Bitter little pill

January 2, 2009 9:01 PM

I want to take birth control pills again. But in the past I've had lots of problems with the three different pills I've tried. I know you are not a doctor, or my doctor, and I will see my doctor. But your experiences with birth control might help me make my choice when I do see the doc. So please, tell me, have you ever taken a birth control pill WITHOUT loss of libido, mood swings, madness, weight gain and skin issues? If so, what pill did you take?

Background
I've tried Diane-35, Triphasil and Marvelon at various times, all with devastating and completely unacceptable side effects. I stopped about nine years ago, after a particularly terrible six months on Marvelon. On all of them, I had mood swings, depression, weight gain, nausea, tearfulness and zero libido.

On Marvelon I felt possibly the worst I have ever felt in my life, ever.

I am not prepared to kiss my sex drive goodbye, be transformed into a raving unstable psycho, have my face covered in zits or stack on a stone to take the pill.

But. My period is agony, I am miserable and PMS-y for a fortnight each month, then exhausted and crampy and faint and sick for three days out of the seven I bleed for.

Have tried everything else I can think of to fix the period issues: acupuncture, lifestyle changes (exercise, cut down caffeine, increased whole foods, fruit, veggies, minimal processed food, a range of supplements including evening primrose); acupuncture; massage; anti-inflammatories; various prescription and non prescription painkillers. All of these have helped, but have not fixed the problem. Also, yes, I have been checked out, I don't have endometriosis, cysts, fibroids, or any other problem like that. At this point, it's so terrible and debilitating, the pill is finally starting to look like something I'd consider again.

When I go and see the doctor, I'm thinking of asking about new low-dose pills and giving those ago, maybe having my period six monthly, or quarterly.

I've read through a stack of birth control questions, and anecdotally, it looks like Tri-cyclen in all its forms cause depression and anxiety symptoms, as do Microgynon, Alesse, Loestrin and Desogen.

Yasmin, Yaz and low estrogen pills seem to show up in the ''it worked for me'' responses, with less mood swing madness. But they also seem to cause loss of libido. This is a deal breaker.

I looked at this table, but it doesn't cover loss of libido (a real deal breaker) and also lists Triphasil as good for s moodiness and depression. Which. No.

So: Does anyone have any recommendations for side-effect minimal birth control pills that might let me keep the lovin' feeling, stay a normal weight, and not go stark raving mad?

Yep, I know, in the end, it will just come down to me and my unique reaction. But your annecdata will help me decide what to try first.

I am NOT interested in: and IUD, a diaphragm, patches, nuva ring or implants.

posted by t0astie to health & fitness (41 comments total)

we just went through this
posted by micawber at 9:07 PM on January 2

My wife had similar issues and now uses the Nuvaring. Why won't you use it?
posted by charlesv at 9:10 PM on January 2 [1 favorite has favorites]

There are two main flavours of hormonal birth control: those that combine synthetic oestrogens and progestins (the pill, NuvaRing, patch, and Lunelle injection), and those that contain only progestin (the Depo Provera injection, Noristerat injection, Mirena IUD, Implanon implant, and the progesterone only pill or 'mini-pill'). Due to the fact that they work locally, the NuvaRing has the lowest possible dose of combination hormones, and the Mirena IUD has the lowest possible dose of progestin-only hormones.

My anecdata: Combination hormones mess me up, but progestin-only hormones don't. On the NuvaRing, I had weight gain, anxiety, libido changes, etc. On Depo Provera and now the Mirena IUD, I haven't had any side effects.

The mini-pill is the cheapest, easiest to quit progestin-only hormonal birth control, so I would recommend trying that if you haven't tried a progestin-only option yet. (IUDs are a pain to get in and out, and I know Depo Provera doesn't have an antidote, so if you react badly, you're stuck for a few months. Of course, if you react well, you're good to go for a while.)
posted by heatherann at 9:30 PM on January 2

Yasmin has been wonderful for me. I was a little worried about the libido thing, but I haven't had any problems so far, and I've been on it for 6 months. If anything, my sex drive is actually a little higher.

