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Birth control bills and spotting

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Posted (edited) · Report post

I don't think I posted this article before. There are several others on the same site about breakthrough spotting/bleeding. They are the ones that got me thinking my problem is that my estrogen levels are too low.

I saw my OB/GYN yesterday. I'm not sure yet that I like her (she's new - this was my second visit). Why is finding a really good doctor (of anything) always so hard? I think she was annoyed that I've done a little (okay a lot) of research on my own. I hate doctors like that.

Anyway... she put me on Yasmin. Which is pretty much the same as Yaz, but with 30 mcg of estrogen (Yaz has 20 mcg). This was one of the things I was considering, but what I was really hoping is that she'd just prescribe 10 mcg of estrogen 1-3x per day so I could experiment with the dosage a little bit. Plus I have two packs of Yaz left and I hate wasting meds like that.

I also found a really good medical journal article that suggests menstrual migraines are caused by low estrogen levels and indicate 10-20 mcg of estrogen for 1-2 weeks (starting 2-3 days before your period starts).

But she wouldn't go for it because "estrogen isn't indicated for migraines." She wouldn't even look at the article. ;)

She is open, however, to letting me take the Yasmin continuously for 3 months at a time. So there's at least that.

Keep your fingers crossed that this one will work! I'm so happy with this medication in all other regards.

Edited by Sunshine

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Posted · Report post

Update because someone posted another topic related to the same issue...

At some point last fall/summer, I switched to Yasmin (due to my suspicion that the BTB was due to not getting enough estrogen and Yasmin has a slightly higher dose of estrogen). Still had the BTB problem. Did lots of research and determined that what I needed was even a little more estrogen, but new OB/GYN was too conventional to try it. She wouldn't even look at the research I brought with me.

Fortunately, my pdoc is not conventional. He not only pored over the research I found, but was genuinely interested in my theory and didn't see any harm in adding in a touch more estrogen (through the patches that are used for hormone replacement therapy). When I started spotting, I added a patch, and the spotting stopped. I eventually stopped spotting completely and don't need the extra estrogen anymore.

The only drawbacks I've experienced so far are a slight decline in mood and a significant decline in sex drive. Both problem enough that I decided to try going off it. Bad idea. The insomnia came back with a vengeance. So next week I'm going back on Wellbutrin... which I haven't been on in years and never as part of a bigger cocktail for severe depression. Should be interesting to see what happens.

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Posted · Report post

Would you mind sharing your age (or thereabouts)? I'm in my late 30s... this all started when I was 33. Before that, I never had PMS and had never had a migraine.

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The way my docs and I dealt with the massive anxiety and mood changes around menses were to increase the pill strength (from Mircette to Yasmin), and to add 1mg of estradiol to the 7 "off days". As long as I remember to take the estradiol it works ok. Also, if I feel really crappy I'll double up on the estrogen for a day or two and that helps immensely. In fact, I'd like to be on an even stronger pill, because I feel best on the days that I miss a pill and then have to double up to catch up. But I get really, really, really suicidal if I don't get enough estrogen, like right now.

How fascinating. I get really, really suicidal with premenstrual moodswings, but i never tied it to anything other than "hormonal fluctuations" (then again, I can't afford to see decent doctors so I get all my information from reading websites).

How did you find out it was lack of estrogen causing it? And where does one get estradiol?

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It's by prescription only (at least in the U.S.). As far as I know, it's only available in patch form. There are no generics, so it's probably not cheap (yet). But since hormone therapy replacement has been around for a while, there must be some inexpensive alternatives. I just don't know what they are.

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Thanks for posting that website with the comparisons on pills! I was on Mirena IUD and then had it taken out, thinking it might have been messing with my mood and now went on Seasonale but it's generic - Quasense. I've read so many people having problems with it and boy have I! I was fine the first 2 months but then had a period for about 4 weeks until I read online that you could stop it by taking 2 pills every 12 hours for 3 days to stop the bleeding. Now I have to do that every time I get breakthrough bleeding! My doctor told me to stay on this pack and see how it goes then we'll discuss changing if things aren't better.

I wish I woulda left the Mirena in! The things for me are acne, weight gain, moods, and oh yeah, I hate periods. I'd go for Depo if I didn't think it would kill my weight and mood.

Damn damn.

