Judd,
let me pose you a question:
If you knew of a way to treat your patient's PMS symptoms (just an example) without increasing her risk of
thromboembolism, retinal thrombosis, thrombophlebitis, MI, cerebral thrombosis, cerebral hemorrhage, HTN, severe hepatic adenoma (rare), cholestatic jaundice, gallbladder dz, depressionan, aphylaxis/anaphylactoid rxn, nausea/vomiting, abdominal cramps, bloating, breakthrough bleeding, altered menstrual flow, amenorrhea, breast tenderness, breast changes, edema, headache/migraine, weight changes, cervical secretion changes, emotional lability, vaginal candidiasis, rash, acne, melasma, contact lenses intolerance, elevated BP, glucose intolerance (list taken from epocrates.com)
...wouldn't you choose that option? I know, as a patient, that I would choose the treatment option with the fewest/no side effects! And, as a doctor, I would want to provide that option to my patient. Point of fact is, there are other ways to treat women other than OCPs. What does an OCP do anyway? It masks symptoms, fools the body into a fake "menstural cycle". Have you fixed anything? Not really. Perhaps the women has lighter periods, fewer cramps, less PMS, etc. But the underlying problem has not been corrected. All you've done is introduce fake hormones into her body that cover it up.
I don't know about you, but my preference would be to get to the underlying homornal imbalances at the root of the problem, or perhaps a structural root, whatever it be. Is that harder? Heck yeah! It requires a little work on the part of the woman, to chart her mucus (which is an EXTREMELY accurate diagnostic tool), perhaps a few blood draws to measure her hormonal levels. The doc has to think a little harder, too- to really figure the problem out. And to me, that is medicine. See a problem. Figure out what it is. Fix it. None of this cover-up business.
Perhaps the reasons that people are so opposed, sometimes violently opposed (as evidenced by many of the posts in this thread) to alternative treatments to OCPs, is that people don't really understand or know ANYTHING about them! Have you ever looked at any of the research? I challenge you to read some of it- it's quite convincing. And I think it's always a good idea to educate oneself about BOTH sides of an issue before coming to a decision.
I'm no expert. I was only just introduced to a lot of this during an internship this past summer. I don't know every single treatment for every single malady. But again, I would point to you
http://www.fertilitycare.org/napro/index.html to start learning a little more. If you have specific questions, please ask and I will see what I can do to find you an answer.
God bless!
and NOT worry about whether it's a "bad time of the month". I would guess that many individuals are in this boat as well and you need to respect that and not try to change their ways with your "educational" methods that are likely to fail. I respect you and your beliefs and if you want to be a pregnant resident then have at it, but most people realize that's ridiculous!
