WOMENS-HEALTH Messages for February, 1998: Re: Need a new pill: how to choose?

Re: Need a new pill: how to choose?

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Fri, 27 Feb 1998 15:08:44 -0600 (CST)

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At Fri, 27 Feb 1998, Holly wrote: >
>I am 29 and had my first child about 6 months ago. I think I need a new
>bc pill. I had a terrible bout of cystic acne after the birth. I have
>been under a dermatologists care for 3.5 months and the acne is clearing
>up. She thinks that I probably developed a cyst that has dissolved on
>its own especially because I had some hair under my chin that has gone
>away completely. I am on many meds: minocycline, benzamycin, and Ortho
>Tricyclen. So I can't be sure what is clearing me up. However, I do
>break out every month towards the end of the first week of a new pack of
>pills. Therefore I don't know if the Ortho T-C is helping to clear me
>up or if it is actually hindering a clearing process that would have
>happened naturally due to hormones getting back to normal. I also have
>other side effects: 1)nausea during the first week of pills, 2)increased
>appetite, and 3)seriously decreased libido. I NEVER had any acne before
>my pregnancy. Therefore, I just feel that my hormones are still not in
>balance with this pill and that there may be something better for me.
>Are there any recommendations for pills that would help control acne as
>well as diminish some of these other side effects? How do I go about
>trying to find the right pill for me? My dermatologist seems to think I
>am on the right pill for the acne but I'm not so sure. And, she doesn't
>know enough about bc pills to recommend a different one. And then, my
>OB/gyn doesn't really know what would be best or worse for the acne. How
>do I figure this out? Is there any other way besides trial and error? My
>face has been through quite enough!!! I would sincerely appreciate any
>pill suggestions you could provide. Thanks,
>
>--
>Holly

Holly,

Are you ready for an incredibly honest answer? Well, here goes ....... it's hit or miss. There are charts of the estrogen strength and progestational strength of various low dose pills and many make choices based upon that. Unfortunately, picking like tht may help one symptom and make another one worse, so we're bacvk to trial and error. The Ortho TC was approved by the FDA to be advertised as an adjunct to acne therapy. I have, in my practice, not noted it to be better or worse tahn many others. the decreased libido is supposed to be reduced in triphasic pills so you (and many others) are the exception to that rule. See what I mean? It's intensely frustrating for patients but the docs are frustrated too. We only wish we could get it perfect first time out. It would save a lot of time, effort and phone calls if this were possible.

--
Harvey S. Marchbein, M.D. FACOG
OBGYN.net U.S. Representative, New York
Great Neck, New York
http://www.obgyn.net/states/bios/marchbein.htm
http://www.obgyn.net/women/advisors/harveym.htm

**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.

**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.

**Thank you for your understanding ;-)

Next message: Harvey S. Marchbein, M.D.: "Re: pyridoxine supplements"
Previous message: Tammy: "Re: Natural Family Planning"
In reply to: Holly: "Need a new pill: how to choose?"

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