Libra, are you sure it wasnt the progesterone in the combined pill that caused you problems? I think that seems to cause more issues than estrogen? If your'e taking a POP then the balance between your estrogen and progesterone will probably be knocked - hence when you're still getting low estrogen issues. The patch with the same progesterone you currently take seems like a good idea, if it's available? You're lucky as a lot of ladies struggle with this progesterone.
This might be of interest to people who are considering the pill but prefer the lower risks of HRT:
As premenstrual depression and other cyclical disorders of this syndrome are related to ovulation, it is logical that the mainstay of treatment should be the suppression of ovulation and the removal of the cyclical hormonal changes (whatever they are) which produce the cyclical symptoms of this condition. It is likely that the essential cause of premenstrual depression is the intolerance to endogenous progesterone following ovulation, and it is regrettable that such patients are also progestogen intolerant to any gestogens administered (20), and these progestogenic side effect are both dose and duration dependant (21). Any progestogen used for endometrial protection in these patients should be one that produces the least symptoms given in the lowest effective dose and the least number of days.
It is for this reason that the birth control pill, although suppressing ovulation and cycles, is not so effective because of the daily progestogen for twenty-one days a month. Even taking the birth control pill back-to-back without a break removes all fluctuations, but in some patients the progestogen component remains a problem and the PMS type symptoms become continuous rather than cyclical. The progestogen drosperinone is a less androgenic gestogen contained in the oral contraceptives Yasmin and Yas. These have been claimed to be effective for the treatment of PMS (22) and have been recommended by some to be suitable as first-line therapy (23).
An effective hormone therapy for severe PMS is the use of transdermal oestrogens for suppression of ovulation (24). This can be by gel (2.5-5.0g grams daily), patch (200 mcgs twice weekly) or --in those patients who have already responded well to transdermal oestrogens -- an oestradiol implant of 50 mgs every six-months, which gives long term therapy (25). They should be warned that they may feel less well in the first two weeks -- rather like the mood changes seen in early pregnancy -- and that it may not work for the first month until ovulation has been suppressed. Oral oestrogens may also be effective, but there are no published studies to support this.
The patients will need progestogen to prevent endometrial hyperplasia and irregular bleeding, but because of the progestogen intolerance found in these women, a smaller dose of shorter duration is recommended, usually in the form of 2.5 mgs of Norethisterone or 100 mgs of Utrogestan for the first seven days of each calendar month; this will produce a regular withdrawal bleed on about day ten of each calendar month. Re-setting the periods in this way prevents abnormal bleeding ; instead normal , usually scanty bleeding occurs at a predictable time of the month. Another minor advantage of this regimen is that periods now occur 12 times a year rather than 13.
http://www.studd.co.uk/depression.php[/b
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Topic: Difference between HRT and BCP (the pill) (Read 14826 times)