Going on the Pill, need reassurance!!

S

susan p

Guest
Ack! My GYN's nurse practitioner and I discussed going on the pill to smooth out perimenopausal irregularities and discomforts which have gotten a little out of hand in the past year. . . She really felt it would be beneficial so I am taking her advice, she gave me three months of samples to see how it goes. Well I read the product inserts today and now I am intimidated to death! I am all geared up to panic at the first sign of a blood clot in my leg or chest, a rupturing liver tumor, a stroke, etc. Sheesh! Oh, and EVEN WORSE (
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) they said it can cause NAUSEA and water retention! ICK! If I even stand next to a person who is taking something that can cause nausea I get ill. I am WAY too oversensitive tummy-wise (case in point, they put some morphine-ish stuff in my spinal during my C-section to help manage post-op pain and instead I THREW UP for 20 hours post-op. Get the picture? DON'T SAY "NAUSEA" TO ME!!!!)

So, anybody want to reassure me here? I am going to be using a low-dose (20 mcg of estrogen) pill with a little extra progesterone, the NP thought it would be perfect for me since I produce so little progesterone naturally. It'll sort of balance out my natural deficiencies.

I was OK with trying this till I read that stupid product insert, now I am going to have bad dreams about clutching my chest and dying or spewing guts everywhere because of an exploding liver tunor (hey, now wouldn't that make a great scene in a horror movie?? oh, forgot, already been done,
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)
 
oh, P.S.

My cycle started today so I will start my pills on Sunday. That means you have about 4 days to either reassure me or convince me to run screaming the other direction! DON'T FAIL ME LADIES!!!
 
here's a pat on the back

<center><font size="1" color="#ff0000">LAST EDITED ON Aug-30-00 AT 00:43AM (EST)</font></center>

...and a few words of encouragement. I'm also an NP and recommend and prescribe low dose BCPs for women who are experiencing perimenopausal symptoms. Today's pill is NOTHING like the pills of even the early to mid 90s...much lower dose, fewer side effects, and easier to tolerate than earlier formulations. These lower dose pills are making the transition towards menopause much more tolerable-menopause and menstruation are not diseases and do not need to be tolerated, esp. when excellent treatment options exist. Although I'm not taking it for perimenopause-I am on a 20mcg estradiol pill (Alesse)-I do not tolerate many BCPs, this was the first with which I did not have any nausea, weight gain, headaches, or bloating feeling.
As far as the package insert-I'm glad you read them, not many patients do-I always try to review the side effects with my patients right in the office, but many extremely uncommon side effects are reported in testing and not actually experienced commonly. As far as blood clots, here's a few questions to ask yourself-do you smoke? have you ever had a blood clot yourself? how about any in your close family members? Because you are active (I'm assuming here) and healthy-and I hope smoke free-low dose pills should be relatively safe. There is a chance of developing liver tumors after long term use of BCPs, these tumors are usually benign.
BCPs have many other excellent "side effects"-help prevent ovarian cysts, prevent bone loss, & prevent endometrial cancer, just to name a few. Well-you've got my long-winded answer now-I'm sure others will join in. Did you check out the thread in the Open Discussion forum about perimenopause and menopause-lots of people posted there.
take care
julie
 
Hi Susan. Relax.

Just wanted to tell you that I have a very weak stomach also, yet the birth control pill has never bothered me in the least. I have been on the pill for around 15 years, and have never suffered any of the serious (or non serious) side effects. Inserts can be SCARY!!!! Just remember the scary side effects will only happen to probably one in several hundred thousand. And the non-scary side effects like vomiting are very rare with today's birth control pill also.

As long as you're not smoking while taking the pill (and you must not smoke or your NP wouldn't have given you a prescription), you will be just fine!!! I threw up for hours also, after having an epidural, so I understand the weak stomach problem, but I have yet to throw up or even feel bad after taking a birth control pill.

