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Diabetes ... Period.

Diabetes and birth control ... WTF?About once a month, there's a certain spike to blood sugar patterns that is both predictable and completely chaotic - welcome to this morning's TMI post about diabetes and the menstrual cycle. 

Two months ago, when the gene for the Factor V Leiden mutation was detected in my blood, my endocrinologist and my gynecologist decided to remove me from my birth control pill and switch me to something with less of a clotting risk.  Since I decided to go on the pill when I was a freshman in college, I have always been on the standard estrogen/progesterone pill (I was on the ortho-tricyclen, then tri-sprintec, if you want a good ol' dose of TMI).  When it came to diabetes and this kind of pill, there was plenty of information out there, so I had a good idea of what to expect.

But this new one?  The progesterone only?  It's a bit of a wildcard.  I'm currently taking the Errin pill (28 days of hormones, no "placebo" pills) and these first two months have been pretty damn tricky.  I'm not sure if it's my age, the ticking of my biological clock, or just the changes in my body as I age, but this pill made my emotions run wildly.   And the information I've received on this pill has varied.  The internet (oh Internet!) informs me that the brand name version of this pill comes with a diabetes-specific warning:  "Diabetes patients - Ortho Micronor may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine."

Oh for crying out loud ... another variable?  

I was on the old pill for almost ten years, in total, and I was used to the effects it had on my body.  I was accustomed to the 28 day cycle, the guaranteed four day period, and the pre-period spikes weren't dramatic.  I actually noticed a drop in my insulin needs while I was on the placebo week, and I had a decade to really adjust to the whole process.  This new bit, with a whole new hormone regimen, has thrown my body into the spin cycle.  I can't anticipate the highs because I'm not sure if/when the actual period is coming.  (Part of the trick with progesterone-only pills is that you may not always have a period, which makes my brain melt.) 

Aside from these unpredictable start times, this seems to be the first pill that affects my emotional state closer to the end of the 28 day cycle ... for example, I came across this video of a singing little six year old and promptly burst into tears.  I had a few days of feeling amped up, over-emotional, and anxious, and these emotions had their own little tea party with my blood sugars.

I want stability.  My whole reason for being on birth control at this point is to protect my body from pregnancy, because my A1C is spikey.  So I take the pill to protect body-from-baby/baby-from-body, yet the pill itself could be contributing to an elevated A1C.  It's frustrating because pill options are limited (thank you, Factor V), pregnancy is not encouraged at this A1C, and I'm a young, newly-wedded woman with a healthy libido.  (Kerri!  Your mother reads this blog!  And so does HIS mother!  Ahhhhhh!  Go delete that!  I'll wait.)

Nope.  Can't delete it.  This is real life with diabetes, awkward bits and all.  Anyone out there on a mini-pill and seeing some numbers (and emotional) fluctuations?  I'm trying to learn everything and anything I can, with the end goal being Nice Healthy Baby Range.  Talk to me - I need some advice!

Comments

No idea what to say, other than I wish it wasn't this way.
I still get the elevated blood sugars at the start of the last week of the pack, and then lower blood sugars during the placebos. So I don't know what to tell you.

hey there kerri...i'm an excellent clotter too! mine's some factor XII issue. and it's lame. they tell me the best birth control method is an IUD, but they didnt say it was unsafe to take the old-school orthotricyclen and they renewed my script anyway. think i'm gonna call them about that.

but an IUD if you get one, they can just take it out when you want to have a baby, that way its controlled a little more. mirena has progestrone though, so you might still be moody.

Wish I could help you - but I'm not on birth control pills. I can say that what you are experiencing sounds very much like periods without the pill. I always get ultra moody about a week before. I usually hit one or two fasting 200s - ugh - although last time my highest pre-period morning reading was 132. Because it's so random, my endo recommended NOT setting up a temp basal for pre-period week. Turns out he was right - imagine what that 132 would have been if I had a basal set expecting a 250!

Hope someone else has had experience with that pill and has better observations than me!!

Sorry, I got nothing. I just can't WAIT until Emma is older. I did post a blog yesterday about squashing a mosquito and then testing the blood that was in it to see if I could figure out who among us it bit. Now THAT'S entertainment.

i couldn't be on the pill due to high blood pressure problems on it. We had to do it the male route (condoms). It makes it not so spontaneous. but then there is nothing having to interfere with your body, and it can get to normal. so go make stock in Trojans go up (bad pun!)

