Women with Hemophilia

Even though hemophilia mostly affects men, women who are carriers of the faulty gene causing hemophilia A and hemophilia B may also experience mild symptoms. They are rarely diagnosed with the disease, however, because the condition is not severe, allowing them to lead full lives. (In hemophilia C, women and men are equally affected).

Women who are carriers have one healthy and one mutated copy of the hemophilia gene on each X chromosome. The disease only truly develops if both copies of the hemophilia gene are mutated, and this is rare occurrence.  In most carriers, one X chromosome gene is healthy and produces enough clotting factor to protect carriers from more severe forms of hemophilia, although clotting factor levels can vary.

Clotting factor levels in carriers generally range from 30 to 70 percent of normal levels, enough to protect from severe bleeding. One common symptom in hemophilia carriers, however, is heavy menstrual bleeding.

Women who have less than 30 percent of normal clotting factor levels are usually said to have mild hemophilia, and up to 60 percent of carriers are thought to have some degree of bleeding problems.

Abnormal bleeding: When to see a doctor

Because women are not usually warned about the possibility of having hemophilia, they should be on the lookout for these symptoms:

  • Menorrhagia, heavy or prolonged menstrual bleeding
  • Abnormal bleeding after childbirth
  • Bruising easily
  • Frequent or prolonged nosebleeds
  • Bleeding abnormally after dental procedures
  • Bleeding abnormally after surgery or trauma

About menorrhagia

Many women do not think of heavy menstrual bleeding as a sign of a bleeding disorder, and consequently don’t speak with a doctor about it. It’s common to think of it as a life-long personal characteristic.

However, menorrhagia can have significant effects on a woman’s life, including chronic fatigue, lost work hours, abnormally severe pain during menstruation (dysmenorrhea), and mood swings.

Unusual menstrual bleeding can also lead a doctor to recommend a hysterectomy, rather than checking for possible hemophilia.

If you suspect you might have a bleeding disorder, ask your doctor to rule out hemophilia first by measuring the level of two clotting factors (factor VIII for hemophilia A and factor IX for hemophilia B) in your blood. A genetic test may also be undertaken to determine the nature of your mutation.

In adolescents, the start of a girl’s menstrual cycle is often accompanied by heavier bleeding. If there is a known family history of hemophilia or any other bleeding disorder, girls should be closely followed through puberty by a gynecologist, a hematologist specialized in bleeding disorders, or a family physician or pediatrician.

Pregnancy and childbirth for women with hemophilia

Pregnancy, as well as childbirth, can also be challenging for women with bleeding disorders. It is critical that a woman’s healthcare team is aware of a carrier (or hemophilia) status so plans can be made for a safe delivery. This includes ensuring for safety measures at the time of birth, and regular monitoring of clotting factors to prevent major bleeding, especially as the date of delivery approaches.

Delivery should be as gentle as possible, for both the mother and the baby. Natural delivery without the use of instruments (forceps, or a suction extraction) is recommended. Use of an epidural or a deep intramuscular injection also are not advised.

According to the Canadian Hemophilia Society, women with hemophilia should talk to their doctors about factor replacement therapy during the first three months of pregnancy to lower the risk of miscarriage.

Plasma-derived factor concentrates can transmit a common virus known as parvovirus B19, which may cause a miscarriage. Pregnant women or those who might become pregnant are advised to avoid factor concentrates made from plasma, if possible. Possible alternatives that might be considered under a physician’s guidance include desmopressin, antifibrinolytic agents, and recombinant (artificial) factor concentrates for deficiencies in factor VII, VIII and IX.

Women with bleeding disorders, however, are often protected from bleeding episodes while pregnant, because of higher-than-usual hormone levels.

After birth, women can maintain these higher hormone levels by breastfeeding – helping to protect them from bleeding in the weeks following delivery.

If a bleeding disorder is suspected in a newborn, parents can request that a sample of cord blood be tested for the disease, and can request that the vitamin K (normally given to the baby shortly after birth) be given by mouth, and not by injection, to prevent bleeding at the site of the injection.

