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Dr. Andrew Rynne

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What are the side effects of Norethisterone?

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Dr. Jacqueline Brown

OBGYN

Practicing since :1996

Answered : 1425 Questions

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Posted on Mon, 9 Nov 2015 in Women's Health
Question: Been taking Noreisterone for 1 year 5mg 3 times a day and have had no issues started last October 31st 2014 and August 15th 2015 I bleed and have had episodes between then where I have bleed for 1 day or more but only light and not all the time or brown or liquid discharge.

Is this normal side effect, or showing my hormones are still working, I Am 18 and suffered from heavy periods so was on XXXXXXX pill due to having heart condition so couldn't take actual pill, and it made me bleed for months and months.

And suffer from lichen sclerosis that effects vulva area and I was wondering I had a really bad flare up recently that caused me to have two lots of antibiotics and creams and had cold sores two months prior to flare up.

so I decided to have a break unitl July 2016 as have college and other commitments not sexual, as was becoming really depressing and when I wasn't on anything I couldn't go out due to 7+ days heavy period all throughout, I was also wondering when I do stop Noreisterone, would transmasic acid be better or is it the same as Noreisterone.
doctor
Answered by Dr. Jacqueline Brown 1 hour later
Brief Answer:
You may do better with other medications or treatment for your heavy period

Detailed Answer:
Hello, and I hope I can help you today.

I am sorry that at such a young age you have such problems with your period. I want to make some suggestions for you for other treatments for heavy periods that you have not necessarily looked into yet- and give you complete information about the products you have tried or are thinking of using.

But first, I would really appreciate it if you could give me some more medical background about what condition you have that prevents you from taking regular combination birth control pills. Coronary heart disease (like a heart attack), a history of blood clots forming in your legs, lungs or brain, active liver disease and liver tumors, are all reasons that women are not recommended to take estrogen containing products.

In addition, did any doctor actually do an evaluation of you to help determine why you bleed so heavily? Do you bleed or bruise easily or in general, like when you brush your teeth or get nosebleeds? This information would be relevant in trying to figure out the right treatment for you as well.

If you truly have a medical condition that affects blood clotting, transaminic acid is not an option for you as it increases the risk of blood clots in the legs or other areas just like estrogen.

There are other progesterone-only products you might benefit from, like the progesterone injection, implant or hormonal IUD. But if you do not mind providing me with this additional information I would be able to help you more effectively.

I hope you can just give me your medical history so I can properly advise you about your options. Please contact me again with more information about your medical condition and I promise to give you the best professional advice I can.

Sincerely, Dr. Brown


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Jacqueline Brown 32 minutes later
I have mild left ventrical systolic impairment (cardiomyopathy))
Lichen sclerosis that recently had major flare up with absesses and cuts and slices.
History of blood clots and coronary heart disease (mother)

I have looked into implants etc but jabe heared reveiws and talked to friends about there exeprience and the restriction of bleedimg for 6 months wad bad enough when i was on the XXXXXXX pill, it worked at first with only brown all the time akd then turned to blood and become heavier, ajd it made me feel depressed and one minuet fine no bleeding 2 hours later bleeding so i didnt know what was happeneing.

so i decided to take noreisterone for around 1 1/2 years to give me a break and enjoy my life and was fine until august this year where i bleed for 1 days and than one week later had rhe worst flare up of my lichen sclerosis ive ever had and then bleed again after that and stopped and started again, so could a really bad infection make the noreisterone become unefective or could it be my conditon (lichen sclerosis) as had cold sores for two months prior and they didnt go until early august.

I have seen a gunecologist and she suggested coil but heared really bad reveiws about that and as young still quiet embarressed for professionals to examine that area.

I have no problem with clotting, my real question is my bleeding episodes normal with being on noreisterone quiet a while, also i have been having brown, yellow and pink/red disharched and i cannot tell wether it may be some sort of blood related to not havinf full period for long time or somthing else like imfection with recent flare ups as there is no blood in my urine only when i wipe but not loads.

Today around 3:00 i had yellow disharge this can be ususal for me as suffered with it when had periods, than around 5:00 i urinated and had bit of blood when wiped, then urinated around 6:00 nothing, than around 6:30 there was blood mixed with fluid disharge and brown but it is coming from near my rectum as the back end of the opening of my vagina it seems although there is a build up of it as it goes from brown to pink to yellow, whenever it wants to and i could have 1 week without anything or 4+ weeks and this is only from august 2015 before than had nothing apart from usual yellow disharge on nroeisterone. Thanks
doctor
Answered by Dr. Jacqueline Brown 43 minutes later
Brief Answer:
Irregular bleeding is normal on progesterone-only contraceptives

Detailed Answer:
Hello XXXXXXX Thanks for responding to me with your medical history.

