Depo-provera Vs. Oral Contraceptives...

[DancingLight]

When I did a search for Depo Provera, I only found a couple of posts on it--one from Laura that she knew folks who had good luck on it and one from Becky, who had a horrible experience on it.

It seems most folks who have issues with their periods (and that is most of us it seems!) are on oral contraceptives to deal with their symptoms.

Currently I am taking the pill--Aviane--continuously to suppress my periods. I have been doing so for probably at least 3 years now and have NOT had a period at all b/c I get so sick and no doctor wanted me to try. However, my ANS doc would definitely like it better if I was able to have a period sometimes...but I have been too unstable to try.

Now, I am feeling a 'bit' more stable, and also am having a LOT of breakthrough bleeding--more than just 'spotting'. It's more like filling the toilet with blood, and when I wipe having clotted blood like when I would have a period. I have to wear pantyliners all of the time (which is fine, but irritating to the skin).

My ob/gyn said that the longer you suppress your period without allowing yourself to have a period every once in a while to shed the lining, the more breakthrough bleeding you will have. I am getting to the point where I don't care for this much bleeding, whereas before I didn't care.

Anyways, she suggested that

1. I try to have a period.

2. Was very interested in trying Depo-Provera. She said that most of her patients after the first three months have no periods.

MY QUESTIONS:

Any opinions on this? Any experiences?

I will be speaking with my ANS specialist on Thursday to get his take.

What I want to know is since so many of us have had success with the pill is this b/c of the ESTROGEN and PROGESTERONE....

Depo is a PROGESTERONE only medication. So, I was wondering if part of what makes us feel better and regulate our hormones ANS-wise is the ESTROGEN too...

Anyone up on this stuff? As I am not!

Any help would be much appreciated!

Thanks!

Later alligators!

Emily

[Guest dionna]

i want the shot so bad! but my gyn won't let me. they are too afraid that it may mess me up even more. with the pills i can just stop at any time but with the shot it will take 6 months.

i am taking ortho- tricyclen. i feel better but i am like you with the bleeding. i just started it and have completed 2 packs but i have bleed for a month now and it is so irritating having to wear the panty liner as you said. and the nasty clotting. i just started on my third pack yesterday so hopefully the bleeding will stop soon. if not i am just going to quit taking them because i get so anemic when i am bleeding. i am taking my iron pills but id rather not have to.

with depo... i know a few women who have shared their experiences with me. one girl had no period at all on it but ended up pregnant. another girl had no period at all and when she went off, she had heavy bleeding for 2 months after, resulting in her having to go back on it- she just had gotten married and wanted to start a family but couldn't. another girl was on it and bleed the entire time.

i guess it would just depend on the person and how her body wanted to act.

ESTROGEN and PROGESTERONE.... i will have to look into that. it seems very interesting to me.

dionna

[Sophia3]

Emily

Never done the three month Depo shot but it can cause SEVERE depression and I was sensitive to progesterone in birth control pills for moods.

And at my age, mood swings naturally!

This here is one of those things you have to look at this way...if you keep on BC pills, but go off long enough to have a good "shedding", that might help the spotting.

If you make the decision to try the DEPO, remember, the side effects can last THREE MONTHS!! If you can psyche yourself up that it will help but be PREPARED if it makes you feel worse, and have emotional help to get you thru the rough times. It can take lots of self talk and distraction but something YOU MUST consider.

We are all different, thought.

Heck I take SHORT ACTING everything meds so if it hits me wrong, I won't be sick for say, 24 hrs. Good luck with your decision. This female stuff is no easy task to decide upon.

[DancingLight]

Thanks Sophia--I was hoping you would chime in. I still wonder though about the estrogen component...And, yes, you are right, the three month commitment is scary!!!! i'm not even sure my doc would go for it. we've had waaaaay too many scares with me.

