TDG: The Bitter End: Our Cravings, Ourselves

[Marlene]

Thank you for adding sustenance to my day!

Menses are no more, but the cravings linger. Although perhaps harder to rationalize, why put aside what is good and sensuous?

TO-CUZ

How true. Welcome Half Full!

[indiagirl]

Maggie, The Dark Thing salutes you. It bows in admiration. You have emancipated it.

ps- I sobbed during Harry Potter.

[maggiethecat]

Maggie, The Dark Thing salutes you. It bows in admiration. You have emancipated it.

ps- I sobbed during Harry Potter.

Thanks indiagirl. I find if I throw a bacon and grilled cheese sandwich at the Dark Think it will scamper away for at least half an hour.

[awbrig]

ps- I sobbed during Harry Potter.

So did I for, I think, a different reason...

Edited April 16, 2003 by awbrig (log)

[alacarte]

I really loved this. Am sending the link to all my female friends...

[geekdoc]

Margaret,

Enjoyed reading your article. You mentioned your "cred". Other than being an excellent writer what is your background? As one of those OBGYNs, I am always interested in any new perspectives on women's experience with their cycle, etc.

Although its obviously highly controversial nowadays, many of my happiest patients are on continous birth control and therefore are not cycling, nor experiencing any of the PMS symptoms, which for some are quite debilitating. Since there seems to be a lower incident of ovarian cancer and several other diseases, as well as the health and personal benefits of avoiding unwanted pregnancy, I think the benefits balance out the risks. (This is based on a fairly thorough review of the current literature)

Any thoughts?

(I know this is miles away from cooking, but I didn't start this train rolling!)

Henry Dorn, MD FACOG

[balmagowry]

Margaret,

Enjoyed reading your article. You mentioned your "cred". Other than being an excellent writer what is your background? As one of those OBGYNs, I am always interested in any new perspectives on women's experience with their cycle, etc.

Although its obviously highly controversial nowadays, many of my happiest patients are on continous birth control and therefore are not cycling, nor experiencing any of the PMS symptoms, which for some are quite debilitating. Since there seems to be a lower incident of ovarian cancer and several other diseases, as well as the health and personal benefits of avoiding unwanted pregnancy, I think the benefits balance out the risks. (This is based on a fairly thorough review of the current literature)

Any thoughts?

(I know this is miles away from cooking, but I didn't start this train rolling!)

Henry Dorn, MD FACOG

Any thoughts? I don't know about Maggie (actually, chances are I do, after reading her recent posts), but I sure have a thought: WAAAAAHHHHH! I have a feeling you'll have a lot of women climbing on this bandwagon (just look at the PMS Cravings Thread if there's the slightest doubt!) - as in, where can I get me some of that no-pain no-pain action?

Seriously - what we'll do about the OT-ness of this tangent I don't know - doubly OT in that it's neither foody (well... pills count, right???? ) nor directly related to the thread itself, but I for one would be extremely interested in a discussion of the pros and cons of this approach, if there's a way to do it without ruffling feathers. I've struggled with this all my life - the extreme pain and the emotional stuff mostly, more than the cravings (though to legitimate the tangent I'll be glad to invent some extra cravings... why yes, I believe I feel a need for potato chips and dulce de leche coming on right NOW); but it took me until perimenopause to discover what it really means to add insult to injury. Cramps and hot flashes at the same time??? I know they said life wasn't fair, but this is ridiculous! (And they ask me why I insist that God can't possibly be female. Hmph. I guarantee you, no female deity would have designed this system! )

Have spoken to my GYN about the continuous approach, and I think she'd be amenable if I insisted, but I got the impression she hasn't yet tried it with any of her own patients and was understandably unwilling to use me as a guinea pig. So would really welcome the opportunity to discuss with someone who's actually been doing it.

Edited March 9, 2004 by balmagowry (log)

[maggiethecat]

Margaret,

Enjoyed reading your article. You mentioned your "cred". Other than being an excellent writer what is your background?

doc:

Um, you caught me out! My only cred is being a functioning female who likes to eat.

But I must agree with you: when I was on "continuous birth control" the ups and downs and cravings and homicidal rage were mitigated. A whole lot. Thing was, I decided to take my chances with condoms and mashed potatoes because of the nasty scares re: oh, 1980? Your system, in my experience, works wonderfully.

[balmagowry]

Um, you caught me out! My only cred is being a functioning female who likes to eat.

