Seasonale v. Ortho Tri-Cyclen

August 25, 2006 12:07 AM

Women of MeFi, your experiences with Seasonale?

As part of a two-pronged attack on my migraine (part two being Zomig), my doctor suggested that I switch from Ortho Tri-Cyclen to Seasonale.

I've never taken anything but OTC, and I'm concerned about the switch. Breakthrough bleeding? Weight gain? (I had very little of the former, and none of the latter, on OTC.) Nausea? Cramps? Decreased libido?

I'm also somewhat concerned about the long-term effects of messing with my body chemistry this much.

Basically, I'm apprehensive about switching, and I'd like a little more information from women who actually have taken it (or their MeFi-inclined boyfriends/husbands/what-have-you).

Don't be shy because you're not a doctor; I have a perfectly good one of those, and pharmacist family members, and what I want is anecdotes and such.

posted by anjamu to health & fitness (21 comments total)

MY doctor in Europe told me that women with migraines shouldn't take the pill. I stopped years ago and haven't had hardly a headache since. I was on OTC for about 3 years.

YMMV and I don't mean to freak you out but he said that having migraines and being on the pill gave me an increased risk of stroke. He was shocked that I'd even been prescribed it in the first place.
posted by fshgrl at 12:22 AM on August 25, 2006

I was on it for about three months, I had stomach pain and nausea quite often and I was still very irregular. After almost four months I decided enough was enough, it was affecting my daily life too much so my Dr switched me to Marvelon and I've been on it for almost 6 months. It made me regular for the first time since I was 13 (I'm 23 now) and I've had no side effects at all from it.
posted by bluehermit at 12:24 AM on August 25, 2006

I was on Ortho Tri Cyclin Lo for about...3 years before switching to Seasonale. I've been on Seasonale for less than a year (approx. 9 months, currently). I can't help you as far as migraine issues go, but I did not experience any extra weight gain (although I think a combo of the Ortho + college is what did me in to my current state of affairs), and I've only had breakthrough bleeding twice. Once when I was just starting it (the first month, last week leading into the second month's pills) and the second time was when I first started on my summertime mission to lose weight.

While on Ortho, I had very light periods, lasting for about 3-4 days, with very little PMS-type symptoms. Now that I've switched to Seasonale, my periods are slightly heavier, last just about the entire length of the placebos, and I have had some recurrencens of PMS symptoms (particularly mild cramps). I think it's a fair trade. (I hate having a menstrual cycle at all.)

I can't comment on the libido thang (I don't dig sex), but I know that a friend of mine who was also contemplating switching from OTC to Seasonale was worried about not having the reassurance of having a "period" every month.


When I talked to my girlydoc about the switch, he said that side effects usually don't happen between different pills, if they are of similar hormonal dosages. From what I remember of looking at the OTC (lo) and Seasonale websites, those two are about the same as far as hormones go. With regular OTC, I'm not so sure. Maybe the websites will help you.

Good luck. :)
posted by sperose at 1:45 AM on August 25, 2006

I do not suffer from migraines and Seasonale is my first experience with the Pill. I do not take any other prescription medicine. I've taken it since December 2005. The first two weeks, I experienced a tiny bit of nausea but that had more to do with taking it before I ate breakfast. Once I ate something and then took it, things got better. I have not experienced any weight gain. It has definitely improved my skin--even minor breakouts have dissipated. I see no effect whatsoever on my libido

Since it's only been 8 months, there have been 3 instances of breakthrough bleeding. I knew to expect this during the first year. While they are annoying, they are not in the least bit painful. The Pill periods are light and pain-free.

I'm really pleased with Seasonale--then again, I have nothing to compare it to.
posted by gsh at 3:17 AM on August 25, 2006

I've just made the switch myself, and while I don't notice any physical effects yet, the $150 pricetag for the threepack, as opposed to $30 for generic Ortho, has left me wondering how long I'll find it worth the price.
posted by bibliowench at 5:25 AM on August 25, 2006

Your doctor obviously knows better, but have you tried skipping the placebos while on the Ortho? I ask because I have migraines as well that are triggered by my menstrual cycle and I've found that "skipping my period" actually DOES NOT help at all. I'm not sure if Seasonale has a different formulation or if you are getting the recommendation simply for the fact that Seasonale has you skipping periods (and the ebbs and flows of estrogen).

Maybe it would be worthwhile to try skipping the placebos on OTC first to see if it gives you any relief before switching to a different pill. Of course, your doctor would know your situation better than I.
posted by stefnet at 6:23 AM on August 25, 2006

I was on Seasonale for almost two years. I've tried three or four other pills before going on (including OTC). I loved it. No noticeable weight gain, no obvious mood side effects (I was miserable for two weeks out of four on OTC), my face cleared up, my periods were *very* short and light towards the end (four days or so, and I could have mostly gotten by with pantiliners), periods were largely cramp-free. Some decrease in libido vs. not being on the pill at all, but about the same as all the other pills I tried.

