WOMENS-HEALTH Messages for October, 1998: Re: ATTN: Dr. Hill

Re: ATTN: Dr. Hill

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Mon, 26 Oct 1998 20:54:52 -0600 (CST)

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Do you find that >women who use chemically based birth control tend to have more
>difficulty conceiving, and with their pregnancies in general?

I was intrigued by your questions, so I did a little looking through my references, and, as I suspected, could find nothing to support or refute the idea that chemical (ie hormonal) birth control methods affect later pregnancy in any way. We are taught that they do not. My personal experience supports this, as I have not seen any obvious link between birth control (except perhaps IUDs) and future fertility, ability to carry a child, miscarriage rates, and actual pregnancy outcome. (IUDs can cause infertility due to infections within the fallopian tube. However, this is uncommon, and is very uncommon in monogamous relationships).

>From a biologic point of view, most hormonal-based birth control, with
the exception of Depo-Provera, is "out of the system" within a matter of days (that's why we advise women to take it every day), so it's unlikely it creates a lasting effect. Two methods that have been well-studied are Norplant and Depo-Provera, both long-acting methods of contraception. Pregnancy rates are no different after the medication is discontinued with Norplant. Patients receiving Depo-Provera often struggle to become pregnant within 6 months of stopping this method, but after 6-9 months, fertility returns to normal. Thus, even this very powerful method does not carry long-term difficulty with conception.

It's a good question, but I suspect someone needs to study this further. It would be a big study. I'm always glad to help my Canadian friends (I lived in B.C. when I was younger)! I recently visited Montreal, and re-learned some French: "Je suis un Gynecologue." It sure sounds cool, but I doubt it has much use when touring the city!

Take care,

Can >prolonged use of these drugs contribute to difficulty with the carriage
>of the baby to full term? On a contrary note , have you found in your
>practice that women experience more occurrences of multiple birth after
>a birth control method is stopped? Can using these drugs improve the
>health of the mother's uterus in any way? Any information you could
>provide related to these questions would be fantastic.
>
> Unfortunately, we are facing a limited time line. We understand that
>you are incredibly busy, but your prompt response would be greatly
>appreciated. If you are unable to forward any information, but know of
>any colleagues with knowledge in this area that would be able to assist
>us, we would be thankful if you could send us their names, or pass this
>letter on to them. Please feel free to respond to my own e-mail, stated
>at the top of this letter.
>
> Thank-you in advance for your help, and best of luck with your very
>important work.
> Respectfully yours,
>
>--
> Tina Hornick
>

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

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