Worried about being one of the women who is genetically predisposed to birth control failure? I have an idea

togetherinjesus

New member
I’m referencing this.

As a disclaimer, I am not a doctor. I am however, a medical professional and a woman on birth control. I have a working knowledge of how birth control works as well as an interest in endocrinology. There is a possibility that I am missing something and I would LOVE to be corrected if I am. This is also partially cross posted from twoX.

In a nut shell, birth control pills work by suppressing Luteinizing Hormone (LH) and Follicular Stimulating Hormone (FSH) these hormones control ovulation. FSH makes eggs mature and LH causes eggs to release. When on birth control, LH Is typically less than 0.7 IU/L. Which means no ovulation. I believe this could be used to determine birth control is effectively controlling ovulation. If LH and FSH are above the reference range for a woman on birth control, then it’s not working, right?

Recently I’ve been having some problems and my doctor sent me for hormone testing. When this study came out, I wasn’t that worried (for myself) because I knew that I was, not only below the 0.7IU/L number, but I did have a measurable amount of LH at all. I’ll need further testing for other stuff, but it’s pretty safe to say that I am not capable of getting pregnant.

So you wouldn’t even need a genetic test to determine if you were part of the group who metabolizes Birth Control too quickly. It would be a simple blood test that could be ordered and read by... well like any doctor. Not even a specialist. Edit: no new tests would need to be devised, your doctor wouldn’t even need to be “in the know,” really. You could just ask to have your hormones checked and if you’re above that level then consider different birth controls.

As evinced by the fact that we are JUST NOW learning about the genetic difference, and knowing the speed at which a lot of doctors learn and implement new information some times, we can’t assume that an individual doctor will know anything about this for awhile. Which is why this solution could be so important for the lay-person to know. It’s important for us to advocate for ourselves.

Another redditor @bab mentions that you could even do this at home using ovulation tests kits. As you would probably need to multiple tests through out a month to be completely sure, this is probably the best option. I’ve never used one personally, so I don’t know the results are displayed.
 
@togetherinjesus There’s a really fascinating field of science called pharmacogenetics that’s emerging that focuses on creating medications that are tailored to our individual genetic makeup. I hadn’t even considered birth controls’ possible role in this. Thanks for the read!
 
@katrina2017 My understanding is that Mirena works by thickening the cervical mucus to prevent sperm entry into the uterus, and thinning the endometrial lining to prevent implantation if some does get through. It does not prevent ovulation. I can't speak to the progesterone only pill though.
 
@antinomian This is absolutely correct!

For progesterone only pills - norethindrone mini pills and levonorgestrel mini pills can sometimes prevent ovulation, but it's not consistent. Desogestrel mini pills prevent ovulation just like combo pills.
 
@katrina2017 Yep. Levonorgestrel and norethindrone suppress ovulation for approx 50% of cycles, whereas desogestrel does so for approx 97% cycles, so slightly less than combined pills but still pretty good for a POP!
 
@togetherinjesus This is such a cool idea! As someone whose family has an interesting history with birth control (a disturbing amount of people got pregnant on various forms of birth control), I would love to see where this goes and how it could help people.
 
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