There was a fair bit of spotting for the first year I was on it, as I recall. I think the first cycle I went through I spotted for the last month of the pack. But that cleared up.

The pricetag is a bit of a bummer, but for me was worth it.
posted by fuzzbean at 6:31 AM on August 25, 2006

I have been on Seasonale for two years. As far as I can tell, it has helped my migraines a lot. I still get them, but much less frequently. However, I find I'm often nauseous, especially in the morning, and I still have breakthrough bleeding a few days a month. I generally feel a bit weird during the breakthroughs - it's kind of hard to explain, but I'm just shaky and fuzzy. I did gain some weight initially, but I have since lost it. I actually stopped taking Seasonale for a couple of months because of the nausea, but on the other pill (I have to be on some BCP because of recurring cysts) my headaches came back with a vengeance. Lately, though, the nausea has been a real pain and I'm thinking of switching again, though I'm reluctant because Seasonale controls my headaches so well. Plus, I have also found my complexion is almost perfect while I'm on it. . . so, do I go for daily nausea or zits and migraines? Hm.

In terms of cramps, mine are somewhat worse with Seasonale than the others I've been on, but they aren't extreme, plus it's only four times a year rather than twelve. My libido is kinda crummy anyway, so I don't blame it on the pill. I haven't noticed much in the way of mood swings or PMS. Anyway, if your migraines are bad enough, I'd recommend giving Seasonale a try. It has definitely helped me in that regard.
posted by katie at 6:47 AM on August 25, 2006

I also have been on Seasonale for a little under two years. I haven't had a truly major migraine since I've been on it. I haven't taken any other prescription medication (other than a fioricet when I have a minor migraine) besides Seasonale. I highly recommend Seasonle - It's really one of the best pills I've ever been on (I have been on the pill for 10 years and used Ortho Tri-Cyclen (seven years) and Yasmin (nine months) before Seasonale). Yasmin actually caused my first aphasic migraine so I went off that immediately. As far as PMS symptoms go, I have realized that I am slightly moodier on Seasonale than I was on Ortho Tri-Cyclen or Yasmin, but it only happens every three months so I tolerate it well. I do have pretty bad cramps, but I had those on the other two pills, too, so having them every three months instead of every month is a vast improvement.

I think it's up to you and your doctor, but in my experience, Seasonale is wonderful.

You may also want to hold out until next year when the FDA is expected to approve a year-long birth control process (no periods - all year!). I forget what it's called, and I can't really research it here at work, but I'm sure if you googled you could find it.
posted by MeetMegan at 8:42 AM on August 25, 2006

Oh yeah, and no breakthrough bleeding and no weight gain (the weight gain I had is attributable to Depakote, a prophylactic I took for migraines - once I went off that the weight started coming off). Libido wise, I think I have actually had increased libido since I've been on Seasonale.
posted by MeetMegan at 8:44 AM on August 25, 2006

stefnet, Ortho Tri-Cyclen is a triphasic pill. That means it's designed around the idea of a 28-day cycle - the hormone amounts vary throughout the month. This makes it a very bad choice to take continuously. Only monophasic pills, like Nordette, which maintain a constant level of hormones throughout the cycle can be used continuously. [Note that many gynecologists are willing to prescribe these sorts of pills for continuous use, and that they're often cheaper than Seasonale.]
posted by ubersturm at 8:44 AM on August 25, 2006

I too experienced really really bad nausea and general ickyness when I first switched to Seasonale. I'd say it lasted me about a month. After that, it went away completely. I did have breakthrough bleeding when I initially switched, but that went away eventually too. I didnt have any problems with more cramping than usual or longer periods. In fact, i think they were shorter! One word of caution: if you happen to forget a pill even ONCE, you may be subject to a really really long period. For some reason, when I skipped one and then started right away the next day, sometimes I still got my period. Those dragged on foreeeever.

My insurance company treats seasonale as regular birth control for some reason! I pay 30 bucks for the WHOLE package. YMMV. In general, I've been pleased with the whole experience. You just have to stick through the first month or so.
posted by theantikitty at 8:56 AM on August 25, 2006

I was on Seasonale for three months (one pack) and *hated* it. I had breakthrough bleeing and general yuckiness on and off the entire time (although the bleeding might have resolved if I'd stuck with it). It was the extreme, excruciating, constant breast pain that got me in the end. I switched to a lower-dose combo of the same hormones (Aviane) and it rocks. YMMV.
posted by robinpME at 9:17 AM on August 25, 2006

It's funny, I started Seasonale about 5 months ago and was thinking of doing an AskMe when I first started getting nausea.

