Continuous birth control question

[ReliableLake]

I'm going to ask my pharmacist when I fill my prescription (which won't be for a few days). I just wanted to ask here first.

I was just prescribed Seasonale by my doctor (a continuous combo pill where you get a period every 3 months).

I've been on Seasonique many years ago (also a continuous birth control where you get 1 period every 3 months). I had stopped because it started giving me yeast infections.

My doctor has recommended that I take Seasonal but to just take regular monthly break weeks (or take a break week every 2 months instead) so that I hopefully avoid the yeast infections.

Side note: I've tried many other types of birth control and they gave me bad anxiety. This specific pill was pretty good for my mood which is why I'm trying it again.

This is probably a dumb question. Seasonale contains 4 weeks worth (28 days) of active hormone pills per month. When I follow my doctor's instructions should I take 28 active pills a month and then a break week? Or should I treat it like a normal pill and take only 21 active pills and then a break week?

I've asked a couple friends who are familiar with birth control and they just keep saying I should be going back to the doctor to get a non continuous pill if I'm not going to use this one as intended. I feel like that is useless seeing as I would essentially get the exact same hormones and my doctor is also away for a few weeks.

[al]

Hi there ReliableLake,

You have the right instinct consulting with a pharmacist about this, because medications and side effects are usually best left to the experts!

My guess is that your doctor was recommending that you take your 21 active pills for 3 weeks, take none for a week (and have withdrawal bleed), then take 21 active pills, and take none for a week, and so on. I can understand the point that your friends are making, in that taking a continuous form of birth control "discontinuously" is a little counter-intuitive, but if your doctor okayed it and you feel this particular dosage of hormones works for you, then it doesn't really matter whether it makes sense to anyone else!

Have you talked with your doctor about other possible contributors to those yeast infections or how to take care of them if they come up?

[ReliableLake]

Thank you for your reply.

I spoke to the pharmacist and seemed really uneasy about my doctors instructions and even said he wouldn't think I would be protected. Honestly this made no logical sense to me seeing as they make non continuous birth control that contains the exact same dosage and type of hormones.

I personally find it's just a waste of my doctors time for me to try and make another appointment with her to get a different brand of pill which would essentially be the same as the one she prescribed lol. I think I'm just going to try this pill continuously as it was intended to be used. If I don't like it then I will see my doctor again.

As for the yeast infections. She hasn't given me many useful suggestions. I've been taking probiotics for years. I also try to live a healthy lifestyle and I use unscented laundry detergent, etc. Birth control usually makes me very dry in the vaginal area so I think I may try a ph balancing gel. Do you have any other suggestions?

[al]

It sounds a bit like the pharmacist was doing what they usually do, which is relying on the pretty strict clinical indications for the drug formulations. Ultimately your doctor is the one who you have the relationship with, and the better sense of whether or not she has your health and best interests in mind.
It may be helpful, if possible, to reach out to your doctor directly about this. While taking the birth control continuously might ultimately be the best choice for you, it's always a good idea to make sure that you and your doc are on the same page. Is it possible for you to call the office, or send a message online?

As for preventing yeast infections, we've got a whole Advice section full of recommendations about it! The most effective thing for me is making sure that I'm regularly taking probiotics/eating yogurt/drinking kombucha or other probiotic teas, because the combo of the bacteria + my body kind of does all the work for me.
In terms of that pH gel, it's possible that it might help, but I'm always wary of adding anything else in that's trying to "fix" what's happening inside the vagina, because the body is usually pretty good at righting itself when it's given the right building blocks. If you do decide to go with a gel or lubricant, try to find one with the least additives (and especially stay away from anything scented). The other really important thing is making sure that you're wearing clean, cotton underwear, and avoiding anything that traps in heat and sweat! Sleeping naked is also helpful for a lot of folks, but I'm not sure if that's a possibility for you.

[ReliableLake]

Unfortunately my doctor is away for a few weeks so I think I'm just going to take it as prescribed and see how I like it after a few months.

Thank you for the great suggestions on preventing yeast infections!

[ReliableLake]

Sorry, I just have one more (dumb) question lol.

Stupid question.

So I just took my first pill of Seasonale today (levonorgestrel/ethinyl estradiol 0.15/0.03mg)

The instruction pamphlet said to start on a Sunday after your period. I started it today because today is the first day of my period. (and this is what I've done in the past).

All other pills I've been on in the past have said you can start at any time and then it gives those stickers that you put on to keep track of which day you start.
Seasonale didn't come with any of those stickers.

Just wanted to make sure it's okay to start on the first day of your period?

[Sam W]

Hi ReliableLake,

Not a silly question at all, since you're figuring out how to adjust to a different medication schedule! Unless your healthcare provider indicated otherwise, you should be just fine having started the pill the first day of your period. To quote from Three questions about taking the birth control pill (and plenty of answers): With a first day start, the pill may be effective as early as that first day, but waiting one full cycle before going without a backup is strongly advised.

A Sunday Start is when you start the pill on the first Sunday AFTER your period begins (or, if it starts on a Sunday, on that Sunday). When you start with a Sunday start, the pill may be effective as early as within one week, but waiting one full cycle before going without a backup is strongly advised. The Sunday Start method was devised primarily for people who would prefer they have their withdrawal bleeds (your period wile using the pill) on a weekday, rather than on weekends, as it makes that more likely.

Unless your healthcare provider suggests one way of starting is better for you, how you start is your call, based on your preferences.

[ReliableLake]

Perfect, thank you so much!

I've been on pills in the past and the pill pamphlet always gave an option of the Sunday start or first day of your period and then included those sticks (Mon, Tues, Wed, etc.)

When this specific pill pamphlet only said to do the Sunday start and didn't give those days of the week stickers I was a bit confused.

I always like to be on my pill for about a month before having sex and we also like to use a backup method as well.

[Sam W]

You're welcome! And since you're using a back-up method anyway, that means you have extra protection in case something goes wonky while you're getting used to the new pill.

[ReliableLake]

Thanks again for all your help!!