Non-cold-sore-inciting birth control?

September 23, 2005 1:17 PM

Are there any birth control pills/shots/drugs that do not incite cold sores?

My girlfriend has had cold sores since she was a young child. The last time she was on birth control (ortho tri-cyclen lo), she noticed an increase in the frequency of the cold sores. These are controllable with medication such that they don't even appear beyond her feeling them, but she really doesn't want to have to deal with them like that. Since then, she's read from X reputable source that birth control, in general, does indeed increase the frequency of the sores. Are there any types/brands of pills or shots or something that won't cause cold sores to rear their ugly heads?

posted by anonymous to Health & Fitness (9 answers total)

This question is best posed to a gynecologist, or another physician familiar with oral contraceptives and their side effects. "Cold sores" are a form of herpes, Herpes simplex type 1, that lies dormant in the body and then becomes active when the body is exposed to certain types of stress. In this case it appears your girlfiend's cold sores are activated by oral contraceptive. There may be certain type(s)/brand(s) of contraceptive that have lower levels of hormones, levels that may not activate the virus in your girlfriend. Physicians who frequently prescribe this type of medication would be your best resource for this. Metafilter is not, since even if someone told you of a medication that anecdotally produced less HSV-1 flare, this medication may not be appropriate for your girlfriend, without knowing her medical and medication history. This information is gathered by her physician, who then uses it, combined with his / her experience and medical judgement, to recommend the best course of action.
posted by cahlers at 1:32 PM on September 23, 2005

Perhaps she could try a form of birth control that doesn't rely on hormones. I have friends who love their IUDs.
posted by Laen at 1:48 PM on September 23, 2005

IUDs may be an option. They might not incite cold sores. However, it will still be necessary to consult a physician for an IUD fitting.
posted by cahlers at 3:00 PM on September 23, 2005

Unfortunately, the type of IUD best suited for women who have not yet had babies is not available in the US, so unless anon's girlfriend is in Europe she's probably out of luck.
posted by footnote at 3:04 PM on September 23, 2005

Side note: I have had very good results using abreva to reduce severity of cold sores.
posted by theora55 at 3:54 PM on September 23, 2005

A lot of women fnd an increased incidence of cold sores immediately before their periods, which is when progesterone is much higher than estrogen and both levels are falling rapidly. This might suggest that a method that avoids these hormonal characteristics might be less likely to cause this outbreak.

As suggested above, a non-hormonal method might be the least problematic, but a hormonal one that cycles on a quarterly (or less) basis rather than monthly might at least provide fewer episodes of exacerbation (if this is indeed the trigger).

Unfortunately, many doctors are poorly-trained or disinterested in the fine points of hormonal effects. The most likely field in which she might find a knowledgeable specialist would be a reproductive endocrinologist, but that doesn't necessarily mean than any given repro/endo might be interested in working with her to limit this effect. That would, however, be a good place to start shopping.
posted by salt at 9:21 PM on September 23, 2005

Not a birthcontrol tip, but a herpes control tip: I've had good luck taking oral L-Lysine as soon as I start to feel a cold sore coming on. Avoid L-Arginine-rich foods (sunflower seeds and pistachios are particularly bad for me). There is apparently a connection between the herpes virus being "activated" by the L-Arginine, and the L-Lysine supressing the L-Arginine.

Perhaps this may help your girlfriend?
posted by soundslikeobiwan at 9:34 PM on September 23, 2005

I agree with soundslikeobiwan about the Lysine. I know this is a little bit of a stretch, but at the vet practice where I work, we treat/manage cats with chronic herpesvirus with Lysine with a high level of success
posted by mabelcolby at 9:16 AM on September 24, 2005

(Aside:

Unfortunately, the type of IUD best suited for women who have not yet had babies is not available in the US, so unless anon's girlfriend is in Europe she's probably out of luck.
posted by footnote at 3:04 PM PST on September 23

Footnote, I have had no children and got my copper IUD right here in the US, no problems.)
posted by astruc at 9:30 PM on September 24, 2005