Which contraceptive pill is best

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Re: Which contraceptive pill is best

Postby yarnstorm » Tue Jun 05, 2012 6:58 am

Hi,

I'm looking for some advice on which pill is best for those of us who bleed too much! I was on Marvelon from my late teens and was happy on it for years, it was only when I had a break for 12-18 months or so that PCOS showed itself. One of my main symptoms was bleeding nearly continuously throughout the month, went for an ultrasound which showed lots and lots of cysts.

I went back on to Marvelon after being diagnosed but to no avail, although it was better I was still only having 1 bleed free week per month. Then tried 6 months of Dianette, before one GP suggested that the bleeding might be caused by my progesterone levels dropping really low mid cycle, so prescribed one of the newer tri-phasic pills TriNovum. This initially seemed like it was helping, but it's been about 9 months now and I'm without fail bleeding from the mid of my cycle onwards. It's really starting to get me down...

GP has said this is pretty much as good as it's going to get and just to come back if I have any more problems. Any advice would be really appreciated!

Thanks x
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Re: Which contraceptive pill is best

Postby Meringoo » Wed Jun 06, 2012 5:20 am

Hi,

Generally, the best PCOS pills are the least effective at controlling bleeding. Anti-androgenic pills such as Marvelon, Yasmin and Dianette often cause, or allow for this problem to occur because they contain progestogens that aren't as potent as the older types such as levenorgestrel, which of course aren't good for PCOS symptoms like excess hair/hair loss and acne because they encourage androgens to be produced. One pill that may be worth trying is Femodene, which is like Marvelon but often used for bleeding problems and seems to help, or Cilest. If your outward PCOS symptoms (hair and skin) aren't bad, then you could go for a 2nd generation pill such as Microgynon or Norimin. Another thing you could do is take 2 pills a day -this is safe to do and you might want to ask your GP for it. You could ask about the Mirena IUS used at the same time as the pill, which is possible. This should stop the uterine bleeding and the pill would control the cysts. I know women with your problems and the Mirena has been such a help. I recently spoke to my gynaecologist about using it with the pill, which I could have done.

I was having constant bleeding on Cilest, and often on other pills as well. I changed to Cerazette (Progestogen-only pill) which contains desogestrel which is used on Marvelon. I really recommend it. I feel so much better, haven't bled much at all and my skin is actually better than before. No issues with cysts and feeling a lot happier. You take it everyday, no breaks.

You might want to take a break from the pill for a month or so and re-start it. This can sometimes help. You don't need to be on your period to start the pill, just as long as you are not pregnant.

I hope this helps xx
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Re: Which contraceptive pill is best

Postby ZM » Fri Jun 08, 2012 9:36 pm

Hi I am interested in hearing about the new tri-phasic pills and PCOS symptoms, particularly acne? After much arguing at the GPs this week (locum) I managed to get a repeat for Dianette. However now the Dianette has resolved the PCOS symptoms - cyctic acne, ovulation pain, weight control issues, irregular/heavy periods and excess hair the Drs as usual are banging on about the DVT risk of combined OCPs and wanting to take me off it again. I have a normal BMI, generally low blood pressure and I am very active which was why my own GP thought it the best way forward to deal with my acne.

They seem to be in the usual cycle of "your cured" (not possible for PCOS) so now you don't need it and then condemn me back to square one again and all the depression and permanent skin scarring that goes with it. They are suggesting as a compromise the new Tri-phasic pills as it is the only option I can't point out to them how last time I had them and they completely failed to help. I am 33 and feel like I have only just got my confidence back again since last being on Dianette in my early twenties. However I am feeling confused whether to agree to change (possibly while I still have a 6 month pile of Dianette to fall back on) in discussion with my OWN GP who saw me at my worst, or give up and save up for a private consultation with a dermatologist and see what they suggest. The other thing that worries me was the decidual cast I had when first back on Dianette - I worry it was not healthy either to have had all that tissue not being shed properly when not on the pill (my mother has had cervical carcinoma-in-situ). It is just so difficult getting GPs to see the negative side of taking me off the combined pill when I am sat there with no visible PCOS symptoms to outweigh the statistical risks.
Self diagnosed: 1999
Formally diagnosed after much pressure!: 2005
Current regime: Massive amounts of weight bearing exercise, and controlled diet. Have taken/tried Metformin, Dianette, Yasmin, Marvelon, Accutane. Now on Spearmint, Agnus Castus and low dose Spirinolactone.
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Re: Which contraceptive pill is best

Postby Hols969 » Fri Jun 08, 2012 10:05 pm

I have been on and off the pill for about 28 years (and yasmin for about 6) and my GP is happy to keep me on it as it does control the PCOS symptoms, I think as long as your BMI and blood pressure is good and you dont smoke then I dont see why they are so reluctant. I would possibly wait and see your GP again and just continue on dianette for now (Yasmin is the alternative as dianette is often not given for long periods).