I switched from Depo (six years) to Seasonale because I had to get off the Depo, and I couldn't stand the thought of having a period every month again after years of little to no periods.

The first month was the toughest. About 2 weeks in, a lot of nausea, to the point that I thought about going off of it. It lasted about 2 weeks (got a little better when I switched to taking it at night) and then it was gone.

MAJOR breast tenderness & soreness for about a month. I think they got bigger. It was weird.. Some weight gain (possibly not related).

The only other major issue is I forgot to take it 2 days in a row during my second round (yeah, I know, that's why I used to be on depo, I'm terrible at remembering this stuff) and on the 3rd day, I started bleeding and I bled for about 2 weeks! Now everything seems to be back on track.
posted by witchstone at 10:51 AM on August 25, 2006

Your doctor obviously knows better, but have you tried skipping the placebos while on the Ortho?

My darling girlfriend did this for about three months - on the advice of her doctor - before making the switch to seasonale (which she has found no better or worse than OTC). The big hassle is if you get any insurance benefits paying for the pill you're trying to get a renewal after 21 days rather than 28 which was a problem Every. Single. Time. that MDG went to get her renewal.

Hassle, argument, pharm calls insurance company, insurance company thinks about it for 24h, prescription filled.
posted by phearlez at 10:57 AM on August 25, 2006

My older sister went on Seasonale and told me that every month when she felt she should be having her period, PMS emotions still kicked in ,mostly from habit she thinks. She said it was weird to have the emotional period stuff going on completely divorced from actual physical stuff.
posted by Sara Anne at 11:07 AM on August 25, 2006

I skip placebos on the regular pill, and highly recommend this. I haven't had a single period in almost 6 years. It also did great things for my skin, and no noticible weight gain. My OB/Gyn approves (and in fact does the same thing herself). I wouldn't pay more for Seasonale to have the same effect. Oh, and I occasionally miss pills; the only time I had even a tiny bit of spotting was after missing 3 or 4 in a row (vacation emergency).
posted by TochterAusElysium at 11:16 AM on August 25, 2006

Took it for a couple of months, had the breakthrough bleeding/spotting, and it made my skin sensitive to sunlight (I got a bad rash after a mild sunburn). I gained four pounds, which I lost practically the day I stopped taking it, so it was clearly water. I was only taking the pill for marginal reasons and decided it wasn't worth it, but I would try Seasonale again if I wanted to go back on the pill. I don't know how much this helps you, as I think brands or hormone combinations are very individual, (but for what it's worth I would NEVER take Yasmin again).
posted by crabintheocean at 5:01 PM on August 25, 2006

I've only ever been on ordinary pills, but your question reminded me that I had heard a very interesting piece on NPR's Morning Edition about this a couple of months ago. It won't speak to your questions about side effects, but it's very relevant to your questions about long-term messing with your body chemistry.

Included in the piece are these observations: That monthly periods on the traditional pill are artificial anyway, that having periods when on the pill was a marketing decision made when the pill was first introduced, and that the decision was based upon outdated factors. Such factors: oral contraception was too revolutionary to be guaranteed market acceptance, and taking periods away would have made it even more so; that there were no OTC pregnancy tests, so the period was needed as a periodic check that the woman wasn't pregnant; and that the devout Catholic co-inventor thought the church would be more likely to accept a pill that didn't mess with menstruation. "What all this has meant, however, is that women who choose oral contraception have lived for decades with decisions that had nothing to do with science or health."

Also in the piece, you'll find fascinating observations about the huge differences in menstruation now vs. over human history, the relationship of those differences to life-time health, and the health implications in favor of Seasonale.
posted by daisyace at 8:02 AM on August 26, 2006

I've been on Seasonale for about 2 years now, and I think it is the best contraceptive I have been on.

I take it before I go to bed every night and that curbs the nausea. There has been no weight gain like I had with OTC. I don't notice any sexual side effects either.

I do notice a few, small PMS symptoms every month (tender breasts and fatigue) but it's not a big deal--I'll take that over excruciating cramps and weep fests any time! It's also cheaper than regular birth control, costing me only $60 for 3 months!
posted by dearest at 9:00 AM on August 26, 2006

Thanks everyone.

Experiences seem to vary (as I expected), so I guess I'm going to give it a try and see how it goes. It seems like this will be a fairly long experiment - my doctor says it can take up to a year for everything to shake out on Seasonale, but I might slip back into this thread and tell you how it went for me.
posted by anjamu at 10:20 PM on August 26, 2006