Numbness as a side effect of the mini pill?

December 14, 2012 1:16 AM

YANMD, but how paranoid am I being? Also some general birth control questions and angst.

Possibly relevent background: I'm 29 years old, generally healthy, in a monogamous long-term relationship, and have never used hormonal birth control. I tend to be hyper-cautious of what I put in my body, and the concept of screwing with my system in such a profound way always squicked me out.

Well, I had my second (unplanned, FAM, user error) baby in two years, about 10 weeks ago. My pregnancies are hell - hello hyperemesis - and I am kind of desperate not to get pregnant again; definitely not soon, maybe never. My body needs a break. Partner has volunteered to get snip-snipped, but I am not 100% sure I don't want more yet and am reluctant to make that call in the midst of my current hormonal upheaval.

So, since I am exclusively breastfeeding, I started a generic version of Ortho Micronor on Monday.

The first two days were fine, mild headaches, nothing unexpected. Then on Wednesday when I was holding my son my arm/hand went numb. I very very rarely have limbs "fall asleep," and never my hand, so this was weird. I put him down, went about my business, it came back.

Then it happened again in the evening, two more times. This time the other hand too. And again when I was trying to fall asleep. A very mild cold/tingly sensation very similar to epidural anesthesia wearing off. It passed through my head that it may have something to do with the pill but I hadn't seen such a side effect, and aware of my own likely paranoia, brushed it off.

Well tonight I was just sitting in the living room playing with my cellphone and my hands both went numb, way more obvious, and my left foot! I panicked. I started looking up side effects and found "if you experience numbness, tingling, loss of vision, etc, call a medical professional immediately." Needless to say, this fueled my panic; it was 11:00 at night and I have no insurance. I called a 24 hour pharmacy and the pharmacist only knew what was on her list, said it wasn't a "common effect," and suggested I call my doctor tomorrow. Which I will do.

I am guessing the doctor will recommend I stop the pills. But I am really confused and conflicted. First, I can find very little info on whether or why the mini-pill might cause such an effect; I keep wondering if perhaps I am having some type of bizarre placebo effect due to my general pill mistrust. But I think I would be more likely to imagine mood effects or headaches, right, not numb limbs? It's just strange. Additionally, since nobody seems to have heard of this problem, how will I know if it's "safe" to try a different pill once I'm done breastfeeding? If my body hates progestin, does that mean I am just SOL on the contraceptive front? Or do I have to start brushing up on my willpower and organizational skills so I won't screw up FAM again? I know this is all "ask your doctor" stuff, but since I'm uninsured, my doctor interaction will be limited to a quick phone call unless I find other options. And I've been given so many mixed answers in my day that I hesitate to trust anything but my own research with the functionings of my body.

You are not my doctor, but thoughts, other BC recommendations, and wild theories as to why limbs may suddenly go numb for no apparent reason are all welcome. I guess I just want to know how paranoid I am being, and what I might do from here if I can't take this pill after all.

posted by celtalitha to Health & Fitness (18 answers total)

I am really really not a doctor. You need to see yours. In between now and then, here are my totally worthless thoughts:

1/ It would be unusual in the extreme for any of the already rare side effects of the minipill to manifest after only two doses/48 hours.

2/ I would be more inclined to suspect feeding positioning as the culprit for numbness in your extremities, or post-partum sciatica. Again, I am not a doctor and pretty much just made that up.

3/ Regardless of the above, you are clearly uncomfortable with the pill and that is not going to set you up for happiness. I would very very very seriously ponder an IUD, either on its own or as a backup to FAM.
posted by DarlingBri at 1:41 AM on December 14, 2012 [4 favorites]

"You are not my doctor, but thoughts, other BC recommendations, and wild theories as to why limbs may suddenly go numb for no apparent reason are all welcome."

Yup we are not your doctor, but your doctor, who you should be calling today, is. Giving you medical advice about what is going on with your limbs without your full medical history, which your doctor has, would be an irresponsible at best use of AskMe, that kind of shit gets complicated and subtle fast.

If your physiology is somehow incompatible with safe use of progestin that does not necessarily mean you are SOL for hormonal birth control, there are other options that your doctor may be able to recommend depending on their judgement on what is going on with you.
posted by Blasdelb at 3:12 AM on December 14, 2012 [2 favorites]

IANAD, but I would stop taking the pill immediately and see a doctor.

