Menopause Matters Forum

Menopause Discussion => Personal Experiences => Topic started by: Poppyflower on October 21, 2015, 02:38:40 PM

Title: Endocrinology appointment and BCP
Post by: Poppyflower on October 21, 2015, 02:38:40 PM
Well I went for my appointment and it was ok.......basically when I questioned her about being on the birth control pill for perimenopause and whether or not my own ovaries could still be shooting through additional hormones she basically said no. She reported that if a women's ovaries were not completely shut down when using the pill then we could still get pregnant and therefore would have a lot of very upset women. Instead what she said is that likely the symptoms we are having while on the birth control pill are due to a reaction our body is having with the pill. She recommends trying many different ones until you find one that settles you as many women in peri have sensitivities to the different progesterones (as we already know). So even though we are not having the fluctuations any longer the accumulation of a progesterone that is not agreeable to us is what is giving us the symptoms and we have to try each pill (as we already know) for at least three months. Like I said the appointment was okay, but not a lot of new information. She also said everyone will react differently to pills and she always recommends marvelon as a starting pill. Also recommends that any women that is still getting a period would find it very difficult to settle her symptoms while taking HRT, and would likely always have symptoms but maybe just a little less intense. when I questioned her about Qlaira she said absolutely not....it is not good in peri as in peri we are having symptoms from fluctuating hormones already and why would we want to take a non steady dose of hormones as qlaira and other cyclic pills have?? Also highly recommends the taking of the pill packs continuously if having a lot of symptoms on pill free week, and also says it may be helpful that instead of having pill free week try 3-4 days instead. Well that's it not sure personally what I am going to do yet just thought I would share my information.
Title: Re: Endocrinology appointment and BCP
Post by: CLKD on October 21, 2015, 02:44:35 PM
Thanks for letting us know. 
Title: Re: Endocrinology appointment and BCP
Post by: Dorothy on October 21, 2015, 03:20:39 PM
Although I had a friend who did have 'normal' hormonal cycle symptoms while on BCP and who also got pregnant while on the pill!  Which is why I would never have relied on it for birth control.
Title: Re: Endocrinology appointment and BCP
Post by: Briony on October 21, 2015, 05:43:32 PM
Really, really useful post. Thank you!  :)

I am intrigued what she said about Q as the FPC, my GP and gyne all said Qlaira was specifically designed for the peri stage. There are fewer days with prog in it and  only two pill free days (so that the days when the dose fluctuates actually means that the dip from the main dose is never very far, unlike with a conventional pill when you go from all to nothing). This has meant I have never had a migraine on it, unlike when I took conventional pills in my early 20s.

.... However, I am convinced that it is still interfering with my own cycle rather than controlling it - perhaps because it's such a low dose? I am going to try printing your post and seeing what my doc says. Marvelon or Yasmine would definitely be the pills I'd like to take if I could!


Thanks again for sharing this x

Title: Re: Endocrinology appointment and BCP
Post by: GypsyRoseLee on October 21, 2015, 05:45:08 PM
I'm so pleased you posted this. It's actually answered a lot of questions for me and explained why I was sort of doing okay on back to back Microgynon until halfway through the 3rd pack it all went wrong and my symptoms came back with a vengence.

 I see now that I'd had too much of a build up of the progesterone in it. And within 3 days of stopping Microgynon I felt much better.

And it makes perfect sense that a cyclical BCP like Qlaira might struggle to even out hormonal fluctuations, when in itself provides a fluctuating level of hormone uptake.

I also found it reassuring that basically my own hormones can't be breaking through anymore. That has bothered me because it made me feel that my hormones were just out of control and there was nothing I can really do about it.

Thank you again. I feel less confused about what is happening to my body now.
Title: Re: Endocrinology appointment and BCP
Post by: Briony on October 21, 2015, 05:52:12 PM
You're right GRL. I remember having issues around day 8 of Q. That was when the first hint of side effects started in month one (chronic itching). And guess what? That's the day when the progesterone increases!

Very interesting to have an endocrinologist's perspective. It makes such sense to start with Marvelon (given what the APL says) yet GPs seem intent on Microgynon (which happens to be miles cheaper as well as the most progesterone dominant BCP around!).
Title: Re: Endocrinology appointment and BCP
Post by: GypsyRoseLee on October 21, 2015, 07:34:24 PM
Yes, I've been thinking for a while that I would love to get an Endocrinologist's take on things. They are much more expert than a GP and probably even a gynaecologist?

I just find what Poppyflower's endo' said to connect lots of dots for me. It never made sense that my own hormones could be breaking through whilst in the Pill, because that would mean there could be a chance I could get pregnant surely?

Title: Re: Endocrinology appointment and BCP
Post by: CLKD on October 21, 2015, 07:42:54 PM
Ladies can become pregnant whilst taking the Pill but it more often 'user' error - i.e. they forget a dose or have D&V and don't think to use other methods.  As a contraceptive, the BCP was 90% effective.  I took it for years and never fell pregnant  ;)
Title: Re: Endocrinology appointment and BCP
Post by: Poppyflower on October 21, 2015, 07:58:42 PM
It is not that I doubt that what the endocrinologist said.....but I wonder if also the balance is incorrect for some of us. For an example wondering if all my period symptom free years I was more estrogeny then progesterony and now while on the pill the balance is different? Not sure if that is possible or makes any sense. Also I think this is a meno symptom LOL-reading and analyzing things too much sometimes. I think that I will be going back to the birth control patch, or back to trying Marvelon. I have felt okay on my 75 estradot, however things are still just there in the background and I just keep waiting for them to get worse, also having new and wonderful things that I do not care for....back to the drawing board!!
Title: Re: Endocrinology appointment and BCP
Post by: Briony on October 21, 2015, 09:03:07 PM
I reckon the fact that Q is bio identical (ie less potent) and that my hormones are crazy might mean that they are still able to fight the pill itself.?  I have had real period type stomach cramps and then a three day bleed on day 14 for the last two months. I have also felt 'odd' - tired, dull head ache and snappy (plus spots) on the day before the blanks start. Weird!

