PCOS post children - now what?

jeninaustria · 07-11-2005, 12:30 PM

I'm 35 and was diagnosed with PCOS 17 years ago - and have basically been on the pill with the exception of infertility treatment for 2 of my 3 children. Now that we are finished having children, which direction do I go? I cannot use the pill any longer; too many side effects (long story) and now a thyroid problem to deal with too. My rep endo suggested I use a Mirena IUD - anyone with experience with it have an opinion? My main concern is - will it prevent fertilization - or should I say, is fertilization even a possibility? I realize it would prevent implantation, and the advertisements say it "may" prevent fertilization. My doctor says it "will". I know, with PCO you'd think ovulation wouldn't be an issue, but my third child was a surprise after only going off the pill. We considered a vasectomy for my husband just to be sure about birth control, but since I went off the pill, I've only cycled twice and now nothing 3 months later, so really, I need some type of treatment other than an oral hormone therapy. Should we do both?

Also, any advice for my skin - I'm breaking out again since I quit the pill - what to do...

Tracy1975 · 07-11-2005, 04:49 PM

I am in the EXACT same situation as you. Needed fertility for baby #1 and #2, went off the pill and surprise baby #3. My husband had a vasectomy in Jan and I am stopping the pill today. Question: did you see any weight loss from going off the pill?

bethers · 07-12-2005, 11:59 AM

Have you thought about using Natural Progesterone Cream (NPC). You would use it for 21 days, stop for 7 (and get your period) and then start back up again. Using NPC for 21 consecutive days will prevent ovulation so you would not have to worry about having an egg to fertilize.

HTH.

jeninaustria · 07-16-2005, 06:07 AM

After going off the pill - no, no weight loss, but my nerves are in much better shape.

Natural progesterone? Can you really rely on it for birth control? - where and how is it used? Would I really get a period? If it's so easy, why don't doctors recommend it? Thanks for the info - I'll do some research too.

jeninaustria · 07-16-2005, 06:08 AM

In reference to the progesterone cream - does it matter that I normally don't get a period at all - (I'm probably not ovulating either, but just in case) - would it make me get a period if I used it 21 days?

RunnerDuck · 07-18-2005, 09:11 PM

I would be *very* leary of relying on natural progesterone cream as a birth control method, especially if you are *sure* you are done having kids.

I'm kind of confused about the whole thing so I am not sure how to explain why. I know there is a progesterone-only "mini-pill" that you can use as birth control. But some doctors say it does not prevent ovulation, it just thickens cervical mucus so sperm can't get through, and it makes the uterine lining inhospitable to implantation. It's often given to nursing women because 1. lack of estrogen means no effect on milk production and 2. nursing acts to supress ovulation and therefore take the place of the estrogen in the combination pill. That is my understanding at any rate. But I have a friend who's doctor says the mini-pill DOES prevent ovulation. I really don't know. I know that progesterone rises after you ovulate, and your body doesn't try to ovulate any more until your next cycle... I know it is said in natural circles that NPC can be used to shut down the ovaries and clear up PCOS symptoms... but I have also been told the mini-pill does not prevent ovulation. At any rate I do know that the mini pill has a higher failure rate than the combination pill, and that it must be taken EVERY day, no breaks... it also does not create the same cycle regulation that the combo pill produces. Some women bleed all the time on it.

My experience with NPC was bad... I planned to use it 10 days to induce a period but by day 6 I was bleeding like crazy. When I have used provera or prometrium, which ever it was - prescription progesterone to bring on a period - I did not have that problem. Could be it was just me, could be the natural stuff just doesn't work the same as prescription stuff. At any rate like I said I personally would be very leary of relying on it as BC.

I don't think I will ever again even try using it as PCOS control. Other people seem to have better luck with it but it just didn't seem to be the thing for me.

I think if you are really done having kids, and really opposed to an IUD, then your husband being snipped is your best bet. Then you can focus on controlling your PCOS without the treatment's effect on fertility even being an issue.

Are you opposed to the fertilization possibility of the IUD from an ethics standpoint or just from an "If it fertilizes, it might implant" standpoint... ie an effectiveness standpoint? I really don't know the truth about the IUD preventing fetilization. There is a chance that the new one, since it has progesterone, would do both to a degree. I thought that the truth was no one really understands how or why the IUD works. But it does seem proven to have very high success rate.

I think that when we are done having kids, if I find some means to regulate my cycles without BCPs, I will go with an IUD... and if not, I will stay on BCPs. Yasmin is actually working really well for me in that it has really reduced my body hair issue. But I don't like what it is doing to my sex drive so I'd kind of like to go off it... at any rate this will be an issue when we have had 3. I don't think either method is fool proof. I got pregnant the first time on BCPs.` So I know it can happen. I guess I am willing to risk a 4th "oops." If we get a 4th, though, we'll definately go a surgical route, knowing that I may still be on BCPs anyway for PCOS.

At any rate I guess it depends on HOW certain you are that you are done and what other methods, if any, work for you to control your PCOS. You may never get pregnant again, even without preventing. But if you don't pick a 100% effective method there is always the chance of an ooops. (and some even say surgical methods aren't ALWAYS 100% effective... but they're the closest you can get short of abstinance)

But I think some methods are far more likely than others to fail and I personally would rank natural progesterone in the less-than-effective category.

I don't know... I feel like that was really rambly and not at all helpful but I really think if you're really sure you're done, have DH snipped and then work on your health without having to worry about preventing pregnancy, too.

unlucky · 07-19-2005, 03:32 PM

How about you getting a tubal? That is what I did. Out-patient surgery.

RunnerDuck · 07-19-2005, 05:02 PM

Quote:

Originally Posted by unlucky

How about you getting a tubal? That is what I did. Out-patient surgery.

Yeah but DH getting snipped is easier... and after a women's popped out 3 kids, I think the man deserves a little pain and suffering, too.

But either way works.

unlucky · 07-19-2005, 11:33 PM

yes, the man's is easier, but some men do not want to do that, big chickens. Which is how I got my third girl!!!

Sometimes when you want something done right.........

Pale Pink Aura · 07-20-2005, 11:09 PM

Personally, after I've had this bub my DH will be getting the snip (with the follow up sperm count afterwards to check it worked!!). I tend to agree with Runnerduck in that I wouldn't rely (personally) on NPC as being wholly effective, although I do have a higher opinion of it. I've also read some research that getting a tubul *may* affect a woman's hormone balance and I don't want to risk anything that may stuff my cycles up at all. My main priority after having kids is to get my cycle right again and avoid all of those nasty PCOS side-effects as much as I can. I don't feel I can do that with any method of contraception other than condoms or DH getting the snip. I personally will be using NPC when needed to help keep my cycle in balance, not as a contraceptive.

coffeequeen · 07-21-2005, 01:32 AM

How long does it take for the natural progesterone cream to start working?? Do you have to have prescription or can you buy it over the counter
Melissa

Pale Pink Aura · 07-21-2005, 01:40 AM

It depends on how progesterone deficient you are as to how long it takes to work, but it may take 3 or 4 months to work properly (it did for me). It depends on where you are from as to whether you need a doc's script or not. In the US you can buy it at a health food shop; in Oz, UK and Canada you need a doctors prescription (or order it over the internet).