attn: female patients who are currently taking and not taking birth control pills

[Guest guest]

Yes, the hormone Relaxin released during pregnancy and menstruation causes

increased joint laxity in all women. The hormone is being used to treat

fibromyalgia, scleroderma, and psoriasis. Relaxin has also been linked to

increased rates of injury in female athletes. Essentially, the increased

joint laxity in women during their menstrual cycle makes them more prone to

joint injury at this time of the month. Pregnant women are also more

susceptible to back pain and joint injury because of relaxin. For some

people with EDS, the relaxin during menstruation causes symptoms of EDS to

worsen.

Birth control pills do vary in terms of the level of synthetic hormones and

the " half life " of those hormones. Half-life refers to how long the

hormones stay in your system. For example, a pill may have a half-life of

18-24 hours, but the generic version of the same pill may vary by 20%, so

the generic half-life could be as much as 14 to 29 hours. For some women,

the lower half-life of some brands of pills will cause spotting and will

make it difficult to skip periods, especially if the pills aren't taken at

exactly the same time every day.

Another important factor in choosing a pill for skipping periods is whether

or not the pills have a consistent level of hormones throughout the cycle or

if they are varied from week to week. Ortho-Novum 7/7/7 has a high dose the

first week, a medium dose the second week, and a low dose the third week.

This low dose in the third week tells the body that it is supposed to have a

period in week 4. Because of the cycling down of the dose over the month,

it is difficult to skip periods on this brand of pills and any other brand

that has gradient dosing. Ortho-cept on the other hand, maintains an equal

dose of hormones for 3 weeks straight, followed by no hormones in the 4th

week. It is easier to skip periods with a consistent dose during the whole

month.

Skipping periods takes time for your body to adjust to. Most women can only

skip one period at first. Over time, you can decrease the frequency of

periods, but you have to do it gradually. My ob/gyn advised starting with

just skipping 1 period at first, so take 6 weeks of pills, then have a

period. If that works, then the next time you go 9 weeks and have a period.

If that works, go 12 weeks and have a period. And then 15 weeks and 18

weeks and so on. She pointed out that most women are incapable of going

beyond 4 months without a period. If you have break-through bleeding or

spotting, maintain at the same frequency for another 2 cycles and try again

the next time.

The FDA has now approved a new birth control pill specifically designed for

women who skip their periods. It's called Seasonale.

http://www.seasonale.com Seasonale is a 3 month pack that gives a

consistent dose for 12 weeks, followed by placebo pills for 1 week. The

regular pills containt 0.15 mg of levonorgestrel (synthetic progestin) and

0.03 mg of ethinyl estradiol. I switched from Ortho-Cept to Seasonale on

January 26 and so far so good.

Ortho Tri-Cyclen and Ortho-Cyclen both contain Norgestimate and Ethinyl

Estradiol. Ortho-Cyclen contains 0.25 mg Norgestimate and 0.035 mg Ethinyl

Estradiol. Ortho-Tri-Cyclen containts 0.035 Ethinyl Estradiol and a varying

dose of Norgestimate - 0.15, 0.215, and 0.25. Ortho-Tri-Cyclen is not a

good pill for switching periods because of the varying dose of Norgestimate.

I couldn't find Nortel, but I think you may have meant Nordette which

contains 0.15 mg Levonorgestrel and 0.03 mg Ethinyl Estradiol. Another one

I found was several brands containing the progestogen Norethindrone.

The difference between these pills is the synthetic progestin. Each type of

synthetic progestin has different potency and so an equal dose of one type

of progestin is not the same as an equal dose of another. For example, 1 mg

of Levonorgestrel is equal to 5.3 mg of Norethindrone in terms of

progestational activity (stopping bleeding). 1 mg of Norgestimate is equal

to 1.3 mg of Norethindrone in terms of progestational activity. From

weakest to strongest, you have Norethindrone, Norgestimate, and

Levonorgestrel.

In your case, switching from the weaker Norgestimate to a much stronger

Levonorgestrel is likely to be what caused you to have problems. In this

case, you would probably want to avoid pills with Levonorgestrel or

Desogestrel as these are very strong synthetic progestins. Seasonale, which

I am taking, is a Levonorgestrel pill and would likely cause you the same

problems as the Nordette/Nortel.

