Dear Dr. AskMe, I know you are not my doctor.
July 7, 2009 11:12 AM   Subscribe

I have a lady problem. Removing my uterus and storing it in my closet until I next need it isn't an option. Please help me find a lady solution. More (TMI) inside.

Excuse my explicit description, but I feel stupid dancing around the issue. When I get my period, the first day tends to incapacitate me. I frequently experience extreme pain for several hours which makes it impossible for me to do more than lie in bed moaning, writhing, and feeling very sorry for myself. This is accompanied by painful diarrhea and, less frequently, the feeling that I am about to pass out (to the point of things starting to go black) which I have so far always been able to head off via immediate lying down.

Living like this is less and less acceptable to me. It's one thing when you're a student and you might have to miss class, but I am entering the legal profession and the hours are long and inflexible. I am worried that I will have a trial at the wrong time of month and not sure how I would cope. It's also making it difficult for me to enjoy my life. I planned a trip around my period, but my cycle was a bit irregular this summer and now my trip date coincides with when I should next be punched in the gut by nature. I am very, very stressed about this. I understand that this is an overreaction, but I am picturing myself strapped into the window seat during a 12 hour flight, unconscious, and covered in blood and poo. I’m trying to be funny, but I’m near tears.

So, the obvious solution is the pill. But I am very, very afraid of the pill. Forgive me, I know it's irrational, but my fear is clearly real enough to have prevented my even trying the pill out despite spending more time than I care to calculate weeping with pain and crawling back and forth between my bed and the toilet.

I am afraid of the pill because it's unnatural (irrational), because of the side effects (more rational, though one of the side effects I most fear is weight gain, which is kind of shameful), because you have to remember to take it every day at the same time and I worry that I wouldn't, and because I hate taking pills in general.

I don’t “have” a doctor, though I have health insurance. My two abortive attempts to talk about this with obgyns in the past were as follows: one doctor told me she wouldn’t give me prescription-strength pain medication because it didn’t happen every time and that was the end of our conversation; one doctor shoved a random pack of pills at me and told me “you WILL get fat,” then asked me to leave because she had another appointment. I am shy about talking about this stuff in person anyway.

Is there any way that I can handle this without taking the pill (or getting an IUD, worse, or the shot, worse)? I have little hope that there is an answer to this question that is not “no.”

More realistically, given that I probably have to take the pill if I want to control this issue, how can I get more comfortable with that idea?

I am very grateful for your help and advice (but, please, don’t tell me to suck it up). I can be reached at lamezilla[at]gmail.
posted by anonymous to Health & Fitness (79 answers total) 6 users marked this as a favorite
Have you been assessed for endometriosis?
posted by otherwordlyglow at 11:16 AM on July 7, 2009 [7 favorites]

This sounds really awful. I hope you find a good solution. And I really hope you can find a doctor who treats you better.

Most of your fears about the pill apply to any hormonal birth control, but I just wanted to make sure that you knew about the Nuva Ring. I think it is the lowest dose out there, because it is continuously enterting your system, and you have to remember it only twice a month (insertion and removal) rather than every day. I love love LOVE the ring.
posted by teragram at 11:19 AM on July 7, 2009

Find another doctor. If that one doesn't help you, find another doctor. You are the best advocate for your own health.
posted by roomthreeseventeen at 11:21 AM on July 7, 2009 [3 favorites]

You need to find a doctor. One who will listen to and not dismiss you or your concerns. It may take a while, but it's worth it. Seriously.
posted by rhapsodie at 11:21 AM on July 7, 2009 [4 favorites]

2nd the ring, I had no to nominal side effects and you don't have to think about it very often.
posted by stormygrey at 11:22 AM on July 7, 2009

It's not a long term situation, but two medication methods that help me:

Take your OTC pain pills. Really. I am sure you do, but I always forget to take them as regularly as I should, and then they wear off, and then I'm crying and whimpering while I'm waiting for them to kick in again. Take them before you're in real pain, and then keep taking them at the maximum dosage at the most frequent intervals allowed on the packaging. I have to treat myself like I'm totally stupid when it comes to this; I set out three ibuprofen and a timer set for five hours and when it goes off, I take them, whether I'm miserable again yet or not.

Smoke pot. I'm serious. I understand that this is not going to help if you have to sit through trial, and might be a little paranoia inducing in the airport if you're not used to it (OH MY GOD IS THAT A DRUG DOG OH WAIT IT'S JUST A HAIRY LITTLE KID), but I have never found anything else that helped relieve the feeling of a vicious flesh-eating bacteria chewing away at the muscles surrounding my spine and the feeling that my guts have been studded with ninja stars which bring me to wincing every time I move.
posted by Juliet Banana at 11:22 AM on July 7, 2009 [9 favorites]

You don't mention what OTC drugs you have tried. Naproxen (500mg--Rx strength, but the regular works, too) might help.

I had similar experiences when I was a teenager (missing school, debilitating cramps, etc) and in college. I started taking a low-dose pill (because of migraines) and the symptoms essentially went away.

But, most importantly you must find a doctor that you can talk to and trust.
posted by Pax at 11:24 AM on July 7, 2009

Your number one priority is finding a doctor - contrary to popular opinion there are lots out there who do listen and act appropriately and effectively on your behalf.

I'm with you on the pill issue - I won't take it. I also occasionally suffer from menstrual cramps so painful that I vomit. Prescription strength naproxen, 500mg (not OTC Aleve) works for this. There are connections with naproxen and heart issues, so you may want to study some information on that (lots available online).
posted by meerkatty at 11:26 AM on July 7, 2009 [1 favorite]

Endometriosis was my first thought as well.

Bottom line is: you have a medical problem. Your period should not be like this. Ask your friends and trusted co-workers if they have an OB they really like. Also, virtually all licensed midwives do well-woman care as well as the baby-related midwife stuff, you might have better luck there.
posted by anastasiav at 11:26 AM on July 7, 2009 [3 favorites]

Seconding endometriosis.

Also, you MUST find a gyno you trust.

And finally, look into acupuncture.
posted by miss tea at 11:27 AM on July 7, 2009 [1 favorite]

Just want to chime in and say that I shared your gripping fears of the pill and its possible side-effects. I was scared of it changing me into a different person, of gaining random weight, or becoming depressed to the point of being suicidal, etc. I was scared shitless. But after I got hit with the worst period of my life that had me wondering if I should be dialing 911, I decided that was enough.

So I tried one brand. The generic of one brand, and the horror stories for generics are even more common online.

But you know, I feel fantastic. I haven't been affected by a single side-effect. And looking back on all that worry, all the irrational fear and most of all, all my stubborn suffering, makes me want to go back in time, turn my younger self upside down, and shake until all the stupid falls out.

