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March 2, 2010

Other Medications

Question from Brighton, East Sussex, England:

I have had type 1 diabetes for the last 10 years (since I was 10). In January, I started taking the mini pill (progesterone only) to regulate my periods (I used to have terrible period pain and heavy periods before). I had intended to go on the combined pill but the doctor told me it was unsuitable for someone with diabetes. I have tried the mini pill for the last three weeks, but have stopped in the last few days because of bad side effects. Would going on the combined pill be any better for me? Are there any other options open to me?


Here in the U.S., we do not prevent patients with type 1 diabetes from using a combined oral contraceptive pill. Both the estrogen and progesterone components of the pill have the potential to cause insulin resistance, fluid retention, and weight gain. That is why the lower dose pills have been more popular recently. It is true that the combined pill has risks. Some of these include an increased chance of blood clots (especially if you smoke), increased blood pressure, some lipid abnormalities, and weight gain. Please talk with your physician regarding the risks most applicable to your situation. The combined pill is also more likely to ease the discomfort and bleeding associated with menstrual periods. I usually counsel my patients to pay close attention to their blood sugars so that adjustments can be made in their insulin dose if the treatment causes higher blood sugars.