Month: May 2021

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Birth Control Health

Does Birth Control Make You Gain Weight?

The truth about birth control and weight gain: it is largely due to water retention instead of actual increase in body fat! 

Are you reluctant to get birth control because you believe it may cause weight gain?

Weight gain is a common risk that most women are afraid of when it comes to birth control. And we do recognise why this may be a cause of concern. It’s one of those side effects you’re bound to constantly debate about with your girlfriends and still come to no clear conclusion at the end of the day.

But is this necessarily true? 

With a wide range of birth control options available now, it’s inevitable different individuals may react differently as well. Especially as birth control is more effective if you use it consistently, weight gain is also attributed to other factors such as lifestyle habits and routines or changes in metabolism as you age.

Most women don’t experience weight gain 

This may come as a form of reassurance but the majority of people on birth control do not actually experience weight gain. Any initial increase in weight is due to water retention rather than an increase in body fat and mass. As birth control may initially lead to water retention, you may feel a little bloated at the start. These effects are temporary and go away within a few weeks after starting birth control.

In fact, a 2008 study of 150 female athletes over two years found that oral contraceptives did not cause weight or fat mass gain. Similarly, a 2014 systematic review revealed that there was no significant causal relationship between weight gain and combination contraceptives as women taking birth control, compared with those in the placebo group, showed no substantial difference in weight.  

All in all, the hormones in birth control may trigger bodily changes but the idea that birth control leads to lasting weight gain is not a factual claim. 

Higher estrogen levels

Combined hormonal contraceptives such as birth control pills, patches and even the vaginal ring typically contain estrogen which prevents ovulation. This occurs as a compound (renin-angiotensin) created by the kidneys becomes stimulated because of the additional estrogen circulating throughout your body. This prompts your body to retain more fluid before your period. Essentially, higher estrogen levels may lead to a slightly higher level of water retention for those on the pill. However, there will usually be a decrease in weight after your period is over. 

Most birth control pills have approximately 30 to 35 micrograms of hormones but if you’re worried about the current dosage of estrogen in your pills, it’s best to consult your doctor and opt for a low-dose estrogen pill which will contain around 20 micrograms of estrogen.  

Higher doses of estrogen can potentially stimulate appetite, which may cause increased calorie intake in some women. 

Birth control implants and shots may be exceptions 

Hormonal implants, which are a form of long-term, reversible birth control may cause weight gain. This method works by inserting an implant into your arm, thereby releasing a synthetic hormone called etonogestrel into your bloodstream. Etonogestrel imitates progesterone by attempting to regulate your menstrual cycle alongside estrogen. 

Birth control shots can contribute to an increase in weight gain from water retention as its effects are meant to last for three months. Alternatively, you may want to opt for low-dose estrogen birth control pills instead. 

A final note

Always check with your doctor if you’re worried about the potential side effects or switching to a new type of birth control that fits your lifestyle. Other plausible causes for sudden weight gain may also be due to underlying health conditions such as thyroid disorders and diabetes. If you do experience bloating, keep in mind it is only temporary and there are other ways you can cope!

Here are some tips on how to reduce water retention: 

  • Lesser salt intake 
  • Staying well-hydrated 
  • Exercise consistently to move your muscles 
  • Wearing compression stockings during prolonged standing 

At Siena, we want to find the most effective and suitable birth control for you that also steers you away as much as possible from any unwanted side effects! Speak to any of our female doctors now from the comfort of your own home to explore your options.

References:

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Birth Control Health Period

Period Pain and Birth Control: How Contraceptives Can Help You Alleviate Your Menstrual Cramps

Do you suffer from excruciating period pain every month knowing you just have to wait it out? Well, birth control is a solution you should definitely keep in mind!

What’s the science behind menstrual cramps?  

It’s pretty much a known fact that period pain is no fun at all and most women are bound to experience it every month. Even then, women can have varying encounters with period cramps. While some regularly face this problem, some are lucky enough to rarely experience it. Of course, most of us may have gotten used to this cycle since our teenage years and it’s just something we accept as part of female reproductive life. But have you ever wondered why this monthly inconvenience comes with its own set of unpleasant characteristics? 

Dysmenorrhea, also known as menstrual cramps, refers to the pain associated with your period. It is usually in the form of throbbing or cramp-like pains in the lower abdomen which occurs just before and during menstruation. There are two types of dysmenorrhea — primary and secondary. 

Primary Dysmenorrhea  

This is the most common type of period pain which most women experience and is not caused by another condition. Simply put, the pain is caused by the period itself. Approximately 50 to 90 percent of the female population suffer from primary dysmenorrhea and its effects are severe on 10 percent of women for one to three days a month. 

