Choosing an OC

[JJFigure]

After W6's Yasmin post, it looks like I need to be looking for a different OC. I've been reading old posts and went to the websitehttp://www.fpnotebook.com/GYN110.htm that compares progestational, estrogenic, and androgenic activity, and have a question. As a natty BB, which type of of the three do I care more about? Should it be more important for the estrogenic activity to be low? Androgenic? It seems there is no option where all three are low.

For example, Alesse seems to be a frequent choice by other women on the board; it has the following profile:

Relative Progestational Activity: 0.5 (low)
Estrogenic Activity: 17 (low)
Androgenic Activity: 0.31 (moderate)

Another choice is Loestrin Fe 1.5/30, which has the following profile:

Relative Progestational Activity: 0.3 (low)
Estrogenic Activity: 35 (moderate)
Androgenic Activity: 0.15 (low)

If it were more important that estrogenic activity be low, I'd go with the Alesse; if it were more important for androgenic activity to be low, I'd go with the Loestrin Fe.

NewGirl also mentioned Orthocept, but I can't find it on this website, so I don't know what type of profile it has. I'd appreciate any help; I need to make a choice early this week.

And the IUD is out - haven't decided on the children issue yet, and since I'm 32, I'd rather not use a longer term solution until I decide whether or not I want to have children.

 

[JJFigure]

Found the Ortho-cept:

Relative Progestational Activity: 1.0 (moderate)
Estrogenic Activity: 30 (moderate)
Androgenic Activity: 0.17 (low)

 

[newgirl-chargeback]

JJ -- I am not a bber however I loved orthocept. As far as estrogenic fat goes, I cannot be a good judge as I am not a competitor, nor have I forced my bf levels to the point that you would need or want. But I found the sides to be less of all I have used over the years and periods were extremely light -- like 2-3 days and flow very moderate to very light. HOWEVER, if you are off dose by just a few hours, I would have break thru bleeding.

Just an FYI.

 

[JJFigure]

W6? MS?

 

[wilson6]

Those stated activities may not translate into what you might expect with regard to body composition change while using the different OCs. For example, how do they define androgenic activity? Virilizing potential or stimulus of muscle protein synthesis. My guess is that it isn't muscle protein synthesis.

Besides, not everyone will respond the same. Best thing is to try each one for at least 6 months and keep training and diet consistent, then monitor body composition changes. Then decide which OC works best for you.

W6

 

[KEL]

try the nuvaring

 

[JJFigure]

Well, it seems taking the time to research this didn't even matter. My doctor just picked one on her own after I told her I wanted to switch to something different from Yasmin. She picked Aviane, which is a generic brand of Alesse. Luckily, that was one of the two I had settled on, but still... She actually seemed a little offended I was even researching on my own. She only sees me once a year, and I'm the only competitive athlete she has. What does it hurt that I want to be informed about how OC will impact me as a BB'er? I really like her and assume I'd probably get the same reaction from any doctor - I just don't understand why they have to be like that.

 

[newgirl-chargeback]

Unfortunately, JJ, they feel they are god and should not be questioned. My best friend is a nephrologist who actually has NO friends in the medical field unless they do research as she has found that every regularly practicing doctor that SHE knows, has a feeling of superiority and cannot be wrong and they are just GOD.

You did the right thing looking out for you and your health. Still, please keep me posted as to how you like it.

 

[FitFossil]

Unfortunately some doctors DO have a god complex. In my experience, a lot of these same doctors are HARDLY walking advertisements for their supposed superior knowledge of good health. As with other subjects, it's my belief that false confidence is a sign of insecurity.

Even so, you still have to take into account how so many patients take no interest in their health until something's wrong, and then they just expect the doctor to fix it, with some drug or surgery - no questions asked.

Doctors aren't very accustomed to patients taking responsibility for their health, god complex or not. On a different note, a lot of the "research" doctors hear from patients is some sort of bunk they got from a less than reliable source. So even if the patient really has good information, it may still take a moment for the doctor to tune in and listen, but if they do, you have a keeper.

