4:23 pm - 11/19/2006

low-dose birth control

i few months ago i went to the gynecologist because i had irregular and very heavy periods. he told me if the problem persisted that i should come back and he'll prescribe me a "low-dose birth control". i didn't ask any questions about it (because my mother was in the room). my question is, what exactly is low dose birth control? my boyfriend is saying that it helps periods but not the prevention of pregnancy. is this true?

i have another question. does birth control really lower your sex drive? ive heard all these myths about it like how you get in bad moods all the time and you really don't ever feel like having sex.
whiterabit 19th-Nov-2006 09:27 pm (UTC)
no its still HBC it protects against pregnancy and prevents ovulation just using less hormones that some brands. like ortho tri cyclen lo, it uses 25 mg of estrogen or whatever hormone isnt of 35mcg of hormones which is what most use.
scien 19th-Nov-2006 09:28 pm (UTC)
No. All doses of birth control pills prevent pregnancy. Some people find that they get fewer side effects on low dose pills, while others get on better with high doses - it's a completely individual thing, and often takes some trial and error to hit on a pill you get on with. But often doctors seem to prefer starting women on a low dose pill - why exactly I'm not sure.

There is a myth going around that low dose = less effective as bc, but fewer side effects, while high dose = super effective, but more side effects. This is I'm afraid only a myth. All the pills have to pass the same safety testing.
queensugar 19th-Nov-2006 10:06 pm (UTC)
I think, essentially, that the reason why doctors often prefer to start women on low-dose pills is due to the medical inference about the effect of larger amounts of estrogen.

We know that higher amounts of estrogen are linked to serious side-effects; we know that pills with 50 micrograms of estrogen or less are safer than the first generation of HBC pills, which contained up to three times as much estrogen.

From the best I can find, there aren't many absolute pronouncements on how the current low-dose (35 micrograms or less) pills relate to a difference in risks, and that appears to be due simply to a lack of studies and some debate about the composition of different estrogens on the market. The medical community still defines low-dose as under 50 micrograms, from what I can tell.

However, some initial research has shown that the total incidence of side-effects is lower in ultra-low-dose 20 microgram estrogen pills than 35 micrograms; even though there are also reports of increased bleeding and thus, increased discontinuation.

Additionally, This AMA report notes that while ischemic stroke is still associated with lower-dose OCs, the risk is less than with higher dose formations.

Basically, prescribing doctors want to ensure that they are prescribing a method that will be met with compliance; side-effects are the largest reason that women choose to stop taking oral contraceptives. So even where no absolute research exists, given what we know about estrogen and side-effects (both serious and not), it makes some degree of sense that doctors may infer that a lower estrogen dose would produce fewer in most women, in addition to possibly further reducing the already low risk of serious side effects, and thus result in better compliance.
queensugar 19th-Nov-2006 10:29 pm (UTC)
Oh, and just quickly, some more links for people to browse, because now I'm interested...

Here's another link discussing how "ultra-low-dose" 20 microgram pills (like Alesse) are theoretically safer, but were shown in trials to produce more breakthrough bleeding and thus reduce compliance; though they note that may be due to the type of progestin used as well. This university site agrees with that.

And finally, This guideline page notes which side-effects are estrogen related, and concludes with the prescribing recommendation "For young, healthy women, choose any low dose oral contraceptive, with less than 50 mg EE. For specific indications, see below. For prior users, place back on previous pill if well tolerated."
queensugar 19th-Nov-2006 09:32 pm (UTC)
Well, "low-dose birth control" wouldn't really be birth control if it didn't prevent pregnancy, would it? :)

Here's the basic answer for ya: all combination birth control pills contain two hormones, estrogen and progestin. When the pill was first developed, the concentration of estrogen was fairly high.

While some women require large doses of estrogen to prevent side-effects like breakthrough bleeding, larger doses of estrogen are more heavily linked to side-effects, including serious ones (for instance, larger amounts of estrogen are more linked to complications like blood clots).

Over the years, pharmaceutical companies have developed birth control pills that use lower and lower doses of estrogen, yet are still equally effective against pregnancy (over 99% when used correctly!). Check out this article from Web MD about low-dose oral contraceptives.

Today, you can find many brands of low-dose pills (including Yasmin, Alesse, Desogen, and others), as well as some brands of higher dose pills.

