Recently, a birth control pill called Lybrel that does away with a woman’s monthly period, was approved by the U.S. Food and Drug Administration. William Davis, MD, obstetrician and gynecologist at University of Iowa Hospitals and Clinics, talks about this new medication and other birth control options for women.

How long ago was the first birth control pill introduced for women?

The mid-1960s. 

In general how reliable are current methods of birth control for women?

When you compare patches, rings, pills, implants, IUDs, injectables, they’re all fairly reliable. It’s a matter of preference and making sure that you use the product correctly. 

Explain the significance of the recently approved birth control pill Lybrel.

Taking the birth control pill continuously, usually people will not have a period. That makes it significantly different than the original pill. 

If you’re talking about a pill that’s designed to control or stop/prevent births, but at the same time allow basically the rest of your body’s chemistry to operate as normal, without getting too technical, how is that possible?

It’s interesting that if you go back in human history when life expectancy was probably early 20s and periods really didn’t start till probably 16 or later, there was no birth control, and so with pregnancy there was no period, obviously. Breast feeding was very prolonged, many times up to two years, both for birth control and for nutrition, and people would go through famine cycles, at which time they wouldn’t have periods either, so they estimate in the old days, that a woman might only have six periods in her entire life cycle. So in a way, not having a period is really natural, as opposed to having one month after month, three or four hundred times during a woman’s lifetime. 

Has there been a strong demand from women for a method of birth control that eliminates monthly bleeding?

There has and it has been interesting; when I first started practicing 30 years ago, if you would have suggested that to a person, they would just have been appalled. But it’s been interesting; surveys have shown that there’s been increasing interest in not having a period every month.  And really, the real reason why a woman might decide against that kind of method is really just tradition. 

Are there risks, side effects or complications that might arise using Lybrel?

Actually, taking the pill both continuously and traditionally, there’s a decrease in a number of modern GYN diseases; things like endometriosis, decrease in infections, decrease in two kinds of cancer over inuterous, and decrease in benign breast problems, so it does have some long-term medical advantage. It may well be that eliminating periods all together is even better. In fact, the only concern we have is what might be the effect of long-term breast health. It looks now like it probably would be positive. It’s a very low dose pill, Lybrel, and there has been no evidence at all that it increases the risk of breast cancer. 

Am I hearing correctly that the side effects and complications are minor? Is there anything that physicians would really want to keep an eye on for somebody that was going to use Lybrel long-term?

As far as major disease, no. We’ve actually done continuous birth control pills for many years to treat endometriosis. And one of the problems, and one reason why this particular product took a while to make it to the marketplace, is that women can have breakthrough bleeding and spotting.  So that can be a nuisance issue, obviously not a major issue, but certainly a nuisance issue.  What I typically do is have somebody take the pill continuously until they have annoying bleeding, and then go off for three or four days and then go back on again, and many times that strategy works just fine. 

How long can a woman safely stay on Lybrel?

Theoretically one could stay on right up through menopause as long as one did not have a major medical problem to contraindicate that, the main one would be smoking. You really shouldn’t use the pill from 35 on if one is a smoker. Certainly a blood clot would be a contraindication. But for the most part, the low-dose pills are a far safer product then what first emerged, and in fact, there’s four to five times less female hormone in the pill today, and in this particular product, than in the original pills. 

If a woman wanted to learn more about Lybrel or any other methods of birth control to determine which might be right for her, is there a phone number she can call?

Actually the Wyeth Pharmaceutical Web site would be the best way to get additional information--that’s at www.wyeth.com . 

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