Seasonique 9 Months Later

I thought I’d do a little update on my experience with Seasonique. I’ve been on it for nine months now, and I’ve been skipping the inactive week since October. All in all, I’m still happy with it. Here are my pros and cons:

Pros
– No more periods, ever!
– A relatively stable mood without the ups and downs of a typical cycle
– No weight gain (though that might be more the endo diet than this pill)
– No more nausea. In the first few months of taking this, I had to eat with it, or I was nauseated for hours. Even sometimes when I did take it with food, I would still end up with waves of what I can only think to describe as seasickness. Thankfully, that side effect has subsided and I no longer eat when I take it.

Cons
– Spotting and cramping randomly. I’ll go weeks without feeling anything, and then bam, it’ll hit and I never know how long it’s going to last. Sometimes, it’ll only be a day, and other times, it’s the entire months of January and February. Dr. X said this is to be expected, especially since I’m skipping the inactive weeks, and that hopefully with time my body will adjust. The worst part is the contraction-like cramps that shoot down to my feet, which Dr. X said is my body trying to have a period. Those have subsided a lot since I started, but they still come and go without warning.
– Mild acne. I was hoping this one would calm down as my body adjusted, but no such luck. I’m diligent about washing my face, exfoliating, and doing masks, but no matter what I try, I still break out.
– Being scatterbrained. This one is new in the last month or so, but I am starting to feel a little nutty. I lost my cell phone one day and found it in the fridge!

I definitely don’t want to be on birth control pills forever more, but if I have to do a solid two years than I’m overall pleased with Seasonique.

A Check In and a Check-Up

I haven’t written in months. In part, it’s laziness, but in truth, it’s difficult to write daily about a chronic disease. Blogging regularly is a constant reminder of what’s wrong with your body, and that’s sometimes a bit too much for the mental and emotional health. Now, I’m not ignoring my endo. I take a pill every day, I strictly follow the endo diet, and I still end up on the couch with a heating pad — so there’s no way this isn’t a routine part of my existence, but I’ve been having trouble writing about it. It’s easier to order a taco without cheese, eat it, and move on with life than it is to order a taco without cheese and then contemplate how to turn that into a blog post about all the things endo has taken from you. Babies, mozzarella sticks, the ability to go through life without pain and bloating… there are a lot of things, and sometimes it’s overwhelming.

But, I guess that’s also kind of the reason I started this blog, because it is hard and there aren’t enough people talking about it. So, I’m going to try to post regularly again…but no promises.

I had my yearly gyno appointment two weeks ago. My surgeon has taken over these routine exams because he wants to be able to check in with me semi-regularly. (Sidenote: While I know this man has literally seen my insides, it was still awkward to have him do a pap.) Anyway, everything went well, and he said that my uterus is no longer tipped. It’s attached to my abdominal wall, but it was also deviated that way, and he said that it seems to have corrected itself post-surgery. While of course it’s always good to have your organs in the correct place, he said it’s also good because then if it tips back, it’ll likely be an indication that the endo is growing back.  So, thanks to my uterus, I guess?

 

Continuous BC

I had an appointment today since I’ve been on the Seasonique for three months, and Dr. X wanted me to check in. I told him how terrible the inactive week was — though he reminded me that Seasonique’s off-week isn’t actually totally inactive, it does have a low dose of estrogen — and he said since I had such a bad experience, I should just skip it in the future! Hooray! Hooray times a million! I’m so happy. He’s even putting in a special note to the insurance company so I can refill it slightly earlier.

 

 

Eating with Endo

Or, maybe that should say “Not Eating with Endo.”

