Birth control: Pill alternatives?

thesuninherhead

Yesterday I went to a doctor to discuss the bizarre numbness that I experienced the day before, presumably as a result of a migraine. When the doctor found out I was on the pill, he was insistent that I should never have been offered it to begin with, and couldn't believe that my migraines have actually decreased whilst on it. He said that even so, the risks are too high for me to be on it to begin with, and told me my alternatives were either depo or the implant, neither of which he seemed to like very much. He also said that our other options were to move our family plans up, or abstain (yeah... I don't think so!). He said I should be getting off the pill asap. 

 

Anyway, I'm going to read some medical journals today and try and educate myself on the issue so that I can form my own opinion and possibly see someone else for their thoughts, but in the meantime: to girls out there who aren't on the pill, what do you use? And to girls with migraine with visual symptoms, have you ever been on the pill? 

TurtlesAllTheWayDown

I haven't read the responses, but there's something called the mini-pill or progesterone-only pill. You HAVE to take it at exactly the same time everyday - even missing by 15 minutes could make a difference. But regular pills are a combo of progesterone and estrogen and estrogen is what triggers migraines. So the mini-pill won't cause migraines.

And of course, a copper IUD. They last 10 years, though, and if you're planning on having kids within the next 3 it might be more hassle than its worth.

The shot and the implant still have hormones, but I'm not sure which kind.

You should consult another doctor because it sounds like he doesn't exactly know what he's talking about.

pooh8402

re: Implanon, it must be recent that it was introduced to the market. I was told only months ago you couldn't get it in the US, by 2 different WHNPs. Norplant IS the name of the implant that was discontinued.

thesuninherhead

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_birth-control-pill-alternatives?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:d3d45790-937d-4371-8b39-7a25013ceff8Post:dd5a2552-dabb-4c4c-b089-ea9b090f9d9a">Re: Birth control: Pill alternatives?</a>:
[QUOTE]For the record, the concern about pills and migraines is not because it can make migraines worse (though they can), but because it increases your risk for a stroke.
Posted by JK10910[/QUOTE]

The funny thing was that he was emphasising the fact that he was surprised that I truly experience migraines yet haven't had worsening of them whilst on the pill- it's actually been the opposite. He mentioned the risk of stroke, but that didn't seem to be his primary concern. In any case, I'm going to spend some time on Ovid today and see what research is out there around the issue, as the doctor was pretty old-school.

JK10910

Yeah, it definitely can worsen migraines, depending on the person and the pill and what have you, but obviously strokes are more important.  FWIW, I've been on several pills (including Yaz for 2 years, oh noez!) and I haven't had a stroke yet   Migraines be damned!  I went off the pill for different reasons.

thesuninherhead

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_birth-control-pill-alternatives?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:d3d45790-937d-4371-8b39-7a25013ceff8Post:6e7c6952-03f7-4d42-ba10-0e7f94fa08d6">Re: Birth control: Pill alternatives?</a>:
[QUOTE] the depo shot can have some side effects, the biggest one being bone loss and fragility. in the US, women have to sign a form when they get depo saying that they have been informed of the risks. you only get it 4 times a year, and it's a depot medication, so it is huge and hurts like the dickens. it will lighten your periods, or stop them completely (or make you bleed constantly). fertility can return immediately, or it may take a year to return.
Posted by pooh8402[/QUOTE]

See, Depo isn't really a good option for me given that I've previously been diagnosed as having osteopenia (this may have improved since then, but I'm unsure) and Nick and I are thinking that we will try for babies at the end of the year/start of next year, so having fertility issues wouldn't exactly be ideal, either.

Anyway, off to do some research- merymac, I tend to agree- I am not sure how good this doctor was, so at this stage I'm going to do some research in medical journals, and if I come by much that seems to contradict what he was saying or make it less black and white, seek out a second opinion.

ExpatPumpkin

I've tried Yazmin (BCP) and a copper IUD.  Neither agreed with me, unfortunately...  I really loved the IUD but couldn't handle the side effects.  

The good news is that most women don't have any problems with the copper IUD, so I'd seriously consider it if I were you.  And it's actually more effective than the pill or condoms

Right now, I'm charting AND using condoms EVERY TIME.  We're not ready for kids just yet, and don't want to take any chances.  I wish my body liked the IUD

thesuninherhead

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_birth-control-pill-alternatives?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:d3d45790-937d-4371-8b39-7a25013ceff8Post:3b7a0b6d-9eaf-40e1-80ea-1ab408c45280">Re: Birth control: Pill alternatives?</a>:
[QUOTE]Yeah, it definitely can worsen migraines, depending on the person and the pill and what have you, but obviously strokes are more important.  FWIW, I've been on several pills (including Yaz for 2 years, oh noez!) and I haven't had a stroke yet ;)  Migraines be damned!  I went off the pill for different reasons.
Posted by JK10910[/QUOTE]

I'm on Yaz right now... eek!

