Hormones out of wack or am I?

April 5, 2010 12:57 PM

Get me off this hormonal rollercoaster or am I just crazy?

I was wondering if anyone else experienced a huge difference before, during, after pregnancy with hormones and emotions.

Before I was pregnant, I was an emotional rollercoaster. Anger, depression, irritable, etc (not talking the additional physical symptoms). I would probably only have one good week out of an entire month where I felt "normal". But I am noticing that the pattern was everything under the sun then the first day of my period--bam---depression to the point of desperation.

But when I was pregnant two years ago, I can honestly say that I felt NORMAL. No ups and downs and all arounds. Just the first month or two and the last month or two I was a little more irritable. But the rest of the time? I felt HAPPY. I never feel happy (diagnosed with dysthimia long ago).

I tried the entire family of Ortho and now on LoEstrin. I got off one or another due to more physical side effects (not working, crampy, etc) than emotional.

My OB mentioned Yaz and it did intrigue me since anything I read about PMDD, I have EVERY symptom. However, the increased blood clot risk scared me. She said that you have to fall into a certain class of risk, and I don't, but still, I don't need a blood clot/death (I love my child too much to leave this early. :)) And the official Yaz website prescribing information stated "has not been tested in more than 3 cycles." So I'm thinking that isn't definative enough of a "yes Yaz will help me" and outweigh the risk/benefit ratio.

On the flip side, I did try Celexia twice (brand and generic)--horrible side effects. And Wellbuturin Sr. about 7 years ago. It worked well for a year then I was emotionally numb and quite frankly I HATE the guinea pig syndrome of trial and error with psych drugs; more so than the side effects.

The final option is thyrod check--did it. Doc said I'm normal.

So I'm at a loss on what to do. Is this really hormonally based and an SSRI or whatnot won't help. Give Yaz a shot knowing that I could put myself at risk? Am I just nuts?

I hate this. And I hate being all over the place for my child. (it doesn't help that my marriage is in flux. My husband said he noticed that I'm all over the place since having our child and is concerned. To me, I'm all over the place since having our child because I felt like it was a huge wake up that things aren't working.)

Help.

posted by stormpooper to Health & Fitness (12 answers total)

Are you thinking about having another kid any time soon? You might look into the Mirena IUD. It has such a low dose that it's barely noticeable, but I'm told that it actually may help increase the efficacy of some antidepressants (or at the very least not make you crazy enough to need a higher dose). It is supposed to only have enough hormones to work in your uterus, but my face was a LOT clearer when I was on it. That makes me think that it might work just well enough for your low level of craziness.

Believe me, I feel your pain. I had also had problems with the emotional rollercoaster of regular BCPs, and I was THRILLED with my IUD. (Too bad it expelled.)
posted by Madamina at 1:25 PM on April 5, 2010

Response by poster: Not a fan of an IUD or constant hormone devices (ring, patch, etc). I'm fine with taking the birth control pill. And depending on the state of my marriage or if I divorce and found someone else, I 100% want another child. The choice of birth control was related to menstrual issues (cysts, fibroids, endo) not actual birth control.

But thank you for the help.
posted by stormpooper at 1:29 PM on April 5, 2010

I know exactly the kind of emotional roller-coaster you're talking about, and I feel for you. For me, it was the birth control pill that was causing my emotional roller-coaster, and only when i switched to a non-hormonal IUD did the roller-coaster finally stop.

Your question doesn't make clear whether or not you were on birth control for any time before you got pregnant, but if you were and had been for a long time, you might consider some non-hormonal option. I went through the pill, the progesterone-only pill and the progesterone implant in the arm before finally feeling okay on the non-hormonal IUD. Just something to consider, depending on your circumstances.
posted by ukdanae at 1:50 PM on April 5, 2010

There are a lot of other hormones besides the ones checked in a thyroid panel. I wonder if a reproductive endocrine specialist could shed more light on your situation.
posted by fairytale of los angeles at 2:01 PM on April 5, 2010

Response by poster: I was on birth control from 25-36 (when I got pregnant). I was off for a total of 13 months (pregnancy and a little afterwards through now).

Before 25, horrible physical symptoms (menorrhagia and dysmennorhea) and emotionally it was worse. I remember totally losing it, irritable, angry during my teen years. It was horrendous all the way around. Birth control totally "cured" the menorrhagia and dysmennorhea, which was a godsend.

The emotional side though never quite was fixed except when I was pregnant.

I don't remember the thyroid panel. I know he did T4 and others as well as calcium and something else that could mean imbalance issues.

