[lastscer]

Hello,

My wife was diagnosed with AA early last year after carrying the dx of ITP for many years. Her issue is mainly platelets (10k~15k) with HGB between 11-12 and ANT between 0.8 and 1.2. Since then, she had extremely heavy menstrual periods every month and needed to be transfused at ER a couple times. We live in a small city and the doctors here do not have much experience in controlling bleeding in AA patients - their recommendation is Lupron shots plus Aygestin (norethindrone). We did some research online and decided to stay away from Lupron so she started Aygestin at 15 mg/day then slowly tapered to 2.5mg/day. This medication did a wonderful job in controlling her bleeding. She actually only had a few days of spotting in the last 6 month with the medication.

Our issue is that a more experienced OB doctor has recently recommended an oral contraceptive pill with both norethindrone and estrogen. He believes the OC pill will be as effective as taking norethindrone alone in controlling the bleed, but can also help to prevent pregnancy. We are concerned with switching over to a different drug would cause breakthrough bleeding, plus given the proven result by Aygestin we are hesitant to switch to something new.

Has anyone here dealt with similar issues before? I would really appreciate it if you could share your experience with either medication, their effectiveness in controlling the bleeding, and any concern with long term side effects (e.g. liver damage).

Thank you for your help!!!

Roger