Just read the book and have ordered fish oil, calcium, gyneflex, etc. Fantastic book BTW. Thank you Marrena. I'm excited to start the diet and the exercises. Your sample weekly meal plan was extremely useful.

I'm wondering, however, how to deal with a couple of the "Orgasm Killers" mentioned in the book.

First and foremost, I am Bipolar and have also been diagnosed as having ADHD and borderline personality disorder. Although I'm not exactly in complete agreement with (all) the DSMV classifications, I do have some relatively serious mental health issues that will most likely always require medication. I know some may see the laundry list of meds I'm on and think I'm over-medicated but without them I've done some pretty scary things. So until there's a better solution, I can't risk going without meds that fall into the categories below. I guess I'm asking if anyone knows what, if any, sexual side effects are associated with the following meds. And if so, whether you know of other similar meds that fall within the same category that might fit better with the diet.

Although I refuse to take Ritalin or SSRI's, I do take Wellbutrin as an antidepressant/ADHD drug. My understanding is that Wellbutrin is actually ok for the purposes of the diet. Is that correct?

I also take Lamictal (a mood stabilizer/anti-convulsant), Buspar (an anti-anxiety med), Klonopin (a benzodiazepan - anti-anxiety med) and Trazodone (and older tricyclic antidepressant - for insomnia, not depression).

For me, thankfully none of these meds seem to have a dampening effect on my sex drive which is pretty strong, but I do have trouble having orgasms with my boyfriend (and all my past boyfriends regardless of their skill, tenacity and/or patience). Any ideas regarding the meds effect on orgasmic ability?

Also, I use Mirena for birth control. Until I recently read the thread on this particular birth control method, I was clueless about what effect it might be having on me (the highs and lows that come with being bipolar make it hard to discern what factor(s) cause/exacerbate my mood swings). I was under the apparently mistaken impression that the synthetic progestin, levonorgestrel, mimicked the "feel good" progesterone hormone. Now I'm under the impression that Mirena may be causing hormonal imbalances that have a negative sexual impact, in addition to causing constant PMS-like irritability symptoms and mood swings. I've made and appointment to have my GYN remove it. But I'm afraid of the potential mood crash while my body re-adjusts. So I'm wondering if anyone here has any suggestions about to transition to a non-hormonal method of birth control. Will I need a locked, padded cell and a straight jacket : )

And as far as non-hormonal birth control methods go, I'm at a bit of a loss. I figure I'll give a diaphram, cervical cap and/or the sympto-thermal method a try. Are there any other simpler options? I've already tried a non-hormonal IUD and had severe cramping and extremely heavy periods for longer than a week each time so I'm not willing to do that again. I realize there's no perfect solution, just thought it might be worth asking whether anyone has any other ideas.

On the bright side I kicked my 17 year smoking habit. Yayy! And this book has motivated me to start the gradual process of trading in my nicotine gum for regular gum. Thanks Marrena for your motivating book! Quitting regular gum (sugar, right?) will have to come later.

If anyone on this site smokes and wants to quit, I know of a few great resources that really helped me throw away the cancer sticks. Let me know if I can help. FYI: I wouldn't try Chantix if dopamine is on your wish list.

Thanks in advance for any advice.

High-dose fish oil helps with general brain health, you may find after a few months on the diet you can adjust your dosages under your doctor's supervision. In particular it helps with bipolar disorder. Make sure you take the full amount of EPA.

Wellbutrin is fine for my diet.