Part of me wonders if I should take a break from the pill all together and see if there is a noticable difference. Based on the fact that we had to go through infertility treatments to get our son, I don't have a lot of confidence that I will get pregnant when not on the pill.
posted by stormpooper at 2:16 PM on April 5, 2010

Well, if you got better when you were off the pill, that might be worth a try to see if it works even when you're not pregnant.
posted by Jacqueline at 2:25 PM on April 5, 2010

Data point: Ortho turned me into a raging psycho hose beast from hell. There are other pills that I was mellow as a kitty on.

As far as the increased risk with Yaz, you should find out what the increased risk actually is. The percentage of women who get blood clots from birth control is pretty small--especially if they are non-smokers under 35 so the increased percentage could also be a fairly small amount as well.
posted by Kimberly at 2:38 PM on April 5, 2010

I am taking a HUGE shot in the dark here, but I'm going to suggest a visit to a reproductive endocrinologist for a full hormone panel (maybe your GYN can do the labwork, but could be worthwhile to have an RE consult on it). Here's why: You mentioned that you had cysts at some point. I have PCOS, and I learned that the cysts on my ovaries would sit there and pump out testosterone, which threw off the rest of my hormone levels, which caused all sorts of problems and caused more cysts. So I'm on BCP (Reclipsen at the moment) to avoid creating new cysts so that I won't be dumping any more testosterone in my system. There's more to it than that, but that's the simple version.

I had a reproductive endo diagnose that from a full blood workup and looking over what was low and what was high. Since you mentioned having to visit a fertility expert (were they a RE?) to conceive, you probably have some bloodwork pre-pregnancy in order to compare to. IANAD, but I think being on BCP while having the bloodwork drawn would skew the results, so you may need to tough it out for a month to see what's really going on.

I have never been pregnant, so this could be a shot in the dark. However, it's an easy blood draw, so it couldn't hurt.
posted by MultiFaceted at 4:11 PM on April 5, 2010

Response by poster: I saw a RE and all tests pointed to normal--no PCOS (his speciality/his wife had it). He said by all counts, I was fairly normal minus some indication that yes, FSH test said I was a 9.2 (10 being oh yea IVF is probably needed; 7 is perfect chance). They chalked it up to unexplained infertility (monitored clomid, IUI, trigger worked for us on the 2nd try). I was off birth control for a year trying to conceive "naturally". It took 2 months before I got pregnant with clomid/IUI/Trigger.


Kimberly--sorry you had to go through that but good to hear that the pill had that effect .Maybe these low estrogen doses are doing me a number. Not sure.

This just sucks. It goes from depression to anxiety/panic because I don't know why I always feel like this, I hope my son never thinks I'm some freak, nor do I ever, ever, ever wish he feels like this in case I do have a mental issue. This feeling is just emotionally painful. I started to keep a cycle/emotion diary to see if there is a pattern.
posted by stormpooper at 7:24 PM on April 5, 2010

hi there, IANYD, but you do realize that the birth control pills you take now, Loestrin, carry the same risk of blood clot as Yaz does, right?

All birth control pills that contain estrogen (or specifically, ethinyl estradiol, their common ingredient) have this risk associated, so if you are willing to accept it for one, why not for another?

If you want to see if your symptoms are consistent with PMDD, why don't you just take the pill you're currently on (that you presumably like) and skip your periods with that? There is nothing magic about Yaz, even though the commercials want you to think there is, it's just basically the same stuff in a different box.
posted by treehorn+bunny at 9:13 PM on April 5, 2010

Actually, Yaz does have a higher risk of clots than other oral contraceptive pills. That being said, the risk is still small--as with other oral contraceptives--and those women most at risk are those who smoke, have high cholesterol or diabetes, etc.

I don't have any opinions as to what is going on with you, but regarding the increased risks with Yaz, I think you need to think of the balance of risks here. Is the slightly increased risk of blood clot something you are willing to take for the chance to have some emotional stability and relief from your symptoms? I know you're concerned about leaving your child without a mother, but it's not healthy for your child to have a mother who is living with depression either (and you seem to realize that).

If I were you, I'd try Yaz, even given the increased risk. Give it a shot and see what happens. If it doesn't work, then you can move on. But for now, this is a concrete option you can explore NOW while you and your doctors continue to explore possible other causes and treatments.
posted by devinemissk at 6:17 AM on April 6, 2010

Another vote for trying Yaz for a couple months to see if it works (or at least talking with a doctor more about the possibility) -- I had very similar symptoms and it calmed down the monthly emotional roller coaster VERY noticeably. I still have issues with depression, but the most extreme low points that I was experiencing consistently right before my period are gone.

Unlike most BCPs, Yaz has 24 active pills instead of 21 in the 28-day pack, which I think may have something to do with its effectiveness at maintaining a more consistent hormone level.

I think that the improvement in mental health is worth the small risk, especially since I'm young (mid-twenties) so my risk is lower. YMMV, of course!
posted by anotherthink at 4:47 PM on April 6, 2010