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.

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.

 

 

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. :/

An IUD and birth control pills TOGETHER!

Getting an IUD is what eventually led to my endometriosis diagnosis. After trying multiple pills and hating the side effects of all of them, not to mention the annoyance of remembering a daily pill, I had my heart set on an IUD. So when Dr. X said he’d need to remove my only two-month-old IUD to do the surgery, I immediately (and in hindsight embarrassingly) whined, “Nooooooo.” To which he replied, in true Dr. X form, “Ok, then I’ll slice across your abdomen and go in that way, and you can keep your IUD.” Needless to say, I let him take it out and do the surgery laparoscopically. And when he was done, with me still under anesthesia, he put a new one in, and I woke up not really knowing the difference.

Except that because my endo is so bad, Dr. X wants me on birth control pills for the next two years (at least) to suppress my ovulation, which even hormonal IUDs don’t do. I have a Skyla and since the hormone levels it releases are minimal, he says it is safe for me to keep the IUD while I’m taking the pills. He prescribed Seasonique, so I’ll only have a period four times a year, and because it has the same progesterone (levonorgestrel) as the Skyla. In the past my body has not reacted well to synthetic hormones, so I asked if I could take the same one since I seemed to be tolerating the Skyla, and Dr. X agreed in a it-doesn’t-make-any-difference-to-me-so-we-might-as-well kind of way. I wholeheartedly believe it pays to research and advocate for yourself.

Speaking of which, in all my research, I have found very few accounts of people also having an IUD while taking pills. Dr. X says the IUD should help with localized symptoms, mostly cramping (though that’ll be a post of its own because I’m pretty sure the IUD is giving me worse cramps), and the pills will stop ovulation, so I understand why he’d treat my endo with both, but still, I’m curious…is anyone else out there on both? Or do you know of anyone on both? Have you heard of treating endo with an IUD and pills?

The Diagnosis

It’s 10:30 at night, my fiancé is out with some friends, and I am sitting here on the couch vaguely nauseated. I spend a lot of time nauseated these days. Because my doctor is requiring me to take birth control pills. Because he doesn’t want me to ovulate for at least two years. Because he had to cut open my ovary and take out a 5.7 centimeter cyst that was full of blood. Because my uterus is attached to my pelvic wall. Because I have severe stage four endometriosis.

I was diagnosed about two months ago, but it’s still weird to say. I have stage four endometriosis. The staging makes it sound scarier than it is – though honestly, it does scares me – but it’s not cancerous and it’s not life threatening, so it doesn’t begin to compare to what most people go through when they’re told they’re stage four. Endometriosis is a chronic disease in which the tissue from inside the uterus goes rogue and grows wherever it wants. Usually, it stays in the abdominal cavity, planting itself on the outside of other organs, bleeding like it would for a menstrual cycle, which creates inflammation, scar tissue, pain, and general chaos. Mine, thankfully, contained itself to the reproductive organs – the cyst in my ovary and the scar tissue that has adhered my uterus to my pelvic wall, which my doctor says is impossible to remove and I’d bleed out if he tried. He’s frank like that. I kind of like it. After my surgery, he said, “You have the worst case of endometriosis I’ve ever seen,” which at first, I was taken back, he could have at least tried to sugarcoat it a little, but as my fiancé pointed out, at least we know he’s not withholding anything. But I’m getting ahead of myself. Want to hear the story? You probably do because you’ve read this far, and I want to tell it because the world of endo is a little lonely and I need something to distract me from the nausea.

We’ll start at the very beginning. In December of 2014, I decided to get an IUD because the birth control pill I was on was making me crazy, but my doctor at the time couldn’t get it in. She tried repeatedly, which was super painful, and eventually concluded that I was too tense. She was nice about it, but after numerous attempts, deep breathing, and the old “imagine you’re on a beach” (because that’s so easy to do while someone is shoving a hunk of plastic up your cervix), she gave up. I felt like I had failed. I have some anxiety issues anyway, so being told that I couldn’t have an IUD because I couldn’t relax didn’t do much for my self-esteem. Instead, I went on a different pill which made me bloated, fat, and miserable. I eventually took myself off of it and never went back to her office again.