I've been on several of those medications - I also refuse to take SSRIs, but have anxiety, ADHD, and occasionally depression, so I've gone through trying every non-SSRI anxiolytic that exists.
Here's what I know:
-Wellbutrin is actually often added to SSRIs to counteract the sexual side effects people have on them - it didn't help me the one time I tried this, but it is common for doctors to do so. So in addition to Marrena's mention of it in the book as the only antidepressant that is fine on her diet, other sources also confirm that it shouldn't negatively impact your libido.
-For a lot of people with ADHD, the medication can actually help with sexual activity - our ability to actually focus and not be distracted helps a ton, and for some people stimulant medications also help counteract the libido-lowering effects of SSRIs.
-I believe klonopin/clonazepam can actually decrease sex drive. While it's the longest-acting benzodiazepine (I think), it still goes in and out of your system reasonably quickly, so if you talk to your doctor about your concerns, if you're on a low dose, it might be easy to test. Do not stop taking clonazepam (or anything) even for a day without talking to your doctors and having his/her/their approval, though; there can be very bad withdrawel effects (including seizures in some people) from clonazepam.
-Buspar/busiprone: this is actually another medication that has been found by some people to reverse the sexual side effects of SSRIs, so that seems positive. I'm not sure what the mechanism is because I can't tolerate Buspar so I haven't read up on it extensively. I think it does have a .1-1% chance of sexual side effects, but I don't know much beyond that.
-Lamictal - I don't know anything about it, but from looking at the prescribing information and a small amount of googling, it doesn't seem to have sexual side effects.
-Trazodone - I believe this one can have sexual side effects, but is less likely to do so than other medications of its type. It shares a lot of properties with the SSRI medications, so that might make sense. However, I've also seen an increase in sex drive listed as a side effect, so who knows.

I can tell you that I have taken medications that made orgasm more difficult. This is often the way sexual side effects of some medications (including SSRIs) show up in guys, but definitely happens to women as well. It can be tough to tell when you change medications and have a new partner, etc.

I've had horrible luck with hormonal birth control (have tried the pill and the patch), and am in the same position trying to find solutions. I am adamant about wanting two forms of birth control at all times, but don't know what to add to condoms. I do have some Plan B stashed in my dresser in case of emergency, but really I need something else. I was considering spermicide, but have read that it can make the condoms less effective. I've used it some and haven't had that problem, but don't really want to risk it. I'm thinking of getting a diaphragm but know almost nothing about them. I doubt I could make much use of the sympto-thermal method; sounds complicated. I do track my periods pretty well (mymonthlycycles.com is a lifesaver), but that's about it.

Also note: I am not a doctor, so don't take my advice or information as fact.

-Steph

Thanks Marrena and Steph

I'd be ecstatic if the fish oil turned out over the long run to allow me to stop taking some or all of my meds. It's taken years to find the right combo in order to function normally so I'm afraid to rock the boat at this point. But after I try the fish oil for a few months I'll take stock of how I'm feeling and ask my shrink about it.

Steph: Thanks for your info and advice on my meds. As far as stimulants go, you're right they very well might help sexually (or at least, they may not hurt) but anything too activating can rapidly send me into a hypo-manic frenzy. On the ADHD side, I've just come to the conclusion that the benefits of stimulant meds are outweighed by the detrimental mania-inducing effects. It's very frustrating finding the right balance.

As for Buspar, that's encouraging news. Sounds like it didn't work too well for you though. That's too bad - I find it really helpful. Were you trying it for anxiety?

Yayy for Wellbutrin! Glad that one is ok. It's been a lifesaver for me. Actually, I should mention that without a mood stabilizer (Lamictal in my case) to balance the activating effect of Wellbutrin, Wellbutrin can also induce manic / hypo-manic symptoms. In the past, I took it without a mood stabilizer and went off the deep end. Not pretty. So thanks for your info on the Lamictal. I was really hoping it would be neutral in terms of the diet.

The Clonazepam is 3x per day "as needed" so I can in fact just not take it if/when I don't need/want it. I purposely take one or two day regular "vacations" from it in order to minimize the tolerance building and withdrawal effects (and yeah, I get somewhat cranky at first - exactly why I continue the "vacations"). I usually use it to help ease anxiety in social situations so I don't usually need it just hanging at home with my boyfriend. It does of course help me to relax (which may be helpful sexually) but it can't hurt to try without it and see whether it makes a difference.

Of course, I can stop the Trazodone and use more Clonazepam to deal with insomnia but if they both have negative sexual side effects it may be a wash. I'll ask my shrink which is the better choice if I could pick one over the other.

