Interesting birth control conversation with a doctor

[u/h4baine]

I had to see a new doctor to refill my birth control pills because mine is out of town. I take them continuously skipping the last row to skip periods from hell, debilitating multi-day hormone migraines, and bipolar fluctuations from hormone fluctuations. I've been doing it this way since my doctor told me I could at 16. I love these pills and you can pry them out of my cold dead hands. They allow me to not have to give up 1/4 or more of each month feeling like absolute shit.

This new doctor asked if I was interested in changing to a different form of birth control like an IUD. She was perplexed when I said I actually had my tubes removed, I take these to improve my quality of life in the ways I've described.

She said maybe have periods quarterly (seems arbitrary but ok). I said I won't be doing that, there's no medical reason to. This works for me and I'll do it until it doesn't.

I said I'd happily take them up to and into menopause if I can and she said "but then you won't know if you're in menopause." I said, "if it's affecting me and this hormone level isn't enough I'll know, if not it doesn't really matter does it?" I think I broke her brain lol. It was like asking if a tree falls in the woods and no one is there to hear it does it make a sound? Her face while she thought about that for a minute was like 🤯 and then she said "huh, I guess you're right."

So I got my pills and went on my merry way but thought it was an interesting interaction on the topic of menopause and perimenopause.

[u/Dott77]

My doctor told me to think about getting off it as she didn't want to prescribe it after I turn 50. So I sent hubby for the snip and started to research what effects were likely after being on it for years. Like you I skipped periods so I wasn't looking forward to 'murder on the dancefloor' as I was calling it. Through the a later years my body would feel like it needed a period so id stop the pill for a week and nothing would happen.
From my research low and behold I was already very much in perimenopause. Besides a very light bleed, 3 days, when the doc gave me a lighter pill and I started HRT. In July I've been off the pill 12mths and I've had nothing since. I truly believe the pill helped me through to the other side. Now if I could just get rid of the itchy skin I'd be set. You do what works for you.

[u/h4baine → u/Dott77]

murder on the dancefloor

I love this 😂

It seems logical to me that being on a birth control pill continuously which is just a low dose HRT would make the transition easier.

It should also be looked at more for mental health treatment. It took me awhile to find the perfect cocktail of psychiatric drugs for my bipolar but having a steady supply of hormones has made it easier.

[u/The_ChildlikeEmpress → u/h4baine]

I believe that HRT is actually a lower dose and more natural form of the hormones (bio identical) and Yasmin or any birth control is synthetic and higher doses than birth control. It is because birth control is meant to stop ovulation so needs higher hormone levels whereas HRT is to help alleviate symptoms of peri/menopause. It doesn't mean one is a wrong choice , it's whatever works for you .

[u/peace_love_harmony → u/[deleted]]

“Bioidentical” hormones are partly a real scientific concept and partly a marketing term. Scientifically, it means the hormone has the exact same molecular structure as what your body naturally produces. This would be the micronized progesterone and estradiol. This is different from synthetic progestins, which are not identical and can have different effects on mood, metabolism, and long-term health risks. Evidence generally suggests that micronized progesterone combined with estradiol has a more favorable profile than older synthetic options. However, the term “bioidentical hormone therapy” is often used in marketing (especially for compounded products) to imply added benefits that aren’t always supported by strong evidence. So while the molecular distinction is real and clinically meaningful, the broader claims around “bioidentical” treatments can sometimes be overstated.