Is Levora® making your PMDD worse?
We're going to take a little side trip today,
because in the past month alone I've had over 100 requests for information on
this subject.
According to information
provided by the website
Drugs.com, it's possible.
Levora® is a combination drug that contains female hormones
that prevent ovulation and also causes changes in your cervical mucus and
uterine lining, making it harder for sperm to reach the uterus and harder for a
fertilized egg to attach to the uterus. It's primarily used as an oral
contraceptive that provides 21 active white tablets and 7 inactive peach
tablets.
The tablets contain levonogestrel
(a totally synthetic
progestogen) and ethinyl estradiol (a synthetic estrogen).
Inactive ingredients in the pills include FD&C
Yellow No.6 (which may contain aluminum) and three forms of lactose.
For more specific information on patient-reported Levora
side effects, go to: the
Rate a Drug site
It should also be noted that continuous combined birth control formulas (such as the one found in Levora®), as opposed to sequentially-based hormone regimens that
mimic the natural female cycle, have also been shown to frequently lower a
woman's sex drive.
According to Dr. Winnifred B. Cutler, in her book,
Hormones
and Your Health, a test on monkeys showed that the combination of ethinyl
estradiol and levonogestrel (the combination in Levora®) caused large elevations
in the stress hormone cortisol, as well as great increases in their heart rates.
Rising rates of
cortisol, among other things,
messes with your metabolism, causes you to gain weight and suppresses your
normal immune functions, leaving you susceptible to every cold and flu that
comes your way.
In time your body can
get so run down that you develop something serious, even terminal.
For instance, Dr. Cutler also recommends that women avoid
ethinyl estradiol after age 45 because it also increases the risk of having a
stroke. In fact, she recommends that (no
matter what your age) you have your triglycerides and CRP (C-reactive proteins)
checked (via blood tests) if you start ANY oral estrogens at three and/or six
months after you start taking them. You
will need to switch hormone regimens if your CRP or triglycerides rise, as
rising levels of either of these is predictive of heart disease, even more so
than rising levels of LDL (aka the bad) cholesterol.
No matter what form of oral contraceptive you may be taking,
I urge you to find out what exactly is in it, and if it is a continuous formula
or a sequential one. This will go a long
way in determining which side effects may or may not apply to you. Besides, it's just plain smart to know what
you're putting into your body. For
instance, if you're having trouble thinking and remembering things, it might be
due to the ethinyl estradiol in your hormone pills. "Estrogen like" as in synthetic
estrogens, is not the same as bioidentical estrogen. Far from it.
Each will have a different impact on your thinking processes.
The rest of the information that follows seems to be the
standard patient information for all oral contraceptives, which include Levora®,
but may or may not be specific to Levora®.
Still, I looked up the medical terminology you find in your patient
information packets, and translated them into everyday words we can understand.
That said, you should not take any combination
birth control pills if you have high blood pressure, heart disease, a
blood-clotting disorder, circulation problems, diabetes, pre-diabetes, unusual
vaginal bleeding, liver disease or liver cancer, jaundice caused by birth
control pills, a heart attack, stroke, or blood clot. Note that there is the possibility of a risk
of heart disease even in very young women who take oral contraceptives. So if you are young, don't go around thinking
you're invincible. While a cause and effect relationship has not been
scientifically established, some studies have also reported an increased
relative risk of developing breast cancer, particularly at a younger age. This increased risk appears to be related to
how long you take the pills. The risk
for benign liver tumors increases after four or more years of use. (Death can occur if a tumor ruptures.) Studies have also shown an increased risk of
developing liver cancer in long term (greater than 8 years) use of oral
contraceptives.
You should discontinue use of your oral contraceptive if you
experience unexplained or complete loss of vision, bulging eyes, swelling of
the optic nerve, or lesions (scars, bumps, bubbles) in your retinal veins.
Also, be aware that cigarette smoking increases the risk of
serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy
smoking (15 or more cigarettes per day).
If you do smoke while taking oral contraceptives, some nasty
things that can happen include heart attack, blood clots (in the lungs and
legs), stroke, liver tumors, and gallbladder disease.
The risk increases significantly if you
already have high blood pressure, high cholesterol, diabetes,
and/or are obese.
Obesity is defined as having a body mass
index of more than 30.
You can figure
out your BMI here.
Oral contraceptives have also been shown to cause glucose
intolerance in a significant percentage of users. Oral contraceptives containing greater than
75 mcg of estrogen (which Levora® does) can cause abnormally high levels of
insulin. People with too much insulin have frequent episodes of low blood sugar
(hypoglycemia). These episodes can be characterized by a lack of energy
(lethargy) and/or irritability. Repeated episodes of low blood sugar increase
the risk for serious complications such as seizures, intellectual disability,
breathing difficulties, and coma.