Sounds like we're in the same boat as far as birth control goes. Although, you, at least, use condoms. I just hate the things. Also, as you said, they're not the most reliable form of birth control - not without something else at least. When I get my Mirena yanked, I'm going to ask about a diaphram. The last time I considered one, my GYN told me I would be hard to fit for one (something about the shape of my cervix, I think). Anyway, I'll ask again. I'll pass along any generally useful info.

I did try the regular non-hormonal IUD for a couple of years and it did work. My problem with it was the relatively bad cramping and the long heavy periods. I think my experience was pretty typical as far as IUD users go. I know I said in my last post that I wouldn't use one again but if it came down to it and it was the only really reliable option, I would probably have one put in again. BTW: I have never had a baby so if you have never given birth you can disregard what the pharma companies say about who can get an IUD. I had 3 GYN's tell me there was no problem. I had no problems with it - only the expected longer, heavier bleeding and cramping. The copper (non-hormonal) IUD was slightly smaller than the Mirena (the hormonal IUC) and it was easier for the doc to insert it (and easily removed as well). So if you're willing to put up with heavier periods and cramping, etc., it is actually a good option. Let me know if you want to know more about it.

I'm leaning towards trying the symto-thermal method combined with a diaphram or cervical cap (assuming the doc can fit me for one) during fertile periods. It sounds like a lot of work but it occurred to me that it might also be a useful way to be acutely aware of how my hormones affect my moods. Something that for me, and perhaps others with mental health concerns, may be particularly useful.

Thanks again for your help!

Lammas -
Yeah, when I wrote that I had briefly forgotten that you were bipolar. Wellbutrin's okay for you? I assume only because you're on the Lamictal? In any case, ideally it should have the same effect that the stims would.
I'm not bipolar and I avoid the stimulants, too, although I'm going to give Vyvanse a shot (only because it has some interesting differences in how it works, and my doctor's convinced it's less likely to send my anxiety out of control). Right now I'm on Wellbutrin too though (and Klonopin, although it's not a good long-term choice for my anxiety, and I've already reached tolerance on my dose, which is pretty low).
The first time I took buspar, it made me very very depressed. The second time, I went on Wellbutrin first to try to avoid that side effect, but when I started taking it, it made me horribly horribly nauseated - I kept taking it for a while hoping it was a temporary side effect, but it never went away and was pretty much intolerable. Right now I'm trying Neurontin (off-label use, but it worked for a friend), but I don't really think it's doing anything. Hard to tell because my life just got a lot more stressful, so I don't know what helping would be.
What dose of the clonazepam are you on? I'm probably going to wind up relying on that, as much as I don't want to, and I was under the impression that most people only took it once a day - or twice if they also had trouble sleeping. I'm doing the "vacation" thing to try to get my dose (.5 mg, because we're only messing with one medication at a time to isolate effects) to start working again, but my life is kind of insane right now so I keep caving and trying it again, finding that it isn't helping, and then stopping again.
As far as trazedone vs clonazepam, I don't know which stays in your system longer, but that might be one way to decide between them - or see if you can find the incidences of sexual side effects for each online - or just see if you can figure out if one or the other or neither is causing you any problems. Since the clonazepam works for sleep and anxiety and you're in a position where you can be flexible about taking it, that might help. Also of course there are a ton of things you can do to help yourself fall asleep (lifelong insomniac plus I've been on stimulants - I know *all* the sleep hygeine tricks), but of course that doesn't always work.
Normally I'm like you though - only need it socially. And, actually, also like you in that relaxing is a big plus in sexual situations, but of course most things that make you relax can also have negative effects there too.
Definitely let me know what you find out about diaphragms. I should have called my gyn when the pill didn't work, but honestly, she was awful (I tense up during exams (and everything else, unfortunately), which causes a huge amount of pain during a pap smear, and instead of slowing down or helping me to relax, she went really fast, told me there was nothing physical causing the pain, asked if I'd been raped (???), and ignored the fact that the pain was so bad I'd started crying. Awesome.
I'm pretty paranoid about always using something, ideally two things, with sex, but since I have gotten to an age where it wouldn't end my life if I had a kid, and I'm with a guy who would be responsible about it even if we broke up, I feel a little better about relying on condoms alone. I'll probably get some spermicide though - that's what I did in my last relationship.
IUDs actually freak me out significantly - I think because if I have side effects from the pill or the patch, I can just stop using them, and I don't like needing to go to the doctor's to get rid of something like that - but also because I'm not willing to risk losing fertility later on - I know I'm going to want kids, and I'm probably going to be pushing the envelope as far as my age goes, so I don't want to risk it. Heavier periods and cramping sound awful, too, though. Last time I got my period my cramps were so bad they woke me up in the middle of the night. Ick.
I wouldn't trust the sympto-thermal method as birth control, personally, but I agree, it seems like it would be worth tracking for other purposes.
If you want an easy way to track at least your symptoms throughout the month and during your period, etc, check out mymonthlycycles.com. When I remember to use it, it's awesome - before I started using it I never had a clue when I was going to get my period - now I get an e-mail a few days in advance. Perfect.
It's been really good comparing notes with someone who has so much in common with me!

