Tag: women's health

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Birth Control

Diane-35® Birth Control: How It Works, Potential Side Effects & Where To Buy In Singapore

Diane-35® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

The type of birth control you use is a personal decision, and there are many options to choose from. If you’re a sexually active person who can become pregnant, you could consider birth control pills.

In this article, we share all you need to know about one of the most common birth control pill brands in Singapore — Diane-35®: 

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Diane-35® in Singapore.

What Is Diane-35®? 

Diane-35® is a brand-name combination birth control pill that contains 2 hormones: 

  • progestogen (2mg cyproterone acetate); and
  • estrogen (0.035mg ethinylestradiol).

Estelle® is a generic version of the brand-name drug Diane-35®.

Besides preventing unwanted pregnancies, Diane-35® can also help to:

How Does Diane-35® Work? 

Diane-35® helps to prevent pregnancy by:

  • Inhibiting ovulation, which is the release of an egg from the ovary;
  • Thickening the cervical mucus (the fluid in the vaginal tract), hindering the sperm from reaching the egg to fertilise it.

How Effective Is Diane-35®?

Diane-35® has shown to be highly effective in preventing pregnancy. According to the Centers for Disease Control and Prevention, when used perfectly Diane-35® is more than 99% effective in preventing pregnancy. Even with typical use (possibly due to missed pills or improper storage), Diane-35® is still around 91% effective. 

In general, birth control pills are more effective than male condoms in preventing pregnancy — male condoms are shown to be 98% effective when used perfectly, and 82% effective with typical use. However, unlike male condoms, sexually transmitted infections (STIs) cannot be prevented by using birth control pills.

Therefore, always use dual protection of condoms and non-barrier contraceptives such as birth control pills during any sexual activity.

How To Take Diane-35® Birth Control Pills?

Diane-35® contains 21 active pills. You should take one pill at the same time every day for 21 days, followed by 7 days where you take no pills. During the pill-free days, a withdrawal bleed usually occurs that is similar to having your period. After the 7-day pill-free interval, start on a new pack of Diane-35® whether or not you have any menstrual bleeding.

You should swallow each pill whole with water. Do not chew the pill. The back of the pill strip states the days of the week (Monday – Sunday). Start your course by taking a pill marked with the correct day of the week and follow the direction of the arrows on the strip.

What To Do If I Missed My Diane-35® Birth Control Pill?

You should establish a regular routine of taking your birth control pills at the same time every day during the 21 days. This is because taking a pill late or missing pills may affect the effectiveness of the pill in preventing pregnancy. 

Diane-35® is considered “missed” if you:

  • don’t take it for 24 hours or more after you were supposed to; or
  • vomit or suffer from diarrhoea within 3 to 4 hours of pill-taking.

If you forget to take a pill, here’s what you should do: 

​​If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day)
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills 
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle
  5. No additional contraceptive protection (e.g. condoms) needed

If you missed two or more active pills (48 hours or more)

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day 
  2. Discard any earlier missed pills 
  3. If the missed pill is within:
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21):
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days

What Are The Potential Side Effects Of Diane-35®?

Women who just started taking Diane-35® may experience some of the following side effects:

  • Nausea, vomiting, bloating and stomach cramps. Take Diane-35® after food to reduce these side effects. 
  • Headache. Can be managed by taking over-the-counter painkillers such as Paracetamol.
  • Spotting between your periods during the first few months of taking oral contraceptives.
  • Breast tenderness
  • Weight changes due to fluid retention, mood swings. Take Diane-35® at the same time every day to avoid huge changes in the hormone levels in your body.

Side effects vary widely among individuals and usually ease within 2–3 months of starting to take the pill as your body adjusts to the hormones. Inform your doctor if the side effects last for a long time (more than 3 months) or bother you.

How To Buy Diane-35® In Singapore?

In Singapore, all hormonal birth controls including Diane-35® can only be purchased if you have a valid prescription from a registered doctor and are unavailable over-the-counter. In other words, you will have to set aside some time amidst your busy schedule to visit the general practitioner or gynaecologist in person.

Siena is a digital health clinic that offers you easy and affordable access to birth control. Simply complete an online questionnaire, and speak with a doctor online from the comfort of your home. If prescribed, we deliver your birth control to you in discreet packaging at no additional charge.

References

Categories
Birth Control

EVRA® Transdermal Birth Control Patch: How It Works, Potential Side Effects And Where To Buy In Singapore

EVRA® Transdermal Birth Control Patch: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

Do you find it difficult to remember to take a pill every day? Do you have difficulty swallowing pills?

If you answered yes to any of the above questions, the birth control patch could be a viable option for you! Both birth control pills and patches use hormones to prevent pregnancy, but the way the hormones are delivered differs. You apply the patch to your skin once a week and forget about it.

In this article, we share all you need to know about the EVRA® Transdermal Patch. Read on to learn more about:

  • How it works;
  • How to use it; 
  • What to do if you missed a patch;
  • Potential side effects; and
  • How to buy EVRA® Transdermal Patch in Singapore.

What Is EVRA® Transdermal Patch? 

The EVRA® Transdermal Patch is a small, beige sticky patch that contains 2 hormones:

  • Progestin (6mg norelgestromin); and
  • Estrogen (0.6mg ethinyl estradiol).

The patch works by releasing hormones into your body through your skin to prevent pregnancy.

The patch is mainly used as contraception to prevent pregnancy. However, women using the EVRA® Transdermal Patch may also benefit from the non-contraceptive effects of estrogen such as:

How Does EVRA® Transdermal Patch Work? 

After the patch is in place, it delivers a steady dose of hormones through your skin and into your bloodstream.

EVRA® Transdermal Patch prevents pregnancy by:

  • Inhibiting ovulation, the release of an egg from the ovary;
  • Thickening the cervical mucus (the fluid in the vaginal tract), such that it is hard for the sperm to reach the egg to fertilise it;
  • Thinning of the uterine lining, such that even if an egg is fertilised, it will be unable to attach to the uterus. The fertilised egg will instead be passed out of the body.

How Effective Is EVRA® Transdermal Patch?

When used perfectly, EVRA® Transdermal Patch is more than 99% effective in preventing pregnancy. It is typically 91% effective (in events of missed applications or improper storage etc.), according to a report by the Centers for Disease Control and Prevention.

Birth control patches are generally more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, it is important to note that birth control patches do not protect women against sexually transmitted infections (STIs), unlike male condoms.

