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As long as you're relatively healthy just about any of the pills would be fine to start with for a 3 month trial. Any adjustments can be made from there is you have any side effects. As a general rule of thumb, starting with a pill with about 20-30 mcg of estradiol is a good choice. Lower estradiol pills have a higher rate of break through bleeding and are more senstivie to taking at exactly the same time daily. The higher estrogen pills with more than 30 mcg of estradiol will have a higher rate of side effects such as nausea and breast tenderness.
None of the pills should impact weight gain much at all but occasionally a woman will have some bloating, in that case a different pill can be tried.
The main differences in the pills have to do with the type of progesterone in the pills. There are at least 1/2 dozen different choices there. The newer progesterones have a slightly higher risk of blood clots so generally speaking, for a new pill start, I tend to use one of the older generation pills.
These include levonorgestrel or norethindrone.
Side effects are much less predictable and include moodiness. If a woman is having trouble with one pill regarding moodiness, we switch to a different progesterone.
All pills will tend to decrease blood flow and cramping plus improve the skin, both acne and decreasing unwanted facial hair.
But some women have worsening on some pills with improvement on others in an unpredictable fashion.
In terms of the brand, there are MANY generic equivalents so that it's impossible for me to list all the pills that are reasonable to start with. I see you're in the UK so let me try to find a few names that might be a good start for you. Be sure to read all the contraindications. Migraines with aura is a contraindication. A woman with that who uses BCPs is at a higher risk of stroke. But since you haven't had migraines in a while, it would be ok to try out. But if you have a return of migraines, you won't be able to use the combination bcps if the migraines have an aura.
Alesse Aviane, Lutera are all good pills but there are dozens of others generic with equivalent ingredients.
The main issue is to focus on a pill that has 20-30 mcg of estradiol and contains either norethindrone or levonorgestrel in it.
Stay away from pills with newer progesterones such as gestodene.
I'm trying to find a more useful list.
If you have a list of what you can choose from, it would be helpful. I'll keep trying.
Microgestin 1/20 is a great pill that is usually my first choice for a start. It comes with a wide range of generic equivalents. You may be able to call a pharmacy and ask what are some of the available equivalents or when you submit the request, ask them to substitute any equivalent they have in stock.
Hi,That's great, thank you. I did a bit of research and one of the most common names that came up was Microgynon 30 - I think that could be a similar one to what you advise.
I do have a list of brands, and will have a quick look
Yes correct. In the old days there were so few pills that any gynecologist would know immediately which one it was by having the woman describe her pill! But now there are dozens of them.
Yes I just confirmed that the Microgynon - 30 is a good pill. The progesterone is an older one with lower risk of stroke and the estradiol = 30 which is in the correct range for pill start.
It will control the bleeding better than a 20 mcg pill.
Any other questions?
That's brilliant, thank you. That was the one I was leaning towards anyway as I've heard it's a good one to start with.I do have quite long periods 8-10 days, and also heard it may be able to shorten them?
I want to be sure you have all the information you need for your situation.
Yes, the pills will tend to shorten and lighten them.
Some women have hardly any bleeding at all. The lower the estradiol, the less bleeding there will be. So with 30 mcg it will likely be lightly but not completely absent.
That would be fantastic, I think that's all. Thank you very much for your help!
If the bleeding stay too heavy, you can drop down to a 20 mcg pill instead.
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Thank you! Will do!
ok, appreciate it.