And who knows how to write about it. Hell, if that don't constitute cred, in these parts, I'd like to know what do.

But I must agree with you: when I was on "continuous birth control" the ups and downs and cravings and homicidal rage were mitigated.  A whole lot.  Thing was, I decided to take my chances with condoms and mashed potatoes because of the nasty scares re: oh, 1980? 

But hasn't the state of the art improved greatly since then? I thought that was rather the point of the recent research on this approach - lower doses, fewer side effects, more consistent hormone levels, better overall control, better understanding of the cycle etc. etc. Certainly my experience of the newer generation of pills is that they seem to require much less acclimation than the old ones from 20-odd years ago - if that's anything to go by. As it is I have to admit that taking one of these new low-dose jobs 3 weeks out of 4 has in itself made for a big improvement - just ask the SO!

OTOH, I'm not sure I want to give up the mashed potatoes. Mmmmmmm, mashed potatoes....

[Marlene]

Seriously - what we'll do about the OT-ness of this tangent I don't know - doubly OT in that it's neither foody (well... pills count, right????  ) nor directly related to the thread itself, but I for one would be extremely interested in a discussion of the pros and cons of this approach

Here, I'll bring it back to the thread for you . Because, hormones, any hormones affect how your body processes food. (there.) Seriously, birth control affects every woman differently. There are some who gained masses of weight on the pill, others who found it to be a very effective form of weight control, never mind alleviating cramps etc. What birth control doesn't do, is alleviate those cravings. (on topic enough ?). (if it get's too off topic, maybe doc can create a bio thread since this would be relevant to him )

I know women who have been placed on the pill to help with the cramps and other assorted problems associated with a woman's cycle, and it appears for them at least to be very effective. When I did take the pill, I found it to be a great weight control thing- I have no idea why, but I still got cravings at that time of the month. That never changed. I couldn't take the pill past 35, because the Pill and smoking over 35 do not go together. Then too, I hit menopause at 40- about 10 years to early and so tried HRT. What I found with HRT was the exact opposite of when I took the pill. My weight started to climb despite a fairly rigourous exercise program (that treadmill to nowhere feeling comes to mind ). Then came the HRT scare and no more hormones for me.

It is possible that continuous birth control would work for some women, but to me, it is HRT in a different context. Because HRT "replaces" hormones, whereas, the Pill, is "adding" hormones. How many extra hormones are "ok" for a woman, when there is already contraversy over "replacing hormones.?"

Just some food for thought.

[balmagowry]

Here, I'll bring it back to the thread for you .  Because, hormones, any hormones affect how your body processes food.  (there.)  Seriously, birth control affects every woman differently.  There are some who gained masses of weight on the pill, others who found it to be a very effective form of weight control, never mind alleviating cramps etc.  What birth control doesn't do, is alleviate those cravings.  (on topic enough ?). (if it get's too off topic, maybe doc can create a bio thread since this would be relevant to him )

Oh. neatly done! Thank you, Marlene.

I know women who have been placed on the pill to help with the cramps and other assorted problems associated with a woman's cycle, and it appears for them at least to be very effective.

I definitely fall into this category. How my SO managed to stand living with me during those crucial few days every month - before I went back on the pill, that is - I cannot imagine. The evil and despairing hag that I became... well, it was almost an out-of-body experience, being her. I often liken it to the fairy tale where the nasty step-sister was placed under an enchantment that caused a toad to fall from her mouth (that's food, sort of, right? ) every time she spoke. I would watch myself saying unbelievably awful things, howling in hysterics, doing anything and everything I could think of to spew the venom. I didn't lose my reason; the watcher in me never failed to understand precisely what was wrong about everything I said or felt or did - but for the life of me I couldn't get That Deranged Creature (i.e. myself, insane with hormones) to pay the slightest attention. She was determined to wreak all the havoc possible. And oh, she was so good at it. It was like being in the audience of a badly-written horror movie: you crumple down into your seat and mutter, "she's going to... no, I can't believe she's giong to... oh hell she IS going to... I can't look!" and you sink even lower and cover your eyes but of course your mind's eye can, and does, still picture the devastation.

And now... it's pretty thrilling that during Those Days I get a bit depressed and whiny and cranky... and that's ALL. Let's hear it for Better Living Through Chemistry!

It is possible that continuous birth control would work for some women, but to me, it is HRT in a different context.  Because HRT "replaces" hormones, whereas, the Pill, is "adding" hormones.  How many extra hormones are "ok" for a woman, when there is already contraversy over "replacing hormones.?"