Therefore, it is recommended to use dual protection of condoms and non-barrier contraceptives such as birth control patches during any sexual activity.

How To Use EVRA® Transdermal Patch?

Each pack of EVRA® Transdermal Patch contains 3 patches. Apply your first patch and wear it for 7 days. On day 8, change the patch to a new one. Change the patch every week for 3 weeks, and then have a patch-free week.

During your patch-free week, you’ll get a withdrawal bleed, like a period, although this may not always happen.

After 7 patch-free days, apply a new patch and start the 4-week cycle again. Start your new cycle even if you’re still bleeding.

Where to put the patch:

  • ​Always put your patch on clean, dry and hairless skin.
  • Put it on the buttock, abdomen, upper outer arm or upper back.
  • Put it on places where it won’t be rubbed by tight clothing.
  • Do not put on the breast or waistline, and on any open wounds, cuts or irritated skin.
  • Do not use adhesive or wraps to hold the patch in place.
  • Do not use creams, oils, lotions, powder or other skin care products on the application site. The patch may not stick well.

How to open the patch:

  • Open the foil sachet by tearing it along the edge with your fingers.
  • Peel away half of the clear protective covering without touching the sticky surface.

How to put the patch:

  • Put the patch on your skin and remove the other half of the protective covering.
  • Press down firmly on the patch with the palm of your hand for 10 seconds, making sure the edges stick well.

What To Do If The Patch Becomes Loose, Lifts At The Edges Or Falls Off?

Usually, the patch remains sticky, even if you get sweaty while exercising or take a shower. On rare occasions where the patch loosens (less than 3% of patches) or falls off (less than 2% of patches), you can follow the below steps to ensure you are still protected against pregnancies.

For less than 48 hours:

  • Try to put the same patch on again or put on a new patch immediately if:
    • it is no longer sticky;
    • it has become stuck to itself or on another surface or material; or
    • it is the second time it has become loose or has fallen off.
  • Change your patch on your normal change day.
  • You’re protected against pregnancy if you’ve used your patch correctly for the past 7 days (and the 7 days before your patch-free week, if you’re in week 1).

For 48 hours or more, or if you are unsure of the duration:

  • Put on a new patch immediately.
  • If you’re in week 1 or 2 of your patch cycle, change your patch on your normal change day.
  • If you’re in week 3, you need to start a new patch cycle (this is now day 1 of your new cycle) and skip your usual patch-free week.
  • Consider taking emergency contraception if you had unprotected sex in the last 7 days.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.

What To Do If I Forget To Change My Patch?

If you forget to change your patch for one to two days (up to 48 hours): 

  • Put on a new patch as soon as you remember.
  • Change your patch on your normal change day.
  • A barrier method of contraception is not needed.

If you forget to change your patch for more than two days (48 hours or more): 

  • Start a new four-week cycle as soon as possible.
  • Consider taking emergency contraception if you had unprotected sex in the last 7 days.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.

If you forget to take off your patch (at Week 4): 

  • Take it off as soon as you remember.
  • Start your next cycle on your normal “Patch Change Day”, the day after Day 28.
  • A barrier method of contraception is not needed.

If you forget to take off your patch (after Week 4):

  • Take it off as soon as you remember.
  • Put on the first patch of your new cycle as soon as you remember.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.
  • You now have a new “Patch Change Day” and new Day 1.

What Are The Potential Side Effects Of EVRA® Transdermal Patch?

Women who just started using EVRA® Transdermal Patch may experience some of the following side effects:

  • Nausea and bloating. Taking the medication after food may help reduce these side effects. 
  • Headache. Taking over-the-counter painkillers such as Paracetamol may help manage the pain.
  • Vaginal bleeding between periods (spotting).
  • Breast soreness.
  • Mood changes.

These symptoms vary among individuals and normally subside within 2-3 months as your body starts to get accustomed to the changes in hormone levels. Do inform your doctor if you experience any of these symptoms for longer than expected or if they are bothering you.

How To Buy EVRA® Transdermal Patch In Singapore?

Birth control patches are prescription-only medicines in Singapore. You would need to consult a doctor in person before you can get started on any birth control.

With Siena, you can have access to affordable birth control without leaving home. Simply complete an online questionnaire, and speak with a doctor online. If prescribed, your medication will be delivered to you in discreet packaging and at no additional charge.

References

Categories
Skin

Isotretinoin for Acne: How It Works, Potential Side Effects And Where To Buy In Singapore

Isotretinoin for Acne: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Gabriella Cetrulo

Acne is a common skin condition that affects over 80 percent of people at some point in life. 

While over-the-counter acne treatments are usually successful for light acne breakouts, many products that are great for milder forms of acne are almost totally ineffective against severe or persistent pimples. 

Commonly known by its original brand name Accutane, Isotretinoin is a potent drug that is U.S. Food and Drug Administration (FDA) approved in 1982 for hard-to-treat acne.

Read on to find out:

  • What is Isotretinoin;
  • How does Isotretinoin works;
  • How effective is Isotretinoin;
  • How to take Isotretinoin;
  • What to do if you missed a dose;
  • Potential side effects;
  • Pregnancy precautions; and
  • Where to buy Isotretinoin in Singapore.

What Is Isotretinoin?

Isotretinoin is available in capsule form and is a vitamin-A derivative (retinoid). Originally created to treat cancer, it is increasingly prescribed for the treatment of acne.

What Are The Requirements For Taking Isotretinoin?

Isotretinoin is typically used for patients with:

  • Severe, nodular acne or cystic acne; or 
  • Moderate to severe acne that has not responded to other acne treatments (such as over-the-counter treatments, topical benzoyl peroxide, topical clindamycin or oral antibiotics for acne); or 
  • Physical or emotional scarring.

What Is Moderate And Severe Acne?

In moderate acne, individuals present with more widespread blackheads and whiteheads, with many papules and pustules. Papules are small red bumps that may feel tender or sore. Pustules are similar to papules but have a white tip in the centre, which is a collection of pus.

In severe acne, individuals present with lots of large, painful papules, pustules, nodules or cysts; you might also have some scarring. Nodules present as large painful bumps and can be red or skin-coloured. Cysts are the most severe forms of acne. They are large and painful and often look like boils. Compared to nodules, cysts feel softer and are pus-filled.

What Is The Right Isotretinoin Dosage?