My skin is also noticeably clearer, and I haven't gone on any near-homicidal rampages (this is a huge contrast to my experience with Ortho Tri-Cyclen.)
posted by arianell at 9:32 PM on January 2

I cycled through a few different forms of birth control - thinking I would find something "better" than Yasmin, and ended right back where I started. No breakouts, mood swings, or weight gain that I can tell. When I was on Nuvaring, I had bad lower back pain. Generic Yasmin caused me to break out (I don't care who says Ocella is the same fomulation sans royalties. It was bad for me). Be careful - my pharmacist filled the generic automatically once because my doctor didn't specifically request the brand-name drug. So, yeah, I'd recommend Yasmin. I'm sure everyone's a bit different though, so YMMV.
posted by xiaolongbao at 9:40 PM on January 2

micawber, I saw that thread, thanks. But I'm looking for specific pill recommendations, not general birth control discussion, not tips on trying an IUD, or Nuva Ring or non-hormonal methods, or general suggestions to ''try another pill''. Charlesv, re why not a ring, or an IUD or whatever, they are just not an option for reasons I don't want to get into.
posted by t0astie at 9:55 PM on January 2

I have NO issues with my pill, not a one - in fact I feel better on it than off it. I take Ortho Tri-Cyclen Lo.
posted by Miko at 10:15 PM on January 2

For me, Cerazette is horrible. For about a week each month my breasts swell at least a full cup size and hurt like hell. I have to sleep in my bra because taking it off at night hurts too much. Considering I'm a 36F, that's a big deal.

I've never had acne before, not even in my teens, but Cerazette made me break out like crazy. Not 1-2 zits at a time, we're talking 17 at once (I counted). Big cystic volcanic ones! Add to that the random bouts of crying and periods every two weeks. That's right, every two weeks. So pretty much every single day I'm either PMS-ing or bleeding.

God I want my Depo back.
posted by ValkoSipuliSuola at 10:15 PM on January 2

Also, keep in mind when reading birth control reviews and internet questions: people who are happy with their medications have little incentive to go online and crow about it. yet people who have a horror story are very eager to do so.

In the end, the best way to know is to give it a try, working with your doctor. Every woman reacts differently to different hormonal medications, so other people's experiences are only so useful as a guide.

Again, I've been prone to depression and anxiety in the past and have never been happier than I've been during the years I've been on Tri-Cyclen. I don't attribute that to the BCP but obviously it's not detracting from my mood. I'm one of many happy customers.
posted by Miko at 10:17 PM on January 2 [1 favorite has favorites]

I've been on generic Mircette (Kariva) for 10 years. I've never experienced anything but good side effects. No weight gain, skin cleared up, lighter periods, almost no cramps, no effect on sex drive. I believe that it is one of the lowest dose pills on the market.
posted by timory at 10:23 PM on January 2

I love my yasmin. No weight gain (a little loss, actually), my skin has never been this clear in my entire life and my libido has seen no change. I do have some breast swelling/tenderness - but it hasn't been that bothersome. I started on the brand name and went to the generic without noticing a difference. I had been off the pill for ages because of all of the same issue you've had with other pills. Everyone I knew was saying such good things about Yasmin that I decided to give it a month and see how it went - and that was 6 months ago.
posted by Wolfie at 10:30 PM on January 2

I was on Mircette when I went super-crazy pants. It definately lowered my sex drive, made me weepy for two weeks out of the month, and depressed me terribly. These effects came on slowly - I was fine for the first few months but then gradually become more and more moody. After I quit taking it I started to feel more emotionally stable and my libido gradually returned. Obviously YMMV.
posted by mai at 10:32 PM on January 2

Taking a survey of what has worked for other people is a really terrible way to pick a birth control pill. People's side effects to hormonal contraception are individual; it really depends on your body. There are plenty of people who have had no side-effects on Diane-35, Triphasil and Marvelon as well as plenty of people who have felt terrible on yasmin, yaz or low estrogen pills. Unfortunately, there's no way to predict which pill will be the easiest for you to tolerate: you just have to try one and see what happens.

That said, yasmin and yaz have a different type of progesterone than other pills, so it wouldn't hurt to try those in case that was causing the problem.
posted by Violet Hour at 10:38 PM on January 2 [3 favorites has favorites]

Nordette (aka Portia aka Levora aka Femigoa (in Germany) and apparently aka Microgynon) has never caused me a single problem. It's monophasic, and it contains 0.15mg levonorgestrel and 0.03mg ethinyl estradiol (a different formulation than the drugs you tried.) Of course, I had problems with depression and anxiety way before I went on birth control pills; the pills do not appear to have affected my mood one way or the other, however, and I've had no other side effects. Oh, I do the quarterly thing as well (thank God); with monophasic generics, it's no problem, and way cheaper than Seasonale.

