Implant to cerazette

implant
progestagen-only-pill

#1

@Dr_Paula hi I’ve recently had my implant removed due to continuous bleeding issues. I’ve had every test and scan going via the hospital and doctors to rule things out. And everything came back clear. I am now on cerazette I take it every night at 9pm. I felt I could rely on the implant whereas all I’m reading about online about cerazette is how many people have got pregnant on it. Its causing me to worry. My partner and I never used condoms when I was on the implant as we are both clear of infections and things whereas now I feel I cant trust the pill. Is the mini pill stronger or weaker than the implant? Or do you have any advice and guidance on how to stop worrying about its effectiveness. A lot of stories I read of people getting pregnant said they took it exactly the same time everyday. I know no form of contreception is 100% but the implant protected me however caused me many other issues.

Kind regards


POP to implant?
#2

Hello @Nadine_Stacie

Many thanks for your question. If used consistently and correctly then progestagen only pills containing desogestrel (like Cerazette) are 99% effective.

They work in 3 ways - they stop you ovulating in 97% of cycles, they also thicken the cervical mucus so that sperm are unlikely to get to the womb and they thin the lining of the womb as a back up so if there was a fertilised egg it would be unlikely to implant.

Things that could decrease effectiveness are other medications that might interact, missed pills (more than 12 hours late) and severe diarrhoea or vomiting within 3 hours of taking the pill.

I completely understand your concern, but all the research evidence suggests that if you are taking it regularly you have a less than one percent chance of pregnancy.

Hope this is helpful, let me know if you would like further information.

Paula


#3

@Dr_Paula thank you for your reply. So is it safe not to use condoms whilst on the mini pill? Also how would I know if I’m allergic to condoms? Especially if I’m not allergic to latex gloves. I’m experiencing soreness and irritation of my clit and clit hood and lips.


#4

Hello @Nadine_Stacie

Yes, the mini pill is over 99% effective when used on its own without condoms as long as it is taken correctly.

In terms of the genital irritation that you describe - there are lots of possible causes:

It could be an allergy - either to the condom or the spermicide used to lubricate the condom - you could try condoms without spermicide or non-latex condoms and see whether this makes a difference. It could also be allergy to something unrelated to sex such as washing powder or soap.

It could be thrush - this is a non-sexually transmitted infection that commonly causes vaginal irritation, usually associated with a ‘clumpy’ white discharge.

Many thanks.

Paula


#5

Hi @Dr_Paula
I’ve been on cerazette a couple of months now. And I’m having my first bleed or period. Since starting the pill I’ve used condoms other than on one occasion about 3 weeks ago. I take at the same time every night and haven’t missed one. Basically since my bleed or period I’ve been dizzy tender boobs and feeling sluggish and having lots of headaches. I’ve been checked for diabetes and things recently and all negative. My question is could I be pregnant (negative tests) or could it be due the pill and my period?

Kind regards


#6

Hello @Nadine_Stacie

Thanks for your question.

Pregnancy tests are pretty sensitive. They are usually positive by 3 weeks after fertilisation occurs, so a negative pregnancy test in your case is very reassuring.

Also the fact that you have taken your pill regularly and not missed any pills is very reassuring.

Your risk of pregnancy must be extremely low. It would not do any harm to re-check a pregnancy test in a weeks time, but a negative pregnancy test 3 weeks after the sex that you are concerned about is very reassuring.

Many thanks

Paula


#7

Thank you @Dr_Paula. Could my symptoms be due to the pill?


#8

Hello @Nadine_Stacie

I think your symptoms are dizziness, breast tenderness, tiredness and headaches.

There is very little conclusive evidence to tell us how often people can experience these side effects on Cerazette, however the manufacturers information lists breast tenderness and headaches as common effects and tiredness as uncommon.

These are all common symptoms so sometimes it is difficult to tell whether it is the pill or not.

I think you have been on Cerazette for a couple of months. Usually the standard advice is to try out a new contraceptive for 3 months, keep a record of any symptoms so it is easier to relate them to the pill or other stuff going on in your life and review at 3 months.

Obviously this is something that you will discuss with whoever prescribes your pill, but these are some of the things to think about when you go for your consultation.

Hope helpful.

Paula


#9

Hi @Dr_Paula

I spoke to my gp regarding my symptoms and have been prescribed noriday 350mcg tablets. I wondered how effective this pill is and also how it is different from cerazette?

Kind regards


#10

Hello @Nadine_Stacie

Sounds like a reasonable plan. Noriday is another progestagen only pill. It works in a similar way to Cerazette - thickening the cervical mucus and thinning the lining of the womb. It is less likely to stop ovulation than Cerazette.

One thing to remember is that you have a 3 hour window to remember to take Noriday (you need to take it within 3 hours of the same time every day) rather than the 12 hour window that you have to remember Cerazette.

As you switch from one to the other it would be worth keeping a diary of any symptoms so that you can look back and see which you prefer.

Many thanks

Paula


#11

@Dr_Paula Hi. Can pop pills cause spotting? I feel like I am going to have a period I noticed a little bit of blood on one occasion and nothing since. Is this normal with pop pills or could it be something else?


#12

Hello @Nadine_Stacie

Yes, the POP can cause spotting - I have given the likelihood of bleeding on the mini pill that contains desogestrel below- but I think you are on Noriday which contains norethisterone (another type of progestagen). I can’t see any data for norethisterone.

It is standard practice other common causes of bleeding and consider checking a pregnancy test, an STI test and making sure that you are up to date with your smear. I am just saying this because if you went to a clinic they would routinely check these things, not because I think it is particularly likely that you have them. Irregular bleeding on the mini pill is common.

Using a mini-pill containing desogestrel bleeding patterns are like this:
● 5 in 10 women can expect to have no bleeding or infrequent bleeding
● 4 in 10 women can expect to have 3–5 bleeding spotting/episodes in 3 months
● 1 in 10 women can expect more than 6 bleeding/spotting episodes in 3 months
● 2 in 10 women will experience bleeding/spotting episode lasting more than14 days (prolonged
bleeding)

Many thanks

Paula