink active pills.
Q. Are there any medications
I shouldn't take while I'm taking SEASONALE ® ?
A. It's important to tell your healthcare professional about all the medications
(prescription, over-the-counter, vitamins, and herbal supplements) you are
currently taking. As with other birth control pills, if SEASONALE ® is
taken with certain other medications, the way either medication works may be
changed.
Q. Will antibiotics reduce the effectiveness
of the pill?
A. Antibiotics may decrease the effectiveness of any birth control pill, including
SEASONALE ® . You should use a backup method of birth control (such as
condoms or spermicide) while you are taking antibiotics or any other drug that
may reduce the effectiveness of your birth control pill. Be sure to tell your
healthcare professional about all the medications (prescription, over-the-counter,
vitamins, and herbal supplements) you are currently taking.
Q. Can I smoke while
taking SEASONALE ® ?
A. As with other birth control pills, smoking while taking SEASONALE ® can
increase your risk for serious side effects such as heart attack, stroke, and
blood clots. Women who use SEASONALE ® , or any birth control pill, should
not smoke. If you are a heavy smoker and over age 35, you should not take SEASONALE ® .
Q. Can I take SEASONALE ® right
after I have a baby?
A. If you are breast-feeding, you should not take any combination birth control
pill, including SEASONALE ® , during that time. If you decide NOT to breast-feed
your baby, you can safely begin taking SEASONALE ® 4 weeks after you give
birth.
Back to Contents
Male Contraceptive Demonstrates Efficacy
and Safety
Mindy Hung
Taken from Medscape Medical News 2003. © 2003
Medscape
Nov. 5, 2003 - A prototype depot androgen/progestin combination
demonstrates high contraceptive efficacy in men, according to results
of a study published in the October issue of the Journal of
Clinical Endocrinology and Metabolism . The male contraceptive
also showed satisfactory short-term safety and recovery of spermatogenesis.
"The prevention of all pregnancies during over 35 person-years
of risk exposure demonstrates high contraceptive efficacy compared
with the benchmarks of condoms, the existing reversible male method,
and oral contraception, the major reversible female contraceptive
method, which have first year failure rates of approximately 12%
and 3%, respectively," write Leo Turner and colleagues from
the ANZAC Research Institute at the University of Sydney in Australia.
Investigators studied 55 men aged 18 to 50 years, who were in
a stable relationship with a female partner for one or more years
and who did not seek pregnancy for at least 12 months. Subjects
had to be in good general health and have normal reproductive function.
Investigators excluded men with a history of major medical or
psychiatric disorders; men whose partners had a history of infertility;
those with regular prescribed medication; and those with contraindications
to minor local surgery or testosterone. Female partners had to
be aged 18 to 38 years, have regular menstrual cycles, and have
a negative pregnancy test.
Treatment was made up of a progestin, 300 mg DMPA injected every
three months, and a depot testosterone (four 200-mg pellets) of
pure crystalline steroid implanted under the abdominal skin under
local anesthetic, lateral to the umbilicus.
Investigators defined efficacy by the contraceptive failure rate
during 12 months of hormonally induced suppression of spermatogenesis
(<1 million/mL). The contraceptive failure rate for men with
sperm concentrations matching those in the efficacy phase of this
trial was 0.74/100 person-years of exposure (95% confidence interval
[CI], 0.09 - 2.7) and was based on a previous World Health Organization
study on male contraception.
Pregnancy was the primary efficacy end point, while secondary
end points were sperm output and gonadotropin and the maintenance
of eugonadal blood testosterone concentrations. The safety end
points were unexpected adverse effects, clinical markers of androgen
effects (gynecomastia, weight, blood pressure, psychological reactions,
and changes in mood, behavior, or sexual function), and biochemical
markers of androgen effects.
Subjects entered the suppression phase with the first hormone
administration and were required to use or switch to barrier contraception.
They entered the efficacy phase when they had two consecutive monthly
semen samples with sperm density less than 1 million/mg and when
the women had negative pregnancy tests.
During the efficacy phase, couples discontinued barrier contraception
after 12 months. The recovery phase then began after the last administered
hormone cycle.
Investigators conducted physical examinations every six months
and routine clinical chemistry every three months. Subjects also
provided monthly semen samples and were evaluated for changes in
well-being and sexual function.
Several men had escape from spermatogenic suppression (semen sample
with more than 1.0 mL and sperm concentration more than 1 million
sperm/mL) and/or symptomatic androgen deficiency between five and
six months after start of the study (29%; CI, 0% - 7.6%). This
prompted a repeat semen analysis after one week. If repeat analysis
confirmed escape, investigators discontinued the couple from the
study.
Interim review found that the six-month interval between testosterone
doses failed to maintain eugonadal testosterone concentrations.
A protocol amendment changed testosterone implantations from every
six to every four months. A second amendment deleted the last medroxyprogesterone
acetate dosage due to the slower than expected rate of recovery
of spermatogenesis.
Of 55 men who entered the study, 14 received treatment in six-month
intervals between testosterone implants, while the remaining 41
received treatment at four-month intervals after the protocol amendment.
No pregnancies occurred in 426 person-months (35.5 person-years;
95% confidence limits for contraceptive failure rate, 0% - 8%/year)
of efficacy exposure among 51 men. Sperm density fell rapidly among
the majority of subjects: 94% of men entered the efficacy phase by
three months; 2 (3.6%) of 55 men were not sufficiently suppressed
to enter the efficacy phase.
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