Birth control pill without the mood swings?
January 4, 2012 12:03 PM   Subscribe

Birth Control Filter: I am have been taking the pill and getting really bad mood swings. I have an appointment with my GP to discuss changing the type of pill that I take. I’m looking for advice on what to ask for.

I have been taking Microgynon 30 ED for the past nine months. I have been getting really bad mood swings, specifically crying a lot. These are always worse the week right before and the week right after the placebo week - I’m actually fine when I’m having my withdrawal period, whereas when I wasn’t on the pill I would get mood swings when I was actually on my period.

These mood swings weren’t too bad at first but they have been a lot worse the past three-four months, which corresponds with a general increase in my anxiety and a generally low mood. Before anyone says ‘therapy’, firstly I don’t think that is the answer to everything. Also I’m in the UK and broke, so I can’t just pick a therapist out of the phonebook. But I have asked my GP for a referral to a psychiatrist, which I have had mixed success with in the past. I’ve been told this psych referral may take up to six months, so in the meantime I’m trying to take some steps myself to improve things. I’ve quit caffeine and started exercising more, both of which have helped in the past and are started to help me now, but only with my general stress levels, not with these mood swings. So I view changing my pill as another way of improving the situation.

I am mainly interested in looking at changing the type of pill rather than other methods of contraception. I am really not keen on any kind of IUD.

What I like about the pill I’m currently taking is how regular it is and how light my periods are - I’ve gone from 5+ days of heavy bleeding on an irregular timescale to 2-3 days of light bleeding like clockwork. That is really important to me as I hate having my period, so I don’t want something which is likely to cause irregular bleeding or breakthrough bleeding.

Another consideration is avoiding side effects like weight gain, as I am already overweight - which the doctor commented on when I was first prescribed the pill. I haven’t had any problems with the pill I’m currently taking, but I’ve heard conflicting reports of weight gain with the pill.

When I was first prescribed the pill I didn’t have any say in what one I was given, other than asking for one with a placebo week – this is unusual in the UK and which the GP was a bit insulting about, but I knew it would be easier for me to remember to take it if it was every day. So what kind of things should I be saying to my doctor and what should I be looking for in a different pill?
posted by anonymous to Health & Fitness (13 answers total) 2 users marked this as a favorite
There are many brands of bc from the Ortho family to more the Loestrin family. The one you taking just might not be right for you. You can ask to switch it up. In the last 20 years I've been on the entire ortho family and then switched over to the loestrin. All worked fine and dandy for a while then changes from cycle to pain to mood happened so they switched me. it happens and is common.

Both brands have a placebo week. For mood you can try vitamin B12 and vitamin D3 (specifically D3 not general D). I can help with mood.

Good luck. I agree. Having a period just blows.
posted by stormpooper at 12:07 PM on January 4, 2012

The shitty thing about BC is that it's totally a personal body chemistry thing, so what works for one of us may not work for you. For me, Loestrin and I did not mix either. I immediately had super stressful moodswings within a few days which my doctor confirmed was a hardcore reaction. Turns out I can't have anything with large amounts of progesterone in it. I'm on Zovia which is another name for Demulen and I really like it. It took about 2 months for things to really even out, but it hasn't left me feeling like a suicidal zombie (like Yaz did) and for that I don't care that I still get acne and a little pain the first day of my period.

Good luck.
posted by These Birds of a Feather at 12:13 PM on January 4, 2012

You could also ask your doc about taking pills consecutively, so that you don't have periods at all, or have only a few a year. I take 4 packages in a row (no placebo week), and have a period every three months. It's a bit more expensive, but it's been very convenient and I'm glad I made the switch. It could also help you with remembering, since you wouldn't have weeks off, except for one every three months.
posted by just_ducky at 12:14 PM on January 4, 2012

Agreed that it is difficult to predict what would work for you because everyone's body chemistry is different. Calcium-magnesium supplements can help with mood swings though.

The Nuvaring was best for me at solving the same problems you're having now. It's not only low-dose but is also absorbed directly, so there's less that goes through the rest of my body making me crazy. It keeps my periods light as well. One thing I dislike about it is that when I was on the pill, my periods were like clockwork too - I could even usually guess what time of day it would star. With the ring, it is pretty inconsistent in start and duration. That said, some people do use the ring consecutively as well. For the ring there's no "placebo week," you just take it out after 21 days, leave it out for 7 days, and then insert a new one - so some women will just switch them every 21 days. I tried this for a few months and it gave me bad cramps and breakthrough bleeding. There was another askme about trying this recently I think but I can't find it at the moment. YMMV on every single part of this, obviously.
posted by fireflies at 12:29 PM on January 4, 2012

It might be helpful to look at a chart of pills that shows the different estrogen doses/types of progestrin - or similar.