Probably not what you are here to hear, but - if you don't have a medical condition that's causing such heavy periods, and that's just how they are for you... The pill can really help. Really.
posted by Bakuun at 11:30 AM on July 7, 2009 [2 favorites]

Have you considered a hormone implant? It's usually a small plastic rod inserted under the skin (sometimes with a local anaesthetic depending upon location) closed with a single stitch. It lasts up to 5 years, and can be removed early.

"The beneficial effects of the oestradiol implant include the alleviation of premenopausal symptoms, the prevention of the onset, or the worsening of osteoporosis, and a reduction in the incidence of cardiovascular disease in the future."

Depending upon the implant though, you may need to also take an additional pill daily for two weeks a month, which would still be a problem, obviously.

By the sounds of it though, you most need to find a more sympathetic doctor. Perhaps a family planning clinic (planned parenthood in the US?)
posted by ArkhanJG at 11:30 AM on July 7, 2009

You really won't consider an IUD? You won't even know it's there. Available with hormone coating (reduces menstruation to a trivial amount in many users) or without (less hormonal weirdness).
posted by lakeroon at 11:31 AM on July 7, 2009 [1 favorite]

Until such point as you can find a doctor, take OTC pills. I find ibuprofen works fine for me. Start taking it as soon as you are aware you are having any symptoms. Keep taking them. Don't wait until you feel symptoms again -- take them every 4 or whatever hours. I have found this is very helpful for PMS management: never ever let the symptoms appear. I do not, personally, worry about taking more than the recommended daily dose, I just take my two extra-strength pills every few hours until I'm a few days into my period. This is because I have decided that it is better that I be functional.

Furthermore, eat as little processed food as you can, avoid things that are even vaguely difficult to digest, try to get enough sleep and exercise, and avoid stress. Ginger tea (steep ginger in boiling water, add sugar) helps with nausea.

I am not a doctor.
posted by jeather at 11:33 AM on July 7, 2009 [1 favorite]

People are of course right that a good, kind doctor who takes you seriously is what you need in the medium term, and specifically that it might help to mention that you're concerned about endometriosis. Since you almost certainly won't have that all squared away before your next period rolls around, though:

Take them before you're in real pain

I have found that this makes an enormous difference to me. If I start taking them as soon as I get the first sign that it's period time, before anything hurts, it goes just fine. If I wait, not only do I have to experience the cramping before the first dose kicks in, I can never really get them under control, even if I am really good about taking them at the max dose, most frequent intervals from then on out.

And for me, naproxen is definitely the OTC painkiller of choice. Have you tried Immodium AD for the diarrhea? It can be pretty miraculous.
posted by redfoxtail at 11:33 AM on July 7, 2009 [2 favorites]

Unfortunately, the non-hormonal IUD version (ParaGard) makes periods heavier. Not the best option. The Mirena, however, would be a very good choice.
posted by Bakuun at 11:33 AM on July 7, 2009 [1 favorite]

First off, what you're describing is NOT normal. I have a perfectly normal period, with minor (minor!) cramps, and I still do everything I can with birth control to avoid having periods as much as possible (which works out to about four times a year). What you're going through sounds unbelievably horrible, and I'm amazed that you've just put up with it so far. I would have been at as many doctors as it took the first time out demanding a solution. I work in a field with a lot of guys, and to me it just seems ridiculous that I should be grouchy, sore, and have to stay near a bathroom for 1/4 of my life when the men I work with don't. What you're talking about sounds significantly more debilitating. Missing classes is NOT an acceptable state of affairs. First figure out if you have an actual medical problem, find a good doctor, and then start problem-solving.

As people have said above, consider getting the NuvaRing, which is much lower a hormone dose than the pill (so, fewer to no side-effects) and you only need to remember to deal with it every three weeks instead of every day. It's great. The "naturalness" of it isn't something I've ever worried about, though I'm a big go-modern-science! person who's just delighted that such a thing exists. If it makes you feel any better, though, women have been on hormonal birth control for a long time, and female doctors have been using it to suppress their period for just as long. My general rule of thumb is that if someone who knows all the details of something is willing to use it on themselves, then it's probably cool.

Also, consider asking your doctor about the weight gain issue, my suspicion is that even if you see that side-effect it wouldn't be permanent if you chose to go off of hormonal birth control. The NuvaRing apparently showed the weight gain side-effect in 4.9% of women. Is your fear of that (even if it were a really horrible side-effect) really worse than what you're going through?
posted by you're a kitty! at 11:35 AM on July 7, 2009

seconding planned parenthood, and nuvaring
posted by 5_13_23_42_69_666 at 11:36 AM on July 7, 2009

Let's hope you've scraped the bottom of the medical barrel. It sure seems so. Any doc who shoves pills at you and walks away with basically no explanation deserves to be disciplined. My DD has/had debilitating periods and went through similar nonsense from people who had never experienced the pain and all that comes with it, esp since it's been like that from the beginning for her and who takes a 12 year old seriously even though they should. For about 3 years, she had depo-provera every so often, I think about every 6 months or so (could well be wrong.) These suppressed her periods. Lately, she's switched to a newer pill to do the same thing, but hasn't shared the name now she's all grown up.

My mum had the same thing, complete with migraines and excess bleeding. Years ago, her gp said there was a simple operation she needed to correct an internal kink. How non-specific could he be? Well, she never had it, being almost menopausal, so we'll never know. No one, unfortunately, has taken my DD's symptoms seriously enough to recommend anything other than suppression, but at least it gives her relief. And, no, she's never gained an ounce with either method. Can you find a gynocologist? Some of them are brutes, too, so you may still have to shop around. I've found that Planned Parenthood is a reasonably reliable source of info wrt birth control information as they don't have a moral axe to grind and aren't selling the pills.
posted by x46 at 11:36 AM on July 7, 2009 [1 favorite]

1) Find a good doctor
What you really need is a good doctor. I can't emphasize this enough. There are a number of medical solutions that could deal with this, and as mentioned, it could be endometriosis, or something else more than just a heavy period. If you need to bring in a notecard to make sure you don't rush through your important points. It can also help to start out by saying "I have a problem that hasn't been dealt with well in the past, and I really need your help addressing it." If you want to me-mail me I can post your city to see if anyone has a GYN recommendation, but absent that you should talk to friends, other dr.'s, or just try again. It's worth extended effort to find a gyn you like and trust.

2) try the pill
I know that birth control pills get a bad reputation on metafilter, but they can be a lifesaver for this type of problem. The important thing to remember about side effects is that they only affect some patients. If you've never been on hormonal birth control, it should totally be a first step for this sort of problem. The nuva ring or the hormonal IUD will also greatly reduce the intensity of your periods, but with the trade-off that the localized nature of the hormones won't have as much affect on the digestive issues. I took birth control pills for about ten years, and went off for some problems with mood/libido, but was happy for the first eight or nine years without any noticeable weight gain. (not that than anecdata is useful, except to say that plenty of people are happy on the pill for years at a time). Finally, if there is weight gain, it's more in the boobs, which may be a consolation.

