QuestionQUESTION: Doctor,
I recently was seen by my doctor for having a bi-monthly Period. I was prescribed a HBC to regulate my ovulation.
My problem is i have been on HBC before. They make me crazy and emotionally unstable (multiple brands). Also, i see a tremendous dip in my libido, which new research is dictating it could be permanent. Permanence or not, that's the last thing i want right now. My boyfriend is definitely amazing and doesn't deserve.abstinence for some indefinite period of time. We are already noticing a difference.
My doc says i HAVE to go on these pills because frequent bleeding can lead to Anemia. DO I HAVE ANY OTHER OPTIONS IN LIFE????!!
ANSWER: Hello Anabel from the U.S.,
Of course you have options. There are many many different kinds of BCP's out there (I am assuming that is what you mean by "HBC") and if one doesn't work well or has side effects, then you have to try a different one. BCP's vary in the type of estrogen they use but more importantly, the type of progesterone. Some progesterone's are more potent than others, leading to more emotional and other side effects, and some have more effects on libido by decreasing it, as you have experienced in the past. You need to work with your doctor and get him/her to find one that works specifically for you. Not one they automatically use. You should try each one for at least a 3 months period to give your body a chance to acclimate to it.
If you don't want to use the birth control pill there are other methods that can be used to regulate your cycles, such as just the addition of progesterone in the last 2 weeks of the cycle. This won't serve as a contraceptive method, however.
Besides being inconvenient, it is not normal to have two bleeds per month and if you bleed enough, you can develop an anemia. A chronic anemia can lead to other long term problems such as heart failure. So, you don't want to keep the way you are. But you don't mention if any testing or investigation has been done. It should not be assumed to be strictly a hormonal problem, although this is the most common. Other things like endometrial polyps, endocervical polyps, uterine hyperplasia, uterine or cervical cancer and vaginal lesions have to be ruled out. Uterine fibroids can also cause abnormal bleeding. The appropriate testing would be a pelvic/vaginal ultrasound, endometrial biopsy and hysteroscopy, in addition, to hormonal testing.
The bottom line is you want to see a doctor who is going to work WITH you and NOT just tell you what to do.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
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QUESTION: Thank you very much!!
Question for you: does adding progesterone to the last two weeks still yield the potential for the sane side effects?
Im not in need of contraception as ive been told i cant get pregnant.
Also i was tested for a lot of things. Anemia included for the very same reasons you mentioned. But i appreciate your thoroughness.
AnswerHello Again,
Taking the progesterone for only two weeks each month has a much less side effect profile than continuously, like used in the birth control pill. In addition, you can use a natural progsterone like prometrium or endometrin, which has very few side effects.
Never assume that you cannot get pregnant. There is ALWAYS the possibility if you don't use contraception. No one can predict the future.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