Dionna--thanks for chiming in...best with the b/c...it might settle as you are only just starting with pack three. rule of thumb is three months to decide whether the pill you are taking is the RIGHT pill for you and give time for side effects to settle. after three months, if side effects haven't settled....time to perhaps consider a different pill or different option, like the depo that you want!

em

[lthomas521]

The thing I don't like about depot injectables is that they stay in the body for a very long time, which is a problem if you have an adverse event. In general, depot injectables are useful in situations where patients can't be relied upon to take their medication on a daily basis (e.g., some antipsychotic drugs) or if a single injection would replace a whole lot of daily injections (e.g., the pituitary suppressing drug used in patients with prostate cancer).

If you want progesterone-only contraception, there's an effective progesterone-only pill called Cerazette, but it isn't available in the United States. You can get it in Canada. Also, there's a new implant, Implanon, that's just becoming available in the United States. If you have a problem with that, you can have it removed.

There are plenty of combination estrogen-progestin contraceptives around, from ordinary pills to the vaginal ring. I wouldn't recommend the patch, because it produces higher blood levels of the hormones. The vaginal ring provides the best cycle control--less breakthrough bleeding.

No one really knows whether estrogen and progesterone are involved in POTS, although most people with POTS are premenopausal women.

[Dizzy Dame]

Hey Em,

I know what you're saying with breakthrough bleeding. I've been supressing my periods for 6 months now and occasionally will bleed very heavily for a day or so. It's very annoying...to say the least.

I tried the depo shot before I began taking pills. However, I bled for 6 months straight when I was on it, and since the shot lasts for 6 months, there wasn't really anything anyone could do about it. However, my case was pretty rare from what I've heard...most people I know who've tried depo didn't have that problem.

[Sophia3]

Emily

While you are much too young to worry about perimenopause or such things, I am having a partial hysterectomy (leaving ovaries and we hope to have a supracervical hyst, done with a laparascopic, leaving cervix, but I need tests on monday to make sure that is ok)

I am choosing to KEEP MY OVARIES even though the fluctuation makes me ill. The hypovolemia WORSENED by HORRILE menstrual flooding (Changin Super Plus Tampons every hour or 90 minutes for 48 hrs!) we hope it may help with removal of the uterus, the worsening fatigue I feel for a couple weeks a month. I have tried to fix this myself for 10 years. My way or ignoring the problem, ain't working anymore.

I am a big believer in Dr. Susan Love's theories, though due to her lifestyle and maverick ways, she is often not given much attention by conservative doctors in this country. I think she is very astute in many of her theories and what she has seen in clinical practice. But I read an online chat with her years ago in Power surge, I think where she commented about the Ovaries: We do NOT know what all they produce so to yank them out is wreckless unless absolutely necessary.

Here is a blurb somebody said on this theory, from Dr. Susan's Love Hormone book.

One of the reasons that Love's book hits the mark is that she is going through what she calls "the hormone dilemma" herself, complete with hotflashes, nightsweats and frustration with the medicalization of menopause. We are able to learn with her, not just from her, as she passes on revelations in her research. One such fact is that the ovary serves in a little understood way long after the reproductive years. "In fact," she says on page 9, "making eggs isn't the ovary's whole function, any more than reproduction is a woman's whole function. The ovary is more than just an egg sac. It's an endocrine organ-an organ that produces hormones. And it produces hormones before during and after menopause." She makes it clear that we should definitely think twice about trading our ovaries in (through a hysterectomy) for a lifetime of hormone therapy that can't duplicate the ovarian endocrine symphony.

It is due to this statement and women my autonomic/endocrinologist has seen ruined by yanking out ovaries, that made me decide to keep them. I am 49 but I am keeping them provided they look healthy upon viewing.

So, I was on birth control for years and then got a tubal ligation in about 1986 or 87. in 89 the insomnia started and by 90, the insomnia fatigue was so bad I had to quit work. While true, in hindsight, I have had autonomic problems since birth (once we connected the dots) the post tubal ligation problems and a cluster of serious stressors could've played a part n the downhill slide of the ANS problems.

