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[Lizab]

Briony, someone posted awhile ago about breakthrough bleeding causes (Hurdity?). If I recall correctly, it could go either way. Too little estrogen would perhaps not supress ovulation and you could have random spotting. On the other hand, too much estrogen could cause the lining to grow to a point that it kind of atrophies (maybe not the right term in this case) and breaks up a little on its own, leading to spotting. I know in my personal experience, my body was too particular for any pill. I tried several different ones in my twenties for 3-6 months at a time and had spotting/breakthrough with all of them. There was one I did fairly well on, but if I was even an hour late taking it, I would bleed. The doctor didn't trust that it was giving sufficient contraceptive protection so I had to abandon hormonal contraceptives altogether.

[Briony]

Ah - that's interesting Lisa and makes a lot of sense. Interesting what your doctor said about still ovulating on the pill, as that was my fear on Qlaira too (even if it's not every month). I think Dangermouse mentioned that she still ovulated on a pill as well? Does this mean, if we are still peri menopausal, we should use be using additional contraception?   

[Lizab]

I *think* if you're having unplanned bleeding at any stage/age on the pill then it shouldn't be considered effective contraceptive. If your periods are coming when they are supposed to, during the "off" week, then I would assume it's all good.

[dangermouse]

There does seem to be mixed views on the lining shedding causes but I suspect, like a lot of our symptoms, they can happen at either end of the spectrum. I just found another article that said the oestrogen stops the lining getting too thin as it can then breakaway and bleed. So yes I think it's all about balance so it's not too big to make it crash through or too small that it can't sustain itself?

I think the main point though is that as long as you aren't having any bleeding then you can take the pill without breaks.

Marvelon made me feel awful too but another oestrogen dominant pill made me feel good, so it's a lot to do with the type of prog. High oestrogen can cause over stimulation nausea and anxiety and low oestrogen makes the adrenal glands throw out more adrenaline (to keep heart beating adequately) which can cause the same nausea and anxiety. It's all about getting the balance right.

I wish there was a low oestrogen and low Norethisterone pill, as 20mcg of oestrogen really seems to suit me but its paired with high prog. The low prog is then paired with 35mcg of oestrogen and Norimin has both of them high! I chickened out of the mini pill only as started getting vague nausea but am thinking of pairing it with Estrogel as I know this is done with the Mirena. I don't really want to fiddle with cyclical progesterone for now. I'm just fine tuning really to try to defeat quite strong lethargy I'm still left with.

The pill mainly works by the artificial progesterone thickening the mucus so that sperm cannot get through. The addition of oestrogen in the combined pill stops ovulation also for most. So even if you still ovulate, you will be getting the same contraceptive protection as if you were on a progesterone only form.

[Briony]

Thanks Dangermouse - that's really helpful and makes sense. Have never made the adrenal gland/nausea connection before. Good reminder that estrogen and  progesterone arent the only parts of the equation.

[Joesmum]

You really must have your thyroid tested. The symptoms you are mentioning could very easily be low thyroid.

Ask for
TSH
FT4
FT3
Thyroid antibodies.

Many years ago I was told that all my symptoms were peri menopause when in fact they were hypothyroidism.