It is completely normal to bleed irregularly on any progesterone-only product. The Northisterone dose you are taking is higher than the contraceptive dose, but it is not as strong as the Depo-Provera shot or the implant, which are better at suppressing your menstrual cycles completely. Typically, women on the shot or implant bleed irregularly for the first 6 months and then do not menstruate anymore at all. It is good that you managed to not bleed at all for so long, but even taking one of your three-times-a-day pills at the wrong time might set up withdrawal bleeding that is difficult to stop once it's started.

The appearance of the blood can vary depending on how fast it is flowing and how much mixes with your normal discharge. Yellow discharge is either normal or mixed with a tiny amount of brown (old) blood and red or purple blood is more fresh. Blood turns brown if it has built up in your vagina and flows out slowly. How the blood comes out of your vagina also has to do with your level of activity and body position (when you are upright you may see more blood; when you lie down it sits in your vagina and then will flow out after you sit or stand). The fact that you only see the blood when you urinate just means your urine is washing some of the blood out but it is so little that there is not enough to leak on your underwear.

Regarding your lichen sclerosis, it may be exacerbated by the lack of estrogen in your body from all the progesterone products you use. Estrogen gives the vagina its normal lubrication and pH and when it is low, many patients can have some degree of skin thinning like in Lichen Sclerosis. I hope your lichen sclerosis has been diagnosed accurately by skin biopsy. If so, the correct medication to treat it is a high-potency steroid cream like Clobetasol and you may need to use the cream once weekly to prevent flare-ups, as lichen sclerosis is a chronic condition.

I personally, as a GYN doctor who has treated many patients with these kinds of problems, sincerely recommend the Mirena coil for you. I know there are many reviews online that may concern you, but remember... people who are generally happy with a product are less likely to post a review than a negative experience. I can tell you that the majority of female physicians I know use the Mirena coil. The great thing about the coil is that the hormones in it are not absorbed by the body, so you ovulate normally and do not get mood side effects like the implant or the shot. It will also not affect the skin of your vulva. I know it is hard to get used to being examined by a GYN doctor, but we can help you better than a general doctor who is not as familiar with female health and anatomy. The coil works for up to 5 years and can be easily removed by a doctor if yo don't like it.

You could also, as you mentioned, just stop all the hormones and see what happens. Sometimes women outgrow their menstrual problems as their system matures. Your hormonal system is still developing until you are at least 21, so your periods may not be as bad now as they used to be.

So in summary, bleeding when taking progesterone is common and normal, even if it hasn't happened to you for a long time. I am sure it has nothing to do with your lichen sclerosis flare, other than that being on progesterone in the first place may be predisposing you to it. And I do really recommend the Mirena IUD. IUD's are most widely used contraceptive in the world. And in the U.S. now, it comes in sizes, they even have an extra-small one for young women who haven't been pregnant.

I encourage you to follow up with your local GYN doctor to come up with the best plan for you going forward. I would discuss the lichen sclerosis issue as well, because most of my patients who get it badly need to be on some kind of maintenance therapy to keep them symptom-free in between flares.

I hope this information was helpful to you and that I was able to answer your question adequately. Please do not hesitate to contact me further if you need clarification of anything or more information.

Best wishes, Dr. Brown
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Jacqueline Brown 32 minutes later
Thank you, i understand but could a severe infection make the noreisterone stop working causing slight bleeding like the little episodes, as had two lots of antibiotics and steroid cream, for my lichen sclerosis i was on medication (long name) and have been for years as cream didnt work, i havent had it for months as havent seen dermotologist for months so i think that may of been a main factor to flare up and the flare up i usually have is like water infections but 10 times worse, but this i have never experienced before and i was in so much pain with it and when on antibiotics didnt bleed and then came off them and bleed and flared up again so got more and then didnt bleed again until after finished them.

P.S i will go to my local GP and have a talk about other things that may be better

Regards,
xxxx
doctor
Answered by Dr. Jacqueline Brown 8 minutes later
Brief Answer:
It is possible that the stress of your infection could have affected it

Detailed Answer:
Hello again,

I agree that without a complete review of your medical records and the treatment you received for your lichen sclerosis it is not possible to accurately speculate what set off this bleeding episode for you. However illness of any kind can affect your metabolism and may have had an effect. The decreased effectiveness of birth control pills with antibiotics is only true for estrogen containing contraceptives, as progesterone is not metabolized in the liver (which is why people with liver disease can use it safely)

I do encourage you to see your dermatologist back as lichen sclerosis is a skin disease and there may be nuances to your particular case that may have been evaluated in the past that I do not have access to.

I hope the information you did receive on Healthcaremagic was helpful to you and that you feel better quickly.

Take care, Dr. Brown
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Jacqueline Brown 4 minutes later
Thank you, i really appreciate it and i will do
doctor
Answered by Dr. Jacqueline Brown 14 minutes later
Brief Answer:
You are very welcome

Detailed Answer:
Thank you again for using Healthcaremagic.com. If you don't mind- please close the question if you are finished with our dialog. Have a great evening.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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