Health Care Information and Resources

19 August

Types of birth control pills

What are birth control pills

More than 45 years since the U.S. Food and Drug Administration (FDA) approved “the pill” in 1960, it continues to be the most popular and one of the most effective forms of reversible birth control. Today, American women have more than 40 different oral contraceptive products from which to choose.

“The pill” is the common name for oral contraception. There are two basic types of birth control pills: combination pills and progestin-only pills. Both are made of hormones like those made by a woman’s ovaries. Combination pills contain estrogen and progestin. Both types require a medical evaluation and prescription. Both can prevent pregnancy.

Progestin-only pills

The progestin-only pills (also called “mini-pills”) became available in the 1970s. Their use was and has been limited - making up only 1 to 10 % of contraceptive market. This type of pills contains no estrogen and therefore they do not usually prevent ovulation. To work effectively, they must be taken at a certain time every 24 hours. Even missing one pill can greatly reduce effectiveness.

Progestin-only pills have specific advantages over combined oral contraceptives. Because they do not contain estrogen, they are a good contraceptive choice for breastfeeding women, as estrogen reduces milk production, and for women with health conditions that preclude use of combined oral contraceptives pills, such as migraine headaches, thromboembolism, and cardiovascular disease. In addition, progestin-only pills do not have most of the estrogen-related side effects of oral contraception: nausea, headaches and other symptoms associated with starting the combined pill are minimal. However, bleeding and spotting days during the intramenstrual period may be higher than with the combined pills and missed pills may result in a higher chance of pregnancy that with the combined oral contraceptives.

Combination pills

When you hear the term “birth control pill,” it most often refers to oral contraceptives containing estrogen and progestin. Combination pills contain a combination of these two hormones. They are categorized as monophasic, biphasic, or triphasic pills depending on whether the level of hormones stays the same during the first three weeks of the menstrual cycle or changes.

Combined birth control pills work by preventing ovulation - the release of a mature egg from a woman’s ovary. The estrogen in the pill causes this.

Monophasic pills

Monophasic pills contain the same amount of estrogen and progestin in all of the active pills in a pack. Examples of monophasic pills include Alesse, Brevicon, Desogen, Levlen, Levlite, Loestrin, Modicon, Nelova, Nordette, Norinyl, Ortho-Cept, Ortho-Cyclen, Ortho-Novum, Ovcon, Yasmin. Because of the uniform hormone level in all the pills, monophasics are least likely to cause side effects, such as mood changes, that can result from fluctuating hormone levels in the body.

The FDA approved a new packaging of a monophasic birth-control pill called Seasonale in 2003. The product is packaged in a 91-day supply and is designed to prevent menstruation for the entire time period. Women taking Seasonale will have only four periods a year. Seasonale contains the same estrogen and progestin in the same amount as many other monophasic birth control pills. Although many other monophasic birth control pills are used in this way, Seasonale is the only product approved for use.

Multiphasic pills

Phasic pills were developed in the 1980s. Multiphasic oral contraceptives contain varied amounts of hormones and are designed to be taken at specific times throughout the entire pill-taking schedule. They were developed to reduce side effects of oral contraceptives, including breakthrough bleeding, spotting and amenorrhea, associated with higher levels of hormones.

Biphasic pills change the level of hormones once during the menstrual cycle. The progesterone dose is increased about halfway through the cycle. Examples of biphasic pills include Jenest, Mircette, Necon 10/11, Nelova 10/11, Ortho-Novum 10/11.

Triphasic pills contain three different doses of hormones in the active pills (changing every seven days during the first three weeks of pills). Triphasic pills gradually increase the dose of estrogen and some pills also increase the progesterone dose. Triphasic pills include Cyclessa, Ortho-Novum 7/7/7, Ortho Tri-Cyclen, Triphasil, Tri-Levlen, Trivora, Tri-Norinyl.

Emergency contraceptive pills (ECP)

Emergency contraceptive pills are not intended to be used regularly as a contraceptive. They are designed to prevent pregnancy after unprotected sex. The FDA has approved one emergency contraception pill called Plan B, which contains the progestin levonorgestrel.

Advantages of ECP:

  • Reduces the chance of unintended pregnancy
  • Can be obtained easily - Plan B will soon be available over the counter for women 18 and over can be obtained in advance and kept handy in case of an emergency.

Disadvantages:

  • Timing. Because you must take the first dose within 120 hour of having unprotected sex. The sooner you take them after unprotected intercourse, the more effective they are.

Which Pill is better?

