4119 replies to this topic

[Plain Jane]

Mene vse kar je treba vstavljat v bistvu odbija.

Ja, enako. Sem razmišljala o Nuva ringu, samo je pri tem tudi ostalo.

[tasika]

Več kot prebiram o tabletkah bolj sem odločena, da jih ne bom jemala. Sem se čisto lepo navadila na kondome, tako, da mi ni problema.
Sem pa ravno zadnič z najboljšo kolegico malo debatirala o tem, in ona je kt že od 15. leta, in jih je začela jest tak zgodaj zaradi kože, potem pa fant, ... Letos poleti je za ena dva meseca nehala, in seveda ji je koža malo ponorela, in ji nikakor nisem mogla dopovedat, da je to zelo vrjetni učinek, ker je nehala jest tablete, in še vsaj pol leta nebo vedla ali je njena koža še zdaj tako problematična, ali pa gre za to, ker je nehala jest tabletke. Zdaj je spet nazaj na kt, zaradi kože. Sej jo razumem, ker je imela res probleme takrat, ampak se mi zdi da je zdaj preveliko paniko prehitro zagnala. Konec koncev je njeno telo, jaz sem ji marsikaj povedla, povedla, tudi kje lahko prebere več, končna odločitev je pa njena.

[Princeska]

Jaz sem se pa odločila, da jih letos še ne neham, ker bi preveč tvegala, drugo leto pa načeloma skenslam, ker potem se bom itak še kako leto, dve spucala, predno bom želela zanosit. Kakršne zgodbe slišim zadnje čase... ma dej. KT so en shit.

[Fluffy The Stud Eater]

Jaz vseeno mislim, da treba vse to jemati z določeno mero rezerve, čeprav tudi v tem primeru stvar ni nedolžna.
Psiha ima neverjetno moč.

[Plain Jane]

Jaz sem se pa odločila, da jih letos še ne neham, ker bi preveč tvegala, drugo leto pa načeloma skenslam, ker potem se bom itak še kako leto, dve spucala, predno bom želela zanosit. Kakršne zgodbe slišim zadnje čase... ma dej. KT so en shit.

Jaz sem zadnjič na RR brala, da se sploh ne rabiš čistit, da je par dni dovolj, pa si očiščena.

[Ana]

Jaz jih bom pomojem jemala dokler ne bom v letih in stanju v katerem ne bi bila kriza če bi zanosila. Če se malo prenaglim in kr napovem, bo to okoli 26 ali 27 leta. Mene je nosečnosti strah kot hudiča križa in najbrž bi se vsak mesec psihirala in imela vse znake nosečnosti, če ne bi bila na kt.

[Princeska]

Jaz sem zadnjič na RR brala, da se sploh ne rabiš čistit, da je par dni dovolj, pa si očiščena.

Kva

Jaz jih bom pomojem jemala dokler ne bom v letih in stanju v katerem ne bi bila kriza če bi zanosila.

Se strinjam

[Plain Jane]

Ja, res, da dolgoletno jemanje tabletk sploh nima nobenih posledic za morebitnega otroka.

[Fluffy The Stud Eater]

Na to temo pa me bi zanimale kakšne strokovne študije, raziskave. Kot zanimivost.
Bom ob priliki malo raziskala.

[Ana]

Jaz pa po neki logiki mislim da par dni itak ni dovolj da se telo sčisti. Če bi naprimer pozabila vzet tabletko se na ta račun ne bi sekirala, ker sem itak "zafilana" s hormoni in se nič ne mora zgodit.

[Fluffy The Stud Eater]

Par dni sigurno ni dovolj. Morda kakšno leto, če ne več, menda ti še za dlje to ostane kje naloženo v telesu.

[ora]

What are the top myths about pills?
Your next patient tells you she would like to useoral contraceptives (OCs) for birth control,
but she says a family member told her using pills would affect her long-term fertility. What information do you provide her regarding OCs? Patients aren’t the only ones with misperceptions about pills. Clinicians have them as well,
says Deborah Kowal, MA, PA, adjunct assistant professor in the Department of Global Health in the Rollins School of Public Health at Emory University in Atlanta. Kowal presented information on the leading myths surrounding oral
The gap between correct and real use of pills remains vast. A 2009 review lists cognitive factors, such as false information, misconceptions, and irrational fears, as one of the leading reasons for Pill noncompliance.

