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Birth control pills for perimenopause symptoms
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An_251791 posted:
Hi there...I am 47 and in the throes of peri...was doing ok, until about 9 months ago, when the emotions, insomnia and sweats took a turn for the worse. Recently, dr. put me on Lo Loestrin (only 10 mcg of estrogen) It's only been 5 days and I'm not doing much better. Has anyone had success with bcp helping control the problems? Can it take a couple of cycles to suppress your ovaries and "take over" so to speak. I took regular Lo Estrin when I was in my 20's and I never had issues taking it. I am still taking some otc supplements and flaxseed oil to help with the heart palps and weird sensations I get a few times a day. I noticed when I looked online for people using bcp to successfully treat their symptoms, that I didn't see a lot of information, other than some other folks asking if it helps like I am now, so I'm trying to see that as a positive, meaning they feel better, more like themselves and have moved on. Any advice or input appreciated.

Thanks,
Pam
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Mary Jane Minkin, MD responded:
Dear An_251791
I am a big fan of low dose birth control pills for perimenopausal symptomatology. It may take more than 5 days for the med to kick in; I would probably give it a full cycle to see exactly what it does for you. If you are better, but not totally so, it is absolutely reasonable to try a slightly higher dose pill; as for example, the lo lo estrin has 10 micrograms of estrogen; loestrin 24/4 is a 20 microgram dose, and I would move up to that next, if you are still having symptoms. I think it is likely to work for you-let us know if you don't.
Good luck,
Mary Jane
 
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periconcern replied to Mary Jane Minkin, MD's response:
Thank you Dr. Minkin for taking the time to reply. It's day 13 and feeling better. I am going to see the dr at the end of the 1st month to evaluate where I am. I do think I would do better at the 20mcg level.

Pam
 
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periconcern replied to periconcern's response:
Hi Dr. Minkin, it is day 17 and no matter what I take or do, anything and everything seems to be giving me what I guess are "flashes", except I never get to the real flash, I just will get this immense head and sinus pressure and maybe a minor sweat. It eventually calms down, but this is just ridiculous. You are talking to someone who could drink coffee all day and eat chocolate. I had my FSH tested last November at 16 (I was very stressed then, just because I didn't realize this peri stuff could leave you feeling so poor) after trying various HRT (patch, ring and only marginally feeling better) I got off everything for 2 weeks and retested at 10, so that seems very peri levels, so that's when I started the Lo Loestrin. I just know that dose isn't going to be high enough.I see the dr in 11 days at end of pack to discuss higher dose. Do you know if it really can take a few cycles to supress the ovaries and let the pill take over? Do my symptoms of flashes make sense? My Dr. hasn't said anything about being out of the ordinary. I just don't break out into the flash but it sure feels like some people describe, mini panic attacks, adrenaline surges, heart palps. This has been going on for too long and I (like a lot of women) just want to feel better. I was going to discuss with my primary if maybe I could try Clonidine in the meantime to see if that helps reduce these symptoms. And could I ask you one more thing please? Do bcp's have a "peak" life if you will? Meaning, I take it around 6:30am and it seems I can tolerate the morning, but it's the after lunch/evening that sees the big jump in the surges? Is it just wearing out by then? Does that get better over time, does it have to build up again, to stop the hormone fluctuations? I appreciate any and all help you can provide.
 
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periconcern replied to periconcern's response:
Hi Dr. Minkin, I just realized I replied to my own response and I was hoping you will see this:
It is now day 17 and no matter what I take or do, anything and everything seems to be giving me what I guess are "flashes", except I never get to the real flash, I just will get this immense head and sinus pressure and maybe a minor sweat. It eventually calms down, but this is just ridiculous. You are talking to someone who could drink coffee all day and eat chocolate. I had my FSH tested last November at 16 (I was very stressed then, just because I didn't realize this peri stuff could leave you feeling so poor) after trying various HRT (patch, ring and only marginally feeling better) I got off everything for 2 weeks and retested at 10, so that seems very peri levels, so that's when I started the Lo Loestrin. I just know that dose isn't going to be high enough.I see the dr in 11 days at end of pack to discuss higher dose. Do you know if it really can take a few cycles to supress the ovaries and let the pill take over? Do my symptoms of flashes make sense? My Dr. hasn't said anything about being out of the ordinary. I just don't break out into the flash but it sure feels like some people describe, mini panic attacks, adrenaline surges, heart palps. This has been going on for too long and I (like a lot of women) just want to feel better. I was going to discuss with my primary if maybe I could try Clonidine in the meantime to see if that helps reduce these symptoms. And could I ask you one more thing please? Do bcp's have a "peak" life every day,if you will? Meaning, I take it around 6:30am and it seems I can tolerate the morning, but it's the after lunch/evening that sees the big jump in the surges? Is it just wearing out by then? Does that get better over time, does it have to build up again, to stop the hormone fluctuations? I appreciate any and all help you can provide.
 