Monophasic birth control pills work as well as the more expensive and more complicated biphasic and triphasic products. Monophasic products with low amounts of estrogen may cause less bloating or breast tenderness but more breakthrough bleeding. So for most women, the monophasic birth control pills represent a good first option. All combination products containing both estrogen and progestogen are more effective in preventing pregnancy than are the “mini-pills.” However, progestin-only pills are a good choice for breastfeeding women and for women who can’t use combined oral contraceptives pills.

Where to buy birth control pills online?

Millions of American live with pain. Chronic pain, daily pain, short term severe pain. Of all the medications sold by online pharmacies, by far the most common type is pain relievers. You might think then that online pharmacies are a great source of pain relievers.

Well, did you know the Drug Enforcement Agency of the United States (DEA) has busted and close over 5000 online pharmacies? Did you know that many online pharmacies sell counterfeit medication? Did you know it is a federal crime for you to order prescription drugs from outside the United States?

It is true, online pharmacies are a great source of pain relief medication. This article teaches you to order pain medication legally, from within the United States, with a legal prescription. It’s the only way to go!

First, the caveats: You cannot legally order medication from outside the United States, even if you have a prescription. We always hear about the elderly taking buses to Canada to buy cheap medicine. The fact is, as of this writing, this course is illegal. Also, you cannot legally order medicine from a pharmacy without a prescription. Many online pharmacies (including my own) have physicians on staff who review your medication request and write you a prescription if they think it’s safe. In addition, NEVER order narcotics through the mail. Forget codeine, Tylenol #3, oxycontin, demerol, percodan and percocet. You can be charged with a federal crime for buying these substances. Lastly, regardless of the medication you buy, be sure to read the package insert (or a monograph on my web site). Drugs interact with each other and with your body- the package insert will tip you off to potentially dangerous behavior with respect to the medication you ordered.

The following are quick summaries of common pain relief drugs you can order through the Internet with very little risk:

Fioricet (butalbital)

Fioricet is a combination drug. It is made up of acetaminophen, caffeine and butalbital. Acetaminophen is the same medication in Tylenol You know caffeine from coffee (or even your favorite candy bar.) Butalbital is a mild barbiturate. It relaxes you.

Medical Science does not have an explanation for the reason this combination of drugs works so well, but the fact is Fioricet (and its generic form butalbital) is highly effective for tension headache. Presumably, it relaxes the muscles in the head and neck which typically tighten during tension headaches.. This is the top selling drug at our pharmacy month after month- it really helps headaches!

Soma (carisoprodol)

Soma is a muscle relaxant. It acts by blocking electrical signals among nerves in the reticular formation of the brain and in the spinal cord. Carisoprodol, combined with rest and physical therapy, is prescribed for the short term relief of painful muscle conditions- particularly muscle spasm (where the muscle tightens and does not relax). Most back strains result in muscle spasm, so patients find carisoprodol highly effective in relieving back pain.

Celebrex (celecoxib)

Celebrex is used in the treatment of symptoms of arthritis. This includes joint pain, stiffness, swelling and inflammation. The medication does not cure arthritis, but does provide symptomatic relief. It s a nonsteroidal anti-inflammatory drug (NSAID) which relieves pain and inflammation. The drug works by blocking the production of prostaglandins in the body. Prostaglandins contribute to the pain and swelling associated with arthritis.

Ultram (tramadol)

Ultram is used for treatment of moderate to severe chronic pain. It binds to the opiod receptors on nerves (the same mechanism used by narcotics), but it has a far lower potential for dependency. It’s the closest medication to a narcotic you can order legally in the US online. It is not a NSAID (nonsteroidal anti- inflammatory drug) and does not carry the risk of stomach ulceration and internal bleeding which can accompany the use of such medications. It is often prescribed for pain associated with shingles, fibromyalgia and other chronic diseases.

Ulracet

Ultracet is a combination of acetaminophen and tramadol. It is typically prescribed for the short term (up to five days) relief of moderately severe acute pain. It is often prescribed for post-surgical pain or after dental procedures.

The ultram mechanism as described above is very similar to the mechanism employed by narcotics. Acetaminophen of course is the active ingredient in Tylenol. It works by increasing the threshold to pain (i.e. it takes more pain stimulus to cause the sensation of pain). These two drugs work by different mechanisms, and they combine to be more effective than either drug alone.

Pain relief medication can be ordered safely online, but one should exercise appropriate caution before doing so. Specifically, it’s important to determine whether you need to see a physician before ordering pain medication. If you have a sudden onset of pain which is not readily explained, you should consult a physician first. If in doubt, go to the emergency room. If however you are a patient who has been diagnosed, and pain is a recurring problem, you can conveniently order pain medication online- typically at a lower cost than the combined cost of a doctor’s appointment and the medication itself.

