These answers are for general informational purposes only and are not a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.
For Birth control pills
The FDA says: “Based on information available to the Agency, we are aware of no oral drug products currently marketed in the United States that contain wheat gluten or wheat flour intentionally added as an inactive ingredient.”
Some drugs may contain Starch. Often it is corn starch or potato starch, not wheat starch.
The FDA stated they do not collect data about gluten contamination. “The amount of gluten would be well below the levels we have estimated an inactive ingredient, such as wheat starch, could potentially contribute to an oral drug product”. If wheat happens to be an impurity in a drug listed as gluten-free, the FDA estimates that it could contain no more than 0.5 mg of gluten per pill (for reference, a slice of bread labeled ‘gluten-free’ may contain up to 0.57 mg of gluten and still meet FDA criteria for being considered gluten-free).
The FDA also says: “If the list of ingredients does not mention wheat gluten or wheat flour, then the product should not contain gluten in an amount that would harm a typical (non-refractory) individual with celiac disease”
Other birth control options that do not include gluten:
birth control patch, birth control ring, birth control shot, IUD with hormone, copper IUD, birth control implant, condoms, spermicide.
Any birth control pill is good for acne. However, some may be better than others. At Pandia Health, the ONLY #WomenFounded #WomenLed #DoctorLed birth control delivery company, we suggest desogestrel, drosperinone (if you can drink 8 glasses of water a day), or norgestimate are best for acne. We’ve found that levonorgestrel and norethindrone are not as good for acne.
It depends on your risk of getting pregnant if you are not on the pill. If you can use a condom or abstain from vaginal intercourse for 4 to 6 weeks before the surgery, then please do STOP the birth control pill, birth control patch, birth control ring 4 to 6 weeks before a surgery.
A paper from 1988 shows: that research from the 1970s (when women were on HIGHER doses of estrogen) that 0.19% of women on the pill versus 0.035% NOT on the pill got a deep vein thrombosis after surgery. Other studies showed: 4.6% of patients who underwent gynecological operations for benign disease, 0 of 99 patients who underwent various abdominal operations, and 20% in 33 patients who had emergency appendectomies had a thrombosis.
From the American College of Obstetrics and Gynecology in 2018: “No trials exist to demonstrate a reduction in postsurgical VTE with preoperative discontinuation of hormone therapy, and this practice should not be routinely recommended. In women using combined oral contraception, prothrombotic clotting factor changes persist 4–6 weeks after discontinuation, and risks associated with stopping oral contraception a month or more before major surgery should be balanced with the very real risk of unintended pregnancy. It is not considered necessary to discontinue combination oral contraceptives before laparoscopic tubal sterilization or other brief surgical procedures. In current users of oral contraceptives who have additional risk factors for VTE having major surgical procedures, heparin prophylaxis should be considered.”
There are 40 different formulations out there of the birth control pill. There are usually 3 different levels of estrogen (10 mcg, 20mcg, 30mcg, we do NOT recommend less than 30mcg for anyone under 30 years old. Too low of estrogen is NOT good for your bone health/density. See our youtube video ) and 8 different progesterones. So NOTE which progesterone and what level estrogen and find a doctor willing to try different ones and work with you.
Pandia Health has birth control expert doctors. If you are in California, Texas, Florida (and soon other US states), we’d be happy to help.
Otherwise, many people do well on norgestimate, desogestrel, drosperinone as the progestin. So perhaps cycle through those with your doctor.
The best birth control if you don’t want to have children are in order from best/most to least effective:
The birth control implant (Nexplanon ®) works better than tubal ligation! Some women do GREAT on it. Some women have a lot of random breakthrough bleeding (BTB).
The IUD with hormone (Mirena ®, Liletta ®, Kyleena ®, Skyla ®) are very well tolerated because it is low dose and progesterone only. 30% of women who go on Mirena and Liletta have no periods. yay! 70% get lighter periods. Kyleena and Skyla are more likely to continue to have periods.
Then comes, Tubal ligation and then copper IUD in terms of efficacy at preventing pregnancy.
If you like the birth control ring (Nuvaring ® or its generics), now there is a 1 year ring. You could just put it in and leave it in for a year!!
Know that there are 40 different birth control pills with estrogen and progesterone. so if you didn’t like 1 then there are 39 other formulations of the birth control pill you could try.
If you are in a long term heterosexual relationship that never wants children, it’s better for the one with the testicles to get a vasectomy than the one with the uterus to have that person’s tubes tied. Vasectomy is more effective and less invasive than tubal ligation. Tubal ligation is invasive! they have to poke 3 holes in your abdomen, blow it up with gas. and it’s NOT as effective as the implant/IUD with hormone! and NOT as effective as vasectomy.
If your doctor is an ob/gyn or even if they are not, you can cite the ACOG committee opinion https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Ethics/Sterilization-of-Women-Ethical-Issues-and-Considerations it says:
“It is ethically permissible to perform a requested sterilization in nulliparous women and young women who do not wish to have children. A request for sterilization in a young woman without children should not automatically trigger a mental health consultation. Although physicians understandably wish to avoid precipitating sterilization regret in women, they should avoid paternalism as well.”
The 5-7 yr IUD with hormone fails 1/1000.
The implant fails 1/1000.
Vasectomy fails 1.5/1000.
Tubal ligation/women’s sterilization fails 5/1000
Copper IUD fails 8/1000
The birth control ring, the birth control patch, and the birth control pill fail 7/100, though the ring and patch, should have a theoretical lower failure rate because you have fewer chances of forgetting/messing up. The ring has 13 chances a year of messing up, the patch 52 times and the pill 365 times.
updated 11.5.20 sy
This depends on what your insurance will allow and what your doctor wrote. Pandia Medical Group’s doctors usually write for 1 year’s supply at a time and California law mandates that insurances allow 1 year’s supply at a time. If you have no insurance, we can ship as many months worth of medication as you are willing to pay (up to a year).
Thank you for your generosity! Pandia enables donations via the Pandia Health Birth Control Fund (sponsored by the Center for Policy Analysis). We welcome all levels of giving.