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Mary Jane Minkin, MD replied to periconcern's response:
Dear Periconcern,
As far as the half life of the pills, they do have a peak level; theoretically, they should last a full day, but it's possible you are noticing some fluctuation within the 24 period. Given your symptoms, it would be totally reasonable to just switch you up to a 20 microgram pill -just switch mid cycle, it's totally fine; or you could just stay with your current lolopill and just add some extra estrogen, (and if you go that route, I'd take it 12 hours apart from your birth control pill, to see if you can control the day variation.) I'd probably do that before jumping into something like clonidine-if you were going to take a vasoactive type medication, related to clonidine, I'd probably suggest a beta blocker type medication, like atenolol, given your symptoms. But I'd push up the estrogen first.
Good luck,
hope you feel better,
Mary Jane
 
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periconcern replied to Mary Jane Minkin, MD's response:
Thank you again Dr. Minkin for taking the time to respond. I didn't realize that I could increase mid pack, but don't have any 20mcg to do so. I do see the dr. again in 9 more days, so I am trying to hold out until then. I think that could really help. I just keep working on deep breathing and thinking positive. I also like the idea of staggering the estrogen. If I do start on the 20mcgs and don't see improvement after a month on that, I will discuss that strategy.
I hope to emal you next month, letting you know I feel better.
Pam
 
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periconcern replied to periconcern's response:
Hi Dr. Minkin,
I eneded up finding my old pack of Gildess FE 1/20 that I had started back late last year (before I had gone to a very expensive hormone specialist, and was started on compouded progesterone for a few weeks but couldn't afford her long term and that's when I found my new gyn who was willing to see if the patch or ring could help), so I did switch to a the 20mcg dose. It's now been over 3 weeks and I will try this for a few more cycles (my dr. was ok that I switched w/o talking to her 1st) I also went and saw a cardiologist and found out through the holter and stress test that I was having over 3000 pvcs a day. I've been on 25 mg of atenolol for a week now. It's definitely helped the heart rate come down and it explains a lot about those adrenaline surges I was having. The cardio (I picked her because she is a 67 year old woman, so I thought if anyone could understand, it would be her) thinks that is a lot for being peri, but I told her, I had none of this prior to last August. Let's just say I was missing the "mood" swings and utter exhaustion, bloating, hypoglycemia (I am a type 2, 11 years, but excellent control) etc. I had been having occassional nightsweats, but wasn't interfering with sleep or anything else I was doing. Heck, I completely missed that I was starting to get wine flushes and just kept thinking it was just too hot in the house ..lol but I can look back now and realize that I was starting to get palps by my 2nd cup of coffee in the am and I also started getting those little "jolts" right before I was going to sleep at night. It just seems that I just kept getting more and more tense and couldn't relax and that started giving me more and more anxiety, so the palps started going more and more and I started not sleeping (once the regular night sweats started, that's when I put 2& 2 together) and even though I knew it was hormonal, I didn't know what to do about it. So, things feel like they are starting to calm down. I am still having night sweats, and will take a few sips of wine and will start flushing fast, so still avoiding caffeine and chocolate for now. Can the bcp really help all these symptoms? From looking at all the previous times you recommended bcp for help, I know you believe it really works (as does my dr) but you've seen women have good success with it? It seems like no one comes back to tell you they are doing better! I know I need to be patient and give it a couple of more months too. It's just scary that it can be this severe for some of us. My Aunt said she had palps in the beginning too but her's calmed down after she went through menopause. I am a single, 47 year old and like to go out and have fun and I am just hoping the next few months see me feeling more like myself. Thank you again for all your input.
 
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Mary Jane Minkin, MD replied to periconcern's response:
Dear periconcern,
Good update! Thanks. Yes, the low dose pills certainly do help many women with the hormonal aspects of the perimenopause; they should basically take away hot flashes, night sweats, and the palpitations associated with the lack of hormones. Now that being said, folks can get palpitations from many sources, not just hormonal issues. I'm glad you're getting good results from the atenolol. You are on a very small dose; so that if in another week or two you are still noting them, do check in with your cardiologist to see if she would want to increase your atenolol dose. Now, it is also possible that even the pill and increased atenolol will not totally take care of flashes/palpitations associated with stimulants such as wine; and what I tell my patients that as long as they are prepared for them, and they want to drink the wine, well, that's OK.
So it certainly sounds like you're getting better, and I'm glad for that-but if some of these problems persist, there are still more adjustments available.
Good luck,
Mary Jane
 