Steph,

Yup the bipolar thing sucks - one med makes you high - the other makes you low while the "side effects" of one are supposed to cancel the other out. It doesn't really seem to make sense.

Lately since I've been doing ok with my meds, I've been out of touch with the newer ones. What's Vyvanse? Is it for anxiety? ADHD? Other? Either way, good luck with it. I know how time-consuming and frustrating it is trying to isolate and figure out the pros and cons of each med. "Normal" people (not that I've met many of these seemingly mythical creatures) have no idea what this constant meds mix-and-match ordeal is like.

Sorry, I'm a bit confused about the Buspar and the Wellbutrin. You said the Buspar made you depressed and that you took Wellbutrin to counteract the depressive effects. When you said you tried it the second time, did you mean the Buspar or the Wellbutrin?

Let me know if I got it wrong but I gather the Buspar didn't end up working for you. If it makes you feel better, although it does work for me in a sort of generalized manner, I really don't believe it does much more than sedate me a little which helps for anxiety problems but is an effect that I'm sure can be mimicked by many other drugs that you would find tolerable. And, unlike Clonazepam (or other benzo's), it doesn't have the fast acting, feel good, relaxing, chilled-out feel to it that helps so much in panic or stress-inducing situations.

I totally get the Clonazepam problem. I take 0.5 mg 3x per day (as needed). For me, "as needed" does tend to be a large majority of the time - at least the time I spend out in the world or dealing with the outside world via phone. But since I do take "vacations" from it, it still works well for me. I've been on it for at least 4 years now. The only increase I've had was from 2 x per day to 3 x per day and that was maybe a year ago. So never had a dosage increase. Although I do not particularly enjoy the 'vacation' withdrawal symptoms, I think it's worth it in the end. And, I truly believe that's why it keeps working for me without a dosage increase.

The other thing that has occurred to me regarding the Clonazepam is that over time it has helped me expose myself to anxiety-provoking situations - ones that I would have, in the past, avoided. And because it has allowed me to calm down and have increasingly positive social interactions, now even without it, I often feel fine or at least not as panicked as I used to. I simply function better even if I haven't taken it. There are limits, of course, but it has helped me re-train my brain to a certain degree to relax more in anxiety-provoking situations. Still, I know I have to work more on deep-breathing, meditation, and other mind over body type techniques rather than relying on drugs though.

But before taking Clonazepam, whenever forced into being in such situations (like going to work everyday), I would suffer through it and end up in what was basically a continuous negative reinforcement cycle. Since I would get more and more anxious in such situations and would, in my opinion, look incompetent and stupid to others. Or act strangely or be inappropriately shy, be unable to speak, unable to stop shaking or blushing or fail to be assertive, etc., I eventually became more and more nervous in social / work situations and became increasingly afraid and more anxiety-ridden. So, despite Clonazepam's limitations, I feel it has helped me a great deal.

How long have you been on it? And do you ever strategically plan little withdrawal "vacations". Also, is your doctor the anti-benzo type generally or is he/she just responding to your own concerns/experiences? I ask only b/c I've run into 3 types of doctors. The ones who think benzo's are all bad and that patients who ask for them are drug-seeking inappropriately. Those who write prescriptions like they're going out of style for large doses to people who don't need them at all. The others, the neutral ones, are the only ones I trust when it comes to benzo's - they'll generally prescribe it appropriately in the right doses when the pros outweigh the cons. What's your experience with that?