General precautions for women with hemophilia

Women with a bleeding disorder may need to follow some general precautions to prevent excessive bleeding, like avoiding medications that affect the platelets, clotting proteins in the blood. Of note, these drugs are often taken to ease menstrual cramps.

Common examples are aspirin, drugs containing aspirin (Midol or Alka-Seltzer), and non-steroidal anti-inflammatory drugs (Advil or Aleve). These drugs are often prescribed to ease menstrual cramps but can actually make bleeding worse.

Ask your doctor or pharmacist for advice, and for information about a drug you are planning to take.


Obstacles to riding safely through pregnancy revealed: Study

In the UK, the National Institute for Clinical Excellence (NICE) and the National Health Service (NHS) both recommend pregnant women engage in daily exercise, but when it comes to cycling, the advice dries up: there are no clear recommendations women can use to decide whether to continue cycling.

Riding During Pregnancy
During pregnancy, depending on women’s proportions and the type of bike, the growing belly can feel physically restrictive.

Pregnant women could get on their bikes and stay healthy with better support, but according to a new study, they are encountering obstacles to riding.

Medical advice from risk-averse health professionals may contribute to some women’s decisions to stop cycling to work during pregnancy, meaning they miss out on the potential benefits of the active commute. The recent research revealed the reasons why women decide to stop or continue cycling to work when they are pregnant, including often ambiguously worded or overly-cautious advice from medical guidelines, midwives and obstetricians.

More people than ever are commuting to work by bicycle in London. According to data from the 2011 census, the city saw a 144% increase in cycle-commuting over the previous decade. This has big health benefits, for the health of the individual cyclist as well as for public health more broadly, as it helps people move more as part of their everyday activities.

In the UK, the National Institute for Clinical Excellence (NICE) and the National Health Service (NHS) both recommend pregnant women engage in daily exercise to help manage common discomforts, reduce pregnancy complications like preeclampsia, reduce discomfort and improve mood. But when it comes to cycling, the advice dries up: there are no clear recommendations women can use to decide whether to continue cycling.

“Despite the clear health benefits of cycling and the push to get more people commuting by bike, especially in cities like London, the medical advice on cycling during pregnancy remains murky,” commented author Davara Lee Bennett. “My research aimed to explore why women do – and don’t – cycle to work when they’re pregnant, with a view to supporting informed decision-making – including, if women so wish, rocking the rust off their chains, and bringing their bikes out from under the stairs and into the light.”

Bennett conducted three individual interviews and held three focus group discussions: with a group of women who had stopped cycling early, a group that had carried on into later pregnancy and a mixed group. She recorded and transcribed all of them, and analyzed the transcripts line-by-line to develop themes.


The resulting factors that affected women’s decisions fell into a few main areas: physical obstacles and enablers, perceptions of risk and of pregnancy itself and advice. The idea of risk was a key factor in decisions about continued cycling: women adjusted their cycling practices to minimize risk, taking partners’ support or concern into account. Although some women had positive encounters with health professionals, the medical advice they received was often noncommittal or risk-averse.

During pregnancy, depending on women’s proportions and the type of bike, the growing belly can feel physically restrictive. Some women stopped cycling because of this, while others found comfort from their daily aches and pains when they commuted by bike. Either way, more comfortable bikes helped: women preferred Dutch-style, upright designs with a low crossbar and a wide, supportive seat.

Perceptions of pregnancy also had an impact on women’s decisions: some preferred to abandon their active commute, opting for a more peaceful state, while others continued to cycle in a bid to remain connected to their authentic selves.

“Understanding the obstacles to women’s cycling during pregnancy can support the development of safer cycling infrastructure and informed medical guidelines, ultimately offering more women the opportunity to benefit from an active commute,” said Bennett. “By addressing some of the more socially prohibitive public discourses on the topic, I hope that my research will not just enable informed decision-making by women, but also encourage more constructive support and advice for women from health professionals.” The study appears in the Journal of Transport & Health.

