Please login or register.

Login with username, password and session length
Advanced search  

News:

Got a story to tell for the magazine? Get in touch with the editor!

media

Pages: [1] 2

Author Topic: Combined contraceptive pill for progesterone intolerance?  (Read 14646 times)

Clovie

  • Member
  • *
  • Posts: 438
Combined contraceptive pill for progesterone intolerance?
« on: May 07, 2013, 07:52:40 AM »

Hello all *waves*

Just wondering if anyone has gone onto the COCP for HRT because they were intolerant of progesterone?
Have been prescribed it, for a short period (as I'm 49) but my specialist is hopeful it will help with my dreadful anxiety/mood swings I get whilst on prog phase of other HRT.

thanks for any replies!  :)
Logged

Limpy

  • Guest
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #1 on: May 07, 2013, 03:26:21 PM »

Hi Clovie

I haven't has the COCP for HRT, but I was put on Loestrin when I was 50 and stayed on it till I was 54.
Thinking back, I think I was probably menopausal at the time, but didn't know because of withdrawal bleeds on the pill.

When I first started Loestrin I got very crabby for a month or two but that settled down. I hadn't had any issues with Microgynon which I had taken previously. Don't know what it was in Loestrin, but it did take a while to settle down. Think it may have been the different progesterone.
Logged

Clovie

  • Member
  • *
  • Posts: 438
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #2 on: May 07, 2013, 04:17:44 PM »

Thank you Limpy  :)
Off to google loestrin out of interest.
been taking it 5 days now and sadly am beginning to feel a bit 'short' today I've noticed (read grumpy and irritable, its quite a recognisable feeling)
- Or maybe I'm just a miserable bag generally???  ;D ;D ;D ;D
Glad to see my sense of humour remains intact, at least for now  ;D ;D 
Logged

Limpy

  • Guest
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #3 on: May 07, 2013, 05:36:49 PM »

'Short' is a good way of putting it, I got very ratty with OH, for no good reason.
In fact it was him that pointed out what was happening. I just thought he was being more awkward than usual.

Sadly, he was right,  :( I suppose it had to happen sometime.  ::)
The good news is that it did wear off, just took a while.

Your sense of humour seems fine!    ;D
Logged

Clovie

  • Member
  • *
  • Posts: 438
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #4 on: May 08, 2013, 09:00:55 AM »

that's funny/weird! - it's always my hubby who points it out to me too!!!!  ;D ;D ;D
Logged

Hurdity

  • Member
  • *
  • Posts: 14055
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #5 on: May 08, 2013, 11:35:19 AM »

Hi Clovie

I am puzzled by this because if you are progesterone intolerant - from the HRT you were using - then the pill also contains a synthetic progesterone (well the synthetic type) so you could still react negatively to it although you generally take the same dose for 3 weeks.

I don't know the relative doses of progesterone in HRT compared to the pill.

What HRT were you on - and where are you in meno/periods etc? Also which COCP have you been given.

Some women who get bad pmt after stopping the progesterone ( the withdrawal - like just before a period) are given the mini pill to lessen the dramtic drop in progesterone that happens pre-menstrually. However the COCP won't prevent this because you have 7 pill free days, and your oestrogen will drop during this time too (unlike with HRT when the oestrogen is generally constant all the time for most brands).

Well this has been prescribed by a specialist so presumably a gynae specialising in menopause rather than GP?

Most women (well at least who have posted on here) who are progesterone intolerant are often even more inolerant to the synthetic progestogens, and tend to be prescribed a shorter course of (bio-identical) micronised progesterone (Utrogetsan) than usual and are monitored craefully by specialists to ensure no womb lining build up.

I would be interested to hear a bit more

Hurdity x

Logged

Clovie

  • Member
  • *
  • Posts: 438
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #6 on: May 08, 2013, 12:48:02 PM »

Hi Hurdity! *waves*

Yes, I do not understand it myself either!?

The HRt I have tried in the past have both really badly affected me in the prog phase = worst PMS I've ever had! (1 cycle of Tridestra and before that 1 month of Cyclo-Progynova)

The lady I saw at the clinic was a meno specialist (womens health specialist at a Menopause Clinic) and she really listened to me when I explained about crashing on the prog phase. :'(

She said she had come across this intolerance many times and had got good results with the COCP for some candidates - she did stress that not all people reacted the same. She said it was because the prog was delivered daily at the same time as the oestrog and the amounts didn't fluctuate?

She showed me a list of treatments for intolerant ladies like me, starting from safest to less safe.

