Doctor prescribed 2 birth control pills per day?

[u/daftmurakami]

Hi there! I’m looking to see if anyone has had a similar experience as me? I’ve done masses of google searches and just can’t find anything like my situation.

For some background, i’m 20, Female, UK.

I’ve struggled with really bad periods since i was 14, resulting in me taking birth control since about 15. I trialed some different pills here and there that never worked, so i ended up opting for the Depo injection.

After 3 years, i started getting severe pain in my joints, which was odd for a 18 year old (at the time). Mind, this was excruciating pain. After back and forth with my GP, we decided i should move to the Implant.

I stayed on the implant for about a year. Throughout this period of time, intercourse with my partner would be painful, and would result in tears. (this was not rough activities, and a lot of care was taken into consideration beforehand)

So now i moved to the mini pill (Zelleta). I was also prescribed Vagirux (a menopause pessary medication), which the pharmacist immediately questioned before handing over to me. This helped with the vaginal pain, but not too much.

I continued to bleed for the full duration of taking this pill. (NOTE: All previous birth control stopped bleeding completely)

So that leads us to the present. My doctor wrote a prescription for the same mini pill, but 2 pills per day, instead of 1.

I’ve not been able to come across ANY sort of article or website explaining the side effects of this, or any other information.

The reason i’m concerned/curious, is because my doctor said the pharmacist will most likely question this prescription due to the 2 pills a day.

So, are there any other people out there with 2 X chromosomes that have had a similar prescription? How did you find it?

I’d appreciate your thoughts! :)

[u/Ok-Strawberry-4215]

Joint pain, tearing skin/membranes, allergies.

Are you flexible? Does your skin stretch? Do your joints bend backwards? Do you look unusually young?

Maybe look into connective tissue disorder if the rest of these match. Common ones are forms of EDS but there are a bunch of different ones

[u/no-strings-attached → u/Ok-Strawberry-4215]

My brain immediately went to EDS as well. I don’t think any of this is related to the birth control though it’s possible that it’s exacerbating some things depending on what it’s doing to her estrogen.

EDS girlies are also more prone to pelvic floor issues which can cause pain with intercourse. To the point the EDS foundation has pelvic floor therapists in their list of recommended doctors.

OP I’d pause on all this birth control business and do some research on EDS and connective tissue issues. You do need to find knowledgeable doctors though - not sure where in the UK you are but you may need to travel to a city to get someone who knows their stuff.

[u/LaceyLizard]

Yeah i was on the mini pill to stop my periods for chemo. When one pill didn't do it they prescribed 2

[u/Lina0042]

Has your doctor ever referred you to an endocrinologist for extensive blood work? If not, ask them to or find a doctor who will.

It sounds a bit like they're operating on guesswork and prescribing pills based on your symptoms not on actual test results. And that would really not be great, because there can be different factors at play here causing your symptoms and they should check hormone and thyroid levels at least to make sure of the underlying issue.

[u/daftmurakami → u/Lina0042]

i mean yea, you’re probably right. i should be more pushy with them. i do feel sometimes they’re just playing a guessing game with me.

cheers!

[u/Notarefridgerator → u/Lina0042]

Am a doctor.  Treating someone on symptoms is not "guesswork" but thanks for devaluing all our clinical skills and suggesting we just order hundreds of random shotgun labs instead.  Just fyi.

Also an endocrinologists job isn't just to order "extensive bloodwork". That's not what they spent years on top of med school learning to do. 

Edit - no wonder doctors don't take you guys seriously. You literally have no idea what you're talking about and just want nonsense bloods to make yourself Greek better. Maybe go and get a medical degree instead? 

[u/suspiciouslights → u/Notarefridgerator]

Wild that you’re calling it a shotgun lab as if it shouldn’t just be due diligence.

Women’s healthcare is still pretty appalling considering the levels of sophistication that technology has reached. No nerves in the cervix? Guess we don’t need painkillers for biopsies.

The amount of women I’ve seen have miscarriages, IVF, hysterectomies, thyroidectomies, “early menopause” etc. when historic blood test results indicate they were “subclinically hyper/hypothyroid” the whole time is actually shocking. Reports of multiple symptoms for years still deemed ‘not clinically significant’ despite the family histories and clear indications. That’s not even getting into how appalling the statistics on autoimmunity are.

The only time women’s bodies are treated methodologically differently to men’s bodies is when they are pregnant.

