Contraception while breastfeeding, PCOS, hypothyroid, overweight
March 30, 2016 7:13 AM Subscribe
Looking for contraception that works while breastfeeding and could even help PCOS or at least not make it worse. Other possibly relevant info: on levotheroxine for underactive thyroid, overweight, irregular periods, might be treated with metformin in the future. My healthcare provider for this proposes cerazette, mirena, or a copper coil. I'll meet her tomorrow to discuss. Any advice, experience or questions I should ask?
I loved my copper coil but right now I'm looking at a bouncing 10 month old who surprised us.... My coil had become dislodged.... We were planning to try for children near that time so it was a happy surprise for us but if I had to do it again I would make sure I could feel and check the strings.... That wasn't explained to me.
posted by catspajammies at 7:51 AM on March 30, 2016
posted by catspajammies at 7:51 AM on March 30, 2016
To help triple check for the medications, a call to infantrisk.com can help ease your mind, too.
posted by jillithd at 7:52 AM on March 30, 2016
posted by jillithd at 7:52 AM on March 30, 2016
Best answer: Your options are limited because of breastfeeding, you can only use a progesterone only method or non hormonal method, such as your healthcare provider recommended.
For the progesterone pill (Cerazette), I personally would never use it for myself because I'm terrible about taking pills on time and it must be taken very close to the same time daily (more so than regular OCs). The progesterone only pills should regularize periods but probably won't help with other PCOS symptoms.
I love Mirena and some docs specifically recommend it for ladies with PCOS. I have PCOS myself and when I tried Mirena I found that it did not treat my PCOS as well as regular OCs because the hormone level in Mirena is low and localized (continued irregular spotting, weight gain, hair growth although it was all pretty minimal). But - regular OCs aren't an option for you right now.
Copper IUD/Paragard has never been appealing to me because I already had super heavy periods and don't want more cramping either, and those are two things it's known for. It would not have much effect on your PCOS, probably not the best option as noonday points out.
If I were you I'd give Mirena a shot, because if you like how it is with your PCOS and don't have any troublesome side effects, it's the easiest and cheapest birth control out there. If at some point you need it out, it's very easy to get removed, and once you're not breastfeeding you can go back to combination oral contraceptive pills which more likely would improve your PCOS symptoms.
posted by treehorn+bunny at 9:10 AM on March 30, 2016 [1 favorite]
For the progesterone pill (Cerazette), I personally would never use it for myself because I'm terrible about taking pills on time and it must be taken very close to the same time daily (more so than regular OCs). The progesterone only pills should regularize periods but probably won't help with other PCOS symptoms.
I love Mirena and some docs specifically recommend it for ladies with PCOS. I have PCOS myself and when I tried Mirena I found that it did not treat my PCOS as well as regular OCs because the hormone level in Mirena is low and localized (continued irregular spotting, weight gain, hair growth although it was all pretty minimal). But - regular OCs aren't an option for you right now.
Copper IUD/Paragard has never been appealing to me because I already had super heavy periods and don't want more cramping either, and those are two things it's known for. It would not have much effect on your PCOS, probably not the best option as noonday points out.
If I were you I'd give Mirena a shot, because if you like how it is with your PCOS and don't have any troublesome side effects, it's the easiest and cheapest birth control out there. If at some point you need it out, it's very easy to get removed, and once you're not breastfeeding you can go back to combination oral contraceptive pills which more likely would improve your PCOS symptoms.
posted by treehorn+bunny at 9:10 AM on March 30, 2016 [1 favorite]
Best answer: I have PCOS and am currently breastfeeding. I went with the Mirena. It's only been about 6 months, but so far have been very happy with my choice.
posted by MandaSayGrr at 9:23 AM on March 30, 2016
posted by MandaSayGrr at 9:23 AM on March 30, 2016
I started taking the mini-pill about four months post partum. I forget what the brand name was, not Cerazette, but I don’t think there’s a lot of difference among them. I hadn’t yet gotten a period since giving birth. Breast feeding my daughter continued to go just fine. I never started menstruating, but I attribute that to breast feeding rather than the pill. I got a Mirena when she was 18 months old and have continued nursing her without a glitch. My doctor tells me that I’ll likely never get a period while the Mirena is in; I’m not sure if that’s the “fix” you’re looking for for irregular cycles (I don’t have PCOS and was very regular prior to pregnancy).
I wish I’d just gone with the Mirena to begin with. The mini-pill’s reliability isn’t great and since I wasn’t menstruating I was always a bit paranoid that I was going to end up as an “I Didn’t Know I Was Pregnant,” story.
posted by Kriesa at 9:24 AM on March 30, 2016
I wish I’d just gone with the Mirena to begin with. The mini-pill’s reliability isn’t great and since I wasn’t menstruating I was always a bit paranoid that I was going to end up as an “I Didn’t Know I Was Pregnant,” story.
posted by Kriesa at 9:24 AM on March 30, 2016
Best answer: For the progesterone pill (Cerazette), I personally would never use it for myself because I'm terrible about taking pills on time and it must be taken very close to the same time daily (more so than regular OCs). The progesterone only pills should regularize periods but probably won't help with other PCOS symptoms.