2 What are the chief misperceptionsregarding birth control pills?
Check the following list, and add the evidence to your counseling knowledge base. How about breast cancer?
After more than 50 studies and 50 years, most experts believe that the Pill has little, if any, effect on the risk of developing breast cancer.3 While older studies of early high-dose pills found a slight increase in the risk of breast cancer,4 in a study that separated women who used pills before 1975 from those who used pills after 1975, earlier users had an increased risk of subsequent breast cancer, while those using the post-1975 low-dose formulations did not.5 Women wishing to use combined OCs can be reassured that their decision is unlikely to place them at higher risk of developing cancer.6 According to Managing Contraception for your Pocket, while there are still unanswered questions about pills and breast cancer, the overall conclusion is that pills do not cause breast cancer.3 “Many years after stopping oral contraceptives use, the main effect may be protection against metastatic disease,”4 it states.

What about fertility?

Ever since OCs have been available in the United States, it has been believed that pills will make it difficult for women to become pregnant when pill taking is ended. Women may believe that use of pills will negatively impact their future fertility, says Kowal. However, this is not the case; return to fertility is rapid following pill discontinuation. A 2009 review looked at studies that have evaluated the return to fertility following cessation of oral contraceptives, including recent evidence in women discontinuing extended-cycle and continuous-
use regimens. It concluded that return of fertility in former OC users (cyclic and extended/ continuous regimens) who stop use in order to conceive is comparable to that observed with other contraceptive methods.7 Reported 12-month conception rates in former cyclic pill users range from 72%-94%, in comparison to those discontinuing intrauterine devices (71%-92%), progestin-only contraceptives (70%-95%), condoms (91%), and natural family planning (92%). While there is a limited amount of data on the time to conception in women stopping extended cycle and continuous- use OCs, data suggest that subsequent return to fertility is generally comparable to that of cyclic pill users.7 Counsel women that the return to fertility following pill use is so rapid and consistent that they
should expect no more than a two-week delay in menses once pill usage is discontinued.

What about pregnancy?

Ever since pills arrived in 1960, women have been asking this question: “What if I get pregnant while I’m on the Pill?” While the Pill is highly effective when used correctly and consistently, 8% of women become pregnant in the first year of typical use of oral contraceptives because of inconsistent use.8 Advise women that Pill users have no higher rates of spontaneous abortion, preterm deliveries, birth defects, or complications in the health of their offspring than do non-users, says Kowal.9-13 No additional testing is required during the prenatal period for women who continue to use pills in the early months of pregnancy. If a woman experiences a spontaneous loss following Pill use, she should be counseled that the Pill was not a factor in the loss.

Can OCs impact libido?

