This time, going to the endocrinologist made me as nervous as my very first visit to her, a little over a year ago. I didn't get as lost on the medical floor as I usually do, and I had an idea of what would happen next, but my hands shook as I tried to read my book in the waiting room.
After two and a half months on Finasteride, I've noticed a negative change. Since coming off the 200mg of Spiro, my body hair has begun to get darker and more numerous. The dark vellus hair on my collarbone has come back, and I'm even getting more spots and blemishes on my back and chest than I did while on Spiro. To visually compare, my body is currently in a furry state somewhere between 100mg and 200mg of Spiro.
I was also finding that since being on the Finasteride, my stomach was even more unpredictable about how it reacted to food. I know Finasteride is reputed to be easier on your stomach than Spiro, so I tried to deny it, but it's certainly true that the strangest things have upset my stomach in the last few months. Maybe that's just a coincidence, because I found the pill itself quite tolerable.
But I figured the endo would probably want to move on to something else. And she did. She asked if I wanted to go back onto the Spiro, but it didn't seem to be worth it to me, since even at its best, I was still shaving every day. She apologized that there was really going to be no cure for me, and I tried to find the words to express that while I knew that, I was still hoping there might be something else to try. Something besides Cyproterone, the thought of which has made me very uncomfortable. I'd spent the whole morning trying to prepare myself by reading about it, and of course frightening myself with all the side effects. On top of which, there was the required birth control pill to worry about as well.
After some discussion, the endo asked if I would like to try a birth control pill on top of the Spiro. I'd spent the last couple of years with the assumption that most women are prescribed the pill along with androgen blockers because of the dangers of those blockers to a male fetus. Apparently, the pill can also reduce the overall amount of testosterone in the blood, which can improve the overall effectiveness of an androgen blocker.
It wasn't what I'd expected, but it was a drug I knew (and a drug I knew worked somewhat) combined with one new thing, rather than two completely new things to worry about. It was probably the most comfortable way to move forward. I agreed. Even if I never find anything that truly works, I like to imagine that I'll feel better knowing I've tried everything I reasonably could. And the endo said that if this treatment works a little better, I might find that laser hair removal will have a longer lasting effect--but likely not a permanent one.
So she has me on Alesse, because although she wants me on a low dose of hormones, she says Yasmin's active ingredient is too similar to Spiro. I really can't voice my own opinion on this choice, having never been on a BCP before, and from what I've read, every woman reacts so differently to each brand of oral contraceptive (some hate and some love each and every one) so it's hard to guess what would work best for me. I have read that Alesse is one of the pills popularly prescribed for acne, but I have also read that uses an androgenic progestogen, and therefore not the best choice for women with hirsutism. I'm not sure how both those things could be true, but I am willing to try it--I trust she has chosen it for good reasons. If any unpleasant symptoms, such as breakthrough bleeding, persist for over three months, she'll put me on something else.
I always feel strange after an endo visit. It feels like both a step forward and a defeat, all in one. And underlying that strange mix of emotions, each time I go seems to be an admittance that there is something medically wrong with me. I hate thinking that about myself. After the appointment, which took all of ten minutes, I walked through the city in a daze, got on the bus, and instead of going home went to the pharmacy to fill my prescription right away. Bought myself some new make-up, because... y'know. And from there, I rode the bus a little more, got the sudden urge to get off and walk to make the trip home longer, and ruminated a little longer.
I've only been on the pill for two days now, and so far so good. I'm actually a little excited I might become regular again. That would be pretty nifty. But there is a slight hang-up; my pharmacy anticipates no Spironolactone shipments for some time. They're not exactly sure when it will get here, but likely not until the new year. They had three pharmacists clicking away at their computers checking it, two of which were girls younger than me, but strangely I didn't feel that embarrassed. I just wanted my pills. I suppose in a way this is a good thing, though--I'll be able to try the BCP by itself for a month and then add the Spiro to it, so I'll be able to compare how I feel with or without it.
So here we go again. Always working away at it, trying to find a way to make life easier.
And now, I must go sleep off this wonderful winter cold. Hope everyone is feeling better than I am right this second! Blech.