Tuesday, June 27, 2006

More Fun with Birth Control

I don't mean to be harping on about The Pill, but there is a public service aspect to this post. So you may recall that last week I went to the gynecologist and she thought it might help my terrible migranes if I used the pill to skip over periods. Of course, you can do this with any oral contraception if you play around with it, but she suggested Seasonale, the highly marketable drug designed specifically for this usage. So I was talking about this with Medusa, who happens to be an ER doc and she said, "You shouldn't be on an estrogen pill if you have migranes. It increases your rate of stroke. And it would really suck to be a young person who has a stroke." Although I think we can all agree that it would indeed suck to have a stroke at any age, I was kind of skeptical. I'd never heard of this before. The gynecologist either didn't know or didn't consider it a threat. And since I already have an appointment to see my neurologist this week, I decided I'd start the pill as planned since four days of estrogen probably wouldn't kill me. Right? Right?? Then Medusa said that she has a friend who is a neurologist I think she said, and she prescribed the pill to a patient with migranes, the woman had a stroke and now this doctor said she won't prescribe it in such cases.

On Sunday I opened up the hot pink tote bag that my free sample of Seasonale came in. There was a full three months supply provided, so basically after that initial outlay they now have something at stake for me to become a regular user. Also inside the bag was more promotional items including a Videocassette (!?!). Of course, I didn't get to play the video because who the hell owns a VCR these days but I imagine that if I popped it in, I would probably be treated to women in short skirts dancing around to benign pop music singing about how great it is to be a girl. Finally I came to the small print. Now, here's the standing birth control warning:

Like other birth control pills, SEASONALE® has serious risks, which can be
life threatening, including blood clots, stroke, and heart attack and are
increased if you smoke cigarettes. Cigarette smoking increases the risk of
serious side effects, especially if you are over 35. Women who use the Pill
should not smoke. Some women should not use the Pill, including women who have
blood clots, certain cancers, a history of heart attack or stroke, as well as
those who are or may be pregnant.

See, nothing about migrane. But then I kept reading, and in the second iteration of this warning I saw the line that risk of stroke is increased in women with migrane. (You can't find this information any where on the website although they do list the following at risk groups: Smokers, people with high blood pressure, clotting disorders, the obese, people with cancer, heart problems, jaundice and liver tumors.) Then, if you read further in the third iteration of this warning they repeat that women who suffer from migranes are at increased risk of stroke, espeically if your migranes are accompanied by aura, like mine are.

So, what the hell is going on? I've been on several different kinds of birth control pills over the years and I always tell my doctors that I suffer from migranes, but no one has ever mentioned an increased risk in stroke to me. Either the risk is negligent or prescribing doctors don't know about this risk? I will get to the bottom of this soon. In the mean time, if you find yourself in a similar situation, you may want to call your doc and challenge them on this point. If there's anything I learned from television's Homicide (thank you, Det. Pembleton) and Sports Night (thank you, guy who used to play Benson), it is that a stroke is no laughing matter.


Lexa said...

Well, now I am just freaked the fuck out. After months of trying to figure out what was wrong with me (MS was on the table for an uncomfortably long time) I was diagnosed with migranes. But, the special kind. I mean, they are all special no doubt, but with mine I don't experience what you think of when you think migraine. I am actually on anti-seizure medicine to treat my symptoms. I am on bc too, and no one has mentioned this to me either. I guess I can take the attitude of my stepfather when ever I tell him to wear his seatbelt, "Something is going to kill me anyway".

Cupcake said...

Lex, that's terrible. It's true, I saw my neurologist today and he told me a migrane is like a mini-seizure. But, here's what he said: that the birth control pill was safe for people with migrane unless you have a history of clotting disorders. He also said you can further decrease teh risk of stroke by staying hydrated, ie drinking a lot of water, especially in summer.

I said to him, "Are you sure? Are you really sure? Because if I have a stroke I am going to be pissed off and it is going to be all your fault." But he said it was okay.

Anonymous said...

Nance, I say if either one of us has a stroke, we write a very stern letter. To...someone. It's a pact. I type this as I sip my water.

MCMCMCLY said...

if you don't believe the brain doctor you could ask ben and the rock. But the guy is a specialist, so I bet his word is as good as any. Except in that 3rd episode of law and order i watched tonight, but i digress. Take the pill and keep babies and headaches away!

Cupcake said...

I am writing a stern letter to Amtrak right now. I will save the template. Just in case we, you know, stroke. Not that we will. I'm sure we're fine.

PatriotDave, it must be nice to have friends who are pharmacists. Too bad my friends are all whacked-out short-attention span humanity kids. Update: 48-hours headache and baby free!

Anonymous said...

You know that's pretty funny because when I mention in passing to my doc that I may have, at one point, suffered a headache they immediatly call in the National Guard a refuse to give me any BC pill including but not limited to the one I'm taking at that moment.

Meg said...

I just hate when you start BC and you're completely crazy...

But at least you can blame those extra five pounds on it.

Jessica said...

There are lots of different types of migraines, esp. as suffered by women. If you get sparkly peripheral vision weirdness, aka "aura", with your headaches, some formulations of BCP are not recommended. Not all BCPs will make you crazy, or even gain weight - I verified this the hard way, with lots of experimentation. It all comes down to your personal body chemistry. My MD helped me find just the right pill to *keep* me from having strokes from my way too regular migraines. It's working perfectly. If only the little old ladies in the pharmacy didn't look at me like I was killing babies - not a big problem since I switched to mail order, but sheesh. I mean. I'm in fricking Berkeley, not a small town in Ohio.
Good luck!

Samantha said...

I just had a migraine yesterday, and I am accompanied by auras all the time. I was told they are like mini seizures. I am currently on Yasmin and 30 yrs old. I do not have a choice where BC is concerned due to other probs..Does anyone know what bc's is a higher and lower risk? Whenever I see my neuro. I feel like I am being diagnosed for bigger problems than I actually have. NEVER has my neuro told me yeah you shouldn't be on BC for increased risk of strokes(yeah I am freaking out). Do you ever feel like your living a scene of Garden state???? I HATE Amitryptaline!!!