Good luck to you.
Lisa
 
Can't tolerate pill

Hi Susan,
Not sure if you need to know this or not, but I have always had problems with the pill. I have major hormone problems and the pill is the best solution for me, but I just can't take it. Some have caused major mood swings and depression for me, and the last one I took caused severe nausea - it was like having that all day morning sickness. The pharmacist told me the nausea would go away after the first few cycles, but I just couldn't tolerate it. It's one thing if you are pregnant and have no choice, but I couldn't handle the nausea from the pill so I stopped.
But, obviously, most people do just fine on the pill otherwise it wouldn't be so popular!! Hopefully you will have a good experience and it will ease the perimenopausal difficulties!!
Erica
 
Its ok

Susan,

I've had experience with BCP and with estrogen. Both have worked out fine, though my body took a couple months to adjust. I did have a little bloating, but nothing really out of my normal monthly range. I also had a bit of nausea for the first month -- more of the "food doesn't seem very interesting" variety, rather than the "loose everything I just ate" variety. I, too, have a sensitive stomach, and it doesn't take much to turn me off eating. Both of these went away after the first couple of cycles.

If you find that the symptoms are too much, check with your HCP to see if a different dose or combination would work better for you. When I started estrogen, the dose was too high for me, and I had the cycle from he** and went off it. As soon as the dose was lowered, I had the couple of adjustment months, then things were fine.

Hope you find a solution that works for you!
 
The Pill and perimenopause

Susan,

I have quite a bit of experience with various BCP's, so I'll tell you what I know/what I think.

I was on the pill for 15 years, with breaks for pregnancies, and then had my tubes tied at 35 yo. I had been taking a 35 mcg estrogen pill, and had no side effects. I was finally pill free, or so I thought.

After a couple of years, I was diagnosed with estrogen dominance (too low progesterone) and had endometrial hyperplasia. My periods were extremely heavy/long with bad cramps like I'd never experienced. I was gaining 5 pounds of water every month and felt horrible for the two weeks prior to my eternal period. The gyn put me on Alesse (20 mcg), and I had breakthrough bleeding. She then upped the estrogen to 30 mcg (LoOvral), and things improved quite a bit.

Well, just last year my periods starting getting heavy again, so they did an endometrial ablation, and now I'm off the pill again. The periods are MUCH lighter and shorter, and I'm happy about that. BUT, I had LESS bloating on the pill and felt better in general, so I'm considering asking to go back on the pill just for those reasons.

Basically, the side effects of the pill were good ones, and you should just try it and see how you do. If there are any problems, call and ask for a different formulation. There are several types of progesterone, and each one has different effects. Different levels of estrogen do different things too. It may take a few brand attempts to get it right.

Good luck,
Sandi
 
As a 3rd year pharmacy student...

Hi there! I can certainly understand your concern, but I agree with your NP. Chances are, you like so many other women are experiences the side effects that come along with menopause which are just unbearable. These hormones, will help to keep your body in sync with the way things were before menopause & decrease side effects such as vaginal dryness, night sweats, mood swings that just effect your well being & quality of life. Not only can these hormones increase the quality of your life, but they can also help your bones stay strong & healthy which is important at this time in your life. So, go ahead and try the estrogen replacement therapy for a while, you shouldn't fear this treatment. I hope this helps. :eek:)
 
Barf Bag Help Line!

Hey, Susan, like you, I'm heading back onto BCPs for the first time in 10 years. I've been doing lots of reading about perimenopause and I'm pretty satisfied that all the good stuff that BCPs can do for me will more than balance out any potential (very rare) side effects such as blood clots, etc. Of course, that's given my health history and family history.

As for the nausea -- I used to get this when I was on the pill "back in the day." I understand that with new lower dosage pills, it's a lot more rare. But in my case, as long as I took the pill in the evening instead of the morning, I did fine.
 
Susan - Thanks for Asking the Questions - New Forum Idea?

This is the second thread in the last couple of weeks to address issues of how our bodies, and therefore how we take care of them, change after 35. This and the other thread have been so informative and reassuring (okay, and sometimes a little scary). There's quite an educated crowd in our Cathe-cyber space
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that has lots of valuable experiences to relay. These two threads also compelled several people to post who hadn't before.

