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Why can I not take Ortho Novum? Have chronic endometriosis and perimenopausal symptoms

I am 55 and just began experiencing menstrual cycle changes about 6 months ago. I figure I haven t been ovulating, became more estrogen dominant than ever, and now my period is a flood (same thing as the last 40 years) but it won t stop. Of course my OB just retired before my troubles began and I started seeing a woman in his practice - she s a huge jerk but skilled at physical treatment. Had endometrial biopsy = chronic endometriosis , tx with flagyl and doxycycline . TVU shows a couple fibroids, not badly placed, the largest of which is less than 4 cm. ECC & cervical biopsy = nothing. She prescribed me Loestrin - which is tremendously expensive - oh yes I have no insurance. And told me to take 3, 2, 1 until the flow stopped. I can t get down to 1 pill without bleeding revving up massively again - though I can control it with with 2. Of course they re all hysterectomy happy - which I can t understand - in the absence of cancer. I have a few other very mild perimenopausal symptoms but they are of zero concern to me - only the bleeding is a problem - when it starts it is uncontrollable and I can t leave the bathroom let alone the house - it s exhausting. My questions are these (the new ob simply smirks, scoffs and walks out of the exam room with her Starbuck s cup - answering NO questions at any visit = ARG!): 1. if it s ok for me to take Loestrin or Loovral 1-20 @ 2 or 3 per day - then why is it not ok for me to take my perfect old friend Ortho Novum 1-35 ONCE per day - which has always worked with no side effects; and 2. is there any way to estimate how long this flooding may go on? My mother and all her sisters were up in their 50s when they had hysterectomies for various issues (no cancer), and my cousins on that side ALL had hysterectomy- or chemo-induced menopause in their mid 50s while still having regular periods before, my dad was an only child and his mother clearly had Von Willebrands (no diagnosis - but it is pretty sure she did - dad too) and had about 15 miscarriages after dad s birth when she was 17, then had a total hysterectomy at age 40 from uncontrollable bleeding that had been going on her entire life - prior to the advent of oral contraceptives. Is there any possibility that due to my sort of advanced age just beginning menopausal changes - that maybe these symptoms will be intense but brief(ish)? I need some hope. Literally - I can not work and as long as I can sleep in, nap in the afternoon, stay close to the bathroom, and keep getting my BCPs refilled - I m ok - for now.
Sat, 22 Mar 2014
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OBGYN 's  Response
Mar 2014
hello and welcome,

You have an extensive history which is a reward for us as it helps us getting closer to the diagnosis.

The only thing is you mentioned endometriosis, is it endometritis as the treatment prescribed is in favor of endometritis.

I must clarify one issue. Cancer is not the only indication for hysterectomy. If there are other issues like fibroids, uncontrolled bleeding even then hysterectomy is the last resort. So please remember that if drugs fail you may need it.
Regarding ortho nuvum amd loestrin. You may take any you like both will have same effect.
If you feel the symptoms are due to estrogen excess, please get a progesterone containing medicine like primolute N tablet twice daily from day 14 to day 21 of your cycle and then stop. Wait for the periods and see if they are still heavy.
You may also take tranexamic acid tablets during periods to control flow.
You will need a hormonal evaluation to find the cause of bleed. Fibroids may also cause such bleeding.

So discuss these with your Ob if possible or try another doctor with whom you are more comfortable.

How long the symptoms will last it is difficult to say until reports on hormones and location of fibroids are available.

Please do not worry. I do understand your concern. Just try it and hopefully you will be alright.
Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist
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