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I started Seasonique (same thing as Seasonale - the birth control pill that you take continuously for 3 months so you only have 4 periods a year) on May 6... 4 days after starting my last real period. I stopped bleeding the next day. 10 days later, I started "spotting" and haven't stopped since (except for maybe 2 or 3 non-consecutive days). On several days (at least 5-7), the spotting was on the heavy side. But even on the light days I need at least a pantyliner (and often that's not enough).

So I'm now almost two weeks into the second pack of pills (6 weeks total). According to the PI sheet, 29% of women in the clinical trials experienced 20 or more days of spotting during the first 90 day cycle. It went down to 16% during the second 90 days, and then 10% during the third and fourth 90 day cycles.

I guess I should at least stick with it for the first full cycle (another 6 weeks), but if I'm already at 30 days halfway through the first 90 day cycle, I can't help but wonder what the odds are that I'm not going to end up in that 10% group six months from now.

I had pretty much the same problem when taking Yasmin 3-4 years ago, but I think I only stayed on it for two months. Does anyone take this (I think they call it "Yaz" now) for three months consecutively (no placebo week)?

BTW... the main reason I went on it was to regulate PMDD and menstrual migraines and it seems to be helping (but hasn't completely cured - especially the latter) in that regard. Otherwise, I'd be off this stuff for sure!

Any thoughts/experiences/ideas?

Edited to change topic title.

I'm a little confused about your timeline. Did you mean you started taking them on March 6th?

Anyway, I spotted off and on through the first pack and a little less through the second. It has gotten better as time goes by and now I seem to be regular, as intended... with a period once every three months and no spotting in between (knock on wood).

I will say that anecdotal evidence on the internet suggests that some women believe that the generic makes them spot more and that it's better on the name brand. I was initially on the generic and since my insurance paid the same either way, I asked specifically for the name brand. My gyno also gave me an additional hormonal pill to take for just a short time to lessen the spotting.

Also, I am taking Seasonale as opposed to Seasonique. I thought there was a slight difference between the two or is it just a patent extender? I don't know.

Stick with it awhile. I have heard it can take up to three packs before everything gets regulated.

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I started Seasonique (same thing as Seasonale - the birth control pill that you take continuously for 3 months so you only have 4 periods a year) on May 6... 4 days after starting my last real period. I stopped bleeding the next day. 10 days later, I started "spotting" and haven't stopped since (except for maybe 2 or 3 non-consecutive days). On several days (at least 5-7), the spotting was on the heavy side. But even on the light days I need at least a pantyliner (and often that's not enough).

So I'm now almost two weeks into the second pack of pills (6 weeks total). According to the PI sheet, 29% of women in the clinical trials experienced 20 or more days of spotting during the first 90 day cycle. It went down to 16% during the second 90 days, and then 10% during the third and fourth 90 day cycles.

I guess I should at least stick with it for the first full cycle (another 6 weeks), but if I'm already at 30 days halfway through the first 90 day cycle, I can't help but wonder what the odds are that I'm not going to end up in that 10% group six months from now.

I had pretty much the same problem when taking Yasmin 3-4 years ago, but I think I only stayed on it for two months. Does anyone take this (I think they call it "Yaz" now) for three months consecutively (no placebo week)?

BTW... the main reason I went on it was to regulate PMDD and menstrual migraines and it seems to be helping (but hasn't completely cured - especially the latter) in that regard. Otherwise, I'd be off this stuff for sure!

Any thoughts/experiences/ideas?

Edited to change topic title.

I'm a little confused about your timeline. Did you mean you started taking them on March 6th?

Anyway, I spotted off and on through the first pack and a little less through the second. It has gotten better as time goes by and now I seem to be regular, as intended... with a period once every three months and no spotting in between (knock on wood).

I will say that anecdotal evidence on the internet suggests that some women believe that the generic makes them spot more and that it's better on the name brand. I was initially on the generic and since my insurance paid the same either way, I asked specifically for the name brand. My gyno also gave me an additional hormonal pill to take for just a short time to lessen the spotting.

Also, I am taking Seasonale as opposed to Seasonique. I thought there was a slight difference between the two or is it just a patent extender? I don't know.

Stick with it awhile. I have heard it can take up to three packs before everything gets regulated.

lol, nevermind. I just looked up at the datestamp on the OP. Mods feel free to delete both of my posts.9

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