Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 Hi, I am sorry but I am not very knowledgeable about Birth Control choices and the effectiveness rates of the various options. I do know that several very reliable patients have become pregnant while taking their birth control pills after surgery. I do not know if this is something that is reported by others or if it is just a " lapse " . I do know it has happened frequently enough that people need to be aware of it. I would appreciate hearing the advice of one of your gynecologists. I will also try to check into it. PS to avoid me having to take the time to moderate this topic please keep you comments on this topic discreet. RR Rutledge, M.D., F.A.C.S. The Center for Laparoscopic Obesity Surgery 4301 Ben lin Blvd. Durham, N.C. 27704 Telephone #: Fax #: E mail: DrR@... ****************************************** Please Visit our Web site: http://clos.net ****************************************** Durham Regional Hospital: Also, Please consider joining the Mini-Gastric Bypass Mailing List at http://www.onelist.com MiniGastricBypass is a general discussion of the Mini-Gastric Bypass ( http://www.onelist.com/community/MiniGastricBypass ) Talk with lots of other Pre and Post Op patients and friends. Keep up to date on the latest news about the Mini-Gastric Bypass. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 More on BCP failures... Here are two articles on BCP failures. One talks about the failure with antibiotics (You get antibiotics after surgery) The other talks about the known incidence of GI upset, nausea and diarrhea being associated with BCP failure... So lets be careful out there: Clin Pharmacokinet 1999 May;36(5):309-13 Interactions between oral contraceptives and antifungals/antibacterials. Is contraceptive failure the result? Weisberg E Sydney Centre for Reproductive Health Research, Family Planning NSW, Ashfield, Australia. eweisberg@... The effectiveness of oral contraceptives may be impaired by concomitant treatment with antimicrobials. This may occur because of reductions in plasma concentrations of ethinylestradiol by the induction of hepatic metabolism, as for rifampicin (rifampin) and possibly griseofulvin, or in a small percentage of women because of interference with enterohepatic recirculation. There are no scientific data to support the anecdotal evidence that the concomitant use of combined oral contraceptives and antimicrobials reduces contraceptive efficacy in the majority of women. It has been postulated that there is a subset of women in whom the enterohepatic recirculation of ethinylestradiol plays an important role. In these women the action of an antimicrobial may reduce the efficacy of oral contraceptives by interfering with this mechanism. Studies that have quantitatively examined these effects may have failed to include women from this subset because of the small numbers involved in the studies. On the other hand, there are no good prospective studies comparing contraceptive failure rates between compliant women who use combined oral contraceptives with and without antimicrobials. All women using combined oral contraceptives should be informed of the very low level of risk of interactions with antimicrobials (probably about 1%) and that it is not possible to identify who may be at risk. Women concerned about this low level of risk should be given information about the use of barrier methods or avoidance of intercourse during the first 7 days of concomitant antimicrobial therapy and for 7 subsequent days. Women who have had previous contraceptive failures or developed breakthrough bleeding during concomitant antimicrobial use should be strongly advised to follow these precautions, as they may be part of the subset of women at higher risk of contraceptive failure. Publication Types: Review Review, tutorial PMID: 10384856, UI: 99312850 ---------------------------------------------------------------------------- ---- Other Formats: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 More on BCP failures... Here are two articles on BCP failures. One talks about the failure with antibiotics (You get antibiotics after surgery) The other talks about the known incidence of GI upset, nausea and diarrhea being associated with BCP failure... So lets be careful out there: Clin Pharmacokinet 1999 May;36(5):309-13 Interactions between oral contraceptives and antifungals/antibacterials. Is contraceptive failure the result? Weisberg E Sydney Centre for Reproductive Health Research, Family Planning NSW, Ashfield, Australia. eweisberg@... The effectiveness of oral contraceptives may be impaired by concomitant treatment with antimicrobials. This may occur because of reductions in plasma concentrations of ethinylestradiol by the induction of hepatic metabolism, as for rifampicin (rifampin) and possibly griseofulvin, or in a small percentage of women because of interference with enterohepatic recirculation. There are no scientific data to support the anecdotal evidence that the concomitant use of combined oral contraceptives and antimicrobials reduces contraceptive efficacy in the majority of women. It has been postulated that there is a subset of women in whom the enterohepatic recirculation of ethinylestradiol plays an important role. In these women the action of an antimicrobial may reduce the efficacy of oral contraceptives by interfering with this mechanism. Studies that have quantitatively examined these effects may have failed to include women from this subset because of the small numbers involved in