Anecdotally, I've heard more problems with people taking triphasic pills (perhaps due to the increased hormone fluctuation) and with people taking low dose pills (lots of breakthrough bleeding with lower estrogen levels.) However. Your gynecologist will have seen the side-effects of birth control in many more women and will be better able to advise you about birth control formulations that are usually well-received; they will also be better able to tell you which formulations to avoid due to your past experiences.

I know you know this, but honestly, even if your doctor thinks one of the drugs everyone here hates is the right one for you (based on your background), it's worth a try. Like brainmeds, birth control medications really do work differently on everyone.
posted by ubersturm at 10:49 PM on January 2

You mentioned being on Marvelon — are you in Canada? If so, then Mircette and Yaz are out because they're not available here. That kind of sucks, considering that they're both low-dose pills.

The pills that are the least likely to cause crazy libido side effects are the ones that are more androgenic. There is a list of "most androgenic" pills on the page you linked to. These pills, however, are more likely to make you break out. That said, I was on Alesse for a few years without any bad side effects, and it made my skin even clearer.

It's probably best to start with a monophasic low-dose (20 mcg) like Alesse or MinEstrin/LoEstrin and adjust from there. All the pills you were on before have either 30 or 35 mcg of estrogen so a lower-dose pill will have a lower likelihood of estrogen-related side effects.
posted by thisjax at 10:51 PM on January 2

The problem with wanting a specific pill recommendation is that your body may react differently to a pill than mine, based on a lot of factors (not the least of which is what hormone levels we start with respectively).

I had tried just about every pill on the market -- and depo provera -- when my gyn recommended I see an endocrinologist. The endocrinologist took me off the pill altogether for a few months, and gave me small doses of pure hormones instead. Using just the hormones, he figured out what my ideal hormonal balance is. Because the hormones weren't tied to contraception, he could change my prescription as soon as we identified undesirable side effects. Once we got the hormonal balance right, the doc just looked for the birth control pill that most closely matched it.

I highly recommend the process that got me there (as opposed to recommending the pill itself).
posted by nadise at 11:07 PM on January 2 [2 favorites has favorites]

The only one that made me really crazy and unhappy was orthotricyclen, and both yasmin and yaz have been good for me. On yaz now, don't notice any libido effects. I've been on yasmin/yaz for about 3 years.
posted by rmless at 11:14 PM on January 2

My experience on Yaz was really good. It completely got rid of my (already mild) cramping. It was too expensive, though, and has no generic. Now I'm on Kariva (Mircette), and have been happy with it as well. The only way it is not as good as Yaz is that I do have some mild cramping again. However, my skin is clear, and I have no negative side-effects that I'm aware of.

If you have those kinds of side-effects from the pills you've tried, you're definitely right in planning on seeing a doctor about the issue. Most HBC nowadays are pretty low doses of hormones (especially compared to the old ones people are usually thinking about when they think of the pill causing bad side effects). It shouldn't put you that much out of whack emotionally, and HBC is not actually supposed to cause any significant weight gain. It's just that women usually start taking it at an age in which they are more prone to start gaining weight anyway (late teens/early 20s).
posted by fructose at 11:25 PM on January 2

I was fine on Loestrin for quite awhile after having had bad experiences with various Ortho formulations. The side effects only crept up on me after about 5 years. So it may be worth a try.
posted by scody at 12:28 AM on January 3

(And by "fine," I mean specifically no loss of libido, and my periods dwindled to practically nothing.)
posted by scody at 12:30 AM on January 3

I took Yaz for about a year and a half, with only mild side effects at the VERY beginning of use (like, the first couple of days). As a matter of fact, I didn't feel any different whatsoever when I was taking Yaz, except for my period being shorter and lighter. I would recommend it for sure; it's the first thing my doctor recommends to people who are just starting out on BC. Anyway, I would inquire about this one. It's been a fabulous pill for me.
posted by I_love_the_rain at 1:36 AM on January 3

I'd recommend Cerazette: no more periods, no loss of libido, weight gain or skin problems and my SO confirms my mood-swings are almost non-existant .... Though ValkoSipuliSuola lives a completely different experience on it.
The best is probably to try different ones until you find the right one, with the help of your gyn. They should be able to suggest different pills according to your reaction to the previous ones you have taken.
posted by tweemy at 1:46 AM on January 3

I've been taking Cerazette for years with no problems, but as other people have noted, polling strangers on the internet is not a good way to choose birth control pills. ValkoSipuliSuola clearly had a horrendous experience with the exact same pill that tweemy and I have had no problems with. The only way to tell how you'll react to a specific pill is to try.
posted by missmagenta at 3:59 AM on January 3

I tried just about everything - Ovranette, Marvelon, Mercilon, Minulet, Organon and eventually the only one which didn't have perceptible side effects was Cilest (and to be honest, I'd have taken weight gain over lengthy and heavy periods, bleeding between periods and high blood pressure anyday!)

