ugh, really annoyed. Help?

[fakeredbangs.livejournal.com]

 I finally found a doctor to see me and that i could afford, after almost 2 years. He wont write me a perception for my yasmin birth control packs. His exact words where " use condoms if you are going to have sex". 

First off, i don't use my BCP for birthconrol. I use them to help keep my face clear and help regulate and lesson the symptoms my period. I asked him how am i going to treat those issues and he brushed it off. 

Now my main reason for seeing him was because of my Lupus and the extreme amount of pain i have been in with limbs swelling, joint stiffness and missing work.  

Now his claim about taking me off BCP says that in combination with my Lupus, its going to kill me but i thought that was proven untrue years ago.

Can anyone show me any resent articles that say one way or another on the BCP issue and lupus. 

Also in case i can't get my BCP- help on how to deal with hormonal cystic acne?

Comments

[hahahabye.livejournal.com]

I have hormonal cystic acne and here's what I have to do:

1. Use Atralin once at night
2. Wash and moisturize in the AM with CeraVe face wash and moisturizer
3. Use Acanya once in the morning after washing
4. Take minocycline twice a day.

It's a pain in the ass of a routine but my skin is like a baby's ass.

[fakeredbangs.livejournal.com]

i dont mind the work if it pays off, but i have never heard of any of these products, must search

[hahahabye.livejournal.com]

if you have an opportunity to go to a derm, please do. The medications I listed are not cheap but imho it's worth it

[fakeredbangs.livejournal.com]

oh didnt realize they where medications. Thank you but its not an option right now.

[hahahabye.livejournal.com]

Any med? Or specifically oral? Because the ones I listed are all topical gels aside from the minocycline which I really don't keep up with.

[hahahabye.livejournal.com]

Also I hate to say it but there is pretty much nothing that helps hormonal acne aside from BC or other topical/oral meds.

[onevoiceinside.livejournal.com]

My opinion... Find another doctor.

[fakeredbangs.livejournal.com]

I agree

[quietchildae.livejournal.com]

I have to agree that this doesn't sound like the best doctor - is there a chance you could switch to another? I don't have the links in front of me, but I have several friends with lupus who are also taking HBC. So, I would like to think, anecdotal as it is, that their doctors are not trying to kill them, and that it's probably ok. Of course, there could be extenuating circumstances about your specific flare up it sounds like you're having right now, and maybe that's why no HBC, but I would certainly look into another opinion, if possible, even if it's just to call up a nurse practioner, or go to a free clinic to get some advice (especially if insurance/payment is an issue.)

[fakeredbangs.livejournal.com]

that seems to be the issue with my area. No free clinics unless you have Hep or HIV. Or i haven't found them yet and nor has anyone else i know. I just live in a really bad place. The Planned parenthood plain out told me they won't treat me with issues concerning my lupus since no one on staff is knowledgeable.

[quietchildae.livejournal.com]

That definitely makes things a little more difficult :( If you have insurance, I know many companies offer a "helpline" type thing to call and talk to someone - they're aren't super helpful in my experience, but it might be worth a try. The other good place to start would be your pharmacist. They should know exactly what your medications are putting you at risk for.

[slinkslowdown.livejournal.com]

Just tossing out another anecdote for you--my mother has lupus and was on HBC for years without it causing any problems.

[heartsasmagnets.livejournal.com]

What a jerk. Find a new doc.

[bloobottle.livejournal.com]

Is there any way to make a complaint about this doctor? If you do end up finding articles that prove that BC and lupus are a safe combination get them all printed and send them to him. If you can't print them yourself I can do it and mail them to you. Your doctor is being a jerk.

Dermatologist

[domiobrien.livejournal.com]

The standard treatment for cystic acne is Accutane. t's expensive (but shop around-- one of my now-grown kids was on it, and the price varied from $180 to $600 a moth at different pharmacies without insurance (fortunately we had insurance, with a $15 copay). It is usual to put females on Acutane on hormonal birth control, since women who get pregnant while on Accutane have deformed babies. You need to see a dermatologist. If you have lupus and a low income, you may qualify for government help with medical expenses. Your state's department of health and human services should be able to do a fast eligibility determination; in some states you can do that online.

