My Chronicle of Strange Illnesses #5 There's No Such Person <Prescribing the Pill>

This is the story of how I, who lived a normal life, came to have what I can only call a "strange illness constitution" (*).
*The term "strange illness" here refers to uncommon diseases, illnesses or conditions of unknown cause, and intractable diseases.

This time, it begins with the story of the "hellish event" that visits me every month.

1. The Monthly Nightmare

Every month, whenever my period came, I would think.
……Is this really "normal"?

First of all, it hurts. It hurts too much.
It feels like my lower abdomen is being grabbed and twisted, and I move around hunched over like a suspicious person.

And then, the volume.
Napkins for heavy days?
They are wiped out in an hour.
The sensation of it gushing out when I stand up.
I have lost count of how many times I realized, (Oh, it's over...) and rushed to the restroom.

Furthermore, I get a fever of 37 to 37.5 degrees Celsius every month.
While many people's body temperature seems to drop, I quietly have a "mini fever festival" every month.
Even when I search online, there is absolutely no one with the same symptoms.
I have always thought,
(Something is definitely wrong...)
but I had given up, thinking,
"The severity of period pain varies from person to person..."

2. That's it, I'll take the pill

Around that time, my husband was sent on a long-term overseas business trip, and I was transferred to a busy department.
I hesitated to face it while still dealing with my monthly malaise.
My children were still young, and I was motivated at work, so I consulted a friend who also had children.
My friend recommended the pill, saying,
"Take the pill! Your period pain will seriously disappear. It will change your world!!"
I had heard that low-dose pills are sometimes used to alleviate period pain.

……Change my world?
Could something so magical really exist!?

At the time, I was still half-doubting, but I started looking for a clinic.

3. "There's no such person"

When I asked people at work for recommendations for an OB-GYN, they suggested a clinic in front of the station, saying, "This place is good!"
The reviews were high, and it seemed pretty good.
Above all, it was close to my house.

I decided to visit that clinic without hesitation.

However,
First, I was appalled by the waiting time.
Three hours...

It was a popular clinic, and although I couldn't make an appointment for my first visit, I was surprised by the unexpected wait.
And the medical interview was long, too.
Because of my strange illness constitution, I have a lot of material (medical history). (See #4 in particular )

I explained the details of my illness and the history to the nurse, and I also honestly consulted them about things that had been bothering me for a long time.
・Severe period pain
・Heavy flow
・Monthly fever
・"Lumps" that have recurred since childhood

What I especially wanted to ask about was the "issue of getting a fever every time I have my period."
Maybe it's because of the fever, but I feel dazed, and it's one of the causes of my poor condition.
Above all, there is no such information on the internet or in books, so I don't know how to deal with it.

The doctor said this right off the bat.
Doctor: "There's no such person."

……No, no, no, no.
But "such a person" is sitting right in front of you right now!?
I mean, I went to the trouble of visiting and asking because it's strange that there's no one else like me.
I don't think you should just dismiss it like that...😭

I desperately swallowed my urge to retort, using the excuse that it was my first visit.
In that moment, I think I delivered the greatest 'mental slap' in history.

And then, when I gathered the courage to ask about the 'lump' I was worried about,
Doctor: 'It's an STD.'

…Huh??????????
Once again, a clean cut.
I've been worried about this since elementary school, I've given birth to children,
and I told you I've never tested positive for an STD in past screenings, did you even listen to me?!?!?!

Without even touching on the possibility of an epidermoid cyst or hidradenitis suppurativa,
they shoved some mysterious medicine into my vagina and that was it (and it hurt, too).

The conversation never clicked from start to finish, but they did prescribe the pill.
(Wait, so you'll prescribe the pill just like that?!)

I felt a bit uneasy, but since I had at least been prescribed the pill, I gave up for the time being.