The diet for endometriosis is quite restrictive, and honestly, pretty overwhelming. When Dr. X first said he thought my cyst was caused by endo, I immediately went home and started researching. The amount of information about what you should and shouldn’t eat is vast, and unfortunately, often conflicting. I ended up putting my trust in three sources:

  1. Endometriosis Resolved – This is a great website which nicely spells out what to eat and why. It’s my go-to resource, and I often refer back to it when I’m craving something and desperately want to cheat. (Read: “Ok, but how bad is this piece of cheese actually…” And then I remind myself about all the ways it can cause me pain and regretfully put it down.)
  2. Stop Endometriosis and Pelvic Pain by Andrew S. Cook – This book is a wonderful resource for anyone with endo. It covers everything from the mysteries and myths of the disease, to different surgery techniques, treatment plans, and other underlying health problems that can be associated. It also has a section on nutrition that I found very helpful.
  3. Endometriosis: A Key to Healing Through Nutrition by Dian Shepperson Mills and Michael Vernon – Written by a nutritionist in England, this book is very in-depth and informative, almost too much so. It’s heavy on science and and gives lengthy explanations about how different parts of the body interact with various foods an chemicals, which is great, but it’s sometimes a bit over my head. Even so, it was incredibly helpful in shaping my diet.

Ok, so after reading through all of these, I came to learn that I need to avoid:

  • Dioxins – An environmental toxin which may change the immune system’s response to unregulated growth of endometrial cells. It can also disrupt how hormones work. Amazingly, they did a study in 1992 with rhesus monkeys, and 79% of the monkeys who were exposed to dioxins developed endo, while those who weren’t exposed had very little or no disease!
    • To reduce your ingestion of dioxins, you need to avoid dairyfatty meats especially red meategg yolks, and bleached paper products. That last one is really important. Tampons and pads are bleached and treated with tons of chemicals. Make the switch to organic, chlorine-free feminine products!
  • Phytic Acid – Found naturally in wheat and soy, phytic acid can aggravate symptoms of endo and reduces the absorption of calcium and other minerals, which is especially important for endo ladies because we’re supposed to cut out dairy.
  • Prostaglandins – These are very complicated, and I still don’t entirely understand them. The Endo Resolved website calls them fatty acids, the Mills and Vernon book refers to them as “oil-based hormones,” and the Cook book (ha, cookbook!) just says they’re “compounds found in tissues that stimulate nerve cells.” So, I don’t know, take from that what you will. Anyway, from what I can gather, prostaglandins cause inflammation, contractions, and pain; however, that’s really their job. Our bodies need prostaglandins to ovulate, menstruate, and give birth. They are also involved in immune responses where we need that inflammation to fight infection. The problem comes when we have too many bad prostaglandins — or prostaglandins that have escaped the uterus and are running rampant in our abdomens! — as they then cause too much cramping and inflammation.
    • So, we want to avoid these bad prostaglandins which are found in saturated fatanimal fat, dairyred meat, and butter, while we increase our consumption of the goods ones, which are found in omega-3 oils and help to reduce inflammation.
  •  Inflammatory foods – It’s pretty obvious why we don’t want more inflammation in our bodies when we’re already growing unexpected tissue all over.
    • To lower your overall inflammation, avoid wheatred meatrefined sugars, and dairy.
  • Caffeine  – I know, I know, I love coffee and chocolate too. But caffeine can increase cramping and more importantly, increase estrogen levels, which we definitely don’t want since endo feeds on estrogen. Sorry, Starbucks lovers.
  • Alcohol – Alcohol robs the body of B vitamins, which are stored in the liver, and we need our livers in tip top shape so they can remove excess estrogen. The Mills and Vernon book states, “the risk of endometriosis was roughly 50% higher in women with any alcohol intake than in control subjects.”

And finally, the most controversial element, which I personally decided to avoid:

  • Phytoestrogens – Phytoestrogens are naturally occurring estrogens in plants like soy, wheat, flax seed, sunflower seeds, and many others. Some researchers think that by consuming this extra estrogen, we are feeding the endo and making it worse. However, others say that these weak plant-based estrogens actually block estrogen receptors in our bodies and are therefore balancing or even lowering the amount circulating estrogen. No one can really decide, which is frustrating. The Endo Resolved site says to avoid high levels of phytoestrogens, while still eating them in balance to block the receptors. Cook’s book encourages ladies with endo to eat phytoestrogen-rich foods for that blocking benefit. The Mills and Vernon book admits that no one conclusively knows what is best and shares two studies. The first study looked at Japanese women who consume a lot of soy and have low rates of breast and uterine cancer, but high rates of endometriosis, leading them to conclude that it’s unclear what the phytoestrogens do in the body. How can they reduce these estrogen-associated cancers but increase estrogen-fueled endo? In another case, a zoo started feeding their exotic cats a diet of 50% soy protein, and they became infertile, but the fertility was restored when they were switched back to chicken!
    • So, it’s kind of a personal choice. I’ve decided to cut out all soy and wheat since they are inflammatory and contain phytic acid as well. However, I will occasionally use flax seed when I’m cooking as it’s a great binder to replace eggs in recipes, and I feel the phytoestrogen from the flax is probably going to hurt me less (and maybe even help) than the dioxins from the eggs. Obviously, make the decision that feels best for you.

