Is There a Link Between Proteinuria and Birth Control Pills? - Family Medicine

Dr. Xiao Yongxun reply Family Medicine

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Dear Ms.
Rona:
1.
There are various pharmacological mechanisms available to reduce the chances of conception, such as preventing ovulation, interfering with egg development or maturation, or disrupting pregnancy.
Currently, the most commonly used pharmacological method to prevent pregnancy is ovulation inhibition.
2.
Products that contain both estrogen and progestin are the most commonly used oral contraceptives.
Monophasic oral contraceptives contain a fixed dose of estrogen and progestin taken continuously for 21 days.
Triphasic oral contraceptives mimic the natural hormonal cycle in women, containing the same amount of estrogen over 21 days, while the progestin dose is gradually increased over three seven-day phases.
Regardless of the type of combination oral contraceptive used, after taking the active pills for 21 days, a 7-day course of placebo pills is taken; this hormone-free interval can trigger withdrawal bleeding.
These formulations are effective in achieving contraceptive effects.
3.
Most adverse reactions are believed to be caused by estrogen; however, cardiovascular issues may result from the combined effects of estrogen and progestin.
Major adverse reactions include breast tenderness, depression, dizziness, edema, headaches, nausea, and vomiting.
The most serious side effects of oral contraceptives are cardiovascular diseases, including thromboembolic events, thrombophlebitis, hypertension, increased incidence of myocardial infarction, and cerebral and coronary embolism.
These adverse reactions are most commonly seen in women who smoke and those over 35 years of age, although they can also affect women of all ages.
Abnormal glucose tolerance (similar to changes during pregnancy) is sometimes associated with the use of oral contraceptives; this medication can also increase the incidence of abnormal glucose tolerance test results (similar to changes during pregnancy).
Combination oral contraceptives can alter the distribution of lipoproteins in the blood: estrogen increases HDL and decreases LDL (a desirable outcome), while progestin has the opposite effect.
Cholestasis, cholecystitis, and cholangitis may also occur.
Therefore, oral contraceptives should not be used in patients with cerebrovascular and thromboembolic diseases, estrogen-dependent tumors, liver diseases, and pregnant women.
Combination oral contraceptives should not be used in heavy smokers over the age of 35.
4.
In simple terms, oral contraceptives theoretically rarely cause proteinuria; of course, this may vary in individuals with specific conditions.
5.
Under normal circumstances, blood cells and large molecules like proteins cannot be filtered out, so normal urine does not contain blood cells or proteins.
If glomerular disease damages the structure, leading to a loss of its filtering function, symptoms such as hematuria and proteinuria may occur.
There are many causes of proteinuria, including excessive exercise, use of analgesics, certain herbal medicines, certain antibiotics, urinary tract infections, excessive intake of food additives, glomerular lesions, diabetic nephropathy, and more.
There are also individuals with unique constitutions who may have persistent proteinuria throughout their lives without any issues.
6.
Please discuss and consult with your family physician for examination; alternatively, seek care at a gynecology outpatient clinic at a regional hospital or higher.

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Reply Date: 2020/09/11