In Singapore, oral isotretinoin is available as 10 mg and 20 mg capsules (Acnotin® brand). Depending on your acne presentation and body weight, the dosage and treatment period required to treat the acne may vary among individuals. Many doctors start their patients on a graduated plan to help mitigate side effects and allow the body to adjust.

Which Brand Of Isotretinoin Is Better?

There are 4 brands of isotretinoin available in Singapore – Acnotin®, Nimegen®, Oratane® and Roaccutane®.

While the brand names are different, all of them contain isotretinoin as the active ingredient and are used for the treatment of moderate to severe acne, which has shown to be successful. They may differ slightly in the inactive ingredients but have little to no impact on the effectiveness of treatment.

How Does Isotretinoin Work?

Isotretinoin works by:

  • Reducing the size of oils glands in the skin and the amount of oil produced
  • Reducing the amount of bacteria in the skin
  • Slowing down the production of skin cells inside pores, preventing clogging of pores
  • Reducing skin inflammation

Unlike spot treatments, the drug addresses acne all over the body, including back, neck, and chest.

How Effective Is Isotretinoin?

First approved in 1982, Isotretinoin remains the most clinically effective prescription anti-acne treatment available that can clear acne and produce long-term remissions.

Isotretinoin is shown to be about 90% effective in reducing acne within 6 weeks of use. Most patients on Isotretinoin will be free of acne by the end of 4 – 6 months of treatment, depending on the dose administered.

How To Take Isotretinoin?

Follow these steps when you are taking Isotretinoin capsules:

  • Isotretinoin is usually taken twice daily for 15-20 weeks, or as directed by your doctor.
  • Swallow the capsule whole with a glass of water.
  • Do not chew or crush the capsule.
  • Take this medication with or after food.

What To Do If I Missed My Isotretinoin Capsule?

If you have forgotten to take a dose of Isotretinoin, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and take the next one at the usual time.

Do not take two doses to make up for the missed dose.

What Are The Potential Side Effects Of Isotretinoin?

As with all medications, Isotretinoin comes with its own set of side effects. These side effects may vary among individuals and tend to subside when you stop taking the medication.

Here are some of the common side effects associated with Isotretinoin:

  • Worsening of acne during the first few weeks before improvement
  • Red, cracked and sore lips. This can be managed by applying lip balm frequently.
  • Irritated and dry eyes. Apply eye drops or artificial tears to relieve the dryness. Do not use contact lenses if irritation persists.
  • Dry skin, sometimes with peeling. Apply moisturiser regularly.
  • Dry mouth. You may drink more water or suck on sweets.
  • Dry nose. In severe cases, nose bleeding may occur. Apply white soft paraffin to the lining inside of your nose. If unresolved, consult your pharmacist or doctor about decreasing the dose of Isotretinoin.
  • Increased risk of sunburn. Avoid direct sun exposure for long durations and wear protective clothing if exposed to direct sunlight. Use a broad-spectrum sunscreen product with a Sun Protection Factor (SPF) of at least 30.

Do not take vitamin A or any vitamin supplement containing vitamin A while using Isotretinoin, unless otherwise directed by your doctor. Doing so may increase the chance of side effects.

If these side effects are persistent or severe, stop treatment immediately and consult your doctor.

Pregnancy Precautions

Isotretinoin can cause very serious birth defects in humans if taken during pregnancy.

Women of childbearing years should rule out pregnancy by taking a pregnancy test before starting treatment. 

For women who are sexually active, it is recommended to use 2 forms of effective birth control while on treatment and at least 4 weeks after stopping Isotretinoin. The most effective forms of birth control are birth control pills, patches, shots, implants or IUD. One of these forms of birth control should be combined with a condom, a diaphragm, or a cervical cap.

Avoid breastfeeding during treatment as it’s unclear if the drug passes to your baby through breast milk.

Blood donation by males and females on Isotretinoin is not allowed in case the blood is used for a pregnant woman.

Where To Buy Isotretinoin In Singapore?

In Singapore, Isotretinoin can only be obtained with a valid doctor’s prescription. 

While extremely effective, Isotretinoin can come with some serious side effects. It is important to use Isotretinoin under the supervision of a doctor. 

At Siena, a MOH-approved digital health clinic, we carry a wide range of acne treatments ranging from topical cream/gel, oral antibiotics, birth control pills to Isotretinoin (Acnotin®). Find out the root cause of your pimples and get a personalised, ongoing acne treatment care plan by connecting with one of our friendly doctors online. Click here to get started!

References

Categories
Emergency Contraception

Ella® or Postinor®-2: How Are They Different and Which Emergency Contraception Is Better?

Ella® or Postinor®-2- How Are They Different and Which Emergency Contraception Is Better?
Image credit: Siena Health

Accidents happen, like the condom broke during sex, or you missed a birth control pill. This is when the morning-after pill, also known as emergency contraception, comes to mind. 

We all want our medications to work but many factors can affect the effectiveness of our medications. With emergency contraception, we will understandably be more concerned as the stakes are much higher.

Emergency contraception is available in two types: Ella® and Postinor®-2 (also known as Plan B). Some questions may then surface: What is the difference between Ella® or Postinor®-2? Which one is better at preventing pregnancy after sexual intercourse? Which one is more suitable for me?

In this article, we will discuss the main differences between Ella® and Postinor®-2.

Differences Between Ella® and Postinor®-2

There are 3 main differences between Ella® and Postinor®-2:

  1. Effectiveness and when they are most effective;
  2. Active ingredient; and
  3. Body Mass Index (BMI)

Effectiveness and when they are most effective

The key difference between Ella® and Postinor®-2 is the effectiveness at preventing pregnancy and when they should be taken after sexual intercourse to experience the maximum benefit.

Ella® is 98% effective at preventing pregnancies up to 120 hours (5 days) after unprotected sex and does not lose effectiveness over that time.

Postinor®-2 is only effective up to 72 hours (3 days) after unprotected sex and is less effective the later you take it in that 72-hour window:

  • 95% effective if taken within first 24 hours
  • 85% effective if taken within between 24-48 hours
  • 58% effective if taken within between 48-72 hours

Ella® reigns superior in terms of effectiveness and longevity. In comparison, Postinor®-2 is most effective only when it is taken within 24 hours after sexual intercourse.

Nevertheless, it is still recommended to take emergency contraceptive pills as soon as possible after sexual intercourse, to reduce the likelihood of pregnancy as much as possible.

