oral contraceptive pill/Heavy painful periods/Thyroid

[Guest Jackie]

is it safe to use oral contraceptive pills after SAH?

[Blondie]

Hi Jackie

You would need to talk to your GP before taking any contraception pills post SAH. I was stopped from taking most types of contraceptive pill immediately, and have been warned that certain ones will never be suitable again.

I went along to the Family Planning Clinic for advice and they just referred me straight to the GP.

Best wishes

Blondie

[Guest Jackie]

:? I seem to have a whole lot of GP's at my surgery which i would not take any advice from what so ever....hence why i thought asking here might help, which it has, I would rather take advice from fellow SAHer's than a GP.

[Karen]

Hi Jackie,

As Blondie has said, you should always seek professional advice ....

I take the contraceptive pill .... I did a bit of research into it as well....I currently have a v.good GP (after seeing a few dud ones) and he was happy to prescribe it......The contraceptive pill is much more of a risk and probably wouldn't be prescribed to those that have had a stroke, the clot type, rather than a bleed......it's the risk of thrombosis, which is the forming of clot in a blood vessel or heart...... our SAH/Stroke was caused by a burst artery, so nothing to do with thrombosis.

Hope this info helps......I can only re-iterate that the contraceptive pill has it's own risks, but as far as I can see, there was no evidence as to why I couldn't take it post-SAH. Like with any drug, there's always a risk of side effects and you just have to weigh up what's good for you.

[Guest Jackie]

you speak volumes of sense, thank you so, so much

kind regards,

Jackie

[Karen]

Hi Jackie,

Glad it helped.......but I would imagine that if anybody was still smoking after their SAH or had high blood pressure.....then the GP might say "no" to the contraceptive pill, which is probably no different than for anybody that hasn't experienced a SAH.

I also suffer from cysts on my ovaries, so the hormones in the contraceptive pill, stop ovulation and keep me from having ovarian cysts......that's my mean reason for staying on it. Ovarian cysts are like giving birth.......without the baby......v.painful! (My medical history is a nightmare.......I blame it on Genetics!)

I believe that there is now a very good contraceptive coil device called the "Merina", "Mirena" coil (spelling?.....please chip in if this is wrong) it normally stops you from having a period or makes you much lighter (that's what I was told!) ..... I've always had very heavy periods, so it was an option, but unfortunately, one of the side effects were ovarian cysts......so, it was "no thanks" in my case and the lesser of the two evils!

Personally, I just researched and weighed up the pro's and con's ..... everybody is different.....

Hope that you are keeping well....xxx

[Blondie]

Hi Karen - are you on the mini pill? The one you have to take at the same time of day, and without a break? They are the only ones I am allowed since the SAH - whereas I would prefer the ones where you stop taking them for a week.

There was actually a section in my GP's big book (!) headed: Contraceptive pill for women post SAH (coiled) - which made me laugh no end. Aside from that I discussed the pill one of the consultants at the FPC who I know personally to be very good, and she said that is was usual only to prescribe that type of pill I'm on now to post-SAH women.

As always it just goes to illustrate further how we get treated/advised differently across the country!

[Karen]

Hi Blondie,

No, it's not the mini pill ..... it called Loestrin ...... I was told that as long as BP was okay, being a non-smoker, cholesterol okay etc ... it was fine and that there wasn't any reason why I couldn't ..... as the stroke, wasn't caused by Thrombosis ..... what reason did they give you as to why, you could only be prescribed the mini pill?

I'm not able to find any reason for the contraceptive pill causing aneurysms to form/burst/bleed or non-aneurysmal SAH's? .....

You're right ..... There is a definite lack of clear info post SAH on the do's and don'ts ....

[Karen]

This is definetly a hard one .... and probably a minefield! ....

All I can say is ..... when I see my GP, I'm going to pose the question again ..... at the minute, taking the contraceptive pill for myself, due to having ovarian cysts since my teens, is my main reason for taking a combined pill .... I used to take the mini pill after my first pregnancy, but it wasn't suitable and I developed more cysts.

It does make you wonder why, women are more susceptible to SAH then men? There's a 101 questions that could be posed .... we could take this topic further .... the biggest common factor between us, is that most of us smoked pre-SAH and enjoyed a drink or two. I have also suffered migraines since my teens and they worsened after childbirth. I've also noted that a few of the male members on this website, have also had migraines. Hard drugs, such as cocaine are also mentioned on a lot of medical papers about SAH.

