First, I am in Japan and options are limited. I am having peri symtpoms though blood work is fine. BIggest problem is fatigue and brain fog.

So I did research and found that sometimes low dose BCP can help. But doc started me on premarin 0.625mg. for first 11 days then add in provera at 2.5mg...then to cycle it and get a period...

Now I am so confused. I read that the average dose of hormone in the low dose birth control pill is 4 times stronger than the "HRT" I am taking. So that means if I was in the USA a low dose BCP is only 1/4 of the strength of it!

My question is can this "low dose" (even lower than BCP) make me feel MORE Fatigued and should I stop it? I think I do feel more fatigued but should I hang in there or am I just taking too low and it will not make me feel better? I am only on day 5 so just taking the premarin right now....I think I am feeling more fatigued and certainly feel depressed....I don't know what to do should I stick with it or go back and get the real equivalent of the low dose BCP that the states has and that is my best bet?

Is it possible that this low dose is only making me worse some how via the pituitary feed back loop...I am so confused and I feel awful...before hormones and now as well.....

Alos do low dose birth control have 11 days of estrogen and then add in progesterone....in other words you are taking different hormones at different times in the cycle or are you on stable levels of progesterone and estrogen throughout usually with low dose? I don't know what to say to the doc to help me....

slowbear,

I feel so bad for you. Going throught all this is bad enough but to be in a foreign country that you're not used to makes it worse.

I take Ortho-Tricyclen Lo and here's what it says:

white pills (7days) contain .180mg progestational compound and .025 mg estrogenic compound.

light blue pills (7days) contain .215 mg progestational compound and .025 mg estrogenic compound.

dark blue pills (7days) contain .250 mg progestational compound and .025 mg estrogenic compound.

Then, of course there are the 7 green pills with nothing in them.

So, it appears that mine has the same amount of estrogen throughout the cycle but increasing amounts of progesterone.

Hope this helps.
bumfuzzled

Oh yes it really helps! Thank you! You gave me the idea too (if I can via the internet) research the other low dose BC pills as well....I think what I understand is for peri it is best to have a steady, and high enough amount of estrogen to close down your own production...this gives you stability throughout the cycle with out the peri ups and downs. I am not sure about the progesterone, whether to have it in increasing amounts or steady dose throughout the cycle..(if that is even done at all with low dose pills)

I would appreciate if anyone is taking low dose pills to also write the amount here if you can.....my doctor seems willing, but women in Japan go thorugh meno differently ....probably because of all the years of soy!

Thanks you and to anyone else who may help me out on this!

Slowbear-

I copied this from drugstore.com - there are different types of pills-
monophasic being the one most prescribed in peri I think. They have the same amounts of ethinyl estrogen and progestin everyday for 21 or 24 days and then the placebo pills. Supposedly they help with fluctuating hormones. I just started taking Yaz, which is monophasic. After two weeks, I don't feel better and even more depressed. No idea if its the pill.

I think it depends what you are taking the pill for. I think its better for bleeding issues than mood issues (anxiety depression) but some women like it. I'm trying to decide whether to stick it out the full month as I don't feel mentally better at all.

This is the article, there are also other sites that describe the specific pills and I'll try to look them up for you -

I have called the companies that make the pills to get info and they are useless. They will not tell you about using the pill for peri symptoms, only birth control.

See article below.



What are the differences among monophasic, biphasic, and triphasic birth control pills?

--------------------------------------------------------------------------------

Birth control pills are one of the most popular and effective forms of birth control. Your doctor can choose from more than 30 different formulations, with different combinations or amounts of hormones.
Most birth control pills contain the hormones estrogen and progestin. They are categorized as monophasic, biphasic, or triphasic pills depending on whether the level of hormones stays the same during the first three weeks of the menstrual cycle or changes. (Pills for the fourth week, if they are included, are usually sugar pills that contain no medicine.)

Monophasic pills contain the same amount of estrogen and progestin in all of the active pills in a pack. Examples of monophasic pills include Ortho-Novum 1/35, Demulen 1/35, Lo-Ovral, Ortho-Cyclen, Loestrin, Alesse, Apri and Ortho-Cept. Because of the uniform hormone level in all the pills, monophasics are least likely to cause side effects, such as mood changes, that can result from fluctuating hormone levels in the body.

