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[dangermouse]

Have been wondering about this, if our own cycle is always present whether we are on BCP, HRT or post meno. This article kind of confirms that even on BCP we grow follicles, albeit tiny, also my aunt who is in her late 70s and not been on HRT for years says she can still feel her cycle subtely and has PMT days!

I am on the BCP (without withdrawal breaks) and have felt all the ups and downs this month in line with my cycle, including hormones falling rapidly when period would have been so I think mini ovulations are occurring.

Would explain why adding hormones only reduces our natural ones to a certain degree, thus giving us varying symptoms depending on our natural day of the month?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891973/

[catlike]

Yeah dangermouse- I reckon that's the case. Can definitely feel mine doing it's up and downs- hrt or not- period or not. Was/am hoping that meno might bring relief- but your aunt can still feel hers! Oh no !

[dangermouse]

Oh she said it's very subtle so dont worry! I guess it explains a lot.

[Dorothy]

I went on BCP at 30 to deal with excessive bleeding & pain & I've always felt my natural cycle was carrying on 'under' the BCP, although my current GP is the only one to accept this might be possible. 

Now on BCP for early meno, taking a break every 3 months.  I still get 'damped down' meno symptoms while I'm on the pill, though I only get extreme symptoms when I'm on the break.

Recently, I went through a period of extreme stress and it was as though I'd stopped taking the pill as I had all the symptoms full-force.  I posted a query about it on here and someone (sorry, can't remember who!) posted a link to an article saying that factors including stress could limit the uptake of the hormone.  Sure enough, when the stress reduced, the pill went back to being effective again.

All of which makes me think that it's not simply a case of BCP 'replacing' our natural cycle, more that it overrides it so that the natural cycle isn't so strong or noticeable.

[Hurdity]

Hi dangermouse

That's a very interesting article! - I have never looked into the Pill and what it does as I only took it for a year in my 20's and have only really looked in detail at HRT.

However the main point is that there can be some follicular activity with the low dose pills that are now used, but most likely to occur during the pill free week - which stands to reason. However ovulation will not be occurring - this is very rare and if it did then the Pill would not work as a contraceptive. You can't have a mini ovulation - I mean it either happens or it doesn't? The possibility of some follicular activity does imply that oestrogen levels will vary - and of course they reduce drastically during the pill free week - but perhaps while taking the Pill they will increase more than they would be expect to from just the oestrogen in the pill - if follicular suppression doesn't completely work - as the follicles will be producing their own oestrogen. So it's not your own cycle as such but caused by the possibly inefficient artificial cycle created by the Pill if you see what I mean.

As Dorothy says - on the Pill your hormones only fall rapidly during the Pill free week, otherwise the Pill wouldn't work? Which one are you on Dorothy - and does it give continuous oestrogen and progestogens at a constant dose?

As I understand it the ovaries do continue to produce some hormones for some years following menopause although I don't think there is any cyclicity as I understand - but I am not sure what controls this hormone production once ovulation has ceased?

Hurdity x

[dangermouse]

Yes I had assumed as no ovulation that our natural oestrogen stayed high and progesterone low, but in barely noticeable amounts but it does feel more sophisticated than that. You'd think there'd be data available from when BCPs were trialled, to show exact hormone activity but not been able to find anything. I didn't notice any fluctuations when younger though so guess it's linked to the stronger peri fluctuations.

I think I read the adrenals take over a lot of the ovarian production of the sex hormones post (or possibly just before) menopause, so may explain why when oestrogen falls, cortisol increases.

[Dorothy]

I'm on Ovranette.  I've only ever used it for health reasons, but I'm not sure I would have trusted it as a contraceptive anyway, due to the way I continued to get ovulation-type and early-period type discomfort while on it.  Especially as I knew someone who had similar and got pregnant while on it!

[Hurdity]

Hi again dangermouse - you're right about the progesterone - if no ovulation then you won't produce any ( well except the normal tiny amounts we need). However natural oestrogen won't be high as in you won't experience the ovulation peak because ovulation doesn't happen - in women who are on the low dose pills ( 20 mcg?) and who do have a pill free week - sometimes ( according to the paper you linked to_ follicles can start to develop - so will produce some extra oestrogen - but this will be negligible compared to the amounts you are taking on the pill and the fluctuations also negligible compared to your natural menstrual cycle.

Complicated innit?!

Hurdity x

[dangermouse]

For sure!

Pre the pill, my nausea symptoms (which was like an over stimulated stomach, you could physically see it churning accompanied by motion sickness) all used to start on Day 2 (between 5-10am) and gradually get worse until around ovulation when I would feel sick nearly the whole day for about 3 days. Then I would feel only queasy for about an hour until Day 2 again.

The high adrenaline/anxiety would start about 2 days before period (5-10am and 2-8pm roughly when natural adrenaline is high) and get worse until ovulation and then reduce for about a week, so both symptoms seemed to ease post ovulation.

I initially figured that progesterone was, hence, what I needed as I only felt better when it should have been dominant in my cycle, but really not sure now as I've read so much about the link with low oestrogen and high cortisol and the oestrogen dominant pill does seem to make the anxiety better.

Funnily enough, the same adrenal pattern (minus the nausea thank goodness!) has occurred on the pill, so after 2 weeks passed I felt more relaxed and back to myself and then then by about Day 19 I felt the adrenaline all come back - not as severe though. Also had crazy skin itchiness from Day 17 which calmed after about 4 days.