If only we could be 'cured'!!
Unless stated, my views do not represent the official views, position or standing of Verity
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Re: Which contraceptive pill is best

Postby sasha_ray » Sat Jun 09, 2012 2:04 am

This is in response to ZMs post.

My advice to you is to just stay on the dianette whilst you save up the money to see a consultant endocrinologist (rather than a dermatologist). They are hormone specialists and unlike (most) GPs have a proper understanding of PCOS and the various treatment options.

I have had a horror story past 6 months after an ill informed GP took me off dianette (I did not agree) who saw the DVT risk above all else. Four months later and the acne was back, as I knew it would be, but not only that my mood was all over the place. The GP said something really annoying when she took me off it - I pointed out that as I have PCOS I knew that without dianette my original symptoms would come back - and she said 'well we weigh up risks and benefits in life and not having 'greasy skin' is not worth the risk of a DVT'. I found it outrageously patronising. After consulting an endocrinologist he confirmed that the risk of DVT with dianette is no more than for any of the third generation pills (like cilest, marvelon, yasmin etc etc), and he put me straight back on the dianette (with the option to switch to Yasmin in 6 months time, or even spironolactone after that). And the fact of the matter is that actually above all else my mental health is the most important thing to me. If I can't enjoy life because my confidence is shot due to acne, depression, awful mood swings etc, then I would say THAT is a risk I can't afford to take. Honestly, its been the most horrendous few months of my life since the GP made that decision. I've been back on the dianette now for nearly three months and its really slow progress. I feel that she has robbed me of the past 6 months of my life.

I really wouldn't want you to be put through the same awful experience. Please ensure you get proper informed advice about your options from a specialist!
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Re: Which contraceptive pill is best

Postby shinycat » Sat Jun 09, 2012 2:38 am

I had differing opinions from doctors over the 10 or so years I took Dianette for. Some doctors never batted an eyelid and just kept repeating it for me, another one told me there was an increased risk of DVT but it was up to me if I stopped taking it or not, and another told me I ought to try another pill before dismissing it.In the end the decision to come off it was my own. I think as long as you go for 6-monthly BP checks and are aware of the symptoms of DVT you should be fine. I have no idea what I'll do when I've completed my family and need to start long-term contraception again, but Dianette was definitely the most effective acne treatment of everything I tried (though not 100%) so I hope it is still an option.
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Re: Which contraceptive pill is best

Postby ZM » Tue Jun 12, 2012 1:00 am

Thanks for sharing your experiences. I am going to ensure I see my own GP when I am due a repeat as he saw me before I had to go on it again so knew how far near the end of my tether I was with it all. If he shows any resistance then I'll get a private consultation. I have been put off endocrinologists as when I had an NHS referral to one to diagnose and manage my PCOS he was only really interested in experimenting with metformin and harassing me about quitting my job to "start a family" and discharged me when I had not changed my mind about having kids as there was no need to treat me or my symptoms if not TTC. I had thought as my worst symptom is the acne that dermatology might be a better route to advice (the other symptoms I can just about put up with if I really had to).

It is interesting that Dianette is not always seen as a higher risk than other pills as they currently seem quite happy to put me on something else. However I expect it would not be long before then they try to get me off combineds altogether which will never work... I still live in disbelief how little they think about the mental effects of living with PCOS symptoms, I have endured bullying throughout school which then continued in the workplace and in my general life. I have lost count of the number of people (mainly older people, strangers and relatives) who have thought nothing of turning round and asking if I wash my face, like I was some grubby kid. I feel GPs are too used to dealing with acne as a phase you just have to put up with and then grow out of and don't see that PCOS is something you live with indefinitely and as such has to be approached differently.
Self diagnosed: 1999
Formally diagnosed after much pressure!: 2005
Current regime: Massive amounts of weight bearing exercise, and controlled diet. Have taken/tried Metformin, Dianette, Yasmin, Marvelon, Accutane. Now on Spearmint, Agnus Castus and low dose Spirinolactone.
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Re: Which contraceptive pill is best