As far as Neurontin goes, I took it for a couple of years and I'm really not sure if it did much. I ended up on the highest possible dose and didn't feel much effect after a while. And I tend to stay on the lower dosage end of any med I take. Don't get me wrong, it helped, just not much. But that's just my experience.

I went off Neurontin and started Lamictal quite a while ago (more than a year) and have been really, really pleased with it. It seems to have not only a mood stabilizing effect but also a bit of an antidepressant effect. And unlike most other mood stabilizers, it doesn't turn me into a half dead, sleepy, fat zombie. Also, it has allowed me to benefit from the antidepressant effects of Wellbutrin without getting high. I know you're not bipolar but I thought I'd throw it out there in case it's something you might want to look into in case it is something that might possibly apply to your situation.

As for your GYN, she sounds AWFUL. It's surprising what a difference a good GYN makes. My current one is so laid back she makes me feel really comfortable. I've had a couple who almost seemed more uncomfortable about the whole exam than I did - they just add to the anxiety and misery of the ordeal. Mine now is great. I feel like I can ask her anything and I can relax so that the exam doesn't hurt. And I only feel mildly embarassed and awkward about the nature of the exam or procedure.

It just occurred to me that they may be able to mildly sedate you if the exams or any procedures are really that painful and uncomfortable. They do it in cosmetic dentistry these days. I only say this because when I went to have the Mirena put in (this was before I had my current GYN), the regular doctor was out sick so an inexperienced doctor from another specialty tried to insert the Mirena. She tried about 4 times to insert it and of course it became increasingly painful each time, so much so that she told me I had a very high pain tolerance. What? I had tears pouring out of my ears (involuntary) and was sweating profusely and felt like I was going to pass out. Even though I said to go on and give it another go she ended up telling me that my cervix was quite small and she was concerned that if she kept trying she might perforate my uterus. Great! That inspired a lot of confidence. Anyway, she set me up with another appointment with a regular GYN who had plenty of experience inserting IUD's and IUC's but mentioned that they may try to give me some sort of sedative when I came in for the next appointment. Of course, the next GYN who did it managed it on the second try and it wasn't really that painful. But because the first one mentioned the possibility of being sedated (I don't know to what degree), it seems logical to me that there may be something they could do to sedate you a little to make exams or any other procedures more bearable for you.

BTW: Please don't let my Mirena insertion experience scare you in terms of any exam or procedure you might undergo at the GYN's office. That experience was definitely an anomaly. Also, apparently the Mirena IUC is LARGER than the regular IUD which may be why even the second, competent GYN had to try twice to insert it. When I had the first non-hormonal, copper IUD inserted, it went right in without any problem and although there was uncomfortable cramping it really wasn't bad at all. Also, when I had the first IUD inserted the doctor had me time it so I had my period (or it was close in time to my period) so that my cervix was already slightly dilated - that allowed for easier insertion and less pain/discomfort.

I'll stop blathering on now, but one last thought I had was about finding yourself a better GYN. Have you considered asking around to get a recommendation from someone you trust for a good GYN? In my experience, the OB/GYN's who do actually work with pregnant women and are frequently involved in actual childbirth situations tend to seem far more comfortable themselves and more likely to help you feel comfortable. Just a thought. Otherwise, I don't know if there's an online rating resource for doctors in your area. If so, I'd check that out. I once found a fantastic dentist recommended on a public thread by a bunch of people in my area. I just did a google search for best dentists in my area and came up with a whole forum on the subject. And, as far as that dentist experience went, the info in the posts were right on target.

Interesting you mentioned age and child-bearing in your post. I'm also in a similar situation. I'm in my mid-30's and have a great bf who actually would like to have a kid if I wanted one. And, like you, even if it didn't work out, I know he'd be a responsible and involved father. And since I may want to have kids at some point in the future, I'm less concerned about pregnancy than I used to be. Then again, I have to remember that I'm on so many damn meds I really can't take the chance of exposing any possible fetus to any of that stuff. I guess I really do have to be careful and make sure if it happens, it is planned. Arrggh, why can't men just take a birth control pill?

