Birth control or norethisterone for teen needing to delay period?
February 3, 2018 6:33 PM Subscribe
Hi,
My daughter is 14 and has acting and modeling jobs occasionally. She loves it so much, but when her agent calls about a job that is coming up, she worries about having her period. She wants to be carefree on these jobs and is hoping to plan it out so she does not have her period.
She is not on birth control and I understand you need a monophasic pill in order to skip the placebos. But then I heard about norethisterone which sounds nicer than putting her on birth control but then I wondered if that is safe for a teen?
So birth control or norethisterone? Anyone have their daughter on one of these in order to delay a period?
And second part question to that..........she does not like tampons and would prefer not to have a pelvic exam and certainly not a PAP smear, so in the United States could we get either one of these online or through a clinic that does not require exams?
Thanks in advance!
She is not on birth control and I understand you need a monophasic pill in order to skip the placebos. But then I heard about norethisterone which sounds nicer than putting her on birth control but then I wondered if that is safe for a teen?
So birth control or norethisterone? Anyone have their daughter on one of these in order to delay a period?
And second part question to that..........she does not like tampons and would prefer not to have a pelvic exam and certainly not a PAP smear, so in the United States could we get either one of these online or through a clinic that does not require exams?
Thanks in advance!
This question would be so, so much better answered by a doctor. I had wonderful experiences with my local Planned Parenthood. If you go there, you can get a doctor's opinion on what medicines are safe or appropriate for your daughter and what exams you do or don't need for those medicines. You can have a doctor address misgivings your daughter has about using tampons or getting a pelvic exam.
posted by sacchan at 7:04 PM on February 3, 2018 [17 favorites]
posted by sacchan at 7:04 PM on February 3, 2018 [17 favorites]
Pap smears are to begin at 21. You don't need a pelvic exam to be prescribed birth control. But you and she really should discussing these matters with her doctor. It's important to start building that relationship and her confidence in her doctor for the issues of reproductive health that are often embarrassing for teens to discuss but for which they really need accurate information.
posted by praemunire at 7:06 PM on February 3, 2018 [15 favorites]
posted by praemunire at 7:06 PM on February 3, 2018 [15 favorites]
I recently decided (age 30) that I wanted to no longer get a period, and I made an appointment with a nurse practitioner who was listed as having a lot of expertise in women's reproductive health. She was very nice, and she explained a lot of options for safely accomplishing this goal with various forms of hormones, including the pros and cons of the various options. No pelvic exam. We talked about potential side effects and how to recognize them. I chose the option that sounded best to me, and it's worked out well so far.
I feel confident about my decision because it integrated the expertise of both a medical professional and myself, and I know I can talk to her if something unexpected happens or if I want to change something.
I wish I'd been offered these options at age 14 instead of waiting until I was 30! I would recommend finding a doctor or nurse practitioner who specializes in women's reproductive health and setting up an appointment for your daughter (and you) to talk to them. I agree with amro that you can confirm with the office that no pelvic exam would be required.
posted by dreamyshade at 7:32 PM on February 3, 2018 [4 favorites]
I feel confident about my decision because it integrated the expertise of both a medical professional and myself, and I know I can talk to her if something unexpected happens or if I want to change something.
I wish I'd been offered these options at age 14 instead of waiting until I was 30! I would recommend finding a doctor or nurse practitioner who specializes in women's reproductive health and setting up an appointment for your daughter (and you) to talk to them. I agree with amro that you can confirm with the office that no pelvic exam would be required.
posted by dreamyshade at 7:32 PM on February 3, 2018 [4 favorites]
I understand you need a monophasic pill in order to skip the placebos
Just to address this part, I don't think monophasic pills have placebos, or at least low-dose norethindrone doesn't, for instance. You get the same dose every day all month, 0.35 milligrams per pill, 28 pills per pack, 13 packs a year. Taking a continuous pill like that can significantly lighten but won't necessarily skip periods. This site has some info, as does this article, but I'd definitely suggest making an appointment for her at a local Planned Parenthood to talk this over.
posted by limeonaire at 7:46 PM on February 3, 2018
Just to address this part, I don't think monophasic pills have placebos, or at least low-dose norethindrone doesn't, for instance. You get the same dose every day all month, 0.35 milligrams per pill, 28 pills per pack, 13 packs a year. Taking a continuous pill like that can significantly lighten but won't necessarily skip periods. This site has some info, as does this article, but I'd definitely suggest making an appointment for her at a local Planned Parenthood to talk this over.
posted by limeonaire at 7:46 PM on February 3, 2018
Oh right, the other thing I was going to mention was that if she gets migraines with aura, you have a family history of strokes or blood-clotting issues, or a few other risk factors, the pills that include estrogen that let you skip periods may be contraindicated for her. So that's something to consider as well as you guys talk this over!
posted by limeonaire at 7:52 PM on February 3, 2018 [6 favorites]
posted by limeonaire at 7:52 PM on February 3, 2018 [6 favorites]
Norethisterone is just a generic progestin; it's in many, many birth control pills alone and with estrogen.
Pap tests and pelvic exams have nothing at all to do with using hormonal birth control, and you should run far far away from any practitioner who requires them for a birth control prescription. They do need to make sure she doesn't have high blood pressure or a family history of heart attack or stroke.
If she already has a regular doctor (even a pediatrician), they should be more than happy to give her a prescription. A PA or NP should also be able to. Several states, like California mentioned above, are starting to give pharmacists the ability to prescribe birth control, and there is a growing movement to make hormonal birth control available over-the-counter. There are also many websites, like lemonaid, that prescribe over the internet. This is a very, very safe thing for a teenager.
posted by Violet Hour at 9:35 PM on February 3, 2018 [2 favorites]
Pap tests and pelvic exams have nothing at all to do with using hormonal birth control, and you should run far far away from any practitioner who requires them for a birth control prescription. They do need to make sure she doesn't have high blood pressure or a family history of heart attack or stroke.
