Can Gradually Reducing Birth Control Pills Help Avoid Telogen Effluvium?
I am a 32-year-old woman, weighing 70 kg and standing at 170 cm, previously an ex-smoker. - I have struggled with menorrhagia and endometriosis. - I underwent laparoscopic surgery in March 2021. - A Mirena IUD was implanted around the same time, in March 2021. - In March 2022, I began taking Microgynon 20ED without any placebo breaks, continuously. - The Mirena device was taken out in November 2024. - I currently continue with Microgynon. Back in 2014, I was on the birth control pill but decided to stop after a while. Unfortunately, within three months of discontinuation, I experienced significant hair loss, losing around half of my hair. I used minoxidil for an extended period during that time, which I found quite unpleasant. After I had the Mirena inserted in June 2021, I did experience a major shed after about three months, but that was the only episode. Interestingly, my hair began to regrow, but the color was white, which was both odd and intriguing. Following the removal of the Mirena in February, I encountered another significant hair loss phase, which only lasted for a day before stopping again. It seems evident that my body reacts strongly to hormonal changes. **Current Situation:** I am in the process of freezing my eggs, which necessitates discontinuing the pill. My hair holds great significance for me; it reaches down to my waist, is naturally strawberry blonde, and has been a part of my identity for years. Losing my hair previously made me feel as though I lost a piece of my femininity and sense of self. I am not dealing with any mental health difficulties; my self-esteem is quite robust. I feel I've endured enough regarding my hair and demonstrated resilience throughout the challenges. I am determined to avoid further hair loss at all costs. **Inquiries:** 1. Would tapering off the pill help reduce the shock from the hormonal changes, making it a safer approach compared to an abrupt stop? 2. Will the hormones involved in the egg freezing process adversely affect my hair regardless? 3. If I resume taking the pill immediately after the egg retrieval, could I face hair loss again? My plan would be to stop the pill, have a menstrual cycle (which is not pleasant), and then start ovulation hormones. Thank you!
Answers (1)
3/19/2025, 10:50:41 PM
OpenHealth AI
It sounds like you’re going through a significant transition and are understandably concerned about protecting your hair during these changes. Here’s a breakdown of your inquiries and how to potentially manage the situation with your birth control and hair health in mind.
Key Points
- Gradually tapering off the birth control pill might help reduce the impact of hormonal changes on your hair.
- The hormones involved in the egg freezing process could also play a role in hair loss.
- Resuming birth control after egg retrieval may lead to another episode of hair loss.
Explanation
Given your history of hair loss related to hormonal fluctuations, careful management during any hormonal changes is crucial. Birth control pills stabilize hormone levels, and an abrupt stop can lead to fluctuations that may trigger hair loss, particularly in individuals sensitive to changes in hormone levels, like yourself.
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Tapering Off Birth Control Pills: Gradually reducing the dosage or frequency of your birth control pill can indeed help mitigate "shock" to your system compared to stopping suddenly. This approach allows your body to adjust slowly to the decrease in hormones, potentially lessening the risk of hair loss.
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Egg Freezing Process: The hormonal medications used during the egg retrieval process (ovulation induction) can affect your hair as they can cause changes in estrogen and progesterone levels. The response can vary, and while some individuals may notice no changes, others may experience adverse effects like increased shedding.
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Resuming Birth Control: If you face a natural menstrual cycle after stopping the pill and your hair remains stable, it may not necessarily guarantee that you won’t experience hair loss upon resuming the pill post-retrieval. Your body could react similarly as it did previously, especially if the hormone levels fluctuate significantly again.
Next Steps
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Consult with Your Healthcare Provider: Discuss the option of tapering off your birth control pills with your doctor and create a tailored plan that suits your hormonal sensitivity and egg freezing timeline.
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Monitor Your Hair Health: Keep an eye on your hair condition throughout this process. Consider using gentle hair-care products and avoiding heat styling to minimize stress on your hair.
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Consider a Nutritional Assessment: Nutrition plays a role in hair health. Ensure you're consuming a balanced diet rich in vitamins and minerals that support hair growth, such as biotin, iron, and omega-3 fatty acids.
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Plan for After Egg Retrieval: If you notice any hair shedding after stopping the pill and during the egg freezing process, discuss with your doctor the best timing for resuming birth control to minimize potential hair loss.
Remember, you have shown great resilience with your hair journey, and taking these thoughtful steps can help you navigate this phase. If you have any further questions or need more tailored advice, feel free to reach out!
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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.