The mini-pill was the first type of birth control pill I ever took. My then doctor actually felt the progestogen only pill was a better option for people with diabetes (?) and was also worried about excess oestrogens kicking off my migraines. I hated the effect of the pill on my moods and my diabetes control so much that I didn't last more than 3-4 months before I got an IUD.

I've since found out that I'm oestrogen deficient (which may explain my response to the mini-pill) and I now use transdermal birth control to replace my missing hormones, but the IUD remains my favourite method of birth control. If I didn't need the hormones to stay sane, I'd definitely get one again. And with a hormone free IUD, fertility returns immediately it is removed.

I was in your boat a few years ago, Kerri. I had a stroke after giving birth to Gabriel (I know, not helping ease your stress) due to pre eclampsia and was not allowed to go back on the pill because of the clot possibilities. So we used condoms and that ummm didn't work too well for us (Ick!) thus resulting in Miss Zoe. haha! I had my tubes tied during my c section with Zoe so now, no problems.

So ummm guess I have nothing really helpful to say so I'll go now. ;-) GOOD LUCK!! I'd look into the IUD.

I've been happy with the Mirena, ever since my daughter was born almost 5 years ago. I don't know if they recommend you get a Mirena prior to having kids or not, but it is so convenient because you don't have to take a pill AND you don't have periods. For five years at a time. : ) I hope you find something that works for you, too!

I can't speak on diabetes + pills, but I have some experience using natural family planning successfully. We've been married for seven years and have had babies when we wanted them and avoided pregnancy when we didn't. I did try pills briefly before deciding I didn't like the side effects. If you can remember to take your pills every day, it isn't any more difficult to take your temperature and track your fertility. There is a learning curve though, so I'd use a barrier method while learning! Great book to check out: Taking Charge of your Fertility by Toni Weschler (highly rated, and there are lots of reviews on amazon to peruse).

Sounds like a tough situation, I hope you find a good solution that works for you!

I agree with Rachel on the BBT (Basal Body Temp). it worked for me, too. I used fertilityfriend.com, and took my temp at 6am every morning, then just rolled over and went back to sleep until it was time to get up. You have to take your temp at the same time every day, and Fertility Friend helps you chart it. (OOOoo charts!!) Then after you get the hang of it, you'll know your most fertile times, but as Rachel said... use a barrier method while you figure all that out!

I, too, have had the unexplained spikes during my period. Ugh!

hi boy am I glad enough that I am the age I am and glad my kids are 23 and 25 . I never want to have to deal with the bc pills again . thank god . I wish I had more info for you Keri . I wish you the best for figuring this out . I know I have been there and it is very hard .

I can almost guarantee that you'll get your numbers where they should be for baby making if you go off the pill. I am now off birth control completely (unfortunately I found out I can't conceive with my hubby). I now actually have blood sugars I can predict, that react to insulin the way they are supposed to and I barely have any spikes or lows. And I don't really try that hard. I never knew all those years on birth control messed with me so much. It made me brittle. If I were you I'd try to find a BC method that doesn't use hormones. You might be able to get pregnant earlier than you think! (Paraguard is a non-hormonal IUD, FYI)

Well, I'm no help, but I can sympathize. After 10 years of Norplant, I was forced to try something new when they took it off the market. I tried Depo shots, and ended up with periods every 2 weeks, so I was like 'screw this', and I was over 30 so no pill for me. I was at a different place about the whole baby thing than you are so I just got a tubal. I was tired of of the aggravation of BC and watching my options for it deflate like a used condom. At least now I can have marital relations to my heart's content without worrying anymore.

Kerri, I am not D (my son is) BUT...I took Erinn a while back and had panic/anxiety attacks and serious mood swings. When the doc took me off, no more issues. So, if these issues are a part of your struggle, it may not be D at all. Check into the NuvaRing, it's great...though after early menopause I don't have to deal with those problems anymore!

I am also a fan of the NuvaRing. It's easy to use and, unlike the pill or patch, does not make one an emotional nightmare. In fact, I worry because I'm NOT crabby before my period and start to think I might be pregnant!

I don't know anything about the blood clotting issue with bc but I am a t1 and have used the nuvaring for years. It doesn't seem to bother my BS. If you could use this it might be worth talking to your doc about it. I hope everything works out and you get your BS where you want them before you have kids. Good Luck!