Active Ingredient

The greatest difference between the two pills is the active ingredient used. Though using different modes of action, both pills ultimately prevent pregnancy.

The active ingredient present in Ella® is ulipristal acetate, a Selective Progesterone Receptor Modulator (SPRM). It suppresses the release of progesterone, a hormone involved in the menstrual cycle, for an extended duration. This results in a delay or inhibition in the release of an egg (ovulation). During this period, sperms which have entered the woman’s body will die. Over time, when the effects of Ella® wane and progesterone levels increase to release an egg, there is no remaining sperm to fertilise it.

On the other hand, levonorgestrel in Postinor®-2 is the active ingredient that prevents pregnancy. Levonorgestrel is a progestogen, which mimics the effects of progesterone. With higher levels of progesterone, effects include:

  • Inhibiting implantation of the fertilised egg on the uterine lining;
  • Stimulating the motility of the fallopian tube;
  • Increasing the viscosity of the cervical mucus, preventing the sperm from reaching the egg.

Body Mass Index (BMI)

Another important factor to consider when deciding between Ella® and Postinor®-2 is BMI. Differences in treatment effectiveness are significant for women with higher BMI.

Evidence has shown that, in general, the risk of pregnancy is much greater in obese women with BMI above 30 as compared to women with normal BMI. Comparing Ella® and Postinor®-2 in obese women, the risk of pregnancy is greater for those taking Postinor®-2.

Which Emergency Contraception Is Better?

There is no definite answer to this question.

Though both Ella® and Postinor®-2 are effective at preventing pregnancy, it is important to consider your circumstances, needs and preferences to decide which emergency contraceptive pill is better suited for you.

How To Get Emergency Contraception In Singapore?

In Singapore, regardless of age, women can only obtain emergency contraception with a valid prescription by a doctor (usually a general practitioner can help).

Need emergency contraception? As a MOH-approved digital health clinic, Siena offers online emergency contraception consultation with one of our friendly doctors, all from the comfort and privacy of your home. If prescribed, the emergency contraception will be delivered in discreet packaging to your doorstep, in 4 hours.

No more rushing, no more panicking!

References

Categories
Birth Control

Yaz® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore

Yaz® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

From birth control pills and patches, to condoms and intrauterine devices (IUD) — have you ever been at a crossroad, debating about which contraceptive to use? If you decided to take “the pill”, then have you ever wondered which one is most suitable for you out of so many brands available?

With a myriad of contraceptive methods available in Singapore, we will be sharing more about some of the more commonly used ones. In this article, we share more about Yaz®:

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Yaz® in Singapore.

What Is Yaz®? 

Yaz® is a brand-name combination birth control pill containing 2 hormones:

  • Progestogen (3mg drospirenone); and
  • Estrogen (0.02mg ethinylestradiol).

Drospera® is a generic version of the brand-name drug Yaz®.

On top of preventing unwanted pregnancies, Yaz® is also FDA-approved to:

  • Treat moderate acne in women who are at least 14 years old and have started having menstrual periods, and who wish to start on birth control pills; and
  • Manage symptoms of premenstrual dysphoric disorder (PMDD).

Some women also take Yaz® for other non-contraceptive purposes such as to:

How Does Yaz® Work? 

Yaz® prevents pregnancy by:

  • Inhibiting ovulation, which is the release of an egg from the ovary;
  • Thickening of the cervical mucus (the fluid in your vaginal tract) which serves as an impedance for the sperm making its way to the egg for fertilisation; and
  • Thinning of the uterine lining, which prevents the fertilised egg from attaching to the uterus, and it would be passed out of the body instead, preventing pregnancy.

How Effective Is Yaz®?

A report by the Centers for Disease Control and Prevention shows that Yaz® is more than 99% effective in preventing pregnancy when used perfectly. However, missed pills and improper storage may occur day-to-day. Hence, in typical use, Yaz® is around 91% effective. 

This shows that birth control pills are more effective than male condoms in preventing pregnancy, with male condoms being 98% effective when used perfectly, and 82% effective in typical use. However, birth control pills do not protect against sexually transmitted infections (STIs), which male condoms do.

Therefore, always use dual protection of condoms and non-barrier contraceptives such as birth control pills during any sexual activity.

How To Take Yaz® Birth Control Pills?

Yaz® contains a total of 28 tablets: 24 pink (active) tablets and 4 white (inactive, hormone-free) tablets. You should take one tablet daily for 28 days in a row, preferably at the same time every day after food, in the correct sequence as indicated on the packaging.

The next pack of Yaz® is immediately started after the last tablet of the previous pack. Withdrawal bleeding (menses) usually starts during the week when you are taking the white tablets.

What To Do If I Missed My Yaz® 30 Birth Control Pill?

It is considered a missed dose, if:

  • you missed a dose for more than 24 hours after your usual time when a tablet is supposed to be taken; or
  • vomiting or diarrhoea occurs within 3 to 4 hours following pill taking.

Missed white film-coated tablets can be disregarded. However, you must follow the steps below if you miss any 24 pink (hormone-containing) tablets to ensure that the contraceptive effect is not reduced.

If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill:

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately.
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day).
  3. Take the 4 inactive pills.
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle.
  5. No additional contraceptive protection (e.g. condoms) is needed.

If you missed two or more active pills (48 hours or more):

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day. 
  2. Discard any earlier missed pills.
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take the 4 inactive pills
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 24): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the 4 inactive pills
      • Begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days.
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days.

What Are The Potential Side Effects Of Yaz®?

With all medications, you may experience some side effects when you first start taking Yaz® such as:

  • Nausea. Take Yaz® after food to reduce these side effects. 
  • Headache. Can be managed by taking over-the-counter painkillers such as Paracetamol.
  • Spotting between your periods during the first few months of taking oral contraceptives.
  • Breast tenderness
  • Weight changes due to fluid retention, mood swings. Take Yaz® at the same time every day to avoid huge changes in the hormone levels in your body.

These symptoms may vary among individuals. As your body gets accustomed to the changes in hormone levels, these symptoms may subside within 2-3 months. However, do consult your doctor if you experience any symptoms for longer than expected or if they are bothering you.

If you missed 2 menstrual periods in a row (or 1 menstrual period if the pill has been incorrectly used), contact your doctor for a pregnancy test.

Where To Buy Yaz® In Singapore?