Lower doses of estrogen cause less glucose intolerance, but the
progestogens in your oral contraceptive can also increase insulin secretion and
create insulin resistance.
Therefore
pre-diabetic and diabetic women should be especially careful while taking oral
contraception.
Talk with your doctor
frequently.
The incidence of high blood pressure also increases with
increasing concentrations of progestogens.
Women with a history of high blood pressure or high blood
pressure-related diseases, as well as kidney disease, should use another method
of contraception.
If you start to get migraines, or your migraines become more
severe, stop taking oral contraception until you determine the cause.
When taking any oral contraceptive, you should follow up
regularly with your doctor. You need to
pay special attention to your blood pressure, breasts, abdomen and pelvic
organs, including pap smears. Women--especially
younger women--with a strong family history of breast cancer should think twice
about taking oral contraceptives.
Birth control pills can also be a problem if you have
varicose veins, a history of depression, an
underactive thyroid, seizures or epilepsy, and/or a history of fibrocystic
breast disease, lumps, nodules, or an abnormal mammogram.
As with any drug, you could have an allergic reaction to
Levora®.
If any of these adverse effects
occurs while you are taking oral contraceptives, call your doctor immediately:
·
Sharp chest
pain, coughing of blood or sudden shortness of breath (indicating a possible
clot in the lung)
·
Pain in the
calf (indicating a possible clot in the leg)
·
Crushing
chest pain or heaviness in the chest (indicating a possible heart attack)
·
Sudden
severe headache or vomiting, dizziness or fainting, disturbances of vision or
speech, weakness or numbness in an arm or leg (indicating a possible stroke)
·
Sudden
partial or complete loss of vision (indicating a possible clot in the eye)
·
Breast lumps
(indicating possible breast cancer or fibrocystic disease of the breast: ask
your doctor or health care provider to show you how to examine your breasts)
·
Severe pain
or tenderness in the stomach area (indicating a possible ruptured liver tumor)
·
Difficulty
in sleeping, weakness, lack of energy, fatigue or change in mood (possibly
indicating severe depression)
Jaundice or
a yellowing of the skin or eyeballs, accompanied frequently by fever, fatigue,
loss of appetite, dark-colored urine or light-colored bowel movements
(indicating possible liver problems)
It's the references to depression
and anxiety that concern and confuse me. Why would a doctor prescribe something for
your PMDD when it could cause more of the very same symptoms you already have? Plus increase your chances of developing
heart disease, among other things.
Side effects they
don't consider serious (but you might) include:
Increased blood pressure
Mild nausea
Breast tenderness or swelling, nipple discharge
Freckles or darkening of facial skin, increased bodily hair
growth, loss of scalp hair
Rashes
Changes in weight or appetite
Fluid retention, particularly in the fingers and ankles
Problems with contact lenses
Headache
Anxiety
Dizziness
Vaginal itching or discharge
and
Decreased sex drive
And this is not a complete list of side effects.
Special note: Certain drugs can make birth control pills
less effective: These include Phenobarbital
and other barbituates, seizure medications, and St.
John's Wort, which many PMDD women use to counter their depression. So beware if you are self-medicating with St.
John's Wort.
In all, there doesn't seem to be a lot of scientific
information on the internet specifically about Levora® making your PMDD
symptoms worse...which is probably why people are looking for it. I hope this post has answered some of your
questions, or at least pointed you in the right direction for the answers you
seek.
That done, I need to get on my personal bandwagon and ask you
to
reconsider using birth control to treat your PMDD.
Is the increased risk of heart disease, the
number one killer of women, worth the risk of masking your PMDD symptoms for a
few years?
Think about this.
Just because fertility and PMDD both involve
hormones does not mean the medications for them are interchangeable.
That's like throwing something against a wall
to see if it sticks.
A good naturopath
or nurse practitioner should be able to help you come up with a hormone regimen
individualized for
your needs and
your body.
The problem with PMDD begins at ovulation. Did you know bioidentical estrogen in high
enough doses can prevent ovulation?
Without all the unpleasant side effects listed above.
I'm not recommending bioidentical estrogen as birth control,
but to help manage your PMDD in a positive and healthy way? It's certainly worth a shot. Especially if you're in peri-menopause.
Of course you can't take unopposed estrogen in any form
without adding back some progesterone, but again, with the right medical
supervision, you can work out a regimen that best suits your body and needs and
lifestyle. That best suits YOU. Rather than the one-size-fits-all mentality
that prevails in the marketplace now.
Don't you deserve to be treated as the individual that you
are?
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