During your menstrual period, the contraction of the uterus allows it to shed its lining. Yes, this is necessary and yet often painful. The pain is actually caused by hormone-like substances (prostaglandins) that are produced by the uterine lining cells which then circulate into your bloodstream. This ultimately triggers the tightening and relaxing of the uterine muscle and it is these contractions that cause cramps. Typically, higher levels of prostaglandins tend to lead to more severe menstrual cramps.

Secondary Dysmenorrhea 

Apart from the common and tolerable pain most women suffer through during their period, some may have it worse due to certain medical conditions that intensify the pain. This usually starts later in life. 

  • Adenomyosis: a condition that causes the inner lining of the uterus to break into the uterus’ muscle walls 
  • Cervical stenosis: a smaller cervix opening can impede menstrual flow and lead to a painful increase of pressure within the uterus 
  • Endometriosis: the tissue lining the uterus grows outside the womb and on the fallopian tubes, ovaries or tissue lining the pelvis instead 
  • Pelvic inflammatory disease: sexually transmitted bacteria that infects the female reproductive organs 
  • Uterine fibroids: non-cancerous growths of the uterus

I’ve been thinking about going on the pill to help with the cramps.

If you’re already on birth control, you probably already know how fuss-free and effective it is in preventing pregnancy. But what about its other non-contraceptive benefits? 

Hormonal birth control is one treatment method used to ease menstrual cramps. Primarily, oral birth control pills contain hormones such as estrogen and progestin which deter ovulation and the production of prostaglandins, thus lowering the severity of period pain. 

A randomised controlled trial conducted in 2012 revealed the effectiveness of taking combination birth control pills cyclically (21 days with active pills followed by seven days of placebo) and those taken continually. The latter involves the continuous administration of active pills during all 28 days, without any placebo at all. As continuous OCP means that users only take the hormone pills and skip the inactive pills, they forgo the monthly bleeding altogether. Both methods were successful in treating primary dysmenorrhea. 

Alternatively, other birth control methods such as patches, the ring, intrauterine devices and implants are also able to alleviate cramps, and even cause periods to become lighter and more predictable.

By using these prescribed birth control methods, you can also safely skip your periods altogether. To postpone or skip your period, you should immediately start on a new pack of active pills right away without taking the sugar pills (inactive pills). 

It’s best to speak with a doctor before trying any new birth control methods or making major adjustments. 

But I’m worried, will there be any side effects?

For first-timers on the pill, don’t worry! It’s natural for your body to take time to adapt to the hormonal changes.

Some women may still temporarily experience discomfort and period-like symptoms at the start. Symptoms such as cramping and spotting may arise if you forget to take your birth control pill.

How we can help

There are different types of birth control for different requirements. If you’re looking to speak with a healthcare professional on coping with menstrual cramps or dysmenorrhea, feel free to talk to one of Siena’s female-only doctors now!

References:

Categories
Birth Control Health Period

Premenstrual Dysphoric Disorder (PMDD): Symptoms and How Hormonal Birth Control Can Help

This extreme version of PMS can be both life-changing and life-threatening. How can birth control help in alleviating symptoms of PMDD?

Premenstrual Dysphoric Disorder (PMDD) is more than just Premenstrual Syndrome (PMS)

For starters, PMDD is not a hormonal imbalance nor is it merely behavioural changes during that excruciating time of the month!

PMDD is commonly defined as an endocrine disorder and is also known to be a more severe form of PMS. They are both similar in terms of experiencing hormone-related symptoms in physical and emotional forms. This typically happens during the premenstrual phase about seven to 10 days before your period starts, and persists for the first few days of your period. 

While this may sound familiar to most women (and significant others or partners who have to bear the brunt of PMS every month), there is a huge difference between PMS and PMDD. In fact, PMDD can be so extreme that sudden shifts in mood can disrupt daily life and even negatively affect relationships. In some cases, besides facing challenges in interpersonal functioning and maintaining social relations, PMDD can also cause occupational impairment. This may refer to frequent outbursts towards loved ones or the inability to cope with the distressing symptoms at work, ultimately requiring one to take medical leave. 

How serious is PMDD?

PMDD affects about 5 percent of women of reproductive age and those who have underlying depression and anxiety are more likely to suffer from it. While there is no clear cause for this disorder, possible causes include genetics, thyroid and detrimental factors such as alcohol and substance abuse. 