[princessselene.livejournal.com]

that doctor is an idiot, considering HBC generally has a higher prevention rate than condoms do when it comes to preventing pregnancy. I know it took a while to find a doctor, but you need to find a different one that won't brush off your questions and concerns. To be honest, he almost sounds like one of those pharmacists that won't dispense HBC because it is against his morals and beliefs. His profession is NOT one he should be in if he refuses to prescribe it for issues that are unrelated to sex.

[mydocuments.livejournal.com]

Her doctor actually isn't an idiot and probably isn't trying to shove religion down her throat. He's trying not to give her a fatal pulmonary embolism or fatal stroke. Lupus is a vasculitis, it causes an increased risk for blood clots. Estrogen containing birth control is contraindicated in patients with clotting disorders.

[mydocuments.livejournal.com]

Lupus and other vasculitis type diseases can cause a drastic increase in the body's likelihood to form blood clots. Many Lupus patients are on life long anti-coagulation therapy to prevent these clots. I have a patient right now with bilateral clots in her lungs and who just had her fourth and fifth toe amputated because od complications for blood clots. The clots in her lungs were critically life threatening.

Estrogen based birth control increases your risk of blood clots. Not by a while lot, mind you... The study I read showed an absolute risk of about 1 in 500 to develop a clout while on Yaz. But I can see why your doctor would be hesitant to prescribe it.

The studies that are coming up for me with a quick google are all about the risk of a lupus flare with hormonal birth control, and not about the risk of blood clots with lupus and birth control, but the docs I've trained with have always held that a clotting disorder is an absolute contradiction to starting a patient on hormonal therapy.

I don't know your past medical history, but if you have ever had a DVT, a PE, our any kind of ischemic/chronic non healing wound, you are not a candidate for estrogen containing birth control. Full stop, do not pass go, do not collect $200.

If someone can find me literature with convincing evidence that the risk of blood clots in SLE patients on combination pills is not increased, then I would love to see it, but I'm inclined to agree with your physician (if not with the awful way he explained things to you.)

A progesterone only pill would perhaps be an option for you, as they don't carry the same risk of blood clots as do combi pills.

As for your acne, ask your doc for spironolactone (Aldactone). Its a potassium sparing diuretic that also blocks androgen receptors in the exact same way as does drosperinone, the progesterone ingredient in Yaz. It works wonders for many women with androgenic acne, as cystic acne usually is, and it is a much safer and cheaper option than Accutane, which someone suggested up thread. (Accutane is really a drug of last resort for acne. It's nasty, with a lot of really awful potential side effects.)

[mydocuments.livejournal.com]

Hormonal methods of birth control vary in how they are administered, and in whether they contain both estrogen and progesterone or progesterone alone. The estrogen-containing methods include pill, patch and vaginal ring. For patients with lupus, the concern with estrogen-containing birth control methods has centered on two risks: increase in lupus flare and risk of thrombosis (blood clots). Recent studies show that for a patient with stable, inactive lupus there is no significant risk of lupus flare with estrogen-containing birth control pills. Risk of thrombosis with oral contraceptives is related to presence of antiphospholipid antibodies (aPL): these autoantibodies are present in one-third of lupus patients and further increase risk of blood clots. Patients with aPL (or any history of blood clots) should not receive estrogen-containing medications.

Here you go, directly from Lupus.org. The guidelines for hormonal contraception in women with lupus.

[fakeredbangs.livejournal.com]

do you have any advice as to how to handle heavy and painful periods? ill deff bring up spironolactone to him.

[mydocuments.livejournal.com]

I would suggest Mirena, a progesterone only IUD. Most women experience a dramatic reduction in their flow; often their periods stop all together. Implanon is another option that works the same way as Mirena, but the hormones are released from it via a matchstick sized silicon implant in your arm.

I am so pissed that your doc just told you... "use condoms" without giving you any other options. I'm assuming he's your rheumatologist? Even if obgyn isn't his field, this is the kind of thing he needs to know ifc he is treating young, ovary/uterus having patients.

