Lots of Period-Related Questions

[lepasse.livejournal.com]

 First of all, please forgive me if these are stupid questions.  I've had PCOS for all of my period-having years, so I'm not very knowledgeable when it comes to how things are supposed to work.  

So, yeah, PCOS.  Highly irregular and infrequent periods.  I took Yasmin for many years to regulate.  In 2008, I got married and started TTC.  Eventually had to seek infertility treatment.  Finally conceived and gave birth last May.  I breastfed on demand and got my first period when my son was 11 months.  It was a weird period.  7 days of light flow, followed by 10 days of heavy flow, then a few more days of tapering off.  About a week after that period ended, I went to see my OBGYN about getting on birth control and spironolactone (for unwanted hair).  She told me to take a pregnancy test in a week, and then another a week from then.  If I wasn't pregnant and didn't get a period by then, I was to start Provera for 7 days to bring on a period, and then start the birth control when that period started.  I ended up having to go the Provera route, since a period never came naturally.  Took Provera May 27th - June 2nd.  Period started June 4th, and I started OrthoTriCyclen.  The period has been BRUTAL.  I've had lots of cramps, I feel very lethargic, and the bleeding is very heavy.  I can soak through a super tampon in about 2 hours.  When I use the bathroom, the entire contents of the toilet bowl is pink-red.  I've passed some clots, too, though nothing super big.

Anyway, here are my questions.

1.  Is it normal for your period to become heavier postpartum?  Both of these periods have been heavier than anything I had before.
2.  How much bleeding is too much?  In other words, do I need to call my doctor?
3.  How long does it take for BCP to be effective?  I'm in no mood for sex with all this bleeding, but I'd like to resume activities as soon as the bleeding ends.  
4.  How come I had to wait for a period to start BCP anyway?

Comments

[kuradi8.livejournal.com]

Sorry, I don't know the answer to your questions so I'm going to go off on a related tangent.

Instead of tampons, are you familiar with menstrual cups? Most of them have measuring lines so you can keep track of your flow -- which is good information to give your doctor. It's quantitative instead of just guessing at how much is in a tampon or a pad. It will help you and your doctor figure out what's normal for you.

Google for more information about them and then go to http://sizecharts.livejournal.com/ if you're interested.

[draiochta-faol.livejournal.com]

1. I think it differs with everyone. Mine became a bit more bearable pain wise, but I never really noticed a change in flow.

2. I believe the rule of thumb is if you fill a pad or tampon every hour you need to go to the ER. Personally, I would call your doc and see what she says. That seems like an awful lot of blood.

3. After 7 days of being on continuous BCP, you are considered protected.

4. Not entirely sure as I have never been on BCP, but most of the lovely VPers here could answer this question better.

[helenkacan.livejournal.com]

re 4.
I believe it's because, when you start your period, you have already ovulated and the drop in hormoines puts you at the lowest risk of being fertile; so it's presumably easier to trick the reproductive system to respond to a new chemical regime.

Actually, when I began hbc in 1972, it was common to begin not on the FIRST day of a natural period, but on the FIFTH (to try to remain as close to a textbook 28-day cycle).

[queensugar.livejournal.com]

I'm not sure the general guideline to start soon after the start of a period is related to efficacy, because HBC is equally effective after seven days whether you take it on the third day of bleeding or in the middle of your cycle.

My understanding is that the guideline is essentially trying to reduce the chance of breakthrough bleeding -- as I've read it, it's more common if you start HBC later in your cycle, and as that is the number one cause for people to discontinue a brand, pill companies want to minimize the chance it will occur.

[archangelbeth]

If you are feeling lethargic and going through a super tampon in 2 hours, consult your doctor. At the least, you may need more iron. If your clots are golf-ball sized, and you cannot contact your doctor, I would suggest that would be "go to the hospital" time, combined with the other symptoms.

So...

1: Maybe? Mine got lighter, though.

2: Soaking a normal pad or tampon in an hour, esp. multiple hours. Passing clots the size of golf-balls. Chills, clamminess, extreme fatigue, dizziness, fainting, graying-out, confusion... signs of extreme blood loss, in other words... are "go to ER" signs.

3: 7 days for pregnancy protection. You may wish to go a full month if you are concerned you may have side effects -- that way, you don't have to decide between "go off HBC right away, but I had otherwise unprotected sex last night" and "stay on HBC another week and have [intolerable side effect]."

4: You don't have to wait for a period to take HBC. It can reduce spotting if you do, and if you're pregnant, then going on HBC is A: pointless, and B: has some theoretical potential to maybe possibly perhaps wonk things up a little hormonally (though overall, people've been taking HBC while pregnant for decades and having no statistical problems). And if you start on the first day of a natural period, you are considered protected immediately: the 7 days required for the hormones to hypnotize your ovaries overlap with when they are least likely to be ovulating.

(Once on HBC, the ovulation stuff reverses: the uterus responds to the placebo pills' lack of hormone by bleeding, but the ovaries start waking up from their hypnosis. Extending the placebo week past 7 days risks that they'll wake up enough to ovulate, even if the uterus is still cheerfully bleeding.)

[babycakies.livejournal.com]

I will give you the information I have learnt first hand on my journey with PCOS.

1. Yes, normal for periods to change postpartum but, you should be aware of a few things. Some women (including myself) with PCOS can be anemic. This can and will effect the bleeding you experience with cycles. Hormonal birth control can effect and worsen anemia which will worsen cycles. Some PCOS woman also develop a Thyroid condition after having a baby. You should get this checked STAT. This can also effect bleeding and being anemic.

2. Yes, call your doctor,.. I have had a scary scenario where I almost needed blood transfusion from the volume of blood I was losing. In some cases a D&C and blood transfusion can be needed. I have always gotten lucky with Bed rest and Iron supplements while on my cycle.

3. My rounds with BCP were NEVER good. I got pregnant on the pill and I had random bleeding all the time and for 3 months straight.

4. Because the first day of your cycle is Day one and syncing up your body and making sure you were not pregnant is easier on your body when starting BCP.