In some countries, doctors no longer DO TUBAL LIGATIONS due to post tubal ligation syndrome.

But when you read books or articles, about Post Tubal ligation "syndrome", it's hard to separate junk science from the real deal. Much like MOST of research today as we need to know who's funding a study and the political/ideological agenda behind it but I digress.

[Suzanne]

Thanks for this thread, as I am trying to figure it all out too. I have not had the injections and would not due to the risk factor. It is bad enough having a bad reaction to a med, without having it in your system for 3-6 months.

At the moment I am trying to find a bc that will stop the bleeding. I seem to be taking higher and higher doses and this worries me and I still keep ovulating. I keep taking the pill and have a breakthrough bleed for about 2 weeks, then it stops for a few weeks. Whilst it is a pain having to use liners, I think it is a small price to pay for not having the drop in bp, the mood problems and the period pain.

Thanks for sharing everyone. Hopefully, between us all we can figure it out. My doctor has no clue!

[wareagle]

Hey Em..I'd be cautious about the shot too...can you just do the period every three mths or so with your pills? I do that now...take contiuous pills for 12 weeks then let myself have a period. Is this something you've already tried or is it just not possible for you?

Speaking of b/c pills...anyone know of any that DON'T have lactose in them? (I'm assuming yours don't Em..going to check them out). I'm trying to go dairy free and looked up my pills and of course they have lactose in them...along with all of the others I've looked up! Is the amount of lactose small enough that it shouldn't effect me?

Good luck Em..let us know what you decide!

[Jan]

I do the non stop pill. I go off it when I start to bleed rather than spot. I have found that if I get a "real period" now and then, I can go about 85 days with no spotting.

What I do is when I start to bleed pretty hard, I go off the pill for two days, I start to get a migrane, but then it will get better when I go back on the pill. If I go off three days, I get a horrible migrane. The two days is enough to shed the lining if I am bleeding to begin with. (the period will last about a week and will occur mostly after I am back on the pill)

If I go off the pill when I am just spotting, or not bleeding at all, then the two days off isn't enough to shed the lining and I end up spotting forever, until I go off and get a real period.

My doctor is the one who told me to only go off for two days, that should be enough.

I find spotting just a real pain, especially since I try to swim twice a week. It isn't enough to use a tampon so dealing with a panty shield in the locker room is a pain.

[Laura]

Hi Em,

I had previously posted that I've some friends on the Depo that absolutely love it and it's been wonderful for. They are still raving about it. However, I don't know what kind of reactions people with POTs, medical conditions, or medicine sensitivities may have to it and as the others have said, it stays in the body a long while. Whatever adverse reactions you may have from the Depo-provera may take a while to subside because of this. It's definitely a good thing to consider when you are weighing your options.

It may be enough for you to stop the pills and have a full cycle as your doctor suggested. That does work very well for some people, though you should be prepared... sometimes when your cycle does come after not having it for quite a while, it can be a little miserable. Might feel like "the worst period ever" but if you are prepared for that, it can make things a little easier!

I had a bit of info on estrogen/ progesterone that I was going to PM to you, but your inbox is full. I've managed to figure out how to save the message, so I'll try to send it off to you sometime later! Take care! Laura.

[bttrflyamby1981]

I was on the depo.......never again! It did a number on me. My doctor agreed that I couldn't stay on it. This was a while ago though, before I got sick. I remember being in pain a lot while on it. That and I gained 20 pounds. I did have a bout of depression on it as well.

The pill worked better for me. Though again, I have not been on anything since I became ill.

Best of luck,

Amber

[DancingLight]

Thank you all for your answers.

My gut feeling is to try to have a period, even if it is only a couple of days off of the pill, and not the full seven.

I'm pretty leary of doing Depo right now given how unstable I am and need to be focusing on my Lyme meds, not changing my b/c.