Birth control pills cannot be obtained over-the-counter in Singapore — you’ll need to get a prescription from a general practitioner or gynaecologist if you wish to get your hands on birth control pills like Yaz®. 

Conventionally, that will mean taking time off work to travel to a physical clinic. With a MOH-approved digital women health clinic like Siena, you can get an online prescription for your birth control needs without leaving home! 

Simply complete an online medical questionnaire and our doctor will video call you at a time of your convenience for a tele-consult. If prescribed, your medication will be delivered to you in discreet packaging at no additional charge.

References

Categories
Birth Control

Microgynon® 30 Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore

Microgynon® 30 Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

If you’re concerned about becoming pregnant, the birth control pill (better known as simply “the pill”) is one of the safest, most reliable forms of contraception available.

In this article, we share all you need to know about one of the popular birth control pill brands in Singapore, Microgynon® 30:

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Microgynon® 30 in Singapore.

What Is Microgynon® 30? 

Microgynon® 30 is a brand-name combination birth control pill. It contains 2 hormones:

  • Progestogen (0.15mg levonorgestrel); and
  • Estrogen (0.03mg ethinylestradiol).

Microgynon® 30 is mainly used as contraception to prevent pregnancy. However, women taking Microgynon® 30 may also benefit from the non-contraceptive effects of estrogen such as:

How Does Microgynon® 30 Work? 

Microgynon® 30 prevents pregnancy by:

  • inhibiting ovulation, which is the release of an egg from the ovary
  • thickening the cervical mucus (the fluid in your vaginal tract). This makes it hard for the sperm to reach the egg to fertilise it.
  • thinning of the uterine lining, so that even if an egg is fertilised, it will be unable to attach to the uterus. The fertilised egg will instead be passed out of the body.

How Effective Is Microgynon® 30?

According to the Centers for Disease Control and Prevention, when used perfectly, Microgynon® 30 is more than 99% effective in preventing pregnancy. However, possibly due to missed pills or improper storage, Microgynon® 30 is typically around 91% effective. 

Birth control pills are generally more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, it is important to note that birth control pills do not protect women against sexually transmitted infections (STIs), unlike male condoms.

Therefore, always use dual protection of condoms and non-barrier contraceptives such as birth control pills during any sexual activity.

How To Take Microgynon® 30 Birth Control Pills?

Microgynon® 30 contains 21 pills. This means that you need to take a pill at the same time every day, for 21 days. You should swallow each pill whole with water. Do not chew the pill.

The back of the pill strip states the days of the week (Monday – Sunday). Start your course by taking a pill marked with the correct day of the week and follow the direction of the arrows on the strip. This is followed by 7 days where no pills are taken.

A few days after taking the last pill from the strip, you will experience a withdrawal bleed, similar to having your period. During the 7 pill-free break, you do not need to use extra contraception such as condoms, as long as you have taken your pills correctly and start the next strip of Microgynon® 30 on time.

What To Do If I Missed My Microgynon® 30 Birth Control Pill?

A regular routine of taking your birth control pills at the same time every day during the 21 days regimen is desirable. This is because taking a pill late or missing doses may affect the effectiveness of the pill in preventing pregnancy.

Microgynon® 30 is considered “missed” if you:

  • don’t take it for 24 hours or more after you were supposed to; or
  • vomit or suffer from diarrhoea within 3 to 4 hours of pill-taking.

Follow these steps below if you have forgotten to take a pill:

​​If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill:

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately.
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day).
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills.
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle.
  5. No additional contraceptive protection (e.g. condoms) is needed.

If you missed two or more active pills (48 hours or more):

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day. 
  2. Discard any earlier missed pills.
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days.
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days.

What Are The Potential Side Effects Of Microgynon® 30?

Women who just started taking Microgynon® 30 may experience some of the following side effects:

  • Nausea and bloating. Taking the medication after food may help reduce these side effects. 
  • Headache. Taking over-the-counter painkillers such as Paracetamol may help manage the pain.
  • Vaginal bleeding between periods (spotting)
  • Breast soreness
  • Mood changes. To avoid huge changes in the hormone levels in your body, it is recommended to take Microgynon® 30 around the same time every day.

These symptoms vary among individuals and normally subside within 2-3 months as your body starts to get accustomed to the changes in hormone levels. Do inform your doctor if you experience any of these symptoms for longer than expected or if they are bothering you.

Where To Buy Microgynon® 30 In Singapore?

Birth control pills are prescription-only medicines in Singapore. You would need to consult a doctor in person before you can get started on any birth control.

With Siena, you can have access to affordable birth control from the comfort of your home. Simply complete an online questionnaire, and speak with a doctor online. If prescribed, your medication will be delivered to you in discreet packaging and at no additional charge.

References

Categories
Birth Control

Yasmin® Birth Control: How It Works, Potential Side Effects & Where To Buy In Singapore

Yasmin® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

Contraceptives come in many different forms — birth control pills and patches, condoms, intrauterine devices (IUD). 

In this article, we share all you need to know about one of the most common birth control pill brands in Singapore — Yasmin®: 

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Yasmin® in Singapore.

What Is Yasmin®? 

Yasmin® is a brand-name combination birth control pill that contains 2 hormones: 

  • Progestogin (3mg drospirenone); and 
  • Estrogen (0.03mg ethinylestradiol).

Liza® is a generic version of the brand-name drug Yasmin®.

Besides preventing unwanted pregnancies, Yasmin® can also help to:

How Does Yasmin® Work? 

Yasmin® prevents pregnancy by inhibiting ovulation, the release of an egg from the ovary. 

Besides preventing ovulation, Yasmin® also thickens cervical mucus (the fluid in your vaginal tract) making it hard for sperm to reach the egg to fertilise it. 

Yasmin® also causes thinning of the uterine lining, so that even if an egg is fertilised, it will be unable to attach to the uterus, and instead be passed out of the body. 

How Effective Is Yasmin®?

According to the Centers for Disease Control and Prevention, Yasmin® is more than 99% effective in preventing pregnancy when used perfectly. However, in typical use (due to missed pills or improper storage), Yasmin® is around 91% effective. 

Birth control pills are more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, birth control pills will not prevent or protect you and your partner from sexually transmitted infections (STIs) unlike male condoms. 

Therefore, it is still important to practice dual protection for safer sex — use both birth control pills and condoms.

