How does birth control affect acid reflux. What are the risks of long-term PPI use. Can estrogen dominance lead to GERD. How to manage heartburn symptoms naturally.

The Link Between Birth Control and Acid Reflux

Birth control pills are widely used for contraception and managing various hormonal issues. However, research has uncovered a concerning connection between oral contraceptives and the development of acid reflux symptoms. A 2007 study published in the Journal of Gastroenterology and Hepatology found a significant relationship between birth control use and acid reflux.

Why does this occur? The hormones in birth control pills, particularly estrogen, can create an “estrogen dominant” state in the body. This excess estrogen has several effects that can contribute to acid reflux:

• Relaxation of the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus
• Increased risk of weight gain, which is a risk factor for reflux
• Potential thyroid issues that can lead to low stomach acid production

Understanding GERD and Acid Reflux Symptoms

Gastroesophageal reflux disease (GERD) and acid reflux are closely related conditions characterized by stomach acid flowing back into the esophagus. Common symptoms include:

• Heartburn
• Regurgitation
• Difficulty swallowing
• Chest pain
• Chronic cough

These symptoms can significantly impact quality of life and may lead to complications if left untreated. Are you experiencing any of these symptoms while on birth control? It’s important to discuss them with your healthcare provider to determine the best course of action.

The Role of Proton Pump Inhibitors (PPIs) in Acid Reflux Treatment

Proton pump inhibitors (PPIs) are a class of medications commonly prescribed to treat acid reflux and GERD. They work by reducing stomach acid production. While effective for symptom relief, long-term PPI use carries potential risks:

• Anemia
• Osteoporosis
• Increased risk of C. difficile infections
• Magnesium and B12 deficiencies
• Potential increased risk of dementia

Given these risks, it’s crucial to use PPIs judiciously and under medical supervision. Are there alternatives to long-term PPI use for managing acid reflux symptoms?

The Estrogen Dominance Factor in GERD Development

Estrogen dominance, a state of hormonal imbalance where estrogen levels are disproportionately high compared to progesterone, can significantly contribute to the development of GERD. This condition can be exacerbated by birth control pills, which often contain synthetic estrogens.

How does estrogen dominance lead to GERD?

1. Relaxation of the lower esophageal sphincter: Excess estrogen can cause this muscle to relax, allowing stomach contents to flow back into the esophagus.
2. Increased inflammation: Estrogen dominance can promote inflammatory processes in the body, potentially affecting the digestive system.
3. Weight gain: Hormonal imbalances can lead to weight gain, a known risk factor for GERD.
4. Altered gut motility: Estrogen can affect smooth muscle function, potentially slowing digestion and increasing the risk of reflux.

Natural Approaches to Managing Heartburn and Acid Reflux

While medication may be necessary in some cases, there are several natural approaches that can help manage heartburn and acid reflux symptoms:

• Dietary modifications: Avoiding trigger foods, eating smaller meals, and not lying down immediately after eating.
• Apple cider vinegar: Some find relief by taking a tablespoon of apple cider vinegar in water before meals to support digestion.
• Lifestyle changes: Maintaining a healthy weight, quitting smoking, and reducing alcohol consumption can all help reduce symptoms.
• Stress management: Stress can exacerbate digestive issues, so practices like meditation, yoga, or deep breathing exercises may be beneficial.
• Herbal remedies: Certain herbs like slippery elm, marshmallow root, and licorice root may help soothe the digestive tract.

Have you tried any of these natural approaches? It’s important to work with a healthcare provider to develop a comprehensive treatment plan that addresses your individual needs.

The Importance of Nutrient Replenishment for Birth Control Users

Birth control pills can deplete certain nutrients in the body, which may contribute to various side effects, including digestive issues. Key nutrients that may be affected include:

• B vitamins, especially B6, B12, and folate
• Magnesium
• Zinc
• Selenium
• Vitamin C
• Vitamin E

Replenishing these nutrients through diet and supplementation can help support overall health and potentially reduce the risk of developing acid reflux and other side effects. How can you ensure you’re getting adequate nutrients while on birth control?

