Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Vicky81 on June 01, 2022, 09:32:35 AM
-
Hi all,
After consulting with my Consultant, he has mentioned that i could benefit from trying he contraceptive pill (Zoely)
Just wanted some advice as whilst on the patches from 19th April, up until Monday (when i took my last 50 patch off for good - granted as you know, i did go up and down on the doses) am still feeling heavy headed, slightly dizzy, and most of all- feeling out of it, like not with it at all/dream-like state (which isn't great whilst at work). Is this normal? As it has really got me worried as i feel like i am on planet zog, not in tune with my colleagues or rest of the world.
Please, kind advice/experience needed as close to tears at work here... xxx
-
It'll take a good few days, I'm sure Vicky.
Fwiw, I think the pill might suit you better. Adding in all that extra estrogen whilst your own is surging up and down in peri I can see would be chaotic. It certainly didn't suit me. It poisoned me.
The pill on the other hand is already balanced estrogen /prog and will take over your own cycle. Hopefully that will work well for you at this stage.
Stay strong.
But... Please give the pill the full 3 months. I didn't find one to suit in the end, but the best fitting one did calm down after 3 months. Xx,
-
Aww Crispy thanks for being so kind. Yes i will give it the three months (unless i feel like keeling over!)
Which pill worked you in the end? xxx
-
None of them I'm afraid.
The best out of a bad bunch was the levongestral prog one (I forget the name. Common one). The least estrogenic. I couldnt seen to tolerate high estrogen any more.
I never got to try zoley or qlaira. I'm hoping it does you well.
I'm no expert, but from all my reading and trials I'd think the pill is a better option in peri when trying to override your cycle, rather than high dose estrogen... Which only supplements your own. :-\
When do you start????
-
Wow, thanks for that. I started yesterday xxx
-
Hi, good luck ! I wish I could take something like Zoely/Qlaira, I think it’s the fluctuations that are the worst for me. Sadly I can’t take oral contraceptives due to migraines. But hey ho.
I do wonder sometimes if the patches are making me worse when my own oestrogen is probably all over the shop ….but there definitely have been major benefits such as no more palpitations and better quality sleep. So I’m sticking as I am for now.
Fingers crossed for you
-
hi Vanilla! Thank you for the lovely message.
Aww glad the patches have helped somewhat....keep going and let me know! xx
-
Really feel for you. I’ve had to stop the Everol patch because
They just didn’t suit me and
Gave me the worst migraines I’ve ever had ….the menopause consultant has transferred me onto Estradot patches which I started today. I totally empathise with all the symptoms you mention I have been feeling just the same. Hope so much you feel lots better soon sending hugs xx
-
Awww thanks pippa....let me know how you get on with edtrodot xxxx
-
Pippa I've private messaged you xxx
-
will read it now x
-
My doctor says that Zoely is a pill she often uses in peri-menopause and it suits a lot of peri-menopausal women because it is quite high in estrogen for a birth control pill. (The prob with a lot of other pills is they have much less estrogen.) And also that the progesterone in it is quite closely related to natural progesterone, although it isn't the body identical one, it's much closer than many others.
I'd be interested to know how you do with it.
-
Hi joziel - oohh interesting! Maybe its me...but I thought zoely had lower oestrogen in it?, which actually made me think "is this going to be right 4 me?" As not much oestrogen.....but if that's what your doctor said...xxxx
-
It has only 1.5mg of estrogen... when you compare that to the amount of Estrogen we take as part HRT it is nothing (and why it didnt work for me personally). The primary part of Zoely is the Progesterone....
Other contraceptivr Pills also have a lower "number" of estrogen but the difference is they contain synthetic forms of estrogen so much stronger (which isn't the case with Zoely and what makes it so attractive and novel, the estrogen used in it is the same natural type as in transdermal HRT)
-
But then Vicky... You're not getting on with high dose estrogen. Gilla, for the most part is.
I didn't.
Peri is a time of great fluctuations. It may well be for you. We're all different
-
Totally agree Crispy - what works / doesnt work for one person isn't going to be the same for another xx
-
Thanks both you are so very kind...I will have yo just see i guess xxx
-
Does anything think adding in one pump of oestrogel would do any harm? I have some bottles here and was sat thinking about it. I'm so fatigued I can't explain.