Hey Kerri-
Hate to weigh into the party late but after many years of shakey control and spikes in my BG I switched to a pill that was like yours. I was having trouble after Chris and I got married and I switched to I think it is called Microgestrin. Stopped it once my A1C was good to start trying for a family and then went right back on it after Izzie.
It was rocky the first few months both times I started it but total smooth sailing after that. They are 21 day pills and no placebo.
Just another option.

You are too funny. Diabetes Period. ROLFLMAO.
But seriously folks you must honor the health of your body first and foremost. I agee with landleigh have hubby step up here and use raincoats. It is the sensible solution until the Doctors can come up with something else that won't cause you harm.
Mark

Kerri, I have never been on the pill or any hormones. My endo is old school and preferred that I stay off of them. I used a diaphram for years with good results. And had two healthy babies while on injections, by the way :)

That said, my sugars are completely wacky between ovulation and my period. The are so unpredictable, and like another poster, my endo said not to raise the basils because things are different day to day.

I have heard great things about the IUD though.

I am a migraine sufferer AND diabetic and after using depo for a few years (and gaining a few 15-20 lbs) I decided to try the copper IUD so I didn't have to deal with crazy hormones. Well, after 2 years of use, I got it removed today. Lengthened my period and intensified my cramping. Might do the Mirena someday, but for now I'm sticking to good ol' condominiums and I'm going to try the basal temp thing. But aside from the cramps, the IUD was one less thing for me to worry about.

My recommendation-- get an IUD!! It works great, you get regular periods, and don't have to worry about hormones because you can get one without hormones. I lost weight, my bp went down, and I felt much better after switching to an IUD instead of the pill. And it works like a charm!

so this may help with those emotions - in fact I think it really should help. I was told once by a nurse in family planning that the pill depletes vitamin b, and thus your emotions go whacky. take a vitamin b complex daily and it should level you out hopefully - with regards to the emotions. I have no idea with regards to the blood sugar! I notice when I don't take my vitamin b i am a bit of a whacky mess. Even when I'm not on the pill the vitamin b helps regulate my moods. hope this helps!

Got to chime in on the IUD angle - I was on the Pill for eight years, and "thought" I felt fine, but the moment I went off it, I lost 8lbs, slept less, was incredibly happier, and my blood sugar seriously stabilized across the month. With a Mirena IUD you don't have a period at all (at least 90% of women don't) so there's no fluctuation (at least not for me) during any particular week. Makes my basals happy.

You don't need to have had any kids yet to get a Mirena, and you're fertile the moment they pop it out. IUDs are also more effective than pills and remove human error - I imagine getting pregnant unexpectedly as a diabetic is a pretty scary experience.

A little late, but better late than never...
Have you looked into Depo-Provera? I know it's a very unpredictable thing, since you have a shot (haha...shot) at either having more periods or none at all, but while I was on it, I didn't have a period for 3 months...then I would get one to remind me to get the shot again. I don't know how it would affect your sugars, since I don't have D, my dad does, but it might be a thought, since you still want a baby and will probably be working on getting your body ready for one for at least the next 3 months...:) Good Luck!!! Being female is tough...adding other factors is hell.

Kerri,
I don't have any words of wisdom, and no experience with any of this, but I wanted you to know I'm proud of you and I'm rooting for you! You are a household word here at our place because you are such an inspiration to me. (my husband even asks each evening 'what did Kerri say today'. Keep up the good work and we are behind you 100%! One day you will have lovely little children and they will be worth all the hard work. Oh, by the way, those 'raincoats for Chris" aren't a bad idea....they can actually be a little fun... blush, blush....
Mousie...becoming a pumper next week!