1. Eat a nutrient-dense, whole foods diet
2. Consider targeted supplementation under the guidance of a healthcare provider
3. Regular blood testing to monitor nutrient levels
4. Explore food-based sources of key nutrients

The Polypharmacy Problem: Addressing Side Effects with More Medications

Polypharmacy, the use of multiple medications to address side effects of previously prescribed drugs, is a growing concern in healthcare. Women on birth control are significantly more likely to be prescribed additional medications to manage side effects, including acid reflux and GERD.

This cascade of prescriptions can lead to:

• Increased risk of drug interactions
• Greater potential for adverse effects
• Higher healthcare costs
• Reduced quality of life due to managing multiple medications

To avoid falling into the cycle of polypharmacy, it’s crucial to:

1. Regularly review all medications with your healthcare provider
2. Explore root causes of symptoms rather than just treating them
3. Consider non-pharmacological approaches when appropriate
4. Be proactive about managing potential side effects through lifestyle and nutritional support

The Role of Low Stomach Acid in Acid Reflux

Contrary to popular belief, many cases of acid reflux are actually caused by low stomach acid (hypochlorhydria) rather than excess acid. This condition can be exacerbated by birth control use and other factors. Low stomach acid can lead to:

• Incomplete digestion of food
• Bacterial overgrowth in the stomach and small intestine
• Increased pressure in the stomach, leading to reflux
• Nutrient deficiencies due to poor absorption

How can you support healthy stomach acid production?

1. Try a tablespoon of apple cider vinegar in water before meals
2. Chew food thoroughly to stimulate digestive processes
3. Consider digestive enzyme supplements
4. Explore herbal bitters to stimulate digestion
5. Address underlying causes of low stomach acid, such as stress or nutrient deficiencies

The Impact of Acid Reflux on Quality of Life

Chronic acid reflux and GERD can significantly impact an individual’s quality of life. Research has shown that people with these conditions often experience:

• Sleep disturbances
• Reduced work productivity
• Social embarrassment
• Dietary restrictions
• Anxiety and depression related to symptoms

A study by Revicki et al. (1998) found that GERD patients reported lower health-related quality of life scores compared to the general population. This underscores the importance of addressing acid reflux symptoms effectively and holistically.

The Potential Long-Term Consequences of Untreated Acid Reflux

While occasional heartburn is common, chronic acid reflux can lead to more serious health issues if left untreated. Potential long-term consequences include:

• Esophagitis (inflammation of the esophagus)
• Barrett’s esophagus (precancerous changes to the esophageal lining)
• Esophageal strictures (narrowing of the esophagus)
• Increased risk of esophageal cancer
• Dental erosion
• Chronic cough and respiratory issues

These potential complications highlight the importance of addressing acid reflux symptoms promptly and effectively. Working with a healthcare provider to develop a comprehensive treatment plan is crucial for preventing long-term health issues.

Balancing Hormones Naturally to Reduce Acid Reflux Risk

For those experiencing acid reflux related to hormonal imbalances from birth control use, there are several natural approaches to support hormone balance:

• Dietary changes: Consuming a diet rich in whole foods, fiber, and healthy fats can support hormone balance.
• Stress management: Chronic stress can disrupt hormone levels, so practices like meditation, yoga, or deep breathing exercises can be beneficial.
• Regular exercise: Physical activity helps regulate hormone levels and supports overall health.
• Adequate sleep: Poor sleep can disrupt hormone production, so prioritizing quality sleep is essential.
• Herbal supplements: Certain herbs like vitex, dong quai, and maca may help support hormone balance (consult with a healthcare provider before use).
• Avoiding endocrine disruptors: Minimize exposure to environmental toxins that can interfere with hormone function.

By addressing hormone balance holistically, it may be possible to reduce the risk of acid reflux and other side effects associated with birth control use.

