Two and a half years ago, I started using Desogen®. I used the Sunday start method and tho I would not spot or have any breakthrough bleeding during the month, when I did get my period during the week of taking the "reminder" pills, it would start anywhere from a Tuesday one month, to a Saturday the next or anywhere in between. My periods had always been irregular so this was one of the reasons I decided to try the pill. Also, I knew they usually lessened the bleeding which was fairly heavy and also helped with cramps. Besides not getting my period on at least approximately the same day each month, they kept getting heavier and heavier each month, and the PMS also increased from one week in advance to having it the entire month. The pill did nothing to help with the cramps, either. I told my gyn and she switched me to LoEstrin 1.5/30® the following year. I also switched the pills to a Friday start so I would get my periods on Sundays.
At first, this pill worked great as far as the bleeding. It lessened it and also shortened the length of time it lasted. I also got it the exact same day (Sunday) each month, which I found very convenient. Unfortunately, it did nothing to help with the cramps and I usually had to take about 24 Advil® within a 24 hour time period for a day or two. Eventually, the Advil® wasn't helping and I switched to using Ultram® which helped much more. But, I noticed a few months after switching pain killers, that the first day of my period became quite heavy---heavier than it even was before I took any BC Pills---and also contained many more clots. For about 12-18 hours on the first day I will bleed very heavily, then it will lessen to average and then go to barely nothing for the next 2-3 days and end. I have since read that using Ibuprofen can lessen the flow and I think that's what happened with me---I stopped taking the Advil® and that's when the periods became heavier. I have become fed up with how heavy it is the first day and have recently asked my doctor what to do.
She suggested using Levlen® instead because it is a stronger pill than both Desogen® and LoEstrin 1.5/30® were. I am just wondering if you think this will help lessen the bleeding or make things worse like the Desogen® did because my understanding is that Desogen® is a stronger pill than LoEstrin®, yet it caused heavier bleeding. From what my pharmacist said, according to her chart, LoEstrin® is considered a "lower level" pill and Desogen® is an "intermediate level" pill. So, I'm thinking that because Desogen® caused me to bleed heavier and it was a higher level pill than the LoEstrin® (which lessened the bleeding in comparison to the two), then is Levlen® (which is a higher level than both of them) what I need or will it, too, cause heavier bleeding as the Desogen® did? Should I be going to a pill that's even lower than LoEstrin®? I guess I don't understand how you figure which way to switch someone's pills. My gyn said that you can't really compare two pills like Desogen® and LoEstrin 1.5/30® because the types of progestin in the two are completely different. I've read that if you have heavy periods that you want to increase the progestin level, but it seems like going from Desogen® to LoEstrin® was a decrease (at least according to the pharmacist's chart), but it did work in lessening the amount of bleeding compared to what I had on the Desogen®. So, now I'm completely confused whether to try this pill or not. I'm not as concerned with the cramps as I am with the bleeding and I'm hoping that my doctor is basing her choice of new pills on the bleeding factor more than the pain factor, which I tried to stress to her. She said she thinks this will help more with both, but I am still leery because, well, I have to worry about everything!!
Is there more progestin in Levlen® than the other two pills, and do you think it sounds like the right choice---or at least a choice that shouldn't make things worse even if it doesn't make things better?? I believe that the levels of progestin in each are:Desogen®---desogestrel 0.15mg LoEstrin®----1.5mg Norethindrone Acetate Levlen®-----0.15mg Levonorgestrel Is it true that you should increase the progestin level for heavy bleeding?? And, according to you, which is the weakest and strongest of all these pills? They all have the same dose of 30mcg of estrogen (the estradiol kind). I've heard that you can use two tampons at once---do you place them next to each other?? Does this really work?? Sorry this letter is so long, but I'm starting college in June and my period is, of course, due that week and I guess I'm looking for some reassurance that I won't be hemorrhaging at the time like with the Desogen®!! Should I give this pill a try--do you agree with her choice and that a stronger pill is what I need in spite of the bleeding, etc. that the Desogen® caused? Also, will I notice any change the first month or will it take a few? If the bleeding gets heavier on this pill in the first month, then I would think that it's not the right choice and change back or try another new one. If it doesn't get less, but stays the same, then I should try it for a few months, anyway. Does this sound correct? I am hoping that this pill will work like the others in that I will get my period the same day each month---do most pills work like that? Besides my Desogen® experience!! Again, sorry that this letter is so long, but for some reason, this is a big issue with me---what I'd really like is a hysterectomy so I won't have to deal with it anymore, but....
Keep in mind that what follows about pill potency is controversial. Some very prominent experts in the field feel that since there is so much individual variability in how any woman's specific tissue reacts to any specific hormone, you can't assign biologic potencies accurately enough to clinically prescribe different formulations according to different symptoms. That being said, pills are assigned biologic potencies as a combination of both the estrogen and the progestin. Since almost all pills have the same estrogen (ethinyl estradiol), the estrogen potency only varies from a few pills at the 20 ug level (Loestrin 1/20® and Allesse®) to the majority at 30 and 35 ug. In this respect Loestrin 1/20® would be considered -low- but actually Loestrin 1.5/30® I wouldn't consider low. The other component is the progestin. Progestin potency has in the past been measured by a "delay of menses" index, i.e., how well a hormone keeps the endometrium from sloughing. The higher the progestin potency (and it doesn't go mg per mg across different formulations) the more likely to stop heavy bleeding. For example Levlen® (levonorgestrel) mg for mg is more potent than many other progestins such as the one in Desogen® which is actually a very mild progestin. Higher progestin potency also tends to decrease cramps more. To complicate matters more, sometimes a higher estrogen potency (dose) is needed to "stabilize" the endometrium if if the progestin makes the endometrium too atrophic. You went from Desogen®, a low potency progestin, to Loestrin®, an intermediate potency progestin and your doctor has now suggested a higher potency progestin in Levlen. It seems like it would be worth a try. Another slightly higher progestin potency pill would be Demulen® 1/35. You may also need to get a thyroid check and a bleeding time check to rule out other causes of heavy bleeding.
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