New research links oral contraceptives to artery clogging plaque

As noted elsewhere on my site, birth control pills are one treatment option for women who suffer from the symptoms of PMS.

Data from a recent study was presented recently at the Amercian Heart Association. It's already well established that oral contraceptives or 'birth control pills' confer several risks including an increased risk of blod clots which can result in heart attacks or strokes--particularly in women who also smoke cigarettes.

Now, new data suggests that BCP's may also increase the risk of artery clogging plaques, even in women who no longer use the pill.

http://www.usatoday.com/news/health/2007-11-06-birth-control-heart_N.htm

Technorati Tags: birth+control+pill, oral+contraceptives, atherosclerosis, risks

Birth control pills with low dose estrogen and PMS

Birth control pills with low does estrogen...

A recent study compared two oral contraceptives with the same quantity of progestin, but differing amounts of estrogen on the effect on premenstrual mood symptoms (Greco et al, 2007). For women who suffer from PMS releted mood symptoms, the low estrogen BCP seems to be a better option.

"This study compared two oral contraceptives (OCs) with the same triphasic regimen of progestin (norgestimate 0.18, 0.215 and 0.25 mg) but differing doses of ethinyl estradiol (EE) - 25 and 35 microg EE - in their effects on androgens, mood and sexual interest in women starting on OCs" (Greco et al, 2007).

"The lower EE pill reduced FT less and was associated with greater improvement in premenstrual mood. A causal relation between these two effects is uncertain" (Greco et al, 2007).

In short, lower dose estrogen birth control pills were more effective at treating mood symptoms of premenstrual syndrome.

Reference:

Greco T, Graham CA, Bancroft J, Tanner A, Doll HA. The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: a comparison of two triphasic formulations containing norgestimate and either 35 or 25 microg of ethinyl estradiol. Contraception. 2007 Jul;76(1):8-17. Epub 2007 May 23.

GnRH anaologs for treating PMS

What is the effectiveness of using gonadotropin releasing hormone analogues (GnRHa) to treat PMS?

GnRH analogues work to stop menstrual periods by decreasing estrogen production. A recent meta-analysis published in the British Journal of Obstetrics and Gynecology concluded that GnRHa treatment appears to be an effective option in the management of PMS.4 Unfortunately, patients who take these analogues can experience several serious side effects, including menopausal type symptoms such as hot flashes, mood swings, vaginal dryness, and increased LDL cholesterol and bone loss.

SSRI's for PMS

How effective are selective serotonin reuptake inhibitors (SSRI’s) for the treatment of PMS?

SSRI’s are a class of drugs used in the treatment of depression, anxiety, and personality disorders. Patients can experience many side effects from the use of these medications including weight changes, increase in anxiety, suicidal thoughts, and sexual dysfunction. A study published in the Cochrane Database concluded that there is very good evidence to support the use of selective serotonin reuptake inhibitors in the management of severe PMS. However, withdrawals due to side effects were 2.5 times more likely to occur in the treatment group than in the placebo group.3

What medical treatments are available for PMS and PMDD?

there are four types of prescription drugs used for PMS/PMDD:

1. Antidepressants that act on serotonin, including fluoxetine, sertraline, and paroxetine.The FDA has recently ordered makers of several antidepressants to issue black box warnings that patients on these medications should be closely monitored for “clinical worsening, suicidality, or unusual changes in behavior.”
2. Agents that suppress ovulation, such as danazol, transdermal estradiol patches, and some oral contraceptives. These medications carry risks for serious side effects and can be very expensive.
3. Other psychotropics to reduce anxiety, such as alprazolam and other anxiolytic benzodiazepines. Since alprazolam has a very short half-life, there is a risk of addiction for patients who are started on this medication.
4. Spironolactone, a diuretic that is only available by prescription. It has proven effective in reducing premenstrual fluid retention, but doesn’t address the other symptoms of PMS.