Can OCs impact libido? Yes, pills definitely can impact libido. What is a myth is the generalization that pills adversely affect most women’s libido. The opposite might be true, because pills diminish women’s fear of pregnancy and lead to less days of vaginal bleeding. Another myth would be that pills have no effect on women’s sexual functioning.
While oral contraceptives provide safe, effective, and reversible contraception, a review of recent literature indicates women experience positive effects, negative effects, as well as no effect on libido during OC use.14 A recent study looked at the impact of two contraceptive pills with different doses of the same components (ethinyl estradiol [EE] 30 mcg and levonorgestrel (LNG) 150 mcg, or EE 20 mcg and LNG 100 mcg) on plasma androgen levels and January 2011 / Contraceptive technology update ® 5 female sexual function among women without previous sexual dysfunction. Both groups showed improvements according to the Female Sexual Function Index, a standardized questionnaire.15
REFERENCES
1. Kowal D. Contraceptive Technology: Highlights of the
soon-to-be-released 20th edition. Presented at the 2010
Contraceptive Technology Quest for Excellence conference.
Atlanta; October 2010.
2. Bitzer J. Contraceptive compliance — why is contraceptive
failure still so frequent? Ther Umsch 2009;66:137-143.
3. Zieman M, Hatcher RA, Cwiak C, et al. 2010-2012
Managing Contraception for Your Pocket. Tiger, GA:
Bridging the Gap Foundation; 2010.
4. Collaborative Group on Hormonal Factors in Breast
Cancer. Breast cancer and hormonal contraceptives: collaborative
reanalysis of individual data on 53,297 women with
breast cancer and 100,239 women without breast cancer from
54 epidemiological studies. Lancet 1996;347:1713-1727.
5. Grabrick DM, Hartmann LC, Cerhan JR, et al. Risk of
breast cancer with oral contraceptive use in women with a
family history of breast cancer. JAMA 2000;284:1791-1798.
6. Cibula D, Gompel A, Mueck AO, et al. Hormonal contraception
and risk of cancer. Hum Reprod Update 2010;
16:631-650.
7. Barnhart KT, Schreiber CA. Return to fertility following
discontinuation of oral contraceptives. Fertil Steril 2009;
91:659-663.
8. Trussell J. Contraceptive efficacy. In: Hatcher RA, Trussell
J, Nelson AL, et al. Contraceptive Technology: 19th revised
edition. New York: Ardent Media; 2007.
9. Raman-Wilms L, Tseng AL, Wighardt S, et al. Fetal genital
effects of first-trimester sex hormone exposure: a meta-analysis.
Obstet Gynecol 1995;85:141-149.
10. Lammer EJ, Cordero JF. Exogenous sex hormone exposure
and the risk for major malformations. JAMA 1986;
255:3128–3132.
11. Bracken MB. Oral contraception and congenital malformations
in offspring: a review and meta-analysis of the prospective
studies. Obstet Gynecol 1990;76(3 Pt 2):552-557.
12. Cardy GC. Outcome of pregnancies after failed hormonal
postcoital contraception an interim report. Br J Fam Plann
1995;21:112-115.
13. Hemminki E, Gissler M, Merilainen J. Reproductive
effects of in utero exposure to estrogen and progestin drugs.
Fertil Steril 1999;71:1092–1098.
14. Davis AR, Castaño PM. Oral contraceptives and libido in
women. Annu Rev Sex Res 2004;15:297-320.
15. Strufaldi R, Pompei LM, Steiner ML, et al. Effects of two
combined hormonal contraceptives with the same composition
and different doses on female sexual function and plasma
androgen levels. Contraception 2010;82:147-154. n

[ora]

To ni moj vidik, je pa iz strokovne revije, ki je spet... Ameriška. Delam na tem...

Samo en del članka, ker je celoten predolg in govori v glavnem o preprečevanju menstrualnih bolečin.

Safety of Extended Dose Regimens

The long-term health effects of extended/continuous COC administration have not been documented; however, a Cochrane review (Edelman et al., 2006) of six randomized controlled trials concluded that the available evidence suggests extended/continuous COC regimens are as safe as conventional administration. Contraceptive effi cacy and compliance were similar between groups, as was the discontinuation rate. Most of the trials revealed no difference or less bleeding/ spotting with continuous dosing than with 21/7 regimens, although it frequently occurred on an irregular, unpredictable schedule. The bleeding/ spotting eventually resolved in most of the women, although it often took many months. Five of the six trials did not fi nd any serious adverse events related to the study medication or regimen; one study reported a pulmonary embolism (extended cycle), cholelithiasis (21/7 cycle) and exacerbation of preexisting depression (21/7 cycle). The long-term effect of continuous/extended COC regimens on fertility is not known, although the available evidence is reassuring. Davis et al. (2006) found that among women
who stopped taking continuous COCs after one year, resumption of menses or pregnancy occurred in 38.5 percent within 30 days, 92.5 percent within 60 days and 99 percent within 90 days. In another study, Davis et al. (2007) found that the median time to return of menses was 32 days after a year of continuous COCs, and the incidence of spontaneous menses or pregnancy at Day ≤90 was 98.9 percent. Birtch et al. (2006) found that following discontinuation of continuous COCs, ovulation took approximately fi ve days longer when compared with natural cycles. Johnson, Grubb, and Constantine (2007) and Miller and Hughes (2003) both documented the endometrial safety of continuous COC use, fi nding neither hyperplasia nor malignancy in their trials. Anderson, Gibbons, and Portman (2006) studied 708 women over one year taking an extended COC regimen consisting of 150 mg levonorgestrel (LNG)/30 mg ethinyl estradiol (EE) for 84 days followed by 7 days of 10 mg EE in place of an HFI. Adverse events were similar to those seen with traditional COC administration, the most frequent being intermenstrual bleeding (11.5 percent), nasopharyngitis (7.2 percent), sinusitis (6.5 percent) and menorrhagia (5.8 percent). Unscheduled bleeding and spotting decreased steadily from an average of 11 to 4 days per three-month cycle. The study also found that changes in laboratory values and vital signs were essentially nonmeaningful and
comparable to those seen with traditional COC administration. The only exception was an increase in platelets, although no thromboembolic events were reported. Serious adverse events judged to be possibly related to the study drug were reported in four patients, consisting of migraine, cholecystitis, cholelithiasis alone and cholelithiasis with pancreatitis. In another study of 2,134 women, Archer et al. (2006) found that the safety profi le of a continuous regimen of LNG 90 mg/EE 20 mg without an HFI was similar to standard COC administration. The incidence of bleeding decreased from 93.9 percent at month 1 to 21 percent at 12 months, at which time 58.7 percent of women reported amenorrhea (complete absence of spotting or bleeding), while an additional 20.3 percent—a total of 79 percent of study participants—had no bleeding but continued to have some spotting that did not require sanitary protection. Both spotting and bleeding decreased steadily throughout the study, with women who were still bleeding at 12 months averaging four days of bleeding and three days of spotting per month. Headaches and dysmenorrhea were the most frequent adverse events. Nausea was experienced by 11.5 percent of study participants in months1 through 6 but decreased to 4.3 percent inmonths 7 through 12. Six serious adverse events deemed possibly related to the study drug included: cholelithiasis, deep vein thrombosis/pulmonary embolism, ectopic pregnancy, prolonged uterine bleeding and enlarged uterine fi broid.