What if you don’t have to use any hair removal method and your hair stops growing at places you don’t want it? Can you believe that happening? Eflornithine Hydrochloride does that. Also called as, Vaniqua (a brand) this chemical is now available as a cream in the strength of 13.9%. It has been found that this cream stops hair growth if used for a long period.

Eflornithine Hydrochloride works by stopping the action of enzyme- ornithine decarboxylase that is mainly responsible for stimulating hair growth. It is to be applied twice a day for a minimum period of two months to show results in most of the users. In some users, the results may appear faster. You will continue using your standard hair removal method till that time. This cream is well absorbed by the skin, and you will begin observing difference in hair growth on your face in short time.

Many women have abnormal hair growth problems such as hirsuitism. Some women experience unwanted hair growth during menopause and some suffer from hormonal diseases and polycystic ovarian syndrome. Because of these hair appears on unwanted places on the face and affects the psychology of the sufferer.

For better results, apply the cream twice a day and leave it in place for at least four hours before washing off. You can apply your cosmetics after the cream is absorbed by the skin and has dried. You should consult your doctor about proper use. Stopping use of this cream for long term may reduce the effects seen. It is well tolerated by most women and if you experience any side effects, you should consult your doctor. Proper use of this cream can get you out of trouble of hair removal forever. Please talk to your doctor about Eflornithine hydrochloride in detail before using it and find out how best to use it.

This article is only for informative purposes. This article is not intended to be a medical advise and it is not a substitute for professional medical advice. Please consult your doctor for your medical concerns. Please follow any tip given in this article only after consulting your doctor. The author is not liable for any outcome or damage resulting from information obtained from this article.

Where to order Vaniqa online?

May 8, 2008 (San Diego) — If your face looks younger than your years but your hands aren’t keeping up, there’s help.

If you’ve got the funds, plastic surgeons have a host of solutions to make your hands look young again — or at least be a closer match to your face.

“The best place to guess someone’s age is their hands,” says Danny Vleggaar, MD, a physician at Clinique Vert Pre in Geneva, Switzerland, and part of a panel of plastic surgeons discussing new options for rejuvenating aging hands at the annual meeting of the American Society for Aesthetic Plastic Surgery in San Diego.

Pigment changes, age spots, texture changes, loss of fat, contour changes, and prominent veins all contribute to make the hands look older, Vleggaar and his colleagues say.

To turn back the clock, plastic surgeons are offering topical treatments, lasers, and soft tissue fillers, the same ones that refresh the face.

Topical and Laser Treatments for the Aging Hand

Topical treatments include tretinoin, says Barry E. DiBernardo, MD, a plastic surgeon in Montclair, N.J., and another panel member. Chemical peels can also improve the appearance of the skin on the hands, he and others say.

Laser treatment can also improve the hand’s appearance. “Feathering” the effect of the laser near the wrist can help prevent a “line of demarcation,” says DiBernardo, who works as a consultant for filler and laser manufacturers.

Filler Treatments for the Aging Hand

Fillers approved for use in the face are being used to restore the lost volume in the hands that often accompanies aging.

DiBernardo mixes the filler Radiesse with lidocaine, an anesthetic, and injects it to help restore a more youthful contour. Once injected, he massages the hand to distribute the filler evenly.

“It will take one or two syringes [of filler] per hand if there is significant contour to improve,” he says.

If patients are happy with the fillers, DiBernardo says he sometimes switches to autologous fat injections (fat collected from your own body) the next time if the patient agrees. The fat is typically longer lasting, he says.

Another filler, Sculptra, may last longer than other fillers, up to two or three years, says Vleggaar, who has presented studies about the filler at professional meetings and works as a consultant for Sculptra’s manufacturer and other companies.

Treating the Veins in Aging Hands

Another alternative is laser removal of unwanted hand veins, a technique favored by Roxanne Guy, MD, a plastic surgeon in Melbourne, Fla., and another speaker.

In her study of the technique, called laser ablation, she and a colleague performed the treatment on 28 women and 54 hands in all, reporting the results in Plastic & Reconstructive Surgery. A laser is placed on the tip of a wire, which is threaded into the vein. As the wire is slowly pulled out, the laser energy heats the veins and damages the vessel wall’s inner lining. Over the next few weeks, the vein dies.

The patients, aged 41 to 68, were followed for up to 31 months. “Patient satisfaction was high,” Guy says. Post-procedure swelling, which was expected, usually resolved within two weeks, she says. On average, most patients had four veins per hand treated. One woman had a skin burn where the laser exited. Even so, all 28 said they were satisfied with the results, Guy says.

