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birth control pills (acne and cramps)
Question from Anonymous on 12/31/2013:

Can you provide some references regarding the harm caused by birth control pills? In particular, when they are prescribed for acne control and mitigation of menstruation cramping. Are there references for alternative methods (i.e., non birth control pills). Thank you in advance.

Answer by Judie Brown on 1/3/2014:

Dear Anonymous

I sent your question to Anthony Dardano, MD and here is his response for you

Birth control pills are generally a combination of the dominant female hormones estrogen and progesterone. They are primarily prescribed as contraceptive agents but there are a few medical uses as well such as to control excessive menstrual flow, severe cramping due to endometriosis and acne. As with any medication one must weigh the benefit versus risk ratio. The medical complications of their use are well known and include hypertension, migraine, stroke, pulmonary emboli, aggravation of diabetes, etc., to name a few. It would be difficult to provide references in this limited forum but all one has to do is read the package insert and you will find all the references you need to become fully informed on the medical risks associated with their use.

One thing you won't find in the package insert is the abortifacient side effect. The pill alters the uterine lining such that it becomes unreceptive to a fertilized egg should "break through ovulation" occur. The fertilized egg, unable to implant, is then lost and is actually an early abortion. This must be taken into consideration when deciding on whether to take them or not. There is never a moral issue in the celibate woman or one who is permanently infertile for some other reason such as hysterectomy, etc. The sexually active, fertile woman may use the pill for a medical indication if she abstains from relations during the therapy which because of the real possibility of medical side effects, should be short term.

There are some alternatives to birth control therapy. For acne, products such as the Proactive line when coupled with the oral antibiotic tetracycline can be quite effective. Menstrual bleeding can be controlled with a non hormonal product Lysteda which acts on the clotting mechanism and is only required to be taken 5 days a month. Many of the non steroidal preparations in prescription strength are quite effective for the cramping. My best advice would be to find a prolife provider who would be willing to work with you providing sound medical treatment while still keeping within sound ethical boundaries.

Speaking from years of experience in this field, you can have both. Anthony N Dardano, MD, FACS, FACOG

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