weird fluconazole side effect?
December 2, 2022 9:22 PM   Subscribe

YANMD and I already have a doctor's appointment on the books for next Thursday but this is so weird to me that I want to poll the hive mind to see if this is common or if I should be concerned.

Background info: I take my birth control pills continuously, no placebo week, to skip my periods because I get treacherous mood swings on my period. My gynecologist approved of this and my psychiatrist and endocrinologist (I have PCOS) concurred. I occasionally have breakthrough bleeding but nothing to write home about.

Recent development: I was recently diagnosed with Type 2 diabetes and prescribed Jardiance. I had been taking Metformin (regular and extended release) for 20 years because my PCOS presented with insulin resistance; however, my digestive system never got acclimated to the Metformin and after two decades of uncomfortable GI symptoms and running for the bathroom I had enough. (I asked a question here earlier about Januvia, which I was given initially while my endocrinologist did the prior auth process with my insurance company for the Jardiance - the prior auth was approved. Only including this info in case my posting history confuses people. I was on Januvia for literally 2 days before I got cleared for Jardiance, which is the med my endocrinologist REALLY wanted me on.)

Fun fact: An uncommon side effect of Jardiance is yeast infection. Despite taking probiotics and managing my blood sugar, after 5 days on Jardiance I got a wicked yeast infection. It was misery. Fire crotch (sorry, but that's what it was). OTC remedies did nothing. I begged my gynecologist to call in a prescription for Diflucan (fluconazole). I took the Diflucan yesterday evening. By this morning I felt so much better. By afternoon, my yeast infection symptoms were mostly gone.

By evening... I... got my period?

I mean. This is a full blown period. Horrible cramps, heavy bleeding (consistent with the amount of flow I would get when I still got monthly periods). I did not stop taking my birth control pill at any point during this sequence of events. I'm technically on Friday of Week 1 of a new pack of pills right now. I never forget to take a pill. I had to go dig up my menstrual cup because this is literal menstruation.

BUT WHY???!!!

Dr Google, who I am well aware has no medical degree, says that occasional spotting can occur on Diflucan. I've also seen comments on forums about women's health that they suddenly got their period when they shouldn't have after taking Diflucan. This is all anecdata though. I cannot find a single credible medical source online that explicitly states that Diflucan can cause menstrual bleeding.

I am scheduled for my annual gynecology appointment this Thursday. Been on the books for months. I will obviously ask him what the hell is going on and let him give me his actual medical opinion borne of a medical degree from medical school. Hopefully this isn't a matter of concern.

(Extra info that may or may not be relevant: my mother had cervical cancer. I only got 2 out of the 3 Gardasil vaccine doses before I turned 26 and my insurance company was a dick about covering the third after I aged out because I was a negligent workaholic flake in my 20s who didn't understand the value of taking care of my health. I had an abnormal Pap smear for the first time in my life in 2021, had a subsequent colposcopy, and the biopsy revealed no cancer cells YAY.)

YES, I will talk to my gynecologist about this at my appointment. But I'm an impatient and anxious sort and so I want to know - has this happened to anyone else with Diflucan? Is this a thing? If so, do you know why it happened? Or is this like, Defcon 1 concerning and I should go to Urgent Care tomorrow and/or call my gynecologist before my appointment to let him know what is going on?

I am writing this on my phone while lying down with a heating pad to deal with menstrual cramps that I have not experienced in 2 years since I started taking the BC pills continuously. I am confused and in pain. (But hey - the yeast infection is gone!)

I also have a parallel concern that if I am going to keep getting frequent yeast infections from the Jardiance (which so far aside from the yeast infection I absolutely LOVE), I may end up having to take more Diflucan to treat them and then I'll just be getting my period all randomly all the time with no predictability and that's just not something I can live with. Should I give my endocrinologist a call too about this or wait to see what the gynecologist says first? Both doctors are a part of the same medical group and communicate with each other frequently.

Anecdata welcome. Any Mefites in the medical profession, I would certainly love your input too.

Thank you.
posted by nayantara to Health & Fitness (5 answers total)

This post was deleted for the following reason: posters request -- frimble

 
Best answer: By evening... I... got my period?

I mean. This is a full blown period. Horrible cramps, heavy bleeding (consistent with the amount of flow I would get when I still got monthly periods). I did not stop taking my birth control pill at any point during this sequence of events.


I think it was the Diflucan
Common side effects include vomiting, diarrhea, rash, and increased liver enzymes.[3] Serious side effects may include liver problems, QT prolongation, and seizures.[3] During pregnancy it may increase the risk of miscarriage while large doses may cause birth defects.[4][3]
Some forms of birth control pills mimic the hormonal profile of pregnancy, and rather than giving you a period-like event, I think the Diflucan gave you a miscarriage-like event.
posted by jamjam at 10:19 PM on December 2, 2022 [2 favorites]


Response by poster: Oh wow.

That makes a lot of sense. Thank you so much jamjam, I would never have been able to suss that out.
posted by nayantara at 10:44 PM on December 2, 2022


Best answer: Also since you sound a little worried about the gardasil vaccine, I think the product has changed and the age limits definitely have - now ok through age 45 so you could ask your doctor about it (or just go to the pharmacy and request it…)
posted by Tandem Affinity at 10:54 PM on December 2, 2022 [1 favorite]


Best answer: Fluconazole may affect drug metabolism which could have affected the effective level of the contraceptive pill hormones circulating in the body, which can do unpredictable things to your bleeding pattern.

(To be technical about it, “ Fluconazole is an inhibitor of the human cytochrome P450 system, particularly the isozyme CYP2C19 (CYP3A4 and CYP2C9 to lesser extent) ”. wiki

Ethinylesteadiol is metabolised by CYP34A. Too many potential progestins for me to get into it but I’m sure they’d be affected too.
posted by chiquitita at 2:18 AM on December 3, 2022


Best answer: Sorry for double posting but I didn’t see your other comment - serious yeast infections are a very common reason to stop meds like Jardiance, and your endocrinologist should know about this incident and address it with you.
posted by chiquitita at 2:21 AM on December 3, 2022


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