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tina72

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Reply with quote  #1 
Hi everybody,
our d is 17 , Phase II and she has a boyfriend. I´m now thinking of taking her to the doctor to talk about prevention. I bet the doctor knows nothing about ED so I have to be prepared. What do you prefer: oral prevention (what about possible purging?) or 3-month-syringe?
Or is it no good idea to come up with hormon at all? She has her period back for 3 month now and its regularly. I just don´t want her to get pregnant in this difficult situation...
What do you think?
Tina
Foodsupport_AUS

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Reply with quote  #2 
The question of contraception in teens is important. Have you spoken to her before about safe sex? 
If she needs protection I would probably go with something such as the implantable contraceptives, they are more effective and don't affect hormone levels as much. 

The three month injection can cause bone loss, and as you point out pills can be purged or more likely just plain old forgotten. 

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
tina72

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Reply with quote  #3 
Thanks for the information about bone loss with the injection, I didn´t know that so that might be contraproductive.
Yes, we surely talked to her about safer sex a lot of times. I do not really know if it is urgend, I think she is not sooo interested in that up to know, but I want to be prepared and I don´t want her to get pregnand anyway but surely not at this phase of recovery. I will ask for implantable contraceptives, thats a good idea.
Thanks!
Tina
scaredmom

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Reply with quote  #4 
Hi ,there is a contraceptive patch (evra). (To be honest, the more estrogen the better for the bones.) Estrogen used to be used for the treatment of osteoporosis.....no longer, as increases risk of breast cancer in that population.
But the condoms are essential to prevent sexually transmitted illnesses. Has she had the HPV shot to prevent cervical cancer? That can be given (here in Canada) up to age 46 if she has not yet had it.
Good luck!

toothfairy

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Reply with quote  #5 
Hi There,
Honestly I would hugely encourage condoms to all young people, along with the woman taking a precaution as well.
The amount of STD'S among young people is just frightening...

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
tina72

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Reply with quote  #6 
Condoms will be added, we talked about that. But this is alone not save enough for my opinion.
Yes, she had the HPV shot 2 years ago. Thanks about the idea with the contraceptive patch. I will ask for this.
Do you think I have to check the bones? They took blood in hospital and said everything is o.k. but on the other hand they gave her Vitamin D for half a year...
Tina
scaredmom

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Reply with quote  #7 
Hi Tina, no I do think you need to check her bones. I t mentioning it as those with AN are higher risk so estrogen is a good thing and the Vit D is great!
toothfairy

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Reply with quote  #8 
Hi Tina,
I gave my kid a calcium supplement which he was told to have after IP ( ALL THE AN PATIENTS WERE TOLD THIS).
My S had great difficulty taking the big chalk like tablet and so I found a liquid form , however the liquid form was A CAL,MAG,ZINC supplement.
He took it no problem for a year... I truly believe that IMHO  the cal,mag,zinc mixture helped with his brain healing too....HE IS DOING GREAT..

if you want to check the bones you can get a DEXA scan.
Best wishes...TF 

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
sk8r31

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Reply with quote  #9 
I will add my voice to second the notion of implantable contraceptives.  

We had an amazing ED doctor/psychiatrist that said he would not recommend any of his clients using contraceptives that interfered with hormones.  



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It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
scaredmom

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Reply with quote  #10 

Just FYI the implants have hormone that stop ovulation. So not sure what is meant by comments " does not affect hormones"?

tina72

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Reply with quote  #11 
I will ask the doctor next week what kind of contraceptives have the minimum impact on the bones. Thanks for that information. Maybe he can take blood to see if the hormon level is normal again before we start to disturb it. I wish we could wait a bit, I must talk to her again and ask for that.
Tina
sk8r31

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Reply with quote  #12 
I defer to Food Support as a women's health provider, and one who has experience of EDs.  IUDs can be a preferable method of birth control for someone who has had an ED.

This article talks about menstrual irregularities, EDs and birth control.

As always, consult with your medical team on the ground & make the best decision based on your family's values & d's health.

Warmly,
sk8r31

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It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
mjkz

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Reply with quote  #13 
Quote:
We had an amazing ED doctor/psychiatrist that said he would not recommend any of his clients using contraceptives that interfered with hormones. 


The only forms of birth control that do not contain hormones are barrier methods (condoms, the female condom, sponge, cervical cap, diaphragm used with spermicide) and the copper containing IUD (Paragard) here in the US.  Mirena IUD's do contain hormones as do implantable contraception outside the uterus (i.e in the arm) and birth control pills.  Paragard does not help with heavy periods and may in fact cause a lot of bleeding and discomfort.