Prenatal exposure to alcohol and stress may up aggression in kids, says study

Epigenetic changes, caused by alcohol, smoking and stressful pregnancies are linked to early onset of fighting, lying and stealing habits in children, warns a study.

Epigenetic changes present at birth could be linked to conduct problems in children.

Exposure to alcohol, smoking and stressful events during pregnancy can lead to epigenetic changes – external modifications to DNA that turn genes ‘on’ or ‘off’ – at birth, linked to early onset of fighting, lying and stealing habits in children, warns a study.

According to researchers from King’s College London and the University of Bristol, epigenetic changes present at birth – in genes related to addiction and aggression, could be linked to conduct problems in children.

Conduct problems (CP) such as fighting, lying and stealing are the most common reason for child treatment referral in the UK. Senior author of the study Dr Edward Barker said that children with early-onset conduct problems are much more likely to engage in antisocial behaviour as adults, so this is clearly a very important group to look at from a societal point of view.

Children who develop conduct problems before the age of 10 (known as early-onset CP) are at a much higher risk for severe and chronic antisocial behaviour across the lifespan, resulting in further social costs related to crime, welfare dependence and health-care needs.Genetic factors are known to strongly influence conduct problems, explaining between 50-80% of the differences between children who develop problems and those who do not.

Understanding changes in DNA methylation, an epigenetic process that regulates how genes are ‘switched on and off’, could aid the development of more effective approaches to preventing later conduct problems. The study used data from Bristol’s Avon Longitudinal Study of Parents and Children (ALSPAC) to examine associations between DNA methylation at birth and conduct problems from the ages of four to 13.

Children with early-onset conduct problems are much more likely to engage in antisocial behaviour as adults. (Shutterstock )

They also measured the influence of environmental factors previously linked to early onset of conduct problems, including maternal diet, smoking, alcohol use and exposure to stressful life events. They found that at birth, epigenetic changes in seven sites across children’s DNA differentiated those who went on to develop early-onset versus those who did not.

Some of these epigenetic differences were associated with prenatal exposures, such as smoking and alcohol use during pregnancy. One of the genes which showed the most significant epigenetic changes, called MGLL, is known to play a role in reward, addiction and pain perception.

Barker added that there is good evidence that exposure to maternal smoking and alcohol is associated with developmental problems in children, yet they don’t know how increased risk for conduct problems occurs

Mothers-to-be, take note: Obesity during pregnancy can double risk of fatty liver in teens

Children of obese mothers are twice as likely to develop non-alcoholic fatty liver disease as teenagers, says a new study. Also, children fed infant formula milk before completing six months of breastfeeding have a 40% likelihood of getting the disease.

Newborns who had obese mothers at the start of pregnancy were twice as likely to develop non-alcoholic fatty liver disease as teenagers.

A study has warned that newborns, who had obese mothers at the start of pregnancy, were twice as likely to develop non-alcoholic fatty liver disease (NAFLD) as adolescents.The study also found that adolescent children of women, who were obese at the start of pregnancy, were twice as likely to have NAFLD, while those fed with infant formula milk before completing six months of breastfeeding, had a 40% increased likelihood of NAFLD.

NAFLD is the most common liver disorder in developed countries, affecting up to one in four adults. It occurs when fat accumulates within the liver cells in people who do not consume excessive alcohol, and is commonly associated with obesity and insulin resistance.

Non-alcoholic fatty liver disease occurs when fat accumulates within the liver cells in people who do not consume excessive alcohol, and is associated with obesity and insulin resistance. (Shutterstock)

Lead investigator Oyekoya T Ayonrinde from the University of Western Australia, Perth, said that there have been studies into the benefits of breastfeeding on other diseases, but there is little information about benefits of breastfeeding linked to liver disease.

Dr Ayonrinde added that the team therefore examined records of Australian adolescents to establish whether infant nutrition and maternal factors could be associated with the subsequent diagnosis of NAFLD. The team performed liver ultrasound on more than 1,100 adolescents aged 17 years and were followed even before their birth.

