Women's Health Community

Dear Julea: While using a birth control pill (BCP) one should be getting enough of the synthetic estrogen to actually treat the hot flashes of a menopausal woman. However, there is a subset of women in whom vaginal dryness can develop while on a BCP. There are two versions of Seasonique. Regular Seasonique has 30 micrograms of estrogen; Seasonique-Lo contains only 20 micrograms. In terms of the vaginal dryness, a switch to another brand or formulation MIGHT be helpful.

Other medical conditions which can create vaginal dryness include: benign pituitary mass, diabetes, and Sjogren's syndrome. Medications such as Lupron, antihistamines, diuretics, or drugs which create dry mouth (eg tricyclic antidepressants) have the potential to create vaginal dryness as well. Yeast infections, or vulvar dermatology problems (eg lichen planus, or lichen sclerosus), can be interpreted as a dry, uncomfortable feeling in the vagina. Even poor lubrication due to genital pain, or inadequate sexual arousal, can create a subjective sensation of vaginal dryness.

In terms of the hot flashes, typically they are seen during the hormone swings of perimenopause. Yet other medical conditions can prompt flashes and/or night sweats. These include: hyperthyroidism, infections (eg HIV/AIDS, TB, malaria), some types of cancers (eg pancreas, adrenal gland, leukemia), generalized anxiety/panic, and autoimmune disorders. Many women have noted a sensation of flushing when the sympathetic nervous system ("fight or flight" response) is activated. Even being a heavy cigarette smoker can be linked to more hot flash activity as smoking decreases blood estrogen levels. Some medications (eg serotonin [SSRI>antidepressants, raloxifene, and others) have been noted to prompt flashes. If your flashes appeared after starting a new medication be sure to ask your pharmacist if flashes are noted as a possible side effect.

Lastly, weight gain can be triggered by hormonal methods of birth control. Other medical conditions can do this as well (eg Type 2 diabetes). You may have to change methods of birth control to see if this was a factor in your weight gain. It sounds like you are doing everything you can--which is amazing considering a full time job and concurrent full time college. When do you get to sleep--what to speak of exercise?

I hope the GYN or clinic that prescribed your Seasonique can evaluate both the flashes and weight gain for other possible medical causes. Once those are ruled out they may suggest that you change your formulation or type of birth control.

In Support,
Jane