Thanks for telling me about the mymonthlycycles site. I'll check it out and maybe start using it after I have the Mirena removed. Right now I don't really have periods (b/c of the hormone in the Mirena) so I can't use it yet. Sounds like it'll be helpful in the future though.

Lammas -
Yes, the medication thing is soo frustrating and time-consuming. I have gone through it before, but have never managed to find a combo that worked for me, both b/c some of my doctors weren't as helpful as I might have liked and because I didn't realize how much I didn't want to be on an SSRI until recently - I sort of knew they might be causing my libido to drop, but when I was younger I wasn't even really comfortable explaining that to my doctor (actually it's still hard).
The guy I have now is trying really hard to come up with a combination, and is really experienced with ADHD at least - the other stuff often coexists with it, so he's done the balancing-anxiety-with-ADD-meds thing before, also. He's not anti-benzo at all, but I have a very strong family history of alcoholism, and I seem to hit tolerance on a given dose pretty quickly, so I actually said I'd rather not rely on it as my primary anti-anxiety medication. If the neurontin doesn't work, though, I'll probably change my mind and just decide to accept it and try to only take it when absolutely necessary.
I know exactly what you mean about the negative reinforcement cycle, though. That's exactly what it's like for me - and the medication has made it much easier for me to do things I couldn't before, like make phone calls to offices or relative strangers - which in turn has made it easier to do even when I hadn't taken it.
Um, let's see. Oh! Vyvanse. It's for ADHD, it's relatively new, and I didn't know anything about it until recently either. It's actually d-ampetamines, but they bound it to lysine so that people couldn't abuse it by snorting it - it only works when taken orally. However, since your body only has a given amount of the enzyme needed to break down lysine available at any given time, this had the side benefit of producing a stimulant medication that works much more gradually than the others, and, it turns out, lasts longer than the previous extended release stuff. It can still have all the same bad side effects other d-amphetamine drugs do, but for a lot of people, it doesn't. I'm pretty excited about it but actually am trying to get the anxiety straightened out first so I don't get to find out if it's going to help me for a while.
And yes, sorry for being unclear, the buspar ended up making me totally nauseated and I just couldn't deal with it - which sucked, because the first time I tried it, it *did* help my anxiety, it just also made me horribly can't-get-out-of-bed depressed. I have no idea why the side effects changed when the only difference was the Wellbutrin, but there you go.
I was on 600 mg of Neurontin a day, and as of tomorrow am doubling that, so we'll see if anything happens.
This time, I've been on the klonopin for maybe 10 months? Not entirely certain. I've tried deliberately not taking it, but don't know how long I need to skip it to get back to the point where .5 mg helps me at all, so I haven't planned them very well.
I actually did almost end up on a mood stabilizer once. I'm not bipolar, but I essentially had a hypomanic episode at one point when I wasn't seeing a doctor regularly (and had just abruptly stopped taking an SSRI and was still on dexedrine) - all the symptoms, but have never had a recurrence, even when on stimulants or antidepressants. I actually think ADHD and bipolar disorder are going to turn out to have a lot more in common than the current models assume. I've read some interesting studies, etc.
As for the gyn, the horrible thing is, this WAS a recommendation from my sister, who's never had a problem with this woman and just thinks she's wonderful. I have no idea at all why our experiences have been so completely different, but there you go. I might try someone else in the same practice, since at least they take my insurance.
That's all I've got for now I think. Oh yeah - how long does it take you going off of klonopin to get the dose to help you again? I know it would vary from person to person, but it might get me into the right ballpark.
Okay now I'm going to bed. Thanks & night!
Steph

Steph,

The Vyvanse sounds promising. Once you get a chance to try it out for a while let me know how it goes.