The study found that NAFLD was diagnosed in about 15% of the adolescents examined. 94% had been breastfed as infants. The duration of breastfeeding before starting supplementary milk was four months in 55% and six months in 40%.

The researchers explained that this study further provided additional reasons to support opportunities for women to breastfeed their infants for at least six months while delaying the start of infant formula milk. “This study further supports the need to encourage comprehensive healthy lifestyles before and during pregnancy and prolonged exclusive breastfeeding for the long-term health benefits of future generations,” the team concluded.

The research has appeared in the journal of Hepatology.

A ‘bitter’ way to stop unwanted contractions that occur during premature labour

By activating the bitter taste receptors in the uterus, the bitter substances relaxed the contracted uterine muscle tissue more completely than the current drugs used to prevent preterm labour in humans.

The study is published online in The FASEB Journal.

According to a recent study, the bitter taste receptors may hold the key to managing preterm labour.

The University of Massachusetts Medical School research suggested that exposing bitter taste receptors in the uterus to certain substances can stop many unwanted contractions that occur during premature labour. “The biological mechanism of labour initiation remains unknown, and a large percentage of preterm pregnancies do not respond well to current medications,” said Ronghua Zhuge.

“The bitter taste receptors that we have found on uterine muscle could be one more piece of the puzzle to understand the onset of labour, both at term and preterm, and develop new therapeutics for preterm labour.”

Zhuge and colleagues attached strips of human and mouse uterine myometrium tissue (also known as smooth muscle) to a machine that measured their contraction efforts. The researchers first exposed the tissue to native hormones such as oxytocin and chemical compounds to make it contract, mimicking normal or premature labour. They then exposed the tissue to bitter substances.

By activating the bitter taste receptors in the uterus, the bitter substances relaxed the contracted uterine muscle tissue more completely than the current drugs used to prevent preterm labour in humans. The researchers also found that giving mice bitter substances before they showed any premature contractions prevented them from having early deliveries. The study is published online in The FASEB Journal.

Dear women, pay attention to oral hygiene if you’re trying to conceive

The finding is independent of other risk factors contributing to conception, such as age, current smoking, and socioeconomic status.

Researchers advise fertile women to take care of their oral health.

If you’re trying to conceive, it might be a good idea to pay attention to your oral care routine. A common bacterium associated with gum disease may delay conception in young women, warns a new study. “Our results encourage young women of fertile age to take care of their oral health and attend periodontal evaluations regularly,” said one of the researchers Susanna Paju of the University of Helsinki in Finland.

Periodontal (gum) disease is an inflammatory reaction to a bacterial infection below the gum line. The study involved 256 healthy non-pregnant women (mean age 29.2 years, range 19 to 42) who had discontinued contraception in order to become pregnant. They were enrolled from the general community from Southern Finland.

Participants were followed-up to establish whether they did or did not become pregnant during the observation period of 12 months. Porphyromonas gingivalis, a bacterium associated with periodontal diseases, was significantly more frequently detected in the saliva among women who did not become pregnant during the one-year follow-up period than among those who did, according to the study published in the Journal of Oral Microbiology.

The levels of salivary and serum antibodies against this pathogen were also significantly higher in women who did not become pregnant. Statistical analysis showed that the finding was independent of other risk factors contributing to conception, such as age, current smoking, socioeconomic status, bacterial vaginosis, previous deliveries, or clinical periodontal disease.

Women who had P. gingivalis in the saliva and higher saliva or serum antibody concentrations against this bacterium had a three-fold hazard for not becoming pregnant compared to their counterparts. Increased hazard was nearly four-fold if more than one of these qualities and clinical signs of periodontitis were present.

“Our study does not answer the question on possible reasons for infertility but it shows that periodontal bacteria may have a systemic effect even in lower amounts, and even before clear clinical signs of gum disease can be seen,” Paju said, adding, “More studies are needed to explain the mechanisms behind this association. Young women are encouraged to take care of their oral health and maintain good oral hygiene when they are planning pregnancy.”