WE--I am not on a lactose free pill. There are some meds it is virtually impossible to find without lactose, and you have to way the pros and cons of that. First, I would just do the dairy free diet and not worry about the meds. Most poeple are honestly not that sensitive that they need to worry about it in their meds. If you start to see improvement on the diet and think you are that sensitive then you could look into dairy free meds. I do take a couple of meds with lactose b/c tehre are no other options. Plus, it's not worth switching pills if you are on one that works well with your body...b/c you don't need to mess with adjusting to a new pill if you like the one you are on! Just my two cents worth.

Laura--I'll go clean out my PM box a bit now! Sorry. It's always full. I apologize.

Emily

[jenwclark]

Speaking of b/c pills...anyone know of any that DON'T have lactose in them? (I'm assuming yours don't Em..going to check them out). I'm trying to go dairy free and looked up my pills and of course they have lactose in them...along with all of the others I've looked up! Is the amount of lactose small enough that it shouldn't effect me?

Em's probably right that you don't need to worry about that amount of lactose, but if you want to avoid it, Nuvaring might be one possibility.

[becky]

Hi Em,

just my tuppence worth, i was on depo for six months (two injections) the weight gain and depression where just two of the effects. at first i had no bleedin and then i had constant bleeding. when i stopped it it took over a year for my body to get back to normal and it's still not right nearly two years later.

The nurse at my new practce said she would never suggest anyone with my condition to have the depo because it's like going thru an early menopause! she's not even that happy about me being on the pill but i take that constantly for three monts and then have a period because i just cannot cope with periods, i just constantly feel like i'm going to pass out - it's ridiculous!

i would say think abot it really hard and long because it's not something that can be easily fixed if your ody is sensitive to it (sorry about the spellin mistakes - my computer isn't working properly!) it stays in your bdy for at least three months. i only didit because the doctors told me it was y only choice and i didn't readup on it before i took it - in fact i didn't even get given a leafet for it til the second time, somthing that i am so careful about now.

good luck with whatever you decide.

bebs x x x

[Kitsakatsa]

I was on depo for 8 years and loved it. Then the onset of POTS began. My doctors and I have been having the debate about whether depot actually caused POTS. Two say yes, two say no. I've been prohibitted by all to go back on it, but I have endometriosis with severe cramps; so I've pursued some therapy. I tried progesterone in the pill form for 3 days and had miserable POTS. I'm currently on Ovral and it stops menstruation just like depo, is a pill that can be stopped, and so far has worked beautifully with POTS and my other meds. It is a dream and its like being on depo again. You may want to talk with your doc about considering this. I don't take the placebos and like you- don't want to pursue a hyster.

Best of Lucky, Ducky!

[morgan617]

I found working in an ob/gyn office, it was either love or hate with depo. NO in between.

Have you thought about the new pill that's out that gives you a period every three months? Technically, if you are taking any kind of progesterone, you won't get a build up in your uterus causing you to have excess bleeding. (Women who have had hysts, don't as a rule take progesterone because of that) But technically and our bodies just don't jive that well!

But since you tolerate the pill okay, you might think about that every three month one. Even with very healthy women, it's always a trial and error, so I was always glad we had samples!

Good luck! morgan

[Sunfish]

em et al -

i think i've written this before in other posts but figured i'd chime in as my "ending" is a bit different now.

the "new" pills morgan is referencing - if i'm thinking of the same thing - is nothing other than a marketing change, i.e. officially telling people they can take the pills continuously for several months....essentially the same thing that myself & many others on the board have been doing for ages. and the same thing that you've been doing to an even greater degree

i took levlite for years but skipping the "blanks" to only have my period only 3-4 months on my own schedule. while still giving me a bad day or two my periods on the pill don't give me nearly the BP/dizziness issues as when i was entirely "au naturale" aka without pills. for me the worst days were always a day or two before my period...not PMS-type stuff but rather my syncope/BP issues. that's how i used to know my period was on it's way....i'd start passing out (as i was symptomatically MUCH more controlled those days).

