Nature Medicine | Spoonful of Medicine

Contraceptives with benefits

bcpills.jpgIn America, contraceptive marketing is the peppier cousin of antidepressant advertising (in this case, limber actresses doing yoga are substituted for the actresses strolling contemplatively through wheat fields). Birth control isn’t just about pregnancy prevention anymore; it’s become hormone therapy to treat everything from acne to mood swings. The prevention of birth defects has been added to that list, and cancer-clearing properties might soon follow.

Currently, the accepted treatment for endometrial cancers (which affect the lining of the uterus) is a complete hysterectomy. But a report in the Annals of Oncology describes how intrauterine devices (IUDs) that release estrogen might be used to treat endometrial cancer. In the 13-year study, 34 women with early-stage endometrial cancer had an IUD that released levonorgestrel inserted for one year, combined with six months of gonadotropin-releasing hormone (GnRH) shots. All were alive at the end of the study without evidence of disease, and nine were able to get pregnant after the IUD was removed.

This kind of hormone-releasing IUD is already on the market — there’s one called Mirena. The hormones are supposed to help with heavy periods, endometriosis and anemia.

The diversification of birth control isn’t limited to IUDs, though. German drug company Bayer will be offering a new birth control pill Beyaz, after obtaining the US Food and Drug Administration (FDA) seal of approval last Friday. Beyaz is modeled after Bayer’s existing birth control pill, Yaz, with one key addition: levomefolate calcium, a metabolite of folic acid.

Pregnant women who don’t get enough folates are more likely to give birth to babies who have defects of the neural tube, such as spina bifida. A 1998 directive from the FDA requires most cereals and bread products in the US to be fortified with folic acid. But the benefits of folates for the fetus are only effective during the first four weeks of pregnancy. Fortifying a birth control pill would be a targeted way of ensuring that any accidental pregnancies will not be further complicated by birth defects.

And while it may seem a bit cross-purpose for a birth control pill to also contain prenatal protections, there’s need for a fail-safe. When taken properly, oral contraceptives are 99.7% effective, but actual usage rates are less than perfect, lowering the efficacy to an estimated 92%-98%. Frankly, since there is such a captive market for birth control, it’s surprising that companies aren’t marketing contraceptives with extra vitamins or supplements already.

Men are probably feeling left out of the fun, but no doubt the crackerjack engineering team at Trojan is hard at work on a condom that administers topical Vitamin C.

Image by Nate Grigg via Flickr Creative Commons


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