4. A Comfortable Life

What was prescribed was Yaz.
It seems that by taking it at the same time every day, you can regulate your menstrual cycle.
Even I, who was skeptical at first, found that once I started taking it—
My life changed.
・Pain → Drastically reduced
・Flow → Drastically reduced
・Fever → Almost completely gone
・Mental state → Stable
It's a different world.
Is this what 'menstruation' is supposed to be like!?
I was shocked.

To be honest, I had my doubts about the hospital's handling of things, but up until this point, everything was going so well that I didn't care about that anymore.

5. Level Up! To Yaz Flex

After continuing the medication for about two months, I was given this suggestion.

Doctor: 'If you switch to Yaz Flex, you can have your period once every three months.'

What a sweet temptation.
A troublesome period, only once every three months!!
I jumped at the chance for 'Yaz Flex' with joy.

To think that the inconvenient life (menstrual period) would only happen once every few months!
Could such a dream-like thing really exist!?

At this time, I was dreaming of a 'future where I could freely control my period,'
and I felt like I had attained a happy life where both work and daily living were perfect.

6. What on earth is this...!!

One night, shortly after I started taking it,
an 'abnormality I had never experienced before' occurred in my body.
Splosh...
Gush...
A massive blood clot, the size of a fist and looking like a giant liver, came out in large quantities.
A blood clot of a size that made me wonder where it could have even come from.
The amount was also abnormal.

'This medicine definitely doesn't agree with me!!'
I realized that immediately.
(*It seems it works incredibly well for some people, but it was a no-go for me.)

The next day. When I hurriedly contacted the hospital by phone, I was instructed to stop taking the medication.

(Does that mean... my dream happy life is...??)
(What about the healthy time I had on Yaz!?)

Furthermore, another problem arose here.
My genital area was tingling with pain. (My strange illness constitution is showing its true colors here too.)
Even if I wanted to go to the hospital, the combination of a hellish schedule and single-handedly raising my child meant I couldn't find the time to go no matter what.
(*I should have just taken time off work, but because I was working reduced hours while raising a child, I was convinced I couldn't take time off.)

That hospital has long wait times. I felt disheartened imagining that I wouldn't be seen right away.
(What is this, seriously...)

I was half in tears, but since I had already felt a bit uncomfortable (and was still holding a grudge about being told "There's no such person" 🤣), I thought,
"Alright, I'll change hospitals! A second opinion it is!" and I desperately searched for a hospital with clinic hours that might work for me.

I found out that a newly opened obstetrics and gynecology clinic had relatively late consultation hours, so I rushed over there immediately.

7. What are low-dose pills?

They are oral medications containing small amounts of two types of female hormones (estrogen + progesterone),
and they are drugs that suppress ovulation to prevent pregnancy.
What is commonly used in Japan is a low-dose pill called LEP (Low Dose Estrogen-Progestin),
and it is often prescribed for therapeutic purposes, such as for menstrual pain, PMS, menstrual irregularities, and anemia improvement, in addition to contraception.

▼ Main effects of low-dose pills
・99% contraceptive rate if taken correctly
・Reduction of menstrual pain
・Decrease in menstrual blood volume (anemia improvement)
・Improvement of PMS (premenstrual syndrome)
・Prevention of endometriosis and ovarian cysts
・Acne improvement effect (depending on the type of medication)

▼ Main side effects
● Likely to occur in the beginning (often disappear within a few weeks)
・Nausea
・Headache
・Breakthrough bleeding
・Breast tenderness
・Mood swings
● Side effects requiring caution (rare)
・Thrombosis (leg pain, shortness of breath, severe headache, etc.)
*Smokers, those over 35, and those who are obese have increased risk

◯ Characteristics of Yaz and Yaz Flex
⚫︎ Yaz is a type of "ultra-low-dose pill"
Because the amount of estrogen contained is even lower at 20µg per day,
it is a type where side effects are relatively less likely to occur.
Drospirenone (a type of progesterone) contained in it has the following characteristics:
・Improvement of swelling (has a diuretic effect)
・Weight gain is less likely to occur
・Acne improvement can be expected
・Effective for PMS, especially PMDD

