BIRTH CONTROL? How it can tie in...

[Guest guest]

HI all.... here's something I've sent in before about Birth control with some thoughts and links. It is long so fair warning. *smile*Something to consider anyway.

hugs

Dee~

----- Original Message -----

HI all,

I myself wouldn't doubt it for a minute that the birth control pills play a big 'part' in the problem of V pain. Being they are mostly progestins.... and P 'blocks' the needed estrogen indeed. It's like a woman has been pregnant for years and years. (Let alone the increase risk of breast cancer from the darn progestins (not the estrogen) *sigh* but that's another story) and worst of all 'in my opinion' are those Depo Provera shots!!! arghhhhh

And it's not only estrogen 'receptors' that get blocked by the progestins/progesterone but the (T) Testosterone receptors as well. BIG TIME, so talk about the loss of libido as well (that is very well known in the medical field by the way) and T is also beneficial for that genital tissue. Latest studies say it may take 'years' to bring that libido back and in some cases may not come back.

1.

Contraception & Family Planning

Researchers Find Possible Association Between Birth Control Pill, Condition Causing Painful Sex

Oral contraceptive use may be associated with vulvar vestibulitis, a condition in which the tissue around the opening of the vagina is inflamed, making sexual intercourse painful, Reuters Health reports.

The condition is most common in young women, and medical treatment is "rarely" successful; most women must have the sensitive tissue surgically removed in order to be free of pain during intercourse. In a study appearing in the Aug. 1 issue of the American Journal of Epidemiology.

Dr. Celine Bouchard of the Hopital du Saint-Sacrement in Quebec and colleagues interviewed 138 women with the condition and 309 women without it.

The researchers found that women who had taken oral contraceptives were almost 'seven times' as likely as women who had never taken oral contraceptives to have vulvar vestibulitis.

Women who began using OCs before the age of 16 were more than nine times as likely to develop the condition as women who had not taken the pills by that age, and the chance of developing vulvar vestibulitis increased further in women who had used OCs for up to two to four years.

Pills that contained higher doses of androgen and progestin and lower amounts of estrogen were found to have the highest correlation with the condition.

Bouchard said that she thinks the hormones in OCs may "act on receptors" in the vulvar tissue, causing the tissue to become "more sensitive to irritating chemicals" and eventually painful to the touch.

However, Bouchard noted that not all cases of vulvar vestibulitis are associated with OC use, and she added that doctors should not stop prescribing birth control pills to young women.

"Until our results are validated by another similar study with a larger cohort of patients, I would be reluctant to suggest to physicians to inform young girls about this association," she said, noting that oral contraceptives are "still the best method of contraception to prevent undesired pregnancies."

However, she said that doctors may want to discuss the link with young women taking OCs for 'non'-contraceptive reasons

(McCook, Reuters Health, 8/7).

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2. MEDSCAPE Article

Use of oral contraceptive pills and vulvar vestibulitis: a case-controlstudy. <clipped>When OCs were first used before age 16 years, the relative risk of vulvar vestibulitis reached 9.3 (95 percent confidence interval: 3.2, 27.2) and increased with duration of OC use up to 2-4 years.

The relative risk was higher when the pill used was of 'high' progestogenic, high androgenic, and 'low' estrogenic potency.

The possibility that OC use may contribute to the occurrence ofvulvar vestibulitis needs to be evaluated carefully.

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3. LIBIDO

<CLIPPED> BY JOE GRAEDON (A PHARMACOLOGIST)

Q: I am convinced that birth control pills have a negative impact on sexual desire. When I asked my pharmacist, she insisted that the levels of hormones are too low to interfere with libido. Is that true? A friend who has had a similar problem suggested I try DHEA: She said it helped her, but I am reluctant to take anything without knowing much about it.

A: According to Dr. Irwin Goldstein, one of the country's leading experts on sexual issues, birth control pills can 'indeed' depress desire.

The dietary supplement DHEA is a precursor to both estrogen and testosterone. While testosterone can be helpful for improving libido, there is a risk that taking DHEA in combination with oral contraceptives could result in excessive estrogen."

(Dee's note* 'because' DHEA does convert to E & E. and T converts to estrogen. Also if one adds 'only' an estrogen as in HRT replacement (without adding T) .. that will 'diminish' the T we do have even further and even more of a cause for lack of libido.

I do have that one study (can't find it right now) that showed less T. with those w. vulvodynia as well as LS and why T can be added topically for it's benefit as well as estrogen cream. AND..... by the way they know that those with LS (lichen sclerosis) also have less or no T. receptors shown via biopsy's and why T was used for so many years previous to the steroids becoming a favorite.

Our hormones MUST be balanced if one is taking any for HRT and it's a delicate one and why those blood levels are SO important and to be tested over and over until it's just right for the person individually not collectively. (I mean for HRT here) not so much topically because a younger persons blood levels may be fine but it doesn't mean their hormone 'receptors' are ok. As both E & T are quite beneficial for the V. skin used topically & regardless of the hormone blood serum levels. DT

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4.