The Ortho-Tri-Cyclen won't let you skip periods because it is a variable

dose. You may be able to gradually build up to skipping multiple periods

over time using the Ortho-Cyclen. You could also try a pill with ethynodial

diacetate (1.4), drospirenone (1.5), or dl-norgestrel (2.6). These three

are stronger than Ortho-Cyclen, but not nearly as strong as Levonorgestrel.

In my personal experience, skipping periods has been very beneficial to my

overall joint laxity, but it took a lot of trial and error before we got it

right. My first doctor put me on Ortho Novum 7/7/7 because that is the pill

I had been on previously. She had no clue that 7/7/7 was inappropriate for

skipping. I couldn't manage to skip periods and would just have my period

during the first week of the next cycle.

I changed doctors (for other reasons) and the new doctor switched me to a

different pill that had a continuous dose. Sorry, I don't remember which

one this was. That pill worked okay for the first couple months, but my

insurance company forced me to take the generic of the same pill. The

generic had a shorter half-life. As a result, I had a period for 18 days

because I had been 8 hours late on a pill one day. The period would not

stop until I had gone off the pills and just let it happen. I became weak

and sick as a result of all the blood loss.

Last August, my doctor referred me to an ob/gyn (his wife) at my request.

She and I spent over an hour going through the various pill options as well

as other methods that may help me stop my periods. After much research, we

agreed on ortho-cept. She made sure to specify on the Rx, no generic and

" continuous " so my insurance would actually pay for it. That worked well

for me, but I have had hassles every 3 weeks with the insurance refusing to

pay for it. Sadly, both my regular MD and the ob/gyn moved out of state and

I had to get a new doctor last September. The insurance company doesn't

like the fact that I take 3/4 of the Rx and throw away a week of pills. The

doctor has to put " continuous " on the Rx, and if he forgets, they refuse to

let me pick it up in time. It got to where every I was in the pharmacy

every other week between the 3-week bcp and my 30-day Rx for thyroid pills.

The insurance would never let me just pick up both Rxs at the same time

because I have to wait until I am down to 7 pills remaining on the current

Rx before they give me more. That's the main reason I switched to

Seasonale. In my case, I went from Ortho-Cept (desogestrel) which is a very

strong progestin to a weaker progestin with Seasonale (Levonorgestrel). I

am apparently not very sensitive to the higher-dose progestin as it never

bothered me to be on the strongest progestin available.

Good luck to you in finding the right pill for you. Here are some sites I

referred to in writing this email and in doing my own research on which pill

was right for me last month.

Which Oral Contraceptive Pill is Best for Me?

http://www.wdxcyber.com/ncontr13.htm

This site has good reference tables for the different synthetic progestins.

Rx List

http://www.rxlist.com/

This site is good for looking up each Rx to find out the dosages

WebMD

http://www.webmd.com/

Good basic info on bcp in general

-Barb

[Guest guest]

Yes, the hormone Relaxin released during pregnancy and menstruation causes

increased joint laxity in all women. The hormone is being used to treat

fibromyalgia, scleroderma, and psoriasis. Relaxin has also been linked to

increased rates of injury in female athletes. Essentially, the increased

joint laxity in women during their menstrual cycle makes them more prone to

joint injury at this time of the month. Pregnant women are also more

susceptible to back pain and joint injury because of relaxin. For some

people with EDS, the relaxin during menstruation causes symptoms of EDS to

worsen.

Birth control pills do vary in terms of the level of synthetic hormones and

the " half life " of those hormones. Half-life refers to how long the

hormones stay in your system. For example, a pill may have a half-life of

18-24 hours, but the generic version of the same pill may vary by 20%, so

the generic half-life could be as much as 14 to 29 hours. For some women,

the lower half-life of some brands of pills will cause spotting and will

make it difficult to skip periods, especially if the pills aren't taken at

exactly the same time every day.

Another important factor in choosing a pill for skipping periods is whether

or not the pills have a consistent level of hormones throughout the cycle or

if they are varied from week to week. Ortho-Novum 7/7/7 has a high dose the

first week, a medium dose the second week, and a low dose the third week.

