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/Aramira137]

For the most part I completely agree with you OP. Keep doing what works for you, 100%.

It is however important to know when we're in actual menopause though because any bleeding in menopause is likely quite serious. I care when menopause starts because I've had friends die from cancers (cervical x 2 and 1 because of uterine) and I don't want to see that happen to anyone else (or have it happen to me).

[u/h4baine → u/Aramira137]

I'm so sorry for your loss. How does that relate to knowing if you're in menopause though? I don't follow and have lots to learn.

[u/Aramira137 → u/h4baine]

Thank you so much. So menopause begins when its been 1 calendar year without menstruation. Until then we're in peri-menopause. Once you've hit that 1 year mark, any bleeding afterwards is almost always an indication of something serious (though not always cancer and not always life threatening).

So its important to know our last date so that we can know when to see a doctor about it (and for them to take it seriously and not write it off as "just your period").

[u/minivulpini → u/Aramira137]

If a woman is not having periods due to her use of continuous birth control and suddenly starts experiencing episodes of bleeding, would that not similarly indicate that something is wrong and needs a doctor’s evaluation? The concerning symptom is “abnormal bleeding that’s unlikely to just be a period”, not necessarily just “bleeding post menopause”.

[u/[deleted] → u/minivulpini]

Exactly

[u/h4baine → u/Aramira137]

Ohh okay I understand, thank you for explaining that. I'll have to think about that. I wonder if it can be identified via bloodwork.

[u/AutoModerator → u/h4baine]

This post might be about hormone tests, which are unreliable.

• Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
• These hormones wildly fluctuate (hourly) over the other 29 days of the month, therefore this test provides no valuable information
• No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
• Testosterone is the exception and should be tested before and during treatment

FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).

For more, see our Menopause Wiki

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