News Highlights
Health Canada approves Seasonale® for release in Canada this fall
Seasonale® is a new oral contraceptive pill that was recently approved by Health Canada. How is it different? Seasonale® is an “extended use” pill, meaning that instead of a 28 day cycle, a woman will have a 91 day cycle. For 84 days in a row, a woman takes an active pill (containing 30 mcg of ethinyl estradiol and 150 mcg levonorgestrel). Then she will either take sugar pills for 7 days or a 7 day break. Taking the pill this way means fewer scheduled menstrual cycles, typically 4 periods per year instead of the usual 13.
The oral contraceptive pills that have long been available in Canada are approved to be used in a 28 day cycle, meaning that you take a hormone containing pill for 21 days in a row and then you either take a sugar pill for 7 days or 7 days off. Many physicians have used these oral contraceptives for extended cycles with women who have difficulties with their periods, for example women with heavy periods, crampy periods, or endometriosis. However, Seasonale is the only oral contraceptive pill that is specifically approved by Health Canada to be used in an extended fashion. Some women also enjoy the flexibility of having fewer periods because it suits their lifestyle.
Seasonale® will be available in Canada this fall. It will be priced similarly to other oral contraceptive pills. The indications and contraindications for Seasonale are the same as for other birth control pills that contain estrogen.
Tubal sterilization not linked to gynaecologic cancer risk
Researchers from the United Kingdom (UK) tried to see if there was a relationship between tubal ligation and cancers of the reproductive tract, breast cancer, and all-cause mortality.
The researchers gathered information from the Royal College of General Practitioners’
Oral Contraception Study, a cohort study of 23,000 women in the UK that started in 1968 and ended in 2004. They identified 2801 women who had a tubal ligation and compared them with women from the original cohort group.
Women who had a tubal ligation were more likely to have had children, smoke, have a history of high blood pressure and cardiovascular disease, and be of a lower socioeconomic class. Women who had tubal ligations did not have a higher risk of cancer or death. In fact, there was a small insignificant decrease in both gynaecologic and breast cancers in women with a tubal ligation.
Theories of why tubal ligation may be protective from gynaecology malignancy are still speculations, but they include the controversial idea that decreased blood flow to the ovaries reduces hormone output, or that less vaginal contaminants enter the pelvic cavity.
Iversen L, Hannaford PC, Elliott AM. Tubal sterilization, all-cause death, and cancer among women in the United Kingdom: evidence from the Royal College of General Practitioners' Oral Contraception Study. Am J Obstet Gynecol. 2007 May;196(5):447.e1-8.
African trials involving “Anti-AIDS” gel halted
An American reproductive health group, CONRAD, has halted trials involving Ushercell, an anti-HIV vaginal gel manufactured in Canada over concerns that the gel may actually lead to an increased risk of acquiring HIV.
Over 1300 women in South Africa, Uganda, and India were involved in the trials. Neither the manufacturer of the product nor the researchers have an explanation for why women that used the gel might be at a higher risk of getting HIV.
In South Africa, they are looking at the ethical protocols for the trials to make sure that women had enough information before they entered the study. Many HIV/AIDS researchers in Africa feel studies such as this need to continue since the condom is currently the only other method of preventing HIV, and this requires co-operation from the male partner. Due to the low socio-economic status of women in many African countries, a method that protects them from HIV without the involvement of a male partner is critically important.
A new trial is already underway in Uganda, while two trials on different gels will continue in Africa.
Wakabi, W. HIV microbicide trials halted. CMAJ. 2007 May: 176(11):1568-69.
Ask Sexualityandu
If you test positive for Chlamydia, does your doctor report it to public health? Will they then inform your partners, or is that up to you?
It depends a bit on where you live. In most places, the lab that finds the positive test sends copies of the results to the doctor that ordered the test and the local public health agency. Your health-care provider may take information from you regarding your sexual contacts and encourage you to inform them yourself. If that is uncomfortable or not possible, the local public health agency will also be speaking to you about your sexual contacts. They will find and inform those contacts confidentially and will help to provide treatment for both you and your partner(s).
I just had an IUD put in. How long before it is good for contraception?
An IUD (such as Nova T, Flexi T 300, or the Mirena® IUS) is actually effective immediately, however most health-care professionals recommend waiting a week (use either condoms or abstinence) before relying on it to protect against pregnancy.
I have missed a couple of pills after having sex (missed them on different days - not 2 days in a row). I have not had sex since then. Is there a risk I might be pregnant?
Any time you miss pills while having vaginal intercourse it is possible to become pregnant. Even with perfect pill use, 1-2 women in 100 will become pregnant each year. If your next period is late, consider a pregnancy test. If you find that you are often forgetting your pills, it’s a good idea to speak to your doctor to try to see if another birth control method would be better for you.
This is the first time I have been on the birth control pill. I have been taking the pill every day at the same time for 2 weeks but I started my period anyway. Is this normal? Will I get my period again when I take the sugar pills in 1 week? Does this mean that the pills are not working for me?
It is common to have unexpected bleeding in the first 2-3 months on a birth control pill. As long as you have taken a pill every day at about the same time, you are protected from pregnancy. Hang in there and keep going with the pills. You may have more bleeding during the week of sugar pills. After 2-3 months of the pill, this irregular bleeding should settle down. If it does not, see your health-care provider to make sure there is not another reason for having bleeding, such as a sexually transmitted infection. Also, if you smoke, that makes it more likely for you to spot.