I never had any reaction from the gel it was just too much faff putting 4 on each day .
-
Zoely is 1.5mg of estrogen: Each film-coated tablet contains 2.5 mg nomegestrol acetate and 1.5 mg estradiol (as hemihydrate).
https://www.medicines.org.uk/emc/product/3038/smpc
This compares as follows:
Sandrena gel 1.5mg
75mcg patches
3 pumps of Oestrogel
Tablets 1.5mg
So it is actually quite a high dose of estrogen for a contraceptive pill. I'm on a 75mcg patch at the moment, so it would be the same amount but orally.
For eg, your bog-standard Microgynon combined pill, is only 30mcg of estrogen: https://www.medicines.org.uk/emc/product/1130/smpc
-
Oh! I didn't know that as I was under the illusion is was very very minimal amout....
-
https://gidonlieberman.com/wp-content/uploads/2019/07/Medical-model-HRT.pdf
If you look on page 4 of this document you will find the equivalent dosages of different HRTs. The Zoely does contain 1.5mg of estradiol but as it is taken orally then some of it is lost in the digestive system. So it’s equivalent to a low/medium dosage of hrt. It’s roughly equal to a 37 patch or 1.5 pumps of Oestrogel.
https://thebms.org.uk/wp-content/uploads/2018/08/HRT-Practical-Prescribing-AUG2018.pdf You’ll find the same information here .
-
Oh, that's interesting. It's not what I read on another website (which is where I copied and pasted that from).
:(
-
Thanks both....ooohhh now confused xx
-
Gosh, which one is correct?
How can we find out? :-\
-
Just to add, you can't compare the numbers of the Estrogen in Zoely to that in other contraceptive pills which use Ethinylestradiol, a synthetic form of Estrogen as it is much more potent than the Estradiol used in both Zoely, Qlaira and trans dermal HRT.
-
I'm with you marchlove......desperate to know myself now xxx
-
Do you know,, I've just been working with a girl tonight, was telling her about all this pill stuff,, she told me her mum was and still is peri and swears by the pill- riverdon?? I'm not sure how to spell it....
She said her mum was bad,, tears the lot and her mum wouldn't go on anything else. .I asked her is your mum jolly etc...she said oh yes! Very jolly . . Completely different...she been on it years.
Never went on HRT for peri .
Xxx
-
Hi…Zoely contains 1.5mg of oestrogen in the form of estradiol. HRT tablets contain 1mg or 2mg of o estradiol. However some of the oestrogen is lost in the digestive system. Therefore, the table that is on the British Menopause Society website is the one to look at for comparisons.
I’m not sure what you’re asking when you say “I don’t know which one is correct”? x
-
Vicki I think you mean Rigevidon, it's just a regular contraceptive with synthetic Estrogen and one of the older (second generation) progesterones.
I think it might help you to not listen to any person or article telling you they've found the answer for them... everyone is so different in this journey that as Crispy says, just because something worked for one person doesn't mean it will for you and vice versa. Give yourself time - at least 3 months - on any one regime before deciding if it's helped or not and then try something else. That's the only way you're going to work through this :-*
-
Sorry dotty I didn't mean anything rude by asking.....I didn't look at the links as was in work.
Gill- I know what yiu mean its difficult sometimes as I guess you try to look for the more positive story/answer xxxx
-
Hi Vicky I didn’t think you were being rude at all. I was just trying to ascertain what you were asking so I could try and help . xxx
-
Awwww thstd good! I'm really grateful dotty for you looking for me....its so sweet xxx
-
It was just to see the comparison from zoely pill strength to other forms of HRT xx
-
Hi Vicky if you look at the table that I posted the link for then you can see the equivalent strengths of different oestrogen preparations . X
-
Thanks dotty xx
-
I can't believe that other source is wrong because it's from a very popular FB group with 'guides' on how to compare various HRTs. But it must be wrong if that's what the BMS says.
I'm a bit confused about what makes Zoely a combined pill rather than HRT then? Or is it sort of both? Or is it a combined pill because it effectively stops ovulation and can function as a contraceptive?
