Update - Ovcon only didn't help, next...

[tesschron]

About a month ago I asked for suggestions, as I had tracked newly recurring flares to specific points in my cycle and Yasmin pill usage; second week of pills, about Wed-Thurs when bleeding started, flared, could get an instillation and calm 70% of it, but mild overactive pelvic nerve activity continued til first few days after resuming pill. I have a wonderful gynecologist, I drew up a chart showing the pattern of period, pill and flares for the last 4 months, with summary of symptoms - she asked a couple of questions, then said - well we have to fix this. You have been doing your research, what have you found out? We conferred, and I decided to try Ovcon only for a couple of months and see if the higher dose of estrogen and different progestin (Yasmin is unique) would help. Well, this time it was Monday of the second week, breakthrough bleeding (nice and red like a young body), and flare just starting. I could have waited to see if it got worse, but knew med insurance was changing (company buyout) soon, so went in for an installation anyway. Killed all symptoms until my true period started two days ago, and while the bladder doesn't hurt, the gotta goes tell me it is in flare. So I called in, and now have Premarin to try too. But how does that compare to Estrace or other external cream? Does anyone have other suggestions, just in case? If the Ovcon did not work, could I go back to Yasmin? I would not miss the weight retention, was losing a pound a week until I started it....

Terry, all experiences and suggestions welcome!

[jjt001]

I've been on Loestrin 24FE for about six months. It's been great, it's really helped with my period flares (and my periods are really short, just like the commercials say!). I don't think it had any negative impact on my IC at all, though I started the Elavil soon after and have felt much, much better since then.

[sami4]

Premarin

Premarin either pill or cream is a much stronger estrogen than bio identical generic estradiol or Estrace. The oral form of Premarin produces more estrone in the body (the estrogen that stimulates breast tissue the most), and for a lot of women causes flares.
I am surprised the Ovcon 35 caused a flare, usually it is the one BC pill least likely to give IC a problem.
Watch the progestins, as they are known bladder irritants and Provera is not only a big irritant, but the nurses study down right stopped the study due to its effects on the breasts.
Sammi

[tesschron]

comments

Thanks, for the input. Sami, I don't think it is the estrogen causing the flare, but the drop in estrogen and rise in progestin that is kicking the flare off. (based on the exact timing of the flares vs. bleeding). Boy do detailed charts and diaries help. I was hoping that starting at a higher estrogen level with Ovcon would then mean the estrogen level would remain high enough after the drop to avoid flares, but apparently no go. And the change in progestin type did not make a difference. I did see a reduction in the flare within 24 hours of the first Premarin use, and within 48 hours was back to no pain, just a little overactive - so I am thinking maybe it is just that the extra estrogen with Ovcon was not reaching the bladder, whereas the Premarin with direct application to the vagina does. I'm going to try this for another month's cycle, (start the next pack of pills today) and see what happens when the premarin goes to twice a week (maintenance dosage), and then talk to my gyn again. I appreciate you all listening, it helps so much to lay it all out for others.

terry

[sami4]

Terry

I think you are totally correct that the hormonal ups and downs are bad, bad flare triggers. That estrogen drop, and progesterone rise is also awful for vulvar disorders as well.
Premarin is a stronger cream, and sounds like you just needed a little more kick to the cream?
Sammi

[tesschron]

Well, I haven't tried any other cream, so don't know if something else would work. I want to see how things go next month, if the flares stop completely or are very mild. If they stop completely with Premarin, I may ask my doctor to let me try the Yasmin again, but with Premarin, so I can find out if I only need the direct high dosage, or both pill and cream high dosage. Just so that if things do advance in a year or two, I have options still....and to keep the estrogen to the minimum necessary to balance. I don't have any family history to cause us to worry about too much estrogen, but I do have migraines, which could mean stroke risk, so have to be cautious. (Like I care about cautious in the middle of a flare...)

terry