Pills That Promise More Than Just Birth Control

(HealthDay is the new name for HealthScoutNews.)

FRIDAY, June 20, 2003 (HealthDayNews) -- In the past, a woman turned to birth control pills for just one reason -- to prevent pregnancy.

But in a world where multi-tasking has become a way of life, an oral contraceptive that offers more than one benefit has become the birth-control buzz of a new generation.

"Women no longer want just birth control from their pill. They want to find the one that gives them the most overall benefits with the fewest number of side effects," says Dr. Steve Goldstein, a professor of obstetrics and gynecology at New York University Medical Center.

"And depending on what they are looking for, there are a wide number of choices they can try," he adds.

While preventing pregnancy is still the number one reason why some 18 million American women request a birth control pill prescription each year, manufacturers are eager to point out myriad other benefits in the approximately 40 pills on the market today.

Those benefits include the ability to control heavy bleeding and clotting, reduce menstrual cramping, resolve some symptoms of PMS, decrease menstrual-related breast pain, and even offer a level of protection from certain serious reproductive diseases, including ovarian and uterine cancer.

While all these bonuses are available no matter which oral contraceptive you choose, the latest buzz concerns "problem-specific" pill formulations -- certain oral contraceptives that purport to accomplish what others cannot.

Among the first was Ortho Tri-Cyclen, an oral contraceptive with the ability to treat acne. Since its manufacturer sought and received U.S. Food and Drug Administration (FDA) approval to promote its skin-clearing benefits, other brands of birth control pills, including Estrostep and Alesse, have sought similar approval.

Also on the market: Pills promoted specifically for contraception in breast-feeding mothers. Such choices now include progestin-only (no estrogen) "mini pills," such as Micronor or Ovrette.

Last year, women were introduced to Yasmin, a birth control pill that, at least anecdotally, helps users lose weight. Or at the very least, it doesn't contribute to the bloating and water retention associated with many other pills.

And the very latest news: A pill that can improve the sound of your voice. In studies published in the April issue of Obstetrics and Gynecology, Israeli researchers found the lower the dose of hormones in birth control pills such as Meliane and Gynera, the better sounding and more stable a woman's voice. Neither of these pills is currently available in the United States.

As enticing as all these claims are, Goldstein notes that just because a pill has been shown to have a specific effect -- even in a majority of women -- there's no guarantee every woman will respond the same way.

"Sometimes a particular pill may be a good starting point for a woman, but that doesn't necessarily mean it will be the final pill she ends up taking. The response to oral contraceptives can be highly unique and individual," Goldstein says.

With the exception of the progesterone-only "mini pill," all other oral contraceptives are a combination of laboratory-created versions of the natural reproductive hormones estrogen and progesterone. The pill prevents pregnancy by blocking ovulation, as well as creating an internal environment decidedly not "sperm friendly."

Although every pill sold in the United States uses the same lab-created estrogen, progesterones can vary. And many doctors believe it's the differences in this ingredient that accounts for some of the varying "bonus" effects of certain pills.

But some doctors say differences in progesterones account for only part of the reason why all pills aren't created equal.

The other half of the equation concerns both the amount and strength of each of the hormones in the formulation, as well as the ratio of estrogen to progesterone, says New York City gynecologist Dr. Michael Silverstein. These are all factors, he says, that can affect what the pill will and won't accomplish for each individual woman -- and why finding the right pill for you might take a little trial and error.

"Every type of oral contraceptive is a little bit different from the others, which is one reason why a woman's response to the pill can be so individualized," says Silverstein. So, just because one type of pill is purported to promote clearer skin, that doesn't mean others won't have a similar effect -- depending on your individual body chemistry, he says.

The bottom line: Doctors say it's OK to seek out a particular brand of pill based on its bonus effects. But don't be too disappointed if you don't get what you expect. And don't be afraid to talk to your doctor about changing brands or formulations within a brand to find the pill that's right for you.

More information

To learn more about all your birth control pill options, visit Planned Parenthood. Or check with The Nemours Foundation.