Dilemma!

[persian--girl.livejournal.com]

I haven't had a period in over 12 months. I was diagnosed with PCOS. The doctor told me to go back on the birth control I was taking (Diane-35). I asked how I was supposed to start taking it again, when in the instructions it says to take your first pill the first day of you period, and I'm not getting my period. So she prescribed me 'progesterone.' (I think. I am pretty sure this is the name of the pill I was prescribed - something she said I take for 5 days, then after a couple days I will start to bleed.)
Well apparantly progsterone is on back order and there wont be any in supply of all of Ontario (where I live) for at least four months.
I'm in this back-and-forth 'calling the doctor's receptionsist then calling the pharmacy game,' getting pretty fed up with it, and decided to ask you fine people before I call my doctors office back (because the lady on the phone was rude and I want to know more information before calling her again).
The doctor's receptionist already said, before I was informed by the pharmacy that the drug is need is out of supply for months, that my doctor said the 'other option' >insert some name I have no idea what she said< would not work in my case, so they didnt prescribe an alertnative.
Are there alternatives? The pharmacist said that there were other things they could give me, and to ask my doctor. *SIGH* So I guess I just want to know if anybody knows of alternatives, particularly the names so I can research them, or if anybody has any advice on what else I should be doing here.
I am pretty sure after a year of not having my period Im going to start putting myself at risk of something bad here.. so I dont want to wait another four months, if they even get it in four months (they arent even sure if it will be there in that time).

Comments

[anthylorrel.livejournal.com]

You can try inducing your period with high doses of vitamin c, parsley tea, or raspberry leaf tea.

But frankly, I would just ask the doctor for a BC pill that doesn't require your period to start it. Most BC pills have progesterone in them anyway.

[persian--girl.livejournal.com]

I am going to go back on Diane because of my original reason of going on it, for acne. And personally I loved being on it. I had no bad side effects from it at all and a perfectly clear face for the 4 years I was on it. So... I dont want to try another one I guess is what I'm saying.

[gatehorse.livejournal.com]

Did your doctor give you a specific reason for starting the pill on the first day of your period? Generally the reason this is recommended is because it's effective against pregnancy immediately if you start it on the first day. You can start it when you're not bleeding, in which case it will be effective against pregnancy after 7 days of taking it. For you, since you are using it for period regulation and not pregnancy protection, it shouldn't matter when you start it (though if you also intend to use it for pregnancy protection, just be aware of the seven day rule).

[persian--girl.livejournal.com]

No she just put me back on the one I was taking (but went off of because I wasnt sexually active anymore, and taking it was a pain a bother).
I want to go back on it because I'm starting to get acne again, and it worked wonders for my acne and I had no side effects from it.

It was suggested from the pharmacist to just take the birth control without my period... She said that her daughter (who also has PCOS) did that, started bleeding within a week, threw out her pack and then started fresh with a new pack.

I really dont want to do anything that isnt exactly specified by the pamphlet of this pill, because I will use it for pregnancy reasons if I am going to go back on it. And this pill is different from a lot of other ones... There is no 7-day rule with this pill.

Anyway, so this wouldnt be a good option for me :(.

[gatehorse.livejournal.com]

As far as I can tell, your pill is a combined pill, which means that yes, there is a 7 day rule. I can't find anything to contradict that, and I don't see a reason it would be contradicted, because it is a combined pill. If you wanted to be really safe to make sure you've gotten back into the habit of taking it, you could use backup while having sex for a month instead of 7 days. But after those 7 days (or a month if you're really worried) you will be protected as protected as if you'd started it on the first day of your period.

[persian--girl.livejournal.com]

In the Diane-35 pamphlet it specifically says if you miss one pill at any point in the cycle of taking it, your protection is then compromised for the rest of the duration of the cycle until you start taking a new pack. There is no 7 day protection rule with this pill.

[persian--girl.livejournal.com]

Ohh disregard this -- I was thinking of something totally different! The whole when you miss a pill, taking a backup pill thing. Sorry!

[gatehorse.livejournal.com]

LOL no worries. Odd that I can't find much info about it online, but yeah, I'm fairly certain it's like any other combined pill, with the 21/7 rule

[paraxeni.livejournal.com]

I take Dianette, which is the UK version of Diane, and it's only when you've missed more than one pill that you have to start a new pack. A pill has to be more than 12 hours late before it can be considered 'missed', so you have some leeway if you accidentally forget. (just checked info for Diane35 and it's the same) The only time it's recommended to start a new pack is if you miss an active pill in the last seven days of the active (usually beige) pills in the pack. If that happens then you carry on with the pack, but instead of taking the placebo pills you start a new pack of active pills instead and skip your placebo week.

In addition, you can start it now. The progesterone your doctor prescribed won't give you a period anyway, just a withdrawal bleed. If you start the Diane now it'll be seven days until you can safely have sex without using another method too. I use Dianette for PCOS (for about 14 years now) and took it without having a period on three or four occasions.