This low dose in the third week tells the body that it is supposed to have a

period in week 4. Because of the cycling down of the dose over the month,

it is difficult to skip periods on this brand of pills and any other brand

that has gradient dosing. Ortho-cept on the other hand, maintains an equal

dose of hormones for 3 weeks straight, followed by no hormones in the 4th

week. It is easier to skip periods with a consistent dose during the whole

month.

Skipping periods takes time for your body to adjust to. Most women can only

skip one period at first. Over time, you can decrease the frequency of

periods, but you have to do it gradually. My ob/gyn advised starting with

just skipping 1 period at first, so take 6 weeks of pills, then have a

period. If that works, then the next time you go 9 weeks and have a period.

If that works, go 12 weeks and have a period. And then 15 weeks and 18

weeks and so on. She pointed out that most women are incapable of going

beyond 4 months without a period. If you have break-through bleeding or

spotting, maintain at the same frequency for another 2 cycles and try again

the next time.

The FDA has now approved a new birth control pill specifically designed for

women who skip their periods. It's called Seasonale.

http://www.seasonale.com Seasonale is a 3 month pack that gives a

consistent dose for 12 weeks, followed by placebo pills for 1 week. The

regular pills containt 0.15 mg of levonorgestrel (synthetic progestin) and

0.03 mg of ethinyl estradiol. I switched from Ortho-Cept to Seasonale on

January 26 and so far so good.

Ortho Tri-Cyclen and Ortho-Cyclen both contain Norgestimate and Ethinyl

Estradiol. Ortho-Cyclen contains 0.25 mg Norgestimate and 0.035 mg Ethinyl

Estradiol. Ortho-Tri-Cyclen containts 0.035 Ethinyl Estradiol and a varying

dose of Norgestimate - 0.15, 0.215, and 0.25. Ortho-Tri-Cyclen is not a

good pill for switching periods because of the varying dose of Norgestimate.

I couldn't find Nortel, but I think you may have meant Nordette which

contains 0.15 mg Levonorgestrel and 0.03 mg Ethinyl Estradiol. Another one

I found was several brands containing the progestogen Norethindrone.

The difference between these pills is the synthetic progestin. Each type of

synthetic progestin has different potency and so an equal dose of one type

of progestin is not the same as an equal dose of another. For example, 1 mg

of Levonorgestrel is equal to 5.3 mg of Norethindrone in terms of

progestational activity (stopping bleeding). 1 mg of Norgestimate is equal

to 1.3 mg of Norethindrone in terms of progestational activity. From

weakest to strongest, you have Norethindrone, Norgestimate, and

Levonorgestrel.

In your case, switching from the weaker Norgestimate to a much stronger

Levonorgestrel is likely to be what caused you to have problems. In this

case, you would probably want to avoid pills with Levonorgestrel or

Desogestrel as these are very strong synthetic progestins. Seasonale, which

I am taking, is a Levonorgestrel pill and would likely cause you the same

problems as the Nordette/Nortel.

The Ortho-Tri-Cyclen won't let you skip periods because it is a variable

dose. You may be able to gradually build up to skipping multiple periods

over time using the Ortho-Cyclen. You could also try a pill with ethynodial

diacetate (1.4), drospirenone (1.5), or dl-norgestrel (2.6). These three

are stronger than Ortho-Cyclen, but not nearly as strong as Levonorgestrel.

In my personal experience, skipping periods has been very beneficial to my

overall joint laxity, but it took a lot of trial and error before we got it

right. My first doctor put me on Ortho Novum 7/7/7 because that is the pill

I had been on previously. She had no clue that 7/7/7 was inappropriate for

skipping. I couldn't manage to skip periods and would just have my period

during the first week of the next cycle.

I changed doctors (for other reasons) and the new doctor switched me to a

different pill that had a continuous dose. Sorry, I don't remember which

one this was. That pill worked okay for the first couple months, but my

insurance company forced me to take the generic of the same pill. The

generic had a shorter half-life. As a result, I had a period for 18 days

because I had been 8 hours late on a pill one day. The period would not

stop until I had gone off the pills and just let it happen. I became weak

and sick as a result of all the blood loss.

Last August, my doctor referred me to an ob/gyn (his wife) at my request.

