Mesntrual Cycle

Dear All,

For those of you who are struggling to get control, and are seeing patterns linked to female hormones, there is a topic link about this in the questions for Healthcare professionals forum. You can follow advice etc. there.
If you are female and are struggling to get BI sorted, you may wish to consider that the problem might be related to your cycle and you may be able to chart the pattern which is a starting point for sorting it.However, you may also find that the step wise approach doesn't cope with this. For a lot of us, it seems to be too slow and lags behind the hormonal variations throughout the month.
It would be good to hear from females who have got this sorted and from females who got their BI and ratios worked out no problem i.e have found that the DAFNE step wise approach worked just fine and you use one BI throughout the month. If you do, can you also let us know if you are on the pill? This could be helpful for others who could try this.
Similarly, if you are struggling, it would be great if you could post too so that we can get an idea of the extent of the problem.

Thank you.

(I will post this in both threads considering I've already posted in that HCP thread you mention)

I think when I first started working out my new lantus doses when I first split, I was not aware of how drastic the changes are, and it's only been since I came on to Levemir that the full extent of the problem actually came to light and the penny dropped that I would need to work hard on this problem.

Working it out progress:

I've still not quite worked out what is going on exactly, but while I am, I've found that if I draw myself up a chart, I've found it has helped me remember for next month instead of checking back in my DAFNE diary. I find that my highs start before the pill has even finished being taken (which (unsurprisingly) surprised one of my DAFNE nurses!)!

It goes like this (roughly) considering I don't have a photo handy of it (written in pencil so it's easy to edit):
Firstly, please note that I start my pill taking on a wednesday so it finishes on a tuesday. I am also on a split dose of Levemir so each change will be marked MORN or EVE. I take my insulin MANUALLY.

Thursday (before the pill finishing tuesday) EVE: 16-18 BI (I'm still unsure which it is because of mixed signals )
Friday MORN: 10 BI

Leave it until...

Thursday (first thurs after pill is finished) EVE: 11 BI
Friday MORN: 9 BI

Period starts late sat/early sun - only lasts a few days (due to pill). Leave it until...

Monday MORN: 7 BI (If I don't do this change, I have very serious hypos - so bad that I hypo twice again after treating the first hypo again! Had to fix that ASAP! This happens EVERY TIME without fail if I don't put it down from 9 BI!)
Monday EVE: 9 BI

Then when the pill starts again Wednesday EVE I'm back to "normal routine" of 6 MORN BI and 11 EVE BI.

Pill talk

I am on the Microgynon pill currently - I do believe this has helped because patterns seem to have been consistent, but I do not want to remain on this pill. I have been considering a hormone free coil but considering the shifts of non-pill users that have been brought up in the Information on menstrual cycle thread found in the HCP section of the forum, I have been a bit afraid to proceed with the change considering I don't yet understand what's happening while on a pill.

At the moment during the time of the month (TOTM), I am only adjusting my BI. Recently though, I'm beginning to doubt that my 'off TOTM' insulin is still not quite right, but I have been very stressed lately with work changing my environment again and the like, so results have been messed up yet again. I have also done a new adjustment of putting my evening meal ratio up to 1:1.5 but considering I've been 1:1 for such a long time and currently under stress, I will be keeping an eye out for hypos.

This TOTM stuff used to frustrate me no end, but it's slowly got easier... but the fact I don't understand it all is keeping the annoyance there.

Back to back pills

Before I forget, I recently went on holiday and I was expecting to have to take two pill backs back to back to prevent period... but I knew that my hormones kicked in before the end of my pill taking so I was very concerned about what would happen if I did take pills back to back.

I did ask one of my DAFNE nurses and she said that instead of risking a hypo from my body going straight back to normal doses straight away. Thankfully, I didn't have to in the end because my TOTM didn't start until after I got home so I didn't back to back in the end.

With this, has anyone established what happens? I know the doctors recommend that you only do pack to pack once or twice a year at most (because it mucks up your hormone patterns - I can vouch - I was stupid enough to do it one on, one off, for a few months) so it's not likely it will get much attention as the straight forward pill taking.

