Which contraceptive pill is best

Metformin, Dianette, Yasmin, Clomid, Herbals, Yoga, Acupuncture, Oils, etc

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Postby Hols969 » Fri Nov 18, 2011 3:09 pm

I think to have 2 migraines in two years isnt anything to be concerned about and a not good enough reason for yout GP to suggest you come off the pill. I get them very occasionally (more than one a year tho) and am on the combined pill (yasmin) and have been on and off for 20 odd years. If this one doesnt suit then perhaps go back to the combined pill but try a different type. Im sure the risk of stroke is minimum (I presume you dont smoke as well?)
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Postby somersetgirl » Fri Nov 18, 2011 3:19 pm

That was exactly what I thought, especially since for the previous 5 years I'd had no problem. But on the actual pill guidelines it said if you have a migraine with aura you shouldn't take it.

To my brief knowledge, it's the aura aspect (for me it was distorted vision with flashing lights etc before the migraine headache part came on) which is the danger sign. Migraines without aura are seen as safe enough to continue with the combined pill provided they're not really frequent.

But who knows. I find it a really tricky situation because she said she had known a patient who had a stroke following staying on the combined pill after migraines with aura and that's enough to frighten you.

I'll keep it in mind though, thank you.
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Postby *AllGirlTogaParty* » Tue Nov 29, 2011 10:42 pm

Meringoo (or any other pill-expert!) , Iwas wondering if you could help me out.

Backstory of my PCOS - Pretty much always had irregular periods greasy skin and acne, but became gradually worse AFTER I had each child. After my daughter -I had her at 18- my periods went to every 2-3 months and my hair thinned somewhat. And after my son (Had him at 21) they were 5-7 months apart (!) and I started getting mild-moderate excess hair on chin etc and also hair thinning constantly :cry: . I long suspected PCOS myself but my GP refused to test for anything except thyroid since she said I didn't 'fit the typical profile of PCOS' apparently because my BMI is 20 and I conceived naturally. Finally I got her to do a blood test and another GP called me and said my hormone levels strongly suggested PCOS and referred me for ultrasound where a few small cysts were found.

My only real problem with the PCOS is my excess hair loss and thinning in "male" places. The acne I can cover, hair can pluck, and lack of periods and fertility not a huge concern to me.

I was put on Microgynon30 pill and I quit after 2 months it was so awful. Felt sick, put on nearly 2 stone, suicidal thoughts, argh!

Then a lady at the Family Planning put me on Marvelon and it has worked very well for me for 2 years. My hair has been infinitely better , no thinning or falling out too much, skin is better (it literally seems to absorb the oil!), chin hair controlled almost, no breakthrough bleeding or period pains. My libido is a bit lower but still there so not so bad.

I do get stress headaches my whole life and whilst on Microgynon I remember getting my first migraine-type headache in the pill-free week. The Marvelon does this too - in the pill-free week I will usually get one or two headaches - a few times bad enough to feel nausea and have to lie in dark room. Very occasionally I had a migraine / bad headache not on the break.

When I went back for my pill check the doctor told me to try taking 3 packs at a time and if I'm still getting headaches then for safety reasons I should maybe consider switching to Cerazette. But not to worry re DVT risk (I'm a worrier!) in meantime since I'm young (24) and don't smoke, just see what happens she said.

Soooooo (finally, drum roll..) my question is - Would Cerazette be likely to be good for my hair loss too? or make no difference? I have felt so much better in myself since my hair has transformed back to normality again since being on Marvelon I'd be pretty upset to have to come off it but obviously if it's risky then I don't want to be at an undue risk of DVT/stroke.

Anyone any ideas? x
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Postby Hols969 » Wed Nov 30, 2011 8:01 am

I take 3 months of the pill and it works for me. There are risks with all medicine but for me I think the reduction of symptoms improves my life. The risk of DVT is minimal. Im 42 and have been on and off the pill for 20 years and the pill reduces the risks of other issues as well so I wouldnt worry (Im a worrier too but the risk is so minimal especially if you are young, dont smoke and are not overweight).
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Postby Meringoo » Wed Nov 30, 2011 11:16 am

The headaches are most likely oestrogen headaches, so when you're on your week break, the changing hormone levels bring headaches on. I used to get the same on Marvelon (don't on Cilest or Yasmin, oddly). As long as you aren't getting migraines with aura (losing sight etc) you are perfectly safe on the pill. Even if you get migraines without aura you are fine. Some GPs and nurses are a little hasty with this. Taking the pill back-to-back for 2 or 3 packs can help, though you may experience headaches when you do take a break after that. Worth a try though.

Cerazette would do very little for your symptoms as it is the oestrogen combined with the progestogen that helps.

Stick with Marvelon if you can. xx
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Postby *AllGirlTogaParty* » Wed Nov 30, 2011 1:14 pm

Thanks x

Was just getting really worried about what will happen if I have to come off combined pill and all my 'excess male hormone' symptoms come back... eeek.

The Family planning specialist told me I likely have the "Androgen" side of PCOS but not the "Insulin" side of things. All I know is that I was always spotty and a bit irregular, but my body regulation just got worse and worse after each child. I waited 2 years with each to see if I would go back to pre-pregnancy cycles (long cycle length but did get them every month-6 weeks) but it just got worse and worse.