She and I spent over an hour going through the various pill options as well

as other methods that may help me stop my periods. After much research, we

agreed on ortho-cept. She made sure to specify on the Rx, no generic and

" continuous " so my insurance would actually pay for it. That worked well

for me, but I have had hassles every 3 weeks with the insurance refusing to

pay for it. Sadly, both my regular MD and the ob/gyn moved out of state and

I had to get a new doctor last September. The insurance company doesn't

like the fact that I take 3/4 of the Rx and throw away a week of pills. The

doctor has to put " continuous " on the Rx, and if he forgets, they refuse to

let me pick it up in time. It got to where every I was in the pharmacy

every other week between the 3-week bcp and my 30-day Rx for thyroid pills.

The insurance would never let me just pick up both Rxs at the same time

because I have to wait until I am down to 7 pills remaining on the current

Rx before they give me more. That's the main reason I switched to

Seasonale. In my case, I went from Ortho-Cept (desogestrel) which is a very

strong progestin to a weaker progestin with Seasonale (Levonorgestrel). I

am apparently not very sensitive to the higher-dose progestin as it never

bothered me to be on the strongest progestin available.

Good luck to you in finding the right pill for you. Here are some sites I

referred to in writing this email and in doing my own research on which pill

was right for me last month.

Which Oral Contraceptive Pill is Best for Me?

http://www.wdxcyber.com/ncontr13.htm

This site has good reference tables for the different synthetic progestins.

Rx List

http://www.rxlist.com/

This site is good for looking up each Rx to find out the dosages

WebMD

http://www.webmd.com/

Good basic info on bcp in general

-Barb

[Guest guest]

Yes, the hormone Relaxin released during pregnancy and menstruation causes

increased joint laxity in all women. The hormone is being used to treat

fibromyalgia, scleroderma, and psoriasis. Relaxin has also been linked to

increased rates of injury in female athletes. Essentially, the increased

joint laxity in women during their menstrual cycle makes them more prone to

joint injury at this time of the month. Pregnant women are also more

susceptible to back pain and joint injury because of relaxin. For some

people with EDS, the relaxin during menstruation causes symptoms of EDS to

worsen.

Birth control pills do vary in terms of the level of synthetic hormones and

the " half life " of those hormones. Half-life refers to how long the

hormones stay in your system. For example, a pill may have a half-life of

18-24 hours, but the generic version of the same pill may vary by 20%, so

the generic half-life could be as much as 14 to 29 hours. For some women,

the lower half-life of some brands of pills will cause spotting and will

make it difficult to skip periods, especially if the pills aren't taken at

exactly the same time every day.

Another important factor in choosing a pill for skipping periods is whether

or not the pills have a consistent level of hormones throughout the cycle or

if they are varied from week to week. Ortho-Novum 7/7/7 has a high dose the

first week, a medium dose the second week, and a low dose the third week.

This low dose in the third week tells the body that it is supposed to have a

period in week 4. Because of the cycling down of the dose over the month,

it is difficult to skip periods on this brand of pills and any other brand

that has gradient dosing. Ortho-cept on the other hand, maintains an equal

dose of hormones for 3 weeks straight, followed by no hormones in the 4th

week. It is easier to skip periods with a consistent dose during the whole

month.

Skipping periods takes time for your body to adjust to. Most women can only

skip one period at first. Over time, you can decrease the frequency of

periods, but you have to do it gradually. My ob/gyn advised starting with

just skipping 1 period at first, so take 6 weeks of pills, then have a

period. If that works, then the next time you go 9 weeks and have a period.

If that works, go 12 weeks and have a period. And then 15 weeks and 18

weeks and so on. She pointed out that most women are incapable of going

beyond 4 months without a period. If you have break-through bleeding or

spotting, maintain at the same frequency for another 2 cycles and try again

the next time.

The FDA has now approved a new birth control pill specifically designed for

women who skip their periods. It's called Seasonale.

http://www.seasonale.com Seasonale is a 3 month pack that gives a

consistent dose for 12 weeks, followed by placebo pills for 1 week. The

regular pills containt 0.15 mg of levonorgestrel (synthetic progestin) and

0.03 mg of ethinyl estradiol. I switched from Ortho-Cept to Seasonale on

January 26 and so far so good.