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periconcern replied to Mary Jane Minkin, MD's response:
Hi Dr. Minkin,
Just passed a full 30 days on the Gildess and 2 weeks on the Atenolol and definitely feeling better. Sleep has much improved and as long as I don't overdue carbs/sugar/alcohol in the evening, I can sleep pretty good. I actually have a nuclear stress test next week, just to take make sure the heart is good and see the cardiologist after that again and can discuss if I should increase the dose to 50 (I don't have hbp, so don't want to make it drop to low either) or be happy with what I have and give the bcp another couple of cycles. Thank you again for all your help. I hope to report back in another month as to how I'm doing.
 
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Mary Jane Minkin, MD replied to periconcern's response:
Dear periconcern,
Thanks for the update-sounds like you are doing very well-I think you are doing everything correctly. Now most important followup: once you get good and comfortable, don't let anybody try to pull you off of any of these meds right away! I strongly discourage folks in general from going off of birth control pills (for control of perimenopausal symptoms) during the summer; everyone should wait till October to give that a try-and there is no hurry to get you off, once you're comfortable.
Enjoy the summer!
Mary Jane
 
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periconcern replied to Mary Jane Minkin, MD's response:
Hi Dr. Minkin,
Go off?...ha, that's funny..if these work for me, you'll have to pry them from me when the dr writes me the script for estrogen pills and prometrium ...lol (though who knows, if I stop in early 50's and find I passed the worse of it, that would be a dream)Well, was doing good, but when I started my next pack, accidentally took a placebo pill the 1st day (my bad, it was dark in the kitchen) and I didn't realize it til 3 days later. By then, my ovaries where doing that thing others talked about, where I could feel them trying to ovulate (I noticed I started getting that "feeling" back on 2011, when I 1st started skipping periods)getting some minor abdominal discomfort, but no period yet. When I realized what I did, I doubled up the pill, but that was 3 days later, so not sure if that will help, but starting yesterday, I almost feel like I did back at the beginning, yuck. I'm sure since I've only been on this new dosage 5 weeks that maybe I'm still trying to ovulate? and I know since I have had some good days,I have to give it more time. I'm just hoping by the end of this pill cycle (I am skipping the placebos, until month 3 or 4) the bcp really starts taking over whatever it is my ovaries are still trying to mange. I can't believe these 2 little things the size of walnuts have so much power..lol. Had I realized I was flashing with wine, I would have run to the dr's office right there and asked for something. When you said more adjustments, other than increasing atenolol (25 seems to have my bp from low to low normal) is asking for a 30 mcg bcp out of the question maybe at the 4 month mark? I am about 50 lbs overweight, so I guess I make more estrogen than a thin woman? I love biking and walking but the heart palps were making it difficult. I've never had this prior to August of last year. I'm hoping that by this year's mark, the pill and the atenolol have put the kabosh on all this nonsense.
Thanks again for all the infomation
 
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sherricl replied to periconcern's response:
Hi Pam, I don't know if you are still here but just wondering how things went for you as far as your symptoms? I am on microgestin 1/20 (which I imagine is the same thing as what you were taking). I am 49; will be 50 in August. I have symptoms of anxiety, doom and gloom, weird body feelings, appetite changes, irregular and heavy periods. Just wondering how the BCP worked for you?
 
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periconcern replied to sherricl's response:
Hi Sherricl...
It took about 6 months and I've switched to the bcp pill I 1st took when I was younger and it's helped a lot. I can sleep really well now, my heart palps have been reduced immensely, I can have some coffee in the morning and wine at night. I take continously, so no more periods for me, but I still had a spontaneous one after 3 months. I still get more sweaty than I used to, but all in all much better and I plan on staying on them for a few more years and we'll see how it plays out. I found a really good dr at a local university and she is reassuring when she says she's seen a lot of this. I'm thankful this option is out there!
Good luck!
 
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An_254570 replied to periconcern's response:
Hi Periconcern and Sherricl...
Thanks for sharing your experience with us. I am on low dose BC pill for 3 month, ( Loestrin Fe 1/20 ), feel much better than without it, but still have ups and downs. Like 1 week is perfect, but the next week I feel anxious, don't have appetite, have palpitation, shaky hands.... and feel like the hormone doesn't work... I take it continuesly too...
Did you take some other supplements, like Mg, vitamin B complex, etc. Please keep update me, it helps a lot I am not alone, and will feel better )))) Thanks !


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