Postby Bramblecat » Sun Jul 01, 2012 10:41 pm

Hi, newbie here looking for some advice please. Diagnosed after heavy bleeds, detection of fibroids, insertion of Mirena. PCOS symptoms are now obesity and excess hair which is manageable!! I fell pregnant without problems and am not wishing to have more kids, husband has been snipped!! I have a doctors appt on Tuesday and want to ask for some advice before I go. I've been having excruciating breast pain, can't feel any lumps, and despite taking vitamin B12 I've not had a pain break this cycle. Cycles are 28 days and currently light due to IUD. The IUD tails are causing some issues for hubs and some after session bleeding. I'm thinking about asking for my Mirena to come out, it's been in four years and due for replacement next year, and to try the combined pill. I've read this thread (which has been brilliant!) and think I should ask to try Cilest, more bleed control, less androgen control though. What do experienced ladies think?
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Re: Which contraceptive pill is best

Postby Nicolajrobinson » Thu Jul 26, 2012 7:56 pm

Hi I was switched from Mercilon to Gedarel and was told this was exactly the same type of pill. I have now been in it about 5-6 months have noticed various side effects. I've had headaches, bloating, feeling sick, but mostly I've been really negative and lethargic and quite moody. I went to the doctors today and have been asked to try jasmine, how does anyone find this in terms of controlling pcos symptoms like weight gain etc?
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Re: Which contraceptive pill is best

Postby Meringoo » Thu Jul 26, 2012 10:08 pm

Bramblecat - Yes I would try Cilest for the symptoms you have described. I've only just seen this - did you go ahead with it??


Nicola - Did the doc give you Gedarel 20/150 (Mercilon) or 30/15 (Marvelon)? If you have been given the higher dose of this combination, that could explain things. Marvelon is better at controlling PCOS than Mercilon, just because of the extra oestrogen. Yasmin (not jasmine) is considered one of the best pills for PCOS. Many women do very well on it. It doesn't control your weight, this is a misconception. It has a slight diuretic effect which can relieve some bloating which is just water weight, not fat.

It is worth a try x
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Re: Which contraceptive pill is best

Postby Nicolajrobinson » Fri Jul 27, 2012 7:19 am

I was on 20/150 before and have just started jasmin. Ive never heard of Cilest before. I was hoping that id be able to control or maybe lose some weight and go back to how i was. I just dont want to put anymore on.
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Re: Which contraceptive pill is best

Postby Meringoo » Fri Jul 27, 2012 10:19 am

Yasmin is great. I didn't put any weight on with it. Mainly weight gain is due to water, and the rest is down to diet. I lost loads of weight on Marvelon (Gedarel 30/150) but that was partly due to good diet and lifestyle. Unfortunately PCOS makes it 3x harder to shift the fat. But if you're sensible with your eating and don't give in to hormonal hunger pangs, you should be fine!

There's a lot of info that I have written at the start of this thread that should help you as a reference.
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Re: Which contraceptive pill is best

Postby mirandag » Sat Jul 28, 2012 10:02 am

Ladies

There seems to be a wealth of info on here concerning the pill and I'm interested in your thoughts........

Ironically, after 7 years of TTC, I went to my doctor and asked to be put on the pill. My periods were bang on regular but extremely painful with bouts of flooding thrown in for good measure!
Basically, I just needed some respite from the hell that seemed to greet me every month and he agreed that it was a good idea.
After reading many posts on here, I asked for Yasmin which was perscribed. My facial hair was getting worse and I hoped that maybe it would help in that area.

However, every month I would start bleeding one or two days before I had finished the packet. It was almost of though my body was just ignoring the effects of the pill!
Another trip to my doctor resulted in me being put on Gederel 20/150 which is even worse. I started a heavy bleed 14 days in to the packet and I'm still spotting now.

Has any one any suggestions where I go from here???

Thanks in advance

Miranda x
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Re: Which contraceptive pill is best

Postby Meringoo » Sat Jul 28, 2012 8:56 pm

Hi,

I have no idea why your doc thought that a very low dose pill (gedarel 20/150) would be better than a standard strength pill (Yasmin) for breakthrough bleeding. Firstly, how long were you on Yasmin for? If it was less than 6 months, then it would have probably settled down. The problem with anti-androgenic pills, e.g. Yasmin, is that they tend not to have as much control over cycles as the slightly older pills (containing 2nd generation progestogens like levenorgestrel - not good for PCOS). Taking an even lower dose pill doesn't help either. You actually need a more potent progestogen with 30-35mcg of oestrogen to control bleeding. Femodene, Cilest or Brevinor/Ovysmen would be good possibilities.

Hope this helps xx
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Re: Which contraceptive pill is best

Postby mirandag » Sun Jul 29, 2012 4:56 pm

Meringoo!

Your knowledge is quite something and I really appreciate the guidance.

I took Femodene years ago and got on fine with it....perhaps I'll request that this time!


Thanks again x
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