Don't Like BCPs

I'm currently on a BCP, OrthoTriCyclen Lo to be exact. I HAVE to be on these for control of endometriosis (I'm 34 and NOT ready for a hysterectomy/oophorectomy yet!!). I asked for the OTC Lo because it seems to have the least amount of side effects. However, I still have monthly acne breakouts and I just don't FEEL as alert and upbeat as my personality would usually have me. A couple years ago, I was on the Ortho-Evra patch. After a warning from the FDA about high hormone levels with the patch, my doctor pulled me off it. My body responded by making my hair fall out in large amounts (this happened w/Depo too). I took a year or so off of any BCP and I felt GREAT. My head was clear, I was upbeat and sharp-thinking. Since going back on the BCP due to the endo, I just feel dull. I've read about similar side-effects, worse with other pills. My OBGYN has offered NuvaRing, but I've read about similar problems with that and am reluctant.

Is there anything that can be done about mood swings, etc. as the result of hormone-releasing contraceptives? My body seems to be very sensitive to hormone changes (hence the acne breakouts & hair loss). Or do I just have to deal w/it (pretty much what my doctor tells me).

[Elaine Brown, MD]

Hi!
I never realized how much I disliked being on OCs until I stopped them!  You are probably already aware of the one other option that I can think of to offer you--
Depot Lupron with hormone replacement.  The advantage of this would be the lower levels of hormones, and if you liked, you could use natural rather than synthetic hormones (eg estradiol and Prometrium).  The disadvantage is the cost of the medications which is going to be MUCH greater.  If you have prescription coverage on your medical insurance, most will cover lupron for endometriosis.

Unfortunately, Lupron, surgery, and contraceptives are the options.

By the way--everyone's hair falls out about 3-4 months after a major hormone shift--so you're not unusual in that.

Good luck!
Dr B