I have PCOS and it’s managed by taking Depo Provera shots every three months to even out my hormone imbalance. I have way too much estrogen and that has led to life-threatening anemia due to bleeding in the past. I’ve been on the shot for years and I worry about the loss of bone density that can happen.
Depo is very effective at controlling my PCOS symptoms but is there an alternative? I realize getting extra vitamin D helps but I still worry. I expect to be on this for a long time since I otherwise bleed dangerously and I don’t think a hysterectomy is a good idea if it can be managed in other ways.
It definitely sounds like you have had some really disruptive and heavy periods over the years given your long standing anemia. I agree, hysterectomy is not needed with the symptoms you have described.
Polycystic ovarian syndrome (PCOS) is known to cause irregular and troublesome periods. Long-acting reversible contraceptives, also known as LARCS’s, include Depo-Provera, Norplant arm implants and intrauterine devices (IUDs). These are frequently used to control erratic bleeding. All of these methods are safe, convenient and effective in controlling irregular bleeding and serve as easy birth control methods.
Depo-Provera, an injection given every 3 months, is a nice option to stop heavy and long periods. The downside of Depo-Provera is that it can cause loss of calcium in the bones which can ultimately lead to weaker bones, known as osteoporosis. It’s recommended using Depo-Provera for no longer than 2 to 3 years given this side effect unless other birth control methods or medications are not effective in controlling the irregular bleeding. Getting more calcium and vitamin D from your diet and/or supplements and having periodic bone density testing is suggested if you have to take Depo-Provera more than 2-3 years.
The good news is another LARC is a great treatment for irregular bleeding with less concerning side effects. The IUDs with progesterone in the arms of the T-shape device can be used to control heavy bleeding and act as a perfect birth control. Two IUD’s serve this purpose:
- Mirena IUD: This progesterone releasing IUD can be used for 5 years. Your periods will be much lighter or non-existent as a result of the progesterone effect in controlling the uterine lining.
- Skylar IUD: This newest member of the IUD family can be used for 3 years. Similar in design to the Mirena, Skylar is smaller in size and recommended for those women who have never been pregnant. The Skylar has a similar effect on your periods making them lighter and more manageable.
Side effects of progesterone releasing IUD’s are uncommon and include prolonged irregular bleeding, uterine perforation and unplanned expulsion of the IUD.
It is worth mentioning that in a recent Committee Opinion on adolescents and Long Acting Reversible Contraception (LARC’s), the American College of Obstetricians and Gynecologists (ACOG) recommends the IUD as a “first-line” option for all women of reproductive age. The 2 benefits are manageable periods and a convenient birth control. Win-win!
I suggest trying one of the progesterone releasing IUDs as an alternative treatment in controlling your heavy and erratic periods.
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