Veliko je člankov na temo bolezni žolčnika in žolčnih vodov zaradi kontacepcije, pa zelo veliko o zdravljenju endometrioze s oralnimi kontraceptivi itd. Vsi članki so večinoma s +, razen kar se tiče pojavov bolezni kot so globoka venska tromboza itd.

[Fluffy The Stud Eater]

ora, hvala!

[Plain Jane]

Hvala Ora! Vpliv AB na zaščito.

ANTHONY SUMMERS reviews evidence of interaction between antibiotics and oral contraceptives

It is common in emergency departments (EDs) for emergency nurse practitioners (ENPs) or doctors to prescribe antibiotics for, and dispense antibiotics to, women who are also taking the oral contraceptive pill (OCP), and for more junior staff to dispense the prescriptions.

Women who take OCPs are advised to take extra contraceptive precautions while taking, and for seven days after finishing, their antibiotics. Those who finish their current packs of OCPs before the end of this seven-day period are advised to start their next packet of OCPs without a break (Gibbons et al 2003).

Women are given this advice because of the potential interaction of the two types of drug, which can lead to OCP failure and therefore unplanned pregnancy.

This article reviews the literature that describes these interactions and examines the basis of this advice.
EFFECTIVENESS OF ORAL CONTRACEPTIVES

Oral contraceptives were introduced in 1961 and are now used by up to 100 million women worldwide Erkkok 2007). They are one of the most popular forms of contraception because they are easy to use, are effective and have a well documented safety record (Cerel-Suhl and Yeager 1999, Weaver and Glasier 1999).

Hatcher et al (1998) divide women who use oral contraception into two categories: 'perfect users' and 'typical users'. Perfect users are women who take the pill at the same time each day and never vomit or have diarrhoea. The failure rate for this category is 0.1 per cent per year. Typical users forget to take the pill occasionally, sometimes at different times of day, and occasionally vomit or have diarrhoea. The failure rate for this category is 5.0 per cent per year.

Calculations of OCP failure rate for the general population are usually based on the figure for typical users.

The first details of possible interactions of oral contraceptives and antibiotics emerged in 1971 when breakthrough menstrual bleeding was reported in patients taking oral contraception and the antibiotic, rifampicin, which is commonly used for the treatment of tuberculosis and inactive meningitis. Further reports linked this combination of drugs with some unplanned pregnancies (Dickinson et al 2001).

There is also evidence that OCPs interact with the antibiotic, griseofulvin, which is commonly used for the treatment of fungal infections, leading to OCP failure and unplanned pregnancy.

Much of the literature on the interaction of OCPs and other antibiotics, however, is anecdotal or descriptive, involves no controls, or has questionable historical control rates (Helms et al 1997), and has led many authors to assert that there is no evidence for the interaction of OCPs and antibiotics other than rifampicin and griseofulvin (Dickinson et al 2001, Helms et al 1997, Weaver and Glasier 1999).

