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节育:如果你有避孕药问题,请举手!

It's our go-to form of birth control here in the U.S.,but those teensy tablets can be confusing.Will they make you fat?Moody?Is there a better Pill out there for you?Finally,答案!

You'd think that something smaller than a Tic Tac,swallowed daily by almost 11 million American women,很简单:吃一粒,once a day;不要怀孕。Right?但专家们说,关于口服避孕药的混乱是猖獗的。“我看到太多的女人喋喋不休地说出他们认为自己知道的关于那颗完全错误的药丸的事实。I've had two do it today!" sighs凯瑟琳·奥康奈尔·怀特,M.D.,M.P.H.,an assistant professor of obstetrics and gynecology at Tufts University School of Medicine and chief of the division of general obstetrics and gynecology at Baystate Medical Center in Springfield,马萨诸塞州。“外面有很多误解。”这是事实。

How do I know which Pill will work best for me?

"Birth control pills are like breakfast cereals," says Dr.O'Connell White.“作为你的医生,I have no idea if you're going to like Frosted Flakes or Rice Krispies until you open the box and try them." That said,你的妇产科医生可能会根据你的具体问题推荐某种类型的药丸。Sara Gottfried,M.D.,author ofThe Hormone Cure,

often steers women who have nasty premenstrual headaches or painful periods toward a "continuous Pill," like Lybrel or Seasonale.And for those who experience PMS or moodiness,yaz或yasmin可能很适合。(尽管存在争议——最近的一项研究发现,yaz和yasmin的合成孕酮可能会增加医生潜在严重血栓的风险。Glamourspoke with still prescribe both.“几率很小:每10000名患者中有10名,compared with six in 10,000 on other types of Pills," explains Orli Etingin,M.D.,director of the Iris Cantor Women's Health Center in New York City."So for most women,the benefits far outweigh the risk.") The point is,today's Pills are very finely tuned;if one's not to your liking,you have other options.And all do equally well at preventing pregnancy.

Will the Pill make me gain weight?那我的情绪和性欲呢?

"It's not a one-answer-fits-all kind of thing," says Dr.Etingin.“每个品牌都有稍微不同的激素组合和防腐剂,and those can be uniquely good or bad for a woman,取决于她的身体化学。I'd say that one in about 15 to 20 women I see have a side effect and need to be put on a new Pill." All the doctorsGlamour有人说他们让病人报告体重增加,headaches or changes in sex drive,心情和胸围(差不多一杯)。But the Pill may not be the cause.“当你看研究的时候,”博士说。O'Connell White,“女性抱怨这些副作用的程度与服用安慰剂和服用避孕药时一样多。我不是说你的情绪和你的节育措施没有关系。但是人们喜欢责怪药丸汽车坏了,这是药丸的错!-可能不会那么简单。例如,如果你体重增加,maybe the reason is you're in a new relationship,多吃少运动“无论如何,如果你有副作用,和你的医生谈谈。

The pharmacy gave me the generic version of my brand-name Pill.有什么区别吗?

泛型are便宜些,所以如果你的药丸有一个通用版本,很可能药剂师会给你。但是仿制药和他们的名牌姐妹不一样。“食品和药物管理局要求一个仿制药在与品牌版本相同的范围内,”博士解释说。Gottfried。“它们在预防怀孕方面同样有效,but as far as hormone levels go,你的仿制药可能会减少20%到25%,这是一个显著的差异,可能会导致副作用,尤其是经期间的突破性出血。Etingin adds,“这些天我看到了很多:一个女人会发现药房换了一个通用的,and it doesn't agree with her." If that's you,告诉你的妇产科医生。She can write a "no substitutes" prescription,and your insurance should cover it.(If not,be a squeaky wheel,says Dr.Gottfried;insurers will almost always change their mind.)

I admit it—I get Pill amnesia.每天同时服药有多重要?

“这一点都不重要,”博士说。O'Connell White,“除了一个例外:小药丸,它只是黄体酮,必须在三个小时内服用。”含有雌激素和黄体酮的药丸,这是所有其他药丸,在你体内保持荷尔蒙活跃超过一天;Dr.奥康奈尔·怀特说,据她所知,医生建议每天在同一时间服用,唯一的原因是这样做建立了一个更容易记住的常规。如果有一天你完全忘记了,“我遇到的女人很少!”第二天她加了两倍,吃了错过的和现在的药丸。Forget two days?"Double up for two days,并且用一个星期的后备避孕方法。O'Connell White.三天?开始一个新的包并使用另一种方法一周。And to be a better rememberer,在手机上设置提醒,or download the Pillboxie or myPill Birth Control Reminder app.

Is it true that the Pill makes your periods lighter?因为现在我的正在踢我的屁股!

"Absolutely," says Dr.Gottfried。“避孕药中的黄体酮有助于使子宫内膜变薄,减少月经负担。O'Connell White agrees: "If the Pill doesn't make your periods lighter,shorter and less crampy within three months,go back and get a different Pill.你应该有快乐的时光。”

我不会撒谎:连续用药的想法是非常有吸引力的,它可以消除经期。但这不是不自然的吗?

Your concern,很多女人都有,研究得很好,但是我们的专家都说:跳过周期是安全的。(我们给你一分钟时间跳一支快乐的舞蹈。)“我告诉病人的是,有30年的经期,只有两个孩子,这是不自然的,as most women do today," says Dr.O'Connell White."Our foremothers got their periods later,died earlier and spent most of the years in between either pregnant or breast-feeding.So from an anthropological standpoint,连续服用避孕药,月经减少更接近正常。“实际上,你不需要有月经的医学原因。”连续服用避孕药甚至可能更安全。"Being on the Pill in general is known to lower your risk for reproductive cancers,而连续的一个可能会进一步降低这些几率,”她补充说。Brands like Seasonale (on which you get four periods a year) and Lybrel (no periods at all) are designed to be taken continuously,但是你也可以使用任何常规的药丸来跳过周期;扔掉安慰剂药片,一旦你现在的药片用完,就开始新的包装。The one downside: Women who skip periods are more likely to have breakthrough bleeding midmonth.

I've been on the Pill a long time—I'm talking years andyears.我应该休息一下吗?

No need."Studies show that taking the Pill long-term is safe and couldlower你患卵巢癌和子宫内膜癌的几率。Etingin.It also appears to protect against ovarian cysts and anemia.没有好的数据显示它会增加你患乳腺癌的风险。So carry on,enlightened Pill user!

Is popping two or three Pills at once the same as taking the morning-after pill?

It depends what Pill you're taking."Two multipill doses of some—but not all—Pills are equivalent to taking emergency contraception [EC] like Plan B One Step or Ella," says Dr.Etingin.“所以如果你害怕,check with your doctor to see if your Pill is interchangeable.It's a call I get a lot!"

这样使用药丸的好处是:

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它比使用B计划更简单、更便宜,大约50美元,不在保险范围内。

But there are significant drawbacks:

“你需要在12小时内重复给药,which may be in the middle of the night," says Dr.O'Connell White.“与EC相比,当你采取避孕措施时,还会有更多的恶心。”并且,最重要的是在这些情况下,EC药片比常规避孕药更有效:88%(有时更高)对75%。

底线?Go the EC route if you can,but know that using regular Pills may be better than nothing!