3. Until then, advil and diet.
Until you can inplement 1, and maybe 2, try the following. If you know when your period is about to begin start taking advil - roughly 3 every 5 hours (assuming you're > 140 lbs, and have no know kidney/liver/clotting issues) about 12-24 hours BEFORE your period starts, and as mentioned above, stick to the schedule. Also, at this point try to moderate your diet to deal with the digestive issues -- consistent fiber intake, reducing spicy and fatty foods, and taking maybe a half a tums at morning and evening. If you still have diarrhea you could up it to a whole tums twice a day. I AM NOT A DOCTOR, but this regimen helped me in my teens when I had similar issues.
posted by mercredi at 11:36 AM on July 7, 2009 [2 favorites]

Similar issues in my family -

1. Find a doctor and get checked out for endometriosis and cysts. If there is no identifiable problem, demand Rx for pain management.
2. In the meanwhile, take the max. dosage of ibuprofen possible as soon as you think you are going to bleed and redose as soon as you safely can. Repeat as necessary.
3. If you know the timing of your cycle, high levels of activity and lots of hydration in the days ahead of bleeding may help somewhat. LOTS of exercise and LOTS of water.
4. If you plan to have children there may be long term help. On more than one occasion my sister had to be taken out of work in a wheelchair after fainting because of painful cycles. Two children later and she has normal (painful, but manageable) cramps.
posted by Cuke at 11:42 AM on July 7, 2009

I've been going to a nurse practitioner instead of a doctor since I've had to deal with this issue and find both the exams and conversations much more comfortable.

I can't really speak to the different kinds of BCP, since I don't actually take them *for* birth control (I'm married to a lady) but rather hormone replacement due to early menopause. I do take Microgestin in a very low dosage and haven't experienced any side effects.
posted by duckus at 11:44 AM on July 7, 2009

I'll fifth (or whatever) finding a good OBGYN. Use Yelp to track down someone amazing--Yelp hasn't let me down once. My friends swear by the ring, but I've never gained weight on Yasmin (even though I can gain weight from simply looking at a doughnut). As far as forgetting to take the pill on time everyday goes, my technique was to set an alarm on my cell phone to go off at 8 pm every evening.
posted by ohyouknow at 11:46 AM on July 7, 2009

I have the Mirena, and while I love it and recommend it to all my girlfriends and it has in fact made my periods lighter, I would not recommend it to someone who has unbearable periods and is terrified of most birth control methods. It actually makes periods heavier and longer at the very beginning. Also, the pain on insertion was equal to the worst period I've ever had.

I usually use that as a selling point-"It sucks, but you're used to it, it's really not any worse than a shitty period, and then you get over it and you're practically sterile for five years, yay!"-but if your periods are already unbearable, having to go to the gyno while on the rag and have the IUD inserted might really suck.

The IUD is a wonderful, wonderful method of birth control, and it does make periods lighter, and I recommend it to almost everyone. Everyone except the OP. Nuvaring FTW.
posted by Juliet Banana at 11:47 AM on July 7, 2009 [1 favorite]

You really don't need any more advice because it's sound, but it's so good it bears repeating: find another doctor, one you are comfortable with. They do exist. A doctor is exactly who can help you with this. Also, just anecdotally and to possibly set your mind at ease--my periods used to be almost as bad as yours on the first couple days. When I began taking birth control-reluctantly, and for the same reasons you don't want to-the problems went away. I didn't gain any weight (in fact, I weigh much less now than I did when I started taking it) and in general I feel so much better on it. But again, a doctor can work with you to help you find something that will work for you. Don't be shy when talking to them and don't minimize your problems. Write down everything you need to bring up beforehand and refer to the note if that's what you need to do. A good OB-GYN realizes that a lot of women are scared and/or nervous and many of them are very patient and will listen to you.
posted by Polychrome at 11:51 AM on July 7, 2009

This is purely anecdotal, and I definitely recommend finding a better gynocologist (ask female friends for recommendations) but I have had similar experiences and I found that taking a vitamin really helps. I take Women's One-A-Day multivitamin. My theory is that it's the iron that makes the difference, but I don't really know.

Good luck.
posted by jschu at 11:53 AM on July 7, 2009

As for hormonal birth control not being natural, here is how I think of it:

If I had been born 100 years ago, or any other time before that, I would probably have gotten married when I was around 18 and gotten pregnant within a year. If you're breastfeeding, then you usually don't ovulate for the first six months. So that's at least 15 months of no ovulation and no periods. Menstruation would probably return to normal for a few months before I got pregnant and started the cycle over again.

My periods were so painful before I started using the pill. I can't imagine having to deal with that kind of pain every month. Nthing the Nuvaring. I've had no side effects except for the good ones like acne clearup.

It is possible you will gain 5 or maybe even 10 pounds. I gained weight after starting on the pill. But I was also 20 years old and drinking beer and eating out every night so I really doubt the weight can be directly attributed to the pill.
posted by betsybetsy at 11:55 AM on July 7, 2009

From my perspective: consider the nuvaring - because the hormones are localized and not metabolized by the liver, the effects are less systemic. Much less systemic, in my case.

My MD boyfriend's perspective: Consider Yaz. It's the only one proven effective against physical PDD symptoms. Also, you can take 20 mg Sarafem for cycle days 15-28 and first day of menses and it significantly alleviates physical and psychological symptoms - and an OBGYN would be able to give it to you - you don't need a psychiatrist. (But if you're anti-medication, I doubt this is a consideration, huh?)

The last thing to keep in mind is that we are all different. I, for one, gained weight on Yasmin, which is the one that was marketed as "ZOMG-no-water-retention!" I went off and IMMEDIATELY lost 5 pounds. Like, within 4 days. So if you're gaining/moody/have no sex drive, give it a month or two and switch.
posted by namesarehard at 11:58 AM on July 7, 2009

Also possibly fibroids. Doctor doctor doctor - and keep trying until you get one who listens and actually wants to help. You're worth the hassle.
posted by Billegible at 11:59 AM on July 7, 2009 [1 favorite]

I agree, what they said! These sisters speak my mind! Planned Parenthood really is a great option, I've been to a few of them in different places over the years and received the best of care from lovely women who listened.

I know that RU486 can help with endometriosis.

Do you have a sister, a girlfriend, your mom, an aunt willing to go with you to doctor? Someone there with a list of all the symptoms you want to talk about, and all the questions you want to ask, who will support you and remind you to speak up.