The Economic Burden of GERD and Acid Reflux

The prevalence of GERD and acid reflux not only affects individual health but also has significant economic implications. A study by Sandler et al. (2002) highlighted the substantial burden of digestive diseases, including GERD, on the United States healthcare system:

• Direct medical costs for GERD treatment
• Indirect costs due to lost productivity
• Over-the-counter medication expenses
• Costs associated with complications and long-term management

Additionally, a study by Henke et al. found that work loss costs due to GERD in a health maintenance organization were substantial. This economic burden underscores the importance of effective prevention and management strategies for acid reflux and GERD.

Integrative Approaches to Managing Birth Control Side Effects

While birth control remains an important option for contraception and managing hormonal issues, an integrative approach can help mitigate side effects like acid reflux. This approach may include:

• Regular monitoring of hormone levels and adjusting birth control formulations as needed
• Targeted nutritional support to address nutrient depletions
• Incorporating stress reduction techniques
• Exploring alternative forms of contraception if side effects persist
• Using functional medicine testing to identify underlying imbalances
• Implementing dietary and lifestyle changes to support overall health

By taking a comprehensive approach to health while using birth control, it may be possible to reduce the risk of developing acid reflux and other side effects, ultimately improving quality of life and long-term health outcomes.

The Role of the Gut Microbiome in Acid Reflux

Emerging research suggests that the gut microbiome may play a significant role in the development and persistence of acid reflux symptoms. The gut microbiome refers to the trillions of microorganisms that inhabit our digestive tract. These microbes influence various aspects of our health, including digestion, immune function, and even hormone balance.

How does the gut microbiome relate to acid reflux?

• Bacterial overgrowth: An imbalance in gut bacteria (dysbiosis) can lead to increased gas production and pressure in the stomach, potentially contributing to reflux.
• Inflammation: Certain gut bacteria can promote inflammation, which may affect the lining of the esophagus and stomach.
• Hormone metabolism: The gut microbiome plays a role in hormone metabolism, including estrogen. This could influence the relationship between birth control use and acid reflux.
• Digestive enzyme production: Some gut bacteria help produce digestive enzymes, which are crucial for proper digestion and may help prevent reflux.

Supporting a healthy gut microbiome may help reduce the risk of acid reflux and improve overall digestive health. Strategies to promote a balanced microbiome include:

1. Consuming a diverse range of plant-based foods
2. Including fermented foods in the diet
3. Minimizing processed foods and artificial sweeteners
4. Considering probiotic supplements under the guidance of a healthcare provider
5. Managing stress, which can negatively impact gut bacteria
6. Avoiding unnecessary antibiotic use

By addressing gut health alongside hormonal balance, it may be possible to reduce the incidence and severity of acid reflux symptoms in birth control users.

The Importance of Individualized Treatment Plans

When it comes to managing acid reflux symptoms related to birth control use, it’s crucial to recognize that there is no one-size-fits-all approach. Each individual’s body responds differently to hormonal contraceptives, and the underlying causes of acid reflux can vary widely. This highlights the importance of working with healthcare providers to develop personalized treatment plans.

Factors to consider in an individualized approach include:

• Specific formulation of birth control being used
• Individual hormone levels and metabolism
• Presence of other health conditions
• Lifestyle factors such as diet, stress levels, and sleep patterns
• Personal health goals and preferences
• Family history of digestive issues or hormonal imbalances

By taking a comprehensive, personalized approach to managing acid reflux symptoms, it’s possible to find effective solutions that balance the benefits of birth control with overall health and well-being. This may involve a combination of strategies, including:

1. Adjusting birth control formulations or exploring alternative methods
2. Implementing targeted nutritional support
3. Incorporating stress management techniques
4. Making dietary modifications
5. Exploring natural remedies for symptom relief
6. Addressing underlying gut health issues
7. Regular monitoring and adjustment of the treatment plan as needed

Remember, open communication with healthcare providers is key to developing and refining an effective treatment plan for managing acid reflux while on birth control.

