Mini pill & Period & Fibroids

bleeding
fibroids
progesterone

#1

Dear Dr Paula,

I’ve suffered from extremely heavy period and chronic anemia caused by fibroids.

I’ve had hormone test recently at around 15days of my cycle, it shows my progesterone level very low, estrogen level a little bit lower than normal. Also T3 thyroid is low which may have been caused by the underlying chronic anemia.

Every month when having period, I have to stay at home because I need to change sanitary pads every 20 - 30 minutes.

I am planning to start on mini pill to stop my period for 3-4 months just to get my blood count back to normal before start my treatments for fibroids.

Could you please advice me? I don’t want to go through another period, I don’t think my body can take that anymore.

Many thanks.


#2

Hello @I-loveSunshine

Many thanks for your question - I am so sorry that you have had such a difficult time with your periods.

You may have all the information that you need about fibroids - but if you need any more then this is quite a useful website http://www.britishfibroidtrust.org.uk/whatis.php

In terms of the ability of the mini pill to stop your period - it may or may not do this. Bleeding patterns on the mini pill are quite variable. I am not sure what mini-pill you have been prescribed but the commonest ones use a hormone called desogestrel. 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 >6 bleeding/spotting episodes in 3 months
● 2 in 10 women will experience bleeding/spotting episode lasting >14 days (prolonged
bleeding).

The hormone coil is often very good for heavy bleeding and by the end of the first year most (but not all) women will have no bleeding at all - but you can get quite a lot of irregular bleeding in the first 6 months.

The combined pill can taken continuously to stop bleeding and if you have no contraindications to this then this can be an effective way of controlling your periods.

Does this all make sense? Do come back to me if not.

Many thanks

Paula


#3

Dear Dr Paula,

Thank you so much.

It’s Cerazette ® 75mcg.

So the bleeding is not guarantee to stop? Do they reduce the flow? If so, by how much? Because all I want is to stop or reduce the flow, is not for contraception.

I am not sure about the combined pills, i’ve had my hormone checked recently, my progesterone is very low, Estrogen is in normal range. I thought it would help to balance my hormone if I take progestin only pill? Is that right?

Many thanks again.


#4

Hello @I-loveSunshine

No the bleeding is not guaranteed to stop. The figures that I quoted in the previous post are for Cerazette.

I am not sure about the results of your hormone checks. Your hormone levels change naturally over the course of your menstrual cycle - so it is quite difficult to say whether any hormone is particularly high or low. You can see that progesterone is high towards the end of the cycle -just before you bleed.

If you take the progestogen only pill it works by stopping you going through this type of cycle at all in most cases. 97% of people who take the progestogen only pill do not ovulate - so they don’t go through the hormonal changes in the picture at all. So, I don’t think the idea of balancing your hormone quite makes sense - you will stop your natural hormone cycle and have different hormone balance dominated by the progestagen (a copy of progesterone) in the pill.

I am not sure how much detail you want about this - let me know?

It seems like your main issue is controlling your periods. The Cerazette might do this - it is definitely worth a try - you can see from the figures about that 5 in 10 or 50% of women will have no bleeding or infrequent bleeding. If this does not work then the IUS (which is used as a long term treatment for heavy bleeding from fibroids) or the combined pills are also options.

Then of course there are other treatments for fibroids - there is more information on these on the British Fibroid Trust website.

I am positive that you will get this sorted out - it is just going to be a case of trying out your options. Hopefully, more information about the different options will help you to make a decision.

Many thanks

Paula


#5

Dear Dr Paula,

Thank you so much, I really appreciate your time, and your kindness.

British Fibroids Trust the last time they’ve updated their website was in 2010. I can see there are a lot of patients sharing their painful experiences but sadly none of them seem to get any help from there?

I have been seeing doctors, apart from being offered iron tablets and surgical treatments, they don’t seem come up with doing a hormone test or any alternative treatment options. I have heard and read many horrific stories from patients undergo fibroids surgical treatments, I do not want to take the risk when I know the surgery can go wrong and the fibroids usually come back again after some period of time.

I know how hard it is to have to live with this type of illness, it’s like a prisoner when we have the monthly period, not to mention the infinity and all the other compilations associated to this. I really hope I can find the cure and I can share my experiences and help those who suffer.

Recently I had came cross a research center for Menstrual Cycle and Ovulation, they based in Canada. After knowing their treatment suggestions, I thought they are the only one had made sense to me. Apart from planning to take the mini pill, I also planning to take progesterone/and progestin treatment which they’ve suggested for treating the heavy flow. I’ve attached their link below in case you would like to take a look.

Thank you so much for taking your time to read.


#6

Hello @I-loveSunshine

Many thanks for sharing this - it is really very interesting and could be useful for many others who are looking at this forum. I checked out the website and the people who run it look like legitimate researchers. They clearly think that progestagens are important in the treatment of heavy menstrual bleeding.

Many thanks for pointing out the the British Fibroids Trust is so out of date - I will definitely not recommend it again.

This could be useful - it is a ‘shared decision making tool’ that sets out the pros and cons of all the different treatments for fibroids. I found it on the National Institute for Clinical Excellence website and it does seem to go through all the options pretty clearly.

http://www.wisdom.wales.nhs.uk/sitesplus/documents/1183/Heavy%20Menstrual%20Bleeding%20Shared%20Decision%20Making%20Aid_GK%20Guideline%202019.pdf

Do let me know how you get on with the mini pill.

Thanks again for sharing your experience.

Paula


#7

this is a really useful site, thanks for posting @I-loveSunshine. I have been experiencing this for a while now and it is getting worse … good to see the options set out here; I am due to go back to my GP about this for a follow up soon and it good to have read this. Thanks.


#8

Hi Katrina,

Sorry to hear that you are experiencing similar problem, I hope your doctor would consider alternative treatment options not only limited to surgical. None of my doctor did, so I had to do my own research. I will update you once I start progesterone treatment.

Be strong & Best of luck!


#9

thanks… will look out for your update!


#10

Hi Katrina,

How are you?
I thought I must update you my experience on taking progesterone to reduce my heavy flow.
I didn’t take mini pill at last, as I was worried about potential side affects. Instead, I took natural progesterone for about 10 days before period, it worked! For the first time in about 3 years! My period has became much lighter and manageable! I was totally over the moon.
It’s only been a month, so I will try for another month, start taking it again about 2 weeks before period, I will update you!
Hope you are well! xx


#11

Oh wow that is really interesting. I guess you have to give this a proper go for a few months and see if the effect is consistent but that sounds really promising. I am very pleased for you. When you say ‘natural progesterone’ what do you mean? Did you have to get it prescribed?


#12

Hi Katrina,

Yes you are right, I must to give this a proper go for a few month, I will keep you updated.

The nature progesterone I took is called Utrogestan, i’ve asked my doctor to prescribe Prometrium, but been told they don’t have them and Utrogestan is the same, i’ve also been offered Provera, but after checking lots of online negative feedbacks, I’ve insisted on having Utrogestan.

The only thing I didn’t follow is that I only took the smallest amount 100mg per day not 300mg, because I am a small built and highly sensitive to all sorts of medications, I thought I would start from small dose, also I did took Ibuprofen and drinking salty water when having period as exactly to what the Canadian research centre mentioned on their website.

Best Wishes.