First she said I could go onto the COCP because I was under 50 (I'm 49, and my periods went irregular about 18 months ago, started with mood swings, anxiety, insomnia and then sweats etc later on, they started last summer I think)

If that doesn't work she would next like me to try Mirena.
I said I was worried that if I became intolerant to the prog in that I couldn't just stop like I can with tablets as I'd need it removing - (but in response to that she said I could see her or a colleague on any 3 clinic days per week to make a quick appt to have it removed)

Then if that doesn't suit me OR if I choose not to have it I can have utrogestan with a sep oestog.

If I still react badly I can then become a candidate for unopposed oestrogen.
This would be obviously last case scenario before a hysterectomy.

The pill she gave me was Microgynon 30.
She said to try this as I reported I seem to recall feeling OK when I used to take this 10+ years ago before my hubby's vasectomy. I had never had PMS before I came off the pill - yet had had PND which she states is also a symptom of being prog intolerant in some women. I am obviously intolerant of my own natural progesterone therefore, as have been on COCP in between my children so was never exposed to it really?

Anyway - have been on it 6 days now and am starting to feel tetchy and short  :(  :(  :(
I was hoping for a bit of a miracle cure, at least for a year or so anyway  :(

I WILL persevere with it though for a month or two. I have a follow up appt in 10 weeks but I can make an earlier appt if I need to.

hope this explains things a little bit more Hurdity, clear as mud to me!!  ;D ;D ;D
what I cannot get my head around is why she said I was allowed to take packs of Microgynon back to back without a bleed. I thought you HAD to bleed to avoid hyperplasia? Or does constant prog cause lining not to build up at all??

I will report back with how my symptoms feel as I progress.
I hate feeling like this - just want to feel normal again.......  :(
Logged

honeybun

  • Guest
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #7 on: May 08, 2013, 06:48:52 PM »

My daughter is on the mini pill. It keeps the lining thin so no need for a bleed much the same as a conti HRT.

It took a few months for her to settle both bleed wise and mood wise. She says it makes her feel a bit flat but for her it's the only one that suits.

I guess you need to give it time to settle.

Honeyb
X
Logged

Limpy

  • Guest
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #8 on: May 08, 2013, 07:33:40 PM »

I thought taking the pill, back to back, was only advisable for 3 packs, after that you had to stop and have a bleed.
If you just carried on spotting was likely to occur (advice from friendly pharmacist)

Mind you this was about 15 ish years ago, things may well have changed.  ::)
Logged

honeybun

  • Guest
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #9 on: May 08, 2013, 07:51:22 PM »

That only applies to the combined pill. You take for 21 days and the have a bleed. It contains oestrogen and progesterone.

The mini pill contains progesterone only. That prevents a build up of the womb lining and therefore is taken constantly with no breaks.

My daughter came off her mini pill recently to see if her terrible cramps would be a bit better now she was older. She had a bleed within a week of stopping the progesterone. Unfortunately she was no better and is now back on her Mycrogynon.

Honeyb
X
Logged

Hurdity

  • Member
  • *
  • Posts: 14055
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #10 on: May 09, 2013, 12:02:58 PM »

honeybun - Clovie has been put onto the combined pill not the mini pill so is odd that she has to take it continuously.

Clovie - I am still puzzled. I wonder if the person you saw was a doctor/gynae or a nurse? The treatment doesn't sound like that usually recommended by gynaes for prog intolerance.

I presume you have been given the pill because you will be getting extra oestrogen and it will give you contraception at the same time?

However I still don't understand why you have been given it back to back too, ie continuously as you won't get a withdrawal bleed. It is my understanding that with the Pill the womb lining builds up even though it contains progestogen - otherwise there would be no bleed when you stop. This means you may end up having a heavier bleed if you then stop??? I freely admit I know very little about the Pill though.

Progesterone intolerance is quite complex and as I mentioned, true intolerance means that women react negatively to any progesterone including their own - headaches, low mood, depression, severe fatigue etc. Many women who are not intolerant experience symptoms when progesterone suddenly increases and when it falls (like just before a period).  That's normal. It happens all our fertile lives. If you've had children and felt fine during your pregnancies - well progesterone is very high all the time and drops after birth.

You might like to read Prof Studd on PND - and the view that it is caused by lack of oestrogen - he is one of the top gynaes in the country and has done lots of research on it:

http://www.studd.co.uk/postnataldepression.php

I don't know why she has suggested a Mirena - except that it will deliver continuous prog and therefore you will not experience any fluctuations ( apart from your own still going on).

In your position I would definitely try separate (low dose) oestrogen and progesterone. If you are not ready to go down the patch route then you can use tablets (eg Elleste) and Utrogestan - the latter would be around 10-11 days per month. You would know how you felt on the Elleste and the Utro and you would definitely know if you were properly prog intolerant and then could be referred to a gynae and perhaps have a shorter course of prog.

If you are feeling rough on the pill too then it sounds as if it is the (synthetic) prog. Years ago I took this (in my 20's) but only for a year as I felt rubbish too.