How To Take Yasmin® Birth Control Pill?

Yasmin® contains 21 active pills. You should take one pill at the same time every day for 21 days, followed by 7 days where you take no pills. During the pill-free days, a withdrawal bleed usually occurs that is similar to having your period. After the 7-day pill-free interval, start on a new pack of Yasmin® whether or not you have any menstrual bleeding.

You should swallow each pill whole with water. Do not chew the pill. The back of the pill strip states the days of the week (Monday – Sunday). Start your course by taking a pill marked with the correct day of the week and follow the direction of the arrows on the strip.

What To Do If I Missed My Yasmin® Birth Control Pill?

You should establish a regular routine of taking your birth control pills at the same time every day during the 21 days. This is because taking a pill late or missing pills may affect the effectiveness of the pill in preventing pregnancy. 

Yasmin® is considered “missed” if you:

  • don’t take it for 24 hours or more after you were supposed to; or
  • vomit or suffer from diarrhoea within 3 to 4 hours of pill-taking.

If you forget to take a pill, here’s what you should do: 

​​If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day)
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills 
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle
  5. No additional contraceptive protection (e.g. condoms) needed

If you missed two or more active pills (48 hours or more)

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day 
  2. Discard any earlier missed pills 
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days 

What Are The Potential Side Effects Of Yasmin®?

Women who just started taking Yasmin® may experience some of the following side effects:

  • Nausea, vomiting, bloating and stomach cramps. Take Yasmin® after food to reduce these side effects. 
  • Headache. Can be managed by taking over-the-counter painkillers such as Paracetamol.
  • Spotting between your periods during the first few months of taking oral contraceptives.
  • Breast tenderness
  • Weight changes due to fluid retention, mood swings. Take Yasmin® at the same time every day to avoid huge changes in the hormone levels in your body.

Side effects vary widely among individuals and usually ease within 2–3 months of starting to take the pill as your body adjusts to the hormones. Inform your doctor if the side effects last for a long time (more than 3 months) or bother you.

How To Buy Yasmin® In Singapore?

Birth control pills are only available with a prescription, so you need to consult a doctor. Conventionally, this means you would need to carve out time to go down to a clinic for a doctor’s consultation before you can get started on birth control. 

Siena is a digital health clinic that offers you easy and affordable access to birth control. Simply complete an online questionnaire, and speak with a doctor online from the comfort of your home. If prescribed, we deliver your birth control to you in discreet packaging at no additional charge.

References

Categories
Birth Control Health Sexual Health

Generic versus Brand Name Birth Control: Everything You Need To Know To Decide Between The Two

When it comes to choosing your preferred choice of birth control pills, do you perceive brand name to be better than generic? Well perhaps, it’s time to rethink some of the criteria you typically use to evaluate whether one is better than the other! 

After all, both brand and generic birth control have to undergo rigorous review processes to establish their safety and effectiveness, before being approved for sale by the United States Food and Drug Administration (FDA). 

By the time you’re done with this article, you’ll hopefully get a better idea of their similarities, differences and why there’s no reason to worry no matter which type of birth control pills you’re prescribed. 

What Is A Brand Name Birth Control Pill? 

They’re the pioneers and innovators! Brand name birth control is exclusively protected under a 20-year patent before the generic version of the drug can be released. 

Some of the common brand names include Yaz, Yasmin, Microgynon 30, Mercilon and Diane 35. 

What Is A Generic Birth Control Pill? 

As the term suggests, they are the generic versions of brand name birth control. Once the patent expires, generics can enter the market to compete too. 

According to the FDA, generics are “copies of brand name drugs that have exactly the same dose, intended use, side effects, route of administration, risks, safety, and strength as the original drug.”

Liza, Estelle 35 and Drospera are a few examples of generic birth control pills. 

So You Might Be Wondering, What’s The Difference Between Generic And Brand Name Birth Control Pills? 

By law, trademark protection requires generic drugs to look different from their brand name counterparts despite having the same effects. Thus, they differ in terms of: 

  • Size 
  • Shape
  • Colour
  • Packaging 
  • Inactive ingredients (e.g. fillers, flavours, preservatives, binders) 

However, it’s important to note that these slight variations will not affect the efficacy of the birth control pills for pregnancy prevention although they may affect the type of side effects you experience (if any).

Some women may face breakthrough bleeding, mood changes, acne or other side effects when switching from one type of birth control to another. 

Birth control has many other benefits besides preventing pregnancy. It is often used to treat heavy menstrual bleeding, period cramps, and PMS. If you’re more sensitive to hormonal variations, you may also find brand name birth control more suitable compared to generics. 

One last differentiating factor between generic and brand name birth control is the cost. Generics are cheaper as they can cost up to 85% less than the branded version.

But ultimately, they work the same! 

Clearing Your Misconceptions On Generic Birth Control

As you’ll see in this section, especially for those of you who are still wary about going on generic birth control, there’s no need to get worked up if you’re prescribed generics!

Generic birth control is as safe and effective as the original brand name birth control

Don’t you worry, both generic and brand name birth control have the same benefits and effects. Manufacturers have to prove that the drugs are bioequivalent, such that they work the same way and are proven to be equally effective. 

Generic drugs can only be FDA-approved if they meet all the same requirements that are also applied to brand name drugs. They also have to adhere to the same quality, strength and purity standards as branded birth control. 

Cheaper doesn’t mean it’s less effective 

You pay for what you get right? Yeah, we know what you might be thinking. 

But it’s different when it comes to birth control medications. The quality of your generic birth control pill is not at all compromised despite its lower cost! In fact, the majority of women also do well on generic birth control. 

The only reason why generics are less expensive is simply because they didn’t have to invest in actually creating the drug. New drugs are usually subjected to years of testing through clinical trials, research and development which can cost up to millions of dollars. 

But for pharmaceutical companies manufacturing generic birth control, all they need to do is manufacture the product and here’s the good news. They pass on these savings to customers like you!

What To Do If You Experience Problems With Your Birth Control Pills

Generally, as both generic and brand name birth control contain the same active ingredients, any side effects are likely to be similar even if you decide to opt for the latter. 

If you do experience problems, definitely seek professional advice from your doctor. If you recently changed your birth control, ask to be switched back to the one you’re used to, or even another generic version of the same formula.  

Should I Choose Branded or Generic Birth Control? 

It really depends on you. We’re just here to assure you that no matter which type of birth control you choose, they’re all safe and work the same!

