Birth Control Medications
   

Birth Control Medications
Monophasic, Biphasic, and Triphasic Preparations

  • Ethinyl Estradiol and Desogestrel
    (Apri®; Desogen®; Mircette™; Ortho-Cept®)
  • Ethinyl Estradiol and Levonorgestrel
    (Alesse™; Levlen®; Levlite®; Levora®; Nordette®; PREVEN™; Tri-Levlen®; Triphasil®)
  • Ethinyl Estradiol and Norethindrone
    (Brevicon®; Estrostep® 21; Estrostep® Fe; Femhrt™; Genora® 0.5/35; Genora® 1/35; Jenest-28™; Loestrin®; Modicon™; Nelova™ 0.5/35E; Nelova™ 10/11; Norethin™ 1/35E; Norinyl® 1+35; Ortho-Novum® 1/35; Ortho-Novum® 10/11; Ortho-Novum® 7/7/7; Ovcon® 35; Ovcon® 50; Tri-Norinyl®)
  • Ethinyl Estradiol and Norgestimate
    (Ortho Tri-Cyclen®; Ortho-Cyclen®; Ortho-Prefest™)


Depletions
Magnesium

Magnesium deficiency affects calcium and vitamin D levels in the body and may be associated with muscle cramps, heart irregularities, high blood pressure, diabetes, and osteoporosis (bone loss).


Vitamin B2 (Riboflavin)

Symptoms of vitamin B2 deficiency may include cracks at the corners of the mouth, inflammation of the skin, growth retardation, and impaired wound healing.


Vitamin B6 (Pyridoxine)

Symptoms of vitamin B6 deficiency may include weakness, nervousness, insomnia, mental confusion, irritability, and anemia. Long-term low levels of this nutrient may also increase the risk of heart disease as well as colon and prostate cancers.


Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, birth defects, and colon cancer.


Vitamin B12 (Cobalamin)

Symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.


Vitamin C (Ascorbic Acid)

Vitamin C deficiency may include bruising, fever, anemia, emotional changes, swollen and bleeding gums, fatigue, lethargy, jaundice (yellowing of the skin and eyes), increased susceptibility to infections, slow wound healing, and swelling of the lower limbs. Severe deficiency leads to scurvy, a disorder that affects muscles and bones and is potentially fatal. However, scurvy is rare these days because of the wide availability of vitamin C from dietary sources.


Zinc

Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, hair loss, skin changes, diarrhea, and increased susceptibility to infection.


Editorial Note

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle as well as the length of time you have been taking the medication. Please consult your healthcare provider; he or she can best assess and address your individual healthcare needs, and determine if you are at risk for nutrient depletions from these medications as well as others not listed here.


Supporting Research

Ahmed F, Bamji MS, Iyengar L. Effect of oral contraceptive agents on vitamin nutrition status. Am J Clin Nutr. 1975;28(6):606-615.

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Berger W. Incidence of severe side effects during therapy with sulfonylureas and biguanides. Horm Metab Res Suppl. 1985;15:111-115.

Bermond P. Therapy of side effects of oral contraceptive agents with vitamin B6. Acta Vitaminol Enzymol. 1982;4(1-2):45-54.

Carpentier JL, Bury J, Luyckx A, Lefebvre P. Vitamin B12 and folic acid serum levels in diabetics under various therapeutic regimens. Diabetes Metab. 1976;2(4):187-190.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr 1999;69:1086-1087.

Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and phosphorus. Proc Nutr Soc. 1999;58:477-487.

Covington T, ed. Nonprescription Drug Therapy Guiding Patient Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.

Dorea JG, Ferraz E, Queiroz EF. [Effects of anovulatory steroids on serum levels of zinc and copper]. Arch Latinoam Nutr. 1982;32(1):101-110.

Falchuk KH. Disturbances in Trace Elements. In: Fauci A, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill Companies Health Professional Division; 1998:490-491.

Green TJ, Houghton LA, Donovan U, et al. Oral contraceptives did not affect biochemical folate indexes and homocysteine concentrations in adolescent females. J Am Diet Assoc. 1998;98:49-55.

Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S Suppl):1344S-1349S.

Hjelt K, Brynskov J, Hippe E, Lundstrom P, Munck O. Oral contraceptives and the cobalamin (vitamin B12) metabolism. Acta Obstet Gynecol Scand. 1985;64(1):59-63.

Kane FJ Jr. Evaluation of emotional reactions to oral contraceptive use. Am J Obstet Gynecol. 1976;126(8):968-972.

Kornberg A, Segal R, Theitler J, et al. Folic acid deficiency, megaloblastic anemia and peripheral polyneuropathy due to oral contraceptives. Isr J Med Sci. 1989;25(3):142-145.

Li X, Ran J, Rao H. [Megaloblastic changes in cervical epithelium associated with oral contraceptives and changes after treatment with folic acid]. Chung Hua Fu Chan Ko Tsa Chih. 1995;30(7):410-413.

Matsui MS, Rozovski SJ. Drug-nutrient interaction. Clin Ther. 1982;4(6):423-440.

Nash AL, Cornish EJ, Hain R. Metabolic effects of oral contraceptives containing 30 micrograms and 50 micrograms of oestrogen. Med J Aust. 1979;2(6):277-281.

National Research Council, Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press; 1989.

Newman LJ, Lopez R, Cole HS, et al. Riboflavin deficiency in women taking oral contraceptive agents. Am J Clin Nutr. 1978;31(2):247-249.

Olatunbosun DA, Adeniyi FA, Adadevoh BK. Effect of oral contraceptives on serum magnesium levels. Int J Fertil. 1974;19(4):224-226.

Powers HJ. Current knowledge concerning optimum nutritional status of riboflavin, niacin and pyridoxine. Proc Nutr Soc. 1999;58(2):435-440.

Prasad AS, Lei KY, Moghissi KS, et al. Effect of oral contraceptives on nutrients. III. Vitamins B6, B12, and folic acid. Am J Obstet Gynecol. 1976;125(8):1063-1069.

Rivers JM. Oral contraceptives and ascorbic acid. Am J Clin Nutr. 1975;28(5):550-554.

Seelig MS. Increased need for magnesium with the use of combined oestrogen and calcium for osteoporosis treatment. Magnes Res. 1990;3(3):197-215.

Seelig MS. Interrelationship of magnesium and estrogen in cardiovascular and bone disorders, eclampsia, migraine and premenstrual syndrome. J Am Coll Nutr. 1993;12(4):442-458.

Shojania AM. Oral contraceptives: effect of folate and vitamin B12 metabolism. Can Med Assoc J. 1982;126(3):244-247.

Slap GB. Oral contraceptives and depression: impact, prevalence and cause. J Adolesc Health Care. 1981;2(1):53-64.

Stanton MF, Lowenstein FW. Serum magnesium in women during pregnancy, while taking contraceptives, and after menopause. J Am Coll Nutr. 1987;6(4):313-319.

Tyrer LB. Nutrition and the pill. J Reprod Med. 1984;29(7 Suppl):547-550.

Webb JL. Nutritional effects of oral contraceptive use: a review. J Reprod Med. 1980;25(4):150-156.

Webb JL. Nutritional effects of oral contraceptive use: a review. J Reprod Med. 1980;25(4):150-156.

Weininger J, King JC. Effect of oral contraceptive agents on ascorbic acid metabolism in the rhesus monkey. Am J Clin Nutr. 1982;35(6):1408-1416.

Wilson JD. Vitamin deficiency and excess. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:483-485.


Review Date: October 2000
Reviewed By: All depletions monographs have been reviewed by a team of experts including Derrick M. DeSilva, Jr., MD, Raritan Bay Medical Center, Perth Amboy, NJ; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc., Boston, MA; John Hinze, PharmD, NMD, Woodbine, IA; Ruth Marlin, MD, Medical Director and Director of Medical Education, Preventive Medicine Research Institute, Sausalito, CA; Brian T Sanderoff, PD, BS in Pharmacy, Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Leonard Wisneski, MD, FACP, George Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA, President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 
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