Aging Hand: Caveats

Not everyone is a candidate to rejuvenate their hands, Vleggaar says. Among the conditions that may disqualify a patient, he says, are osteoarthritis, rheumatoid arthritis, hand tremors, or Parkinson’s disease.

Not everyone thinks the dermal fillers should be used in the hands. On its web site, the Physicians Coalition for Injectable Safety states that dermal fillers shouldn’t be used in the hands. Fat injections in the hands, however, are viewed as acceptable by the American Society for Aesthetic Plastic Surgery.

What Price for Pretty Hands?

“It can get quite costly, between lasers and injectables, to treat a hand,” DiBernardo says. “Overall, the cost could be $3,000-$5,000, if you did everything.”

For patients on a budget, DiBernardo suggests they “set up a treatment protocol according to the problem you would like to tackle.”

Or if you want the most return for just one treatment, he suggests correcting the contour with filler. “It’s a very dramatic result and you can see it right away.” Most patients who have their pigment problems treated seem happy too, he says.

While the fillers are temporary, Guy says she believes her vein removal procedure is permanent, “but we have only followed these people for a couple years.”

Second Opinion: Aging Hands

Skin treatments with lasers or a technique known as intense pulsed light (IPL) therapy may be the best bets for hand rejuvenation, says Jack Friedland, MD, a Scottsdale, Ariz., plastic surgeon not involved in the panel discussion.

Lasers or IPL ”that treat brown pigmented spots for removal work,” he tells WebMD.

He says he is not convinced that the fillers used in the hand give a completely natural look.

Aging Hands: The Jewelry Alternative

Another alternative for younger-looking hands? Wear jewelry.

In a survey, published in Plastic & Reconstructive Surgery and cited by Guy, hands with jewelry were rated as younger looking by observers than those without, although the differences weren’t significant.

SOURCES: Roxanne J. Guy, MD, plastic surgeon, Melbourne, Fla. Jack A. Friedland, MD, plastic surgeon, Scottsdale, Ariz. Danny Vleggaar, MD, physician, Clinique Vert Pre, Geneva, Switzerland. Barry E. DiBernardo, MD, plastic surgeon, Montclair, N.J.; clinical associate professor of plastic surgery, University of Medicine & Dentistry of New Jersey. Bains, R. Plastic & Reconstructive Surgery, June 2006; vol 117: pp 2212-2218. Guy, R. Shamma, A. Plastic and Reconstructive Surgery, December 2007; vol 120: pp 2017-2024. Physicians Coalition for Injectable Safety. American Society for Aesthetic Plastic Surgery. American Society for Aesthetic Plastic Surgery Annual Meeting, San Diego, May 2-6, 2008.

© 2008 WebMD Inc. All rights reserved.

Where to buy Tretinoin?

20 June

Dry Skin and Itching

Many older people suffer from dry skin, particularly on their lower legs, elbows, and forearms. The skin feels rough and scaly and often is accompanied by a distressing, intense itchiness. Low humidity — caused by overheating during the winter and air conditioning during the summer — contributes to dryness and itching. The loss of sweat and oil glands as you age also may worsen dry skin.  Anything that further dries your skin — such as overuse of soaps, antiperspirants, perfumes, or hot baths — will make the problem worse. Dehydration, sun exposure, smoking, and stress also may cause dry skin.

Dry skin itches because it is irritated easily. If your skin is very dry and itchy, see a doctor. Dry skin and itching can affect your  sleep, cause irritability, or be a symptom of a disease. For example, diabetes and kidney disease can cause itching. Some medicines make the itchiness worse.

The most common treatment for dry skin is the use of moisturizers to reduce water loss and soothe the skin. Moisturizers come in several forms — ointments, creams, and lotions.

Ointments are mixtures of water in oil, usually either lanolin or petrolatum.

Creams are preparations of oil in water, which is the main ingredient. Creams must be applied more often than ointments to be most effective. One of most known skin care cream Tretinoin is used to to treat aged, sun damaged skin.

Lotions contain powder crystals dissolved in water, again the main ingredient. Because of their high water content, they feel cool on the skin and don’t leave the skin feeling greasy. Although they are easy to apply and may be more pleasing than ointments and creams, lotions don’t have the same protective qualities. You may need to apply them frequently to relieve the signs and symptoms of dryness. Moisturizers should be used indefinitely to prevent recurrence of dry skin.

A humidifier can add moisture to the air. Bathing less often and using milder soaps also can help relieve dry skin. Warm water is less irritating to dry skin than hot water.