If you're really not used to talking about this stuff with anyone you've made a good start here, now keep going.
posted by mareli at 12:01 PM on July 7, 2009

I found that taking a vitamin really helps. I take Women's One-A-Day multivitamin. My theory is that it's the iron that makes the difference, but I don't really know.

Just a note, anonymous and others, the pill often has some iron in it. Be careful if you decide to take it and have a vitamin/supplement or other medicine going. The combined iron can be too much and cause really unpleasant nausea.
posted by Solon and Thanks at 12:11 PM on July 7, 2009

Anon, I've sent a message to the email address you've included in your post.
posted by Hellgirl at 12:15 PM on July 7, 2009

The pill won't make you fat. It's 5 to 10 pounds max. For some, that's not even a clothing size. And remembering to take a pill everyday isn't that hard. You're going into the legal profession? You must be decently organized. Put a reminder on your calendar or blackberry for whatever time. Besides, I've missed days before, been hours late, and nothing traumatic has happened.

I know my posting does have a kind of "suck it up" vibe, and I'm sorry. I agree with everyone about finding a doctor you like. But I just graduated from school and had to find doctors myself, and I still haven't found one I like. So in the meanwhile, just take the pill. Women have been taking it since the 60s, and there's no serious side effects and no reason to be so worried. :)
posted by CPAGirl at 12:15 PM on July 7, 2009

Lots of good advice here already. Finding a good doctor who treats you with respect and compassion and is interested in your specific needs and concerns will open up a lot of options.

If you decide you might still be open to the pill, suggest asking about versions with low levels of estrogen, which are far less likely to cause debilitating or upsetting side effects, such as acne or weight gain.

I also wanted to address one specific element of how your previous doctors dealt with you, and that's this: you should not have to be in pain. Many doctors, and this unfortunately includes some gynos, don't take complaints of menstrual pain seriously. I think at some level our culture still buys into the idea that it's natural for women to suffer, and it's unacceptable. A helpful sign of whether you're dealing with good doctor you can trust is if they take your suffering seriously.

Finally, can you tell the mods where you live? Perhaps people have some recommendations for good doctors in your area.
posted by foxy_hedgehog at 12:17 PM on July 7, 2009

Everyone who says you need to be preemptive with the non-steroidal anti-inflamatories (Aleve, Motrin, etc.) is right. This works because your uterus makes prostaglandins which contribute to cramps. The NSAIDs can block the prostaglandins from having that effect, but only if you make sure they beat your uterus to the punch, so to speak. That means take as much as is safe as soon as you think you might be starting your period.
posted by slow graffiti at 12:18 PM on July 7, 2009 [2 favorites]

This is outrageous. You should not be suffering like this.

I have had good experience seeing a midwife for things like this. A lot of women don't realize that midwives give female exams to child-less women. And I think they are better at it than gynecologists. Also I have had better luck with nurse practitioners than doctors. I have had terrible luck with gynecologists so I don't go to them.
posted by cda at 12:21 PM on July 7, 2009

Seconding that what you're experiencing is not normal. Also not normal is your debilitating fear of hormonal birth control which could solve your problems. Keep looking until you find a doctor that you trust and like, and ask about all your options for handling what sounds very much like endometriosis. I'd rather be 10 pounds heavier than experience the periods you're describing any day (and for what it's worth, three different brands of pills AND the depo shot over the last ten years didn't give me a single side effect I'm not thrilled with).
posted by peanut_mcgillicuty at 12:29 PM on July 7, 2009

Oh, sweetheart, you really need to find a much better doctor. Find a doctor who won't say things to you like this:

Also not normal is your debilitating fear of hormonal birth control which could solve your problems.

Sorry to call you out, peanut, but the way to help someone get over a fear is not to call it irrational. Nor is it just prescibing it to you and walking away. A good doctor is someone who will help you assess all your options and make the best decision that you feel comfortable with.

And while hormonal birth control will definitely help -- it is perfectly valid for you to still not want to use it. A good doctor can discuss your fears about hormonal birth control with you, but will not exert undue pressure you one way or the other, and will let you have the final say over this choice. It's very possible that a good doctor will alleviate your concerns to the point that you change your mind anyway. But don't completely dismiss your concerns by calling them "irrational" -- they're concerns you have. You deserve to have them alleviated.

Find a MUCH, MUCH better doctor and discuss your concerns with him/her, at length. Ask about all possible options. Then make the choice you are personally comfortable with, whatever that choice may be.

Good luck.
posted by EmpressCallipygos at 12:38 PM on July 7, 2009

If you really don't want to go on hormonal BCP, since I haven't seen this mentioned upthread, I find that hitting myself with a cocktail of menstrual-relief herbal tea (red raspberry leaf is a good ingredient), evening primrose oil, and yoga (there's a book called Yoga For Your Menstrual Cycle) makes a big difference.

I'm not usually granola about medicine, but when I've been desperate enough to try anything (I can't be on BCP because of blood clotting issues), the alternative stuff in combination with Advil makes periods pretty tolerable.
posted by Jeanne at 12:38 PM on July 7, 2009

I am also thinking you may be dealing with either endometriosis or perhaps fibroids. Maybe with a bit of period-related IBS tied in for fun. Endometriosis seems more common, but what you're talking about describes my symptoms very closely, and I have fibroids.

I'd do a bit of research on all three of those, and when you do get a doctor (there's seriously no shame in asking female friends, relatives, or coworkers for recommendations), say you want to be tested for them when you make your appointment. That way they know it may take a bit more time than a basic annual exam, and schedule you accordingly, so you're not getting rushed out the door.
posted by Kellydamnit at 12:44 PM on July 7, 2009

Your fears about pill-induced weight gain are absolutely rational. Weight gain is not just an aesthetic issue, it's a health issue. I started taking the pill at 14 thanks to similar problems to yours, and in my 30s developed insulin resistance, high blood pressure, and obesity. I've reversed a lot of this by going off of the pill and a number of other lifestyle-related changes, but still - I can't help wondering if this would have happened to me had I been given codeine for my occasional pain, rather than something that effected my hormones every day of my life. I can't blame the pill with 100% certainty, but if you search PubMed and other sites you'll find plenty of studies suspecting a link between the pill and insulin resistance. Ortho Tricyclen even includes a warning on their patient information that their product may cause or worsen this.

The only recommendation I can give you is to go to a gynecologist, not a GP, if you can. Otherwise, try to find an internist with an interest in women's health. Many doctors these days have web sites; try to find one that expresses interest in women's issues.
posted by chez shoes at 12:48 PM on July 7, 2009 [1 favorite]

Just logging in as another woman who's had the same issue, who's found that 600-800 mg Advil the morning of and ASAP prevents the cold sweats, pain, lightheadedness, and other debilitating symptoms before they even start. Also, I've had trouble getting taken seriously on this and am amazed at how many women suffer the same severity of symptoms (not just pain but literally lying on the floor in a cold sweat for those first few hours).
posted by availablelight at 12:49 PM on July 7, 2009

As everyone hear has said, you need a good gynecologist that will listen to you and take your concerns seriously. The best way to find a good doctor is to ask your friends and family.