Acid Reflex and PPI’s — Dr. Molly Sears, ND

Once again-I am all for the use of Birth Control, it is empowering. I am also all for the use of adequate Informed consent about the use of the birth control and I love empowering women through education surrounding the use of the birth control. This week I will be sharing a series about the reality of the Pill and PolyPharm (;the use of multiple medications to address side effects of previously prescribed medications.)

Women on the birth control are SIGNIFICANTLY more likely to be prescribed multiple drugs after starting Hormonal Birth Control:

Used to manage

• Acid reflex

• GERD

• Heartburn

The Facts

• According to the authors of a 2007 study in the “Journal of Gastroenterology and Hepatology,” a relationship has been found between the use of oral contraceptives and the development of acid reflux.

• Long term use of PPI’s can put you as risk of Anemia, Osteoporosis, C. Diff infections, Magnesium and B12 deficiencies, and Dementia.

Developing Heartburn, GERD, and Acid Reflex while on the Pill: The connection

• Hormonal birth control can cause an “estrogen dominant” state within the body. This excess estrogen relaxes the lower esophageal sphincter, allowing regurgitation up the esophagus

• An Increase in Estrogen predisposes you to obesity and vice versa. Both being overweight and this state of estrogen excess caused by the pill concurrently increases your risk for developing Acid reflex.

• Thyroid issues that arise on the pill can contribute to hypochlorydia (low stomach acid) and most acid reflex is caused by low amounts of stomach acid

Final thoughts:

Does this mean you need to come off the birth control? Again, maybe- but probably not, it is your choice. I am writing this to create a space where women can educate themselves and empower them to know what side effects there are, what it can lead to, and how awareness can help them avoid falling into the cycle of poly pharm. With my patients on hormonal birth control we work to specifically ensure that we are replenishing the nutrient depletions, supporting our immune system, and optimizing our inflammation in our body to prevent these negative processes from occurring. For low stomach acid and heartburn symptoms clinically we try a simple intervention with Apple Cider Vinegar to manage this symptom. Sometimes this is enough and sometimes your body requires additional digestive support and repair.

Resources:

Heidelbaugh JJ, Kim AH, Chang R, Walker PC. Overutilization of proton-pump inhibitors: what the clinician needs to know. Ther Adv Gastroenterol. 2012;5(4):219-232.

Schoenfeld AJ, Grady D. Adverse effects associated with proton pump inhibitors. JAMA Intern Med. 2016;176(2):172-174.

Molly SearsNovember 5, 2019

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Postmenopausal hormone therapy as a risk factor for gastroesophageal reflux symptoms among female twins

1. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Prevalence of gastro-oesophageal reflux symptoms and the influence of age and sex. Scand J Gastroenterol. 2004;39:1040–5. [PubMed] [Google Scholar]

2. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54:710–7. [PMC free article] [PubMed] [Google Scholar]

3. Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis. 1976;21:953–6. [PubMed] [Google Scholar]

4. Locke GR, 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ., 3rd Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997;112:1448–56. [PubMed] [Google Scholar]

5. Revicki DA, Wood M, Maton PN, Sorensen S. The impact of gastroesophageal reflux disease on health-related quality of life. Am J Med. 1998;104:252–8. [PubMed] [Google Scholar]

6. Eloubeidi MA, Provenzale D. Health-related quality of life and severity of symptoms in patients with Barrett’s esophagus and gastroesophageal reflux disease patients without Barrett’s esophagus. Am J Gastroenterol. 2000;95:1881–7. [PubMed] [Google Scholar]

7. Solaymani-Dodaran M, Logan RF, West J, Card T. Mortality associated with Barrett’s esophagus and gastroesophageal reflux disease diagnoses-a population-based cohort study. Am J Gastroenterol. 2005;100:2616–21. [PubMed] [Google Scholar]

8. Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–11. [PubMed] [Google Scholar]

