I'll start from the beginning. I'm a 25 yo F. 3.5 years ago I got pregnant while taking BC pills, religiously. I ended up having an abortion and putting in the mirena IUD. I Couldn't figure out why I got pregnant since I was on the pill, I mean I know they aren't 100% but really, the cloud over my head isnt THAT big, is it? I finally put it together that I had just recently been prescribed Topomax. WWW.WWWW.WW says topomax "may lower the affectiveness" of bc. So I'm guessed it was adding the topomax. Well I just had the mirena taken out (after 3.5 years) because after insertion I had horrible cramps, it hurt to poop (sharp pain in my pelvic area just before I would poop), I also went all crazy and got acne again. I felt like a 15 year old again. well now that I've taken it out, I want to start taking Lybrel as my form of BC. My doctor (who I don't have a ton of faith in) says it's stronger than my old bc that I got pregnant on so the topomax wont affect it that much... is that true? are there stronger bc pills? I know there is still a risk, but I want to know, is the topomax so strong that I might as well not even use bc? or as my friend said, "is it like the pill is a condom, and the pill + topomax is just pulling out?" lol. and also, the drug that was in the mirena the levo something made me insane and acne ridden, so I'm confused how the Lybrel, which also has the Levo something in it is supposed to help treat acne pmdd and cramping... so a quick recap of my questions: Does topomax at 200mgs effect the bc so much that I have a pretty good chance of getting pregnant? and Since the Lybrel is levonorgestel and ethinyl estradiol, and the Mirena was the Levonorgestel (which made be go ape shit) - will the ethinyl estradiol really make that much of a difference? and last but not least, why does it still hurt so bad- like acute pain in my pelvic area when I poop?