Girls only!

Sounds like a doctor visit is about 5 years overdue.... including what may have caused lack of periods while the hormonal implant was already depleted.

And evaluating whether there should or should not exist concern moving forward (bone density concerns for example).

Doctors are occasionally known to be useful ... if you visit them!🤷🏻‍♂️

Never feel silly about visiting the doctor - I would go and talk it over and make sure everything is okay with your implant. Could be a complete coincidence but best get it checked out

As an aside, years and years and years ago I had irregular (timing) periods, was diagnosed with pcos, and put on the pill to regulate my periods. The doctor said not having them would be toxic.

Is that not true anymore? Was it ever true?

I'm way past all that but now I'm curious because of the whole not having a period for 6 or 7 years thing.

OP: to answer your question

Any stress on your body can trigger breakthrough bleeding when on continuous hormonal birth control. That's not unusual at all, but you should mention it to your doctor, because the stress could be something other than your new diet and the timing could just be a coincidence.

It's normal enough that I wouldn't worry about it, but definitely mention it and take note of the date of when it happened if in the future you ever need to recall the first time it happened.

Fellow Nexplanon-haver here I got my first one placed in November 2016, replaced in December 2019, will be up for replacement again this December 2022 (if I can't get insurance to cover a tubal). For most of the past 5 years I've been in the 200-250lb range, and other than about 6 months of spotting after the initial placement, had experienced 0 periods and 0 babies throughout that time. Once I got close to, and then passed, the 200lb mark into Onederland, my period came back - I think it had more to do with being Class II obese and then losing 50 lbs than anything to do with the implant itself, though. Small silver lining, I haven't had many symptoms besides, uh, the main one, so to speak - no cramping, no obvious PMS (I did have a brief anxiety/irritability spike over the weekend but I don't know if I just overbooked/overtaxed myself with social stuff or if the period was the culprit).

glassyo wrote: »

Xellercin wrote: »

glassyo wrote: »

As an aside, years and years and years ago I had irregular (timing) periods, was diagnosed with pcos, and put on the pill to regulate my periods. The doctor said not having them would be toxic.

Is that not true anymore? Was it ever true?

I'm way past all that but now I'm curious because of the whole not having a period for 6 or 7 years thing.

No, that was never true. Even using the word "toxic" is just ridiculous.

You don't even get a period on the pill, you get what is called a "reassuring bleed," which isn't a period and serves no real purpose other than to mimic a period, just so that you will feel reassured.

Having regular periods actually significantly increases your chances of developing cancer. In fact, a lot of the original research behind the pill was for cancer prevention.

I personally haven't had regular periods in over 20 years. I have Mirena and plan to until menopause. My husband had a vasectomy and I still have a Mirena just to avoid having periods. I actually can't fathom voluntarily going through that every month for decades.

I had a few periods in 2019 when I took a few months to replace my last Mirena, and every time I got a period I would start yelling at the top of my lungs "THIS IS UN-F$&KING-CIVILIZED!"

Honestly, I don't know how women tolerate it.

Thanks! To be fair, this was in the early 80s so.......

Periods are annoying and expensive but I guess I got lucky since I never really had cramps or PMS (some would say I'm making up for the PMS part now 😁).

You said you're past this, but for others with periods:

Expensive? Try menstrual cups!

https://gladrags.com/collections/menstrual-cups

Other brands can be cheaper on Amazon but I like this brand very much.

kshama2001 wrote: »

Xellercin wrote: »

glassyo wrote: »

As an aside, years and years and years ago I had irregular (timing) periods, was diagnosed with pcos, and put on the pill to regulate my periods. The doctor said not having them would be toxic.

Is that not true anymore? Was it ever true?

I'm way past all that but now I'm curious because of the whole not having a period for 6 or 7 years thing.

No, that was never true. Even using the word "toxic" is just ridiculous.

You don't even get a period on the pill, you get what is called a "reassuring bleed," which isn't a period and serves no real purpose other than to mimic a period, just so that you will feel reassured.

