I would like to change birth control pills to reduce acne breakouts during my period (Alesse to Seasonale), but the latter seems to be contraindicated with Crohn's disease. What should I do?

Hello,

First of all, you should know that Seasonale contains the same medications as your Alesse, only the content of the medications inside is a bit higher. In this context, I would like to inform you that you could very well take the pill continuously with Alesse, which you are already taking and which seems to do the trick, rather than switching to Seasonale. Just skip the 7 sugar pills in your Alesse pack, and start another pack instead, and stop taking it for 7 days, every three months!

That being said, the precaution for Crohn's disease is indeed present in the product monograph. However, it is not an absolute contraindication. It is that patients with this disease may have decreased absorption of medications, especially when the disease is not controlled and patients have frequent diarrhea.

On another note, patients with Crohn's disease or ulcerative colitis have a slightly increased risk of developing phlebitis, a clot that forms in the legs and can be very serious, especially when it "rises" to the lung to cause a pulmonary embolism. Be aware that this risk is also increased by taking the contraceptive pill, and that taking the pill continuously (whether Alesse or Seasonale) increases the exposure to the medication and thus the risk of a clot.

All of these risks are very small, but still present. So the question here is, does your menstrual acne bother you much, once you know the risks here?

We look forward to seeing you,

Alexandre Chagnon, pharmacist