A. The Pill
I. Definition
The Pill normally is prescribed by your doctor to reduce the heavy period blood for woman with or with out endometriosis as well as in treating of period pain, or contraceptive purpose ( 21 days on and 7 days off).
II. How it works
In endometriosis, the pill helps to
a) Reduce the period blood flow as resulting in lowering the risk of more developing of endometriosis.
b) Reduce the bleeding by thinning the endometrial lining.
c) Reduce the period pain by inhibiting the hormone prostaglandins hormones that cause the uterine muscles spasm.
d) Shrink the endometriosis and reduce the bleeding of into cysts and pelvic cavity because the Pill creates the pregnant-like state.
e) Suppress the estrogen that is needed to start a menstrual cycle.
III. Symptoms and Risks
1. Blood clots
All hormonal methods of birth control pose a threat to normal blood flow.The oral contraceptive combination pill is no exception, it increases the risk of of blood clots in your legs or on the lung caused by estrogen in the pill that makes your blood thicker in the veins.
2. Stroke
Woman who takes the oral contraceptive combination pill increases the risk of stroke caused by blockage of blood flow to the brain as resulting of high level of estrogen in the pill that reduces the oxygen transportation as the blood getting thicker.
3. Heart disease
Similar to the stroke, as our blood get thicker, our heart has to pump harder to provide oxygen for our body cells need causing hypertension. If our heart has to work that hard for a prolong period of time because of long term use of birth control pill, it will be damaged causing heart disease.
4. Skin pigment
Some woman may experience increasing of pigmentation of skin that shows up in patchy and light brown area caused by estrogen in the pill.
5. Mood swing
Some women may experience mood swing while taking the pill, it is caused by significant changes in your hormone levels affecting the chemicals that regulate mood such as level of estrogen and progesterone in the pill.
6. Infertility
Some women after coming off the birth control pill and hope to get pregnant, they may be disappointed. Not only the effects of birth control pill maybe needed sometime to wire off, our body may never be able to adjust causing lost of period permanently.
8. Increase the size of fibroids
Oral contraceptive combination pill contains estrogen that promote the growth of fibroids. If you have fibroids and you want take the oral contraceptive pill, you should talk to your doctor first.
VI. Side effects
a) Bleeding and spotting
Bleeding and spotting is normal for the first six months for women starting any oral contraceptive combination pill because our body needs time to adjust to the new medication.
b) Lost interest in sex
Women who take the contraceptive pill are in danger of permanently lost their interest in sex because the oral contraceptive pill inhibits testosterone, the hormone that drives sexual desire even aftyer if they stop the pill.
c) Chloasma or melasma
It caused by hormonal changes, as in pregnancy and intake of estrogen in the oral contraceptive pill.
d) Nutritional deficiency
Oral contraceptive pill causes vitamin and mineral imbalances or deficiencies. It depletes magnesium for healthy heart, coenzyme Q10 for healthy heart muscles, folic acid for preventing cervical abnormalities, vitamin B6, B2, B3, zinc, etc.
B. Progesterone agonist
I. Definition
This type of pill contains no estrogen also known as the progesterone-like pill or progestins, it helps to maintain milk production for breastfeeding mother and to thicken the cervical mucus, thereby preventing sperm from entering the uterus. This type of pill must be taken at a certain time every 24 hours for effectively.
II. Types of Progesterone medicines
a) Injecting medicine
Type of progesterone medication injected in the women body every three months, such as Depo Provera. It is good for women who want to have long term contraception, it may work well for some women but study shows that it causes bone loss and sometimes osteoporosis.
b) Implant medicine
The other type of progesterone like medicine such as Implanon is implanted into the fat of a non dominant arm and last about 3 years. It may not cause bone loss as Depo Provera, but it causes male like pattern such as excessive hair growth and deepening the voice.
c) Progesterone-like pills
i) Progesterone like pill in treating excessive menstruation
If a woman does not have progesterone irregularity, her doctor may prescribe this type of medicine for her. It helps to complete shredding of the endometrium and stops the abnormal bleeding. Besides all the good thing of this type of progesterone like pill, it also has it side effects, such as elevating level of cholesterol.
ii) Other types
Other types of progesterone like medicines, such as Provera, Duphaston, they helps to relieve of menstrual cramp with no long term serious side effects by creating the pregnancy-like state but their short term side effects including spotting and bleeding.
IV. Side effects
Most side effects are caused by high levels of progesterone for women taking the progesterone only pill, such as
1) Mood swings
2) Weight gain
3) Reduced libido
4) Fluid retention
5) Acne
6) Breast tenderness
V. Risks
1) Ectopic pregnancy
Women taking the progesterone only pill may increase the risk of pregnancy inside the fallopian tube and not in the uterus.
2) Progesterone only pill may increase the risk of pain in the lower abdomen, shortly after a missed or light period.
3) It also increases the risk of developing small, benign cysts in the ovary.