But if cost is a factor for you when it comes to buying birth control, it might be worth trying generic birth control pills first.

And if you’re sensitive or possibly allergic to certain drugs or ingredients, have a look at the list of inactive ingredients before you decide. Although in most cases, you usually won’t be able to predict and know for sure how your body will react to the contraceptive pill till you try it.

Remember, be patient with yourself as it’s all about trial and error! Here at Siena, we’re ready to help you explore your options just so you can find the perfect birth control suitable for your unique bodies.

References: 

Categories
Birth Control Health Period

Polycystic Ovary Syndrome (PCOS): Symptoms, Causes and Treatment

symptoms, causes and treatment for polycystic ovary syndrome (PCOS)
Image credit: Getty Images

Feel like you never get your periods? Or when you do get them, it seems like there’s no end to it? Well, you may be suffering from a condition called polycystic ovary syndrome (PCOS) that affects your hormone levels.

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a common hormonal disorder that affects approximately 10% of women who are of reproductive age. The infrequent or prolonged menstrual periods caused by excess male hormones or androgen levels are one of the most obvious signs of PCOS.

Those suffering from PCOS have an imbalance of female hormones that prevents their ovaries from releasing an egg monthly. As a result, the ovaries end up developing countless small collections of fluid sacs (follicles) and fail to regularly release eggs. Each sac contains an immature egg that is unable to mature enough to trigger ovulation. 

You may be wondering where the term “polycystic” comes from. As the unreleased eggs remain in the ovaries, these multiple small cysts contribute to the polycystic appearance of the ovaries.

Essentially, by also producing higher-than-normal amounts of male hormones leading to hormonal balance, this causes your body to skip menstrual periods and makes it harder for you to get pregnant.

Image credit: National University Hospital

Signs and Symptoms of PCOS

Signs and symptoms of PCOS often develop during puberty, around the time you go through your first menstrual cycle. However, PCOS can also develop at a later stage due to substantial weight gain. 

You’ll definitely want to pay attention to: 

  • Irregular periods: could be infrequent, prolonged or even absent 
  • Heavy bleeding 
  • Hair growth
  • Acne 
  • Weight gain
  • Male-pattern baldness 
  • Darkening of the skin
  • Headaches

If you think you have PCOS, you should observe and track your periods as they are usually the most common signs. 

Other symptoms that may be more obvious are associated with physical changes. These refer to excess facial and body hair, severe acne and male-pattern baldness as they signify the presence of excess androgen in your body. 

Severe symptoms usually arise if you’re obese.

Causes of PCOS 

So far, the exact cause for PCOS is unknown although it may be hereditary as research suggests genes also contribute to PCOS. 

But the most commonly cited reason is probably excess male hormones called androgen. Women normally produce androgen in small quantities but for those with PCOS, they produce an excessive amount which explains the male-pattern hair growth (i.e. on the chin, chest, inner thighs, etc) and the formation of acne. When your ovaries produce abnormally high levels of androgen, you can also gain weight both easily and quickly.

Some studies have also shown that excess insulin increases androgen production which contributes to PCOS. Insulin is the hormone produced in your pancreas allowing cells to use sugar and also acts as your body’s primary sugar supply. If your cells become insulin-resistant, your blood sugar levels can rise thus causing your body to produce more insulin. 

How is PCOS Diagnosed? 

A diagnosis of PCOS is made when you experience at least two of these signs: 

Irregular periods– Infrequent, irregular or prolonged menstrual cycles are the most common signs of PCOS.
– A good gauge would be: if you have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods. 
Excess androgen Elevated levels of male hormones (androgen) may cause physical changes like excess facial and body hair (hirsutism), occasionally severe acne and male-pattern baldness. 
Polycystic ovariesEnlarged ovaries that contain follicles surrounding the eggs. Thus, the ovaries may not be able to function regularly. 
Diagnosing PCOS

Other ways to diagnose PCOS:

  1. Hormonal blood tests
    • By analysing your blood to measure your hormone levels, you can then safely exclude other plausible causes like menstrual abnormalities or merely androgen excess mimicking PCOS. 
  2. Pelvic ultrasound scan
    • Examine the appearance of your reproductive organs and the thickness of your uterine lining. 

Targeted Treatments To Cope With PCOS

PCOS is not completely reversible but several treatments can help reduce or minimise uncomfortable symptoms, allowing you to better cope with the condition. 

Birth control for irregular periods and its related symptoms 

Already on birth control? Well, you may be killing two birds with one stone if you’re currently struggling with PCOS too. 

Combined hormonal contraceptives are usually prescribed to control various PCOS symptoms. Some examples are the combined birth control pill, patch and even the vaginal ring. The estrogen and progestin hormones present in the hormonal birth control help decrease androgen and regulate estrogen levels instead.

To treat irregular periods (a common PCOS symptom), combined hormonal contraceptives are also recommended to aid in fixing hormonal imbalance and regulating the menstrual cycle.

What’s more, regulating hormones can even lower your risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne! 

Clomiphene or surgery for infertility 

The irregular and infrequent ovulation caused by PCOS can make it difficult for you to conceive. So if you’re planning for a baby or if you intend to get pregnant in the near future, it’ll definitely be useful to know that ovulation can be artificially induced using medications. 

A common drug used to induce ovulation is clomiphene (Clomid) which has to be taken orally for five days. If the tablet fails, you may need to consider hormone injections to stimulate the ovaries. But of course, this depends on the recommended treatment plan based on professional advice and guidance from your doctor or specialist. 

If you find that your body is unresponsive to medical treatment, there’s also the option for surgery. Laparoscopic ovarian drilling is typically used to trigger ovulation by using electrocautery or a laser to destroy parts of the ovaries. This corrects hormonal imbalance and restores normal ovulation. 

Hair removal medications for excessive hair growth

Excess hair may be something you’re not used to and find frustrating when you experience PCOS symptoms. Several fuss-free and convenient techniques include depilatory creams, shaving, waxing, bleaching, plucking and electrolysis. However, these methods have to be sustained or repeated in order to manage hair growth.

Suppression of male hormone production with tablets like the oral contraceptive pill or anti-male hormone drug may also reduce excessive hair growth if used for at least nine months. 

Lastly, you can also consider laser hair removal as it’s the most effective long-term method to help tackle the problem of excess hair. However, it’s probably one of the most expensive options as well. 