So, I dont know if you remember me or not but I met you at FFL this year and I would be the mom with the 3 year old Madilyn, with diabetes and TWINS, Landon and Leah. Ummmm...I really dont want to be the bearer of bad news, but I got Pregnant with the TWINS while on Errin! Ok....calm down...breath into a bag or something...it does not mean this will happen to you. I do know what you mean about the emotions with progestin only pills, and depo (the shot) causes the same, worse for me as you get a larger dose of hormone at once, I love love love, my Mirena IUD, but it is really recommended for women who have had at least one child (has to do with insertion issues). The good news is that Micronor worked for Henry and I for 3 years before we had Madilyn, and she was planned (took 3 months after stopping the pills). So chances are my hormones were askew due to having a kid already, when I got pg with the twins. Its hard when you are limited with birthcontrol options, I have a friend who did not know she had factor 5 and ended up in the hospital with a blood clot due to the orthotricyclen. I have lupus and cant take extrogen, so its frustrating. I would really look into the natural planning methods, it takes work, but worth it if you want to be in control of if/when you get pregnant. Sorry this was so long!
Please feel free to email me if you want anymore overbearing/unwarrented advice or horrible scary twin stories!! haha!
-Trish

I have not had any children and successfully use IUD w/out hormones. I don't like yet another variable to deal with. I do see a regular spike just before I get my period but I have only just started to get the hang of this to begin to recognize the patterns. I recently found a site to help visualize with charting & timing of my cycle http://go28days.com/ combine this with a decent bg graph and a usable pattern might emerge.

I just got married in March and studied a lot about different birth control options. I've been type 1 for 13 years and am currently in nursing school and definitely dont want to get pregnant at this point. i knew the combo pills had the added blood clot risk (altho its a slim one) and wanted to avoid those all together (i knew i would just worry about it too much). My dr actually told me that I shouldnt have an IUD if ive never had any kids...and when i read about the very slight chance that an IUD could become embedded or put a tear in your uterus and possibly mess up your chances of getting pregnant later, i decided against it. i dont want to put anything up there that could mess me up. Also the nuva-ring contains estrogen and has as much of a blood clotting risk as the combo pills (if not more) and the depo shots dont contain estrogen but if you happen to react to it weird, its already in your system and active for 3 months. there are some studies and controversial statements that suggest it can deplete your bones of calcium and they arent sure if it can be replaced...which is why they suggest you only be on it for a couple years. I personally hate dealing with birth control and became so frustrated with the whole thing because there isnt anything out there without a side effect or chance of something bad happening and I'm a bit of a hypochondriac and just over cautious with this stuff...lets just say i decided on the Errin pill that you're on now. it seemed the least harmful. i started out feeling fine the first couple months altho i had some weird cramping off and on when i wasnt on my period, which my dr didnt seem concerned about. my periods were always somewhat irregular before i even got on the pill and so the pill just followed the same pattern. my periods are shorter and a little lighter. now that im nine months into taking it, i feel like my moods have been all over the place. my emotions seem to be right on the surface and i cry a lot more now. HOWEVER, i did just start nursing school 2 months ago and it has stressed me out more than i have ever been stressed, lol. which has made my sugars wacky and emotions all over the place. i dont know if the pill has anything to do with it. Also, i talked to my endo before i started Errin and he said it shouldnt mess with my sugars at all...and for the first 6 months it didnt, so it must just be stress. anyway! the thing with Errin and every other BC out there is you wont know how it will affect you until you try it and sometimes it may take a few months for your body to adjust. Give it a go! and dont be afraid to go the condom route, everyone told me it would be awful and not as fun but its not bad at all. (sometimes we "double-up" -- condom and the errin pill cos i get freaked out about getting pregnant....yes, im crazy) You make it what you want it to be :) do what you have to do for the time being so that you can have yourself a healthy pregnancy!

Honestly, Kerri? I went off the pill four years ago in favor of good old fashioned trojans. (ack! i just typed trojans and now it's on the internet forever!)

I went off the pill after we suspected it was messing with my cholesterol levels. Even on the lowest dose hormone they could find for me, my cholesterol went up 30%.

I'm hoping to be released for conception soon because I have my A1cs down to the 6s now. But up until now, for what it's worth, traditional contraception methods have served me well.

I'm not on the pill due to many reasons, including the craziness with affecting blood sugar. I'm also extremely sensitive to any medications etc, so if there was a side effect to be had, I would get it. I tried so many different pills over the yrs. I finally said enough.

So we're just very careful. Like you, I'm a young newly married (3 yrs). Luckily I have very regular periods on my own, so we use natural birth control. Risky some say, but it's worked for ahem 4 yrs...

My last A1c was around 7, my dr's have told me I'm probably fine if I get pregnant. But personally I'd like to be below 6. I don't know if that will happen for me...I've never had one that low my entire diabetic life.

But we'll just wait and see. I'm working on it...all the time.

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