PF-  on the  assumption you need to suppress ovulation in order to prevent fluctuations, you would need a minimum of 100 mcg in a patch (Proff Studd recommends 200) to override your own hormones.
Title: Re: Endocrinology appointment and BCP
Post by: GypsyRoseLee on October 22, 2015, 08:15:04 AM
Yes I reckon there's a good chance your hormones are still breaking through. But then if Qlaira can be used as a contraceptive then that really shouldn't happen?

Is it as effective as a contraceptive as regular BCPs?
Title: Re: Endocrinology appointment and BCP
Post by: Dorothy on October 22, 2015, 10:20:54 AM
Did the endocrinologist say anything that might suggest why we can get peri symptoms while taking BCP?  I get hot flushes etc while I'm taking it though not as bad as I do on my pill break.  Really don't understand how that works.
Title: Re: Endocrinology appointment and BCP
Post by: Briony on October 22, 2015, 03:59:41 PM
Dorothy, which pill do you take?
Title: Re: Endocrinology appointment and BCP
Post by: Limpy on October 22, 2015, 06:28:52 PM
Dorothy - even though you are taking the BCP your underlying hormones (or lack of ) will still have an effect. The BCP masks things but can't stop them completely.
Title: Re: Endocrinology appointment and BCP
Post by: Dorothy on October 22, 2015, 09:10:53 PM
Briony, I'm on Ovranette. 

Limpy, it makes sense to me that my own hormones are still having some say in things, but it doesn't seem to match with what Poppyflower's endocrinologist said.  Find the whole thing really puzzling. 

Interested by the idea of not having the full week's break but I usually get crashing fatigue within 48 hours of my last pill so a 3-4 day break wouldn't really work for me.  It's good to know there are possibilities other than continuous or standard though.
Title: Re: Endocrinology appointment and BCP
Post by: Briony on October 22, 2015, 09:12:27 PM
Yes I reckon there's a good chance your hormones are still breaking through. But then if Qlaira can be used as a contraceptive then that really shouldn't happen?

Is it as effective as a contraceptive as regular BCPs?

Given that the estrogen is identical to eg. Femeston 2/10, which isn't a contraceptive,  I guess it must be the progesterone in Q  that assists its contraceptive property?
Title: Re: Endocrinology appointment and BCP
Post by: GypsyRoseLee on October 22, 2015, 09:17:15 PM
I think the BCP should stop your own hormone production, which is why you can't get pregnant. So if your own hormones have been fluctuating and causes issues taking the BCP should stop the fluctuations by shutting down your ovaries/hormones production.

But shutting down your ovaries and instead giving you a set daily dose of hormone might not entirely suit you either, and cause issues.

I took Microgynon back to back for nearly 3 months, and eventually I think I reacted to a build up of too much progesterone in my system.
Title: Re: Endocrinology appointment and BCP
Post by: GypsyRoseLee on October 22, 2015, 09:20:06 PM
I just don't know enough about how the Pill works. But I do know that the high levels of oestrogen and progesterone trick your body into thinking it's already pregnant, so you don't ovulate.

So it must be the combination of the two? Maybe?
Title: Re: Endocrinology appointment and BCP
Post by: Briony on October 22, 2015, 09:32:30 PM
Did the endocrinologist say anything that might suggest why we can get peri symptoms while taking BCP?  I get hot flushes etc while I'm taking it though not as bad as I do on my pill break.  Really don't understand how that works.

Given what PF says at the start of this thread, I wonder if it's actually related to the progesterone in your pill? The reason I say this is that I think Ovranette is  like Microgynon (what GRL took previously) which is the least estrogenic pill in the pill ladder. I wonder if you took one that had a less dominant progesterone, whether your symptoms would be reduced?

Title: Re: Endocrinology appointment and BCP
Post by: Poppyflower on October 22, 2015, 10:31:57 PM
Yes the hormones from birth control cause a negative feedback to the pituitary stopping the production of LH and FSH which in turn stops you from ovulating and therefore no release of estrogen and progesterone. That is why my gynecologist suggested that now that I am at the moment on HRT I could sort of check myself to see what my hormones are doing by using a home ovulation kit.....if ovulating then progesterone will fluctuate and if not then no progesterone fluctuation. The endocrinologist suggests a intolerance to the buildup of progesterone as the possible culprit for still getting symptoms. Everyone will react differently to all of the different Progesterone in BCP as well as the different combinations as is the same in HRT when synthetic and sometimes even with prometrium (utrogestin). Also the estrogen in Qlaira would appear to help with the decreasing or fluctuating estrogen but is perhaps not what is stopping ovulation as I think that is the progesterone doing that in that pill....would probably be similar to the effect of having a mirena and topping up with estrogen for symptoms but all combined in a pill?? This is just what I think on the matter....it can get all very confusing but together I think we will figure it out...it is very helpful to post about our different experiences and just wanted to thank everyone!!