I was fortunate enough to have a very sympathetic GP who was happy to try me on everything until I found one that suited me. I think that's a good place to start. Good luck :)
posted by highrise at 4:21 AM on January 3

I took Loestrin for many years with no side effects and only switched to ortho-tricyclen lo after I started getting breakthrough bleeding every month (not that much of a big deal but I'd rather not have it). Ortho-tricyclen lo has been fine too, although my weight flips around a little bit with it (+/- 5 lb during a cycle, but it never stays there).
posted by gaspode at 5:48 AM on January 3

I've tried at least 10 different types of hormonal birthcontrol. Everything from Allesse to Yasmine, the patch and NuvaRing.

I can tell you, very confidently, that I experienced at least one noticeable negative side effect for each and every one. Often it was break-through bleeding, despite religious use. Sometimes it was awful moodswings that made me question my own sanity. Worse was when I erm... 'dried up' and didn't want any sex.

I am a much happier woman without hormonal b/c, albeit a little more zitty. *sigh* We can't always win.
posted by sunshinesky at 6:20 AM on January 3

I've heard dozens of horror stories about Depo Provera, but I used it for 11 years and absolutely loved it. The only reason I stopped using it is because I moved and I can't get it where I am now. Tweemy and missmagenta use Cerazette and are completely happy with it, while it turned me in to a complete basketcase.

My point is, I'm afraid we can't help you with this. The only benefit I can see is that maybe someone here will mention a new-ish pill you haven't heard of, but I'm not sure how that's any better than a Google search. You won't know if it works for you until you try it. Sadly, this is one you're going to have to figure out on your own through trial and error.

Believe me, I wish there were an easier way....
posted by ValkoSipuliSuola at 6:44 AM on January 3

I'm not familiar with all of the drug names here, but I can't see if anyone suggested Seasonale or its analogues. For me, 3 months of the same dose every day has been the solution to all of my problems with birth control. I had been on Ortho Tri-cyclen previously and it turns out that most of my problems were due to the weekly fluctuations in dose. It did take until the second pack (i.e., 3 months in) before I could tell that everything was evening out and feeling good.
posted by hydropsyche at 7:19 AM on January 3

Ocella (the generic of Yasmin) has done wonders for me. Yasmin was pretty good, but after a while, it started to give me mood swings and I had no appetite. I was switched to Ocella and I'm fine. My sex drive is great, no break outs, no mood swings. I get a bit more cramping then I did with Yasmin, but it's not like it was without the pill.

Ocella will make you want to eat everything in the first two weeks but it dies down after that and your normal appetite comes back. I didn't gain any weight those first two weeks either, I didn't crave junk food, I just wanted dinner all the time.
posted by Attackpanda at 7:58 AM on January 3

I had issues with hormonal birth control, and I also have a very long, very heavy period. I started losing weight and eating a quasi-Paleo diet--no sugars, no grains, high vegetables, medium fruit, low dairy, lots of healthy fat and lean meats--and my periods get lighter and shorter every cycle. Plus my acne is pretty much nil at this point. If you are overweight at all, it can fuck up your hormones.
posted by schroedinger at 8:22 AM on January 3

Dissenting opinion on yasmin here. It made me incredibly depressed, moody, and gave me horrible leg cramps daily because I peed constantly on it (it contains a diuretic, hence the lack of water weight gain).

I'm on Portia now (which is a generic of something, but I'll be damned if I remember what) and though I've gained weight on it--mostly in my boobs--I've otherwise had zero side effects. Our biologies all react differently on different hormones, and all of these anecdotes likely mean little to nothing about how you, personally, will react.
posted by PhoBWanKenobi at 8:25 AM on January 3

I've been on several pills without ever having any of those issues (and all of them cleared up my skin!), so my suggestions won't work for most people, but I did realize I like the pills that are all the same color for the active pills (I took Ovcon 35) better than Ortho Tri Cyclen Lo, where the pills are different doses every week. The reason for this is that I could easily skip my period one month if I needed to go on vacation or whatnot just by throwing out the inactive pills and going on to the new pack. So those are really convenient - no spotting or anything weird. I heard that with Ortho Tri Cyclen Lo you can skip your period, but you have to start the second pack backwards, and that's just too confusing.
posted by KateHasQuestions at 8:59 AM on January 3

I've been taking Kariva (generic of Mircette) since last summer and completely lost my libido. Totally gone. I also have a lot of breakthrough bleeding and mood swings. My doctor is going to switch me this week, so I'm pretty happy about that. The happiest I was on birth control was when I was using Ortho Tri Cyclen Lo.
posted by bristolcat at 9:22 AM on January 3

There is absolutely no way of knowing in what ways any particular pill or other hormonal medication will affect you. For example, I was on Lo/Ovral for 3 years before my libido died and the migraines started. The worst symptoms might not show up for a long time and you may not even realize that hormones have made you a murderous harpy until you've got some random passer-by in a bloody headlock.