Having regular periods actually significantly increases your chances of developing cancer. In fact, a lot of the original research behind the pill was for cancer prevention.

I personally haven't had regular periods in over 20 years. I have Mirena and plan to until menopause. My husband had a vasectomy and I still have a Mirena just to avoid having periods. I actually can't fathom voluntarily going through that every month for decades.

I had a few periods in 2019 when I took a few months to replace my last Mirena, and every time I got a period I would start yelling at the top of my lungs "THIS IS UN-F$&KING-CIVILIZED!"

Honestly, I don't know how women tolerate it.

@Xellercin I was just prescribed norethindrone acetate. I'd been taking prometrium to regulate my periods, and it had stopped working - I was getting one every 2-3 weeks.

I'm supposed to take the norethindrone acetate continuously, and I guess I won't have a period. If this is true, I cannot for the life of me understand why my GYN didn't prescribe this years ago - I have very large uterine fibroids, heavy bleeding, have been struggling with anemia for some time, and in 2020 ended up in the ER for a blood transfusion after a blood test showed a ferritin level of > 2, and have been getting periodic iron infusions ever since.

My mind boggles at the thought of not having a period, so it was good to read your post.

As I said, if you've been on birth control, you haven't been having periods, you've been taking your pills in a way that imitates a period, but it isn't a period and never was. Think of it this way, pregnant women don't get periods and hormonal birth control mimics pregnancy, so why would you get a period? You don't, you get drug withdrawal and that's what causes the bleeding.

Now that said, if you are on hormonal birth control, your uterus still will need to bleed occasionally as it does need to shed some lining sometimes, and if you have fibroids and are prone to heavy bleeding, a continuous pill won't necessarily stop that. It will just stop the "reassuring bleed" caused by withdrawal from the drugs every month. I'm prone to heavy uterine bleeding too and I get fairly frequent bleeding, sometimes for a few days, and it can be heavy.

It's still not a period.

So don't feel weird about not getting a period because you haven't had one in years. You've had breakthrough bleeding that you induced regularly by purposefully putting your body into withdrawal of the hormones. If you don't induce this withdrawal on purpose, you will still bleed, but more unpredictably. If you had a healthy uterus, you might bleed very very little and very infrequently. But since you have fibroids and bleeding problems, you may bleed less, you may bleed more, it's impossible to say, but it certainly sounds like it's worth trying something new.

Don't think of this as some huge change, it isn't. It's just a minor adjustment to the schedule of how you take your hormones, which will adjust how and when your uterine bleeding occurs. But none of it is a period, so don't feel weird about losing something you haven't had in a very long time.

As for why doctors don't automatically recommend it? That's a good question for your doctor, but it has to do with how the drugs are approved. Only some drugs are marketed as continuous use, others aren't. If they aren't, then the doctor has to prescribe them "off label" if they're going to be used continuously, which means the doctor has to be comfortable with that.

Some pills are better for controlling bleeding than others, even if they have a week of withdrawal and a "reassuring bleed" every month. The overall level of bleeding might be less on these pills for people like you who have fibroids. Because the bleeding isn't a period, it's heaviness has nothing to do with periods. So different pills will have different impacts on your bleeding level. It's really trial and error when dealing with an abnormal uterus that bleeds for abnormal reasons.

In your case it's a matter of finding which drug best mitigates your bleeding levels, regardless of the schedule of pills and placebo. I hope your new pills do a better job than the last ones, but it's impossible to predict. I'm sorry you are dealing with this. I have an a-hole uterus myself, but no fibroids, and I'm well managed with Mirena. It took me a decade of trying things to find what works for me, and I would lose it if I developed fibroids and started bleeding like crazy again.

Good luck, and don't ever hesitate to ask your doctor A LOT of questions, it's their legal obligation to inform you enough about treatment so that you can give "informed consent." If you don't ask, they're legally allowed to assume that you understand enough to decide. It's your responsibility to speak up when you don't, and it's their job to make sure you feel confident in deciding which pills to try next. That's technically NOT their choice, it's yours.