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North Carolina GYN Care & Treatment

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Progestin-Only Pills: Breaking Down the Myths and Misconceptions

Conditions and Management

Raleigh Gynecology June 19, 2023

woman head text form by word progesteroneA physician-prescribed oral contraceptive, the “minipill,” is a birth control tablet medication composed of a single hormone (progestogen) pharmaceutical compound for suppressing ovulation in women.

Excepting compound differentiation and a few discretionary details for use, progestin pills offer the same pregnancy prevention benefits as combined pill (progestogen and estrogen) prescriptions.

The following is a breakdown of contraceptive care facts dispelling the misconceptions and myths about prescription progestin pill use.

Misconception: Oral contraceptive treatment is a hassle

Instructions for using progestin pills are daily oral ingestion at the same time for 28 days before initiating a new cycle. For maximum effectiveness, birth control tablets should be taken at the same time each day.

The pill can be used safely continuously, without a periodic break in treatment. Taking a break from oral contraceptive prescription use has the potential to lead to pregnancy.

Misconception: The pill is an ineffective form of birth control

Birth control contraceptives are 92% to 99% effective and function by inhibiting ovulation and causing a thickening of the cervix’s mucus, blocking sperm penetration during sexual intercourse. A common effect of oral contraceptive use is menstrual regulation, usually accompanied by reduced episodic cramping.

Misconception: Birth control pill contraception causes cancer

Birth control pills are proven protection from endometrial and ovarian cancer, ectopic pregnancy, and fallopian tube infections. The clinical record shows the incidence of cervical cancer associated with oral birth control use to be low.

Untreated human papillomavirus is a commonly diagnosed sexually transmitted infection (STI) connected to cervical cancer in women. Oral birth control pill use does not protect against the transmission of viral STIs.

Misconception: Taking the pill has no secondary health benefits

Raleigh, NC woman looking at birth control pillsThe health benefits of oral birth control contraception use for long-term duration are reduced incidence of anemia, cancer, ovarian cysts, and pelvic inflammatory disease.

Birth control pills are also thought to reduce menstrual bleeding, cramps, ovulatory pain, and the symptoms and onset of endometriosis and polycystic ovarian syndrome.

Myth: Birth control pill ingestion leads to short-term health problems

Some patients taking the pill may experience short-term health problems from oral contraceptive prescription drug use. Breast tenderness, headaches, and nausea are commonly cited symptoms of oral contraceptive treatment. Short-term side effects are not generally signs of severe illness and usually cease within the first two to three months of progestin pill treatment.

Myth: Oral contraception causes infertility in women

The notion that oral contraceptive care causes infertility is a myth. Depending on the patient’s age, the number of pregnancies, and the length of time taking oral contraceptive care, there may be variations in a patient’s ability to get pregnant after pill use has ceased.

Myth: The pill induces sexual promiscuity

Contraceptive care physicians reject the fallacy that oral birth control contraceptives are medically linked to increased libido, or the induction of sentience leading to sexual promiscuity. There is no evidence that oral contraceptive care is directly connected to sexual behavior, including any increase or decrease in sexual activity or performance.

Myth: Contraceptive birth control pills absorb unevenly

Concern that oral birth control pill ingestion leads to excess accumulation or uneven distribution in the body thus increasing the potential for disease and tumor growth, is false.

There is no evidence that oral contraceptives accumulate in the stomach, ovaries, and uterus. Instead, once ingested, the pill dissolves in the digestive system, causing the hormones to be absorbed by the bloodstream and metabolized by the liver and gut before discharge.

Myth: There are zero negative side-effects

Packets of contraceptive pillsPotential side effects include breast tenderness, headaches, nausea, and weight fluctuation. Less common side effects are vascular-related conditions such as blood clots, heart attack, or stroke. There is a higher risk of cancer and vascular disorders for women over the age of 35 years who smoke.

Myth: The pill is protection from STI risk

Birth control pills are not adequate protection against STIs (i.e., HIV/Aids). Condoms are the only proven effective birth control method for protection from STIs.

Myth: The pill leads to birth defects

There is no clinical evidence linking birth control pill use with birth defects or in vitro fetal immortality. In the rare circumstance that a pregnancy occurs during birth control pill contraceptive use should be ceased immediately with physician notice to determine the next steps for family planning and future contraceptive care.

Prescription Contraceptive Care

Raleigh Gynecology and Wellness is a licensed medical provider of gynecology and wellness services in Raleigh, North Caroline. Our healthcare practice specializes in routine care and contraceptive care, including progestin-only birth control pill prescriptions.