9. Henke CJ, Levin TR, Henning JM, Potter LP. Work loss costs due to peptic ulcer disease and gastroesophageal reflux disease in a health maintenance organization. Am J Gastroenterol. 2000;95:788–92. [PubMed] [Google Scholar]

10. Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–31. [PubMed] [Google Scholar]

11. Berrino F. World Health Organization IAfRoCaCotEC. Vol. 151. Lyon: IARC scientific publications; 1999. Survival of Cancer Patients in Europe: The EUROCARE-2 Study. [PubMed] [Google Scholar]

12. Devesa SS, Blot WJ, Fraumeni JF., Jr Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998;83:2049–53. [PubMed] [Google Scholar]

13. Cameron AJ, Lagergren J, Henriksson C, Nyren O, Locke GR, 3rd, Pedersen NL. Gastroesophageal reflux disease in monozygotic and dizygotic twins. Gastroenterology. 2002;122:55–9. [PubMed] [Google Scholar]

14. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. Jama. 2003;290:66–72. [PubMed] [Google Scholar]

15. Corley DA, Kubo A. Body Mass Index and Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2006 [PubMed] [Google Scholar]

16. Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA., Jr Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 2006;354:2340–8. [PMC free article] [PubMed] [Google Scholar]

17. Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143:199–211. [PubMed] [Google Scholar]

18. Locke GR, 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ., 3rd Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106:642–9. [PubMed] [Google Scholar]

19. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut. 2004;53:1730–5. [PMC free article] [PubMed] [Google Scholar]

20. Mohammed I, Cherkas LF, Riley SA, Spector TD, Trudgill NJ. Genetic influences in gastro-oesophageal reflux disease: a twin study. Gut. 2003;52:1085–9. [PMC free article] [PubMed] [Google Scholar]

21. Nilsson M, Lundegardh G, Carling L, Ye W, Lagergren J. Body mass and reflux oesophagitis: an oestrogen-dependent association? Scand J Gastroenterol. 2002;37:626–30. [PubMed] [Google Scholar]

22. Lichtenstein P, De Faire U, Floderus B, Svartengren M, Svedberg P, Pedersen NL. The Swedish Twin Registry: a unique resource for clinical, epidemiological and genetic studies. J Intern Med. 2002;252:184–205. [PubMed] [Google Scholar]

23. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–20. quiz 1943. [PubMed] [Google Scholar]

24. Lubin JH, Gail MH. Biased selection of controls for case-control analyses of cohort studies. Biometrics. 1984;40:63–75. [PubMed] [Google Scholar]

25. Hawkes CH. Twin studies in medicine–what do they tell us? Qjm. 1997;90:311–21. [PubMed] [Google Scholar]

26. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986;42:121–30. [PubMed] [Google Scholar]

27. WHO. WHO Technical Report Series. Vol. 724. Geneva: World Health Organization; 1985. Energy and protein requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. Geneva, WHO; pp. 1–67. [PubMed] [Google Scholar]

28. Eslick GD, Jones MP, Talley NJ. Non-cardiac chest pain: prevalence, risk factors, impact and consulting–a population-based study. Aliment Pharmacol Ther. 2003;17:1115–24. [PubMed] [Google Scholar]

29. Klauser AG, Schindlbeck NE, Muller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990;335:205–8. [PubMed] [Google Scholar]

30. Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease. Qual Life Res. 1998;7:75–83. [PubMed] [Google Scholar]

31. Norell SE, Boethius G, Persson I. Oral contraceptive use: interview data versus pharmacy records. Int J Epidemiol. 1998;27:1033–7. [PubMed] [Google Scholar]

32. Wilson PW, Garrison RJ, Castelli WP. Postmenopausal estrogen use, cigarette smoking, and cardiovascular morbidity in women over 50. The Framingham Study. N Engl J Med. 1985;313:1038–43. [PubMed] [Google Scholar]

33. Colditz GA, Hankinson SE, Hunter DJ, Willett WC, Manson JE, Stampfer MJ, Hennekens C, Rosner B, Speizer FE. The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. N Engl J Med. 1995;332:1589–93. [PubMed] [Google Scholar]

