Happy Birthday, Pills!

Birth control pills are 50 years old now. From the very start birth control pills have been popular, effective when used correctly, safe for most, but not all, women, and often embroiled in controversy. 

YAZ is one of the most recent pills – there are now more than 80 pills being hawked to American women.  There are all too many different pills. YAZ has 20 micrograms of the estrogen, ethinyl estradiol, and 3 mg of the progestin, drospirenone. YAZ is the most commonly prescribed pill in the United States as of January, 2010, the month of the 50th birthday of oral contraceptives. YAZ finds itself surrounded by some of the same issues pills encountered in their first 10 to 15 years. Why are lawyers reaching out to women using YAZ birth control pills? You have seen their ads. The complications that have come to the attention of lawyers are in the same family as the earliest serious pill complications: blood clots and pulmonary emboli. But it remains unclear if serious complications are more frequent in women on YAZ than in women on other pills.

You have seen other ads about YAZ because YAZ is still under patent and sells for upwards of about $85 per cycle. A woman takes thirteen (13) 28 day cycles of pills per year so 13 x $85 = $1,105 per year.  As Yogi Berra says: “That’s real money.”

Now I have been critical of Wal-Mart for a number of things, but a woman can go to her local Wal-Mart and buy Tri-Sprintec or Sprintec for about $10 per cycle or 13 x $10 = $130 per year. The advantages of YAZ are minimal and I suggest that clinicians prescribe and women buy and use Sprintec or Tri-Sprintec.

But back to the question of safety. Below is one prominent Emory physician’s overview of the issue of the safety of YAZ and Yasmin pills. Dr. Mimi Zieman has added the following paragraph to the soon-to-be- published 2010-2012 edition of Managing Contraception:

“A very large prospective study of the risk of VTE with drospirenone, sponsored by the manufacturer, found no relative increase in risk with the use of DRSP compared with LNG pills (Dinger). However, 2 recent large studies (one case-control, and one very large retrospective cohort) did find small increases in risk with the use of DRSP pills compared with LNG pills (Lidegaard, A van Hylckand Vlieg). A debate about whether these studies adequately controlled for confounding factors is ongoing.” 

Dr. Jeffrey T. Jenson, professor of obstetrics and gynecology at the Oregon Health Sciences University in Portland, Oregon, recently reviewed the issue of venous thromboembolism in the November, 2009 issue of OB/GYN Alert.  He is clearly impressed by the European study of 58,674 women followed for 142,475 woman-years of observation [Dinger JC. Contraception 2007]. Only 2.44% of women were lost to follow-up. The investigators found no difference in the overall incidence of serious adverse events between users of pills containing drospirenone like YAZ and Yasmin and any other oral contraceptive groups.