TL;DR

Foods to Avoid

– Dairy
: Very inflammatory, a primary food source of dioxins, contains growth factors and hormones, increases bad prostaglandins
– Wheat (Gluten): Contains phytic acid, promotes inflammation, and many ladies with endo also have a gluten sensitivity
– Red Meat: Contain growth hormones, bad prostaglandins, dioxins, and causes inflammation
– Sugar: Inflammation, inflammation, inflammation
– Coffee and Chocolate: both contain caffeine which can increase estrogen levels, interrupt liver functions, and is a phytoestrogen. Chocolate also has sugar, see above.
– Alcohol: Impedes the liver’s ability to remove excess estrogen
– Egg Yolks and Animal Fat: Dioxins are stored in the fat of animals
– Soy: Research goes either way on the phytoestrogen component of soy, but it also contains phytic acid. There’s a great article about why you should avoid soy on Endo Resolved, which you can read here.

Foods to Embrace
– Omega-3 Fatty Acids: Found in salmon, flax seed, walnuts, and leafy greens, they increase good prostaglandins which reduce inflammation
Fiber: Good sources include oatmeal, legumes, brown rice, fruits and veggies. Fiber helps decrease circulating estrogen levels.
– Cruciferous Vegetables: Broccoli, brussels sprouts, kale, cabbage, mustard greens, etc. These vegetables help metabolize estrogen healthily.
– Immune Boosters: Garlic, ginger, onions, carrots, rhubarb, legumes, seeds, and green tea.

Good luck and happy eating! 🙂

Seasonique – My Inactive Week of Horror

I never imagined I would long for active birth control pills, but good golly, this week has been terrible. Terrible. Terrible.

I just started crying because we are out of white rice. Issue #1 of the inactive week: Constant crying and rollercoaster emotions. Issue #2: Stomach pains, nausea, and loss of appetite. Hence the rice. I can’t bring myself to eat much of anything…which of course makes me feel lousy in its own right.

Add to that the wicked cramps that ibuprofen doesn’t touch, yesterday’s eight-hour headache, and my inability to sleep, and well, yeah, I can’t stand this.

My surgery was just over three months ago, and this is only the second period I’ve had, so maybe that’s part of why the cramps are so awful. (How long should it take to heal internally?) But it’s much worse than my normal periods used to be. It’s very light, so that’s nice, but usually I have two really painful days, and then the rest of the time, I just take some pain meds, and I’m fine. This time, I’m on day five of those really painful cramps, and I just want to scream.

Oh, and the hot flashes. I have a new respect for menopausal women. I don’t know how they deal with constant hot flashes.

I’m very aware of how out of balance my hormones are this week, and if nothing else, it reaffirms my belief that the Seasonique is otherwise helping me.

Sunday night can’t come soon enough.

Seasonique: A Review

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Full disclosure: I’m actually on a generic of Seasonique called Ashlyna, but since it is the same exact chemical make-up and there are a bunch of generics that are all the same thing, for ease, I’ll just refer to it as Seasonique in this review.

Trying to find honest, balanced reviews of birth control online is difficult. Most reviews are negative, which makes sense, people rarely go to medical website to share their good experience, instead they want to warn others about the scary side effects they had. And oftentimes reading these reviews can be downright scary. So, I decided to write my own review to share the good and the bad (which honestly isn’t that bad).

The Boring Details: Seasonique is a 90-day pill, so you only have four periods a year. The active pills contain 0.15 mg of the synthetic progesterone levonorgestrel and .03 mg of the synthetic estrogen ethinyl estradiol. The inactive pills contain .01 mg of ethinyl estradiol. Levonorgestrel is a second generation progestin that was developed in the 1960s and many, many, many studies have determined that it is safer than newer progestins, which have twice the risk for blood clots. It is also the same progestin that is in Plan B, Mirena, and Skyla.