My daughter tried the injection and for her it was horrible because she had a bad reaction to it.  Once you inject it, there is undoing it but to wait.  It messed up her cycle for a long time afterward.  Any form of birth control that altered hormones sent her into a tail spin mood wise.  She went with condoms and a diaphragm but she was older and less likely to just go along in the moment. 

Do not assume because any woman has no period that she cannot get pregnant.  A lot of women who are anorexic may not have periods but can still get pregnant.  I think you have to be realistic about what your kid is able to do and go from there.  Nothing is fail proof so take your daughter to a doctor who has experience with eating disorders as well as gynecology. 

To check bone density, you get a scan called a DEXA scan which is taken of the lumbar spine and hip.  It is similar to an X-ray.  That is then compared to a "normal for age" scan and you get something called a T-score where -1 is normal.  The system my daughter had her DEXA scan through rated anything equal to or higher than -2.5 as osteoporosis and osteopenia was -1.8 to -2.4.
deenl

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Reply with quote  #14 
Quote:
Originally Posted by mjkz


My daughter tried the injection and for her it was horrible because she had a bad reaction to it.  Once you inject it, there is undoing it but to wait. 


My sister in law had a terrible reaction too. Yep, I a non stop 3 month period. And like Mjkz said you can only wait as it works its way out of your system.

It's great that you are being proactive about this and not taking chances.

Warm wishes
D

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2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
evamusby_UK

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Reply with quote  #15 
We used a specialised family planning/STD centre, and I was interested and pleased to see that "do you have an eating disorder" was part of their standard questions. 

With mine it looked like the only choices that would be acceptable health-wise were the contraceptive pill and the Mirena IUD. I haven't worried about the hormonal component of these but I have been sad that I have lost one indicator that, with regular periods, she is probably on track with her (independent) eating.
Still, priorities... As you say, pregnancy would not be OK!

I have found it interesting how as a mum I've had to assert my "Mum" role in this area. We don't magically know how to handle these things. The protests of "But mum, it's not that kind of relationship" and the "You're ruining it all with your talk" made me seek out other mums' experiences. Once the decisions were taken it was clear I didn't ruin anything and it was the right thing to do.


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Eva Musby, mother, author, produces lots of resources for parents at http://anorexiafamily.com and on YouTube https://www.youtube.com/user/EvaMusby/playlists
[comp]
aloha

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Reply with quote  #16 
BTW tooth fairy in response to your post.
can you tell me name of the supplement, have been advised on this, osteoporosis is quite severe
no periods yet thereby underoesgenised.
thanks ed is still lurking in the shadows but not as strong as before but weight is static!

A.  
tina72

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Reply with quote  #17 
Hi aloha,
at least we took a contraceptive patch (name is Evra in Germany).
The doctor told us it will not harm the bones. My d´s period is back for 4 cycles. The doctor would have given it even without period because the danger of pregnancy is there even without period. And nobody wants that in our situation...
If there is no period back, think about weight, maybe its not enough. Sometimes another 2-3 pounds make the difference...

Tina72
MegsMom

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Reply with quote  #18 
My two cents:
My d became sexually active when she headed off to University, in recovery but with a very strict contract (I saw her every 2 weeks with a scale and dinner reservations and my own assessment of her state).  She was still having some trouble with purging but maintaining weight and working on "state".  Under doctor supervision, therapy etc.  Her treatment team recommended an IUD.  Place it and forget it.  Needless to say 2 years later - no pregnancy but an STD. Luckily treated with antibiotics.  Every child is unique - every situation needs to be reviewed with what our children can handle and what we are willing to work with.
I knew she still had impulse behaviors that were not going to be compatible with condom use.   her purging eliminated oral contraceptives and our medical team wanted to stay away from hormones as she was also taking antidepressants and anti anxiety meds.  There are a lot of options out there, find one that fits where she is at today.
<hugs>

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MegsMom
sahmmy

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Reply with quote  #19 
My d's pediatric endocrinologist, who did her thesis on low bone density in eating disorders, recommended the patch. She said it's the only contraceptive that evidence shows won't decrease bone density, and may even help bone density.
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d=18, R-AN, Generalized Anxiety Disorder. Refed at home with information gathered from this forum and lots of books. Relapsed. Refed. Relapsed. Refed. 17 sessions with an excellent individual therapist. 19 sessions with unhelpful dietician. 3 sessions of DBT (didn't like it). Psychiatrist available if needed. Prozac - fail. Lexapro - fail. 5HTP - fail. Clorazepam/Klonopin = major improvement, only used when necessary. Genomind SLC6A4 short/short - not able to process SSRI's.
d=15, lost 14 lbs in 8 months, Ped [nono]diagnosed as a crystal on a hair in the ear canal
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