But I've been on other pills consecutively for about 8 years now. My migraines were worse before I started taking them, and have almost disappeared in the last couple of years since I've been taking three packs consecutively and thus only having a period every 2.5 months. Also, with better eating and keeping hydrated, I've kept the migraines at bay. Confounding effects, but I do think that the pill has helped me get over them rather than hindered. The risk of stroke is still higher for me being on it though, obviously, although I'd never been told that by a doctor before yesterday.

Sunshine9463

Late to the pill-party, but FWIW:

I've been on Depo for over 5 years and absolutely love it. I take calcium supplements because of the bone density concerns, as recommended by my OB.

I looove not having to worry about taking a pill every day (I'm absentminded like that,) and not having a regular period (I get mine once every three months, a week before the next shot is due) is fanfreakingtastic.

[Deleted User]

i have an iud, but hopefully h is getting snipped soon.

JessAndTrav

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_birth-control-pill-alternatives?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:d3d45790-937d-4371-8b39-7a25013ceff8Post:e78e48ad-5f76-46eb-8827-94a9c0f2f637">Re: Birth control: Pill alternatives?</a>:
[QUOTE]First off: In Response to Re: Birth control: Pill alternatives? : ^ that is not true at all. You can break it down into hormonal, barrier and other. Hormonal: progesterone only "mini" pill, Depo shot, implantable Barrier: condoms, diaphragm, cervical cap, female condom Other: fertility awareness (with or without barrier), copper IUD, spermicide, withdrawl I would be here all day if I went in the pros and cons of all of them. I think Planned Parenthood's website has a chart that details all of this.
Posted by bel138[/QUOTE]

I should have elaborated. Out of barrier methods, that one is the closest to the pill. They're what, 97-99% effective? The pill is 99%?

pooh8402

condoms are only about 98% effective, with PERFECT use. with actual use, they drop to about 85-88% effective.

http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=416&Itemid=336
http://www.americanpregnancy.org/preventingpregnancy/malecondom.html

back when I was an RA, I have sat in and taught many programs on preventing pregnancy.

JessAndTrav

I wouldn't ever do the IUD before having kids. I hear that a delayed side effect to the IUD can be having troubles when TTC.

I don't chart because my cycle isn't a cycle at all. It's bi-polar or something. For a few months it'll be regular, and then I'll go 6-8 months without one. I produce too much potassium, which doesn't mix well with estrogen. I remember that when we found this out, the doctor gave me a hormone (non-bc) to balance the overload of potassium, and it started with a pro-. It was very quite possibly progesterone. If it was, I'm going to talk to him about getting on that form of BC.

[Deleted User]

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_birth-control-pill-alternatives?plckFindPostKey=Cat:Wedding BoardsForum:9Discussion:d3d45790-937d-4371-8b39-7a25013ceff8Post:ed5889bc-f6a4-423f-b69f-081defe86be1">Re: Birth control: Pill alternatives?</a>:
[QUOTE]I wouldn't ever do the IUD before having kids. I hear that a delayed side effect to the IUD can be having troubles when TTC.
Posted by JessAndTrav[/QUOTE]

this doesn't concern me in the least.

but, i don't believe that is true for the copper one...?

m983

There are two issues to address here. First, is the worsening of your migraines.  Second, is the avoidance of stroke.  thesuninherhead- it sounds like your doctor is either not communicating with you well or is an idiot.  I'm guessing the second with his suggestion to change your life plans just because he hasn't does his own research.  Consider going to a neurologist followed by a gynecologist. 

So, worsening of your migraines: many women's migraines are complicated by the fluctuating hormones of menstruation cycles.  Many pills (e.g. cyclins) also have cyclic hormone levels and can make migraines worse.  Other hormonal birth control (e.g. Depo or taking some pills continuously) keeps hormone levels constant improving migraine.