Although my nurse has pointed out to me that hormonal changes due to TOTM could be causing some hypo's with me, (I went through a phase that I was hypoing continuously and had to stay with my parents for a few days) I still havent thought about how to get a pattern, I just assumed it would sort itself out, in thinkin about it I guess I do still hypo quite often around my TOTM but now I certainly will try n find out exactly when and how my 3wks on and 1wk of pill will affect my BG and how to control it better.

Hi JWo,

I too seem to go up and down around my cycle. Since I did my DAFNE course I have been trying to log my levels re my cycle. So far nothing major but I have recently also changed my pill to Micronor (a mini pill)
I had alot of trouble with going very low usualy the week before and during my cycle though when I used to be on Microgynon. Just wondering if it may have been because of the type of pill as I don't seem to go AS up and down as I used to? I cant say for sure as this has only been my first cycle since the DAFNE course (having more info) but thinking back I definately haven't Hypo'd as much since changing the pill.

Might be totaly different for you but thought i'd let you know. I will be keeping an eye on the changes through my cycle, see if I can make sense of it too! The hormone changes definately seem to make a difference!

thanks to JWo, tweety and endtherapies for replying to this. I was really interested in hearing your ecperiences with the pill.
It doesn't sound much better than being off the pill to be honest. I do find that natural hormones cause a drop of bg just prior to menstruation, down to that low dose which then lasts throughout that week. It then starts to edge up and I have to increase BI until about 10 days before menstruation where it reaches a peak and stays there. I have the level for this peak sorted, I have the dropping down to menstruation sorted ( no gradual change just have to go straight to the low dose)i.e. not follow the step wise approach as like tweety, to not turn it straight down causes nightime and daytime hypos , and the remaining on the low does during my period sorted so it is gettting there. It is the rise over the coming weeks leading up to the peak dose that is causing the trouble.
Think the idea of a chart is great. I just realised that something funny was going on as I kept ending up at the same dose and then crashing down to the same dose and I started recognising these as familiar. I luckily keep a record of my periods so when I then notice d that this was a montly pattern I did wonder. Then of course I saw tha t there were 2 distinct BI's a high one and a low one. At the highest does that I use, my BI is double that of the lowest one that I use just prior and during my period, so you can see why it causes so much trouble as it is not a couple of units here and there. Think I will psot to see if any girls of menstruating age are using the on BI throuoghout the month. See what people reply. I did say to other women on my course with whom I have kept in touch to look to see wha t they noticed as none of them had thought of this and had given up on DAFNE as being no use for them.There is no doubt that charting and tracking is the only way to learn about the patterns.
I expect to end up with a ready reccknor thing writeen into the front of the diary with the dose for each day of the month once I get it sorted. It is exasperating how long this is taking especially as meantime we are feeling dreadful.
I am interested in the QA ratios as a method to sort this as I suppose the alternative is to pick a BI and alter the QA to sort it.
I think I may give this a try on the rising bit of the month seeing as I have the BI sorted for 2 times a month.

Great to hear from you all and good luck.

To bring it even more into light how worthwhile it is to chart the changes... I've not hit the first thursday yet and I'm already taking the "hormonal time" high doses! Madness!

I'm really not sure what to expect now you say that Edentherapies! The main great thing I find about taking a pill generally is the regularity of it. I was often around a week late when I was a teenager and off the pill so I wonder if that will still be the case now... it's madness to think what it's going to be like for my doses.

I completely agree with the reoccurring statement that DAFNE's waiting rule does not help the situation of working this all out, but I would like to bring to light about some advice one of my DAFNE nurses gave me after I showed that I'd been adjusting my BI a lot... she told me that I should give it at least a week before adjusting my BI again. With this, I've been concentrating on adjusting my ratios more for now before I go "that's definitely BI" like I was before and only leaving it for 2 days.

I think leaving the BI for a week odd has made me aware of the need to put the higher dose on earlier... (I am really confused by this now though - it completely throws out the idea that it's just the week before the TOTM!).

I really ought to mark on my calendar when my periods are expected considering I tend to avoid taking packs back to back if I can.