Fast forward to the spring of 2016. I had since moved 150 miles away and had a new doctor. I decided to ask at my annual exam if she would try to put in an IUD. When I told her the story of my first attempt, she made two things very clear 1) She would never prescribe the abortion pill for an IUD placement right out of the gate, which my first doctor did and which made me feel incredibly sick, and 2) There was no way my nervousness could close my cervix. She ordered a Skyla and told me to call the office when my next period started because that’s when IUDs are easiest to put in. Unfortunately (or maybe fortunately considering how the story unfolded), she wasn’t there the day I got my period, so I was given an appointment with a midwife instead. The midwife, who had read my file, said she’d try but that she had one of the doctors on stand-by who’s “great at IUDs,” as she didn’t want to further traumatize me. After two painful jabs, the midwife went to fetch the doctor, who unbeknownst to me, is male. I’d never had a male gyno, and usually I’d have been a bit uncomfortable with the situation, but I was already in pain and so badly wanted the whole thing over with that I wouldn’t have cared if Rob Lowe came in to do it. The doctor, who I’ll call Dr. X, made two attempts and seemed baffled as to why it wouldn’t go in. He stopped and felt my abdomen as I told him that the pain was too much and I wanted to stop. “Your uterus is tipped,” he said, “Has anyone ever told you that?” (They hadn’t.) “Give me one more try and I’m sure I can do it now that I know how it’s tilted.” Miraculously, and painlessly(!), he was done seconds after that. And then he dropped the bomb: “I want you to get an ultrasound because even though it’s tipped, that was too hard. I think you might have a wall in the middle of your uterus, or maybe you have two. We’ll have to see what the ultrasound says.”  I told you he was frank. Needless to say, I was pretty floored, while at the same time just so relieved to have an IUD, be off the pill, and know for sure that it wasn’t my anxiety that failed me the first time.

The ultrasound – which no one warned me would be transvaginal! – showed I had one wall-less uterus. It also showed a 5.4 centimeter ovarian cyst that was full of blood. Awesome. Dr. X told me it could be a “normal” cyst that grew too large and a blood vessel burst into, which would go away on its own, or it was an endometrioma, caused be endometriosis, which would not go away and would require surgery. There was nothing to do but wait and see. So for the next month, I was not to have intercourse, play sports, run, dance, or do anything that would jostle my abdomen and cause the cyst to burst. “If it bursts,” he told me, “call my office immediately, even after hours, and get to the emergency room.” “How will I know if it bursts?” I asked naively. “You’ll be in excruciating pain,” he replied. Double awesome. I spent the next month on the couch whenever possible, hoping and wishing that it wouldn’t burst and would go away.

The follow-up ultrasound showed that it was still there, of course, which I already knew because I could feel it. I had started having to sleep on my other side to avoid the dull ache.  Now at 5.7 centimeters, he was sure that it was an endometrioma, but because it was right on the borderline size of operating or waiting another month, he left the choice up to me…though he made it clear that he thought he was going to operate eventually no matter what I chose. Not wanting it to burst, or twist and kill my ovary (another happy possibility), and trusting his judgment, I decided to have the surgery.

And then I cried for weeks, sure I was going die from the anesthesia or wake up in the middle of the operation, or have some terrible complication…I was so scared of the surgery, I didn’t even consider the fact that he thought I had a chronic disease. I’ll write another post on the day of the surgery itself, but suffice it to say, there were no complications, he saved the ovary, and I have endometriosis and scar tissue all over the outside of my uterus. He lasered off what he could, put in a new IUD (because he had to remove the other one to “move the uterus out of the way while I operate on the ovary”), and stitched me back up.

At the follow-up appointment a week and a half later, he said I needed to be on birth control pills for at least two years because the IUD wouldn’t stop me from ovulating (though it would help with other aspects of endo) and ovulating = menstruating = scar tissue.

So here I am. Nearly two years after I decided I wanted to get off birth control pills because I couldn’t stand the side effects, swallowing my daily Seasonique while my Skyla silently works its magic.

And that, as they say, is that.