As for the pill, I've been on a few different formulations, and by far, I have had the best experience with Yasmin (brand name, not generic). There has been no weight gain, no loss of libido, no skin issues, and in general, a better period. In fact, I just plain feel better on Yasmin than off it (which makes no sense, but it is what it is). That isn't to say that Yasmin is the one for you or that the pill will solve your problems, but it is worth a shot. If you end up with bad side effects, you can try a different one and/or stop altogether.
posted by katemcd at 12:50 PM on July 7, 2009

Nthing finding a better doctor, and checking for endometriosis. But I'll also mention that when I was in my late teens and throughout my 20s, I had similar symptoms during my first day - debilitating pain, shortness of breath when I walked (and the feeling that I was going to pass out), along with the trots. When I finally went to the doctor, he checked for endo and I don't know what else, and gave me a prescription for Motrin (it wasn't available over the counter at that time). At the time, it seemed to me like a miracle drug; as soon as I felt the hint of cramps beginning, took a Motrin and then I actually forgot about my period for the next four hours or so (until it was time for the next dose). Sometimes the Motrin made me a little sleepy, but not groggy or anything. (Immodium AD helped with the other problem, by the way.) (Another by the way, by the time I hit my 30s the first-day symptoms mellowed out a bit; still enough tummy pain to require meds, but Midol or Pamprin did the trick by then, and I didn't get the shortness of breath or "weak" feeling any more.) Best of luck to you!!
posted by Oriole Adams at 12:50 PM on July 7, 2009

Sounds like you may have a case of my own personal demon, endometriosis (see otherwordlyglow's link). The bad news? It sucks, it really powerfully massively sucks. There is no cure. If you do have endo, you'll likely be dealing with this for a long, long time. At times, it will feel like it's ruining your life. There's a whole load of emotional and physical side effects that come along with a diagnosis and I'm so, so sorry if you have to go through them. Even if you don't have endo, it could be fibroids or any number of other things going wrong. No one here will really be able to diagnose you.

The good news? If you get a diagnosis reassures you that you aren't just crazy/hysterical/a weenie with no pain tolerance. And it gives you the option of a game plan.

I've been down this road for a while. I've had surgery and drugs (Lupron, oh drug of doom) that make birth control pills look like tic tacs. But you know what? It's worth it. Because if I hadn't started dealing with my endo, I think I would have killed myself by now. In all seriousness, my life was unlivable and the combination of pain and anxiety had become impossible. It sounds like you're about there.

The first step, the step I wish someone had forced me to take when I was 18 and starting this, is to get informed and take what control you can. Start doing your reading to know what you're up against. Keep a pain/symptom diary to show to your doctor. You've got insurance, so keep looking until you find an Ob who will take you seriously (this is sometimes hard).

The first step will certainly be birth control pills (or the patch or ring). You're having a lot of pain and misery right now, so I think you're having a hard time thinking rationally about them. That's a mental hurdle you'll have to work through. If you aren't willing to change, then you will always feel like this, and you don't deserve to feel like this. The first pill you try may not work for you, but for a lot of women with a lot of gynocological problems, they're enough to make a huge difference.

You probably aren't going to ever get painkillers (oh, how I've plead), but start taking 2 pills every 6 hours a few days before your period. When it starts, take 800 milligrams (4 pills) of ibuprofen every 5-6 hours with food to protect your stomach. It sounds like a lot, but that's an Rx strength dosage. It builds up in your system and can make a big difference in symptoms.

For me, my most workable solution right now is to cycle my birth control pills so I only have about five periods a year. Those bastards are still miserable, but it lets me life my live very nearly like a normal person all the rest of the time.

First step? Get serious about feeling better. You're paralyzed by fear right now because you're under siege from your own body, but you've got to empower yourself to do what you can. First thing is you must find a decent doctor. Make it a project, reward yourself for a job well done. Please memail me if there's any questions I can answer.
posted by mostlymartha at 12:54 PM on July 7, 2009 [3 favorites]

OP, if you would have one of the mods post even a general location, you could probably get many good recommendations for a doctor that you need/deserve (i.e. one who will listen to your concerns and extensively discuss your options with you.)
posted by wuzandfuzz at 12:54 PM on July 7, 2009

hormonal birth control will definitely help -- it is perfectly valid for you to still not want to use it

Seconding this, but also chiming in to say anecdotally that hormonal birth control may not help. I have been on the pill for close to a year because I was having periods that came every 24 days and lasted for 10...and the only improvement the pill caused was to move my 10-day periods to 28 days apart, which was an improvement, but hardly the outcome I was hoping for. Now trying a new birth control pill, which, even taking into account the reality of an adjustment time, isn't exactly a magic bullet, either, since I'm now on the 14th day of my period.

I still think that if you can talk to a doctor about your concerns about the pill, it would probably be worth trying. I'm probably an outlier, but just wanted to mention that women like me do exist.

Let me 100th "find a new doctor." I now have a new doctor, who, at my last appointment, said to me, "We'll figure this out. You've suffered enough." That's the kind of doctor you need, and deserve, and they exist.

Do you have a friend you could take to the next doctor appointment with you? A tough friend who is willing and able to say, "Wait a minute, she really needs pain management!" or to stand in the door and say, "I'm sorry to keep your next patient waiting, but my friend needs a couple more minutes of your time," or to otherwise help you say what needs to be said? When I was pregnant, my partner used to go with me to appointments in part to help me not chicken out about talking about the embarrassing bits, and to help me not just say meekly, "Oh, OK, then," when they didn't respond helpfully right away to a problem.
posted by not that girl at 12:59 PM on July 7, 2009 [2 favorites]

This is more what supplements might help than medical advice but I read a study a long time ago about how woman who increased calcium in their diet had much shorter periods. I'm pretty sure it was Prevention way back in the 80's when they use to be more hardcore alternative medicine. Since most woman could use more calcium in their diet, it's a low risk thing to try. I'd go for one that has magnesium in it too since that's suppose to help with bone density.
Vitamin E really helps with cramps but it's a blood thinner. It might cause more bleeding but fewer clots. If you want to try it, start with a low dose (200 IU) and take another if you still need it. I'd also second taking a little iron during your period but check the amount on the bottle. Some have mega doses and it's better to just have it in the normal RDA. Hope you find something that helps you!
posted by stray thoughts at 1:00 PM on July 7, 2009

I share all of your problems in every detail. I am also a lawyer and to be honest with you, my condition has seriously affected my career path. It is not possible to do trial work while bleeding this heavily. At times I go through a super tampon and overnight pad in less than an hour, and have debilitating cramps, diarrhea, and weakness. Court appearances are simply not possible, nor is it possible, as a practical matter, to schedule around them. I have other medical conditions which preclude my taking hormonal birth control, but if you don't, then I think you owe it to yourself to give it a try. There's a lot on the line here.

