Since 2003 I've been on a combination of Lamictal (currently 400 mg/day) and Ortho Cyclen (for both BC and as treatment for debilitating endometriosis). Last time I went to Planned Parenthood to pick up a new pack of pills they told me that my Blood Pressure was too high and they were going to want to switch me to something with no estrogen. There are a bunch of reasons why this is an issue:

1.) Lamictal is supposed to lessen the effects of birth control and vice versa. All doctors involved have pretty much said that if I haven't ever gotten pregnant (and haven't started having GMs again), then this combination is probably working. I chalked this up to the fact that Ortho Cyclen is a comparatively "old" pill so it has more estrogen than the newer ones. The RNs at Planned Parenthood want me to go on something with no estrogen at all! A non-estrogen "mini pill" is only about 97% effective on its own, mixed with Lamictal, who knows? I offered to try one of the new "low dose" pills but that's still against their policy. I'm not supposed to switch brands or go off of the pill without consulting my neuro either which makes this extra complicated.

2.) I'm also taking Ortho Cyclen for endometriosis (severe menstrual cramps), I'm concerned that something without estrogen isn't going to help as much and I know that an IUD is out of the question as it makes cramps much, much worse. Prior to taking BCPs, the pain from these was so bad that I could barely get out of bed. Even when I wasn't menstruating I was having stabbing pains into the cyst which would make me double over.

I'm pretty sure the Blood Pressure issues are just from stress and my stress level goes WAY up whenever I'm at that clinic which I think is why it comes up so high there and not at other places.

As for all my risk factors: I'm 31, 5',1" about 105 pounds, eat a vegetarian diet high in veggies low in salt and processed foods, non-smoker, sometimes drinker, no coffee and only green or decaf tea. I have a fairly high stress level because I'm in grad school right now and there's been a lot of problems within our department (I'm kind of a type-A personality, too).

I'm trying to find a way to talk to my neuro but she has a 1 1/2 month waiting list and the clinic wants me back within 3 weeks. Thanks for reading. Please help!