According to the manual for assessment and diagnosis of mental disorders DSM-5, PMDD is also defined as a depressive disorder that requires prescription medication, unlike PMS. As its effects on women’s mental health are consistent and yet intermittent, PMDD tends to be underdiagnosed and undertreated. Thus, although PMDD may be uncommon compared to PMS, it is important to render conscientious attention and treatment as symptoms may worsen over time especially upon entering into menopause. As such, those with PMDD may harbour suicidal thoughts and behaviour which can be life-threatening. 

What are the symptoms of PMDD?

Similar to PMS, PMDD also causes bloating, breast tenderness, fatigue and changes in diet and sleeping habits. But the display of at least one of the below emotional and behavioural traits differentiates PMDD from PMS: 

  • Feeling sad or hopeless 
  • Severe moodiness 
  • Anxiety or tension 
  • Easily irritable or angry 

If you experience either one of the symptoms alongside other common symptoms* which occur before your menstrual flow that significantly disrupts your ability to function in everyday life, there is a chance you may be suffering from PMDD. 

Emotional SymptomsPhysical Symptoms 
– Agitation or nervousness
– Irritability
– Feeling overwhelmed and out of control
– Crying spells
– Anger, sadness
– Suicidal thoughts
– Panic attacks, paranoia
– Moodiness
– Forgetfulness
– Loss of interest in activities and relationships		– Acne
– Back, joint or muscle pain
– Bloating
– Breast swelling and tenderness
– Constipation, diarrhoea, nausea, vomiting
– Cramps
– Dizziness, headaches
– Appetite changes
– Reduced sex drive
– Lethargy or fatigue
– Sleep disturbance 
Common symptoms of Premenstrual Dysphoric Disorder (PMDD)

If you feel you check most of these boxes, you can first take a self-screening test online. As PMDD symptoms may overlap with features of other medical conditions that mimic PMDD, it is strongly advised to seek professional help and speak with a healthcare provider for a diagnosis thereafter. 

How can birth control help with PMDD? 

Yes, birth control does more than helping you prevent pregnancy!

Hormonal interventions utilising oral contraceptives is one useful method in treating both PMS and PMDD. PMDD symptoms tend to arise once ovulation begins. Thus, as birth control pills prevent ovulation, they can regulate hormone levels in order to suppress ovulation and its related hormone changes, thereby avoiding premenstrual symptoms.

Most birth control pills are usually prescribed such that there are 21 active pills followed by seven days of placebo pills containing only sugar. This creates a hormone-free interval where the transition from taking active pills to sugar pills causes a sudden decrease in hormones.

Currently, Yaz is the only FDA-approved hormonal birth control pill used to treat PMDD. It implements a 24-day dosing regimen with active pills, followed by four inactive sugar pills. Similarly, other birth control options such as contraceptive patches and rings can also help to treat PMDD. 

Nonetheless, these benefits are also accompanied by certain risks for some individuals. Some may be more sensitive toward the sudden fluctuations in hormone levels and instead experience even more severe mood swings. Unsuitable candidates for treating PMDD with hormonal medications also include: 

  • Those with a past medical history of blood clots, stroke or migraine 
  • Smokers, especially those over 35 years of age 

What are other treatment options or alternatives? 

More often than not, a combination of solutions is needed in order to treat PMDD. 

Other ways to prevent or minimise PMDD symptoms:

  • Selective serotonin reuptake inhibitors (SSRIs) — commonly prescribed antidepressants 
  • Nutritional supplements rich in calcium
  • Over-the-counter pain relievers such as ibuprofen and aspirin to relieve physical symptoms 
  • Stress management

What’s next? Well, taking charge of your own health and wellness is also extremely important in treating PMDD. Firstly, you can start with small steps such as having frequent meals lower in salt but high in nutrients from fruits, vegetables and whole grains. Next, have sufficient hours of sleep or try out various relaxation techniques like meditation and yoga.

Exercising five days a week for at least half an hour a day and cultivating healthy sleep habits will also aid in reducing premenstrual symptoms. And if you’re a coffee addict or frequent bar-goer every TGIF, perhaps it’s time to cut down on both the caffeine and alcohol as they will also help to ease symptoms. 

Remember, you can take charge!

Ultimately, it is always important to get the right diagnosis if you feel like you have PMDD. So here’s an important tip: A tracking journal will be most useful for you to start tracking and recording your symptoms before you decide to visit the doctor. Different remedies may work differently for every individual but if you do decide to opt for birth control as a solution, don’t hesitate to find out more about your options with Siena!

References: 

Categories
Birth Control Sexual Health

Birth Control Before The Pill: How Women Prevented Pregnancy Throughout History

Discover a brief history of contraception before the invention of the birth control pill. You’ll be surprised to know about various bizarre and ancient methods!