C. Oral contraceptive pills
I. Definition
The oral contraceptive combination pill is defined as one type of birth control pill containing both estrogen and progesterone that helps to control unwanted pregnancy and reducing symptoms of abdominal pain before, during or after menstrual cycle such as endometriosis, premenstrual symptoms etc.
II. How the pill works
The pill is taken 21 days on, 7 day off. In endometriosis
a) It will help to reduce the bleeding by thinning the endometrial lining and reducing the flow of the period blood that help to decreases the risk of retrograde menstruation in endometriosis.
b) It also helps to inhibit hormone prostaglandins that causes muscle spasm in the ovary reducing the menstrual cramps.
c) Since the pill reduces the bleeding of endometriosis, it lesson the risk of bleeding into cysts and pelvic cavity.
d) Shrinking the endometriosis by creating a continual pregnant-like state.
III. Symptoms and risks
a) Symptoms
i) Bleeding and spotting as our body needs time to adjust to the substance in the pill, Normally, the bleeding and spotting will end in six months.
ii) Acne and weigh gain caused by synthetic progesterone in the pill in some women.
b) Risks
i) Since the oral contraceptive combination pill contains estrogen, it may cause blood clots, stroke and heart disease
ii) Hypertension caused by thickening of blood in arteries.
D. GnRH agonists
I. Definition
GnRH is a hormone released by the hypothalamus which stimulates the pituitary to produce luteinising hormones (LH) and follicle that stimulate hormone (FSH) to drive a menstrual cycle.
II. Effectiveness of GnRH
Just likes progesterone-like agonists, GnRH ( gonadotrophin-releasing hormone) have been used in treating endometriosis for more than 20 years. They come in different forms: three-monthly injection, monthly injection, daily injection and nasal spray because of their chemical make up. GnRH are natural hormone blocking medicines, they help to stop the ovulation and create a temporary menopause state.
Study shows that GnRH are effective in reducing the symptoms and the size of endometrial implants but unfortunately, symptoms tend to return after stopping treatment in 4 months.
III. Side effects
a) Hot flush, dry vagina caused by temporary of menopause state.
b) Loss of libido caused by low level of estrogen and vagina dryness.
c) Loss of bone density caused by low level of estrogen and progesterone.
d) Nutritional deficiency caused by symptoms of menopause state as our body is no longer absorb magnesium and calcium effectively.
IV. Risks
1. Loss of bone density
Loss of bone density is normal for women taking the GnRH drug. Since it causes menopause state, it deplete the calcium in the body that is essential for building a healthy bone. It also distorts the ratio of magnesium and calcium.
2) Reducing sexual desire
Sexual libido may be caused by dry vagina, one of many symptoms of GnRH. It may also be caused by low level of estrogen that is essential for driving sexual desire.
3) Increase the risk of developing of ovarian cysts.
E. Prostaglandins Inhibitors
I. Definition
prostaglandins inhibitors are men made prostaglandins hormones that help to block the production of prostaglandins from our body during menstrual cycle. Since over production of certain types of prostaglandins hormones cause over contraction of uterine muscles resulting in menstrual cramps and blocking them are benefits for women with severe period pain.
II. How Prostaglandins Inhibitors work
a) Inhibiting the natural prostaglandins in the women menstrual cycle will reduce the over active uterine and ovarian muscles that cause the abdominal pain, if endometrial implants and adhesion in the wall of the ovary.
b) The medication can be brought without prescription, such as Aspirin, Ponstan, Nurofen, etc.
c) They also help to reduce the heavy period as uterine muscles now are being controlled by the effects of the medication.
d) They are more effective in treating symptoms of menstrual cycle if taking together with other oral contraceptive pills.
e) They sometime may also correct the prostaglandins imbalance for some women.
III. Risks
a) Most prostaglandins inhibitors only correct the symptoms while they are around. Symptoms of menstrual cycle will re appear when the medication is wire off.
b) Over taking porstaglandins inhibitor will severely damage the liver, causing variety of diseases.
c) The medication may cause gastro-intestine system problem, such as stomach pain, vomiting, nausea, constipation. Taking them with foods can reduce the above side effects.
d) Increase the risk of asthma, lupus and clotting disorders.
e) They may cause pelvic inflammatory diseases.
IV. Side effects
It is advised that prostaglandins inhibitors drugs should be taken with food to prevent any problem with the gastro-intestine system. Since prostaglandins inhibitors are nonsteroidal anti-inflammatory drug, they have below side effects if overdose.
1) Nausea
2) Vomiting
3) Stomach pain
4) Micro-bleeding and ulcers
5) Abdominal cramps
Since endometriosis is treatable and manageable by natural remedies and self help, if you have endometroisis, please look at the bright side.
I hope this information will help. If you need more information or insurance advice, please follow my article series of the above subject at my home page at: http://medicaladvisorjournals.blogspot.com
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