Medical Uses of the Birth Control Pill

Adolescent girls and young women are frequently prescribed birth control pills for irregular or absent menstrual periods, menstrual cramps, acne, PMS, endometriosis, and for Polycystic Ovary Syndrome. Girls who are diagnosed with PCOS are often prescribed oral contraceptives to lower their hormone levels and regulate their menstrual periods.

Birth control pills (sometimes called “the Pill”, oral contraceptive pills-OCP's, or hormonal pills) contain one or two types of synthetic (man-made) female hormones, estrogen and/or progestin. Similar hormones are normally made by the ovaries. There are many different types of oral contraceptive pills.

What kinds of medical conditions can be helped with birth control pills?

Polycystic Ovary Syndrome (PCOS): is a hormonal imbalance which causes irregular menstrual periods, acne, and excess hair growth. Birth control pills work by lowering certain hormone levels to regulate menstrual periods. When hormone levels are decreased to normal, acne and hair growth often improve.

Endometriosis: Most girls with endometriosis have cramps or pelvic pain during their menstrual cycle. Birth control pills are often prescribed to treat endometriosis and work by temporarily preventing periods. When hormonal treatment is prescribed continuously, young women will rarely have periods, or not at all. Since periods can cause pain for young women with endometriosis, stopping periods will usually improve cramps and pelvic pain.

Lack of periods (“amenorrhea”) from low weight, stress, excessive exercise, or damage to the ovaries from radiation or chemotherapy: With any of these conditions, the hormone “estrogen” is not made in normal amounts by the body. Birth control pills may be prescribed to replace estrogen, which helps to regulate the menstrual cycle. For girls whose menstrual periods are irregular (too few - or not at all), birth control pills can help to regulate the menstrual cycle to every 28 days and provide the body with normal amounts of estrogen. Normal estrogen levels are important for healthy bones.

Menstrual Cramps: When over-the-counter medications don't help with severe cramps, birth control pills may be the solution because they prevent ovulation and lighten periods.

Premenstrual Syndrome (PMS): Symptoms of PMS such as mood swings, breast soreness, and bloating, along with acne can occur up to 2 weeks before a young women's period. Birth control pills may be prescribed to stop ovulation and keep hormone levels balanced. Symptoms may improve, particularly when oral contraceptive pills are prescribed continuously.

Heavy Menstrual Periods: Birth control pills can reduce the amount and length of menstrual bleeding.

Acne: For moderate to severe acne, which over-the-counter and prescription medications haven't cured, birth control pills may be prescribed. The hormones in the Pill can help stop acne from forming. Be patient though, since it takes several months for birth control pills to work.

Other Medical Benefits

Because there is less menstrual bleeding when taking birth control pills, you are less likely to get anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Birth control pills lower your chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts.

What are the side effects of birth control pills?

Most women have no side effects when taking birth control pills, but some women do experience irregular periods, nausea, headaches, or weight change. Each type of oral contraceptive pill can affect each woman differently.

Spotting or Irregular Periods: Very light bleeding (you don't need to use a regular pad, just a panty shield) may occur during the first 3 weeks of taking the Pill and may continue up to 3 cycles, but this is not serious. If the bleeding becomes heavier (more than just a very light flow or lasts more than a few days), call your health care provider.

Nausea: Sometimes a young woman can feel nauseated, but the feeling usually goes away if the pill is taken with food or with a bedtime snack. Sometimes a pill with less estrogen is prescribed if the nausea doesn't go away.

Headaches: Sometimes, young women may complain of headaches when they start taking birth control pills. Most often headaches happen because of stress or other reasons such as skipping meals, not enough sleep, sinus infections, or migraines. If your health care provider thinks your headaches are related to the Pill, he/she may prescribe a different pill with a lower amount of estrogen or may take you off of it completely and watch to see if headaches improve.

Mood changes: Feeling up and down emotionally can sometimes happen to anyone and is unlikely to be caused by the Pill. Exercise and a healthy diet may help, but if they don't, you may need to talk with your health care provider and try a different kind of oral contraceptive pill.

Breakouts: Usually the pill helps cure acne, but a few women feel they get acne from a certain kind of birth control pill.

Sore or enlarged breasts: Your breasts may become tender or may get larger.

Weight: Some teens gain weight and some teens lose weight while taking birth control pills, but most teens stay exactly the same weight. Many times a young woman thinks she has gained 5-10 pounds, but when her weight is actually checked, there is no change. If you think you may have gained weight while taking the Pill talk to your health care provider. Try to remember to watch your portion sizes and eat 5-7 servings of fruits and veggies each day and don't forget to exercise. Your appetite may increase or stay the same.

Side effects usually go away in the first three to four cycles. If you do have side effects, you should talk to your health care provider. If the side effects are very uncomfortable or if they don't go away after three cycles, your health care provider may switch you to a different pill.

Are there any risks with birth control pills?

Birth control pills with estrogen may cause a slight increase in the risk of developing blood clots in the legs. Among young women who do not take the Pill, 5 out of 100,000 teens and young women per year develop blood clots. Among women who do take the Pill, the risk slightly increases to 15-20 out of 100,000 women per year. Find out if anyone in your family (blood relative) has had blood clots, especially when they were young. If you are a smoker, try to quit as soon as possible.

What if I forget to take one or more birth control pills?

If you forget to take your birth control pill at your usual time, take it as soon as you remember. Take your next pill at the regular time. If you do not remember until the next day, take two pills that day. If you are also using the pill to prevent pregnancy.

What if my period is very light while I'm taking birth control pills?

Your period may be so light when you are taking birth control pills that you may have only a brown smudge on a tampon, pad, panty shield or underwear. The hormone doses in birth control pills are very low. This means that the lining of your uterus doesn't become very thick so very little blood needs to come out each month.

Are there side effects that I should contact my health care provider about?

Most young women who take birth control pills have few or no problems. However, if you have any of the following problems, call your health care provider right away.

• Abdominal or stomach pain (severe)
• Chest pain (severe), cough, shortness of breath
• Headache (severe), dizziness, weakness, or numbness
• Eye problems (vision loss or blurring), speech problems
• Severe leg pain (calf or thigh)

Remember: ACHES

What if I am also using birth control pills to prevent pregnancy?

If you take birth control pills for a medical reason, you're also protected from getting pregnant. The Pill however does not protect you against sexually transmitted diseases. It's therefore very important to ALWAYS use a condom when having sexual intercourse.