Meanwhile, I recommend that you start taking your pain medications a day before your period starts and take them consistently during your period. I also find it very helpful to avoid dairy and caffeine.

There is also something you can do when planning for big events to avoid getting your period. I did this when I discovered I would be getting my period during the bar exam. That was about 11 years ago now so I forget the name of the drug, but my doctor gave me some pills to take that brought my period on early. It was a lifesaver.
posted by HotToddy at 1:08 PM on July 7, 2009

I had endometriosis and ovarian cysts and had pain very similar to what you describe.

1. Go to a doctor. If it's endo, you need to know it. It can spread and mess with other internal organs and it's not something to ignore.

2. Don't assume that birth control is the only solution. I wouldn't take any hormonal solution because of my family's strong history of estrogenic cancers, so I got a prescription for pain killers (usually codeine). They helped take the edge off so I could sort-of watch a movie instead of moaning and thrashing.

However, since you're in the legal profession and need a sharp brain at all times, you might want to consider non-narcotic solutions, which could be different hormones that combat endo or surgery. My endo definitely affected my career and was one of the reasons I started my own business.

Surgery finally ended the pain for me (had my ovaries removed). If it's endo, less permanent surgery can provide temporary relief, but to find out you need to see a doctor.
posted by PatoPata at 1:12 PM on July 7, 2009

I just want to kindly reinforce the point that you don't know what side effects you'd have. Many women have none of the deal-breaker side effects. Why not give b.c. a try, cautiously?
posted by wryly at 1:15 PM on July 7, 2009

As mentioned above many times, get a better doctor. Keep trying until you find one you can talk to and you feel will listen to you. This will make all the difference in the world.

Here's the thing with the pill -- you can just try it. If it doesn't work, you can stop. Now, granted, it can take up to 3 months to do its thing, but if you causes you grief, just stop. Yes, there are all sorts of horror stories about the pill out there. What you don't hear however are the stories of the millions of people who the pill has helped! I'm sure you know this, but at this point, your fears are no longer rational thought (and I'm sure you know this as well), but it doesn't matter -- it is what it is. And what it is is needless suffering. You need a good doc who will help you sort though all this, physical AND mental, and find a solution. You cannot do it alone.

Personally, Marvelon was the pill that worked for me, until I had to get an IUD. On the pill I had no weight gain, no mood swings, insanely light periods and NO CRAMPING -- the world was just generally a better place. I had to go off the pill for unrelated reasons, but the Mirena for me is equally as wonderful. It's probably not the best option for you though.

Good luck... you don't need to suffer like this. Keep telling yourself that!
posted by cgg at 1:17 PM on July 7, 2009

I had all these problems too.

Firstly, please please please go and get yourself checked out for endometriosis, or possible cysts / fibroids. I'm in the UK, so I don't know how things work there, but over here I went to my GP with the same complaints, was being scanned at the hospital less than a month later.

I understand why you would be cautious about being on the pill, but trust me, after your first completely pain free month you'll love it. My pill, I would recommend to everyone (female at least!), is called Cerazette, not sure if it's available there, but Im sure something like it is. It's a 'mini' pill that you take every day without fail, and you don't actually have any period anymore (except I did the first month and it was awful, but i'm so glad i persevered). Now I have no pain, no PMT symptoms, and my only issue is remembering to take it. And because it's a mini pill it has fewer health risks than the normal pill and you can take it long term.

Please do not take no for answer for getting checked out if your doctor / ob/gyn is being less than helpful. There is no reason why anybody should have to go through agony every single month in this day and age.
posted by nunoidia at 1:18 PM on July 7, 2009

Definitely get checked out and make sure endometriosis is ruled out. Second, don't fear the pill. I used to feel like you in that I didn't want to mess with hormonal contraception, was afraid of the side effects, including potential lowered libido and possible weight gain. At the time I went on it, I was actually trying to lose weight and felt this was the last thing I needed.

That first kind made me crazy. Horribly depressed, weeping every day, shorter temper, and just horrible overall. Next pill had no weird side effects or weight gain, but things were a little uh, dry. So I changed again.

I am on something that I see no side effects with. I feel like me. It might take some trial and error, but something will work with your body, so if you try something and it doesn't feel right, you can change. This is why it's important to have a good, receptive doctor you can consult when needed.
posted by cmgonzalez at 1:19 PM on July 7, 2009 [1 favorite]

Try taking evening primrose oil supplements. I've found they make my incredibly painful cramps much more bearable. They're also good for breast tenderness and bloating.
posted by canadia at 1:22 PM on July 7, 2009

ps. forgot to say. yes there are side effects to most pills, you have to find one that works for you. Bad side effects I've had from previous pills have been migraines (Microgynon), weight gain (Marvalon / Loestrin), bigger boobs. Actually that last one I thought was great as I was a double AA nothing for most of my teens / twenties. However, the pill I'm on now? Not a single bad side effect noted so far, no weight gain. Only thing I've heard is if you come off it the period you next have can be very heavy and long, somewhat like the one I had after going on it I guess.
posted by nunoidia at 1:22 PM on July 7, 2009

Chiming in with everyone else - get a new doctor. I currently have the best gynecologist I've ever worked with and I'll tell you how I found him.

I went on my health insurance website, and found a doctor who was associated with the trauma/teaching hospital in my area. I live in a major metropolitan area, by the way. Then I called the doctors practice and asked the receptionist to call me back when she had a few minutes to talk to me.

The practice has 7 OB/GYN doctor's, so I asked her who was the most qualified and the most popular with patients. She did not hesitate to tell me his name, and let me know that he was the head of the OBGYN unit at this hospital. Fortunately, he was taking new patients and I have been seeing him for 3 years now. He is terrific. I knew it when he met with me for 15 minutes before the appointment to talk to me about what I needed from him.

Do some research and ask questions! Speak to a nurse first, tell them what you need from the doctor and ask them to recommend someone specific in the practice.
posted by lootie777 at 1:29 PM on July 7, 2009

Chiming in with people's responses about taking pain meds BEFORE the pain begins!

I get gawdawful cramps (though not nearly as bodywracking as yours). The minute I see that my period's started, I take 3 ibuprofen pills (with food) and repeat every 3-4 hours.

If I wait until the pain actually begins, for whatever reason, the pills are much less effective (if at all).
posted by cadge at 1:32 PM on July 7, 2009

No offense at the callout, Empress, but I didn’t call her fear irrational. I simply pointed out that it’s not normal to be afraid of something that can help solve her problems if she hasn’t actually given it a chance and experienced those side effects herself—they don’t affect everyone. I did encourage her to explore all options with her doctor, and find one that she trusts, which presumes that the doctor listens to her fears.