Will stick to this just now as she is happy to keep me on Marvelon as long as no aura. Or she said possibly switch to Cilest. But Yasmin only as 3rd choice she said as expensive.

I was really happy to be referred there (was referred by a family planning nurse) as the GP was really unsympathetic and basically told me "I have had 4 kids and have always had irregular periods. What makes you think you have PCOS if you have had 2 young children? i wouldn't have thought you fit the profile with you being slim" and very huffily and reluctantly sent for blood tests the second time I went. Then she was adamant I should go on the 3 year implant (she was literally about to take the implant out the pack and do it there and then before I even had chance to say no!!) or the Mirena Coil since I don't want more kids. When I said I don't want anything not easy to reverse in case of side effects, she was then adamant I would try Microgynon even though I said I had read that was bad for PCOS. She seemed to believe that contraception was the main aim, when in fact she couldn't 'get' that control of the hair loss and painful acne and cramps due to no periods for 7 months was my aim. In the past I'd always just used condoms or the copper coil for contraception and they worked fine.

It's crazy how little some health professionals actually know about PCOS or even take into account women's choices/needs for contraception. Sometimes I've felt like a contraception guinea-pig of whatever the new 'fad' is at the time (when I was a teen it was 'put you on the pill', then it was the injection is best after my daughter - got a copper coil instead- , now it is the implant). The specialist doctor at the Family Planning place seems much better.

Thanks for your advice Meringoo. You have been so informative on this thread x
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Postby evie48 » Fri Jan 27, 2012 9:19 pm

Hi!
I've copied this in from another post as I realised that I should've put it here first for the pill guru to see!!!

I have PCOS & problems with excess body/ face hair/ spots.
Periods were inconsistant & heavy & v. bad pmt but regular.

It took forever to be diagnosed but eventually a few cysts & blood tests that showed my LH levels were wrong finally got me diagnosed.

I've been on dianette happily for 5 years ish. I doesn't totally get rid of my body hair but definitely helps slow it down & reduce it, also helps my PMT moods & oily skin/spots.

I think it reduces my libido & seems to dry my lips a lot & Im a bit curvier (but have always been slim so didnt mind a half a stone) but I've been so happy that the hair growth is better that I haven't minded these other things.

BUT......
The nurse at my GP's is worried due to the reports of kidney/liver damage from longterm diannette use & despite my liver function test being normal she's urging me to take a break- 3-6 months or change.

Ive been signed off by endocrinologist years ago- she said only come back if you want to get pregnant, but she did say if they tried to take me off dianette ask for yasmin.

Has anyone else had to do this?
Will hair growth go back to normal if I take a 3-6 month break?
I've had many hours of (excrutiating) electrolyses on my face & many IPL/ lasers (my area of expertise!) on my body which has improved most areas- (bar some that seem weirdly resistant) but Im totally paranoid that its all just dormant waiting for the pill to stop & then will all come back!!

Isn't spironolactone the active ingredient in yasmin? I did try this years ago when I was first diagnosed but cannot remember if it worked- was also on metformin (I dunno why they put me on that as I understand it's for the weight side of things) & a higher dose of cyproretone acetate at the time.

Which pill is better? Am I better off having a break then going back to diannette?!

All questions that the nurse can't help with- I hope the guru can-

Im having a tricky time at the moment as I have longterm RSI injuries/ damaged arm nerves and am already having counselling for that...id be destroyed if I had to go back to square one with the hair.

Eve
xxxxx
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Postby Hols969 » Fri Jan 27, 2012 9:26 pm

Yes I did, I actually prefer yasmin to dianette. Dont break if possible, I got much hairer (and fatter) when I came off the pill to TTC. There is no reason why you should need to.
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Postby evie48 » Wed Feb 22, 2012 3:29 pm

Thanks Holly,

I've been away on holiday so haven't been able to check but really appreciate this being here when I got back. I go to see the nurse on Tuesday & feel much better knowing what I want/ need.

Have another question if you dont mind?
Dianette seems to affect my sex drive (makes it lower) - did you have this & if so any improvement on Yasmin?

Thanks again xxxx
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Postby Hols969 » Wed Feb 22, 2012 4:36 pm

I think the contraceptive pill can affect it anyway. Ive been married almost 20 years (which can affect your sex drive!!) and to be honest I dont remember it being that different on the two, it is worth trying yasmin but it is a know side effect of the contraceptive pill.
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Postby Meringoo » Wed Feb 22, 2012 6:21 pm

Hi,

Just thought I would say a few things...

Like Holly said, don't stop taking it if it works for you. Having regular liver function tests is good, and obviously you are being monitored in that way so it should be fine. Yasmin isn't quite as effective as Dianette for sorting out excess hair and severe acne, but it is a good pill.

Anti-androgens have an effect on libido, so yes, being on an anti-androgenic pill like Dianette or Yasmin often reduces your sex drive, which is a shame!

