DEAR DR. GOTT: I’m 20 years old and have been on birth control from the time I was 13. I’ve been depressed all my life. I think the medication causes my depression to worsen. I also have polycystic ovary syndrome. I tried metformin instead of birth control. It made me sick but less depressed. Can you tell me of a birth-control medication that will not cause depression?
DEAR READER: Medications can definitely cause feelings of sadness, despair and discouragement. All are feelings commonly associated with depression.
The metformin you were prescribed is commonly used to treat type 2 diabetes or pre-diabetes. It helps control the amount of sugar in the blood and decreases the amount of glucose absorbed from food and the glucose made by the liver. It can also be prescribed to regulate menstrual cycles but does not prevent pregnancy. Common side effects include nausea, vomiting and diarrhea, but not depression.
Your polycystic ovary syndrome (PCOS) can cause erratic or prolonged menstrual cycles, obesity, acne and excessive hair growth. Women with the diagnosis may have difficulties becoming pregnant because of the infrequency of ovulation.
My guess is that you were prescribed birth control to help regulate your cycles, because low-dose birth control with a combination of synthetic estrogen and progesterone can decrease androgen production, correct any abnormal bleeding, and decrease your risk of endometrial cancer. An alternative to this would be to take progesterone for up to 14 days every month, which will reduce your risk of endometrial cancer and regulate your menstrual cycle but will not improve your androgen levels. Treatment for PCOS is geared toward management of obesity, acne, hair growth and infertility.
I don’t know if you have a weight problem as a result of your PCOS, but exercise will go a long way toward lowering your blood-sugar levels. Speak with your physician before beginning any exercise regimen. Request a referral to a gynecologist familiar with PCOS who can direct you in terms of treatment and your depression. Perhaps counseling is in line. A nutritionist can get you on the right track regarding your diet.
It appears you have a lot going on at 20 years of age. You deserve a better outlook, and the help is out there.
To provide related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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