Birth control pills and doctors

[danaeris]

So, I mentioned something having to do with PCOS pissed me off yesterday. Here it is, and it applies to birth control pills in general.

As it turns out, progestin decreases glucose tolerance, and estrogen increases glucose tolerance. Most birth control pills contain both of these hormones, but they are not necessarily perfectly balanced, especially since every woman's body will digest it differently.

Overall, birth control pills containing progestin tend to decrease glucose tolerance. Depo Provera, by the way, only contains progestogens. I'd begun to suspect that being on Depo may have sparked my PCOS. I know I've always had the symptoms, the disposition, but it didn't get super bad until I went on Depo. I've found a few comments, posts, and essays from women on the net who had the same experience.

What does a decrease in glucose tolerance mean?

(1) Anyone who is consuming a diet high in simple carbohydrates will gain weight. So that weight gain you had from your pill? If your doctor had just told you to cut out or cut down on the simple carbs while you were on the pill, it wouldn't have happened.

(2) According to the little medication slip included with your pills, those with diabetes, prediabetes, at risk for high lipid levels, and several other things women with PCOS are at risk for, should be closely supervised when administered birth control pills containing progestin. This is ironic, since for the last few decades, the first thing a doctor does when a woman is diagnosed with PCOS (previously known as stein-leventhal) is put that woman on the pill. Of course, that's not their fault until recently. The link between insulin resistance (a form of prediabetes) and PCOS was only made in the last three or so years, and I'm not sure that it is absolutely confirmed. I think they're pretty damn sure, though.

This doesn't mean that women with PCOS CAN'T use birth control pills, but it DOES mean that they should not be using it to treat PCOS. It should be viewed solely as a method of birth control, and one to be used very carefully, under the supervision of a doctor who knows about your special needs. The crucial factor here is that women with PCOS bleed at least four times/year to prevent uterine cancer or endemetriosis. And, this can be prompted using a course of progestin four times a year, which leaves you with only forty days in a year of potential glucose intolerance, as opposed to the whole year.

This morning, my father dropped off a letter at my medical clinic asking for a referral to the PCOS clinic in Toronto. *crosses fingers* I hope that my doctor is sufficiently eager to get rid of me that she faxes the referral right away.

I haven't decided yet what I'm going to do about my own birth control. My body may bleed on its own. And, I'm not regularly having sex with men right now anyway, so it's not like I'm likely to get pregnant. When I do have sex, I fully plan to use condoms. So, I might just stop taking it. Or, use it to establish a regular cycle and then go off it and see what happens. We'll see.

Comments

[velvetpage.livejournal.com]

One more way to say that at least some of my weight gain the last ten years was not my fault.

I'm not sure if that's good to know, actually. It absolves me of some guilt, but it also could make me slack off a bit.

I do know that I stopped gaining significant amounts of weight after going off the pill. I've been off the pill for three and a half years now, and I'm within five pounds of the weight I was when I stopped taking it.

At least one of my diets during that time was very high in carbs, which may explain why I actually gained some weight while on it.

Well, I wasn't planning to go back on the pill anyway, for other reasons. This is just one more reason.

[artemidite.livejournal.com]

Weird! (Found your journal via steeldonut...incase you're wondering). I gained about 20 lbs from starting the pill and had no idea why... I was placed on a low fat diet, and so much of what I eat has been carbs because, I need energy, and have to eat something. :0/ Crazy! That's probably where the majority of my problem is coming from!

What, then, do they suggest that you eat for carbs, if you wanna curb weight gain, and possibly, lose weight? What should people eat?

[velvetpage.livejournal.com]

More protein, moderate amounts of fat, all the veggies you can, and carbs limited to naturally-occuring ones in fruits and the occasional serving of bread. Not a strict low-carb diet - those don't have enough fruit and fibre in them - but lower-carb than most North American diets, and strict limits on amounts of refined sugar.

[danaeris.livejournal.com]

What velvetpage said is right: If you have decreased glucose tolerance, then when you eat anything with carbs in it that your body can break down easily (white bread, pasta, rice, or even large quantities of whole wheat/brown, sugary stuff) a disproportionate amount of that goes straight to fat instead of fueling you. So then you're hungry and overdue for calories, so you crave more carbs because that's normally how your body gets instant energy. But your body can't handle it anymore! It's a vicious cycle that leads to overeating, constant hunger, constant inadequate blood sugar, and so forth. Well, that's the bad case, untreated.

With the pill, in someone who is not normally inclined to diabetes or insulin resistance like women with PCOS are, it is probably less extreme. But the goal is still to cut out simple carbs and if you want to lose weight, rather than maintain, cut out the fat too. This leaves you with grainy breads, vegetables, protein (low fat dairy, meat, poultry, fish), and fruit. With much emphasis on the protein and vegetables.

If you really want to learn about it, I'd recommend reading The Insulin Resistance Diet. The Hamilton Library has a copy. Other key phrases are the Low GI Diet.

[plymouth.livejournal.com]

I was under the impression that the fact that the pill causes weight gain was common knowledge in medical communities for some time. It is certainly common knowledge among my friends though admittedly I have never heard it directly from a doctor so perhaps I am assuming too much.

Depo is scary stuff. Is there perhaps a tri-cyclic type of pill that would have lower progesterone except during the week it induces bleeding?

[danaeris.livejournal.com]

A lot of doctors still tell their patients that it doesn't cause weight gain. But that wasn't the point of my frustration. The point of my frustration is that apparently it has been known for years WHY it causes weight gain. Until now, sure, doctors would say, "This may cause you to gain weight." But they never said why, or what if anything you could do to prevent it.

If they TOLD patients it was a glucose thing, the ones who are motivated to do something about it could cut the simple carbs out of their diet and prevent the weight gain from happening.

[aaangyl.livejournal.com]

Hum. That's interesting, and almost certainly explains why I exploded so when I was on depo. In fact, that might even explain why I have to vary my eating patterns with portion of my cycle to successfully maintain my weight loss. Huh.