Find out more about family planning and pregnancy prevention by scheduling an appointment to speak with a specialist about your contraceptive care options.

Raleigh Gynecology June 12, 2023

NC women putting contraceptive tablets in pursePregnancy prevention with a birth control patch can sometimes have side effects. Find out about patch placement, commonly addressed concerns related to this popular contraceptive method, and combined uses with other contraceptive care options like the vaginal ring in this article spotlighting common birth control patch reactions.

The Patch

A convenient birth control method, the transdermal contraceptive patch releases estrogen, and progestin hormones once applied to the skin, thus preventing pregnancy by ceasing the body’s ovulation process. The two main brands of birth control patches available in the healthcare marketplace today are the Twirla and Xulane patches.

Patch birth control contraception provides up to 99% pregnancy prevention effectiveness when used properly. Birth control patches used as prescribed are placed on the back, hips, or stomach. Patch birth control contraception does not protect against sexually transmitted infections (STIs) unless used in combination with a condom.

Pregnancy Prevention Effectiveness

The key to patch ineffectiveness is patch placement. Failure to apply a patch to a safe area of the body where it will not fall off is key for effective pregnancy prevention. Depending on which brand of patch is used, the highest risk of contraceptive failure occurs after 1 to 2 days of patch detachment.

There are also prescription medications and over-the-counter supplements known to reduce birth control patch contraceptive effectiveness. Excessive weight gain by a patch user also has the potential to alter the effectiveness of a birth control patch during use.

Birth Control Patch Side Effects

Raleigh, NC woman applying birth control patch on the waistBirth control patch use may involve negative side effects for some patients. Similar to other hormonal forms of birth control, patch users may experience temporary adverse hormonal reactions such as break through bleeding for the first 2 to 3 months.

Most physicians recommend continued use during the first few months of patch prescription when side effects are present to give the body time to adjust.

Negative Side Effects

Patch use can have more persistent negative side effects for some patients. The most common side effects of the patch are menstrual cycle reactions, such as light bleeding between periods, discharge, headaches, nausea, or sore breasts.

Reactions considered to be more serious, like blood clotting or other vascular problems connected to patch use, are much less common. These should be responded to with immediate medical consultation and discontinuation of use.There is also potential for skin-related reactions such as dryness, itching, pain, rash, or swelling.

Most side effects are not dangerous but can be uncomfortable. If minor side effects continue after the first few months, consult with a contraceptive care physician about alternate birth control contraceptive options, such as the vaginal ring insertion method that may be more suitable for you.

Positive Side Effects

Some users experience positive side effects from patch contraceptive use, such as menstrual regularity and the benefit of preventive care for certain conditions. The most common positive side effect is that the patch usually alleviates irregular, heavy, or painful menstrual period symptoms.

Birth control patch use may protect against acne, anemia, bone thinning, and cysts in the breasts and ovaries. Symptoms may recur after patch use is terminated. Commonly cited is the recurrence of acne after birth control patch contraception discontinuation. Medical studies also link the birth control patch to the preemptive prevention of ovarian cancer and other cancers.

Discontinuation Side Effects

vaginal careThere may be temporary side effects if discontinuing birth control patch contraceptive use. The most common side effects of going off patch use are hormonal fluctuation and a return to a normal menstrual cycle, increasing pregnancy risk. An alternative pregnancy prevention measure should accompany the discontinued use of the patch due to side effects.

For more information about the side effects and risks of birth control patch contraception use, speak with a physician specializing in family planning and contraceptive care services.

Contraceptive Care Specialists

When considering birth control options, a contraceptive care practitioner can provide information about pregnancy prevention services. Raleigh Gynecology & Wellness Is a licensed medical provider of women’s gynecology and wellness in Raleigh, North Carolina.

Our office offers clients routine and contraceptive care services, including procedural and birth control services. Please make an appointment with one of our contraceptive care specialists to discuss birth control options that may be right for you.

Raleigh Gynecology June 5, 2023

 Raliegh, NC woman applying birth control patch on stomachThe birth control patch is an effective method of pregnancy prevention. Patch treatment also regulates the menstrual cycle, thus reducing discomfort before and during a woman’s monthly period. A birth control patch is a plastic-coated square sticker designed for discreet body application.

Here is a contraceptive care guide for mastering the birth control patch application-to-removal process.