The Libido & progesterone.

Excessive progesterone may decrease libido due to anti-estrogen and anti-androgen effect 9, . As well as decreasing libido, excessive levels may also induce depression and moodiness. 11.

(9) Mauvais-Jarvis P, Kuttenn F. [is progesterone carcinogenic]? [Article in French] Nouv Presse Med 1;4(5):323-326

11) Glick ID, SE. Psychiatric complications of progesterone and oral contraceptives. J Clin Psychopharmacol (6):350-367

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5.

http://www.aafp.org/afp/20000701/127.html

Female Sexual dysfunction, Amer. Fam. Physicians

<clipped from a long article.>

The role of progesterone therapy, which is necessary in estrogen-treated patients with an intact uterus, has not been widely studied in terms of sexuality, but one study suggests that it exhibits a negative impact by dampening mood and decreasing available androgens.''

(So P. again progesterone does diminish the testosterone and from what I've read if the E levels are kept below a certain number or range, the addition of the P may not be necessary at all to protect the uterus. I add E & T orally and do NOT use a progestin at all (prob. 4 yrs now and have my uterus) but I keep an eye on those E. levels. DT

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6.

(clipped from long article on dermatological diseases from Medscape )

Autoimmune Progesterone Dermatitis (AIPD)

Description of disease. AIPD represents an autoimmune hypersensitivity reaction to endogenous progesterone.[3] The condition presents with a variety of skin eruptions characterized by cyclical recurrent premenstrual exacerbations due to progesterone fluctuation during the menstrual cycle.

The type of skin eruptions observed in AIPD include dermatitis, erythema multiforme, urticaria, vesicular lesions, stomatitis, herpes-like dermatitis, and papular lesions.[2] There are no classic morphologic or histologic features. AIPD usually presents during early adult life, and the disease may periodically go into spontaneous remission.

Exogenous progesterone (eg, in oral contraceptives containing progestational agents like norethindrone or synthetic progestogens like norgestrel or levonorgestrel) may aggravate the skin eruptions of AIPD. (thinking of V tissue pain here) DT

These eruptions usually flare up during the latter half of the menstrual cycle, peaking premenstrually and resolving within a few days of menses. This disease may become worse during pregnancy.[4]

(note* Esp. those who have more pain the last two weeks of ones cycle AND with pregnancy when Progesterone is excessively high, DT)

Differential diagnoses. The differential diagnosis of AIPD includes the skin disorders it mimics, such as endogenous and contact dermatitis, various cases of urticaria, erythema multiforme, drug eruption, insect bite reaction, and scabies. The syndrome is confirmed by evidence of hypersensitivity to progesterone, which is demonstrated by intradermal skin testing with progesterone.

Treatment. Definitive treatment of AIPD involves the use of anovulatory agents (such as estrogen) to suppress endogenous progesterone secretion. In mild disease, the skin eruptions may be controlled with midpotency topical steroids and oral antihistamines. However, when patients do not respond to conventional treatment or to oral estrogen preparations, systemic steroids may be necessary.

Tamoxifen, a nonsteroidal antiestrogen agent, may be effective in some patients but may cause amenorrhea. In some cases, the eruptions often settle spontaneously after a period of successful treatment.[2] In the most severe cases, however, oophorectomy may be required to control the skin eruptions of AIPD.

================================== 7. Birth control pills & Libido! http://www.lifesite.net/ldn/2005/may/05052603.html Birth Control Pill May Permanently Reduce Sex Drive Study Finds ====================================

8. This is from a long (4 hr) cont. med. ed. class/seminar with Dr. Natchigal, Sarrel, et al, Very well known in the hormonal field and gyne area. Whizzed an A in the test before I even read the lecture, *smile*..

<clip>

''Nachtigall: ''Our topic has been vaginal atrophy in the postmenopausal woman, but these examples of similar problems in younger woman underscore the fact that vaginal atrophy stems from estrogen deficiency, however it comes about.'' ''Sarrel: We've seen it even in young students taking oral contraceptives (w. progestins) and with those who have high sex hormone-binding globulin levels. (SHBG,) ''

(This SHBG 'binds' up the active portion of those hormones, dee)

''That (contraceptive use) leads to 'very low' levels of free estradiol and consequent 'loss' of the good superficial vaginal cells.''

''Changing to a different contraceptive formulation can sometimes solve theproblem, but frequently 'local' treatment with estradiol tablets is effective and much simpler to use.'' ............ ''

(by 'local' here, they mean using an E pill *tablet* (example..Vagifem or E-string possibly, directly inside of the vagina *intravaginally* ) DT

That's MORE enough for now, *smile* (forgive me) and hope those help a bit.

Dee~