It's definetly a hard one to answer .... so, my conclusion is, that you have to pose the question to the professionals, research it and then make your mind up, by weighing up all the pro's and con's......

[Blondie]

Hi Karen, thanks for that... I wonder if it's because I'm an ex-smoker? I gave up when the SAH happened, but I smoked heavily before that.

It was a long time back, and I don't remember the exact detail now, but I'm sure they just said it was due to the increased risk of stroke - which annoyed me no end at the time.

Otherwise I can only assume it is the geographic difference!!

Blondie x

[Guest Jackie]

well I seemed to have opened a whole canof worms here girls!

I tell you I really think sites like this one are an absolute life line, no one can really tell us all the answers even the neurologists...my tack ha always been, no haemorrhage, no comment! So all your bits of information are ever so helpful to me.

oh by the way I manage to piece together my SAH experience by volunteering earlier this year with Wolfson(Cambridge University) brain imaging dept, their help was invaluable in assessing my brain, why it aall happened, they even shot down the GP's who palm us of with drugs afterwards instead of talking to us and listening to us. i also got hold of my medical records which read like a book and founf my SAH was not just middel cerebral but was in my Sylvian Fissure, responsible for languages and complicated words, it all began to add up and hence why i was texting people in Dutch for a while (I lives the previous year before my SAH in Belgium) and my brain craved really complicated books.

I am still a smoker though not very many now and determined to give them up, the research lot reckon my life was saved as I have always had remarkably low blood pressure! And it still is, I want to go back on the pill to stop these painful period pains I am getting, I was told years ago by a gynacologist that being on the pill is the only way to stop the pain, been off the pill for 18 months now, cannot stand the pain any longer and want to stop it as I feel I have been through enough.

Thank you girls for all your information and as ever , it is all so very valuable. lots of love, Jackie XX

[Guest Jackie]

sorry about the spelling mistakes, brain is a we bit tired...but ehn you all understand squiffy language!!! JX

[Blondie]

Just seen your last post Karen... I'm going to ask my doctor again - even if he does sigh and look frustrated every time I mention the SAH, it would be good to know their logic behind the decision to keep me to this type of pill.

I also suffered bad headaches pre-SAH, even as a child, although they were less frequent then.

You're right Jackie, no problems with the squiffy typing

Blondie

[Karen]

Hi Ladies,

Well, this is a can of worms and I can only relay my own personal experience ..... Firstly, I've always had heavy and painful periods..... They have become worse since the SAH, so I'm going to ask the GP what the results were for my Thyroid function test. Apparently, an underactive thyroid can be the cause of heavy periods and a huge myriad of other problems.

The Pituitary & Hypothalamus is extremely close to the Circle of Willis....which is where we've have had an aneurysm....from what I've researched, both can be affected after a SAH. Blondie, I know that you said that you have a problem of not putting on enough weight or keeping it on?

I've recently found a med paper that I shall be taking to the Doc's (yes, he's going to love me, isn't he? )

Anyway, here's a few quoted parts from the paper:

It has been suggested that aneurysmal subarachnoid haem (SAH) poses a risk for hypothalamic-pituitary dysfunction, given the proximity of these structures to the arterial circle of Willis.

Posthaemorrhagic local tissue pressure changes, high intracranial pressure changes, toxic effects of the extravasated blood, ischemia caused by vasospasm, high intracranial pressure, hydrocephalus, or local destruction during cerebral surgery.

Studies following-up patients who have survived SAH have noted relatively high rates of functional limitations with quality of life impairment, such as fatigue, decreased mobility, loss of motivation, abnormally low independence and participation on measures of social functioning, even in those patients making good neurological recovery. The cause of these functional problems remain, at least in part unclear. Of interest, many of these symptoms are similar to those occuring in patients with untreated hypopituitarism.

Okay, so the conclusion was: Long term survivors of aneurysmal SAH frequently exhibit endocrine changes, with growth hormone and gonadal deficiencies predominating. Thus, screening of pituitary function is recommended in patients surviving SAH. The relationship between late hormonal alterations and functional outcomes in patients with SAH warrants further study.

Okay.....sorry to blind with science ..... but for me....the thyroid also plays a role in the metabolism of calcium ..... which I'm now on supplements for ...... it will be interesting to se what my test results are in a couple of weeks. I also have hair loss ..... amongst many other weird things....also my periods stopped for 3 months after the SAH .... and then returned with a vengeance.