IUD's are awesome, and much, much more effective than FAM, which is obviously not working out for you.
posted by roomthreeseventeen at 4:37 AM on December 14, 2012 [4 favorites]

If you do decide to stop taking the pill, a copper IUD might be a good choice. The side effects are minimal - mostly increased bleeding and slightly longer periods, but that evens out over time (usually the first 6 months are the worst). There are no hormones, so you don't have to worry about that at all. It's ridiculously effective for up to 10 years, but return to fertility is pretty much immediate after removal. Serious complications are rare and a lot of those are due to inexperienced practitioners doing the insertion, so find someone who does a lot of them. This can also cut down on the pain, which can be pretty terrible but is supposed to be easier in women who have given birth.

Getting used to something that you don't have to be thinking about constantly would probably be a major adjustment for you and might make it a little difficult to trust it, but it does get easier. I was crazy paranoid about something going wrong for the first few months after I got my IUD, but now I pretty much only think about it when I'm talking about how awesome it is.

The IUD_Divas community on livejournal is a great resource if you're interested in learning more about that option, but there are also tons of relevant questions here. Feel free to email me, too.
posted by SugarAndSass at 4:50 AM on December 14, 2012 [2 favorites]

Ten weeks postpartum can really ramp up the anxiety, even if you were just dealing with a minor stomach bug. But since you aren't and it's numbness, yes, you do really need to talk to your doctor. And this is a serious enough issue to warrant it (coming from someone that has seriously gotten herself in trouble by ignoring symptoms before).
posted by ejaned8 at 5:05 AM on December 14, 2012

Don't have much to add except that I think you should plan to call your doctor, stop taking the pill and then stop freaking out until after you talk. Also, definitely consider an IUD. I have one and insertion was unpleasant but supposedly it's a lot easier if you've previously given birth.
posted by kat518 at 5:10 AM on December 14, 2012

I also think an IUD would be a good future option for you; I know several people who are very happy with the Mirena. It is expensive if you are uninsured, but works out over 5 years to be less expensive than many birth control pill options.
posted by insectosaurus at 5:31 AM on December 14, 2012

I can only speak to other bc recommendations, and it's to echo SugarAndSass. I have had a Mirena IUD and now have a copper IUD, and they've been great! The copper IUD has no hormones, so might be a better choice for you. The Mirena has a low dose of hormone, and many people think that the hormones are only local, but that's not the case, though the levels in your blood are very small compared to the pill. The Mirena info says, ""The Intrauterine release of levonorgestrel results in the absorption of the drug into the systemic circulation. The drug can be detected in plasma within 15 minuites of insertion and maximum concentrations are seen within a few hours. Plasma levels of levonorgestrel stabilize after the first few weeks of use at between 150-200 pg/mL."
posted by amarynth at 5:39 AM on December 14, 2012

FWIW (not much, call a doctor), carpal tunnel is common with new mothers. I think it's a combination of water retention and body stress -- holding the baby for breastfeeding, being exhausted and using your hands continuously.

I really think an IUD is the way to go for you. I have gone without hormonal birth control for most of my reproductive years because I did not like the side effects. But we didn't use FAM but used condoms and never got pregnant. Every now and then I'd try something like a pill or Nuvaring but was never happy with the side effects. However, with a newborn and now a toddler running around, I'm so glad I went with the Mirena. I just don't need to have another thing to think about and having an unplanned baby is far worse to me than side effects. Happily, there have been just very minor effects for me with Mirena. It's good for five years (though non-medical sources confirm it can work longer) and can be removed easily if you decide to have another baby or don't like it.

Go to Planned Parenthood to plan your parenthood!
posted by amanda at 7:19 AM on December 14, 2012 [2 favorites]

I'm both a hormonal birth control vet as well as a childbirth/newborn vet. (Not a physician.) I've been on HBC for about 20 years, and I've been on various forms (pills and IUD). I have never had any numbness or tingling that has been related to my BCPs or IUD. You did the right thing by calling the pharmacist, though; deep-vein thrombosis, where you get clots in your veins, are a big deal and can happen as a side effect from hormonal birth control and long periods of inactivity (were you on bedrest? Are you spending a lot of time sedentary?).

After childbirth, as you know, your body is downright weird. In the three months after I gave birth, I had night sweats and hot flashes, for instance. It takes time to get back to normal. I wouldn't imagine numbness or tingling would be out of the ordinary for a postpartum woman, especially considering sustaining positions for feeding/nursing and bending over to reach a bassinet/crib/playpen. Factor in a loss of sleep, and for some women, weaker nutrition (not eating/drinking right because of caring for others), and your body is in flux.

I'm hopeful that you are just fine and you are enjoying your new little one. Best to see what your doctor says, of course.