You might also want to check out our HBC Vulvapedia entry for more info on how hormonal birth control works with a woman's body. :)
queensugar 19th-Nov-2006 10:09 pm (UTC)
As per your edit: decreased libido can be a side effect of HBC. However, there's no way to know whether you'll experience that side effect or not on an individual brand. Generally, a woman is advised to stick with a method for at least three months (many side-effects go away by then). If the side-effect persists after that point, it may be worth switching brands to see if a different brand doesn't produce that effect.
wilddcherry16 19th-Nov-2006 09:37 pm (UTC)
i'm on a low dose pill to keep me baby free =]
aechei 19th-Nov-2006 09:53 pm (UTC)
hbc often causes lowered sex drive. not all people are susceptable to the side effect, and not all pills will do it to the same degree for every person. a pill that makes me never want to masturbate again might be just fine for you and vice versa. the only real way to know is to try one. every bc i have been on lowered my sex drive somewhat. nuvaring was probably the best of the 3 (pill, patch, ring) for me, and also the most convenient and lowest dosage. EVERY hormonal bc i was on did wonders for my skin. i had PERFECT skin.

now i have an iud (mirena, which has teeeeny doses of progesterone but no estrogen) and my sex drive has gone way up. my skin, unfortunately, has gone back to its pre-hbc state. however, this is a tradeoff i happily make, because i do not have to worry about bc for 5 years, and i have no periods. also it is cheap.
littlesillymoo 19th-Nov-2006 10:01 pm (UTC)
Low-dose is effective in the same way that regular-dose are, but the side effects are another business entirely. I think that docs tend to try to start women off on the low-dose because you're less likely to have "bad" side effects, and if you're having them anyway, they can just switch you up to the higher dose, whereas with the higher dose, you're increasing the chances that you'll have the side effects and usually want to switch to a low-dose anyway (or so my gyn explained to me).

As for lowered sex drive, that depends on the person. Personally, I'm on OTC-Lo and haven't experienced a lowered sex drive or any of the more serious side effects, for that matter. I've also got a few friends on it, and we all admit that it has, if anything, increased our sex drives and have not experienced depression since getting on it (mind you, we had all suffered from depression prior to getting on the pill), possibly due to the increased sex drive. :)

Two years and baby free!
betterbebalboa 19th-Nov-2006 10:28 pm (UTC)
1. As everyone has said, low-dose does not mean lower effectiveness :)

2. Those are side effects that may or may not occur depending on the type of pill and the individual taking it; it's hard to predict. They are less likely to occur on a low-dose pill. Personally, I'm on Mircette, which is pretty low-dose, and I've experienced no more moodiness than before and a BIGGER sex drive.
batgirl_x 19th-Nov-2006 10:31 pm (UTC)
I haven't had any problems since going on birth control and mines is a high dose...Infact I find my drive is alot higher! lol.
skeos 19th-Nov-2006 11:16 pm (UTC)
Don't be scared of birth control. I was. I was scared that I would gain 30 pounds and experience raging moodswings that made me unfit for human companionship. It was all for naught: the right birth control can do wonders for you--even if you have to switch brands a few times.

I was lucky enough to be prescribed the right birth control on the first try. I have actually lost weight, the residual odd pimples from my teen years have stopped making their random appearances, my sex drive is still through the roof, my migraines have cleared up and... yeah, I'm protected against pregnancy too, on my low-dose triphasic pill. I love birth control now. But when I first started, I was so terrified. You only hear the bad things, like weight loss, and sex drive loss, and moodswings--which can happen to you on the wrong pill. But you don't get to hear from the people like me, who have been positively affected by it. If people with bad side effects were the majority, then there wouldn't be such a large amount of women on the pill!
skeos 19th-Nov-2006 11:17 pm (UTC)
sorry, weight GAIN on that last paragraph.
loonylupinlover 20th-Nov-2006 09:58 pm (UTC)
Honestly, you'll never know until you're on a certain method if it will affect your libido or your moods. The NuvaRing, which is a low-dose method, gave me horrid mood swings at first and seems to be decreasing my libido somewhat (though I still generally have great sex with my boyfriend, I'm not very interested in masturbation anymore and it takes me a bit longer to get warmed up). The Patch, which is a high-dose method, made me tear up more easily but not burst out sobbing or become super bitchy, and my libido was fabulous on it. Everyone's different, so don't feel bad if you try a low-dose method and it doesn't work out for you.

And yes, no worries, low-dose birth control is just as effective as high-dose at preventing pregnancy. :)
kfitzpatrick 20th-Nov-2006 10:06 pm (UTC)
thanks everyone!
aruinedepiphany 21st-Nov-2006 09:38 pm (UTC)
I'm on a low-dose HBC and have been for a year and a half.. and no babies yet! :P

as for the lowered libido question, i have noticed it a bit (and it can also cause you to have a hard time getting "wet" when having sex.. which i did notice, but not to an extreme). neither have bothered me immensely, although i have noticed them, and i'm thinking of switching to an iud soon. mostly because i don't want to forget to take pills and the emotional mood swings (which aren't too pronounced for me, either, but are there). so yeah, it depends on the woman :)
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