The generic version of loestrin fe worked well for the short/light period part of your equation but I haven't had a history of bad mood swings with other pills either (desogen), so not sure if it's also good for that.
posted by ejaned8 at 12:36 PM on January 4, 2012 [1 favorite]

I have been on three different pills in the past 14 months as I try to figure out the right formulation for me. It's perfectly reasonable for you to ask your GP for a different prescription. I would think the mood swings you describe are directly a result of the pills and would be a really good reason to switch. In fact, I wouldn't even bother with the psychiatrist, and just concentrate on getting a new pill.

My doctor required me to stay at least 3 months on each pill because it takes time for your body to adjust to the new formulation each time.

The first pill I had was Loestrin FE, which was ok but caused breakthrough bleeding. I switched after 6 months to Apri, which was really horrible. But I stuck with it for 3 months. Then I called my doctor's office and the nurse gave me a filler prescription of the Loestrin so I could go back on that until my next doctor appointment 3 months later. My doctor prescribed Beyaz then, which I've been on for two months and have been fine with. But it still takes some time.

If I were you, I'd call the doctor's office and ask to speak with a nurse and explain it. It's possible the doctor could just prescribe you a new pill over the phone. It really does take a lot of tries to make birth control work for a woman, so I would be surprised if they made you come in every time you needed to try a new one.
posted by aabbbiee at 12:46 PM on January 4, 2012

Wow. Crying all the time is not a fun way to live.

I had your problem and switched between 8 different BCPs until I tried the mini-pill (progestin only). It was the only thing that seemed to work without causing mood swings except for yeah - the breakthrough bleeding. If you can live with that, though, the mini-pill is great.

I know you're looking for the best BCP option, but one thing you might want to consider trying (if you have strong routine in your life and generally have your shit together) is FAM. I used the guidelines in the book Taking Charge of Your Fertility for years and never got pregnant.

So far that's been my favorite form of birth control in terms of my moods.
posted by jennyhead at 1:00 PM on January 4, 2012 [1 favorite]

Nthing the "everybody's body is different" thing.

I've never been able to use anything with hormones due to a combination of mood swings and migraines, but there were plenty that were better (and worse) than others.

I had a good doctor that worked with me to try almost everything. While they want you on something for a few months to stabilize, I've been pulled off of things in shorter time when they caused severe reactions. (Except depo. It's bad to learn it gives you migraines one week into a 3-month run.)

So, talk to them right away (or the nurse), get a new prescription and good luck finding the one that works with your special self. Good luck. I hate, hate, hate that feeling.
posted by Gucky at 1:04 PM on January 4, 2012

Be sure to ask your doctor about the effectiveness of something like the minipill for your body. You mention that you are overweight, and there's some research (though unfortunately, not a lot, since drug manufacturers are not required to test their drugs on people of different body sizes) suggesting that the pill can be less effective in women with larger bodies because it's not dosed by weight. Pills with lower doses of active ingredients can make the problem worse. If you're depending on the pill to keep you from getting pregnant, make sure you choose a pill that will be effective given your body weight.
posted by decathecting at 1:44 PM on January 4, 2012

Is this exclusively for birth control? Can you use a diaphragm or condoms instead? I did not react well to HBC and got off of it, and didn't mess with it after awhile. Using a nonhormonal contraceptive might be where it's at, if you're only using it for birth control purposes.
posted by anniecat at 1:47 PM on January 4, 2012

I recommend Yasmin (ethinylestradiol and drospirenone). I'm sure this depends on your body chemistry, but I've been on it for 10 years with no ill weight gain, mood swings, etc. If you do end up getting that, be absolutely certain that the doctor marks the prescription DAR (dispense as written) as the generic substitute is terrible - breakouts, pain, heavy bleeding, feeling ill. I also tried Nuvaring and had a bad reaction to that, too - terrible back pain.

And, a bit of unsolicited, but related, advice if you're not on the bandwagon: DivaCup. Not too sure the UK availability, but this thing is a godsend (not to mention a money-/hassle-saver). I wish I could give one to all my female friends without seeming utterly creepy.

Sorry for what you're experiencing. I feel for you. Good luck.
posted by xiaolongbao at 1:52 PM on January 4, 2012

I've had good luck on the "low dose" pills. I first took OrthoTriCylen Lo (don't know if they still make that) several years ago when I was having undesirable reactions to the normal level. Currently I went back to the pill after mood swings and such on the Nuvaring. I'm on a low dose one -- Lutera. It works great -- I had spotting the first month (and am on the second month) but from my experience I get a regular, but very light, period on the low dose BCP. I don't get mood swings or menstrual headaches like I do without BC. Other BC has made those symptoms worse -- this one has been good so far.
posted by DoubleLune at 2:54 PM on January 4, 2012

I know you said probably no IUD, but the copper coil one-Paraguard-- is the only bc that's as reliable (or more!) that doesn't have hormones, I think. Perhaps worth another thought.
posted by manicure12 at 6:25 PM on January 4, 2012

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