onight

New to the board, hello Warning: this might get a bit long. I've now been off the pill (I was previously prescribed Diane 35 and took it for about 5 years) for about three months. I was taken off the pill because I had high blood pressure readings in the last two or so months I was on it. Diane worked brilliantly for me - I had regular periods, I've lost about 13 kg and had great skin, even my neck discolouration went away.

Now that I'm off the pill I'm still getting the regular periods 3 months on which is good, but I've noticed that my skin's gotten a lot worse and I'm steadily gaining weight. I absolutely hate it and I want to get back on the pill, but my GP is erring on the side of caution and wants me to be completely off it. I was referred to an endocrinologist to chat about my options, but she basically spent that time dismissing my concerns - she didn't believe I have PCOS because I don't "look" like I have PCOS. Duh, I've worked really hard to look like I do now??? The original doctor who diagnosed me with PCOS 5 years ago didn't check for cysts but saw that my hormone levels are whacked and said that I don't need to have cysts to have PCOS symptoms. The endo on the other hand thinks that you need to have cysts to have PCOS and thought that the diagnosis was made in error.

I'm due for a follow up with the endo in February next year and I plan to talk to her about oral contraceptive options but I want to go in there with as much info as I can about any possible options so I don't leave without knowing that I've asked her everything I need to know.

So! After that mini novel (thank you if you got to this point btw ) - what are my non-barrier contraceptive options? I'm basically looking for something that helps the PCOS, doesn't affect blood pressure and ideally won't make me gain heaps of weight. Nice skin is also a bonus. Does such a thing exist or am I just dreaming? Someone else recommended the Mirena IUD but I don't think they'll give it to me since I haven't had kids (I'm in Australia). Also the pain factor of IUD insertion scares me a bit. Thanks for any insight!

Ashleystar

Hi,

I don't know exactly what's available to you in Australia, but here are some ideas you could look into:

Cerazette progestogen-only pill (75mg desogestrel) - Taken everyday, alters mucus and inhibits ovulation. Far less androgenic than other POPs, so could help.

Implant - "Implanon" progestogen implant. Can last up to 3 years (depending on your weight.) Inserted into the arm, slow release hormones. Acts like the pill.

Depo injection - longterm method, takes longer to get natural cycles back after cessation. Not the best for PCOS as it can cause weight gain and hair loss more than other methods, and you have to ride it out.

Mirena IUS - plastic IUD inserted into the womb, which releases small amounts of levenorgestrel directly into the womb. Less side effects due to localised hormones (i.e. not going through your whole body), but insertion can be difficult and painful. Can discuss with trained doctor/nurse.

Hope this helps x

Ashleystar

They can still insert an IUD or Mirena IUS if you haven't had children. It is common practice in northern Europe (countries like Sweden). It can be more painful and tricky to do so, but you can be given pain relief etc.

I personally would opt for a pill!

All the options I have suggested would alter your bleeding pattern, making it irregular, less predictable and eventually non-exsistent in some cases. This is not harmful as the womb lining doesn't build up properly so it doesn't need to be shed regularly.

Congrats on the weight loss too x

onight

Thank you!!! I've heard that the mini pill tends to make you put on weight but I don't know if that's a general thing for PCOSers or if it's different with every woman.

Ashleystar

With any pill you can have an increase in hunger and sometimes in fat storage in your body. With oestrogen, the extra weight is due to water retention. With progestogens, appetite may be increased and the metabolism can be affected slightly. Some people are really sensitive to this. I have been on Cerazette POP for a couple of months and haven't gained weight BUT I am being careful. The trick is to realise if a pill is making you hungrier than normal, and try not to act on it. I know it's tricky though. Some progestogens are worse than others, but I think the newer ones such as desogestrel and drosperinone are better.

I know for a fact that the implant seems to cause big weight gain, from my friends who have had it. I have a friend on the depo and she maintains rather than loses any...but I know she's not trying so hard, nor does she have PCOS.

The good thing about pills is that you can stop taking them and get back to normal quicker than with an injection etc.

The main requirement for PCOS control is stopping ovulation so that cysts don't form. Cerazette does this in about 99% of cases, whereas other POPs don't. I think the implant works for this too, but the Mirena IUS doesn't stop ovulation, therefore not a good option. Yes, having regular bleeds can help with the PCOS build up that's very uncomfortable but on the progestogen methods, the need is reduced because a) you're not normally ovulating, and b) the build up is far less than normal, and it sheds when needed.

One thing I personally like about using a POP is that my breasts aren't achey or sore like when on a combined pill, I don't get the water retention I used to, I can take it everyday and don't need to think about breaks and it's better for my endometriosis as well!

One thing I'm not so keen on is the slight increase in spots around my "period", but it's nothing major tbh.

Hope this all helps.

megsybad

I'm just about to start taking Dianne-35, but before that I had implanon which I highly recommend for birth control. The only downside is that it doesn't impact on any PCOS symptoms, which is a bummer. Here's hoping I have the same reaction to Dianne as you did (minus the blood pressure factor). Maybe discuss with your Dr the possibility of going back on it if it's had such a positive impact as blood pressure can be affected by lots of things and can vary a lot.