About Me

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Scottsdale, Arizona, United States
Angela M. DeRosa DO, MBA, CPE graduated from the Chicago College of Osteopathic Medicine in 1995. She went on to do an Internal Medicine Residency with a fast track emphasis in Women’s Health at Lutheran General Hospital. After her residency, she became the Director of Women’s Health Services and Education at Lutheran General Hospital. After two years of practice she started a full time career as the West Coast Senior Medical Director with Procter and Gamble Pharmaceuticals. There she worked on women's health product development, research and marketing. Seven years after starting this position, Dr. DeRosa decided to pursue other clinical endeavors. Dr. DeRosa is a nationally recognized internist and women’s health expert. Her clinical focus is on revitalizing the physician-patient relationship; striving to provide the highest quality of care to her patients in a warm compassionate environment.

Saturday, November 24, 2012

Birth Control Pills Over the Counter? NO WAY!

OB-GYNs are saying birth control pills should be over the counter. I disagree strongly and hope you and anyone you know who is on the pill or considering it will read this and share with others. 

The  ACOG is making this suggestion based on pregnancy rates.  However, what makes me crazy is that OB/GYNs are surgeons and deliver babies.  They usually do not fully understand the differences of oral contraceptive pills (OCPs) and just give them out without understanding the effects on the rest of the body. They only think about the vagina, ovaries and uterus.

Oral birth control is great at preventing pregnancy, yes, but they have metabolic consequences especially the low estrogen OCPs.  They can lower free testosterone (because the ovary makes this and you just shut it down) which increases your risk for depression, low libido, weight gain, sugar problems and even diabetes. They affect your thyroid function..slowing it down.  The low estrogen pills also have a relative high ratio of progesterone, which makes women crabby and gain weight, but also puts women into ametabolic syndrome which is high sugars, high lipids, increased weight and higher risk for heart attack and stroke.  OB-GYN’s don’t think about these things….they just want the contraceptive effect and to stop women from having heavy periods.  This is a good thing, but you need to know what you are doing first.

You can balance these effects by using OCPs with good Estrogen levels especially lowering the progesterone effect….unless you have Polycystic ovary syndrome (PCOS) which is a whole other topic.  You often need to provide or add back testosterone to these women.

There are other options to oral birth control, which are better including: ortho evra patches, nuva-ring and IUD’s.  These avoid processing through the liver and does not increase clotting risk. They also free up some of the testosterone made by the adrenal glands. (10%)  Less chance of the weight gain, low libido, depression etc.

 If OCPs go over the counter, doctors cannot advise women properly about which contraception is uniquely best for that patient. Also, the annual well women exam which is where most young women get their birth control refill would be lost….they would not be compelled to come in as often and we lose an opportunity to provide health education and the needed examinations to ensure they are and stay healthy.