34. Matthews KA, Kuller LH, Wing RR, Meilahn EN, Plantinga P. Prior to use of estrogen replacement therapy, are users healthier than nonusers? Am J Epidemiol. 1996;143:971–8. [PubMed] [Google Scholar]

35. Weiner CP, Lizasoain I, Baylis SA, Knowles RG, Charles IG, Moncada S. Induction of calcium-dependent nitric oxide synthases by sex hormones. Proc Natl Acad Sci U S A. 1994;91:5212–6. [PMC free article] [PubMed] [Google Scholar]

36. Hirsch DP, Holloway RH, Tytgat GN, Boeckxstaens GE. Involvement of nitric oxide in human transient lower esophageal sphincter relaxations and esophageal primary peristalsis. Gastroenterology. 1998;115:1374–80. [PubMed] [Google Scholar]

37. Van Thiel DH, Gavaler JS, Stremple J. Lower esophageal sphincter pressure in women using sequential oral contraceptives. Gastroenterology. 1976;71:232–4. [PubMed] [Google Scholar]

38. Richter JE. Gastroesophageal reflux disease during pregnancy. Gastroenterol Clin North Am. 2003;32:235–61. [PubMed] [Google Scholar]

39. Olans LB, Wolf JL. Gastroesophageal reflux in pregnancy. Gastrointest Endosc Clin N Am. 1994;4:699–712. [PubMed] [Google Scholar]

40. Torbey CF, Richter JE. Gastrointestinal motility disorders in pregnancy. Semin Gastrointest Dis. 1995;6:203–16. [PubMed] [Google Scholar]

41. Van Thiel DH, Wald A. Evidence refuting a role for increased abdominal pressure in the pathogenesis of the heartburn associated with pregnancy. Am J Obstet Gynecol. 1981;140:420–2. [PubMed] [Google Scholar]

42. Fisher RS, Roberts GS, Grabowski CJ, Cohen S. Altered lower esophageal sphincter function during early pregnancy. Gastroenterology. 1978;74:1233–7. [PubMed] [Google Scholar]

43. Fisher RS, Roberts GS, Grabowski CJ, Cohen S. Inhibition of lower esophageal sphincter circular muscle by female sex hormones. Am J Physiol. 1978;234:E243–7. [PubMed] [Google Scholar]

44. Lagergren J. Controversies surrounding body mass, reflux, and risk of oesophageal adenocarcinoma. Lancet Oncol. 2006;7:347–9. [PubMed] [Google Scholar]

“Birth control pills have made my life a nightmare”

January 13, 2017

Millions of women take birth control pills, and many are quite happy. However, there are times when these pills have a detrimental effect on the psyche.

Vicki Spratt, Associate Editor of The Debrief, tells how she battled depression, anxiety and panic attacks for years while trying to find the right medication.

How it all started o

My mother and I came to my local doctor with a complaint that my periods had not ended for three weeks. She recommended birth control pills for me – with some reservations, of course. Pills do not protect against sexually transmitted diseases, the doctor stressed, and unprotected sex can lead to the development of cervical cancer. She was forced to say this, although I was only 14 years old, and I thought about sex last.

Image copyright VICKY SPRATT

The nurse filled out the prescription and I ended up with a three month supply of oral contraceptives. Going to the pharmacy for green blisters with tiny yellow pills I took as a kind of rite of passage into women. These were not just pills, but a sweetened concentrate of feminism, the struggle for women’s rights, medical progress.

That’s how it all started. It was 14 years ago, and since then I have been “playing drug roulette” for more than ten years, testing various drugs on myself with varying success. At the same time, I began to experience anxiety, depression, and mood swings that, with minor interruptions, haunted me all my adult life.

I had several failed romances and had to miss a year of university. All this I attributed to my shortcomings. Like, such a person I am: unadapted to life, insecure, unhappy. It wasn’t until my 20s, when I had already graduated from university and my mental and behavioral problems could no longer be attributed to “difficult adolescence”, that I first seriously thought about the side effects of pills.

