Contraceptive pill for mental health
June 19, 2022 10:02 PM Subscribe
My gynaecologist has put me on a contraceptive pill to help regulate my anxiety and other symptoms. I'm curious about other's experience with this use of hormonal birth control.
Gynecologist is incredibly expensive and my GP can't answer my question so I'm hoping someone here might have ideas.
I had a partial hysterectomy in January 2020. I still have my ovaries. So I'm cycling but since I no longer have periods I don't always know where I am in my cycle at any given time.
I'm 50.
My gynecologist has determined that I'm not yet menopausal, by scanning my ovaries.
I have pretty severe anxiety and depression that seems to be strongly related to perimenopause.
Much better now that I'm taking Lexapro. But that seems to have exacerbated some symptoms.
Since starting Lexapro, it's almost as if I'm more sensitive to hormonal change.
Since starting Lexapro, I got pretty bad breast pain and breast swelling on certain days, and my anxiety increased and decreased through the month (while still being overall less. )
My gynecologist put me on Qlaira contraceptive pill to help with this and it seems to be helping. Very little breast pain now, and my anxiety levels seem steadier.
But she said I should take the placebo pills, and on those days I have a pretty bad headache, and anxiety flares ups.
I'm wondering if I should skip the placebos, or ask for a more steady dose pill. Qlaira has different levels of estrogen throughout the cycle.
On the other hand Qlaira is supposed to contain a type of estrogen that's identical to what my body is producing so, better than other pills?
I see that Lexapro is sometimes prescribed to help with menopause symptoms like hot flushes so that seems to suggest it has some effect on estrogen?
Most of the online stuff I'm finding about contraceptive pills assumes you're using it for contraception so I'm not really sure how to navigate this.
I had a partial hysterectomy in January 2020. I still have my ovaries. So I'm cycling but since I no longer have periods I don't always know where I am in my cycle at any given time.
I'm 50.
My gynecologist has determined that I'm not yet menopausal, by scanning my ovaries.
I have pretty severe anxiety and depression that seems to be strongly related to perimenopause.
Much better now that I'm taking Lexapro. But that seems to have exacerbated some symptoms.
Since starting Lexapro, it's almost as if I'm more sensitive to hormonal change.
Since starting Lexapro, I got pretty bad breast pain and breast swelling on certain days, and my anxiety increased and decreased through the month (while still being overall less. )
My gynecologist put me on Qlaira contraceptive pill to help with this and it seems to be helping. Very little breast pain now, and my anxiety levels seem steadier.
But she said I should take the placebo pills, and on those days I have a pretty bad headache, and anxiety flares ups.
I'm wondering if I should skip the placebos, or ask for a more steady dose pill. Qlaira has different levels of estrogen throughout the cycle.
On the other hand Qlaira is supposed to contain a type of estrogen that's identical to what my body is producing so, better than other pills?
I see that Lexapro is sometimes prescribed to help with menopause symptoms like hot flushes so that seems to suggest it has some effect on estrogen?
Most of the online stuff I'm finding about contraceptive pills assumes you're using it for contraception so I'm not really sure how to navigate this.
I take Yaz to manage PMDD and always skip the placebo pills because the extreme hormones expedite the onset of hypomanic symptoms (I have bipolar ii). I also take Lexapro and Lamictal. The latter decreases the efficacy of the pill, but the former doesn't seem to. Every person's body is different, so I think you should get a second opinion about whether Lexapro is the right supplemental treatment for you. There are many other options.
Wishing you good health.
posted by The Adventure Begins at 10:38 PM on June 19, 2022 [2 favorites]
Wishing you good health.
posted by The Adventure Begins at 10:38 PM on June 19, 2022 [2 favorites]
I'm a decade younger than you, but Qlaira (in my case for heavy menstrual bleeding) causes similar mood symptoms. It's been much better since I got my thyroid and vitamin D regulated, so that might be worth looking into, but generally I pay closer attention to mood for those two days, pamper myself a little and look forward to the "happy pills" that are the first two in the next box.
FWIW, when I was on my third box and I had an episode of heavy bleeding while travelling, my gyno said the rule was that if you skip the placebo, you should go straight to the yellow ones, so skipping the first week as well. I ended up taking just one placebo a few times instead. Overall I'm very happy with Qlaira, especially since with the additional endocrinological tweaks I'm having no bleeding at all.
posted by I claim sanctuary at 12:49 AM on June 20, 2022 [1 favorite]
FWIW, when I was on my third box and I had an episode of heavy bleeding while travelling, my gyno said the rule was that if you skip the placebo, you should go straight to the yellow ones, so skipping the first week as well. I ended up taking just one placebo a few times instead. Overall I'm very happy with Qlaira, especially since with the additional endocrinological tweaks I'm having no bleeding at all.
posted by I claim sanctuary at 12:49 AM on June 20, 2022 [1 favorite]
I had all kinds of hormonal bad feelings on a tricyclic pill. I've been on Seasonale (steady hormonal dose every day for 3 months, then a placebo row if you want it) for years and do not miss those terrible hormone cycles one bit.
posted by hydropsyche at 5:29 AM on June 20, 2022 [1 favorite]
posted by hydropsyche at 5:29 AM on June 20, 2022 [1 favorite]
Just skip the placebos, seriously. I have been doing that for 30 years and it's fine. Every 5 months or so I'll get breakthrough bleeding and take a week off to let that work out. But having no period ever is honestly awesome.
I have had many conversations over the years with gynecologists and GPs about this issue. GPs will tell you it's essential to have the placebo week because... well because! Gynecologists have mixed views, but many admit that it's really not necessary to have a pretend period (unless, like the original designers of the pill imagined, you don't feel like a 'real woman' without an entirely pointless week of cramps and blood once a month).
posted by EllaEm at 5:58 AM on June 20, 2022 [1 favorite]
I have had many conversations over the years with gynecologists and GPs about this issue. GPs will tell you it's essential to have the placebo week because... well because! Gynecologists have mixed views, but many admit that it's really not necessary to have a pretend period (unless, like the original designers of the pill imagined, you don't feel like a 'real woman' without an entirely pointless week of cramps and blood once a month).
posted by EllaEm at 5:58 AM on June 20, 2022 [1 favorite]
I used ocp continuously for many years because I so very much appreciated the even keel of my emotions without hormonal cycling. I'm a big fan of that use. I am no longer allowed estrogen due to an increased clotting risk, and I really miss it.
posted by Dashy at 6:20 AM on June 21, 2022 [1 favorite]
posted by Dashy at 6:20 AM on June 21, 2022 [1 favorite]
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