Pills and things....

C

clareMc

Cathlete
Dear ladies (Trevor and Wayne, skip!!):

My doctor has put me on Trilevlen birth control pills for a while to see if they can help me level out my hormones, which are dropping fast it seems. But I seem to be bloating up with them already. I feel as fat as a blue whale. I hate the tight pants look.

Is this a common side effect of the pill that wears off after a few months? Did you experience it? Did it go away?

Any personal narratives or suggestions, comments, most welcome! Any reassurance?

Thanks,

Clare
 
Hi Clare, I had to switch back to my old Levlite 28 after 6 months on Orthotricyclen Lo. Ortho gave me great skin, but it made my hair fall out that I had tiny bald patches on the top of my head. I was extremely bloated, and I had headaches that never went away. The inserts in these pills always say that side effects go away in three months, but my side effects with Ortho just went on forever. So I went back to my old pills. I'm breaking out again, but this is something I can tolerate.

Pinky
 
Hey,

I most definitely have problems with water weight gain... It didn't start with the pill, but it has been more of a problem with it. Now, everybody reacts differently with each kind. I was put on Nordette 28 and I loved it! Cleared my skin, my chest grew, my psoriasis went away, and I had no emotional problems with it... the water weight I gained was minimal, except for the few days before my period. THEN, I was forced to switch to the generic form. It's supposed to be the same, right? Nope. Not even close. After only one week on the generic, I was bloated to the point of pain. My boobs hurt so bad I couldn't wear a regular bra (and they were huge!!), my joints hurt and my ankles swelled. The first two months were the worst, but after 5 or 6 months... it didn't go away. NOt to mention the fact that my acne came back, my psoriasis came back, and I became pretty depressed. So I have been paying top money for the normal stuff, and my bad symptoms went away.

I think you should wait 3 months... If they don't go away, I would consider talking to somebody who really has experience dealing with stuff and they can listen to the problems you have. There are so many kinds of birth control, that your options are pretty good. They might be able to come up with several options that will give you the benefits you want without the aggravation. Good luck! But if your doctor tells you she doesn't think any other will work, I suggest going to another... Perhaps even a health nurse or a planned parenthood nurse. They tend to have more personal experience and will sit and talk with you for a long time. Then you can take the info you learned back to your doctor and get your prescription. That's what I did, and I don't regret it. They are fantastic people to talk to.

Sara
 
The only birth control that ever got me all fat and bloaty was the depo provera injection - I had a LOT of problems on that....other than that the actual pill itself never bothered me apart from the combined pill gave me migraines.

Josie
 
Hi Clare! Yes, this is a side effect of the pill. I always tell my clients to give whatever pill I prescribe three months for the body to adjust; however, if there is a side effect that cannot be tolerated (coninuous break through bleeding, introlerable mood swings, etc.) to give us a call for a pill change. I think in most cases health care providers try to prescribe the pill that will be most compatible with the client. I base my decision on the client's history and needs (heavy cramps, acne, etc.), then I go to my cheat book and adjust according to the client. This does not always work as some women respond the opposite of what is anticipated. For example, I am one of those women who gained weight and expereinced worse acne on Ortho Tricyclen, but I did great on Depo Provera. So, if you can tolerate it, give your body the three months. If you still experience this, talk to your doctor. There are so many combinations available that USUALLY a pill can be found (but there are always exceptions).

Hope this helps.

Autumn
 
I've never noticed a difference with the pills I've been on. Years ago I used Ortho Novum and now I use Ovcon 35. I believe certain pills have a higher risk of weight gain than others.

Colleen
 
Sara,

You covered all the bases, and I couldn't agree more. :)

Also, I had to thank you regarding your commnent about those of us working in family planning. :)

Autumn
 
Thanks Pinky. So. what we learn from this is to take "three months" with a pinch of salt..... I hope your hair grew back!

Clare
 
Thanks Autumn and all others. At least it isn't just me. I will try the three months and to adjust my attitude and try and bear it....

Clare
 
So, Autumn, if I can pick your professional brains a little, what would you recommend for a 38 year old woman, entering premenopuase, experiencing increased anxiety, hormone levels cut in half since last year's blood work and suffering thinning hair and hair loss as a result?

Can you suggest what you might prescribe?