two years ago i was then switched to seasonale after i had some abnormal ovarian cysts as it was a bit of a higher dose pill. the fact that it is marketed for three month "blocks" didn't really change a thing b/c that's how i'd been doing it for ages anyway.

today we (my PCP & i) decided to try nuvaring b/c of my GI absorption issues...we're trying to switch as many of my meds as possible to non-GI routes of intake/absorption. i'll be starting it next week & can report back then. i'll still be using it continuously with a break/bleed every 3-4 months or so at my discretion/timing. i'll likely be absorbing more of the actual med/hormone since we'll be bypassing my GI tract so that may or may not affect things for me.

the reason i do "allow" myself a period every 3-4 months is that it keeps me from spotting/bleeding at all in between. essentially as soon as my body decides to start spotting/bleeding i soon thereafter give the pill a break for a few days. my docs have all been supportive of this. with the ring i'll probably hold out until the 3-week ring cycle is over to allow a period.

hope this helps...

melissa

p.s. i would never try the shot for the same reason others have mentioned....once it's in there's WAY too long of a period to rid your system of it if things don't go so well.

[DancingLight]

Sunfish,

I will be very interested to hear how the Nuva Ring works for you!

Em

[morgan617]

The Nuva Ring had just been released when I left the office, so i will find it interesting too.

My gyn put me on an estrogen patch as opposed to the pills, as he feels I don't absorb meds well either. However, I really don't tolerate adhesives. So back on the pill, just at a higher dose. I am now thrilled to be spiraling into the world of menopause.....woohooo...as soon as you get those pesky hormones under control with a pill or ring or patch, you become peri menopausal, or menopausal.

You are right Melissa, you could do that with any pill, I just found for some reason many doctors were hesitant to mess with pills not indicated for use that way. They just really pushed the depo to stop periods. But then, they didn't have deal with it, i guess....

[DancingLight]

I haven't had any problem getting doctors to agree to suppress my period. Dr. Grubb jumped right on the idea, my ob/gyn was comfortable with it (although not thrilled with the idea of suppressing it ALL of the time, like I do) and my current ANS doc was good with it too...but also would have preferred 'breaks' for periods. But, then, when they realized how sick I was they weren't willing to throw a period into the mess of things...

Now, though, I think I may have to give a period a shot b/c of soooo much breakthrough bleeding and spotting.

I've probably been suppressing completely for three years now at least.

Morgan--I caught one thing you said and was wondering about it. I always thought that if you suppressed your periods with the pill, you would simply re-absorb whatever you didn't 'slough off' during a period. That is why I was surprised when my doctor said that the longer you suppress without having any breaks for periods, the more breakthrough bleeding you will have. Why is that? Do you have too much to re-absorb or something? I'm confused! (nothing new, right?)

Em

[jenwclark]

I realize it may be a bit late to throw another question into this thread, but here it is anyway.

I've been on Nuvaring for a year and a half, it's the first time I've been on birth control, and I started it specifically to try to lighten my periods. That part has worked -- my periods are much lighter and less incapacitating than before. But they're also less predictable and often longer. The pattern seems to be that at some point in the month I start spotting, and I keep spotting more and more heavily straight through until I take out the ring and have a full blown period. The thing is, this is the second month in a row I've started bleeding within a week of putting the ring in. I've talked to my doctor about skipping periods, but I'm not quite sure what would happen if I tried, since it seems my body really, really wants to bleed.

Don't get me wrong, I'm still much happier than I was without the ring, but I'm curious why this is happening? Has anybody else had their cycle become more irregular on the pill than off?

spike

[morgan617]

Emily, the progesterone suppresses the buildup on the lining of the uterus. All that is, is the uterus building up a "padding" for a fertilized egg. If there is no fertilized egg, you have a period to get rid of it. The pill has progesterone to help prevent that build up, but it can't stop it altogether. It's why most women on the pill have much lighter periods though.