 

[Candi Barr]

Have you considered barrier methods? I tried the pill for 6 months as a teenager and felt it made my asthma worse, then used a diaphram successfully. There are other choices as well.

 

[JJFigure]

I tried the diaphram and didn't like it at all. I hope, with the lower estrogen pills, that I won't have many problems with the pill. I really didn't have problems with Ortho Novum - just heavy water retention 2 weeks every month. The main thing I like about the pill is it regulates my cycle - before I started to take the pill I was very irregular. At least now I know exactly when my period is. Hopefully, this new one will work out ok.

 

[Nonerz]

there is also "the patch" which is applied directly to the skin and is replaced with a new on for 3 consecutive weeks...then off for one week. you can find the website if you do a search...they have a good info-video via the web and lots of information. i found it to be very similar to the pill and very simple (especially if you are forgetfull or have an odd day-to-day schedule). they are remarkably thin and are even stay on in the water.

 

[JJFigure]

Well, after reading about how the low dose OCs supress free testosterone, I've given up on OC - at least as long as I'm competing. I'm looking into my other options - MS pointed me toward the Mirena IUS - and of course, I can always just abstain. That's much less fun, but at least I don't worry about getting pregnant. Men have it so easy.

 

[newgirl-chargeback]

JJ -- Mirena does release low dose hormones. While MS is alot smarter in this arena than I am (or most of the population for that matter), I am disputing her -- but I would check their website. When I decided to go off OC myself and asked my doc about Mirena instead, she said it was not much of a difference with regards to the impact of hormones on a body that is trying to lessen the overall estrogenic effect.

 

[JJFigure]

Yes, but Mirena has 1/7th of the dosage that an OC would have. I think Mirena may be my long term choice, but not my short term choice. I haven't decided if I'm going to continue competing after my June comps, so I'll hold off making a long term decision until then. Short term I guess we'll just have to double-up with non-hormonal methods.

 

[newgirl-chargeback]

Well in any event...and a missed point on my part...GOOD LUCK in contest prep.

Your decision to use nothing for now is the best bet.

 

[MS]

"asked my
doc about Mirena instead, she said it was not much of a difference with regards to the impact of hormones on a body that
is trying to lessen the overall estrogenic effect."

newgirl, it is not my place to dispute advice given to you by you physician, but in rare cases I feel obliged. Mirena is NOT estrogenic AT ALL. It is a low dose progestin. Very little, VERY LITTLE of it is absorbed from the uterus. The device release around 20micrograms of drug into the uterus each day, but the long term plasma concentrations of drug only reach 150-200 picograms per ml. this is around 1/7th of the plasma levels of the same drug seen with traditional oral contraceptives. On top of this, as I already mentioned, there is absolutely no estrogen released by the device, so you're WAY ahead of the game here in terms of effect on blood hormone levels.

I am not advocating or pushing this method of contraception, merely providing info. Personally I don't think you can do better than abstinence in terms of birth control, sexually transmitted diseases, risk of ovarian cancer, and generally focusing more energy into bodybuilding instead obtaing safe sex. But since most people don't share my point of view, I try to offer the safest, most effective alternative methods that will suit an individual's needs for contraception. If I needed a contraceptive, I would personally use ormeloxifene (aka Saheli or Choice-7).

If you're going with non-hormonal methods for now JJ, I would advise you get plenty of caffeine in your diet......it can reduce fertility by ~50% in otherwise healthy women!

 

[JJFigure]

Woohoo! The morning coffe is back in! Thanks again for all your advice, MS. You've helped me tremendously.

 

[newgirl-chargeback]

MS -- I re-read my post and erroneously did not inlcude the word "NOT" in the phrase " I am disputing MS...." blech -- sorry 'bout that ....here I am complimenting you by saying that you are smarter and more informed in these areas than most -- and the quick typer that I am flew by and forgot ONE word of incredible importance...the word NOT. Good thing I am not a lawyer drawing up contracts! Nonetheless please forgive the mistake -- I make a point of reading the threads that you have replied to.