CLare
 
Autumn:

to add, I am sorry if this is what people always do to you, asking you for medical advice once they learn of your professional expertise.....didn't mean to put you on the spot or anything, neither am I going to rush out and demand instant changes of prescription, it's just that there are so many types of pill, I don't know what they are prescribing for me when they do, and anything I ask for at all has to be referred through my PCP since I am part of an HMO, so it helps to have reasons for asking for referrals, to be as informed about the possibilities as possible. Sometimes I wish I could bypass her, and I am wondering if I should just seek an appointment with a gynecologist or endocrinologist.....she (PCP) said it would be possible, but she wants me to try the pills first. OK but sometimes I wonder if she has just prescribed the one she prefers or the brand which might most help me...... oh well, time will tell...

Clare
 
Clare,

No need to apologize. :) I am used to it... I can't tell you how many blood pressures I have taken at family gatherings... no pap smears though :)

I can't give you solid advice on my what my first pill choice would have been, I would need your lab values, symptoms of premenopause, complete history, and physical exam in front of me. I am assuming your PCP ran other lab work to rule out other causes (i. e., hypo- or hyper- thyroidism, etc.) of some of your symptoms (i. e., hair loss).

That being said... if your only complaint on the Trilevlen is bloating, I would choose a pill that increased progestin or progestational activity. According to Managing Contracpetive Pill Patients by Richard Dickey, bloating with pill use is either from etrogen excess or progesterone deficiency. Since you are premenopausal, I would hate to decrease your estrogen so I'd look at increasing the progestational activity. As I said before, this may not work but it would be a staring point. I should add that not all doctors find the book I mentioned helpful, but my colleagues and I find it invaluable.

Also, have you read the book "What your Doctor Many Not Tell you about Premenopause" by John Lee, MD. Some women find it very helpful, so it may be worth checking out. I should add that it is not a "traditional" approach, and there are medical studies that contradict Dr. Lee's advice BUT it does work for some women.

Clare, if you decide to stick with the pill approach and need a change, I would be more than happy to email you more specific information (don't want to break any copyright laws :).

Sorry this is so long.

Autumn

Oh, and I think an appointment with a gynecologist or endocrinolgist may be a good idea.

Edited to also add: A pill with less androgenic activity may be of benefit.
 
Autumn:

thank you so much for your advice. You are an invaluable and knowledgeable person. I am writing it all down to keep in my "health notes book". Let me ask you another thing, if I may.

I have read the book by Dr. Lee, I keep it by my bedside. I wondered, since added progestin may be needed for me, do you think it is safe to take Trilevlen (or any bc pill) and also use progesterone cream as recommended in Dr. Lee's book?

I bought some cream and used it for one month before going on the pill, and it delayed the onset of my ovulation etc.. But from what I read in his book, lack of progesterone is probably what is triggering my symptoms.

Any thoughts on this issue?

I admire you: I find the cycles of women's sex hormones and menstruation cycle so hard to understand!

Clare
 
The pill that seems to be very popular among my perimenopausal friends is Yasmin. It is a new pill and the progesterone is a new formulation that prevents fluid retention (supposedly) which might be just the pill you're looking for. I myself am on Desogen, which has definitely caused about 5 pounds weight gain and a little bloating, but it has cured my awful migraine headaches so it is worth it to me.
Beth
 
Clare,

Thank you for your kind words! I hope I can get out of this room with my big head. ;) Sincerely, thank you!

Now to your question:

It is great you have read Dr. Lee's book and are familiar with his thoughts. You are correct that his book names lack of progesterone as the cause of the symptoms you decribed, so did you experience any improvements with the progesterone cream?

I am by no means an expert in the area of natural hormone replacement. If this is an option you are interested in, I would find an expert on the subject. I believe Dr. Schwarzbein (I think she has some great info in her books) also advises the use of natural hormones and finding an expert to manage them. It sounds reasonable that you could add the progesterone cream, but the natural progesterone and progestin would compete for receptor sites. Most of what I have read or heard is that you should use either the natural progesterone for your symptoms or synthetics. As with most medical questions, expert opionions are like... well you know. :)

I hope that natural hormone replacement will become the norm, and I am seeing more about it in my journals and hearing about it at conferences so just maybe it will. I also know there is a need for the synthetics... especially in the area of contraception... especially until menopause is confirmed for some women. :) So, I am not in favor of one or the other. :)

I have to amend my statment above, I used progestin interchangeable with progesterone and that is incorrect. At least I recognize the error of this, so many doctors, NPs, etc. use the words interchangeable (which I am guilty of in this post). ;)

I have been fascinated with reproduction since I learned about the birds and the bees. It is a subject I never become bored with and am always learning new things... and it seems so cut and dry.