[gryphonwing.livejournal.com]

While there are some risks of building up lots of uterine lining, I wouldn't worry a bit about triggering a bleed. Just go on the pill and use it normally. Your first withdrawal bleed might be heavy (or not, hard to say - PCOS makes everything screwy) or you might have breakthrough bleeding, but it's ultimately not a big deal.

All you would be doing with progesterone is, essentially, triggering a withdrawal bleed. And your body does not care if you do that now or in four weeks. And triggering a withdrawal bleed with progesterone is not the same as having a period - it will not mean you're more or less fertile or having a menstrual cycle. It will just mean you bleed.

So there's no way to make sure you're at the start of a natural menstrual cycle because you don't have one. PCOS is good for that. Since there's no way to tell, just start your pill whenever you want to. Take your pills regardless of breakthrough bleeding.

I did a bit of research and even though Diane-35 is an odd sort of pill I'm pretty sure the 21/7 rule will still apply. You should be protected after 7 days. But you can always use backup for the first month, then consider yourself protected, if it would make you feel better about it.

The anti-androgen half of it is probably why you respond to it so well. PCOS means plenty of androgens floating around, which can cause acne and other fun symptoms. Some people say it works particularly well paired with spironolactone, if that's something you want to check out.

Anyway, short version: you don't currently have a menstrual cycle, so there's no way to make sure you start on day one, and even a triggered bleed is not a menstrual cycle.

[paraxeni.livejournal.com]

I should have scrolled down before replying, you covered it for me!

[gryphonwing.livejournal.com]

Ah, but you know the actual pill, and I wasn't certain about the difference between this one and others. :)

[redheadedrebel.livejournal.com]

You can generally start BC pills on any day that you want and it doesn't have to be the first day of your period. Thats just suggested because while you are on your period, you're not likely to be ovulating and so you are protected sooner from pregnancy(after 7 days I believe). And sometimes people spot if they start it at a random point in the month since the body goes "woah hormones! must do something!" But it gets straightened out after the first month.

The general rule for pregnancy protection is at least 21 days of active pills and no more than 7 days without. You can have more than 21 days of active pills(ex: skipping a withdrawl bleed), but just make sure to not go more than 7 days without.

you could always see if theres a online pharmacy or mail-order pharmacy that has the prescription available, then have your doctor fax in the prescription.

someone correct me if I'm wrong...I'm a bit tired(ugh finals!) and my brain may be overworked.

[zippiner.livejournal.com]

I'd suggest what the people above are. With an added: Talk to your doctor about it.

I have PCOS, but not in need of birth control, and I was given Metformin (a diabetic medicine) and it worked for me like a charm in regulating my period, and such like I was supposed to.

[sandi1743.livejournal.com]

there is a lot of controversy about having women with PCOS take met w/o having IR or Type 2.

[paraxeni.livejournal.com]

Do you have any links to that?

[sandi1743.livejournal.com]

oh the data - do a pubmed such you'll see all kinds of data out there - is it conclusive? not at all!
There is no multi times reproduced good data which points to it helping or hurting long term in females w/no issues such as IR, Type2, other risk factors such as obesity, HTN, hyperlipidemia etc - which is the issue. Not every female with PCOS has IR or Type 2 - however most will go on to develop it.
Met is not without it's own risk and the way (IMHO/E) some medics throw it around is just not safe. There are a number of blood tests to be done before it is rx'ed, it has to be put though a "work up" phase, bloods re-tested and possibly have the med readjusted.

I will say this - It is well known that women with PCOS that are not IR or T2 that are having having issues getting pregnant/staying pregnant often will be given a mix of Met and Clomid - but even for this "common" practice there is no good data to tell us how the Met works etc and it is not done long term.

Also - there is no data to indicate that Met helps prevent IR or Type 2 which is one of the main concerns of women/medics when it comes to PCOS.

[asunlitrose.livejournal.com]

Diane-35 is a combined oral contraceptive, and there are a few different ways you can start (http://www.vaginapagina.com/index.php?title=Hormonal_Birth_Control#OK.2C_I.27ve_got_some_HBC_now._How_do_I_start_taking_it.3F). The "day one" start that you mentioned means that you're protected immediately, but you can start ANY day of your cycle and be protected after seven days.

I'm unsure why you would need to take medication to bleed in order to start taking your birth control. If it were me, I would just get the Diane-35 and start the day I get it, but it should be your decision.

[morwensdoor.livejournal.com]

I agree with everyone above - I'd say just start it on a day that seems convenient to you (some folks prefer starting on a particular day of the week) and go from there. If you're going to be using it for contraception use a backup form (condoms, whatever) for whatever period of time the pamphlet recommends - usually 1 week or 1 full pill cycle.

When talking about starting hormonal birth control the recommendation is usually to start while you're on your period OR, if you don't have regular periods (this is you!) to start it on a day that works for you. Like an above poster mentioned, the recommendation to start while on your period is for added pregnancy protection.

Still ... I don't know that much about PCOS and it could be worth it to phone your doctor to double check that there isn't some other factor. We all seem pretty much agreed that you should be able to start taking this BC and have adequate pregnancy protection, but I'm not sure if your doctor is trying to do something else with your body as well.