Cerazette has a 12 hour window unlike most mini-pills. I've never heard of birth control pills being used to treat symptoms of PCOS other than period-related issues. (they certainly don't treat weight gain or hair loss). Cerazette is my life-saver, my periods are awful depressive nightmares, I don't know how much of that is the PCOS but Cerazette completely eliminated my periods and associated issues.
posted by missmagenta at 9:47 AM on March 30, 2016
Cerazette has a 12 hour window unlike most mini-pills. I've never heard of birth control pills being used to treat symptoms of PCOS other than period-related issues. (they certainly don't treat weight gain or hair loss). Cerazette is my life-saver, my periods are awful depressive nightmares, I don't know how much of that is the PCOS but Cerazette completely eliminated my periods and associated issues.
posted by missmagenta at 9:47 AM on March 30, 2016
I've never heard of birth control pills being used to treat symptoms of PCOS other than period-related issues. (they certainly don't treat weight gain or hair loss).
Low-androgen birth control pills are prescribed to help PCOS symptoms like acne and hair loss when combined with an anti-androgen like Spironolactone. But that combination is not a possibility while breastfeeding.
posted by cecic at 11:06 AM on March 30, 2016
Low-androgen birth control pills are prescribed to help PCOS symptoms like acne and hair loss when combined with an anti-androgen like Spironolactone. But that combination is not a possibility while breastfeeding.
posted by cecic at 11:06 AM on March 30, 2016
I loved the simplicity of my nexplanon arm implant. Super easy to put in and take out. Though full disclosure I only had it on for a month. No hormonal side effects but I have some health issues that didn't mesh with hormones. But I recommend it to anyone who is considering an IUD because the arm implant takes 30 seconds, you're numb, and you just get some arm pain and bruising for a couple weeks. (Now I'm hormone free.)
posted by Crystalinne at 11:59 AM on March 30, 2016
posted by Crystalinne at 11:59 AM on March 30, 2016
I have a Mirena IUD and I love it. The installation was a breeze (Me to my midwife five minutes in, "Um, that's it?" and then she laughed at me), I've had minimal side effects, and I don't even know it's there. I was breastfeeding when it was put in, though I've since weaned. I didn't notice any effect on my already crappy supply.
posted by Aquifer at 5:48 PM on March 31, 2016
posted by Aquifer at 5:48 PM on March 31, 2016
Response by poster: Went with the mirena. Thanks, everyone.
posted by meijusa at 12:10 AM on April 1, 2016
posted by meijusa at 12:10 AM on April 1, 2016
For future answer-seekers - to be clear, hormones treat two aspects of PCOS.
The most important aspect is prevention of thickened endometrial lining, which can put PCOS women at risk of endometrial hyperplasia (cells at high risk of becoming endometrial cancer). This can be achieved with progesterone-only or progesterone+estrogen methods of birth control.
The second aspect is addressing the consequences of elevated testosterone levels (acne, issues with hair distribution). This is treated hormonally with birth control methods that contain estrogen (which reduces the level of free testosterone).
After delivery, estrogen containing birth control is not recommended for four weeks after delivery due to concern for developing clots. With breastfeeding, progesterone-only methods are generally recommended primarily due to concern for reduction of milk supply, although theoretically speaking once breastfeeding is"well-established" (generally by 4-6 weeks after delivery) estrogen shouldn't impact production.
Hoep that helps.
posted by noonday at 4:23 AM on April 1, 2016
The most important aspect is prevention of thickened endometrial lining, which can put PCOS women at risk of endometrial hyperplasia (cells at high risk of becoming endometrial cancer). This can be achieved with progesterone-only or progesterone+estrogen methods of birth control.
The second aspect is addressing the consequences of elevated testosterone levels (acne, issues with hair distribution). This is treated hormonally with birth control methods that contain estrogen (which reduces the level of free testosterone).
After delivery, estrogen containing birth control is not recommended for four weeks after delivery due to concern for developing clots. With breastfeeding, progesterone-only methods are generally recommended primarily due to concern for reduction of milk supply, although theoretically speaking once breastfeeding is"well-established" (generally by 4-6 weeks after delivery) estrogen shouldn't impact production.
Hoep that helps.
posted by noonday at 4:23 AM on April 1, 2016
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Copper coil (Paragard) does come with heavier/longer bleeding and furthermore doesn't provide protection to the endometrial lining (which would be important for PCOS). I would steer away from that.
posted by noonday at 7:48 AM on March 30, 2016 [1 favorite]