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[bombsh3ll]

I would say the progestins in most combined pills are roughly biologically equivalent in shutting down ovarian function.

The developers have tested different doses in large groups of women, most of them probably under 35, in order to identify the dose that is universally effective. 

I am 100 percent confident that either 150mcg desogestrel or zoely (active pills daily) will shut you down after around 6-12 weeks max.

Both shut me down and my nickname during IVF was the Easter Bunny. I had OHSS twice, very high egg yields and was difficult to shut down on Buserelin. I had, and still have, an antral follicle count and AMH consistent with someone 15 years younger. And my ovaries are clinically, biochemically and radiologically quiescent on both of these treatments. 

I believe the progestin in Zoely is better tolerated by some individuals, possibly because it is less active at off-target receptors, however I personally did not experience any noticeable difference. Also some would experience negative quality of life effects in the hypoestrogenic state resulting from taking desogestrel 150mcg with no additional estrogen, which again I did not notice myself.

However there are arguments for considering the desogestrel in your case - it is easier to work out what is going on if you are using a single vs combined agent. Also if you wanted to check your baseline blood level on desogestrel (you would be shut down but unless you are postmenopausal or very close it will not be zero - mine was around 100 pmol/L) this may be of more value to you than measuring it on Zoely and would help you monitor any add back estrogen.

Access to treatment - desogestrel can be obtained pretty easily including bought over the counter without a prescription until age 55, however getting a combined pill such as Zoely prescribed may be difficult at 49 and impossible at 50.

[CrispyChick]

Some good points bombshell. Thank you.

I have obtained zoley online.

I'll start with double cerazette then see where I am and discuss with my lovely GP. She tries to help wherever she can. So hopefully she'll support this latest trial.

I'm most scared of it not working and making me feel worse - which 1x cerazette did last April.  And /or the side affects - as cerazette tends to attack my mood and give me anxiety. Cause headaches and stomach issues.  But, right now, I'm so ill, I'll need to suck that up.

Thanks for helping me see the right path to start on. 👍

[CrispyChick]

If I start my double cerazette on day 1 of cycle. Will it already affect a day 3 FSH test I want to do???

Anyone know?

[bombsh3ll]

It might, and if you are paying for the test/care about the result I wouldn't take the chance as you won't know if you can trust the result.

Why not do your test clean, and then start directly after this on the morning of day 3?

Starting a pill on day 3 is still perfectly good enough to stop any ovulation that cycle.

[CrispyChick]

Hmmm because my E peaks like day 9 nowadays. So I'm trying to curb that peak as soon as I can.

No. I think my hormonal trial is more important than an FSH nosey reading.  . So I'll either do it and potentially waste it. Or not bother. Thanks for the heads up.

It could only hold FSH down, right?

[bombsh3ll]

Yes that's right it suppresses FSH.

So if you do test, either it will be unaffected that soon, or the FSH will be artificially lowered.

[CrispyChick]

Me again!!

I've just trawled all my I trial posts on here from 5 years ago. Very, very enlightening.

I concluded all my issues were hormonal -because, the Coc 30mg pills took them away!!!!  My giddy aunt. 

So. Where does this leave me?

Back then on cerazette I was better, but still pretty rough and had terrible moods. 20mg E coc pills didnt help sufficiently. 30mg E coc did. But gave me terrible daily migraines.  HRT was horrific. Being on nothing was horrific.

I do think there's now more going on than there was back then. I now have serious reactive symptoms. In my stomach, in my head (nose pressure), tingly pulling sensations when trying hormones. MCAS possibly.

So. I guess my question is, will 2x cerazette shut me down as well as a high dose estrogen coc - which, at 49, I'm now unlikely to get. Especially when it gives migraines.  . Because I'm assuming it was it's ability to suppress and override that made things better.

But concerned, since I did try 20mg coc with desogestral (150mcg) and it wasn't good.

I think I can clearly see HRT will not help me.

Help...

[bombsh3ll]

Yes, I am sure it will shut you down.