I believe unfortunately the most docs have the best intentions for their patients however they understand very little about the subtle nuances that can change the body of someone in the midst of fine tuning for a competition.

So I was not disputing your words merely pointing my doctor's reply stressed that if I wanted out of hormones added to my body - that I would be unhappy with Mirena overall as well.

My premise for dropping birth control last spring was to help get past a plateau and felt it would make a difference in my overall body composition and ability to build muscle (I am not a competitor but felt the hormones held me back so to speak).....

I find so far, it has not made that much of a difference in my physique....but then again...I am not at the level necessary to compete.

 

[MS]

I did not take any offense at what you said newgirl. I EXPECT that people should question anything they read on these boards whether it is written by me or whoever. But likewise I also encourage everyone to question things their doc tells them! I was just clarifying my position/understanding of how Mirena is different to other methods of hormonal contraception.

As an example about professional medical advice, I have a little anecdote that is worth relating. I recently accompanied a friend to see a specialist women's endocrinologist regarding her perimenopausal symptom of very sore breasts. It took 4 months to get her this appointment and in the interim I recommended a very small dose of winny to alleviate the breast tenderness. Winny is a potent antiprogesterone and has been used succesfully 'off label' for this kind of complaint (along with Danazol and Bromocriptine, neither of which was readily available). So anyway, this worked great and she had 4 months without anymore problems. I advised her to tell the endocrinologist EVERYTHING that she had been taking, including the winny. The endo's response was "that's kinda a sledge hammer approach, inhibiting ovarian hormone production with androgens" (she didn't even ask what the dose was, and given my friends otherwise normal menstrual cycles I think this was way off the mark-she completely lacked any idea that we were using it as an antiprogesterone). On top of that, she added that "this method was also likely to backfire on a woman because the AAS is very likely to convert to estrogen at a high rate, leading to even worsening symptoms of breast pain." (Winny cannot aromatize to estrogen, so this is completely wrong, and progesterone is more likely the cause of breast pain anyway, which is why anti-progestins or prolactin inhibitors like bromocriptine are useful). Anyway, my point is that doctors certainly don't know everything about medicine, they know almost nothing about preventative medicine, even less about bodybuilding, and an enquiring, proactive mind is more likely to get better health care than someone who just believes anything a doctor tells them.

All in all this specialist knew nothing about it, and so advised it was not a good idea to take winny and that she should stick to evening primrose oil, eliminating caffeine and alcohol, and that there was otherwise nothing that could be done to help short of putting her on oral contraceptives to control hormonal fluctuations! My friend had tried all of that already (not that the specialist ever asked....)

 

[Ceebs]

If you're going with non-hormonal methods for now JJ, I would advise you get plenty of caffeine in your diet......it can reduce fertility by ~50% in otherwise healthy women!

Why is that? I'm curious about the method of action. And is this caffiene in general, or specifically from coffee?

Also, what's ormeloxifene? I couldn't find it on Rxlist.com...

 

[JJFigure]

I tried to look up ormeloxifene too, and came up with nothing useful.

 

[MS]

" Why is that? I'm curious about the method of action. And is this caffiene in general, or specifically from coffee? ".....................................Good questions. We're talking humans here, so there's very little research other than epidemiological. What this shows is that women who drink a lot of caffeine (more than 300mg per day) have higher follicular phase estradiol levels and lower conception rates. I don't think anyone can say for sure that the caffeine is reducing fertility. It may just be an interaction such that women with high early estradiol levels happen to have a craving for caffeine and therefore drink more of it. In other words, the woman may already have naturally high estrogen levels which predisposes her to drink more coffee.
None of it makes much sense. On the one hand we have high estrogen levels that interfere with the metabolism of caffeine (which you would think would cause a woman to reduce her caffeine intake), yet on the other hand we have high caffeine intake associated with high estrogen levels (for at least part of the cycle). There's something fishy going on, but I can't quite put my finger on it.

