WOMENS-HEALTH Messages for July, 1998: Re: Triphasic versus Monophasic Birth Control Pills

Re: Triphasic versus Monophasic Birth Control Pills

From: Christina (anonymous@obgyn.net)
Fri, 31 Jul 1998 13:32:25 -0400

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I'm just telling you what my doctor said to me. I did not even connect the two until my doctor made the suggestion. I never said that I had medical proof. And, I did say that I was only sharing my experience. As I said at the end of my message, one should try different brands. And, I will add here that just because one brand or dosage works for one woman, it does not mean the same one will work for another woman. Whichever one has the least side effects for you, go with that. I can't explain why I got the migraines on the second placebo pill every single month I was on a monophasic pill. But, because of the migraines, my dr took me off of them and now I rarely have them.

--Christina Mitchell

-- ---------- From: Thomas Ind[SMTP:anonymous@obgyn.net Sent: Friday, July 31, 1998 1:02 PM To: Multiple recipients of list Subject: Re: Triphasic versus Monophasic Birth Control Pills

At Fri, 31 Jul 1998, Christina wrote: > >>From my experience, if you have trouble with headaches and migraines before getting on the Pill, don't try the monophasic pills. I had a horrible time with migraines whenever I got to the second placebo pill in my pack. It occurred at the exact same time every single month. My dr attributed it to the sudden drop in estrogen. With triphasic, the drop is gradual throughout the month and so you're eased into the placebo pills. With monophasic, the drop triggered these debilitating headaches that kept me up all night throwing up and in severe pain. This might have been something with me, but I just thought I'd share my experience. I still get headaches, but they are throughout the month and not migraines. And, when I do get migraines, they are so sporadic that I don't think it has anything to do with the Pill. I did have to experiment with triphasic before I found the right dosage. I had problems with severe breast tenderness, bloating, breakthrough bleeding, and clots. I've fi! nally fou >nd the right dosage with Orthocept. Just keep in mind that finding the right pill is a trial and error process. You might not like the side effects of one brand, but then another brand could be perfect for you. > >Just my 2 cents, >Christina Mitchell

I think we are developing a discussion point here.

First of all may I remind everyone that focal migraine is an absolute contra-indication for the combined pill (monophasic or triphasic). This does not apply to simple headaches and non-focal migraines.

I know of no triphasic pill which has any estrogens in it that is less than 30 or 20 mcg (these are the most common dose estrogens in the new monophasic pills). In fact the drop in estrogen dose when going onto placebo or a pill free period is either the same or greater with triphasic pills. This theory of a sudden drop in estrogens therefore doesn't hold.

I don't dispute that some women do better on triphasic pills and I'm a great believer in keeping a woman on a pill that has worked for her. However, my argumment is that most women do better on monophasic low dose estrogen pills. I have seen no evidence in the medical literature to the contrary.

Perhaps some other women should contribute at this stage. Just remember, there are so many brands and combinations of combined pills around that going on the pill is like buying a pair of shoes. If you don't like them when you've got them home, you can always take them back to the shop and have them changed.

--
Dr Thomas Ind MB BS MD MRCOG
St George Hospital
Kogarah
Sydney
NSW 2217
AUSTRALIA

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Maybe in reply to: Stephanie: "Triphasic versus Monophasic Birth Control Pills"

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