Lifestyle changes 

As substantial weight gain has also been attributed to PCOS, paying attention to your diet and regularly exercising to reduce excess weight may help to improve symptoms by restoring normal hormonal balance. 

To do so, you can also limit your intake of carbohydrates to increase insulin levels, or opt for food high in complex carbohydrates (e.g. whole grains and vegetables) to gradually raise your blood sugar levels. 

The Bottom Line 

If you suspect you have PCOS, it’s really important to seek timely and appropriate treatment to prevent further complications. That said, always seek help from your doctor first to figure out the best approach or course of treatment for your body and lifestyle.

Considering birth control? Here at Siena, we also want to help you find a solution to help you manage your PCOS symptoms. If you’re considering birth control, don’t hesitate to reach out and book a consult with one of our female doctors to explore your options! 

References: 

Categories
Birth Control Emergency Contraception Health Sexual Health

Missed Birth Control Pills: What To Do If You Forget Your Pills?

Credit: Illustration by Siena Health

Realising you missed your birth control pills can be a scary and stressful experience, and we know that. So here’s a step-by-step guide on what you can do to ease your worries! 

Perhaps you were running late and in a moment of panic, you couldn’t afford to indulge in your regular morning routine. Or you didn’t purchase your refills in time and realised it was way too late. 

Whichever’s the case, missing your birth control pills can most definitely leave you in a flurry, especially when you have devoted yourself to it. But alas, it happens so don’t beat yourself up about it! Thankfully, there are ways to manage this (mini) crisis. 

If you missed your pills, your next line of action should take into consideration:

  • Number of pills you have missed 
  • When you missed the pill (how far in are you with your pack)
  • Type of birth control pill you’re on (combined contraceptive pill or the progestogen-only pill)

The information leaflet that comes with your contraceptive pills should also have stated specific instructions on the steps you should take regarding the specific brand of birth control you are on. 

Symptoms you may notice if you missed your pills 

If you aren’t 100% sure, there are several symptoms that are pretty clear indicators you missed taking your birth control pills. The most common side effect is light bleeding or starting your period. You may experience menstrual cramps and nausea associated with it. 

Typically, there’s nothing to worry about and everything should return to normal once you’re back on the contraceptive pills regularly!

Combined contraceptive pill

The combined contraceptive pill contains both estrogen and progestin. There is a great variety of combined contraceptive pills you can choose from but some of the common combination pill brand names include Yaz, Yasmin, Microgynon 30, Liza, Mercilon and Drospera. A combination pill is considered “missed” if you don’t take it for 24 hours or more after you were supposed to. 

If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day)
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills 
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle
  5. No additional contraceptive protection (e.g. condoms) needed

If you missed two or more active pills (48 hours or more)

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day 
  2. Discard any earlier missed pills 
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take the inactive (sugar) pills or a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the inactive (sugar) pills or a 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days 

If you missed inactive pills 

If you miss 1 or more inactive (sugar) pills, simply throw away the missed pills and take the next pill at the usual time. Remember, you also have to stay on track with your active pills as there should be no more than 7 consecutive active pill-free days between packs.  

Missed birth control pills: a brief overview

ScenarioRecommended ActionsEmergency ContraceptionBack-up Birth Control
Late or missed 1 active pill– Take the late or missed pill immediately
– Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day).		Consider only if you missed the pill earlier in the pack or in the last week of your previous packNot required
Missed 2 or more active pills– Take the last pill that you missed immediately even if it means taking 2 pills a day
– Discard any earlier missed pills 

If you missed the pill within week 1 – 2 of the pack (pills 1 to 14):
– Continue to take the active pills in your current pack daily
– Take the inactive (sugar) pills or a 7-day break, begin a new pack the next day

If you missed the pill within week 3 of the pack (pills 15 to 21):
– Continue to take the active pills in your current pack daily
– Skip the inactive (sugar) pills or 7-day break, begin a new pack the next day		Consider only if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days.Use extra contraception or abstain from sex for the next 7 days 
Missed 1 or more inactive pills– Discard missed pills and take the next pill at the usual timeNot requiredNot required

Progestogen-only pill or mini pill 

Unlike the combined contraceptive pill, progestogen-only pills (aka mini pills) contain progestin and not estrogen. They are taken continuously without any hormone-free breaks. 

If you missed a pill within the 3-hour (mini pills) or 12-hour window period (desogestrel pill)

You will still be protected against pregnancy if you are: 

  • Less than 3 hours late in taking a progestogen-only pill
  • Less than 12 hours late in taking a desogestrel pill

What you should do: 

  1. Take your missed pill as soon as you remember 
  2. Take your next pill at the usual time 
  3. There’s no need for an additional form of contraception or emergency contraception even if you’ve had unprotected sex

If you missed a pill for more than 3 hours (mini pills) or 12 hours (desogestrel pill)

Heads-up, according to the National Health Service, you’re likely unprotected against pregnancy! 

What you should do: 

  1. Take 1 pill as soon as you remember even if you have missed more than 1 pill
  2. Take your next pill at the usual time – this may mean taking 2 pills in a day (1 when you remember and the other at the usual time) which is totally okay to do so 
  3. Continue taking your remaining pills daily at the same time 
  4. You may need emergency contraception if you’ve had unprotected sex in the last 5 days
  5. Use back-up contraceptives for the next 2 days (48 hours) after taking the missed pills or simply refrain from having sex 

Useful tips to help you remember to take your pills on time

Whether or not you’re trying out a new routine to remind yourself to take the pill or ensuring you’re way more well-equipped after your first “missed birth control pill” scare, the following list of tips we’ve compiled will definitely help you.  

  • Opt for another birth control method such as the patch as it only needs to be changed once a week 
  • Set a recurring alarm or reminder on your phone 
  • Use a birth control pill reminder application 
  • Incorporate it into your daily routine 
  • Place the pills in an easily noticeable spot (e.g. bedside table, beside your toothbrush)
  • Get your partner to remind you

Seek help if you need to

We totally get that it can be real confusing knowing you missed your pill and the follow-up steps taken vary depending on what type of birth control pill you’re on. But hopefully, this condensed guide can be your saving grace in times of need (and that you won’t be referencing it anytime soon!).

Feel free to reach out to Siena’s doctors, if you are unsure which instructions pertain to your oral contraceptive pills or to discuss any other concerns you may have with your birth control method. 

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