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Birth Control/Birth Control Options


I just had my appointment with my OBGYN this morning, and I'm a bit stressed out now. For the majority of the last 10 years I've been on birth control pills. Most recently on Lo Loestrin. My doctor is concerned about my blood pressure (it's been up and down in the past, and was high again today). She is unwilling to write another script for me for any type of pill.

She gave me three options, and sent me home with the info for them, which I've looked over. In 2 weeks when I'm finished with my current pill pack I need to switch to one of these she says. The options are: Mirena, Depo-Provera. and the Depo-SubQ which she said is the Depo shot, but one you can give yourself.

I've loved being on both the Loestrin and the Lo Loestrin. Not only because it's been effective birth control, but because my periods are much more tolerable. When I'm not on the pill my periods are 8 or 9 days and extremely heavy, to the point I've had to have ultrasounds, and found out I had endometrial hyperplasia. I also was anemic from my heavy periods in the past,and had to take iron which killed my stomach. With the Lo Loestrin my periods are only a few hours of spotting and I absolutely love it.

So the main thing I'm wanting besides effective birth control is something that will make my periods tolerable, and this is why I'm upset about not being able to stay on the pill. After reading the information I see that all 3 options say they can lighten periods, but I'm fearful of the side effects. I'm already overweight and really struggle with my weight and I'm scared of weight gain with the Depo.

I'm also freaked out after reading the Mirena brochure, which talked about how if pregnancy does happen the Mirena can cause loss of the pregnancy or even loss of fertility, and it mentioned the possibility of it perforating the uterus and requiring surgery to remove. That scares me to death. I've already lost 3 pregnancies and don't want to live in fear of conceiving while on the IUD and having something tragic happen.

With the Depo, I'm scared of the weight gain and I'm also scared of it worsening my depression (which I've struggled severely with). I feel like my doctor is giving me poor options. I tried to tell her this, but she said she wasn't going to argue with me, and that these side effects weren't as bad as having a stroke.

Which birth control would you think would be best for my situation? Which would lighten periods the most, the Depo or the Mirena? Can you think of any other options besides the three my doctor recommended? I need to make a decision soon, because I need to switch to something else in 2 weeks and schedule the appointment and get insurance authorization prior to that. Thanks for your help.

I think the Mirena would be a good option for you.  We often use it in women to control heavy periods, and it almost always does.  Pregnancy is unlikely, but if it does occur, miscarriage is possible.  As long as the Mirena is removed at the first sign of pregnancy, miscarriage is not likely.

If you read the package insert with birth control pills, it will usually be equally scarey regarding all the possible risks and dangers.  The Mirena is considered a very safe method of birth control.  Pregnancy itself is a pretty hazardous condition.

I don't believe that the Mirena will cause loss of fertility except in pretty unusual circumstances.  Perforation of the uterus can occur with any IUD, and may require surgery.  Usually that means laparoscopy, and is a minor procedure.  Perforation is fairly rare.

Depo provera can be associated with both weight gain and depression, so I think it would not be the best option for you.

I think your doctor has given you good advice.

Birth Control

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Norman Solberg


I am an OB-GYN physician. I can answer almost any question related to women's health.


35 years in an active OB-GYN practice.

Fellow, American College of Obstetrics and Gynecology

MD OB-GYN specialist

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