Alcohol is actually even better at reducing fertility, but I didn't really think JJ wants to get pickled every night during her competition prep??? Which reminds me, I must tell you all the tale of increased ethanol consumption AFTER discontinuing estrogen therapy.......

I doubt you'll find ormeloxifene on Rxlist or most other American-based drug sites. I don't honestly know if you can get it on prescription in America (yet...). Try a google search and see what you find?

 

[MS]

Try googling for "Centchroman" instead. I think you'll get more meaningful info that way!

 

[MS]

The need for a safer alternative to Progestogen - Estrogen combination pills has
been felt ever since the sixties. Clearer understanding of the role of
estrogen-progesterone balance in the development of fertilized ovum and the
priming of the uterus for implantation served as the basis for developing an agent
that would prevent pregnancy by interfering with implantation but without disturbing
the hypothalamus-pituitary-ovarian axis. Researchers the world over have been
designing and synthesising non-steroidal estrogen antagonists that would act by
disturbing the delicate balance between estrogen and progesterone at the uterine
level without interfering with their synthesis or blood levels. Centchroman developed
by CDRI precisely does this.

Centchroman is a novel non-steroidal agent unrelated to any conventionally used
contraceptive. This is the only anti-implantation agent approved for clinical use in
the world. It offers a unique combination of weak estrogenic and potent
antiestrogenic properties. Due to this subtle mix of estrogenic and antiestorgenic
action it inhibits the fertilized ovum from nidation and thus prevents pregnancy, but
at the same time it does not appear to disturb the other estrogen effects.

Use of Centchroman as a contraceptive has been extensively evaluated in more
than 2000 women of the reproductive age groups who wanted to space their
children. Intensive monitoring by clinical examination, haematology and
biochemical tests as well as laparascopy and ultrasonographic examinations of
ovaries and uterus have shown the drug to be quite safe. Centchroman does not
cause nausea, vomiting, dizziness and break through bleeding and has no adverse
effect on lipid profile and platelet function as is seen with steroidal contraceptives.
Babies born to use failure cases have shown normal milestones. The contraceptive
effect is readily reversible and subsequent pregnancy and its outcome is normal. It
scores over steroidal contraceptive pills because it does not disturb the endocrine
system and the normal ovulatory cycle is maintained.

Centchroman has been licensed to two companies in India.

Hindustan Latex Ltd., Trivandrum, which is marketing it under the trade name,
Saheli.
Torrent Pharmaceuticals Ltd, Ahmedabad, which marketed it under the trade
name, Centron.

Centchroman as an antibreast cancer agent
Centchroman has also been found effective as an anti-breast cancer agent.
Multicentric trials in stage III/IV breast cancer patients, who were not responsive to
other modalities of therapy, were found to respond to Centchroman with an overall
responsive rate of about 56%. The data is being compiled for seeking marketing
permission from DCG(I).

 

[newgirl-chargeback]

MS -- I thought your story posted above was disturbing but not at all uncommon. And the simple fact that docs REFUSE to learn anything about prevententive medicine in my mind is more than inexcusable -- it is down right irresponsible.

I hope your friend either searched for a doctor who was more open-minded OR, was able to get enough information so she could arm herself with a plan....sounds like your first course of advise was a step in the right direction for her.

And, she waited four months for an appointment where her concerns were nearly rebuffed. Gotta love it.

 

[Ceebs]

I doubt you'll find ormeloxifene on Rxlist or most other American-based drug sites. I don't honestly know if you can get it on prescription in America (yet...). Try a google search and see what you find?

Oh, THAT pill! I was intrigued when I read about it on this board a few months ago. I'll bump the thread...

I've been using the sympto-thermal method to track my ovulation, but I certainly wouldn't mind getting my hands on some ormeloxifene just to be on the safe side. I don't understand why the most invasive, potentially carcinogenic contraceptives are approved by the FDA here, but not ormeloxifene. Grr.