You could possibly e-mail a question to Dr Currie giving her as full information as possible (lke you have posted) - it only costs £15 and would be an alternative professional opinion - as we are not medical experts!

Keep us posted...

Hurdity x


Logged

Suzi Q

  • Member
  • *
  • Posts: 7474
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #11 on: May 09, 2013, 12:41:11 PM »

I didnt take HRT went over 36/7
I took mini pill and Ovestin in place worked brilliantly so much so
Thats both my female cousins in UK asked their GP when there tune came and he reluctantly at first gave it to them
Now it seems where I lived more more GPS giving this out in place of HRT to women who wont or cant take HRT pills
Logged

Hurdity

  • Member
  • *
  • Posts: 14055
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #12 on: May 09, 2013, 03:00:28 PM »

Hi Suzi Q - if the doc prescribes mini pill for early meno at that age then you won't be getting the oestrogen you need and is your right to protect your bones until age 50. Was this the case for you ie mini-pill = progesterone only from age 36 ish? Ovestin just does for the vag area and not systemic. Have you been checked for osteoporosis? Might be an idea if you had premature meno and didn't take the full contraceptive pill?

Hurdity x
Logged

Clovie

  • Member
  • *
  • Posts: 438
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #13 on: May 10, 2013, 08:04:19 AM »

very interesting article by Prof Studd, Hurdity.

Am more confused than ever, as had previously read up a lot and read that prog was to blame!?!
However, the oestrogen makes sense - I felt reasonably Ok on the first phase of each HRT I tried, perhaps I just needed the oestrogen upping to feel better still?
Both times I crashed on the prog  >:(

I have taken 6 tablets now of the Microgynon - and I feel awful - prob because of the progesterone in it, even though I am getting more oestrogen - the prog is cancelling it out!?

Arrrggghhh!
Think I will give it another week then go back to the clinic (She was definitely a doctor Hurdity, I saw the nurse before I went in to see her) and cut to the chase.
I want to try a higher amount of oestrogen and then as short a period of time on utrogestan as I can safely can.

Hurdity - you seem to be very knowledgeable on this, can I please ask, do you have any recommendations on a 'higher' dose oestrogen in tablet form I could ask for/research? Is the elleste a higher dose than say the Tridestra I was on?

I am at my wits end I really am.
So confused.  :o
I mean, I woke up crying this morning - yes, WOKE UP sobbing. What's that all about????;D ;D ;D

thanks for reading
xxxxxx
Logged

Hurdity

  • Member
  • *
  • Posts: 14055
Re: Combined contraceptive pill for progesterone intolerance?
« Reply #14 on: May 10, 2013, 02:19:17 PM »

Hi Clovie

Look I only know what's on here plus I've read a few research papers etc as I am interested in the subject, so my knowledge is quite limited but I can help to a certain extent - but doesn't replace proper medical advice - although as we have seen this is patchy and in many cases lots of us on here know more about HRT and current thinking than GPs - because of course they are just that - general practitioners.

Re Microgynon - I said I took this years ago and it used to have the same effect - I would cry for no reason and I was young then.

I don't know what Elleste you took?

If you look at the HRT preparations listed on this site,

http://www.menopausematters.co.uk/perimeno.php

you will see that Elleste can be Estradiol 1 mg or 2 mg. Tridestra contains 2 mg Oestrogen in the form of Estradiol valerate which is converted to Estradiol in the body. I seem to remember that the serum levels of estradiol obtained from estradiol valerate in tablet form were less than that obtained from estradiol alone, but don't have time to look this up at the moment. However all the studies on oestradiol levels from given tablets will be based on quite small populations ( of women) and women do vary in how the level of estradiol that gets into their blood after digestion/liver etc.

I know there are women especially those who have had hysterectomoy that have taken more than 1 tablet of Elleste per day to increase the amount of oestrogen - with the advice of their doctor.

You may not want to consider patches or gel - but some women find they can increase the dose easier with gel - but the size of the application area is quite critical I understand (from what I've read) - but I have never used it so can't comment. Also I think you can get a higher dose with patches (100 mcg) without having to resort to horse estrogens - although I haven't checked what levels you would expect.

Of course the higher dose of oestrogen you take the correspondingly higher dose of progestogen you need and this may not suit you. On the Tridestra you would have needed a high dose of prog to counter nearly 3 months of unopposed oestrogen, so I can see how that would make you feel bad!

Many of us find it is a tricky balance between feeling the benefits of oestrogen while minimising the negative effects of the progesterone!

I hope this helps and keep us posted. Maybe think about E-mailing Dr Currie - I have just e-mailed her about another issue.

Hurdity x





Logged
Pages: [1] 2