Biphasic and triphasic pills contain different dosages of progestin or estrogen throughout the pill pack. Compared with monophasics, these pills reduce the total hormone dosage a woman receives and are thought to better match the body’s natural menstrual cycle. Biphasic pills change the level of hormones once during the menstrual cycle. Examples of biphasic pills include Ortho-Novum 10/11, Mircette and Necon 10/11.

Triphasic pills contain three different doses of hormones in the active pills (changing every seven days during the first three weeks of pills). Triphasic pills include Ortho-Novum 7/7/7, Ortho Tri-Cyclen, Triphasil, Tri-Levlen, and Tri-Norinyl.

Despite the differences, no single pill or pill type rates as the "best" one. Experts consider all combination pills equally effective in preventing pregnancy, provided the pills are used appropriately. Your doctor can help you choose a pill based on your age, medical history, and lifestyle, and cost.



Slowbear-

You can also check out the site below- they give you the dosages of the various bcps. Hope you have better luck than I have.


http://www.wdxcyber.com/ncontr13.htm

Lidge

Hi lidge and thanks! Yes, I looked around the internet and found similar info on monophasic (new word for me!) BCP as probably the best for perimenopause. My sister has been on Loestrin for years and was doing fairly well up to this year when she turned 50 and ift sort of stopped working for her.... I am 47 so still a few years to go.

From what I have read as well, you may have to try a few different one to find the right dosing for your that best fits the amount of hormones you body feels comfortable with. Right now the doc seems to have me on a bi-phasic kind of thing....yes, like you not feeling so great and wondering if stick with it is best....will try I think and do blood test....he did say that the first month can be rough as your body adjusts but by the second you should start to see some improvements (if it is helping) and by the third all set to go. The trick is to wait long enough but not so long that you are waisting your time trying something that will not work...gosh I REALLY understand this feeling! Probably by the time I get all this sorted out I will be out of it!

Anyway, since my sister is my sister and we have some of the same genes it seems worth a try to try something that has worked for her....how aobut you...any sisters or a mother or aunt perhaps?

Hi slowbear -

My mother died when I was young, and my only blood relative that I could ask is my older sister. She doesn't seem to have had this so bad and she has essentially shut me out of her life since my life went downhill last year. If I'm not fun to be with, she would just as soon not hear from me. Pathetic, huh?

My gyno said I should feel some benefit in weeks. I'm trying to make it throught the pack. I feel like I'm worse so I at least want to see how I feel when I'm off it. I want to try something else -
I've never been on bCP and have not read anywhere that it is good for my problems which are anxiety, depression, and
chest pain (reflux?) What exactly are the symptoms that you are trying to alleviate slowbear?

Lidge

sorry about you and your sister....these kind of intimate sibling relationships are delicate are they not?

Well, my story, probably like yours, is a bit complicated. You see, I had (have) Graves disease (hyper thyroid). Unfortunatly I think I started getting the peri symptoms as well...in any case, ovarian hormones and thyroid hormones are all part of the endocrine system including the pituitary and with all of this I think mine is pretty out of whack!

Given those two things (peri and Graves) my symptoms have almost always been fatigue and brain fog as the major ones. I have also had off and on sore breasts, heavy periods, light periods, body aches, TMJ, canker sores and night sweats and so forth. Most of the little things I can put up with.

For whatever reason, it seems the symptoms seem to get worse the week of my period and the week after that up until ovulation (or what should be ovulation and I don't think I am ovulating every time). Since symptoms seem to be cycical, and docs are no help, I am on my own....my thinking was try to get some stability in my hormones...stable hormones thoughout the cycle....as you can see what my doc has me on now is not the case and I guess we miscommunicated, so I am going back to see him monday.

From what I have read recently with the internet search and your info (think you!) monophasic may be the best to even things out and that is what I would like to try. Depending on the BCP there seems there are differerent amounts of ethinyl estradiol and progestin in the pills and it may take some trial and error to find the one that suites you the best....I think that is the hard part!

One site I read from in Maine that has a team for women for women issues only has great information and they often prescribe for women (I will not mention the phasics) Loestrin, Mircette, Yasmin, Ovcon-35, Allese and lo/Ovral. Yasmin does not have progestin but has drospirenone (whatever that is!).