The Patch. Why Use It?

Each birth control patch contains the two same synthetic hormones found in birth control pills: estrogen and progesterone. Hormonal release from the patch within the body prevents ovulation. The patch also thickens the surrounding cervical mucus, blocking penetration by sperm during sexual intercourse.

For immediate effectiveness, initial patch application should be performed between the first and fifth days of a woman’s period. A secondary form of birth control contraception, such as a condom, should be used for a week or more if the patch is applied during an alternate time than the prescribed period.

The Patch. Where to Place It

Physician-recommended instructions for birth control patch treatment indicate application to an area of the body where the skin is clean and dry:

  • Buttocks
  • Hips
  • Shoulder
  • Stomach
  • Upper arm
  • Upper back

Avoid applying a birth control contraceptive patch in the following areas:

  • Head
  • Breasts
  • Chest
  • Neck
  • Irritated or sore skin
  • Areas rubbed by apparel
  • Areas where cosmetics are applied

The Patch. How to Use It

birth control patch in pink backgroundBirth control contraceptive patch application is performed manually and is relatively simple. It is recommended to wash and dry the hands and the skin area where the patch will be placed before birth control contraceptive patch application.

Open the foil pouch by holding it flat and partially peel the patch without touching the adhesive. Apply the patch to the skin and peel off the remainder of the plastic tab backing. Finally, press the applied patch against the skin for ten seconds.

The Patch. Length of Use

The birth control patch is intended for seven days of use. Therefore, each patch application should be removed and replaced weekly for three weeks, followed by a 1 week break the fourth week.

If a patch application has not been changed according to schedule, and the duration of use is less than ten days, its effectiveness is reliable. If applied for longer, it should be replaced on the next scheduled date.

Physicians recommend use of a secondary contraceptive method in the interim. The secondary form of contraception can be eliminated after the next patch is in place for seven days.
It is advisable to check an applied patch daily. Check patch application after exercise activities which tend to cause the skin to sweat. Patch adhesive lasts up to 30 minutes in water. After a half hour of bathing or swimming, a patch may dislodge and require replacement.

When using the patch during the final 7-day cycle period, there may be some withdrawal bleeding or similar menstrual period spotting. If such an occurrence is accompanied by excessive pain, contact your physician.

The Patch. How to Remove It

If a patch detaches within the first 24-hour period post-application and still exhibits adhesive stickiness, reapply. If the adhesive has disintegrated, the patch should be replaced. If a patch application detaches after more than 24 hours post application, replace it.

The scheduled removal day for standard patch replacement is within the first three days after the end of the 7th day. To remove a patch, peel it away from the skin, fold it in half so the adhesive is stuck to itself and dispose.

Failure to remove a patch at the scheduled time after the third week should be followed by replacement on the next scheduled start day. Therefore, the scheduled patchless week will be shorter. Physicians recommend using a secondary birth control method with the patch for seven days after a lapse, followed by replacement.

Pregnancy Prevention. You Have Options

Birth control pills and condomsThe birth control patch method is considered one of the safest pregnancy prevention treatments available from a medical doctor. Birth control patch pregnancy prevention treatment is also suitable for use with other contraceptive methods.

Find out if the birth control patch or other contraceptive care option is right for you. Pregnancy prevention is a choice. Explore your contraceptive care options. Consult with a licensed gynecologist healthcare practice.

Contraceptive Care Raleigh

Raleigh Gynecology & Wellness is a licensed medical physician practice providing routine care and procedural care services in Raleigh, North Carolina. Our practice specializes in gynecological and pregnancy prevention services, including birth control patch prescriptions.

Discuss your healthcare options with a physician by scheduling an appointment with Raleigh Gynecology & Wellness.

Raleigh Gynecology May 22, 2023

person during heart hand gestureNexplanon is a form of contraception, or birth control. It is a small, plastic rod about the size of a matchstick that is inserted under the skin of your upper arm. Nexplanon is a contraceptive that protects against pregnancy for up to 3 years.

If you have decided to elect Nexplanon insertion, for post-procedure, physicians recommend to follow the “7-day Rule” for combined use with another form of birth control contraceptive to avoid pregnancy.

How does Nexplanon work?

After insertion of a Nexplanon implant, progestin is released. This is a hormone that stops the release of an egg from the ovaries during the ovulation phase of the menstrual cycle. Nexplanon works by thickening the mucus within the vaginal canal and cervix, thus preventing sperm from entry to the uterus.