If she already has a regular doctor (even a pediatrician), they should be more than happy to give her a prescription. A PA or NP should also be able to. Several states, like California mentioned above, are starting to give pharmacists the ability to prescribe birth control, and there is a growing movement to make hormonal birth control available over-the-counter. There are also many websites, like lemonaid, that prescribe over the internet. This is a very, very safe thing for a teenager.
posted by Violet Hour at 9:35 PM on February 3, 2018 [2 favorites]
Just to address this part, I don't think monophasic pills have placebos, or at least low-dose norethindrone doesn't, for instance.
This is not really correct. As far as I know, all oral contraceptives taken continuously are monophasic, but by no means are all monophasic oral contraceptives intended to be taken continuously. Monophasic means only that on days when pills contain hormones, the levels are always the same. Many/most still have a hormoneless week. However, you can skip the hormoneless week to get the same effect as the continuous or quarterly-break pills like Seasonale/Seasonique, and this can (or at least used to) be more affordable on some insurance plans. You cannot do this with multiphasic pills like Ortho Tri-Cyclen, because their hormone levels change every week and would likely cause weird breakthrough bleeding if taken continuously in an attempt at period suppression.
While doctors used to commonly require annual Paps & exams to prescribe birth control, the past decade has definitely seen a shift away from both annual Paps and requiring exams in return for birth control prescriptions.
All of which is to say that the OP should absolutely take her kid to Planned Parenthood to see an actual expert who is up to date on everything, rather than listening too closely to us random internet people.
posted by ubersturm at 10:51 PM on February 3, 2018 [5 favorites]
This is not really correct. As far as I know, all oral contraceptives taken continuously are monophasic, but by no means are all monophasic oral contraceptives intended to be taken continuously. Monophasic means only that on days when pills contain hormones, the levels are always the same. Many/most still have a hormoneless week. However, you can skip the hormoneless week to get the same effect as the continuous or quarterly-break pills like Seasonale/Seasonique, and this can (or at least used to) be more affordable on some insurance plans. You cannot do this with multiphasic pills like Ortho Tri-Cyclen, because their hormone levels change every week and would likely cause weird breakthrough bleeding if taken continuously in an attempt at period suppression.
While doctors used to commonly require annual Paps & exams to prescribe birth control, the past decade has definitely seen a shift away from both annual Paps and requiring exams in return for birth control prescriptions.
All of which is to say that the OP should absolutely take her kid to Planned Parenthood to see an actual expert who is up to date on everything, rather than listening too closely to us random internet people.
posted by ubersturm at 10:51 PM on February 3, 2018 [5 favorites]
Yeah, upon searching some more, I guess there are some monophasic pills that have placebos for one week or part of one week. The one I mentioned, the norethindrone mini pill, does not have placebos, as far as I know, though. Definitely agree with the suggestion to consult Planned Parenthood, in any case!
posted by limeonaire at 12:25 AM on February 4, 2018
posted by limeonaire at 12:25 AM on February 4, 2018
Yes, go to a doctor. Both my daughters have tried birth control pills as teens in order to avoid severe menstrual pain and for both of them, it led to depressions which were far worse than the pain. So that's another perspective on this decision.
posted by mumimor at 6:09 AM on February 4, 2018 [2 favorites]
posted by mumimor at 6:09 AM on February 4, 2018 [2 favorites]
I can't talk about pills, but I haven't had a period since I took up Depo shots. I thrive on them (plus I don't have cramps allllll the time any more), but that may not be for everyone. I've asked my doctor if anything else gets rid of periods in the same way and she said no, though.
posted by jenfullmoon at 2:14 PM on February 4, 2018
posted by jenfullmoon at 2:14 PM on February 4, 2018
As another data point, my doc requires a pelvic and pap before renewing my BC every year. Even though the ACOG guidlines have paps down to like once every 4 or 5 years.
posted by misanthropicsarah at 8:37 AM on February 5, 2018
posted by misanthropicsarah at 8:37 AM on February 5, 2018
re: Depo shots mentioned above--I knew one person who just had a period every day all day until her Depo shot wore off. Approach that option with a lot of caution as it is not reversible--you just have to wait for it wear off, which is something like six months from the time you got it!
I've suppressed periods completely with a monophasic pill (skipping the placebo). I liked the monophasic pill because it delivered the same amount of hormones every time, rather than taking me on a hormonal roller coaster (which I already had enough of, thank you).
After you discuss with the doctor, watch for depression. She may also find that her body shape changes a bit with different hormones too. This is one of those things that isn't listed in the official side effects of a pill, but almost everyone I know noticed it when they took the pill.
posted by purple_bird at 9:58 AM on February 5, 2018 [1 favorite]
I've suppressed periods completely with a monophasic pill (skipping the placebo). I liked the monophasic pill because it delivered the same amount of hormones every time, rather than taking me on a hormonal roller coaster (which I already had enough of, thank you).
After you discuss with the doctor, watch for depression. She may also find that her body shape changes a bit with different hormones too. This is one of those things that isn't listed in the official side effects of a pill, but almost everyone I know noticed it when they took the pill.
posted by purple_bird at 9:58 AM on February 5, 2018 [1 favorite]
This thread is closed to new comments.
posted by amro at 7:02 PM on February 3, 2018 [3 favorites]