More important for you to consider though, is the increased risk of stroke with some hormonal BC.  This is very specific to ESTROGEN therapy, not included with progesterone-related therapies.  Thus, Depo is fine (has other risk factors mentioned above).  Minipill is also fine (but can make some migraineuers worsen due to sensitivity in hormone levels if you can't take it at the exact same time every day).  Your doctor mentioned an implant which is also fine, but he was probably talking about bars (implanon) that are inserted just under the skin in your arm (sounds creepy to me but lots like it).  IUDs are a great option for migraineurs because they are a highly effective form of birth control (as effective as getting your tubes cut, but easily reversible).  The copper form has no hormone.  Mirena is progestin-based so won't increase risk of stroke and may have the added advantage of diminishing some hormonal-cycle related migraines (not clinically proven but logical and works for me). 

IT IS REALLY IMPORTANT TO NOT BE ON ESTROGEN BIRTH CONTROL!

Good luck in whatever you choose- this is a completely manageable problem!

thesuninherhead

Thank you, very knowledgable lurker! You're right that there are two issues here, and that I need to discuss both the changes in symptoms with the migraines AND the birth control issue with someone knowledgable in the area.

I've made an appointment to discuss the situation and get any appropriate referrals from a women's specialist GP next monday. Having reflected upon the visit to this other doctor yesterday, I really don't feel that his approach was appropriate and I think his views are rather outdated. You're right that he was talking about implant bars rather than IUDs- he didn't actually even mention IUDs at all, which suggests to me that he's not particularly up-to-date in regards to birth control to begin with... thus, I'm thinking a second opinion with someone else is a good idea. Thanks for your advice!

sucrets4

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_birth-control-pill-alternatives?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:d3d45790-937d-4371-8b39-7a25013ceff8Post:ed5889bc-f6a4-423f-b69f-081defe86be1">Re: Birth control: Pill alternatives?</a>:
[QUOTE]I wouldn't ever do the IUD before having kids. I hear that a delayed side effect to the IUD can be having troubles when TTC. I don't chart because my cycle isn't a cycle at all. It's bi-polar or something. For a few months it'll be regular, and then I'll go 6-8 months without one. I produce too much potassium, which doesn't mix well with estrogen. I remember that when we found this out, the doctor gave me a hormone (non-bc) to balance the overload of potassium, and it started with a pro-. It was very quite possibly progesterone. If it was, I'm going to talk to him about getting on that form of BC.
Posted by JessAndTrav[/QUOTE]

Ah, but charting will help explain what's going on with your body.  I've always had messed up cycles and although I only charted 2 cycles before I got pg, charting helped me predict what was going on.  Plus, it gives more info to the dr if you're having issues with irregular cycles.

LesaBear

I get killer migraines and ocular migraines. Did you see a neurologist that specializes in migraines? If not I wouldn’t take this too seriously until you do. My doc told me that the patterns differ from person to person and that for me birth control won’t affect it much because I first had migraines before I started my period (I won’t go into why, just trying to give you some background).   I was on the pill for 5 years and my migraines varied greatly throughout that period (mine are more due to stress and sleep).

I would see a specialist if you can’t bear it but be sure to discuss the BC options with your gyno too. And beware many migraine medicines cause birth defects.

SunnyCanadian

II've only had 3-4 migraines in my lifetime, but the last one I had made me go to Emerg. because I thought I was having a stroke! My left arm and cheek started to go numb and tingly while I was out for lunch with my coworkers. Then I lost the ability to put words together, my coworkers thought I lost my marbles!

They rushed me to Emerg...during my time there, my vision went wonky, and I started to get a mild, dull headache. When I finally saw the neurologist, she told me what I experienced was "migraine with aura". I thought it was a little weird as my headache wasn't that bad.

But when she found out I was on the pill, (actually the patch), she told me I needed to stop it immediately and recommended either the mini-pill or Depo. She explained that I was at higher risk of stroke because of my migraine with aura symptoms.

So now I take the mini-pill. And its a pain in the a$$ to remember it at the same time every single day. I can't "delay" my period like I could with the pill, it just comes whenever. The pill helped my skin clear up, the mini-pill not so much.

But I don't want to have a stroke! And my friends have had some horrible experiences with Depo and IUD's so the mini pill  (or condoms) is my only option.

Good luck!

stephaniehall

I saw that someone had mentioned the implanon. I have had it for about 6 months and love it! It's a small rod that is inserted in your arm...is good for 3 years or you can have it removed if you would like to have children sooner than that. check out implanon-usa.com for more info...def. worth asking your doctor about

goheels05

I'm charting using Taking Charge of Your Fertility by Toni Weschler.  I was on Yaz and 2 other prescriptions unrelated to prevention of offspring, and I decided that taking 3 pills a day was more than enough.  I'm so glad to be off the pill.

Now, TCYOF really is supposed to be as effective as BCP if used correctly.  After you read the book, it's pretty easy to consistently follow the advice.