The moral of this? Stop asking for reviews of hormones on the internet and go see an endocrinologist. In the meantime, use a condom. They do work, you know.
posted by sian at 10:11 AM on January 3 [3 favorites has favorites]

Nuvaring.

Had a little bit of weight gain (really, not substantial) but it made my boobs bigger, my mood better, I had no cramps period and raging libido.

I vote Nuvaring. You can try one for free (most of the time) just by going to Planned Parenthood and having an exam.
posted by big open mouth at 10:44 AM on January 3

Perhaps your body just doesn't like the pill? My body hates the pill! I was on it from 18-21 years old with no side effects, and all of a sudden my body wouldn't stop break through bleeding. My doctor had me try a bunch of different pills trying to find one that worked. I tried Demulin (that was the one that worked for 4 years), Marvelon, Orval (the worst), tri-(something), and Yasmin. Before Demulin, I had tried Diane. I had side effects with each one, from breast tenderness to break through bleeding to crazy hormones making me want to cry or scream. I've never had a problem with weight gain though.

Once my cycle comes, I'm going to try Nuva Ring. My gynecologist has said that since the hormones in the ring are localized just in my reproductive area, that it can cut down substantially on the side effects elsewhere and hopefully stop the break through bleeding.

If the Nuva Ring doesn't work, then I might just stick with a condom and keep track of my cycles to avoid all the side effects all together.
posted by DorothySmith at 11:13 AM on January 3

Since all you want is personal anecdotes...yaz was great for me. It improved my skin and I wasn't moody. The other stuff, well, if I'm working out actively I typically don't gain weight from the pill and I've never noticed any drug to affect my libido, it's pretty much always strong. If your period is as miserable as you say it is I would think that would affect your libido more than the pill, as in "wow, i feel crappy and bloated and I'm losing major amounts of blood, could I feel any less sexy?" But that's just me. Good luck!
posted by thankyouforyourconsideration at 2:14 PM on January 3

I've been on Desogen and two generic versions of it for over 3 years, and it's amazing -- even/predictable cycles, no cramps, no weight gain, no crazy moods, better skin... No idea about the libido, as I've been on it for so long. Comparatively, orthotricyclen didn't work at all for me.
posted by Maarika at 3:55 PM on January 3

Nthing Seasonale/Seasonique. For me, it's $60 for three months, but the need to eat the entire house once a month, kill people in general and cry at long-distance commercials is gone. I'd rather have cramps and a crappy period for a few days four times a year than temporary insanity for a week to 10 days each month.

Anecdotally, I DO have cystic fibroids and have been on some kind of birth control since I was 17. I have tried Demulen, Ortho-Tricyclen, Yasmin, and a bunch of other things I can't remember. Hated the Nuvaring with a white-hot passion.

I've been on this form of birth control for six months now and my sex drive is quite strong, I have pretty much zero PMS, my skin has cleared up (I only ever broke out on my neck/back/shoulders anyway) and I didn't have much adjustment time to the new schedule. It was pretty much instantaneous; I feared "phantom" symptoms the first month (like bloating) but there were none.
posted by Unicorn on the cob at 9:06 PM on January 3

I took triphasil and then its generic for a year but I had lots of bad symptoms including migraines, malaise and nausea. I took Yasmin for 2 years and lost about 10 pounds and went up a cup size but I totally lost my sex drive after a year. I went off Yasmin and didn't start a new pill and experienced a crazy libido rubberband that gave me whiplash.

I'm now on Loestrin 24 for the past year and aside from a few days of breakthrough bleeding every third or so month I wouldn't know I'm on a pill at all. My period is shorter by a few days than without the pill so when you add it up it evens out.
posted by tinamonster at 10:17 PM on January 3

Thank you all. I still haven't made up my mind what I'll do, but all your answers have given me lots of food for thought and lots of different options to consider.
posted by t0astie at 11:16 PM on January 5