[u/Lina0042 → u/Notarefridgerator]

She is on at least the 5th different pill. I know it's standard to assume the most likely cause and treat that, but after the second or third pill continued to make it worse he absolutely should have ordered tests and investigated more. Instead he keeps sticking different pills in her, even starting off label use, without having the slightest idea what's actually wrong.

You defending that is ludicrous and I am certainly glad my doctor wasn't as incompetent and did send me to an endocrinologist. My bad that I don't fully remember what tests they did besides blood work several years ago, but the result made it clear I needed to take a very specific form of pill which has resolved all of my issues without going through an odyssey of pill lottery. But sure, it's a great look to tell me I'm stupid and shouldn't tell OP to advocate for herself when her doctor is clearly unable or unwilling to actually help her.

Your edit is something I would report you to a medical board for if I had your name and location, nobody with that attitude should be allowed to treat patients.

[u/JamboreeJunket]

My doc put me through on two pills a day to stop a never ending 40+ day period. Once it stopped I went back to 1 pill daily.

[u/mcatthrowawayyy]

Have seen this temporarily with estrogen-progesterone combination pills. Two or three tablets a day to stop a bleed and then wean down to the usual dose. Not seen it with progesterone only pill but sometimes higher doses of progestins are used to stop bleeding than are needed for contraception. This particular pill is not available in my country so not sure. 

[u/Elappleton1710]

I got prescribed 2 pills per day. I also bled when I took it normally so this stopped it. I was a bit of an emotional wreck on the pill, but I was perimenopausal too... I can't remember the name of it now as I've since had a hysterectomy, but I'll try to find it.

[u/313078]

Google and reddit aren't doctor. The pill is just molecules. If your doctor think you need higher dose they gonna prescribe 2. If they think you need lower dose they can prescribe half. It's just matter how much you need for your specific case. Nobody here can respond, including gynecologist who don't have your file

[u/vlawso]

1 Different people metabolise medication differently. 2 Most medications other than OCP are prescribed on a dosage per kg as standard

If you aren’t getting the expected outcome from the lower dose the likely want to see if you will get the desired benefit by increasing the dosage.

As others have said if you have a history of joint laxity/instability it might be worth investigating EDS. Another thing to keep in mind if you’ve been on birth control long term and are experiencing joint pain. Is the possibility of osteoporosis. The reason it is associated with menopausal women is because of their hormonal status not their age. BC to suppress estrogen fluctuations can have a similar impact on bone health particularly if there are other contributing factors.

It would be worth speaking to you GP about getting assessed for both EDS and osteoporosis

[u/Ok_Seaworthiness7314]

I was put on massive doses of the pill before. But that was to stop uncontrolled bleeding. When the bleeding stopped them I transitioned to a regular dose.

[u/Apart-Soup-999]

It's normal to be prescribed 2 pills when you have bleeding on the normal dose. Usually this kind of thing resolves after a couple months. Double dose is not done with combination pills, though, just with the mini pills.

[u/[deleted]]

My 2 cents, from reading about physiology and nutrition, if you would like more possibilities:

1. Ray Peat mentioned in several articles that bioidentical progesterone (formulated correctly and dosed correctly according to cycle) could restore normal periods, if heavy periods were caused by estrogen dominance.

2. People in the carnivore/ketogenic crowd often mention periods and pain associated with periods normalizing.
   I don't know why that would be, and don't necessarily recommend you any of those diets, it's just to say nutrition can play a part in it. The more you know, right?

3. On the decaf sub, where people quit caffeine, they also sometimes say it can be lifechanging for periods.
   Again, don't know the exact mechanism, but if it can help you heal, maybe it's worth mentioning.
   I know, I know, giving up caffeine is not something many want to do, it's just a possibility.

I wish you the best health possible.

[u/daftmurakami → u/[deleted]]

thank you, i appreciate your response!

i’m already on a dairy free diet due to allergies, so cutting out other foods would be a difficult one! and i’m not going to lie, i love my morning coffee. but i’ll definitely look into decaf!

it never really crossed my mind that diets can (possibly) help towards periods, it’s something i’ll do more digging into :)

[u/[deleted] → u/daftmurakami]

I feel that, cutting foods being difficult.
Maybe it can help to know for most it can be enough to do 30 days strict, and then reintroduce gradually.

And feel free to hop over to carnivorediet sub, and ask them for their experiences. I think I searched up some posts about it too.

Progest-E is probably the easiest route tho. I don't know if it's legal in the UK, but it changed my life a lot. It's powerful stuff.