Procedurally performed by a doctor, a Nexplanon implant can be replaced immediately once an earlier insertion is removed. Nexplanon contraception does not block pregnancy if removed and not replaced. Therefore, it is possible to become pregnant shortly after Nexplanon removal.

The 7 Day Rule

When scheduling an appointment, the timing of a Nexplanon implant insertion is important. If the procedure is performed within the first 5 days of a patient’s menstrual period, no back-up birth control method is required.

If the implant is performed after the 5th day of a patient’s menstrual period, a condom or other back-up method should be used for the first 7 days after insertion. If already employing a physician prescribed contraceptive method such as the piil, patch or ring, usage should be continued for 7 days after Nexplanon implant surgery.

Preparation for a Nexplanon Procedure

The Nexplanon implant is an in-office procedure that requires about 10 minutes. Preparation begins with cleaning of the arm with an antiseptic solution, followed by an anesthesia injection to reduce pain.

women with NexplanonNexplanon implants are inserted procedurally by a physician under the skin of the inside of the upper arm, followed by a topical bandage. A bandage should be worn 3 to 5 days after the procedure. Some discomfort or pressure during Nexplanon implant procedure is common.

Removal of an existing Nexplanon implant follows a similar procedure, beginning with the cleaning and numbing of the arm, then a scalpel is employed for making a slight incision adjacent to the implant location.

Surgical instruments are used to access and extirpate the contraceptive. A new Nexplanon implant can be inserted to replace the one removed for continued use of the same form of birth control. Nexplanon implant duration of use is 3-years, and should be removed on or before the expiration date.

FAQs

Will a patient experience post-procedure pain?

Patients who have recently had a Nexplanon implant procedure performed by their gynecologist should be aware of the risks. Bruising, discomfort, pain, and swelling in the location where the Nexplanon implant is placed may be a sign of infection.

It is recommended that a patient contact their physician if bleeding is excessive, or if any associated pain is not alleviated with over-the-counter pain reliever medication. Do not attempt to remove the implant yourself.

Contact your medical provider for a checkup and to avoid any long-term scarring of the skin. Contraceptive care patients experiencing severe pain, swelling or a fever above 102oF within the 3 days post-procedure period are advised to visit an emergency room.

Why pregnancy testing before a procedure?

Most physicians recommend a pregnancy test to ensure you are not pregnant prior to Nexplanon implantation. It is advised to avoid unprotected sex during the two weeks prior to the implant procedure, as it is often impossible to 100% confirm a negative pregnancy test until later in the gestation cycle. In a case where there are signs of pregnancy, Nexplanon implant contraception should be discontinued immediately.

What to expect during the menstrual cycle?

girl with periods painA benefit of Nexplanon implant is that some patients experience little to no menstrual bleeding after insertion. However, there may be a risk of irregular menstruation during the first few months after implant insertion.

Will an implant protect against STIs?

Nexplanon and other birth control contraceptives do not protect users against sexually transmitted infections (STIs). It is recommended that a condom be used with other birth control contraceptives to eliminate the risk of STIs during sex.

Contraceptive Care Specialists

We are a full-service, women’s healthcare medical provider, offering patients contraceptive care and other specialized gynecological services in Raleigh, NC. Our licensed physicians are specialists in in-patient, procedural contraceptive care, including Nexplanon implantation. If interested in finding out more about birth control contraception by prescription or Nexplanon implant procedure, schedule an appointment with a consultation today.

Raleigh Gynecology April 17, 2023

many kind of contraceptive brandBirth control pills are currently one of the most popular types of female contraception in the United States. According to the Centers for Disease Control and Prevention, 65% of women who are at childbearing age are using some form of birth control to prevent unwanted pregnancy.

Birth control pills are preferred by many women because of their availability, effectiveness and ease of use. However, despite being referred to informally as “the pill” in a collective sense, there are many different types available, and it may take some trial and error to find the right choice for you.

What is a Combination Birth Control Pill?

Most birth control pills work by releasing hormones into a woman’s body that can prevent pregnancy from occurring. Combination pills use a blend of the hormone estrogen and one of the many different types of progestin. These are the most popular types of birth control pills, and many brands make them for the U.S. market.