the studies. On the other hand, there are no good prospective studies comparing contraceptive failure rates between compliant women who use combined oral contraceptives with and without antimicrobials. All women using combined oral contraceptives should be informed of the very low level of risk of interactions with antimicrobials (probably about 1%) and that it is not possible to identify who may be at risk. Women concerned about this low level of risk should be given information about the use of barrier methods or avoidance of intercourse during the first 7 days of concomitant antimicrobial therapy and for 7 subsequent days. Women who have had previous contraceptive failures or developed breakthrough bleeding during concomitant antimicrobial use should be strongly advised to follow these precautions, as they may be part of the subset of women at higher risk of contraceptive failure. Publication Types: Review Review, tutorial PMID: 10384856, UI: 99312850 ---------------------------------------------------------------------------- ---- Other Formats: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 More on BCP failures... Here are two articles on BCP failures. One talks about the failure with antibiotics (You get antibiotics after surgery) The other talks about the known incidence of GI upset, nausea and diarrhea being associated with BCP failure... So lets be careful out there: Clin Pharmacokinet 1999 May;36(5):309-13 Interactions between oral contraceptives and antifungals/antibacterials. Is contraceptive failure the result? Weisberg E Sydney Centre for Reproductive Health Research, Family Planning NSW, Ashfield, Australia. eweisberg@... The effectiveness of oral contraceptives may be impaired by concomitant treatment with antimicrobials. This may occur because of reductions in plasma concentrations of ethinylestradiol by the induction of hepatic metabolism, as for rifampicin (rifampin) and possibly griseofulvin, or in a small percentage of women because of interference with enterohepatic recirculation. There are no scientific data to support the anecdotal evidence that the concomitant use of combined oral contraceptives and antimicrobials reduces contraceptive efficacy in the majority of women. It has been postulated that there is a subset of women in whom the enterohepatic recirculation of ethinylestradiol plays an important role. In these women the action of an antimicrobial may reduce the efficacy of oral contraceptives by interfering with this mechanism. Studies that have quantitatively examined these effects may have failed to include women from this subset because of the small numbers involved in the studies. On the other hand, there are no good prospective studies comparing contraceptive failure rates between compliant women who use combined oral contraceptives with and without antimicrobials. All women using combined oral contraceptives should be informed of the very low level of risk of interactions with antimicrobials (probably about 1%) and that it is not possible to identify who may be at risk. Women concerned about this low level of risk should be given information about the use of barrier methods or avoidance of intercourse during the first 7 days of concomitant antimicrobial therapy and for 7 subsequent days. Women who have had previous contraceptive failures or developed breakthrough bleeding during concomitant antimicrobial use should be strongly advised to follow these precautions, as they may be part of the subset of women at higher risk of contraceptive failure. Publication Types: Review Review, tutorial PMID: 10384856, UI: 99312850 ---------------------------------------------------------------------------- ---- Other Formats: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 Hi, Ok here is one more article and maybe this does the best in my mind of explaining the known risks with our patients situation: What they found causes BCPill failure: Smoking (Some of us) Diarrhea and/or vomiting (46%) (Yep!) Drug interactions (33%) (Yep!) Systemic illness (Yep!) Severe psychological stress (Yep!) Menstrual disturbances (Yep!) So CONCLUSION: BC Pills may not be an effective method after the operation until those factors have resolved. N Z Med J 1989 Nov 8;102(879):575-7 Pregnancies in reliable pill takers. Sparrow MJ Parkview Clinic, Wellington Hospital. This study is an extension of a previous study on oral contraceptive pill method failure in reliable pill takers. It documents 137 cases which presented during the 3 year period from December 1985 to December 1988. The most important new finding is that smoking is a significant risk factor in failure on the combined pill (67% were smokers, n = 118), but not on the progestagen-only pill, although the numbers in the latter group were small (n = 19). Diarrhoea and/or vomiting (46%) and drug interactions (33%) are confirmed as important predisposing factors. Systemic illness and/or severe psychological stress may also affect pill utilisation and such factors were found in 47%. Menstrual disturbances were found in 32% of women on the combined pill and 68% of these were smokers. Multiple factors were present in most cases (79%). Repeat failures occurred in 25% RR Rutledge, M.D., F.A.C.S. The Center for Laparoscopic Obesity Surgery 4301 Ben lin Blvd. Durham, N.C. 27704 Telephone #: Fax #: E mail: DrR@... ****************************************** Please Visit our Web site: http://clos.net ****************************************** Durham Regional Hospital: Also, Please consider joining the Mini-Gastric Bypass Mailing