Mounjaro has stopped the mini pill from working

[Squeeeeek]

DD has been on Cerelle for a year to control her PCOS symptoms. Her really bad acne cleared up beautifully.

She started on mounjaro 8 weeks ago and is still on 2.5mg, 19lbs lost which she’s thrilled about as she was very, very overweight, carrying all her weight on her back, shoulders arms etc.

Sadly the acne has come back with vengeance, she’s full broken out on her chest and face with deep, purple cysts and pustules.
Shes also constantly spotting, bleeding when wiping and she’s losing small bits of tissue.

Why does mounjaro affect the pill so much? Is there anything else she can do or take to get the acne back under control? Has this happened to anyone else?

you should of been warned about this.. when you fill in the medical questionnaire it asks if you are on the pill. I think its because mounjaro delays your stomach emptying, so everything is in there longer, so stuff like the pill wont get absorbed and wont work as well, people that use it for contraception are told to use other methods whilst taking mounjaro.

Could she bear roaccutane? Not sure if that is OK with MJ.

I should add she doesn’t use the pill for contraception but it was working beautifully to clear her skin, which is a shame as she seems to be either depressed about the weight or her skin

It’s more likely the weight loss is causing period change due to pcos. Pop causes acne and 1/3 of patients to spot. Daily even. Sure, It is listed that vomiting or diarrhoea or can affect absorption and delayed gastric emptying will affect a 3 hr pill but in the absence of d and v cerelle will be fine. At a better bmi she can try cocp but again not really for 100 per ent contraception but for better skin control. Pop worsens acne, don’t touch the implants as the same. Depot causes weight gain. If not needing contraception use oral antibiotics or get referred for roccuatane. I hope one day all the pcos lot can get mounjaro as it’s so much better than metformin. Condoms if she is I. Relationship and ditch the pop!

Could she talk to her Doctor about whether another progesterone only contraceptive might work instead?

Mirena, Depo injections or the implant might be worth a try as they aren't digested in the stomach so aren't affected by MJ.

I have a friend (not on MJ) who uses both the mini pill and mirena because one alone doesn't stop her bleeding. Could be worth asking the GP about too.

Op you will find any implied criticism of MJ gets short shrift on here.

Desogestrel (the active ingredient of Cerelle) is metabolised to etonogestrel, which is the ingredient in the implant, and the implant isn't affected by Mounjaro. So having an implant fitted would be sensible.

Have you replied to the wrong thread?

The OP wasn't critical about MJ and nobody has given her short shrift.

It will definitely be having an affect, really sorry to hear it's so bad - I know what it's like, still spotty well in to my middle age! I'd def see if she can get something topical from her GP to try to keep it calm (and reduce further possible scarring) while the weight loss settles which will in turn help her hormones settle and hopefully things can improve again.

What are you on about? During the consultation, patient leaflet, advice from pharmacists, it's said over and over that Mounjaro affects the efficacy of oral contraceptives and people should make further arrangements regarding this if they need to. Its also explained further as to why and what.

If anything, this is yet again another example of people who don't seem to have read and researched the medication they've applied for and been prescribed and are surprised with the obvious side effects and how it works. This is not the criticism you think it is. The "short shrift" isn't whether it happens or not but why it is a surprise that it can do.

not for skin though!

I agree. I’m not even taking contraceptives and I’m aware of the antagonistic drug interaction ie MJ making contraception less effective. I’m aware of this because there’s disclaimers about it before you purchase and on the patient leaflet which I read…

I think it’s always worth cross referencing any new medication you take with the medication you currently take, and making an informed decision before you go ahead.

In this situation, I’d recommend finding another way to manage acne. I also suffer from it and had success with topical treatments. Also chances are that weight loss may improve her acne, as being overweight and obese can increase the risk of acne.

if the pill helped her skin the implant would do too

I’m on Cerelle and have also been having similar break through bleeding. Have been a little spotty as well which is unusual for me.

I was expecting it as per the advice leaflets, but have noticed that it seems to be calming down now, perhaps as my body gets used to new rates of digestion.

Might be worth giving it a few more weeks and see if it does settle down. Hope she’s okay, must feel a bit disheartening to lose some weight that has been bothering her and then the acne rearing its head again.

Also do encourage her to raise it with the GP and her provider, they may have some good advice.

Thanks all, happy to hear all advice. Shes thrilled with the weight loss and says that even though the acne is bad, its the lesser of two evils for her.
I’ll suggest she revisits the GP.

When you all talk about the implant, do you mean Mirena or the arm under the skin one?

No mirena is a coil.

Implant is in the arm
Coil/mirena is in the uterus