To the OP, I wanted to re-chime in about cysts. I’ve been thinking about your situation and remembered that a college roommate described similar symptoms and her doctor ended up diagnosing her with ovarian cysts. Just one more thing to ask about when you do find a doctor.

As for being uncomfortable talking about embarrassing things, tell yourself that this is in no way the worst thing that doctor has ever had described to him or her. It might help to also bring in a checklist of things that concern you or that you’d like to address instead of trying to remember everything off the top of your head—and I’ve found that if you mention that you’d like a slightly longer consultation time with the doctor when booking the appointment, you’ll frequently get it.
posted by peanut_mcgillicuty at 1:39 PM on July 7, 2009

Broken record part: Get another doctor! Ask friends for recommendations. Other women are great resources for finding an ob/gyn who listens!

Something that hasn't been mentioned: How are you talking to the doctor? Do NOT downplay your symptoms or act wishy-washy. Be assertive! You are your own best advocate.

Something along the lines of, "I have such severe pain and physical complications with my period that it is taking over my life. I want to find out why and treat it, and I don't want to just go on birth control pills." Then describe your symptoms. A good doctor works *with* you.

You really need to see a doctor before this vacation, too. The possibility of endometriosis, fibroids or PID, all of which are serious, should not be ignored.
posted by misha at 1:39 PM on July 7, 2009

Oh, and about ovarian cysts: they *could* be the reason, but most benign cysts disappear on their own after a few cycles.

Have shoulder pain? Pain only ever OTHER month? Then a problem with one of your ovaries, like a cyst, is more likely--but you still have to see a doctor to make it go away.
posted by misha at 1:41 PM on July 7, 2009

What about the Implanon? It's still unnatural by your definition, but weight gain isn't among the side effects I've heard of, and you don't have to think about it for three years. Breakthrough bleeding is the most common reason for removal, as I understand it. My friend just got it inserted (just a quick, painless procedure) and she loves it. I'm on the NuvaRing and adore it- no side effects at all. The one month in the past 7 years in which I was off of birth control, I had symptoms like you described.
posted by emilyd22222 at 1:45 PM on July 7, 2009

A lot of research seems to indicate that menstrual cramping is caused by a drop in blood calcium. You might want to research calcium supplements. I've also heard that taking a modest vitamin E supplement daily will greatly reduce the severity of cramping. Both the vitamin E and the calcium thing are suggested by Adelle Davis, who my mom swore by. Not sure if anyone still respects her theories but she seems to have been on to something here.
posted by Go Banana at 2:08 PM on July 7, 2009

@Juliet Banana: The IUD is a wonderful, wonderful method of birth control, and it does make periods lighter much heavier.

FTFY (at least in my experience with the Mrs.)
posted by plinth at 2:09 PM on July 7, 2009

"I am afraid of the pill because it's unnatural (irrational), [...] because you have to remember to take it every day at the same time and I worry that I wouldn't"

Taking it at the nearly the same time is important for the anti-pregnancy effects. It is less critical when you're after one of the other effects.
posted by Mitheral at 2:20 PM on July 7, 2009

I don't quite understand the claim that it is 'unnatural'. Natural can be bad, too (c.f. some herbal 'remedies' that alterna-medicine quacks give to people). What matters is that it works for you. Hell, I take some medications that are totally 'unnatural' in that they are synthesized in a lab and they dick with, say, my response to some allergens (which, while natural, is intensely uncomfortable if not prevented by medication), and I'm fine.

Side effects, on the other hand, are to be considered. Consider different levels of hormones and talk about it with a gynecologist, after they've ruled out that there's nothing else going wrong.
posted by kldickson at 2:36 PM on July 7, 2009 [2 favorites]

It took me 6 doctors until I finally found a gyno I liked, and it's so so much better to be comfortable talking to your doctor. Since you probably don't have that much time for trial and error, try asking the receptionist your concerns - "will the doctor listen to me or just shove pills in my hand?" etc.. usually the receptionist is a good indication of whether you'll be able to talk to the doctor comfortably or not.

I don't have any advice for your problem, but the pill generally does not make you gain weight. It clears up your skin. Makes the pain go away. Made the diarrhea go away (yea, I had that on the first couple of days of my period). Makes your periods regular. In fact, I used to have cramps and irregular periods before getting on the pill, and then a year later I got off the pill and the cramps went away and my period was still regular! I wouldn't be that afraid of it - maybe try it temporarily (6mo-year to give it enough time) and see how your body acts after you get off the pill. It's also really really useful for planning vacations and skipping a period if you want to if something fun comes up the week you're supposed to get it.
posted by KateHasQuestions at 3:04 PM on July 7, 2009

I am afraid of the pill ... because you have to remember to take it every day at the same time

Yes, there would be a higher risk of pregnancy (assuming you are engaging in some sort of activity where this would be a concern). You can keep doing whatever you are currently doing to prevent pregnancy while on the pill, and take the pill at some flexible time like "lunchtime" or "bedtime". Cross off one fear.
posted by yohko at 3:15 PM on July 7, 2009

Don't be shy about asking friends for gyno recommendations. Everyone I know who has a good gyno loves to recommend them when asked. Everyone who has had a bad one understands why you're asking.

I also agree with those who suggested seeing a nurse practitioner. They lack that doctor arrogance that too many of them seem to have. I go to an all-female practice that has doctors and NP's. It's great.
posted by Mavri at 3:17 PM on July 7, 2009

I would seriously considering adding some sort of omega-3 supplementation to your diet. There is lots of evidence that it can help this sort of thing. After supplementing for a few months I had many of my menstruation problems go away. I was taking a lot of meds for IBS around my period, because I had, you know....those same problems you were. I tried just about every kind of BC pill and Nuvaring to no avail.

I don't have the perfect period, but I don't have to carry around an arsenal of pills anymore and I managed to travel throughout the world with no problems, which I had previously dreaded doing. I never have cramps, my stomach feels fine, and bleeding is minimal.

I would also note to be fair that I went from being overweight to normal during that time because I made other changes in my diet including less sugar and more vegetables that might have been a factor. I saw a doctor that worked with me to improve my diet. Previous doctors had just said low-fat, high-fiber, but in my experience things like metamucil and whole grains made things much worse. During my period now I get all my fiber from green vegetables and I eat pretty high in fat, but you have to experiment and find what works for you.