So after a period of time (no pun intended ) Your body will eventually still have enough of a build up to start sloughing it off, hence, spotting or bleeding.

That is what happens to women who are menopausal and still have their uterus, but don't take progesterone. Even tho they are no longer ovulating, if they are taking estrogen, their bodies will still build up that lining. After awhile, it will get congested and they will spot or have postmenopausal bleeding. So even post menopausal women taking estrogen, must take progesterone too, as long as they have not had a hyst.

If a post menopausal woman stops hormones, they will not usually have any more problems with bleeding. Many researchers believe not allowing yourself to ever have periods may increase your chances of uterine cancer, hence, they want you to have a period once in awhile. In post menopausal women this is much more of a concern. It is very uncommon in young women.

And as has happened with you, you can only go so long before your body is going to do what nature tells it to do. Which is get rid of that stuff because there's no fertilized egg. So it doesn't reabsorb, it just doesn't build up as quickly because of the progesterone. It doesn't allow it to, to a large degree, but over three years, you are going to have some build up and I would assume your body is doing what it would do naturally, if you weren't on the pill.

I hope that makes sense. In post menoausal women, they produce so little estrogen and progesterone, it just doesn't matter. Ther's not enough hormone to make that stuff to line the uterus. In you babies though, it wants to do what it's supposed to.

My guess is you will continue to spot and bleed until you have some full blown stuff or you end up with a procedure to clean it out. It variable, so hard to tell.

So to make a long answer even longer, nope, it doesn't reabsorb, it just doesn't become, or it does at a fraction of the rate,....it's suppressed. hope that helps...morgan

[DancingLight]

THANK YOU ALL! This thread has been incredibly helpful to me.

I have no desire to try the Depo at this point. But, will consider, when I feel 'stable enough' trying to have a period.

Morgan---thank you, thank you, thank you! I'm losing my knowledge base and it's showing. I used to LOVE, love, love this stuff and wanted to be a nurse practitioner and do sex education! I did work at a family planning clinic, do sex education on campus, etc. etc. but doing that you don't really learn all the ins and outs of things like you know as a nurse. It's more 'this is how you use the pill', ya know?

I know it's controversial to take the pill for so long and suppress for so long...I think we all felt caught between a rock and a hard place and voted to suppress...but I know my ANS doc would be MUCH happier if I was able to at least have a period a couple of times a year.

I guess my body is telling me something, eh????? Maybe sometimes I just want to block it out that I even have the capability to fertilize an egg b/c I just don't see myself ever having kids...ya know? So suppressing my period is a way of avoidance on top of the actual reason to do it out of absolute necessity...

Spike---is it possible that the dose of hormones in the Nuva ring is too low for you? And that is why you are spotting so much inbetween? Or perhaps it is just not the 'right' pill/ring/patch for you. It can take some trial and error for women to find a pill that suits them best. Since you're not skipping periods and still having breakthrough bleeding that can mean, from what I understand, that the dose of hormones is too low for you? But, I may be wrong on this, as I thought I was reabsorbing what I didn't slough off! Oops!!!!

Em

[Guest sonotech]

Emily,

I have never had the Depo injections because my GYN refused to try it on me. Her concern was that if I had a bad response to it, then there was nothing they could do until it was out of my system in 3 months! I have also encountered patients that had lots of "break-through" bleeding which of course can be an inconvinience. There had even been patients that bled or spotted "non-stop" while on the injection. So......basically it is a gamble.....either it works or it doesn't.

The "pill" can at least be stopped at anytime, so there is more control with that.

I DID take "Seasonale" the "3 month pill" where you only have a cycle every 3 months. At first it was great and worked perfectly with no side affects, but after being on it for almost a year.......I started having CONSTANT breakthrough bleeding so I had to stop.

You might consider trying the Seasonale first and see how you do. At least you could stop using it if you had any problems (unlike the injection).....just a thought.