Women lactating without pregnancy sign of infertility: IVF experts

According to doctors, this medical condition is known as hyperprolactinemia in which a woman witnesses loss of menstrual cycles and libido besides the production of milk.

More than 75 per cent of the women in this condition produce milk without being pregnant.

Women lactating without pregnancy, caused due to the increase of prolactin hormone, is a sign of infertility, say doctors.

According to doctors, this medical condition is known as hyperprolactinemia in which a woman witnesses loss of menstrual cycles and libido besides the production of milk. “In hyperprolactinemia, there is a rise of prolactin hormone over the normal level. High levels interfere with estrogen production and cause changes in ovulatory cycles leading to irregular menstrual periods. Though not very common, high levels of prolactin in men can lead to loss of impotency, erectile and dysfunction,” said Arvind Vaid, IVF specialist at Indira IVF Hospital here.

He said high prolactin levels in blood affect reproduction by either disinhibition or excess production from prolactinoma, which inhibits the secretion of gonadotropin-releasing hormone from the hypothalamus. “This decrease in level of gonadotropin-releasing hormone in turn decrease the secretion of luteinizing hormone and follicle stimulating hormone leading to infertility,” said Vaid. Proclactin’s primary function is to enhance breast development during pregnancy and to induce lactation.

Though small amounts of this hormone circulate in the blood, even though a woman is not pregnant, the amounts increase during pregnancy and after birth. More than 75 per cent of the women in this condition produce milk without being pregnant. “In some cases, changes in menstrual flow is marked along with amenorrhoea. Even on not being pregnant, breast produces milk with pain due to tissue changes there with increased levels of prolactin and loss of libido also causing vaginal dryness,” said Simanti Pathak, gynaecologist at Safdarjung hospital.

About diagnosing hyperprolactinemia, doctors advised, as a first step, a blood test to check serum prolactin levels, preferably fasting. If the levels are high, further assisting tests may be required.

“In case if the prolactin levels are very high, a tumor may be suspected and in that case, MRI of the brain and pituitary glands is advised that uses high frequency radio waves to obtain images of the tissues and the size of tumor,” said Ahmedabad-based IVF expert Parth Joshi.

Dear Pregnant women, beware! Paracetamol might affect sex drive in male progeny

The use of pain reliever paracetamol when pregnant is linked to reduced sex drive and aggressive behaviour in males, finds study.

Taking paracetamol during pregnancy might damage the development of male behaviour.

Although paracetamol is usually considered safe during pregnancy, a new research from the University of Copenhagen in Denmark suggests that if you are pregnant, you should think twice before popping these pills as their use is linked to reduced sex drive and aggressive behaviour in males. In an animal model, the use of the popular pain reliever paracetamol was found to damage the development of male behaviour, according to a paper published in the journal Reproduction.

The researchers said that the dosage administered to the mice was very close to the recommended dosage for pregnant women. But they cautioned that because the trials are restricted to mice, the results cannot be transferred directly to humans. However, the researchers’ certainty about the harmful effects of paracetamol means it would be improper to undertake the same trials on humans, explained David Mobjerg Kristensen, who was associated with the University of Copenhagen during the study.

Paracetamol can inhibit the development of the male sex hormone testosterone in male foetuses.

“In a trial, mice exposed to paracetamol at the foetal stage were simply unable to copulate in the same way as our control animals. Male programming had not been properly established during their foetal development and this could be seen long afterwards in their adult life. It is very worrying,” Mobjerg Kristensen, now associated with the Institut de Recherche en Sante, Environnement et Travail (IRSET) in France, said.

Previous studies have shown paracetamol can inhibit the development of the male sex hormone testosterone in male foetuses, thus increasing the risk of malformation of the testicles in infants. But a reduced level of testosterone at the foetal stage is also significant for the behaviour of adult males, Mobjerg Kristensen added. Testosterone is the primary male sex hormone that helps develop the male body and male programming of the brain. The masculine behaviour in mice observed by the researchers involved aggressiveness towards other male mice, ability to copulate and the need for territorial marking.