Image copyright BSIP/Getty

Types of birth control pills

There are two main types of birth control pills: combination pills, which contain estrogen and progestin (a synthetic form of progesterone), and “pure progestin pills” or “mini pills,” which contain only one hormone (progestin).

• Combination tablets are available under many different names. They differ in dosage and ratio of estrogen and progestin.
• Progestin tablets also vary depending on the combination of norethisterone or desogestrel in their composition.
• Many women experience individual intolerance to certain components of hormonal contraceptives.

One day after another panic attack and as a result of a sleepless night, I sat down at the computer and started looking for information on Google. The day before, I switched to new progestin contraceptives, which I was prescribed because of a migraine. As it turned out, combination pills are contraindicated for those who suffer from migraine with aura.

I typed in the name of my drug and the words “depression” and “anxiety”. The Internet immediately showed me forum threads and posts by bloggers who were suffering from the same symptoms as me.

By that time, I had already gone to my local doctor several times complaining of sudden and powerful panic attacks – this had never happened before. The topic of contraceptives never came up in the conversation, despite the fact that the attacks occurred simultaneously with the transition to new pills. Instead, I was prescribed a large dose of beta-blockers – drugs that treat anxiety – and advised to take a course of cognitive-behavioral therapy.

So I lived for about six or eight months. I can’t say for sure, because this period in my memory is very blurred and accelerated, because the feeling of anxiety and danger was constantly pulsing in my veins.

Photo credit, BSIP/Getty

Learn more

The Debrief conducted a survey of 1022 readers aged 18 to 30:

• 93% of respondents were taking birth control intravenous tablets at or before the interview .
• Of these, 45% suffered from anxiety, the other 45% from depression.
• 46% said the pills reduced their sex drive.
• 58% believe the pills have had a negative impact on their mental health.
• 4% speak of the positive effect of the tablets.

I would like to laugh when I think about it. This is how all good stories should end, right? But there was nothing funny about what I went through. It was horror. I felt fear all the time. I did not recognize myself, did not love and could not live in peace. I didn’t know what to do, who to turn to and whether this would end. In addition to anxiety, I was seized by apathy. I felt like a complete mediocrity and blamed only myself for what was happening.

Thinking I was crazy, I told my doctor that I “felt like I’m not myself, but someone else,” as if my brain had become moldy and shrunken.

“Don’t you think it has something to do with my pills?” I asked. I remember the expression on her face: she was trying to keep a neutral look, but she could hardly contain her sarcasm. I explained that six of the seven types of pills I was taking had a negative effect on my well-being. The only exception was high estrogen pills, which made me feel like a superwoman for a year until they were discontinued (partly due to migraines, partly because long-term use of this drug increases the risk of thrombosis).

Having mastered herself, the doctor said categorically “no”: my problems are not related to pills.

However, I didn’t listen to her or my therapist and stopped taking progestin pills.

What happened next, I can only call a gradual and careful return of my “I”. After three to four weeks, I stopped taking beta-blockers. To this day, I always carry them with me in my purse in case I fall “off the high rock of my consciousness” again. However, for three and a half years they were never needed.

Of course, my problems didn’t disappear overnight, but the panic attacks stopped. None have happened over the years. From time to time I experience depression, anxiety and stress, but not to the extent that when I took the progestin pills. I remembered what joy is. My sex drive has returned. I stopped being afraid of everyone and everyone.

A year after the panic attacks stopped, I went on a solo trip to the other side of the world. A year earlier, this would have been unthinkable. Sitting on a distant tropical beach under a warm thunderstorm, I suddenly burst into tears of joy. What a relief it was that I became myself again, that I can control my thoughts, that I was not mistaken – I really know myself better than the doctors assured me.

I am now 28 years old and no longer take hormonal contraceptives. With the exception of mild mood swings during the day before my period, I was completely free from anxiety, depression, and panic attacks.