I know about what you mean about feeling worse! My doc says that at first you may feel worse because your body has it own hormones and then you are adding on top of them for a while and it takes a while for your body to shut down its own production and let the outside hormones take over. So, for a while you really have a lot of hormones in your body...but given that, it seems that you shouldn't feel bad for more that the first month (my thinking) and start definitaely seeing improvements in the second as it all evens out....it is so hard to guess if you feel rotten enough to stop it or just a little rotten and you should stick it out....

As it so happens, starting yesterday (with just so happens to also be day 13 of my cycle!) I started feeling better...so now I am wondering to really see the doc or to hang on and see a bit long how this may go....in a few weeks, however, according to his protocol (and I don't think he knows beans about peri) I will start 2.5mg of progestin...so he has me really doing a biphasic thing....

Some part of me thinks to start the 2.5 in a week like he says and see how I feel...maybe by chance it may work and I am already into this 7 days....what to do!

Have you decided to stick or change ?

Hi slowbear-

My thought is to quit all bcps at this point. I have found my problems to be all month long, unlike you as you seem to find a cycle to it. Some of your issues like heavy periods seem much more conducive to being helped by the pill.

I'm starting to think I need an antidepressant, but I could not tolerate the one I tried, and I am unable to find competent help on my crappy HMO plan. The good shrinks don't take insurance and I have already spent a truckload of money out of pocket trying to help myself.

I'm thinking about trying a different hormonal route, ie. compounded bios or patch etc.

Most of what I read does not point to bcps for solving mood problems (anxiety or depression). I agreed to try it because the gyno told me to. I'm hoping that when I stop, my body isn't further plunged into chaos. If I don't feel some dramatic benefit in this cycle, I will stop to see what happens.

I take some comfort that many women on PS got relief from anxiety with bios, but it may take more than that. I am still
debating how to handle this.

I'm sick of being told to give things months to work. If that's the case, then we need the expertise to tell us what stands the best chance of helping us, not just throwing the whole pharmaceutical goody bag at us and have us choose from column A or column B.
This is too serious, and I'm sick of being treated like a guinea pig.

Sorry to vent, I'm just at the end of my rope lately.

Please research carefully what you take Slowbear. I have not read much good about Provera. Did you ask if you can take prometrium instead? I don't want to introduce doubt, just make you aware of what I have read. It may be just the thing for you.

Yes, I have done a lot of reading about everything and the conclusion? I am scared of EVERYTHING!!!!

Yes, I think I do not want to be on premarin and provera....It seems that all in all the usual BCP may be better....I have anxiety try to figure this all out without getting cancer of anything....and never sure what the best bet may be.

I had (still have i guess but got fed up with him) a holistic doc in USA and he did prescribe bio-idential progesterone cream for me at 100mg...and though I had all the labs and salivia test...I am not sure he took very good look or care of me. That amount made all my symtpoms much, much worse...perhaps a smaller amount would have helped, I don't know...but my fatigue and brain fog just got much, much worse and he kept telling me to hang in and I only toook it for the last 14 days of the cycle and tried for two months and I was so miserable it just wasn't for me...maybe we can know very quickly...maybe just listening to our gut instincts are the best...a little discomfort seems ok, but feeling much, much worse does not ...does it? SO, to make a long story short...now I am very leary about the bio-identicals as well...they are real hormones and bio-identical or not, they will effect your system in a similar way I think....

But I have seem lots of women do well where all else has failed...unfortunately it is not one size fits all ...so frustrating...wearing me out....

I just hate having to deal with a doctor that knows nothing about this...though he at least will let me pretty much try what I like....

I don't have the heavy periods any more...they seem to be lighter now....I am so confused if I still am not suffering with thryoid issues though blood tests look really good....but something obviously is not right...and I can't get any good answers...

Go ahead and RANT...I just did....I have not sufferend with the severe depression and anxiety, but have had occassional bouts....my sister has, however, so perhaps I still have that to look forward to.....My mom finally took an antidepresent and does to this day....she is feeling great and always says...you can take away anything but my antidepresent! Don't know what she is taking.....

Why don't the doctors seem to know as much as we do?