Monique Rainford - HER HEALTH

My patients who are on the oral contraceptive pill often ask me which pill is best for them. I hope that my answers to these questions will help others with similar concerns.

Dear Dr Rainford,

I am a 35-year-old married woman who needs your help in choosing a contraceptive pill. In my late 20s, I was placed on minigynon by my ob/gyn, but had a lot of spotting. He changed the pill to Ovral which my body tolerated. I had to switch to another pill because of availability. I took it for a while and had a child who is now nine years old. After she was born, I noticed that I had all the side effects of this pill, especially depression. I need to start taking another pill, what do you recommend?

Dear Reader,

I am assuming that you are a non-smoker without any medical problems such as diabetes or hypertension. Women who are 35 or older who smoke should not use the Pill. If you have health problems, you should definitely consult with your doctor before you start using the Pill.

Oral contraceptive pills are comprised of two types of hormones — an oestrogen and a progestin. All formulations have the same type of oestrogen, ethinyl estradiol, although there are slight variations in the dose. However, there are a few different types of progestins in these pills. These include levonorgestrel, (which is the progestin in minigynon and microgynon 30), norgestrel, norethindrone, norgestimate, gestodene, desogestrel and drospirenone.

Ovral which you have also used has norgestrel which is chemically related to levonorgestrel. Depression is a side effect of the progestin in the pill. Therefore, you may try a formulation with a different progestin, for example yasmin contains drospirenone, novynette contains desogestrel or gynera which contains gestodene. Unfortunately, this does not guarantee that you will not have this side effect even with a different formulation. If that is the case, consult your doctor about an alternative form of contraception.

Irregular periods

Dear Dr Rainford,

I started having irregular periods after the first month of my first bleeding at the age of 13. After a few months, it started again and lasted for two months without stopping until I went to see a doctor. He did a hormonal test and said my progesterone and oestrogen levels are low. He placed me on contraceptives for a few months and during that period, my menses came and stopped after five days. But immediately after I stopped taking the drugs, my period ceased. Now I am 29 years old and still don't see my periods except when I take contraceptives and it will make it come for that month only. Please advise me on good drugs that I can take to regularise my period. Thanks

Dear Reader,

Unfortunately, many women such as yourself, suffer from menstrual irregularities. Although I do not have enough information to explain your particular hormonal irregularity, I can advise you that oral contraceptive pills are excellent medications to regularise periods. I suggest that you meet with your doctor to gain a full understanding of your specific problem and to start on the appropriate medication.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.