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» Scarleteen Boards: 2000 - 2014 (Archive) » EXPERT ADVICE » Emergencies and Crises » Mini pill to combined pill + anxiety - advice please?

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Author Topic: Mini pill to combined pill + anxiety - advice please?
azerty
Neophyte
Member # 70068

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Hi Scarleteen,

I have been looking at your website quite a lot and found a lot of your articles on pregnancy scares as well as your replies to other topics on the messageboards very useful, but not much on mini pills and switching back to combination pills.

This is quite a long story, but I hope you will hear me out and give me reassurance:

I was on the combined pill Femodette from October 2010-December 2010 and was then made to change to the mini pill Micronor towards the end of December when my prescription ran out due to higher blood pressure. (I did not take a break between the two types when I made the switch.) I was very sad about this because the combined pill suited me well and I did not experience any severe side effects or spotting/bleeding between packs.

I have been on Micronor since the end of December 2010 until this past Monday (June 27th, 2011) when my gyn took my blood pressure, said it was fine and agreed to put me on the combined pill again (Femodene). He said I could start the combined pill right away without waiting until the end of the Micronor pack. To double check, is this ok? I am making the switch while my boyfriend is away for over 5 weeks, so I will not have any sexual contact with anyone until I next see him so I don't get in any risky situations while making the switch.

I particularly wanted to switch back from the mini pill to the combined pill because my bleeding became extremely erratic. Sometimes I would have a normal period and perhaps a day or two of spotting, but in May and June this year I have experienced on-off bleeding/spotting separated by a few days or up to two weeks and it makes me extremely anxious. I heard that this erratic bleeding/spotting is normally supposed to stop on the mini pill after a while, but for me it became worse, is this normal? The bleeding and spotting I have had in May and June have not resembled periods in terms of flow and amount of discharge, but it lasts up to 7 days. I am no longer capable of determining what is and what isn't a period and this makes me nervous. Is it possible for me to just have spotting and very little bleeding and no full blown periods after being on the mini pill for 6 months? Is spotting/bleeding on the mini pill but no full blown period an indicator of pregnancy? Or should I rather be concerned about pregnancy if I have no bleeding/spotting at all for 45 days (like the Micronor leaflet says)?

Is there anything I can expect while switching from the mini pill to the combined pill? Will I get my withdrawal bleed? I am most worried that the bleeding will still be erratic and make me a nervous wreck.

Just a quick note - I took my Micronor religiously at 2pm with the help of a phone alarm, no delays whatsoever. I never skipped/missed (due to diarrhoea/vomiting/antibiotics) a single pill since I knew the effect of the mini pill is so easy to reverse if you miss one. Never took breaks between packets. So the erratic bleeding was not caused by missed/malabsorbed pills, I believe.

When I have vaginal intercourse my boyfriend always uses a condom throughout all genital contact. Last time I had vaginal intercourse was May 17th, I took a blood pregnancy test 14 and 23 days after our protected intercourse and obviously it came out negative. (I was very paranoid, since we are in different countries right now for the summer and I don't deal well with long periods of separation.)

My boyfriend came to visit from June 9th-28th and I told him I would rather abstain from vaginal intercourse during his stay since I had a pregnancy scare earlier that month. Instead we practiced oral and manual sex (no condoms, we are both tested and clean, monogamous for 4 years, I know that this carries some risks, but I am willing to take them as long as we do regular tests). Last time we had manual sex was June 25th, I was on Micronor for one more day after that and then switched to Femoden on the 27th and had no more sexual contact after the 25th. Am I still protected from pregnancy?

When we have oral/manual sex, he always does me first and then I do him, making sure no preejaculate or semen reaches my vulva/vaginal area. His semen always ends up in my mouth and then I dispose of it in either the sink or a tissue and then wash my hands with soap and water.

I get worried that my boyfriend may have touched his penis lightly while performing oral/manual sex on me (but before coming, he might have not even had any preejaculate yet) and then touched me lightly with his hand (we mainly stick to oral though), is there any risk that his preejaculate could come into contact with my vaginal area and impregnate me even though I use the pill very well? I underline, we did not have any direct genital contact or vaginal/anal intercourse, he always comes last and there is not sexual contact after that.

My rational side is telling me that I will be fine, but I have moments when he's gone that I get extremely anxious and worry about getting pregnant from preejaculate despite being on the pill. Even writing this now seems quite absurd since I have read in your articles that oral/manual sex does not present a risk unless someone's hand was covered in semen and then touched the vulva (which in my case, it simply didn't).

Perhaps I need a break from any sexual activity to calm myself down. This anxiety could be triggered by my conservative upbringing that I have managed to throw off, until it creeps back up on me when I come back home where I currently am at the moment. I'm mainly writing this to hear a human voice reassure me that I will be ok, because I don't have anyone I could talk to about this in depth since my boyfriend is abroad. He is very supportive and constantly reassures me we will be ok and I trust him, it's only when the anxiety kicks in that I lose all rational thinking. So, please Scarleteen, could you give me some good advice?

Thank you for your time!

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azerty
Neophyte
Member # 70068

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I also wanted to add that on June 26th (day before I switched to the Femodene combined pill) I experienced another bout of spotting which has lasted until today (June 30th) (note: I have been on the combined pill since the 27th), there is hardly any fresh blood, mainly just dark brown discharge which looks like bits of endometrial lining, flow is not heavy at all, it needs a panty liner or two per day. What do I classify this as - period? Spotting? Breakthrough bleeding? What are the primary differences between these three? This erratic mini pill business has got me so confused!

Thanks!

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azerty
Neophyte
Member # 70068

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Any reassurance would be really helpful! Thanks!
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Heather
Executive Director & Founder
Member # 3

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Hey there.

So, let me just try and track through all of your questions here. If I wind up missing any, just give a shout and I'll double back.

Yes, it's okay to switch to a combined pill pack in the middle of your minipill pack. It's okay to do that with any kind of BC pill, ultimately.

When it comes to spotting and bleeding with the minipill or other progestin-only methods, people's experiences vary. Some people have little to none, ever. Some people only have it sometimes, or in the first few cycles of starting. Some people have it the whole time (when we get trained on counseling with these methods, we're usually told to always let people know that could happen).

You're right: right now, figuring out what is and what isn't a period is likely to be nigh unto impossible. If that's making you anxious around pregnancy, I'd just get a box of pregnancy tests, if you can, so you can take one when you feel at wit's end. I'd also figure it's likely going to take a least a few packs of the new pill to have bleeding on any kind of schedule. It may take even longer, I can't say or predict that for you well.

You are using a birth control pill and condoms for the kinds of sex where pregnancy is a real risk. So, I don't see pregnancy as at all likely. With the activities that don't present risks, like manual sex, I'm equally not concerned. The situation you're worried about is simply not at all likely to present a risk of pregnancy even for someone not using a hormonal method, let alone for someone who is.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

Posts: 68290 | From: An island near Seattle | Registered: May 2000  |  IP: Logged | Report this post to a Moderator
azerty
Neophyte
Member # 70068

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Dear Heather,

You have no idea how much you have helped me with your message! Thank you! I have a lot of admiration for what you do at Scarleteen!

Best wishes!

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Heather
Executive Director & Founder
Member # 3

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Oh, fantastic! Glad that could sort you out. [Smile]

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

Posts: 68290 | From: An island near Seattle | Registered: May 2000  |  IP: Logged | Report this post to a Moderator
   

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