I've been wondering...not that Cathe and SNM don't have enough to do...but given the interest and the obvious need for a safe place to discuss these issues, would any of you be interested in asking Cathe to start a new forum (similar to the FitMoms Pregnancy Forum) for those of us wanting to post questions and comments about nutrition and exercise after 35 (or thereabouts)? Cathe and SNM, I don't want to sneak up on you with this question, but if no one else is interested, then I'll know it wasn't a good idea. If others are, you'll know there is interest
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.

The open forum is great, but having read through the candid, descriptive and therefore informative pregnancy forum threads, the value of a dedicated forum is apparent, IMHO.

Also, after reading some of the books recommended in the threads, I wish I would have had that information at 35 instead of 44 (better late than never). I would have taken care of myself in different ways.

Anyway, dedicated forum for exercisers 35 (or thereabouts) and over? - just a suggestion, take it or leave it
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Janet
 
Great Idea, Janet!!!

Hi Janet,
What a great idea. I am just about to turn 35 and although I have become somewhat educated about fitness over the last few years, I was unaware (until recently) that things would change so much at 35. Obviously, we all know that maintaining our weight gets more difficult with age, but sounds like there is much more to this than the weight issue. I would love to be better educated about what to expect after 35. Hey, maybe someone will write another "What to Expect" book on the topic. Okay, maybe thats corny. Just wanted you to know that I'm very interested in this. Thanks,
Lisa
 
Yes!

I would vote for the new forum idea. I see MAJOR changes taking place this year in this ole bod of mine. "35" was pretty kind to me, "45" things really started changing, but let's say "47" is giving me a run for my money!! We can never learn enough. Great idea!

DebbieH
 
Hey Lisa & Debbie - ?

What do you think would be the best way to approach Cathe and SNM with the idea? I know they don't always check into the open forum as frequently as they do the other two. Should I post a new topic in the Ask Cathe forum and see what kind of response it generates? Or should I be more low-key and e-mail them?

Your advice would be appreciated!

Janet
 
Janet!

I think you could do either. SNM is real good about responding back both in posts or E-mails. You could even mention the thread in this forum that they could refer to. I also think that a new thread would generate some more people in the Cathe Forum. Good Luck! I'll check in with you when I get back from Chicago late Monday night. Have a nice holiday!

DebbieH
 
blood clot test

There is a simple test they can do to check if you have a tendency to have blood clots. My new doctor did one on me, even though I've been on the Pill for many years because I mentioned that my mom had clots in her leg many years ago. It came back ok. So if you're really concerned about that, get it done!

Marcia
 
thanks a lot for the info

Thanks to all of you for your info and encouragement ("barf bag helpline"?? --Daphne you're a hoot!). I'm going to start tomorrow, going to take my pill at night just in case.

Regarding a forum for mid-life women's issues, I think it's a great idea. Although I am still fascinated by the pregnancy forum and find myself posting there a lot. I could hop back and forth fron talking about pregnancy and babies to talking about menopause and low-impact modifications. Hehe! What fun!
 
Happy P-Day, Susan! :)

I guess we're on the same schedule--I just started my new pack today, too! Ya think we can remind each other?
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I was on the Pill years ago before my first pregnancy. I went back on it about a year ago after a 7-year hiatus because of changes in my cycle--mainly breakthrough bleeding. I'm guessing that it relates to perimenopause. Even though I'm only 34 my mother and grandmother both went through full-blown menopause at 45. My CNM put me on Alesse. I was also worried about side effects, especially weight gain. I can tell you that I haven't noticed any significant weight gain, water retention, etc. I still have some breakthrough bleeding, but nothing compared to what I had. I'm convinced that going on the Pill was the right decision for me, especially since I have a family history of osteoporosis as well (with that stress fracture I had, that was a big concern). I have my annual next week, and I'm wondering if my GYN is going to switch my prescription again because of continuing breakthrough bleeding.

Also, thanks, Julie for your great information!

Kristin
 
I Re-Posted This on Ask Cathe

...to make sure Cathe and SNM see the suggestion. So, if you folks have a chance, perhaps you could weigh in there as well.

Thanks for your support. Hope you weekend is going well!

Janet
 
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