It's worth doing an internet search and taking a peak at the Pituitary & Hypothalamus.....

I'm sure that this thread will run and run.......

[Blondie]

Hi Karen

Thanks for that. You're right, I find it hard to put weight on and to keep it on, though I do weigh quite a bit more than I did pre-SAH.

My periods were heavy and painful pre-SAH but are actually a lot better now, lighter and less painful.

I'll be having a bit more of a look online, thanks for the pointers, and letus know how you get on at the docs

Blondie

[Karen]

Will do! It's probably another madcap theory for the Doc to dismiss....but due to see him Sept 20th ... (armed with an A4 diary and a a wad of print-off's! )

[Guest Jackie]

just found something which may interest you girls.

for the full information see this link and look for the heading risk factors.

http://www.emedicine.com/med/topic2883.htm

I have also found other ones as well saying the same thing and as they are all from neurologists I am inclined to believe the experts in their area and not the General Practitioners who seem to have conflicting information

Risk factors

Although risk factors for SAH have been evaluated extensively, little conclusive evidence has been derived. Smoking appears to be a significant risk factor, as does heavy alcohol consumption. Data regarding the relationship between hypertension and SAH are conflicting. The following do not appear to be significant risk factors for SAH:

Use of oral contraceptives

Hormone replacement therapy

Hypercholesterolemia

Vigorous physical activity

I hope this helps.

Jackie

[Karen]

Was stress mentioned? I seem to have had stacks of that in the last 7 years or more..... I shall take a peak at the link, Jackie .... gosh, this is a minefield....

[Guest Portia del Carmen]

That was a fairly in depth read for this time of night...

I have given up asking my GP practically anything, let alone anything SAH related - my neurosurgeon is very email efficient when necessary!

He told me no problems for me with oral contraceptives since the risk with them is clotting - but I suspect that the answer will depend on other effects of the SAH such as ischaemic effects.

For me I was unwilling to go back on the pill after the 1st SAH as I'd only been back on it for a couple of months before the bleed. Almost certainly no causal effect I'm sure, but the brain does funny little things, after all (!) and I wasn't too sure of my memory function at the time, which is especially important with the "mini-pill"

My GP therefore suggested an IUD which was fine although my periods became very much heavier over the 3 years it was in. When I came to have it replaced the (now female and much more down to earth) GP suggested the one with a hormone implant (Mirena I think, as referred to above) which has been an absolute miracle. Periods much less, almost not there (but sufficiently there so I don't panic!) no pain and it seems less hormonal emotion, although not sure hubby woukld agree with the last bit.

I would say ask your consultant over anything that makes you feel nervous - GPs aren't and can't be the experts on everything they have to treat/ deal with after all. Mine still expresses surprise I can even talk whenever I go in to see him... which may be said with the best will in the world but it's a tad annoying and disconcerting!

[Karen]

I can remember somebody quoting what their GP said post SAH .... "We GP's know a little about everything" ...... In my opinion, I think that you have to do your research and then do what's comfortable for you ........ take advice and do everything in your power to find the "in's and out's" ... only make a decision, if you know that it's right for you ..... we are all very different ... pre-SAH and post-SAH.....

All I can say is, thank goodness for the internet .....

[Skippy]

Hey there

I have the Merina (although I sometimes get it mixed up and say Mereva which would imply I have a Vauxhall people carrier about my person!!!). I've had mine if for three years now and it's fantastic. No periods and very little pain if any around the time of ovulation. I forget it's there and don't have to worry about periods anymore - just shaving - is this what it's like to be a man!!! WOW!!!!!!! But seriously, I'll be using the Merina for as long as possible.

Cheers

Sami xxx

[Guest Portia del Carmen]

Rossigirl!

I am so glad you mentioned shaving... which sounds a bit odd but I have had a real problem with lower chin hair since having this coil - hadn't thought about it in those terms before!

Chinese medicine says that anything (hair, spots, etc) on the chin part of the law bone for us girls is hormone-related - and this explains it!

Never had the problem in the past when I took the pill which always put up my blood pressure. Knowing I'm not the only one with the tweezers out every morning makes me feel so much better!

[Janet]

Hi Sarah

It must be hormone related as I get the same problem as you with the hair on the chin but I don't use any sort of contraceptive device.

I had a hysterectomy in 97 but because of my age then 34 they left the ovaries rather than induce an early menopause. Side effects are my hormones seem to make my body produce more hair and its much coarser than it used to be.

Janet x