I also came in to recommend an IUD. While I'm not as averse to using hormonal birth control as you say you are--I have PCOS and endometriosis, and it really helps me--I have really appreciated my year plus with Mirena. It is almost pregnancy proof, and I no longer feel rage-y. I feel like myself again. It has lightened my flow and cramps. It is a great device, in my opinion.
posted by FergieBelle at 8:06 AM on December 14, 2012 [1 favorite]

There are plenty of options that are neither hormonal nor FAM. I like condoms. They have never done me wrong and they have the advantage that you can start using them today.
posted by redfoxtail at 8:34 AM on December 14, 2012 [3 favorites]

Agreed that you should see a doctor, because the foot thing is weird. However: I do not (and did not) take any hormonal birth control, but after the birth of my son I had SEVERE post-partum carpal tunnel syndrome. It worsened around 8 weeks, and I had it for months. To take my son out of the crib, I had to bend my arms at 90 degrees and scoop him up like a forklift. It was agonizing, but normal. I think it faded around 4 or 5 months.
posted by peep at 8:48 AM on December 14, 2012

Doctor.

But the first thing this made me think of was a back/nerve issue. Maybe all the changes your body has gone through has affected your back. When you see your doctor, I would ask about that possibility.
posted by Vaike at 8:56 AM on December 14, 2012

Yes, I had carpal tunnel problems with two of my three kids and throughout one pregnancy which caused numb tingly hands. Having the baby's head putting pressure in the crook of your arm all day (and night) is what did it. Also lugging that heavy infant carseat in the same spot. I got sciatica with the third kid which gave me a tingly numb foot. It could be some delightful combo of those. In any case, for that you'd need to see a doctor too to get whatever kind of (sweet sweet) cortisone that you can have while breast feeding.

The mini pill while breast feeding is the one that you have to take at the exact same time every day, right? With a newborn? That's why my friend has a third child. A 3 year old, an 18 month old and a one month old.
posted by artychoke at 9:15 AM on December 14, 2012 [1 favorite]

You mentioned you did not have insurance. Call Planned Parenthood today. They work on a sliding scale and offer both types of IUD's. Good luck!
posted by Coffee Bean at 9:32 AM on December 14, 2012 [1 favorite]

Response by poster: Thank you for all the responses. I'm sorry for the novel of an original post; chronic sleep deprivation + anxiety + 2 am = not thinking super clearly.

I called my GYN practice this morning and the two nurses I spoke to didn't think my symptoms had anything to do with the pill, but they did recommend I see a regular doctor, which will be complicated due to the no-insurance thing. Other possibilities are carpal tunnel (as a few of you suggested) or thyroid issues (which run in my family, are common postpartum, and for some reason I totally didn't think of). Apparently the "call your dr immediately!" urgency I was seeing is in case the numbness is a precurser of TIA or stroke, which mine was most likely not (bilateral, no vision or speech issues).

As for the birth control, I am fine remembering to take a pill as I'm a SAHM currently and set an alarm for around lunchtime (when I know I'll be awake, alert, and usually home). Mirena was my other top choice, but expensive, and a bigger commitment. The copper IUD was lower on the list due to my borderline iron levels and the likelihood of heavier bleeding.

Overall I've accepted that none of the choices are really ideal, for now, and I'm willing to take some side effects for the added security, I just didn't want to potentially ignore something major.
posted by celtalitha at 11:07 AM on December 14, 2012

Response by poster: Oh! And I did use condoms with modified (very conservative) FAM, successfully, for many years, before my first child. I'm allergic to spermicide though, and I hate the things generally, so it's an evil I want to avoid if I can.
posted by celtalitha at 11:12 AM on December 14, 2012

I wanted to echo that carpal tunnel in pregnancy/postpartum can be awful. I know someone (not a patient of mine, but) who thought she was developing multiple sclerosis, because it was so bad.

Re: numbness, the nurses are right; if you develop numbness and particularly *weakness* in just one side, particularly your face, then get your ass to the doctor emergently. Like the ER.

If you're uninsured and your income is low, you can qualify for a free/very inexpensive Mirena through the Arches foundation. Your provider/planned parenthood should be able to hook this up -- also depending on the state you live in, you can qualify for free/extremely cheap birth control, including long-acting methods like IUDs. I admit I like the Mirena a whole lot, since it's really great in so many ways, particularly when you really need to not get pregnant any time soon, and have a baby, which makes remembering pills harder (though it sounds like you're really on top of that). Both IUDs have better efficacy rates than sterilization, if I remember right. One thing that's nice about the IUDs is that you can just get them yanked out if you have serious problems, versus say, once you get a Depo shot you just have to live with it for 3 months...

You are not SOL for birth control methods! It can really feel that way sometimes, particularly since the choices are so varied (just within hormonal birth control, there are a bazillion formulations of them). Public health departments are another place to start in terms of getting cheap/free birth control, but I'd probably start with Planned Parenthood.
posted by circle_b at 11:41 AM on December 14, 2012