It shut me down at 41 with really high ovarian reserve.

No bleeding, quiescent ovaries on scan and estradiol levels just above postmenopausal range.

Whether you will feel well on it I can't say. But you have options for adding estradiol if needed.

A 30mcg ethinylestradiol pill would not normally be recommended with migraines especially in the 40's, however if someone has no quality of life any other way it could be considered, alongside treatment for the migraines.

Also some women, if they are taking the combined pill 21/28 days, which is not just medically unnecessary but can be harmful, can experience migraines in the pill free week, and taking it continuously may prevent this.

[CrispyChick]

Thanks bomb.

I've been reading on chat gpt (thanks dangernouse) - I'm hooked now!

Apparently cerazette can be stronger in suppression than a 20mcg coc pill because the estrogen affects the progestin metabolism. And, that's before I doubled the dose - which chat gpt doesn't agree with 

I'm not remotely worried about low E symptoms right now. Well, because I've been through the brutality of chem meno. That was something else. This is solely an attempt to flatline my own hormones, in a less intense manner.

I'm still concerned about who would support hrt add on on 2x desogestral. But I guess that's an argument to have, should I ever get there.

Right now I think my GP is gonna freak. 

But, I mean, these I trial posts confirm it. I was horrific when swapping from cerazette (not amazing) to 20mcg coc, then on nothing was off the scale, then the 30mcg coc calmed it all down by the end of a month.

This was 5 years ago, but I've been chasing it ever since ...hrt doesn't work as my body overreacts(?) to hormonal changes, big stylie.

I'm defo thinking prof paney.

None of it explains why chem meno was the worst disaster ever though. The only thing I can think is my body overreacted to the severe shut down. Then I never got enough, stable E in me. I felt so utterly ill I couldn't continue.

[bombsh3ll]

Your GP will happily prescribe one desogestrel daily alongside any HRT you take, for "contraception".

You can buy more over the counter without a prescription up to age 55, as long as you say it's for contraception.

Many specialists would be happy to support this based on existing evidence, but if you are just working with a GP who doesn't have a particular interest in this area it is sometimes just better to meet them where they are rather than asking for something non standard.

[CrispyChick]

Yeah, but I would defo not want any other progesterone.

I guess E patch plus 'utrogestan'  in that situation.

But I'll probably never ever get to that point anyway.

[CrispyChick]

Just thinking about what you said about quality of life...

And migraine treatment.

This was 5 years ago though. So god knows how my reactive body would cope now.

But you make a good point. Every day I tell my husband I don't want to live any more, as I cant stand feeling this ill...

Food for thought.

[CrispyChick]

Ok.

So I, coincidentally, had a gynae ultrasound this morn. Been waiting about 9 months.

Anyway, all fine. But whilst in there we chatted through my history and I said about starting cerazette.

She could see follicles as per a normal cycle.  . Now, is this because I'm only day 11 of first cycle?? I started on day 1 of my cycle.

Or, is this why cerazette has never worked for my awful symptoms like the 30mg COC did???

From my reading, cerazette stops the LH surge and therefore ovulation. But doesn't affect FSH so much. Whereas a coc pill reduces fsh substantially. Hence full expression.

And, especially deep in peri, my fsh and E are dancing mega high at times.

Really appreciate some thoughts? Thanks. X

[bombsh3ll]

One 75mcg cerazette pills isn't intended to shut you down like a combined pill.

That's white is half the dose that you would get in mercilon or Marvelon.

The difference is it is ok to be shut down on a cocp as you have the estrogen added back.

It wouldn't be appropriate to shut young women down long term for contraception with no estrogen added back.

Some women do achieve amenorrhoea on cerazette but this doesn't equal full suppression
 There is still some follicular activity.

That's why in my opinion cerazette as a single dose is neither use nor ornament for any therapeutic indication, it prevents pregnancy, nothing else.

[CrispyChick]

But I'm on the double dose of 150mg.

So I'm 11 days into 2x cerazette and follicles were seen on my ultrasound.