Birth control options are now more than ever readily accessible in both physical and online spaces. But have you ever wondered how it was like for women in the past when technology wasn’t a thing yet? Read on and I imagine you will count yourselves lucky to be living in the 21st century. Now, you can even get your birth control online and delivered right to your doorstep.

Ancient birth control methods, no thanks!

Commonly used traditional methods comprise largely home-made techniques, some of which may (or may not) surprise you. In the ancient era, women relied on disturbing ingredients like crocodile dung, and bizarre concoctions of edibles such as honey and acacia. Condoms were made from animal membranes and there was a common practice of washing and soaking one’s genitals with ingredients like lemon and olive oil. Lastly, a deadly-sounding method even includes ingesting lead and mercury. Otherwise, before the discovery of chemical and hormonal contraception, the traditional withdrawal (pull-out) method was just as common back then. 

British artist William Blake’s depiction of King Minos. Image credit: National Gallery of Victoria

What about the trusty “wetsuit”? The first known documentation of the use of condoms was by King Minos of Crete in about 3000 B.C. Apparently, his semen contained “serpents and scorpions” which killed his mistresses after intercourse. Back then, condoms were subjected to primitive ideals and definitely did not come in the clean, rubber form we are now accustomed to. Thus, as a form of protection, a goat’s bladder was inserted in the vagina of King Minos’ wife to act as a sheath. Essentially, animal bladders were primarily employed to prevent the contraction of venereal diseases rather than to prevent pregnancy. Resourceful or downright nasty? You decide. 

Finally (and thankfully), rubber was introduced in the manufacturing of condoms which brought about real technological advances. By the 1860s, there was a rise in the large-scale production and popular use of latex condoms, altogether replacing skin condoms made from animal intestines or bladder. 

The battle for birth control

Despite being normally associated with family planning, birth control faced resistance in the 1800s. Many perceived contraception as immoral and akin to encouraging prostitution. (Source: Stanford Medicine)

In fact, under the Comstock Act of 1873 in the United States, even medically prescribed writings or materials regarding contraception and abortion were made illegal as they were seen as obscene and indecent. As a result, the enforcement of the sale and distribution of materials concerning birth control eventually prompted social reformers to advocate the repealing of the federal law. Before the birth control movement became closely tied to the feminist movement, worry-free and safe sex were pretty out of reach for women in those days.

From the 1940s to 1950s, activists Margaret Sanger and Katharine McCormick embarked on a vigorous scientific research in search for the pill that could potentially control fertility. Oh boy did this cause a shift in the previously uneven level playing field for women to take charge of their sexual health. The first invented pill was both effective and simple to use, thus attracting millions of women to partake the first of oral contraceptives. (Source: Planned Parenthood Federation of America) 

Implants such as the intrauterine device (IUD) also made their mark in history since 1909. IUDs were first experimented using a ring made of silkworm gut with two protruding ends of the cervical os. Subsequently, other physicians such as Ernest Graefenberg (FYI: the G-spot was named after him), developed similar versions that proved more effective with the use of a mixture of metals including copper. Ultimately, it was only in the 1980s did the FDA-approved Copper-T gain more significant traction as one of the most effective and safest forms of contraception. 

Revolutionary effects

Needless to say, birth control has improved drastically and we should all be grateful for today’s plethora of reliable birth control methods to choose from. Beyond mere access to birth control pills, other forms of birth control such as patches and emergency contraception have likewise allowed women all around the world to be empowered, educated and take charge of their own health.

References:
Armitage, H. (2018). Contraception: An evolution and history. Stanford Medicine. https://scopeblog.stanford.edu/2018/05/16/contraception-evolving-the-options/

Burnette, B.R. (2009). Comstock Act of 1873 (1873). The First Amendment Encyclopedia. https://www.mtsu.edu/first-amendment/article/1038/comstock-act-of-1873#:~:text=%2C%20public%20domain

Khan, F., Mukhtar, S., Sriprasad, S., & Dickinson, I. K. (2013). The story of the condom. Indian Journal of Urology, 29(1), 12-15. https://doi.org/10.4103/0970-1591.109976

Margulies, L. (1975). History of intrauterine devices. Bulletin of the New York Academy of Medicine, 51(5), 662-667. https://pubmed.ncbi.nlm.nih.gov/1093589/

Marhol, A. (2021). Ancient Birth Control Methods: How Did Women Prevent Pregnancy Throughout the Ages? Flo. flo.health/menstrual-cycle/sex/birth-control/ancient-birth-control-methods

Planned Parenthood Federation of America. (2015). Birth Control – History of the Pill. https://www.plannedparenthood.org/files/1514/3518/7100/Pill_History_FactSheet.pdf