perimenopause, IC, and hormones

[dminton]

I'll see if I can phrase this correctly so my question is clear (here goes!):

For those who need estrogen supplementation but still have a uterus and therefore cannot use estrogen unopposed by progesterone (increases risk of uterine cancer), but also find that progesterone worsens IC, what the heck do you do? They won't let you use the estrogen you need without the progesterone, is what it boils down to.

My provider is suggesting I try a progesterone IUD so that I can use estrogen patches. This seems extreme to me. Aren't there any combination patches that women can use that are not at such a high dose that they qualify as birth control (Ortho Evra for example) but that still relieves some of the perimenopause symptoms due to dropping and fluctuating hormone levels?

I want to experiment and go off Ortho Evra to see if my IC calms down. I feel better on the week that I don't use it and just have on a little estrogen patch so I don't crash from low estrogen. I therefore suspect that the progesterone component is the culprit, and I have read that this is often the case for IC. But, they won't let me use just the estrogen patch because I still have a uterus.

Hope this makes sense!

[sugu22]

I took Provera for 10 days because of abnormal bleeding. Right after that my bladder problems started all over again after being really good for 4 yrs.

[kadi]

I don't know if this is exactly relevant, but different birth control pills can have different types & concentrations of progesterone (which can cause or solve side effects). I printed out the article, "Which oral contraceptive pill is best for me" (Sorry, wish I knew how to link it!)

www.wdxcyber.com/ncontr13.html

and took it to my gynecologist for discussion. The article has several helpful charts- you might be interested in the one that discusses which pill has higher progestin side effects. Hope it helps!

[kadi]

Wow, okay, I linked it without realizing it! I don't know why it says the link is broken eek , but just type in birth control pills for the search. On the next page it gives you, you'll find the "Which birth control pill is right for me?" in the ARTICLES section on the right hand side. (Weird!

[dminton]

Thanks for your info! Unfortunately, I can't take oral contraceptives due to worsening of migraines. But I appreciate your response.

[dminton]

Well, after a 9-day phase of having some good days thrown in, which is unusually lucky for me, I have pain again. The deal was that I had the OrthoEvra patch off for the 7-day length of time to have my period, put the patch back on Monday, and here I am two days into it with pain again!

I am seriously considering getting off the patch entirely, and switching to a progesterone IUD (very low progesterone) and then I can use estrogen-only patches to my heart's content because the estrogen is opposed. This should in theory provide my bladder with a break because the hormone doses will be so much lower than they are with the Evra patch. I really think the progesterone is the culprit.

Hopefully this will be useful information for any other perimenopausal women out there that still have their uterus and who react to progesterone!

[Zanni2]

Hi, I'm Zanni2:

I had a complete hysterectomy (with removal of ovaries) six months ago at age 37. I have been put on Premarin (the vaginal cream version). My gynecologist told me this would minimize side effects like weight gain which is more pronounced with the pill and patch versions. Is estrogen replacement alright for my IC? Sometimes I wonder. Could there be any natural alternatives that would be safer and bladder friendly?

If anyone has any insights, please let me know.