Which contraceptive pill is best

[superhannahmarie]

Meringoo, thanks for all the great info - I'm sure you know more about the pill than my hopeless GP does!

I just wondered if you know which of these pills are monophasic (same levels of hormones given each day) and which are triphasic (varying levels of hormones given throughout the cycle)? I'm think I remember reading somewhere that triphasic pills may be better for avoiding mood swings - is that right?

[Meringoo]

You're welcome. I've become a bit of a pill buff solely due to having to sort out my own flippin' treatment over the years due to hopeless/disinterested doctors.

Bi-phasic/Triphasic aren't better for mood swings because you have changes in your hormone levels throughout the pack, which mimic the changes you get when NOT on the pill. Therefore, because you're hormones aren't level and constant like on a monophasic pill, you may find you get moody. Phasic pills can be good if you have heavy and painful periods, or if you don't bleed much or at all during the 7 day break.

Personally, I'd try to stick to monophasic pills, especially with PCOS because a) there's more choice of anti-androgenic pills, b) there's no confusion over which pill to take during the pack and c) you can easily bi-cycle or tri-cycle a monophasic pill to reduce side effects, whereas this isn't as easy or possible on phasic pills.

In this thread I think I have been talking about monophasic pills (Yasmin, Cilest, Dianette, Marvelon...) and also Cerazette.

Here's a list of phasic pills so that you are aware of them, but like I've said, I would stick to monophasic perparations.

Trinovum, Binovum, Synphase (Ethinylestradiol/Norethisterone)

Logynon, Trinordiol (Ethinylestradiol/Levenorgestrel)

Triadene (Ethinylestradiol/Gestodene)

Hope this helps xx

[rugbykirsty87]

After a very long battle, I am now on Trinovum. Which i have to say, they are good, but my period pains are still so bad (the main reason Im on them) im bed wridden and ive just been put on Menephenic Acid for when im due. Which puzzles me as i thought your not ment to have what feels like a painful period when due on. x

[Meringoo]

If your periods are that painful then there really is no point in being on that pill! Perhaps a monophasic pill would help. I must say that Yasmin was the best for sorting out my dreadful periods. I have endometriosis too. You should look into that with your doctor if it doesn't improve.

[rugbykirsty87]

The problem is I can't go on a high dose pill so was suggest trinovum as a last resort

[Meringoo]

The pills I suggested were low dose pills. You would only be given a high dose pill, which would mean it contained more than 35mcg of ethinloestradiol, if you were epileptic as those drugs stop normal, low dose pills from working.
I think you really should get a different pill as you should not be experiencing such pain and discomfort. You honestly would be better off taking a monophasic pill continuously for 3 packs and then having a week off. This would reduce the number of periods and hormonal fluctuations you have, and make you feel better in general. A gynaecologist would probably tell you do this too. xx

[rugbykirsty87]

I've had 4 different types of pills in ad many months due to my sensitivitey to what I know as being eastrogen. I was crying constantly, randomly and was just a mess with the pills I had so went on cerezette to be taken off due to constantly feeling unwell.
I am hoping as m nearly on my 3rd month ill get better. I'm scared to change as I've been so ill before I'm so scared of my reactions. X

[Meringoo]

Ok then. I just don't like to think that you're going through so much pain when it can be helped.
If you're so sensitive to oestrogen, taking a phasic pill as you are will surely make that problem worse, as the level of oestrogen increases during the packet.

[Hol86]

Hi,

I just wanted to let you know about my experience of Marvelon, I've already written about it on another post:

'Unfortunately Marvelon really didn't agree with me. I managed two months on it before stopping. Firstly, I bled almost every day that I was on it and then still had a period in the gap too, so it didn't fulfil it's purpose at all. Secondly, I was an emotional wreck. About two weeks into the first packet I burst into tears on my way home from work for no reason and from then on I was constantly either in tears or on the edge of tears. I felt shaky and emotional and nervous, I would suddenly get snappy and aggressive for no reason, I couldn't make decisions or deal with any kind of pressure at all, libido disappeared and felt useless. In my final week of taking it I even found myself constantly thinking about death... That's when I went to see my GP. It took me a while to realise the pill was the cause as I've had depression in the past and at first was scared it was returning. But even at my lowest ebb I didn't cry constantly, and over the past three months lots of good things have happened in my life so it wasn't related to any bad events. I had a look online and found that lots of women have had the same reaction as me, possibly as a result of the type/levels of progesterone used in Marvelon. I'm now taking Yasmin and already the bad/tearful moods have gone. I've had some headaches and nausea but apparently that's common at first so I'll see how it goes.'