Image copyright VICKY SPRATT

Ever since I lost myself on progestin pills and found myself again on a South Asian beach, my problem has gradually begun to attract more and more attention. In 2013, Holly Grigg Spall’s book Sweetening The Pill was published, in which the author stated the impact of hormonal contraception on women’s mental health.

In addition, an important study was conducted: Professor Øyvind Lidegaard from the University of Copenhagen found that women who take birth control pills (both combined and progestin) are more likely to be prescribed antidepressants than others. This difference was especially noticeable among young women aged 15-19 who took the combination pill.

Lidegaard was able to carry out this study because he was given access to the health records of over a million Danish women aged 15 to 34.

After reading about this study, I sent an information request to the National Health Service. As a journalist for The Debrief, I knew that many British women also suffer from such effects of pills – our readers complained to us almost daily. I asked how many women take birth control pills along with antidepressants or beta-blockers. I was told that their system does not yet allow sampling of this data.

Pills and depression

Here is what Professor Helen Stokes-Lampard, President of the Royal College of Physicians says:

“Hormones have been proven to affect mood – both positively and negatively. For most women, reliable contraception and regulation of the menstrual cycle are undeniable the benefits outweigh the side effects, if any. In addition, many women claim that hormonal drugs improve their mood.

If a woman thinks that contraceptives are negatively affecting her mood, she should see a doctor. ”

Depression is now considered a possible but rare side effect of hormonal contraceptives, according to the instructions that come with the pills. The National Health Service website refers to “mood swings” without directly naming depression, anxiety, or panic attacks.

You don’t have to give up pills, but you don’t have to put up with the negative side effects that keep us from living. We need information to make a choice. We need more thorough research on the effect of hormonal contraceptives on the female psyche, monitoring the reaction of patients, more support for those who suffer from serious side effects. Women should not feel ignored or not taken seriously.

Vicki Spratt is Associate Editor of The Debrief, website for women in their 20s and 30s. Now this site publishes a series of materials “ Mad About The Pill “.

Use of clindamycin in the treatment of children with cancer

Antibiotic

Brand names:

Cleocin®, Clindacin®, Clindagel®, Clindesse®, Evoclin®

Often used for:

Infections

Clindamycin is an antibiotic used to prevent and treat infections caused by bacteria. Clindamycin is available in various dosage forms. This medication can also be applied to the skin to treat acne.

During therapy, the patient may need to donate blood to check the content of blood cells and to monitor the functioning of the liver and kidneys.

Oral capsules

Oral liquid form

Intramuscular injection in liquid form

Intravenous administration (drip) in liquid form

Skin application (topical application)

• Nausea and vomiting
• Diarrhea
• Bad or metallic taste in the mouth
• Heartburn
• Abdominal pain
• Joint pain
• Skin rash, itching, redness or irritation
• Itching, burning in the vagina or discharge from the vagina
• Low blood pressure (when administered intravenously)
• Changes in liver function

Symptoms of an allergic reaction may occur: rash, hives, itching, chills, fever, headache, muscle pain, shortness of breath, cough, tightness in the throat, swelling of the face or neck

The listed side effects are not observed in all patients who are prescribed clindamycin. The most common side effects are highlighted in bold, but others are not excluded. Report all possible side effects to your doctor or pharmacist.

Be sure to discuss these and other recommendations with your doctor or pharmacist.

• Tell your doctor if you have severe diarrhea while taking this drug.
• Therapy with clindamycin may reduce the effectiveness of birth control pills and other hormonal methods of contraception. Sexually active patients should also use other methods of contraception, such as condoms.
• Pregnant or breastfeeding patients should notify their physician.
• The course of taking the drug must be completed completely in accordance with the recommendations of the attending physician or pharmacist.

Home use of clindamycin:

• Liquid form: shake well before use, measure with the measuring device provided. Store at room temperature. It is forbidden to store the drug in the refrigerator.