“We have demonstrated that a reduced level of testosterone means that male characteristics do not develop as they should. This also affects sex drive,” Mobjerg Kristensen said. But even if paracetamol is harmful, that does not mean it should never be taken, even when pregnant, the researchers said. “I personally think that people should think carefully before taking medicine. These days it has become so common to take paracetamol that we forget it is a medicine and all medicine has side effects. If you are ill, you should naturally take the medicine you need. After all, having a sick mother is more harmful for the foetus,” Mobjerg Kristensen noted.

According to Britain’s National Health Service (NHS), “paracetamol is usually safe to take” during pregnancy. Kristensen emphasised that pregnant women should continue to follow the guidelines given by their country’s health authorities and recommends people to contact their GP if in doubt about the use of paracetamol

Should pregnant women shun meat and lust?

Pregnancy advice

The claim: The Indian government is advising pregnant women to exercise, avoid eggs and meat, shun desire and lust, and hang beautiful photos in the bedroom.

Reality Check verdict: Some of the advice is good, some bad, and some downright ridiculous.

India’s Ayush ministry, which promotes traditional and alternative medicine, last week distributed a tiny 16-page booklet on Mother and Child Care to journalists. It’s three years old but it’s been dominating news since its re-release just ahead of the annual International Yoga Day, which is being celebrated on Wednesday.

Produced by the Central Council for Research in Yoga and Naturopathy, which is a part of Ayush, the booklet dishes out advice on the yoga exercises that pregnant women should – and should not – do; lists of food they should – and should not – eat; and also offers suggestions on what to read, what sort of company to keep, what sort of photos to look at, and so on and so forth.

Doctors in India say though there is merit in some of the advice, it would not be wise to follow the guidelines in their entirety.

Take for instance the advice on food.

The booklet prescribes a long list of items that pregnant and lactating women should take and that includes sprouts, lentils, fruits, leafy vegetables like spinach, dry fruits, juices and whole grain. All very good, say doctors.

Then it lists foods to be avoided – tea, coffee, sugar, spices, white flour, fried items and, rather controversially, “eggs and non-vegetarian” food.

An Indian woman makes an omelette in Kolkata

Critics say that is in keeping with India’s Hindu nationalist BJP government’s policy to promote vegetarianism, and that it’s dangerous advice in a country where malnutrition and anaemia among pregnant women has meant India has the highest rate of maternal mortality in the world.

Stung by the criticism, the Ayush ministry has issued clarification saying that their suggestion that non-vegetarian food may be avoided is because “yoga and naturopathy doesn’t advocate non-vegetarian food in its practice”. They have also accused the press of “selectively” highlighting the advisory on eggs and meat while forgetting to mention the unhealthy items on the list.

It’s not just the media though, doctors too have questioned their advisory.

“As a doctor I do not see any merit in advising a pregnant woman to not eat eggs or meat. Egg is the easiest and best source of protein,” Delhi-based gynaecologist Dr Sonia Naik told the BBC. “My advice would be that whoever is comfortable with whatever diet, they should continue with it.”

The advice is also at odds with the one offered by India’s health ministry on its website: “The foetus extracts iron from the mother, even if she suffers from anaemia, so iron rich foods such as meat, liver, egg, green peas, lentils, green leafy vegetables… should be encouraged to be taken by the mother.”

If many found the advisory on food unpalatable, the next few paragraphs of the booklet offered advice that seemed even more strange:

Although the Ayush ministry insists that it does not “prescribe” that “pregnant women in India” should “say no to sex after conception”, many say the words “detach… from desire and lust” appear to mean exactly that.

Although the health ministry is silent on the matter, doctors say there’s no harm in having sex during pregnancy.

In fact, Dr Naik says that “because of hormonal reasons, some pregnant women may want more sex than usual and we don’t tell them to abstain unless it’s a high-risk pregnancy”.