I'm looking for something which does that (if I switch from what I'm on) because I have mild endo. When I took 50 Estradot and 100mg of Utrogestan, my endo was starting to happen again. So I re-started Cerazette to quiet it down again. I also increased estrogen to 75 because my bloods were 233nmol and I still had some symptoms. But I am getting migraines again on Cerazette - I had these when I was on it before too, but I thought they might be due to low estrogen.
So - I want to get off Cerazette again now. Which means I need to figure out what else to try - a progesterone solution which turns off my ovaries, stops ovulation, and prevents build up of endo. I can try 200mg of utrogestan first, which I probably will (got appointment with dr on Weds). But I feel like I need Plan B in case that doesn't work...
The other option which has been suggested to me is Femoston Conti, because the progesterone in it is dydrogesterone which is also supposed to be a relatively good progesterone and it's good for suppressing endo - but it seems that it actually is less estrogen than Zoely then?? It's 1mg.
-
Hi Joziel Can you post a link of the document you mention that you have seen ? x
-
Its so confusing! I've got a telephone appointment later tonight with dr karen morton...I went with her first back in jan. She dies a helpline so I'm going to ask xx
-
Not sure whether to just go on the normal contraceptive pill ...I'm in your boat with this joziel......how can it work if its only got very small dose estrogen,?
-
https://www.menopausematters.co.uk/forum/index.php?topic=33225.0
Have a look at this post.
Zoely contains the body identical oestrogen unlike many combined pills which are synthetic.
-
Thanks dotty will do...
Whats your take on it?, do you think going back on the normal combined pill would be better?
-
Joziel it's a combined Pill because of the synthetic progesterone contained within it (nomegestrol acetate, which is the newest generation of progesterones) as well as the estrogen. The only difference between it and other contraceptive pills (aside from the type of progesterone, which varies in all Pills) is that it uses estriadol as the estrogen, the body identical form (and therefore has a more favourable side effect profile).
The theory about using it (or any contraceptive pill for peri) is that shutting off ovulation will prevent the fluctuations that some people experience as part of it. Zoely shuts off ovulation via its progesterone. However that wasn't the case for me - it did prevent ovulation (as all contraceptive Pills do) but it didn't stop my hormones from fluctuating underneath (ovulation and movement in your hormone levels aren't the same thing necessarily). I was fine for about 6 weeks and then all my symptoms started up again and after 3 months I had blood tests done over the course of a month which showed that my own hormone levels were fluctuating like mad, worse than before I started the Pill. It's possible if I had given it a year or 6 months that they would eventually dampened down, but I wasn't prepared to wait that long. I then tried Yasmin (a contraceptive pill like most with synthetic estrogen in it instead of estriadol) and it was the same experience. After that I tried Lenzetto and that's what worked for me in the end.
However as I've said before this was my experience and doesn't mean that others will have the same, as everyone's hormones and situation are so unique! You really need to find what works for you and unfortunately it's often a case of trial and error. Just because it didn't prevent my stoopid hormones from going mad, doesn't mean the same will happen for someone else xx
-
Hi Gill
Thanks 4 your message. So forgive me as I'm new to all this.....does the zoely shut down ovulation? Again in shutting down ovulation shouldn't that mean no fluctuations?,
What was the reason you kept fluctuating on it?,
What did you need extra of?,
Sorry its me I just don't understand all this lol...I feel like just going back on the average contraceptive pill. My symptoms as you know are high anxiety,, no interest in anything at all,, no social life because if anxiety and if its fluctuations that's causing all this then I just need yhe correct strength medication to do this ....this is why I'm now thinking is zoely strong enough?? Xxxx
-
Yes Zoely shuts down ovulation, like all contraceptive Pills. But shutting down ovulation doesn't necessarily mean your hormones are not fluctuating - this is the assumption I also made before starting the Pill (so don't think it's anything to do with you not understanding). All I can say is that in my case (proved by both being highly symptomatic and then blood tests I had done) my E & P levels were both spiking and falling wildly while I was on both Zoely AND Yasmin and I was symptomatic throughout (night sweats and 3am insomnia), rather than it being in a pattern of only being the two weeks before my period, which was happening before starting anything. As I said, it may well have been after 6 or 12 months that those fluctuations would have stopped/been dampened down. I gave Zoely 3 and a bit months, then tried Yasmin for 1 month and felt horrendous so moved onto Lenzetto and that worked for me.