Furthermore, there is no evidence in the literature reviewed by the author that the actions of OCPs on the drug on living cells, or their pharmacodynamics, are affected by antibiotics. This suggests that interaction of the two types of drug is related to how OCPs are absorbed, metabolised, distributed and excreted, or the pharmacokinetics of OCPs (Dickinson et al 2001).
PHARMACOKINETIC INTERACTION

The main hypotheses about how pharmacokinetic interactions of OCPs and antibiotics can result in unplanned pregnancies concern:

* Decreased enterohepatic circulation.

* Increased liver degradation.

* Antibiotic-induced diarrhoea or vomiting.

* Failure to take OCPs in women who experience adverse effects such as vomiting or diarrhoea (Archer and Archer 2002).
Decreased enterohepatic circulation

Oral contraceptives are well absorbed after administration and are subject to first-pass effect, in which the concentrations of drugs are greatly reduced in the gut mucosa and liver.

After absorption, OCPs are hydroxylated into inactive metabolites by the hepatic cytochrome P450, before being excreted in the bile, and then the faeces, and the urine.

The hydroxylation process can be accelerated by rifampicin and griseofulvin (Barditch-Crovo et al 1999), as well as by antiepileptic drugs such as carbamazepine or phenytoin (Sabers 2008). This may be the mechanism by which OCPs fail to work and therefore cause either breakthrough bleeding or unplanned pregnancy.

The hydroxylation process can be reversed if certain bacteria are present in the gut, causing OCP compounds in the bile to be reabsorbed in the small intestine and reused by the body via the enterohepatic circulation process.
Illness

According to Weaver and Glasier (1999), illnesses such as vomiting and diarrhoea, including antibiotic-induced vomiting and diarrhoea, are more likely causes of OCP failure than decreased enterohepatic circulation or increased liver degradation because these symptoms lead to reduced OCP absorption.

However, there is no literature to support the suggestion by Archer and Archer (2002) and Weaver and Glasier (1999) that women are less likely to take OCPs simply because they are ill.
IDENTIFYING THOSE AT RISK

Because there is a lack of evidence about the mechanism of interaction of OCPs and antibiotics (DeRossi and Hersh 2002, Shenfield 1993), women who are at risk of OCP failure through this interaction cannot be identified in routine diagnostic tests.

However, women who take OCPs and antibiotics are at a high risk of failure if they experience breakthrough bleeding, cramp, nausea, vomiting or diarrhoea (Bauer and Wolf 2005, DeRossi and Hersh 2002).

As previously discussed, the OCP failure rate is estimated to be between 0.1 and 5.0 per cent (Dickinson et al 2001, Hatcher et al 1998).

Retrospective surveys of patients taking OCPs and antibiotics report failure rates of between 1.2 and 1.6 per cent (DeSano and Hurley 1982, Hughes and Cunliffe 1990, London and Lookingbill 1994), which fall well within the limits of typical users. These figures suggest that taking OCPs with antibiotics is no more dangerous than taking OCPs on their own for typical users.

There is no evidence in the literature of any interaction of OCPs and antibiotics other than rifampicin and griseofulvin, and studies of such interactions show only that the failure rate is equivalent to that found in typical OCP users.

The literature suggests that some women are at high risk of the consequences of interaction but, although there are some clinical indicators of these consequences, there is no predictive test. However, the interaction of OCPs and antibiotics can cause unplanned pregnancy (Weaver and Glasier 1999).

The ramifications of this cannot be predicted, and none of the studies reviewed consider the effect of unplanned pregnancy on the women involved. For this reason, ED nurses should continue to advise women who take OCPs to take extra contraceptive precautions while taking, and for seven days after finishing, their antibiotics, until more reliable evidence about the interaction of OCPs and antibiotics is available.

[Immortelle]

Mene pa zanima, če prodajajo kje v kakšnih drogerijah pri nas spermicidna sredstva?
Ali je treba prav v lekarno?

Sicer uporabljava kondom, ampak ne jemljem KT in me velikokrat obhajajo strahovi, pa čeprav se na koncu prepričam, da je kondom cel...
Če bi imela kak spermicidni gel, bi bila bolj pomirjena...

[Sarah]

Sicer ne vem če to kje prodajajo, vem pa da obstajajo kondomi že s tem.

[Immortelle]

Ja, vem. Sem malo brskala po netu, pa izgleda, da se niti v lekarnah to ne dobi.
Samo online. Npr:
http://naravno-intim...-60ml-tuba.html

[Adriane]

V lekarnah je na voljo Contragel. http://www.lekarnar....spermicidni-gel

[Immortelle]

Super! Hvala!