You can stay on Dianette long-term. If your symptoms get much better/disappear for 3-6 months, you can switch to another pill, such as Yasmin or Marvelon/Gedarel, but other pills don't work as fiercely against hair and spots. The fact that you have PCOS puts you in the long-term Dianette user category anyway, so don't be afraid to say no to the nurse!! xx
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Re: Which contraceptive pill is best

Postby Nikki » Sun Mar 11, 2012 7:45 am

Hello

Im actually very confused about PCOS there is so much information out there, do i do the natural way or for once and for all try to get a grip of my hormones through using the pill. Now the pill for me sounds likea great idea with all of the benefits that can come with it. The acne is ruining my confidence, the thin hair is really depressing, let alone the constant sugar cravings i feel pretty tired of my hormones. To give the medical background i have confirmed cysts on my ovaries one which ruptured yesterday and sent me to the gynecology emergencies which will now bleed itself away, it was 54 mm by 40 mm pretty big. Secondly confirmed high LH levels on third day of cycle, missed menstruation, skin and hair issues, and sugar cravings. please note am not overweight and run half marathons, this keeps me sane! This is because i ignored everything my doctor told me to do, denial confusion im not sure. However yet again i have arrived at the point where the doctor has advised that i must take pills. Now i know why i dont take them its because of migranes im in a really catch 22 situation migranes, or ruptured cysts the migranes are quite bad and i struggle for a few days with them. The real question im hoping to seek an answer to is if i reduced the estrogen in the pill from the 35 mcg in dianette to say a 20mcg pill like mercilon or yaz which is available here or even the nuvaring would that help with my migranes or is it just the fact that there is estrogen in the pill and i should now be looking at a progesterone only method.

I would realky appreciate your experiences if you have a similar situation regarding the pill and migranes as other than the migranes i felt really good but cant live with very bad headaches. Thank you in advance nikki :)
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Re: Which contraceptive pill is best

Postby Meringoo » Mon Mar 12, 2012 10:42 pm

Hi,

Sorry that you are suffering with those cysts. They can be nasty! A quick answer to you question is, if you take the combined pill, you will find that the risk of cysts decreases and the other PCOS symptoms will be more successfully managed. A pill with 30-35mcg of oestrogen will always be better for PCOS than a lower dose pill, or a progestogen-only method. The main function you need is for something to stop ovulation (to decrease and stop cysts) and for the pill to contain an anti-androgenic progestogen such as drosperinone, desogestrel or norgestimate - in order of preference. If you get cyclical headaches, not migraines with aura, you could try taking the pill back-to-back for 3 packs and then having a week off. This reduces some issues, decreases the chance of ovulation occurring and can help acne and hair more than taking it in the 21/7 regimen. A very low dose pill like Mercilon is less effective for PCOS but you can still use it, though breakthrough bleeding is common, like with a progestogen only pill, which you would have to take every day without any breaks. Cerazette would be an option if your GP says you can't have a combined pill due to migraines with aura. I get migraines but without aura so I can take the combined pill. If you don't have any risk factors, you'll be fine, and it sounds like you are fit and healthy otherwise. From what you have written, it would seem as though they are hormone-related headaches, which can improve when you use the pill, but it may take a few months. xx
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Re: Which contraceptive pill is best

Postby littlepoppet » Sun Jun 03, 2012 3:49 am

Hiya Meringoo,

You really are very knowledgeable so maybe you can help me, espeically as you've answered a few ladies who have cysts.

diagnosed with PCOS in 2007, no real problems except periods every 2-5 months and a few spots. I was put on Cerazette as a contraceptive a few year back due to migraines with aura. Last summer I was hospitalised due to severe abdo pains and was told I had an enlarged right ovary (22cc) and most likely ruptured a cyst. Since then constant abdo pain, no sex drive, bad acne on chin, terrible mood swings, weight gain, tiredness - constant PMS really! Back in February I started to have periods every fortnight which has made all of that list so much worse. My GP put me on Noriday (Norethisterone) but no change. I had another scan in May which showed right ovary had gotten bigger (60cc) with a 2cm cyst. Can you recommend anything? And what do you know about Noriday (I've not seen it in this thread I think).

Thanks x
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Re: Which contraceptive pill is best

Postby Meringoo » Sun Jun 03, 2012 4:33 am

Hello,

Aww thanks, I hope I can help as many ladies as possible!

Sorry to read you have been going through so much recently. It doesn't make any sense that your GP would put you on Noriday, especially if you were getting cysts on Cerazette, which is much better at stopping ovulation, therefore, in theory better at preventing painful cysts. I think really you need to see a gynaecologist, and possibly have the cysts removed, or try a much stronger treatment since the combined pill isn't a suggestion. You may be able to try a GnRH analogue injection before surgery, which can be as effective as laser treatment. I have had that treatment before (for endometriosis), and it helped me, though it does put you a state of fake menopause, so aching joints, hot flushes and low moods tend to be part of it, but the results can be very good. I would ask a specialist about this treatment. The drugs are called Zoladex or Decapeptyl (I tried this one), and you have them every month or every three months. It is an expensive treatment, but not as expensive as surgery, so in your case they should look into it really.

Get referred to a gyanecologist via your GP. Hope this helps!

xx
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