All I can say is what works/doesn't work for one woman isn't going to be the case for another and you need to give things time to work that out, rather than switching every week or two. Good luck x
-
Wow, that's crazy. I thought hormones were produced by the ovaries so if you shut them down, you'd stabilise your levels. This is all v confusing. I've no idea what I'm looking for now then ;D
I can't post a link to where I saw the comparisons because it was in a closed FB group so I don't think I'm allowed to. But the group is The HRT Truth Collective (bit of a misnomer ;D ) and then click on the link to Guides and scroll down to HRT dose equivalents.
This is what they have:
Sandrena gel 0.5mg
25mcg patches
1 pump of Oestrogel
Tablets 0.5mg
Sandrena gel 1mg
50mcg patches (inc the combined Evorel Sequi or Conti)
2 pumps of Oestrogel
Tablets 1mg
Sandrena gel 1.5mg
75mcg patches
3 pumps of Oestrogel
Tablets 1.5mg
Sandrena gel 2mg
100mcg patches
4 pumps of Oestrogel
Tablets 2mg
-
That's interesting xxx
When I've spoken to Dr morton tonight il post sn update on this thread xx
-
Just to note....back in 2016 i started cerelle pill...I just googled the box to make sure it was the pink one! I had absolutely no trouble on this back then... obviously it was purely to prevent conception. But if I did choose this again would I need oestrogen too? Say in firm of patch or gel? Or purely just the cerelle?
-
Cerelle is the brand name for desogestrel - Cerazette, the pill I'm on, is another brand name for the same pill - desogestrel. There seem to be about 4 different brands, all desogestrel 75mcg, no idea why we need 4 of these.... ;D
Desogestrel isn't licensed to be used as the progesterone for HRT purposes. There is some limited research where it was used at double the dose and was fine, but it was a limited sample size so not considered acceptable to prescribe on that basis. I think in future years there will be more research and it will be accepted but not yet.
Which means that if you want to take desogestrel, you also need to take a progesterone which can function for HRT purposes to protect the uterus. Like utrogestan for eg. That's what I do. I only take desogestrel to suppress my endo, but some women are on it for contraception alongside HRT.
You will always need estrogen if you take HRT, that's the heart of HRT. Progesterone alone you could get from taking a POP if you wanted, but estrogen is what declines and has most impact and causes all the symptoms.
-
Aahh ok ...so if I decide (which I'm really thinking of calling gp for monday), to go on normal combined pill that would be ok?
My friends mum has been on rigverdon in peri 4 years (gp gave) and hadnt looked back. X
-
Well, not really....
Firstly, you have to come off the combined pill at 50 due to clot/stroke risk. So even if you love it, you're only going to be able to use it for a few years till you're 50 and then will have another transition to make onto HRT. So may as well find a HRT that works for you now.
Second, almost all pills use a different estrogen to what our body makes. It's a synthetic estrogen. Which isn't as effective in terms of bone protection and other health benefits as a body identical estrogen. And the clot risk is higher because of that.
Third, most combined pills don't give you enough estrogen because they are designed for younger women whose ovaries are also producing estrogen. And you can't add in more estrogen without more progesterone as it wouldn't be safe/enough protection.
Fourth, the progesterone in all pills is synthetic too. And really the lowest risk (if you can use it okay) is micronised progesterone/utrogestan - which is body identical progesterone. Synthetic progesterones can be estrogenic or androgenic or have slightly increased risk of breast cancer.
Whilst some women do use the combined pill in peri with no problems, it's probably best to go onto HRT - unless you are already on a combined pill, in which case just continuing it until 50 might be best unless you have symptoms. Or unless you also need contraception. (Although you can take the mini pill along with HRT if you need contraception.) Or maybe also if you have endo and need to shut your ovaries down somewhat(!).
Is there a reason you specifically want an oral tablet rather than transdermal? Some women don't get on with transdermal but it's probably the safest/best thing to try in the first instance. That would be either a gel or patch along with utrogestan. If you're still having periods and are peri, you would take the utrogestan 2 weeks of the month and still have a bleed.
-
Thanks so much for that lengthy explanation hin I really appreciate it.
Ok, I'm sticking with zoely....see how I get on.
Much love xxxx