My Background: A couple of years ago, I tried two different birth control pills, Viorele, a generic for Mircette, which made me an emotional crazy person and gave me huge painful breasts and a ton of bloating. It was then that I decided I wanted an IUD, but my doctor couldn’t get it in, so she prescribed a progestin-only mini-pill called Micronor (I’m sure I had the generic, but I can’t remember what the name of it was) because she said it was the same hormone as the Mirena that she couldn’t get in. It wasn’t though. Micronor’s progestin is norethindrone, and Mirena, as I said, is levonorgestrel. I really didn’t like that doctor. Anyway, the Micronor made me incredibly bloated and I ended up gaining about 15 pounds in the few months I was on it. I was pretty set against ever being on pills again. Fast forward, and now that I have been diagnosed with severe endo, I don’t have a choice. It was this or Lupron shots, which I never want to do, so back on the pill I went, hoping and praying Seasonique would be better. I have only been on it for 11 weeks at this point, so I haven’t yet taken the inactive pills, but here is my evaluation so far…

Pros:
– Four periods a year!
– No emotional, psychological, or mood effects. If anything, I feel more balanced and leveled out.
– Only mild bloating that appeared in the first month and has since mostly gone away. Once in a while I’ll feel a little bloated for a day, but it’s nothing like other pills made me.
– No weight gain at all. In fact, I have lost weight since I started Seasonique, but I’ve also drastically changed my diet, which I’ll write a post about soon, so that is more likely the cause of the weight loss, but still, no gain!

Cons:
– So. Much. Spotting. At first, it wasn’t bad, a day here or there, but the longer I have taken it, the more consistent it has become. For the past month, it’s been pretty much daily. I’m guessing my body is just all confused and trying desperately to have a period since it hasn’t in so long. Fingers crossed that this will stop after I finally get to the inactive pills.
– Mild acne. It’s frustrating for sure, but I will take having to diligently wash my face morning and night with acne wash over all the symptoms I had on other pills. Speaking of, if anyone is looking for a good acne face wash, I am obsessed with this Yes to Tomatoes Activated Charcoal Bar Soap. I had very acne-prone teenage years and nothing ever worked as well as this soap. Hopefully, the acne will go away as my body adjusts, but if not, at least I found this soap!

Overall, I’m happy with Seasonique. Obviously, every body is different and my experience isn’t necessarily going to be your experience, but I just wanted to share. If anything drastically changes on my second pack, I’ll be sure to write an update.

Months of Cramps with Skyla?

I alluded to this yesterday, but I think my Skyla might be doing more harm than good. In between getting it inserted and my first period with it, Dr. X discovered the ovarian cyst (an endometrioma) that was over 5 cm, so when my period came and the cramps were cripplingly awful, I wasn’t sure what to think, was it the IUD or was it the cyst throwing things out of whack? I’ve never had a baby, but the only way I can think to describe these cramps are contraction-like. They squeeze and pull, and the pains shoot down my legs and into my feet. It’ll be the worst thing ever for 30-60 seconds, and then it just goes away. I’ll be walking along fine one minute, literally crying from the pain the next, and then back to perfectly fine. It’s weird. And it sucks.

I told Dr. X in a pre-surgical appointment that I was having these bad cramps which I associated with the IUD, and he said that shouldn’t be the case, that the IUD should relieve cramps, not make them worse. So, I figured it was the cyst, and eagerly agreed to having him put the IUD back in after my surgery (he had to take it out because a tool has to go in the uterus during surgery to move it out of the way).

It has been nearly three months since my surgery, and those cramping pains keep coming. I haven’t reached the placebo week of the Seasonique yet, so I haven’t had an actual period, but the spotting has been almost constant and these cramps are sometimes unbearable. The spotting is my body adjusting the pill, I’m okay with that, and I’ve read repeatedly that it’s a common side effect and can take months to stop, but these cramps? I think it has to be the Skyla. I have an appointment in three weeks, and unless something drastically improves, I’m going to ask about having it removed. :/