Indian women doing yogaImage copyrightGETTY IMAGES

There is, however, one bit of advice the booklet offers on which there is general consensus – the benefits of yoga.

Although traditional wisdom believed pregnancy to be a delicate time and advised expectant mothers to rest and take it easy, over the years doctors have been advising mothers-to-be to build some form of exercise into their daily routine.

“We all live very sedentary lives now so yoga and exercise are healthy. In fact, we do recommend to women who come to us to do some form of exercise, we even hold prenatal classes for them,” Dr Naik said.

The health ministry too lists the benefits of staying physically active although it advises pregnant women to stay away from “activities in which you can get hit in the abdomen like kickboxing, soccer, basketball, or ice hockey” or “activities in which you can fall like horseback riding, downhill skiing, and gymnastics”.


Study finds the birth control pill has a pretty terrible impact on women’s wellbeing

So, how’s that male pill coming along?


A new study has reinforced what many women have been saying for years – the oral contraceptive pill is associated with reduced quality of life and wellbeing in healthy women.

The double-blind, randomised, placebo-controlled trial found that healthy women reported reduced quality of life, mood, and physical wellbeing after taking a common birth control pill containing ethinylestradiol and levonorgestrel for three months.

 The findings reinforce earlier research and anecdotal claims that women are struggling with the side effects of the contraceptive pill.

But there was no significant evidence that the contraceptive increased depressive symptoms in the latest study… so, there’s that.

Surprisingly, this is one of the most rigorous studies to date to look into the impact of the pill on women’s quality of life.

“Despite the fact that an estimated 100 million women around the world use contraceptive pills we know surprisingly little today about the pill’s effect on women’s health,” said lead researcher Angelica Lindén Hirschberg from the Karolinska Institutet in Sweden.

“The scientific base is very limited as regards the contraceptive pill’s effect on quality of life and depression and there is a great need for randomised studies where it is compared with placebos.”

To fix that, her team took 340 healthy women aged between 18 and 35 and gave them either placebo pills, or contraceptive pills containing ethinylestradiol and levonorgestrel over a three-month period.

 Ethinylestradiol and levonorgestrel-containing pills are among the most common form of combined oral contraceptive pills around the world because they’re the least associated with a risk of blood clots, and they include brand names such as LevlenMicrogynonPortia, and Alesse.

The study was double blind, which meant that neither the researchers giving out the pills or the women taking them knew whether they were getting a placebo or not.

At the start of the study, the women had their general health measured, including weight, height, and blood pressure.

They also filled out two well-known surveys on general wellbeing and depressive symptoms – the Psychological General Wellbeing Index and the Beck Depression Inventory.

They then went through the same tests at the end of the three months so the researchers could compare the results.

The women who were given contraceptive pills reported that their quality of life was significantly lower at the end of the study than those who were given placebos.

This was true for general quality of life and also specific aspects of wellbeing, such as self control and energy levels.

No significant increase in depressive symptoms was observed.

While it’s an interesting first step towards better measuring the pills’ side effects, the researchers caution that the changes were relatively small so we can’t read too much into them just yet. And we can only apply these findings to ethinylestradiol and levonorgestrel-containg pills.

Also, the study only looked at women over three months – it will require longer monitoring to get a more accurate idea of how the contraceptive pill affects women.

“This might in some cases be a contributing cause of low compliance and irregular use of contraceptive pills,” said one of the researchers, Niklas Zethraeus.

“This possible degradation of quality of life should be paid attention to and taken into account in conjunction with prescribing of contraceptive pills and when choosing a method of contraception.”

With recent research also providing insight into why periods can be so damn painful and heavy, it seems scientists are finally starting to take women’s reproductive health and contraceptive side effects seriously.

And we’re getting some male options too – scientists are making progress with a hormonal contraceptive injection for men, as well as a reversible, condom-free gel that blocks sperm.

More research is needed before we can identify more accurately how the pill impacts women, but these early results are reassuring for many women who’ve struggled with side effects while on the pill.

Source:Fertility and Sterility.