1

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PCOS..help menstruating options..

Answered on August 19, 2014
Created May 04, 2012 at 9:19 PM

So after my disaster of a hormonal storm...I have realized that I am not able to menstruate on my own, despite eating strict Paleo for 1 year now, exercising 5-6 times a week, and generally being quite healthy. I must admit this is rather disappointing. Moving forward my options will be as follows, if anyone could help me understand what would be best, that would be great. Thank you.

Currently on Diane 35 - very high estrogen pill - been on it since 16 ~ Option #1 Just stay on this pill

Move to a lower dose pill such as Yaz or something with 20MC of Estrogen rather then 35

Progesterone Only Pill - which will limit the amount of synthetic estrogens

Bio-identical Progesterone Cream Day 14-28 of cycle to help ovaries to ovulate

Metformin - No pill - or Metformin with Pill

My biggest concerns are as follows - I have never been able to build muscle properly and move forward with getting leaner while on this pill (it suppresses androgens.test. so much that I just stay round and a little flabby rather then getting toned) - So i would like to be able to move forward with fitness goals...

Also, I would like to choose an option that will of course not just delay the obvious, having to deal with this eventually.

I would like to choose the option that will provide with me with the ability to have the greatest amount of STABILITY>>>as of lately...i would say 12-17 days of each MONTH is a complete write-off with me being immobilized with menstrual issues.

I just want to minimize that and feel good for more than 7 days max.

One other question - If I choose the Bio-iden. Hormones...so i will be using my own estrogen..and balancing that with the progesterone cream...will be own extrogen levels be likely higher or lower than say the 20mcg i would get from a low dose pill?

Thanks in Advance!!!

6747a5447a3440b5c87ebf5f2c1e0ead

(231)

on May 22, 2012
at 06:25 PM

I would be really careful with the bio-identical progesterone cream. I was put on it, despite my cries of protest, to deal with PCOS related issues. Not only did it not help, it made every single one of my symptoms more pronounced and that much harder to deal with. It also resulted in a wicked inability to lose weight.

Ddfdaa75ac9f47e01fc71162dd0d38dc

on May 19, 2012
at 05:04 PM

Progesterone can make you cranky all the way to full blown screaming rages. It often causes fat gain in the lower half of the body. It will reduce body hair - including head hair. So you have thin hair, thunder thighs and are a howling crazy woman. Use with care under doctor guidance ONLY.

E68bdbd83e45fd5be130e393ace9c9a9

(2058)

on May 19, 2012
at 04:39 PM

invisible ink -- I'm sorry, can you can clarify that? you were on a copper IUD and birth control pills at the same time? or you got jaundice/liver failure from BC pills and then later had horrific periods and PMS from the copper IUD?

16e617676c5ac710e5235e0b773edc0b

(2640)

on May 19, 2012
at 02:30 AM

What do you suggest for someone who has gotten extremely ill (jaundice/liver failure) from hormonal birth control pills and horrific periods and PMS (for the entire year+ I had it while eating a strict low carb paleo diet) from the copper non-hormone-releasing IUD? I feel like my birth control options are now limited to barrier methods only but at least I don't have any of the issues I had before. Any ideas would be great. I feel like a weirdo having so many health problems from birth control. :(

293ba4c95d190bc616b27d85b10d705a

(661)

on May 06, 2012
at 06:53 PM

i hope this didnt do any long term damage. i was on accutane and diane 35 and a ton of antibiotics as a teen :(

293ba4c95d190bc616b27d85b10d705a

(661)

on May 06, 2012
at 06:52 PM

it effects your cortisol somehow, i believe. when i took it i became very very irritable

59ee717de524f921efb7f2984157339f

(871)

on May 05, 2012
at 01:07 AM

Don - what kind if IUD is a Prog IUD? Also, If my goal is to be able to gain muscle and improve body comp (which i don't feel has been successful on this pill - because of lack of natural testosterone) What would you recommend that would allow me to have SOME free flowing Test. to build muslce and feel better?

59ee717de524f921efb7f2984157339f

(871)

on May 04, 2012
at 11:45 PM

what were the bad experiences?

59ee717de524f921efb7f2984157339f

(871)

on May 04, 2012
at 11:42 PM

Primal Trig...what were the biggest difference you saw when you switched to Yasmin ? was is a hard transition? I don't know if i can handle another Hormonal storm while transitioning...

59ee717de524f921efb7f2984157339f

(871)

on May 04, 2012
at 11:41 PM

Well the 35 is the amount of Estrogen...vs. other pills like Yasmin etc that have 20..

293ba4c95d190bc616b27d85b10d705a

(661)

on May 04, 2012
at 11:31 PM

So weird because I was on Diane 35 for several years as a teen. I didn't know it was high estrogen.

2fdb7a6236b04bdfc3dacaf2bc236515

(528)

on May 04, 2012
at 10:40 PM

Yasmin and Yaz both made me absolutely crazy. Your milage, of course, may vary :)

31381cfeb5d6da6fc75f80ab68e041ea

(560)

on May 04, 2012
at 10:26 PM

as a side thought? if you are on a high dose estrogen pill, yasmin (a lower dose pill) might leave you spotting all month. i didn't do well on it, but good luck if you try it!

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5 Answers

1
F5a0ddffcf9ef5beca864050f090a790

(15515)

on May 05, 2012
at 02:02 AM

I don't know if I should even comment from now on since my herbal experience changed the way I view sickness and disease. I highly recommend seeing a good Chinese herbal doctor. That's the only thing that worked for me. And I can only recommend what I believe in.