◯ Differences between Yaz and Yaz Flex
Yaz is a pill of the "period comes every month" type,
and Yaz Flex is a pill of the "can reduce the number of periods" type.
Yaz has a cycle of taking it for 24 days and resting for 4 days, so there is a solid bleed once a month.
On the other hand, Yaz Flex can be taken continuously for up to 120 days (about 4 months),
so it is suitable for people who want to reduce the number of periods or those who have strong menstrual pain.
The ingredients are almost the same, and the effects and purposes are similar, but
the point that "you can adjust the timing of bleeding yourself" is a major feature of Yaz Flex.

◯ Who is it suitable for?
Yaz
・Feeling depressed before menstruation
・Body tends to swell
・Menstrual pain is painful
・PMS or PMDD interferes with daily life
Yaz Flex
・Want to reduce the number of periods
・Painful symptoms occur every time you have a period
・Want to avoid menstruation during events, exams, or work
・Want to prevent endometriosis or prevent it from worsening

◯ Side effects of Yaz/Yaz Flex
▼ Common:
・Breakthrough bleeding (especially from the start to 3 months)
・Nausea
・Dizziness
・Headache
・Emotional ups and downs
・Stomach upset
▼ Requires caution (rare)
・Thrombosis (leg swelling, shortness of breath, severe headache, etc.)
・Hyperkalemia (when having kidney disease or using specific medications)
*Since drospirenone has a diuretic effect, while it is good for swelling, some people may have high potassium.

In my case, the fact that a large amount of liver-like blood clots came out (= breakthrough bleeding was abnormally heavy) was judged as a sign that it did not suit my body, and I stopped taking it under the doctor's instructions.

8. Refusal of acceptance

Me: "I've been having a tingling pain in my genital area recently..."
New Doctor: "Ah, this is herpes. I'll prescribe some medicine for you."

It was fine up to this point.
The problem starts here.

Me: "Also, um... I was taking a pill, but when I changed the medicine, it didn't suit me...
I want to change back to the original medicine, but could you please prescribe it here?"
New Doctor: "If it's being prescribed at another hospital, I think you should go there."
Me: "No, I'm coming here because I can't go to that original hospital..."
New Doctor: "If it's being prescribed at another hospital, we cannot prescribe the pill here."

Oh no.
I'm completely stuck.
・Original hospital → The times don't work out
・Another hospital → "We can't prescribe that here"

In the end.
I decided to stop taking the medication to eliminate the stress of going to the hospital.

9. Afterword

After stopping the medication, the stress of going to the hospital disappeared, and I felt a little relieved.

I don't think I "gave up on treatment," but rather chose to "protect myself for the time being."

Menstrual pain isn't pain I can't endure, but it's also pain I don't have to endure.
The pill certainly saved me for a time.
On the other hand, I also went through hell because of a bad compatibility with medical care and medication.

Everyone has their own "compatibility" with hospitals and medications.
Given our daily rhythms and circumstances,
trying to choose "only what fits perfectly" from the start is an impossible game.

Since that day when I was told, "There's no such person,"
I learned the importance of facing my own body and making choices while being at the mercy of the hospital lottery.

Going to the hospital is important.
But,
stopping for a moment to listen to the voice of your own body,
I think this is also a valid "choice."

◁Previous strange illness here→Minority Morning Sickness/Gestational Diabetes
▷Next strange illness here→Hand Eczema

References
Bayer Yakuhin, Ltd. Yaz Combination Tablets Interview Form, Revised April 2024.
Bayer Yakuhin, Ltd. Yaz Flex Combination Tablets Product Basic Information, December 2020 Edition.
Ministry of Health, Labour and Welfare. Regarding Thrombosis Caused by the Dysmenorrhea Treatment Drug "Yaz Combination Tablets." January 17, 2014.