And all that said, if your SLE is 100% inactive, no flares, and no clots ever, then you could still conceivably be a candidate for a combi pill, even though its more risky.

Good luck!

[daysees.livejournal.com]

If I can add to this comment: I had horrible acne forever and my dermatologist put me on spironolactone and I cleared up almost instantaneously.

[dkwgdk.livejournal.com]

I have a Mirena and it's been great...HOWEVER it caused an acne flare (more on that in a moment). I got it to help with Periods from Hell and it is definitely doing the job. A year in, I still have periods but they are so much more manageable than they used to be. Mirena is progestin-only, so it doesn't have the potential for causing clots that estrogen does. I need to avoid estrogen myself because of mood problems and also a history of migraine with aura. If you don't want an IUD, there are progestin-only birth control pills that might be able to help. I don't know their track record for dealing with cystic acne.

Okay, about the acne. I had definite cystic acne, d/xed by a derm and incredibly painful. The only thing that fixed it was Accutane. It can have mood side effects, but I was on lithium for depression anyway (yes, lithium, long story involving nothing else working) and I didn't have mood issues from it. My skin has been really great ever since. UNTIL...I got the Mirena.

When I got the Mirena, it caused a flare of acne. I -think- some of it was cystic in that it lasted for a LONG time (weeks) and was painful. There were also tiny spots. The thing that hands-down helped was a topical sulfur ointment AND taking zinc. The zinc was recommended to me here and it's amazing! My spots are far smaller and far, far shorter-lived. Now, part of that might be the Mirena "settling in" to my body. But I think part of it is just the beneficial effects of the zinc.

Just wanted to throw that out there fwiw. If you can get a new doc, though? I would. I say this only because severe period symptoms are not something to screw around with. By the time I convinced a doc that I had a problem I was losing 20oz of fluid each period and having debilitating pain. (There is no reason for this -- no polyps, cysts, fibroids, adenomyosis, nothing. It just happens.) So, yeah. You need a doc who will take that seriously.

[ancientastronot.livejournal.com]

I used to have awful cystic acne, as well as hormonal acne. I have not tried any medications, but here is what I do to manage it naturally:

1) Wash face daily with sulfur soap (This is my favorite brand. (http://www.vitaminherbstore.com/bornagainmsmherbalsoap3oz.aspx)
2) Avoid touching face with anything but washed hands or oil blotting sheets. Avoid make-up as much as possible.
3) Wash/change pillowcases regularly, or cover pillow with a fresh clean towel every night. This can be a HUGE game-changer for some people!
4) Drink lots and lots of water, eat healthy, and exercise!
5) Spray colloidal silver on face after washing. It might seem a little strange, but I think this is really what made the most difference for me. Silver has natural antibacterial properties, and since the colloidal silver contains silver nano-particles, it deeply penetrates my skin and prevents those nasty cysts from even starting. I haven't had any large cysts since I starting using it on my face.

I hope you find something that works for you. If you're at all interested in managing your menstrual cycle or acne without medication, I've got lots of tips.

[ancientastronot.livejournal.com]

I experience pretty awful cystic acne, as well as hormonal acne. I have not tried any medications, but here is what I do to manage it:

1) Wash my face daily with sulfur soap This is my favorite brand. (http://www.vitaminherbstore.com/bornagainmsmherbalsoap3oz.aspx)
2) Avoid touching face with anything but washed hands and oil blotting sheets. Avoid make-up as much as possible.
3) Wash/change your pillowcases regularly, or cover your pillow with a fresh clean towel every night. This can be a HUGE game-changer for some people!
4) Drink lots and lots of water, eat healthy, and exercise!
5) Spray colloidal silver on face after washing. It might seem a little strange, but I think this is really what made the most difference for me. Silver has natural antibacterial properties, and since the colloidal silver contains silver nano-particles, it deeply penetrates my skin and prevents those nasty cysts from even starting. I haven't had any large cysts since I starting using it on my face.

I hope you find something that works for you! If you want more tips on managing your menstrual cycle without medication, I've got plenty!