List at http://www.onelist.com MiniGastricBypass is a general discussion of the Mini-Gastric Bypass ( http://www.onelist.com/community/MiniGastricBypass ) Talk with lots of other Pre and Post Op patients and friends. Keep up to date on the latest news about the Mini-Gastric Bypass. > RE: Birth Control After MGB > > > > > More on BCP failures... > > Here are two articles on BCP failures. > > One talks about the failure with antibiotics (You get antibiotics after > surgery) > The other talks about the known incidence of GI upset, nausea and diarrhea > being associated with BCP failure... > > So lets be careful out there: > > Clin Pharmacokinet 1999 May;36(5):309-13 > > > > Interactions between oral contraceptives and > antifungals/antibacterials. Is > contraceptive failure the result? > > Weisberg E > Sydney Centre for Reproductive Health Research, Family Planning NSW, > Ashfield, Australia. eweisberg@... > > The effectiveness of oral contraceptives may be impaired by concomitant > treatment with antimicrobials. This may occur because of reductions in > plasma concentrations of ethinylestradiol by the induction of hepatic > metabolism, as for rifampicin (rifampin) and possibly > griseofulvin, or in a > small percentage of women because of interference with enterohepatic > recirculation. There are no scientific data to support the anecdotal > evidence that the concomitant use of combined oral contraceptives and > antimicrobials reduces contraceptive efficacy in the majority of women. It > has been postulated that there is a subset of women in whom the > enterohepatic recirculation of ethinylestradiol plays an > important role. In > these women the action of an antimicrobial may reduce the efficacy of oral > contraceptives by interfering with this mechanism. Studies that have > quantitatively examined these effects may have failed to include > women from > this subset because of the small numbers involved in the studies. On the > other hand, there are no good prospective studies comparing contraceptive > failure rates between compliant women who use combined oral contraceptives > with and without antimicrobials. All women using combined oral > contraceptives should be informed of the very low level of risk of > interactions with antimicrobials (probably about 1%) and that it is not > possible to identify who may be at risk. Women concerned about this low > level of risk should be given information about the use of barrier methods > or avoidance of intercourse during the first 7 days of concomitant > antimicrobial therapy and for 7 subsequent days. Women who have > had previous > contraceptive failures or developed breakthrough bleeding during > concomitant > antimicrobial use should be strongly advised to follow these > precautions, as > they may be part of the subset of women at higher risk of contraceptive > failure. > > Publication Types: > > > Review > Review, tutorial > PMID: 10384856, UI: 99312850 > > > ------------------------------------------------------------------ > ---------- > ---- > > Other Formats: > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 Another medication that could be considered is Depo-Provera! It is injectable and you only need an injection every 12 weeks. As for costs, it is no more than a monthly supply of BCP and the advantage is that with the majority of females, it stops the menses cycle totally while you are on it. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 Another medication that could be considered is Depo-Provera! It is injectable and you only need an injection every 12 weeks. As for costs, it is no more than a monthly supply of BCP and the advantage is that with the majority of females, it stops the menses cycle totally while you are on it. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2000 Report Share Posted February 20, 2000 Hi, We have seen complications with major Nausea and vomiting in patients using Depo-Provera. Please discuss its use with me before your surgery. 2-3 months after surgery you may choose to use what you and your gynecologist think best. RR Rutledge, M.D., F.A.C.S. The Center for Laparoscopic Obesity Surgery 4301 Ben lin Blvd. Durham, N.C. 27704 Telephone #: Fax #: E mail: DrR@... ****************************************** Please Visit our Web site: http://clos.net ****************************************** Durham Regional Hospital: Also, Please consider joining the Mini-Gastric Bypass Mailing List at http://www.onelist.com MiniGastricBypass is a general discussion of the Mini-Gastric Bypass ( http://www.onelist.com/community/MiniGastricBypass ) Talk with lots of other Pre and Post Op patients and friends. Keep up to date on the latest news about the Mini-Gastric Bypass. > Re: Birth Control After MGB > > > From: apexkas@... > > Another medication that could be considered is Depo-Provera! It is > injectable and you only need an injection every 12 weeks. As for > costs, it > is no more than a monthly supply of BCP and the advantage is that > with the > majority of females, it stops the menses cycle totally while you > are on it. > > ------------------------------------------------------------------------ > GET A NEXTCARD VISA, in 30 seconds! Get rates > as low as 0.0% Intro APR and no hidden fees. > Apply NOW! > http://click./1/967/2/_/_/_/951058558/ > ------------------------------------------------------------------------ > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > > Quote Link to comment Share on other sites More sharing options...
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