Ortho Tri-Cyclen and Ortho-Cyclen both contain Norgestimate and Ethinyl

Estradiol. Ortho-Cyclen contains 0.25 mg Norgestimate and 0.035 mg Ethinyl

Estradiol. Ortho-Tri-Cyclen containts 0.035 Ethinyl Estradiol and a varying

dose of Norgestimate - 0.15, 0.215, and 0.25. Ortho-Tri-Cyclen is not a

good pill for switching periods because of the varying dose of Norgestimate.

I couldn't find Nortel, but I think you may have meant Nordette which

contains 0.15 mg Levonorgestrel and 0.03 mg Ethinyl Estradiol. Another one

I found was several brands containing the progestogen Norethindrone.

The difference between these pills is the synthetic progestin. Each type of

synthetic progestin has different potency and so an equal dose of one type

of progestin is not the same as an equal dose of another. For example, 1 mg

of Levonorgestrel is equal to 5.3 mg of Norethindrone in terms of

progestational activity (stopping bleeding). 1 mg of Norgestimate is equal

to 1.3 mg of Norethindrone in terms of progestational activity. From

weakest to strongest, you have Norethindrone, Norgestimate, and

Levonorgestrel.

In your case, switching from the weaker Norgestimate to a much stronger

Levonorgestrel is likely to be what caused you to have problems. In this

case, you would probably want to avoid pills with Levonorgestrel or

Desogestrel as these are very strong synthetic progestins. Seasonale, which

I am taking, is a Levonorgestrel pill and would likely cause you the same

problems as the Nordette/Nortel.

The Ortho-Tri-Cyclen won't let you skip periods because it is a variable

dose. You may be able to gradually build up to skipping multiple periods

over time using the Ortho-Cyclen. You could also try a pill with ethynodial

diacetate (1.4), drospirenone (1.5), or dl-norgestrel (2.6). These three

are stronger than Ortho-Cyclen, but not nearly as strong as Levonorgestrel.

In my personal experience, skipping periods has been very beneficial to my

overall joint laxity, but it took a lot of trial and error before we got it

right. My first doctor put me on Ortho Novum 7/7/7 because that is the pill

I had been on previously. She had no clue that 7/7/7 was inappropriate for

skipping. I couldn't manage to skip periods and would just have my period

during the first week of the next cycle.

I changed doctors (for other reasons) and the new doctor switched me to a

different pill that had a continuous dose. Sorry, I don't remember which

one this was. That pill worked okay for the first couple months, but my

insurance company forced me to take the generic of the same pill. The

generic had a shorter half-life. As a result, I had a period for 18 days

because I had been 8 hours late on a pill one day. The period would not

stop until I had gone off the pills and just let it happen. I became weak

and sick as a result of all the blood loss.

Last August, my doctor referred me to an ob/gyn (his wife) at my request.

She and I spent over an hour going through the various pill options as well

as other methods that may help me stop my periods. After much research, we

agreed on ortho-cept. She made sure to specify on the Rx, no generic and

" continuous " so my insurance would actually pay for it. That worked well

for me, but I have had hassles every 3 weeks with the insurance refusing to

pay for it. Sadly, both my regular MD and the ob/gyn moved out of state and

I had to get a new doctor last September. The insurance company doesn't

like the fact that I take 3/4 of the Rx and throw away a week of pills. The

doctor has to put " continuous " on the Rx, and if he forgets, they refuse to

let me pick it up in time. It got to where every I was in the pharmacy

every other week between the 3-week bcp and my 30-day Rx for thyroid pills.

The insurance would never let me just pick up both Rxs at the same time

because I have to wait until I am down to 7 pills remaining on the current

Rx before they give me more. That's the main reason I switched to

Seasonale. In my case, I went from Ortho-Cept (desogestrel) which is a very

strong progestin to a weaker progestin with Seasonale (Levonorgestrel). I

am apparently not very sensitive to the higher-dose progestin as it never

bothered me to be on the strongest progestin available.

Good luck to you in finding the right pill for you. Here are some sites I

referred to in writing this email and in doing my own research on which pill

was right for me last month.

Which Oral Contraceptive Pill is Best for Me?

http://www.wdxcyber.com/ncontr13.htm

This site has good reference tables for the different synthetic progestins.

Rx List

http://www.rxlist.com/

This site is good for looking up each Rx to find out the dosages

WebMD

http://www.webmd.com/

Good basic info on bcp in general

-Barb