u/ColomarOlivia

I was suspecting no estrogen from Slynd and my own estrogen fluctuations were triggering especially mood swings (depression, lethargy) and migraines. I was correct because since going on Nextstellis my mood is much better and my migraines didn’t happen again. However, I’m having the following side effects: feeling anxious or agitated (like jittery, nervous, having nightmares, sleep disturbances, waking up scared or worried) and dizziness. Seems like estrogen is wiring me up (?). Is this a normal side effect? Idk if it will go away. Slynd’s downsides never did after 4 packs.

Context: 31F, 5’3” (162 cm), 51 kg (112 lbs), don’t smoke, don’t do drugs, no relevant health issues, negative for genetic thrombophilia, no cases of cardiovascular disease in my family, annual checkup with a cardiologist because I’m an endurance runner (my average blood pressure checked by an ABPM test was 100/60).

At 19 I started with aura migraines that are SOLELY hormonal. They come before/during/after my period and last for one or two days. At 20 I was diagnosed with PMDD by a psychiatrist who prescribed birth control Yasmin without the breaks. I asked him about the aura migraines and stroke risk (had heard about it), he said Yasmin without the breaks could actually improve my menstrual migraines and the absolute risk for stroke was still very low in my individual case. Indeed, he was correct. After being put on Yasmin without the breaks I NEVER had an aura migraine episode again and my PMDD improved a lot. I had a normal life again for 5 years.

However I contracted COVID and had long COVID and one of my symptoms was hypertension. They had to put me off Yasmin (and my hypertension did improve from getting off Yasmin). After my hypertension resolved on its own they tried to put me on a lower dose BC, Yaz. Weirdly, my BP raised from that. So doctors went to the progestin-only methods that block ovulation: Cerazette worsened my PCOS symptoms like cystic acne because it’s androgenic, I didn’t tolerate spironolactone (I needed an IV in the hospital from low blood volume and sodium loss) and Slynd still allows natural estradiol production and fluctuations and after the 4th pack I still had PMDD-like episodes (with suicide attempts and suicide ideations) and aura migraines, on and off.

Had a serious talk with my neurologist, cardiologist and gynecologist and they came up with Slynd + an estrogen patch, both without breaks. However, I’m unemployed and I can’t afford both. There’s no way I could pay for those. It’s either Slynd or the patch. So they came up with the decision that Nextstellis (estetrol + drospirenone) without the breaks is a reasonable choice under close supervision (blood pressure evaluation, worsening aura migraines etc). My neurologist said my case is a challenge regarding risk vs benefit assessment.

I went to another gynecologist for another reason (emergency room) and told her everything that is going on with me and she said “I’m sorry but if you were my patient I’d have to dismiss you. Knowing you have aura migraines and leaving you on any combo method is an unacceptable risk and I could lose my job and even go to jail if something ever happened to you”. She talked like I’m about to have a stroke.

Anyone could please enlighten me on this? I just want my suffering gone but I’m left with pretty much no choices. I’m 31, I don’t want kids but I live in a conservative, non-Western country where it’s hard to get an oophorectomy in my case. I’m devastated, I suffer from PMDD since I was 12 and menstrual aura migraines since I was 19. I’m depressed, I have no quality of life.