These pills are taken at the same time every day, and their approach to preventing pregnancy is threefold:

  • They suppress ovulation: When an egg is not released from the ovaries, there is no way for it to be fertilized and implanted which would result in pregnancy.
    They stop sperm from reaching an egg: These pills thicken a woman’s cervical mucus to a degree that prevents sperm from passing through it, which means the sperm cannot reach an egg to fertilize it.
  • They thin the endometrial lining: Although the first two approaches are generally enough to stop pregnancy from occurring, these pills also thin the endometrial lining of the uterus. This means that if an egg is somehow fertilized, it will have trouble implanting due to the thin lining.

For preventing pregnancy, a combination pill is 99 percent effective when used correctly, which means it must be taken at the same time each day without fail. Typical use effectiveness, which accounts for incorrect use, is 93 percent. Women who forget to take a pill on time should use a condom as a backup method.

Combination Birth Control Pill Types

Combination birth control pills fall into one of three general categories: monophasic, biphasic or triphasic.

  • Packets of contraceptive pillsMonophasic: These pills contain the same amount of estrogen and progestin in each active pill in the pack.
  • Biphasic: With a biphasic birth control pill, the levels of estrogen and progestin change one time while a woman takes the active pills. This generally involves raising the level of progestin during the second half of the cycle.
  • Triphasic: In triphasic birth control pills, the levels of hormones change three times during the woman’s cycle. The levels of both progestin and estrogen typically change throughout the cycle in these pills.

There are also variations in the number of pills that are included in a one-month supply. Most packs contain a set number of active birth control pills and reminder pills that do not contain hormones. These reminder pills serve to help women maintain their routine of taking a pill every day.

What Are The Most Popular Brands Of Birth Control Pills?

Here’s a look at some of the most popular brands of birth control pills in the U.S., listed by type.

Monophasic

  • Alesse
  • Apri
  • Estrostep Fe
  • Levora
  • Loestrin
  • Nordette
  • Ortho-Novum
  • Yaz
  • Yasmin

Biphasic

  • Mircette
  • Azurette

Triphasic

  • Ortho Tri-Cyclen
  • Caziant
  • Velivet

Choosing the Right Combination Birth Control Pill

Your doctor can provide valuable guidance on the right type and brand of birth control for you. While all types of birth control pills currently available are considered effective, the options available to you will depend on your lifestyle and personal health history.

For example, one possible side effect of combination birth control pills is elevated blood pressure. For women who have a history of high blood pressure, a low-dose combination pill might be the best choice. They contain less than 50 micrograms of estrogen in each active pill, but they may cause more breakthrough bleeding than their higher-dose counterparts.

Popular low-dose pill brand names in the U.S. include:

  • Loestrin
  • Apri
  • Lo Ovral
  • Yaz
  • Yasmin
  • Levora
  • Aviane

a collection of pills that are used for hormonal contraceptionIt takes approximately three months for your body to adjust to a new type of birth control pill. If you find that you experience side effects after this adjustment period, your doctor may suggest a different option.

Some women, like those with a history of stroke or smokers over the age of 35, are not good candidates for combination birth control pills. There are estrogen free forms of birth control that may work well for them, including progestin only birth control pills, Depo Provera, contraceptive Implants and IUDs.

The Side Effects of Combination Birth Control Pills

Although many women can safely use these pills without experiencing any side effects, some will experience certain symptoms or effects due to the fluctuations in their hormone levels, particularly when they first start to take the pill.

These include bleeding between periods, breast tenderness, fluid retention, weight gain, vomiting, nausea and headaches.

Schedule an Appointment to Discuss Contraceptive Care

If you are sexually active and looking for an effective birth control pill, the contraceptive care team at Raleigh Gynecology and Wellness can provide valuable guidance. Contact us today to schedule an appointment.

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Conditions & Management

  • Abnormal PAP Smears
  • Endometriosis
  • Initial Evaluation of Infertility
  • Menopause & Peri-Menopause Care
  • Menstrual Disorders
  • PCOS
  • Pelvic Relaxation & Prolapse
  • Sexual Health & Sexual Dysfunction
  • Urinary Problems
  • Vaginal Dryness & Painful Sex
  • Vaginitis Care

Procedures

  • Colposcopy
  • Endometrial Biopsy
  • IUD Insertion
  • LEEP
  • MonaLisa Touch
  • Nexplanon
  • Pelvic Floor Therapy
  • Pessary Fitting
  • Sonohysterography & Ultrasound

Routine Care

  • Breast Care
  • Contraceptive Care
  • Emergency Contraception
  • Gardasil Vaccination
  • GYN Wellness Screening
  • HPV Counseling
  • Mammography
  • PAP Test
  • STD Testing

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