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From Pimples To Desire, What Might Happen When You Ditch The Pill

(Becca Schmidt/Flickr via Compfight)

(Becca Schmidt/Flickr via Compfight)

By Veronica Thomas
Guest Contributor

So you’re thinking about going off the pill. Maybe you’ve been feeling depressed, getting headaches, or keep forgetting to pop the tiny tablet. Perhaps you’ve been experiencing some really strange stuff that didn’t happen before you started the pill—like inflamed, bleeding gums or cringing at another person’s touch.

Both personal anecdotes and research studies have linked these and other side effects, such as breast tenderness and nausea, to the pill. (One study suggested it might even make you pick the “wrong” partner by altering your chemical attraction to a man’s scent.)

Most randomized control trials haven’t actually found any real difference in the frequency of side effects among women taking the pill versus those taking a placebo.

“It’s an interesting phenomenon,” says Dr. Alisa Goldberg, director of clinical research and training at the Planned Parenthood League of Massachusetts. “Clearly some women are sensitive to the pill and experience these things, but when you try to study it scientifically on a population basis, there’s really no difference.”

Still, while four out of five American women have used the pill at some point, 30 percent have discontinued its use due to dissatisfaction—most commonly because of its side effects. The latest federal statistics on contraception use are due this fall, and experts expect trends from recent years to continue: IUD use will continue to rise, while pill use seems to have plateaued.

I tried five different formulations of the pill, but never managed to escape all the annoying symptoms.

The issues a woman experiences—or whether she has any at all—vary greatly based on the specific dosage of hormones and the unique individual swallowing them every day. Personally, along with bloating and mood swings, I got migraines with an aura, or what felt like a laser light show in my left eyeball. Twice I had to retreat to my office’s “Pump and Pray Room”—reserved for new mothers and religious employees—to lie down and recover. (What I did not know at the time was that, because of this symptom, I should not have been on an estrogen-containing pill in the first place. Women with aura migraines, along with other conditions that put them at risk for strokes, blood clots, heart disease or some cancers, should not take combination pills.)

Finally, I gave up on the pill—only to be blindsided by a whole new challenge: the unexpected side effects of going off the pill. To help others avoid similar unpleasant surprises, I spoke with three experts about what to expect when you ditch the pill for another birth control method.

Of course, just as each woman has a unique reaction to the pill, she’ll also have a unique reaction to going off. According to the feminist women’s health organization Our Bodies, Ourselves, there is “enormous variability in any individual’s response to her own hormones or any synthetic hormones she takes.” One woman’s skin may break out in pimples, while another’s clears up completely.

With this disclaimer in mind, here are eight possibly unexpected changes you might experience when you cancel your monthly refill of that crinkly foil packet:

1. Most of the side effects should disappear in a few days.

First off, while many women decide to have their period before pitching the pack, it’s safe to stop taking the pill at any point. However, you should stop immediately if experiencing any serious side effects, like headaches or high blood pressure, says Dr. Jennifer Moore Kickham, the medical director of a Massachusetts General Hospital outpatient gynecology clinic. Continue reading

Virtual Check-Ups: The Doctor Will See Your Online Responses Now

(Medisoft via Compfight/Flickr)

(Medisoft via Compfight/Flickr)

Veronica Thomas
CommonHealth Intern

Like many patients with chronic conditions, Lesley Watts used to come in to the doctor’s office for a check-up on her digestive disorder every 12 months. This not only meant time spent in traffic and scouring for a parking spot, but also the brain fog and stress of answering her doctor’s questions on the spot.

But a year ago, when it was time for her visit, she instead  received an email reminder to pull up an online form that asked her everything her doctor needed to know about her symptoms. From the comfort of her recliner, Watts carefully answered the questions, among them: “Overall, how have your reflux symptoms been since your last office visit?” “How much have your symptoms affected your work, social, and/or home life?”

When she was satisfied with her responses, she clicked “submit.” The next day, she received instructions from her doctor about how to manage her symptoms better. Visit complete. And patient satisfied.

“It asked me questions that I had never been asked before, and as a consequence, I learned about symptoms I had not recognized,” she remembers. “I believe I received better care because I was able to take my time and provide more accurate answers.”

“We believe that it can actually increase your engagement with the system because you’re thinking about your condition outside of the physician’s office.”

– Dr. Ronald Dixon

Virtual care and tele-medicine are hot health topics, replete with weighty promises of revolutionizing healthcare. But they often refer to realtime video-chatting or texting with a clinician—whether it’s your personal provider or a random doctor overseas.

The Massachusetts General Hospital service that Lesley Watts participated in aims to conduct virtual visits without the realtime interaction.

Instead, patients complete an online questionnaire for their specific conditions, and send it to their personal doctor—whom they already know and trust—for review and response. For the past two years, primary care clinicians at an MGH Beacon Hill practice have been using over 30 different forms to follow up with some of their adult patients.

According to Dr. Amy Fogelman, a physician at the Beacon Hill practice, the clinical questionnaires are especially useful for chronic conditions that need management over time, like obesity and hypertension. In fact, the obesity questionnaire has proven more effective at helping patients lose weight than any other method she’s tried, she says. Continue reading

Ebola Forecast: What To Expect Now And How To Contain Future Outbreaks

(European Commission DG ECHO via Compfight/Flickr)

(European Commission DG ECHO via Compfight/Flickr)

Veronica Thomas
CommonHealth Intern

A digital surveillance program used Twitter feeds and news headlines to pick up on the Ebola outbreak in West Africa a full nine days before the World Health Organization proclaimed it an epidemic. 

But that doesn’t mean the outbreak could have been prevented.

Dr. Alessandro Vespignani, a professor of computer science and physics at Northeastern University, uses network science to model and forecast the spread of disease. Like HealthMap, the online tool cited above, Vespignani’s computer simulations cannot anticipate an outbreak before it actually begins.

“They don’t have a crystal ball either,” he says. “HealthMap is really a novel way of doing disease surveillance that can provide a real edge in the early detection of outbreaks by monitoring news articles, journals, Twitter or other digital sources. But they can’t do this before the actual occurrence of the event. There was already a situation in West Africa. HealthMap was just able to pick up the anomaly before anyone else.”

As the death toll climbs over 1,000 in West Africa, I was curious to know what makes this particular outbreak so relentless and what the global community can do to contain its spread. My conversation with Dr. Vespignani, lightly edited:

First of all, what exactly are big data and network science research? And how do you use them to track disease outbreaks?

We create large-scale models for disease forecasting by creating a synthetic world in the computer that integrates all data about human mobility. Then we plug an infectious individual into the model and look at the spread of the disease. You can look at different levels of granularity—whether locally or internationally. Network science is important because most disease now spreads by human mobility. What you hear many times is, “We’re all one hop away from West Africa,” although it’s thousands of kilometers away. No one has a crystal ball, so we cannot say when there will be an Ebola disease outbreak. As soon as we have the data on the outbreak, what we can do is try understanding how it will evolve in the next few weeks or months, which is what we do with this modeling.
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