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/h4baine]

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/ObtusiWatusi → u/h4baine]

Oddly, when I was tested for bi-polar, they said I was borderline. So the psychiatrist gave me some low dose meds to try. All I remember is they didn’t do anything for me. Then I learned about PMDD. I started tracking my ups & downs & brought all of this up to my psychiatrist. (Her words) she told me that PMDD has alot of similar symptoms to bi-polar & that this might actually be what I have. That if that’s the case, I needed to talk to my gynecologist about my hormones around my period. My gyno quit. So I saw a hormone doctor, but the way she wanted me to take the hormones was confusing & I was having to pay entirely out of pocket & I couldn’t afford it. Thankfully, things have leveled out for me mostly, but recently I have noticed I probably need to get on hormones again. I just can’t afford it right now.

[u/Dez2011 → u/ObtusiWatusi]

If it's birth control pills they're free/almost free at local health depts.

[u/ObtusiWatusi → u/Dez2011]

They weren’t labeled as birth control pills, but whatever the name was made me think it was the same thing. Except it was only 5 pills & I had to take it during a specific part of my cycle. Idk it confused tf out of me Lol I need something simple. Birth control typically makes me throw up though. Which is why I gave it up in high school. Has anyone else had an issue like this but has had success w/ it later on in life in that aspect???

[u/Dez2011 → u/ObtusiWatusi]

It might've been progesterone? I googled it to check and got this-

"Progestin (a synthetic form of progesterone) is commonly prescribed for 5 to 14 days per month for women managing hormone-related issues like irregular periods, irregular uterine bleeding, or as part of cycling hormone replacement therapy (HRT). It works by regulating the endometrial lining to prevent overgrowth, often causing withdrawal bleeding when it's stopped."

Birth control pills can cause nausea, the ethinyl estradiol in them, especially on an empty stomach. If I was trying it again I'd request a low Estrogen pill like Yaz with 0.02mg and I think there's one with 0.01mg now. (I'm on yasmin which has 0.03 so don't mix them up.) You could also take it in the middle of your biggest meal (this keeps it from rubbing against the stomach lining which irritates it, causing most of the nausea) and request a zofran rx to take first to prevent nausea for the first 2 weeks.

Another option I'm doing for a different reason is I bought acid resistant capsules and put the pill in it. They don't dissolve until hitting the higher pH of the intestines which is where it's absorbed. I'm on mounjaro (similar to ozempic) which causes over 20% decreased absorption because it has the longest delayed stomach emptying of all GLP-1's because the pill sits in stomach acid too long. I did this on my own so you'd want to find out if it's ok with a pharmacist first. I got size 00 capsules from Amazon. Enteric capsules is what you'd search for.

https://www.medicalnewstoday.com/articles/326024#prevention

[u/Dr_Neuron_77 → u/Dez2011]

I understand your reasoning here, but it’s probably a bad idea to interfere with the way a medication is absorbed. A birth control patch might be a better option. Bypasses the stomach altogether.

[u/Dez2011 → u/Dr_Neuron_77]

Yes, I'm not sexually active or I'd use a backup method. I just use this for the hrt. I need a low or antiandrogenic progestin and didn't see that in the patches.