1
3bf8a40c64e77f8ccaf480bc03c7fbef

on May 05, 2012
at 12:39 AM

Whoa, I love dealing with PCOS! I see a lot of pts with it. First of all.... consider your goals. If your goal is menstrual control, and the Diane-35 is working well for this, do NOT change it. However, if you feel unwell on it, then you should consider something different.

Re: Yaz. The progestin (synthetic progesterone) component is called drosperinone. It is an analog of spironolactone, one of your body's own mineralocorticoids. It is HIGHLY anti-androgenic, which means it is wickedly good at suppressing androgen effects. It can be very good at stopping issues like acne and male-pattern hair growth, both by direct androgen receptor blocking, as well as the usual method common to all other combined oral contraceptives, which is increasing the liver's production of Sex Hormone Binding Globulin (SHBG). This latter method basically 'imprisons' androgens bound to a protein in the circulation, preventing them from activating cell receptors. However, one down side is very low libido for some women.

If your goal is ovulation because you are pursuing FERTILITY - then Metformin is an excellent choice. But going on Metformin in the hopes that you will just spontaneously ovulate and thus have regular menstrual cycles, I don't think this is something too reliable for most women with fairly severe PCOS. One upside, however, is it increases insulin sensitivity, and often leads to a moderate weight loss.

Re: Biotidentical hormones - there is minimal evidence to support their use. They do not 'promote ovulation' as you mentioned. The degree to which they absorb and stabilize the uterine lining (endometrium) is variable and unreliable. Not recommended.

One other option which you haven't mentioned is the progesterone-releasing IUD. This has minimal systemic absorbtion, so therefore minimal systemic side effects (a bonus over oral contraceptives and cyclical progestins). It provides highly effective endometrial protection, and will thin down the endometrium significantly by counteracting estrogen in the uterine lining. Menses become very light with this, and may even stop. But there is an adjustment period of 3-6 months with irregular spotting and bleeding at the beginning of use.

Congrats on your committment to Paleo, too. The lower carb you go, the better response you will have in improving your insulin sensitivity (one of the underlying problems in PCOS is insulin resistance).

59ee717de524f921efb7f2984157339f

(871)

on May 05, 2012
at 01:07 AM

Don - what kind if IUD is a Prog IUD? Also, If my goal is to be able to gain muscle and improve body comp (which i don't feel has been successful on this pill - because of lack of natural testosterone) What would you recommend that would allow me to have SOME free flowing Test. to build muslce and feel better?

16e617676c5ac710e5235e0b773edc0b

(2640)

on May 19, 2012
at 02:30 AM

What do you suggest for someone who has gotten extremely ill (jaundice/liver failure) from hormonal birth control pills and horrific periods and PMS (for the entire year+ I had it while eating a strict low carb paleo diet) from the copper non-hormone-releasing IUD? I feel like my birth control options are now limited to barrier methods only but at least I don't have any of the issues I had before. Any ideas would be great. I feel like a weirdo having so many health problems from birth control. :(

E68bdbd83e45fd5be130e393ace9c9a9

(2058)

on May 19, 2012
at 04:39 PM

invisible ink -- I'm sorry, can you can clarify that? you were on a copper IUD and birth control pills at the same time? or you got jaundice/liver failure from BC pills and then later had horrific periods and PMS from the copper IUD?

1
293ba4c95d190bc616b27d85b10d705a

(661)

on May 04, 2012
at 11:33 PM

Be careful with progesterone. I've had bad experiences on even a small dose and so have a lot of other people

59ee717de524f921efb7f2984157339f

(871)

on May 04, 2012
at 11:45 PM

what were the bad experiences?

293ba4c95d190bc616b27d85b10d705a

(661)

on May 06, 2012
at 06:52 PM

it effects your cortisol somehow, i believe. when i took it i became very very irritable

Ddfdaa75ac9f47e01fc71162dd0d38dc

on May 19, 2012
at 05:04 PM

Progesterone can make you cranky all the way to full blown screaming rages. It often causes fat gain in the lower half of the body. It will reduce body hair - including head hair. So you have thin hair, thunder thighs and are a howling crazy woman. Use with care under doctor guidance ONLY.

0
5fca1ceaa4c6c65a4beea4a832aadcbe

on May 04, 2012
at 10:25 PM

I would suggest that u move onto Yasmin. I have been on both and it is much better. It definately screwed me up less. When u are moving off the pill I would recommend Dim and Agnus Castus to help balance your hormones. I have too much testonerone and estrogen.

31381cfeb5d6da6fc75f80ab68e041ea

(560)

on May 04, 2012
at 10:26 PM

as a side thought? if you are on a high dose estrogen pill, yasmin (a lower dose pill) might leave you spotting all month. i didn't do well on it, but good luck if you try it!

59ee717de524f921efb7f2984157339f

(871)

on May 04, 2012
at 11:42 PM

Primal Trig...what were the biggest difference you saw when you switched to Yasmin ? was is a hard transition? I don't know if i can handle another Hormonal storm while transitioning...

2fdb7a6236b04bdfc3dacaf2bc236515

(528)

on May 04, 2012
at 10:40 PM

Yasmin and Yaz both made me absolutely crazy. Your milage, of course, may vary :)

0
31381cfeb5d6da6fc75f80ab68e041ea

(560)

on May 04, 2012
at 10:25 PM

hey paleo4ever! i don't have much advice, but i can't think that what you are taking now could even be helping. 12-17 days of the month a write-off? i say be bold and make a change. how could it be worse? praying for you!

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