[Meringoo]

Thank you. That's a shame, but like you say, some progestogens just don't work for some women. While it is good for PCOS symptoms, if it changes your mood so dramatically, then it's better to change to something else. You can get constant bleeding, low moods and tearful episodes when in your first few cycles of any pill, and if you find it distressing, you should see your GP - as you say you did.

I'm glad you are feeling much better on Yasmin, and it is worth giving it a few cycles if you can before deciding. My first few cycles (each time I've switched to Yasmin) were not the same on each occasion. The first time I felt very panicky and got bad headaches. The second time I got a bit of breakthrough bleeding and extreme nausea. The third time I got very sore boobs and an increase in acne. After the initial 3-6 cycles, I had no side effects really. But it is trial and error, as we're all different.

[superhannahmarie]

Meringoo, thanks again for all your help I was hoping I could pick your brains again?

After reading all your info on here and doing some of my own research I decided to come off Dianette (which I had been on for 12 years) as I was concerned about the DVT risk. I went to my GP armed with a list of info copied off here and she agreed to give me 3 months worth of Mercilon. However, I'm at the end of my 3rd pack and desperate to get off of it - I'm going back to the docs tommorow to get something else.

Problems I've had with Mercilon -
- Violent mood swings, depression, crying all the time
- Constant heavy bleeding
- Complete loss of libido, pain and bleeding after sex
- Migraine that put me in bed for 3 days

Now I know that Mercilon is a low oestrogen pill, and I was wondering how this compared to the Dianette I was on originally? While I had a low libido and some moodiness on Dianette, it was nothing compared to the hell I've been through the last 3 months on Mercilon! Do you think it could be the low oestrogen thats causing all these dreadful side effects? And if so, would it be sensible to try going the opposite way and use a higher oestrogen pill instead to stop them? I was thinking of asking my GP for Yasmin this time - do you think this would be a good idea?

I ask you because my doctor hasn't got a clue. I'm hoping to do what I can to change that, starting by giving them a stack of Verity leaflets when I visit tommorow!

Edited to add: What do we know about Ovysmen and Brevinor? I've read that these are oestrogen dominant, but are they any good for PCOS?

[Meringoo]

Oh dear, that sounds pretty miserable. I would say definitely ask for a different pill. Yasmin is always worth trying. I found it helped my mood swings, made my periods very light and less painful, gave me great cycle control, and helped PCOS symptoms. I'm on Cilest again now, which I like. It is often given if you have heavy and/or prolonged bleeding, and is good as a treatment for acne and PMT. I recommend it. It could be that with Mercilon, there just isn't enough oestrogen for you, which is quite normal, and the progestogen, desogestrel doesn't agree with you.

Ovysmen and Brevinor (the same) are oestrogen dominant, but slightly less so than Yasmin, Cilest, and Marvelon.

Ideally, PCOS women should use an oestrogen dominant pill, because it will produce less progestogenic side effects (in fact it will discourage them), such as acne, weight gain, excess hair, lack of libido - so basically the PCOS side effects you don't want in the first place. In terms of contraception, whether it is oestrogenic or progestogenic doesn't matter, but for side effects, this matters greatly.

Let me know how you get on with the GP xx

[superhannahmarie]

Well I managed to get the Yasmin - but it wasn't easy

My usual female GP who is brilliant was on leave so I ended up seeing the elderly male GP, who was determined to give me Microgynon. When I explained I couldn't take it, he then started pushing me to have a Merina coil instead (which I don't want).

After 15 minutes of arguing he finally gave up and grudgingly wrote a prescription for the Yasmin I'd asked for in the first place while muttering something under his breath about 'being difficult'.

Nevermind, I got my Yasmin!

[Meringoo]

Yay! Bet you're glad you were clued up enough to stand your ground! Good luck with the new pill. Xx

[purplestar]

Yasmin has been absolutely the best pill I've been on (and I've tried most over the years!)- only one where I've not put weight on, which is really important for me.