Stopping birth control pills every two years?

[queenjulie]

My brand-new, 2011-edition pharmacology text says, "Many health care providers prefer to have patients discontinue birth control pills for 3 of every 28 months. This allows the body to return to a normal cycle."

Is this true? I've never heard of stopping birth control for several months (I took the pill for ten years myself, and no one ever suggested stopping every two years). It seems like it would be just inviting unintended, unwanted pregnancies. Are nurses and doctors advising stopping pills for several months nowadays?

[metal_m0nk, BSN, RN]

"My brand-new, 2011-edition pharmacology text says, "Many health care providers prefer to have patients discontinue birth control pills for 3 of every 28 months. This allows the body to return to a normal cycle."

What textbook it is?

Anyway, it is not about cervical cancer (there's no evidence of any increasing or decreasing of its risk and taking pills in non-high risk populations); it is hardly can be about breast cancer (if there is an additional risk of it because of pills, it appears to be rather small) and not at all about uterine or overian cancers (against which pills provide some degree of protection). If there's a question about "nature" and such stuff, then three months of freedom after 28 of suppression is not enough for the system to reload itself anyway. The hormones are deposited in body fat and eliminated very slowly (weeks/months)

It was a rather ancient method of treatment of so-called "female functional infertility" and irregular cycles (all tests are OK, but either no evidence of ovulation in three subsequent cycles, or cycles are irregular and all that was considered to be the reason for inability to concieve): patients were given a year of pills and then stop abruptly and "resume active attempts". The expected result, in otherwise healthy young patient would be increase of axis activity and multiple ovulations, or at least ovulation in every cycle for a while. It worked in many cases, so maybe some practitoners still use pills for this purpose. But if patient doesn't plan to get pregnant, then such tactics will only expose her to high and unnecessary risk of unwanted pregnancy.

P.S. i take low-dose pills for 20+ years with break only for baby, and never, ever was told to have a break. I don't have any additional risk factors, though.

Didn't the WHO, after reviewing all of the available literature, declare combination oral contraceptives a Group 1 carcinogen?

I think I remember reading something about that not long ago...

[gymnut]

I am on Depo Provera for almost 3 years to treat my endometriosis and I LOVE not getting my periods. My only regret is that I didn't go on it sooner.

It does say in the pamphlet that I shouldn't be on it for more than 2 years unless recommended by a doctor but, I think that's because of the increased risk of osteoporosis.

[OCNRN63, RN]

I take BCP, skip the placebo week and start a new pack. I've been doing this for several years, with no adverse effects.

[mercuryrawks]

Didn't the WHO, after reviewing all of the available literature, declare combination oral contraceptives a Group 1 carcinogen?

I think I remember reading something about that not long ago...

http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf

Yep, they did.

[April, RN, BSN, RN]

Wow, I can't believe I've never heard or read that before! Thankfully, the article states:

"They regularly review

the safety of COCs and assess the balance

of risks and benefits of COC use and they

have determined that for most healthy

women, the health benefits clearly exceed

the health risks."

[KatieMI, BSN, MSN, RN]

Didn't the WHO, after reviewing all of the available literature, declare combination oral contraceptives a Group 1 carcinogen?

I think I remember reading something about that not long ago...

:):)

Just for clarification:

http://ntp.niehs.nih.gov/index.cfm?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932

http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s084ster.pdf

only estrogen is declared to be a "known human carcinogen", and that's why postmenopausal estrogen replacement therapy was outlawed. Before this, diestilbestrol was taken off for the same reason. There were 3 studies about causative correlation between breast cancer and combination oral contaceptives, and the relative additional risk was found to be "small", about 5 additional tumors/1000 women/lifetime; I guess that other risk factors add much more.

After all, breast cancer can be screened early enough to cure. Ovarian and uterine cancers (which are prevented by taking oral contraceptives with up to 50% decreasing risk for ovarian cancer) are much more difficult to find and much less likely even to be put into good remission.

[carolmaccas66, BSN, RN]

http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf

Yep, they did.

Thank you for posting this link. It is very helpful for further research and to keep our nursing knowledge up to date.

[carolmaccas66, BSN, RN]

Yes I know what the endometriosis sufferers have gone through. As soon as I stop my pill (I had to have a series of blood tests done not long ago and had to cease the pill for a month b4 hand), and all my bleeding, pain, etc (well more like haemorrhaging), came back full force. I don't like taking the OCP and have tried every other available alternative for endometriosis but the OCP seems to work best. I could not go to work or function without it as the pain is horrific.

[queenjulie, RN]

What textbook it is?

Basic Pharmacology for Nurses (13th ed.) by Clayton, Stock, and Cooper, published by Mosby.