I totally agree with you on the Bipolar / ADHD connection (in addition to the blurred lines between many other mental issues). Funny how some doctors will insist that the DSMV categories and criteria are pretty much fixed and on target. Psychiatry has always been an inexact and ever-changing field. I guess, had be been around and diagnosed earlier this century we would both have been considered to have "Minimal Brain Disorder (or Dysfunction)". Gotta love that one. Considering our "minimal" brain function, based on our ability to think and write, I'd say we're doing pretty well : )

I read an interesting book by Dr. Amen (think that's the name) who used SPECT scans (brain imaging studies on blood flow in the brain) to study people with ADD / ADHD. He theorized that there are a bunch of sub-categories of ADHD - one of which appeared to me to be a combination of classic ADHD symptoms and Bipolar (though not full blown, Bipolar 1) symptoms. I noticed also, that within all of these psychiatric "disorders" there is so much crossover between certain criteria for some similar problems - things that the docs will often consider to be 'co-morbidity disorders' - that my faith in the DSMV criteria is seriously undermined.

You said you'd read some interesting research on these issues. Anything you'd recommend my looking into?

Imagine if taking gobs of fish oil solved, or at least minimized all these mental health issues. That'd be fantastic. How long have you been taking the fish oil and doing the diet/exercises, etc.? How well has it worked for you both sexually and mental health-wise?

Klonopin 'vacations': I guess they vary. Depends on my situation at the time. The longest I've probably ever gone without is about a week. I may just have gotten used to being cranky after a couple of days but it does seem to me that after 3 days, the withrawal crankiness had worn off and I only felt the effect of the lack of the actual anti-anxiety effects of the medication itself. Hard to tell the difference of course. But when I did start it again, I definitely felt the effects immediately and it felt VERY calming and stronger than I remembered pre-'vactation'. So generally I would say, at least for me (or at least based on my perception) 2-3 days has generally been long enough. However there are two other factors that probably play into that: 1. I take these 'vacations' at least once a month, probably more., 2. I'm also on the Buspar so I have a secondary anti-anxiety med that probably does, during these 'vacations', a lot to help me through. I know you said you didn't tolerate the Buspar well so it may not be the same for you.

IMO: you should definitely change your GYN. Maybe your current GYN and your sister just happen to click well in a way that is simply a personality thing. Sounds like you don't have much to lose by trying a different one within the same practice. Maybe, if you feel comfortable enough doing so, you could mention to the new or potentially new GYN, exactly why you wanted to switch and exactly what your concerns are.

Grrrr!!! Have researched the sympto-thermal method and have come to the unfortunate conclusion that it won't work for me. Aside from the fact that it requires a lot of work, essentially, you either have to abstain from sex during what are likely your fertile days (which could be up to 10 days per month) or you have to use a barrier method during that time. So, for you, I guess unless you abstained during that time, you'd want to use condoms AND a barrier method like a diaphram, cervical cap or shield. Except for the Shield, the other two require being fitted for them by a doctor. The Shield, does not require a fitting but does require a prescription. On the other hand, there is the Today Sponge which may work well in combination with condoms. And you can buy the Today sponge over the counter without a doctor's exam or a prescription. Of course, if any of the above barrier methods would work for you generally, you could always just use both the barrier method and condoms throughout the month without bothering with the sympto-thermal method. I dunno - just throwing it out there.

My problem with all of the above, something I once knew but forgot, is that all the above barrier methods (except condoms, which I'm not going to use) require the use of spermicide containing nonoxodyl 9. I can't use it b/c I'm either allergic to it or it simply irritates me a lot. The Today sponge, also irritates my skin / flesh. I gather neither the diaphram, cervical cap, nor the Shield are particularly effective without the spermicide.

Oh, how very frustrating! I think I may have to go back to the old, non-hormonal copper IUD if nothing else magically appears. Heavy periods and cramping suck but I guess they're better than abstinence or an unplanned pregnancy.

I should mention that my current boyfriend and I have what I guess, generally, is a LOT of sex. On average, it's about twice a day (a true average, not just on the 4-5 days a week we see each other). My libido is not the problem, just my ability to orgasm from anything other than masturbation. Because the sex is so frequent, I definitely can't use any irritating chemicals as my body would never have a chance to recover.

That's my dissertation for the day.

Lammas