Yup - this is exactly what concerns me. I'm at very high risk for breast cancer: my mother had two of them (entirely separate - no metastasis), as well as a handful of other cancers, so she had to give up any hope of HRT early on (with the result that she suffered terrible debilitating hot flashes for the last 25 years of her life). My GYN knew and loved her well, so she's au courant about my concerns. And I trust her completely. OTOH, according to her the pill I'm on now doesn't pose an unacceptable risk, so the question I don't know how to evaluate is whether taking it or its equivalent on a full-time basis would increase the risk, and if so how dramatically.

Just some food for thought.

Indeed! Very much so.

Yup - this definitely gives us plenty to chew on.

Edited March 9, 2004 by balmagowry (log)

[Fresser]

A nice read Lily, thanks for sharing.  And FG, thanks for pointing it out.

But what's so shameful about two hours on the couch, wallowing in a pint of Chubby Hubby and admiring Ralph Fiennes's bare butt while you sob your way through The End of the Affair? Nothing. Or so I thought.

Forgot to ask, may I choose someone else's bare butt?

I'll be right over...

[geekdoc]

I'm glad to see that I wasn't blasted out of the forum my "non-natural" suggestion that avoiding cyclic "changes" using hormones might be a good thing.

As opposed to the pill which has a fairly high serum hormonal level a few hours after ingestion and drops over the next 20 hours or so to an "adequate level" to prevent ovulation, the Nuvaring provides a very steady state hormonal level approximately equivalent to the LOWEST level that the pill reaches just before it is time to take another. (On a graph it looks like the Himalayas versus Kansas).

It also minimizes the "screwup" factor, which ALL studies have proven, that being, despite what patients report, they do a lousy job taking their pills on time.

Also, because this product provides adequate levels for at least 35 days, one would not have to buy extra product each month to fill in the gaps - remember only 21 of the 28 pills in a BC pack contain hormone - the rest are placebo/marker pills.

At this time I have 100's of patients using Nuvaring continuously and only 2 have wanted to switch to something else - really unprecedented compliance in my experience. The idea of little to no bleeding, no hormonally related mood swings (can't account for anything else!), no other cyclic events such as pain, migraines, etc which many patients experience, is appealing to lots of women to say the least. It is also a very good option in the perimenopause, when the periods and everything else go haywire.

I should add that I have absolutely no ties to the company nor get any kickbacks from its sale - I just like something that reduces patients minor (and sometimes major) complaints with a fairly safe risk profile (all of the same caveats which apply to oral contraceptives, apply to Nuvaring, but may be actually less due to its overall lower level).

Feel free to bounce any other questions off me, as long as the site admin doesn't mind!

Geekdoc

aka Henry Dorn

[geekdoc]

(if it get's too off topic, maybe doc can create a bio thread since this would be relevant to him)

What is a "bio thread'?

As for the risks of cancer etc, there is much we don't know. However, I like to make the analogy that chronic pain/ arthritis/etc patients use NSAIDS (Ibuprofen,Motrin, Advil, Aleive, etc) in huge quantities nationally even though it is well documented that catastrophic GI bleeds directly attributable to NSAID use kill more people annually than AIDS (30-60,000). Why? Because they know those medicines IMPROVE THEIR QUALITY OF LIFE. So the first thing I would ask myself before starting or continuing any medication, is how much will it improve my quality of life, and am I willing to accept the risks. For me, I find that coffee improves my day to day quality of life even though it is probably not the healthiest thing in the world. I quit for 6 months a while back and hated the way I felt, so...

Finally, one needs to really look closely at the breast cancer data from the WHI study. It is not nearly as scary as the press misinterpreted it to be. One needs some real knowledge of statistics to appreciate what things like relative risk mean.

In the case of breast CA and HRT, women showed a 30% increased relative risk of breast cancer, which means that instead of 3 women per 1000 per year it rises to 4 women per thousand per year, not 300 (30% OF 1000)!

[balmagowry]

I'm glad to see that I wasn't blasted out of the forum my "non-natural" suggestion that avoiding cyclic "changes" using hormones might be a good thing.

Goodness, no. IAC, where did I read recently that we were originally designed to ovulate only 3-4 times a year? I forget the ramifications, but the gist is that monthly courses aren't necessarily any more natural than quarterly ones.