Autumn
 
It is a very popular pill with my the younger clients too. It has been shown to help with bloating associated with fluid retention. It is also antiandrogenic... again helpful with bloating and hair loss. You are absolutely correct with the "supposedly" prevents fluid retention, because there are women who respond the opposite of what is expected. :) Treating the individual is soooo important, but sadly not always practiced.

I should add that if bloating or weight gain is during the entire pack of pills, then that is another culprit.

Ok, I gotta go meet Cathe. :)

Autumn
 
I have to chime in here because I'm having a horrible time right now trying to find a pill for me. Back in August my gyn. changed my pills because I was having break thru bleeding and also a lot of pain similar to the pain that ovarian cysts cause (which I have had in the past). She changed my pills to Yasmin and I had horrible results with it. I gained five pounds immediately and my mood swings were horrible! I stayed on the pills for 3 months but the mood swings only got worse! So now she has put me on Loestrin which has made me gain 4 more pounds and as was previously said I feel like a big bloated whale! I am prone to have headaches anyway but I have had one every day since taking the Loestrin. But I am so afraid to have her change my pills again because I can't afford to gain any more weight! I already had quite a bit to lose anyway and now add 9 more pounds to that! Do you think those 9 pounds is just fluid retention? If I stopped taking pills completely would those 9 pounds just go away?
Sorry to ramble on so long but I am so frustrated right now about this and really need some good advice on where to go from here!

Thanks a lot!
Norma
 
I'll add my 2 cents if it helps anyone. I am 44, and had used a diaphram for about 21 years as when I first took the pill I hated the side affects. In November of 2002 I read about Nuvaring: NuvaRing® is a hormone-based contraceptive. It’s a soft, flexible ring about two inches in diameter. You insert NuvaRing® into your vagina only once a month. The muscles in your vaginal wall will keep NuvaRing® in place for three weeks. During that time, it will slowly release a low dose of the hormones needed to prevent pregnancy.

When 21 days are completed, simply remove NuvaRing® to allow your body to have its menstrual cycle. After a seven-day break, you will insert a new ring to continue to be protected against pregnancy.

NuvaRing® contains two types of hormones, estrogen and progestin, that prevent your ovaries from producing mature eggs. NuvaRing® provides benefits similar to oral contraceptives, but without the daily pill-taking routine.

It has worked well for me so far with hardly any side affects, maybe a 5 lb weight gain, although I have not been eating very clean. I had hoped the weight gain would help my barely 34A's...but no...probably right to my derrieire...:)...anyway I realize everyone has a different reaction to the different kinds of birth control, just wanted to let you know what worked for me...:)...Carole
 
Norma,

First, I think you should call your doctor to discuss the headaches everyday. You may be told to wait three months (regarding the bloating and weight gain too), but it is worth discussing with your doc. Finding a pill can be a challenge.

I understand your frustration; however, there are so many pills available that I hate for you to give up. :) And, there are other options now (the NuvaRing that Carole mentioned and the patch). The five pounds immediately and four pounds in one-month sounds like fluid. Have you noticed an increase in fat tissue over the breast, hips, or thighs (this would less likely be from fluid)? Several questions would need to be answered to really know what adjustments may be beneficial, but you are on a pill with low estrogen activity (regardless of whether it is Loestrin 1.5/30 or Loestrin 1/20) so it probably is the progestin. The decision of stopping OCs or changing scripts is something you will have to really think about. As for losing the weight... if the 9 pounds are fluid, they will (most likely) drop faster than if the pounds are related to fat tissue, but each of us is unique and unpredictable.

I know you are frustrated, so keep the questions coming if needed. :)

Autumn
 
You must log in or register to reply here.

Our Newsletter

Get awesome content delivered straight to your inbox.

Top