I would suggest looking for a doctor who is into nutritional treatment like mine and willing to talk to you and if you end up with the pill, finding one that works for you. Your current doc doesn't seem like "the one." I went to 5 doctors before finding a good one.
posted by melissam at 3:24 PM on July 7, 2009

like lootie777, I love my gyn, and they are a large practice affiliated with the big teaching/trauma hospital in my area.
Perhaps somewhere like that is more likely to be used to difficult cases, due to their hospital association, and more happy to search for the full solution as it would be a teaching experience for the residents working there.

Also, if the daily pill is an issue I strongly recommend nuvaring. You don't have to remember it every day, the actual ring has four weeks of hormones so stacking them to skip periods is very easy, and you don't run into issues with your insurance company refusing to pay for extra rings a year if you do.
posted by Kellydamnit at 3:26 PM on July 7, 2009

I am afraid of the pill because it's unnatural

So is menstruation itself. Not being flip; there's a reasonable argument that throughout most of human evolution, menstruation was experienced very rarely, because women of childbearing age were almost always either pregnant or nursing and rarely survived long beyond the age of menopause.

because of the side effects (more rational, though one of the side effects I most fear is weight gain, which is kind of shameful)

I didn't gain weight because of the Pill. Most people I know didn't. I was also afraid of this, and my doctor minimized the fear: for those who do gain weight, the majority gain less than 5 pounds, and a fair amount of the gain is often in the breasts.

because you have to remember to take it every day at the same time

Hm, mainly important for birth control reasons. If you're taking the Pill for menstrual health this is a bit less important. But there are ways you can remember to always take it at breakfast, lunch, morning coffee, bedtime, whatever. If you do need birth control you can use a backup method if you fear you are not regular enough in your Pill taking.

posted by Miko at 3:35 PM on July 7, 2009

As everyone else said, you need a better doctor.

I used to have the same problem -- I basically lost a day every month. Some months I would even vomit, too. It was bad news. Prescription strength Anaprox (Naproxen sodium) was the miracle drug for me. Ibuprofen never seemed to have any effect, but Anaprox made the cramps almost entirely disappear. When it went over the counter as Aleve, I was pretty happy. OTC strength worked OK for me -- I would take two (which the package says is OK if needed).

The interesting thing, though, is that as I got older, the problem mostly went away. Nowdays I don't even always have to take any Aleve at all. Many months I have no symptoms. (I still get the migraine a day or two before, though... Aleve works on those too.) My mom told me that once she had a baby, her cramps went away. I never had a baby, but mine went away too. So you may have that to look forward to, if my experience is at all typical.

I never took the pill, mostly for similar reasons as you, so I don't know how well that would work.
posted by litlnemo at 4:01 PM on July 7, 2009

As an expert on women's health once said: "Natural is being pregnant or lactating pretty much constantly from the time you're old enough to conceive until you die or hit menopause." As in, breeding for your entire adult life.

The pill's hormone levels are quite low nowadays. The risks are very low, and there are health benefits. HBC can slightly increase breast cancer risk, but that depends on what formulation, and they are shown to decrease risk of endometrial and ovarian cancer.

If you are suffering, you should really consider hormonal birth control as a safe method to reduce your symptoms, or whatever else is suggested that might work. This is especially true if you want to hold normal work hours.
posted by ishotjr at 4:16 PM on July 7, 2009

Wow, I agree with all of the above about you needing a better doctor - even if you do decide the pill is the right route, your first one might not fit very well, and you need medical advice from someone who will take you seriously and work with you to find something to alleviate your symptoms. I went through an awful lot before I found (an old-school combined) one that did more good than harm, and it's easy to get frustrated when someone else's magic bullet turns out to be your source of, say, constant migraines (hello, Yasmin!) or massive mood swings (thanks, Nuvaring!), and having a doctor not make light of it is very helpful.

I've had the same horrible thing, although mercifully not to that extreme every month any more, and I found that pre-emptively taking Imodium (IANAD, YKIANYD!) at least toned the digestive symptoms down to painful and uncomfortable but slightly less...urgent. It still wouldn't make me want to jump on a long-distance flight, but it's not constant diarrhea either.

Also, not to ignore your fears, but on cold analysis, I imagine the career- and freedom-related gain in not writing off a day a month would really feel worth carrying or losing 5-10 pounds, long term, if you do happen to experience weight gain.
posted by carbide at 4:32 PM on July 7, 2009

If you don't already have one, get a DivaCup and read the livejournal community for information about it. It will make your period more manageable, once you get used to it.
posted by hooray at 6:06 PM on July 7, 2009

Are you okay with OTC medicines? If you take any, what do you take?

Be willing to try some other type. As stated above, some women stick to Aleve, some Motrin, some other things, depending.

I know that Tylenol does jack squat for me when I'm on my "bad day", but Ibuprofen makes me totally functional. I've never tried Aleve/naproxen sodium, so I don't know how it'd do for me. Aspirin also helps somewhat, but it's pretty bad on my stomach. With nothing, I can be pretty well incapacitated--even lying down feels draining.

I take two Ibuprofen every 5-8 hours for the first couple days, and then I'm fine. Ibuprofen does not help with my stomach issues, but since nothing else really works, I struggle through it. I know people who need to take 3 or 4 pills at a time to get reasonable results. Watch the limits, but don't be afraid to take more than a standard dose.

If you're afraid of the hormonal birth control (I still am, even though I used it for a little while with almost no side effects), try the OTC drugs to see if you can get a reasonable result first!
posted by that girl at 7:43 PM on July 7, 2009

I just really, really, really want to echo the above posts about taking naproxen or ibuprofen BEFORE the cramps start (24 hours before is best--the advantage, for me, of being on the pill is that I know almost exactly when the bleeding/cramps will start, so I can pre-medicate with INCREDIBLE SUCCESS). I am in a very similar situation as the one you describe, and the pill was supposed to make the cramps go away for me, according to every doctor I've talked to since I began menstruating, but it certainly did not make the cramps go away. The ONE, MAGICAL, WONDERFUL thing that has honestly made a difference is taking the max dosage of Aleve at regular 8-12 hour intervals the instant I start to sense my period coming on (or, if I'm on the pill, a day before the day I know the withdrawal bleeding will start).

I hate being on the pill, because I sometimes feel like it makes me crazy, but damned if it doesn't relieve the stress of having to think about what would happen if I were pregnant! And it's nice to be able to predict my periods, now that I realize what an irregular cycle I have naturally.
posted by so_gracefully at 10:03 PM on July 7, 2009

follow up from the OP
Dear everyone, including those who emailed me:

THANK YOU. You have changed my life. The NuvaRing is amazing. You gave me the courage to try it (especially the person who said it was like a jelly bracelet - that totally worked for me and was a very comforting image). I am so happy. Because of you. Dr. Metafilter, you are my favorite doctor.
posted by jessamyn at 12:31 PM on August 25, 2009

« Older How do I get allmusic to display the correct album...   |   RV'ing in Italy Newer »
This thread is closed to new comments.