It also minimizes the "screwup" factor, which ALL studies have proven, that being, despite what patients report, they do a lousy job taking their pills on time. Also, because this product provides adequate levels for at least 35 days, one would not have to buy extra product each month to fill in the gaps - remember only 21 of the 28 pills in a BC pack contain hormone - the rest are placebo/marker pills.

Yes, this had occurred to me, of course, especially in light of the fuss one's insurance carrier would make! One Per Month is all they will consider - that's their story and they're sticking to it, and they sure as hell won't stand for anyone confusing them with the facts.

As for the risks of cancer etc, there is much we don't know. However, I like to make the analogy that chronic pain/ arthritis/etc patients use NSAIDS (Ibuprofen,Motrin, Advil, Aleive, etc) in huge quantities nationally even though it is well documented that catastrophic GI bleeds directly attributable to NSAID use kill more people annually than AIDS (30-60,000). Why? Because they know those medicines IMPROVE THEIR QUALITY OF LIFE. So the first thing I would ask myself before starting or continuing any medication, is how much will it improve my quality of life, and am I willing to accept the risks. For me, I find that coffee improves my day to day quality of life even though it is probably not the healthiest thing in the world. I quit for 6 months a while back and hated the way I felt, so...

Yes, this all makes a great deal of sense to me - as a dancer I am already a bit too free with NSAIDs, and I know it, so anything that would help me need fewer of them for my quality of life is distinctly a Good Thing.

My only question on this - and I know it's one that doesn't have a hard and fast answer, but I'm certainly interested in your educated guestimate - is whether all this still holds equally true for someone who is at statistically high cancer risk. Yes, aren't we all, I know; but I come from a particularly cancer-ridden family. My mother's two breast cancers were not the only ones on her resume - in the course of 42 years she had eight separate cancers. My father has had two. Both my maternal grandparents died of cancer, as did my paternal grandfather. I sort of have to figure it's only a matter of time anyway... so I need to weigh the priorities. Oddly enough, despite the above, I'm not a big worrier over these things - I like my creature comforts (I too am not about to give up coffee!) and enjoy living well and am not haunted by the future - but one wants to try to be reasonable.

[Marlene]

(if it get's too off topic, maybe doc can create a bio thread since this would be relevant to him)

What is a "bio thread'?

Member bio threads. This is where members post bios of themselves. Off topic gets a bit more free rein here as long as the subject is relevant to the member's bio. Since this is your profession, I suspect it has relevancy

[geekdoc]

lg

regarding your mother's history of cancer, it would be important to know exactly what types of cancers she had (e.g. ductal carcinoma of the breast, etc).

OCP's and HRT have been shown to decrease the risk of colon and ovarian cancers, so its not a one sided thing.

You might want to have a genetics consult where someone reviews your family history in detail to sort out which diseases are heritable and which are essentially random. It does seem like she has some genes which increase her succeptibility, but if she were a heavy smoker who worked in an asbestos plant and sniffed glue on the weekends, then... (just kidding of course).

[geekdoc]

Addendum

I posted the suggested bio thread (painful to write about oneself) if anyone wants to discuss HRT, etc.

http://forums.egullet.org/index.php?showtopic=38696

Eat well

Geekdoc

[hathor]

Fantastic Maggiethecat!! I think you've just become an internet celebrity. Maybe you can be the next Domestic Diva. I'm a firm believer in the value of hedonism, on a steady basis. No need for only once a month !

Very much looking forward to the next installment!!

[maggiethecat]

I'm a firm believer in the value of hedonism, on a steady basis. No need for only once a month !  

Very much looking forward to the next installment!!

No, there is no need to confine oneself to That Time of the Month!

Thank you, hathor. I did write the next installment, sorta:here.

(shameless self-promotion department!)

[balmagowry]

Addendum

I posted the suggested bio thread (painful to write about oneself) if anyone wants to discuss HRT, etc.

http://forums.egullet.org/index.php?showtopic=38696

Eat well

Geekdoc

Cool! See you there!

[balmagowry]

I'm a firm believer in the value of hedonism, on a steady basis. No need for only once a month !  

Very much looking forward to the next installment!!

No, there is no need to confine oneself to That Time of the Month!

Thank you, hathor. I did write the next installment, sorta:here.

(shameless slef-promotion department!)

Shameless self-promotion, my foot. Obviously I haven't examined TDG closely enough, because I had missed seeing this piece. I for one am grateful to be pointed toward anything of yours, so no false modesty, please.

You must stir it and stump it

And blow your own trumpet

Or, trust me, you haven't a chance!

--W. S. Gilbert