Endometriosis 'curbside' anyone?

[kbrown]

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I'm a 4th year med student with some questions about treatment of endometriosis. The prescribing physician is not in the office currently and I have no idea how to take Micronor.

I am a pt with endometriosis, treated with Lupron injections each month for 6 months, then subsequently started on Micronor. Told by physician to make it so that I only menstruated q3months. Three questions. First, micronor is a constant dose, 28-day pills with no placebo. How/when is menses supposed to occur? Second, while on micronor, if menses begins spontaneously, should I continue to take the micronor, or stop and then start up again after menses has ceased? Third, since micronor has no placebo week, how do you ensure that you will only cycle q3months (like Seasonal)?

 

[DrBuzzLightYear]

I have no idea how to take Micronor.

Orally, with water.

How/when is menses supposed to occur?

Whenever you stop taking it. But if you're trying to go 3 months w/o menstruating, its not guaranteed. Some women have just as many days of break through bleeding as they would have normally had if they'd stopped every month. You need to find out how your body tolerates it. Have you ever tried skipping placebo's before? How did your body do with it?

Second, while on micronor, if menses begins spontaneously, should I continue to take the micronor, or stop and then start up again after menses has ceased?

I'd guess that your physician would want you to keep taking the micronor. You may have breakthrough bleeding, but the amount and duration will be much less than if you weren't taking the pills. Your doctor is trying to stop you from menstruating (making the endo worse), if taking the micronor straight through doesn't stop you, at least it will be making it less frequent and lighter.

Third, since micronor has no placebo week, how do you ensure that you will only cycle q3months (like Seasonal)?

When you want your period you simply stop taking the pills. You'll bleed shortly there after. Just start crossing days off on your calender, when three months has passed, stop taking the pills.

 

[kbrown]

thanx

 

[mustangsally65]

I am taking Micronor right now, for endometriosis as well. But it wasn't prescribed to skip a period every three months. I take the same dose every day, and have done so since February of 2004.

Sometimes my periods are irregular, last summer I went every two months for 4 months, then got back on schedule for the winter, having one every month. This year, I went three months from March until June without having a period. Don't know what's going to happen now, but it's helped with my pain. It's .35 mg, so I don't know what your dose is.

I think everyone reacts differently to this, so you'll just have to see. I've not had any breakthrough bleeding, and have noticed an improvement of my endometriosis symptoms.

Good luck!

 

[DrBuzzLightYear]

Sometimes my periods are irregular, last summer I went every two months for 4 months, then got back on schedule for the winter, having one every month. This year, I went three months from March until June without having a period. Don't know what's going to happen now, but it's helped with my pain. It's .35 mg, so I don't know what your dose is.
Good luck!

ive been told that in terms of future fertility, the less often you menstruate, the better.

 

[fuzzyerin]

ive been told that in terms of future fertility, the less often you menstruate, the better.

That's not true for fertility as much as it is for cancer. You've got a predetermined number of eggs you're going to release and they die at a certain rate, whether you release them or not, so stopping your period isn't going to save the eggs for later. However, by not sloughing the endometial lining every month, you decrease your risk of endometrial cancer. And I think you might decrease ovarian cancer too by not releasing eggs.

Personally, I'm a big proponent of Depo and other drugs that stop menstruation. I'd rather not bleed once a month, thanks.

 

[DrBuzzLightYear]

That's not true for fertility as much as it is for cancer.

no, its true for some kinds of cancer and for fertility. endometriosis is an extremely common cause of infertility. the frequency of endometriosis goes up with the frequency of menstruation.

 

[fuzzyerin]

no, its true for some kinds of cancer and for fertility. endometriosis is an extremely common cause of infertility. the frequency of endometriosis goes up with the frequency of menstruation.

Good point. Didn't think it through enough. We both raised some good points. I'm still all for no menses if you don't need them, for all the medical reasons and the psychosocial reasons as well.

 

[Celiac Plexus]

That's not true for fertility as much as it is for cancer. You've got a predetermined number of eggs you're going to release and they die at a certain rate, whether you release them or not, so stopping your period isn't going to save the eggs for later. However, by not sloughing the endometial lining every month, you decrease your risk of endometrial cancer. And I think you might decrease ovarian cancer too by not releasing eggs.

Personally, I'm a big proponent of Depo and other drugs that stop menstruation. I'd rather not bleed once a month, thanks.

uh.... unopposed estrogen increases the risk for endometrial cancer, not lessens it. that's why estrogen replacement therapy is typically supplemented by progesterone.