End Fatigue

Birth Control Pills and Hormone Replacement Can Be Taken Every Day

Wiped out around your period? This often reflects estrogen and progesterone deficiency, and can be helped with bioidentical hormones, or even the birth control pill. But you do not need to stop them for a week a month (and feel awful) — you only need to stop 1 week each 6 months.

Estrogen and progesterone levels drop around one's period, which is what causes the period to occur. These hormones are critical for sleep and energy, and in women who are already deficient, the drop in hormone levels can cause fatigue, pain, insomnia and often anxiety — leaving them miserable around their period. These women are also usually estrogen deficient the rest of the month, and the questions that I find best tells me who needs treatment for estrogen deficiency are:

	Are your fatigue/achiness symptoms worse around your period?
	Do you have decreased vaginal lubrication?
	Do you have day or night sweats or hot flashes?
	Have you had a hysterectomy, ovaries removed, or a tubal ligation?
	Do you have decreased libido?

We have safely used this approach of not cycling the hormones in women who feel worse around their period for almost a decade (this is not the first study showing it is an acceptable approach). In this placebo controlled study, women either took the birth control pill every day or in the usual cycled manner for 6 months.

Women in both groups had the same number of bleeding days, but those who did not cycle the pills, taking them every day, had much lighter periods along with less menstrual pain. They also felt better.

This is not to be confused with PMS (Pre Menstrual Syndrome) which is where you get so irritable that those around you fear for their lives. PMS reflects deficiencies in progesterone (your holistic doctor can add bioidentical progesterone around your cycle), magnesium (take 200-400 mg a day), vitamin B6 (take 200 mg a day) and essential fatty acids (take primrose or borage oil 3,000+ mg every day for 3 months and then just for the week before your period). Give these 3 months to work, but they can be very helpful.

For those of you who feel fine during the week off your pill, I would keep cycling it (3 weeks on, 1 week off). For the rest of you, ask your doctor to OK your stopping it only 1 week each 6 months. Why feel miserable each month when you don't have to?

References

Richard S. Legro, Jaimey G. Pauli, Allen R. Kunselman, Juliana W. Meadows, James S. Kesner, Richard J. Zaino, Laurence M. Demers, Carol L. Gnatuk and William C. Dodson. Effects of Continuous Versus Cyclical Oral Contraception: A Randomized Controlled Trial. Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc. 2007-2287; Vol. 93, No. 2; 420-429;2008; Click here for online article.