Womens Health, Fitness, Weight Loss, Beauty and More

Birth control pills for dysfunctional uterine bleeding and perimenopausal symptoms

Examples

Brand Name: Alesse, Loestrin 1/20, Mircette

Chemical Name: Very low-dose pills

Brand Name: Lo/Ovral, Seasonale, Yasmin

Chemical Name: Low-dose pills

Brand Name: Ortho-Novum 7/7/7, Ortho Tri-Cyclen Lo, Triphasil

Chemical Name: Phasic pills

Brand Name: Demulen 1/50, Ortho-Novum 1/50, Ovral

Chemical Name: High-dose pills

How It Works

Birth control pills, which are also called oral contraceptives, regulate the body’s estrogen and progesterone levels. You take birth control pills every day. Birth control pills:

Prevent the ovaries from releasing an egg every month (ovulation). This prevents pregnancy.
Minimize growth of the uterine lining, called the endometrium. This reduces or stops dysfunctional uterine bleeding (thick endometrial growth leads to heavy bleeding).
May cause you to have fewer menstrual periods if taken continuously for a long period of time.
May improve perimenopausal symptoms that are caused by fluctuating hormone levels.
Why It Is Used

Birth control pills are commonly used to:

Stop a teen’s irregular menstrual bleeding (dysfunctional uterine bleeding) and regulate her cycle.
Regulate a perimenopausal woman’s irregular periods (dysfunctional uterine bleeding).
Regulate perimenopausal hormone levels, with the intention of reducing hormone-related symptoms while providing effective birth control.1, 2
Regulate a woman’s menstrual cycles that have been chronically irregular.
How Well It Works

The endocrine system, which produces hormones, is complex and not fully understood. Therefore, as with any hormone treatment, birth control pills do not reduce symptoms in all women. They cause troublesome side effects in some women, but not others. If you have problems with ineffectiveness or side effects, ask your health professional whether a different hormone formulation may work better.

Dysfunctional uterine bleeding. Birth control pills reduce heavy menstrual bleeding by about 60%.3

Perimenopausal symptoms. Birth control pills reduce or eliminate hot flashes and improve sleep problems and depression in most perimenopausal women, while effectively preventing pregnancy.2, 4 Studies report a range of 65% to 100% of women gaining partial to full relief from hot flashes when using birth control pills.2

Disease prevention. The estrogen in birth control pills maintains or improves bone density (osteoporosis prevention) during perimenopause, when bone loss begins to increase.2 Long-term use (4 or more years) of birth control pills helps preventendometrial cancer and ovarian cancer. Experts suspect that progestin is the protective factor.5

Recurrence
When you stop taking birth control pills, dysfunctional uterine bleeding or perimenopausal symptoms may return.

Side Effects

Side effects of birth control pills are generally the most severe during the first few months of use and then gradually subside. The most common side effects are:

Breast tenderness.
Nausea.
Although some women report weight gain with birth control pill use, studies suggest that generally, long-term weight gain is not a common side effect.2

The risk of serious side effects increases in women who smoke.

Rare, but more serious, side effects include:

High blood pressure.
Blood clots in a vein (deep vein thrombosis) or lung (pulmonary embolism).
Heart problems.
Possible increased risk of cervical cancer.
If you have serious side effects, call your health professional for immediate follow-up.

If you have bothersome side effects, report them to your health professional at your next regularly scheduled visit.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Do not use birth control pills if you:

Are older than 35 and smoke, have complications from diabetes, or have an increased risk of heart disease.
Have a personal history of breast cancer. Estrogen stimulates certain types of breast cancer.
Have uncontrolled high blood pressure.
Have liver disease.
Have a history of blood clots in a vein (deep vein thrombosis) or lung (pulmonary embolism).
Have a history of stroke.
For women older than 35, low-dose birth control pills are recommended. If you have no risk factors, such as a history of heart problems or stroke, you may use birth control pills until menopause is completed. Birth control pills are not recommended for use after menopause.

Birth control pills for the treatment of chronic pelvic pain

Examples

Brand Name: Brevicon, Demulen, Levlen, Lo/Ovral, Modicon, Nelova 1/35, Nelova 10/11, Nordette, Norethin 1/35E, Norethin 1/50M, Norinyl 1+35, Ortho-Novum 1/35, Ovcon, Tri-Levlen, Tri-Norinyl, Triphasil

Chemical Name: estrogen/progestin combination pills

Brand Name: Micronor, Nor-Q.D., Ovrette

Chemical Name: progestin-only pills

How are these medications taken?
For information on progestin injections, see the Medications section of the topic Chronic Female Pelvic Pain.

How It Works

Birth control pills control female pelvic pain by:1

Stabilizing the production of the hormones that stimulate endometrial growth (estrogen and progestin).
Preventing ovulation.
Decreasing the amount of blood loss during the menstrual period.
Stopping the menstrual periods for long periods of time when the continuous 15-week regimen is used.
Why It Is Used

Birth control pills may be used before a laparoscopy (surgical procedure for investigating the source of pelvic pain) when:

Symptoms are mild to moderate.
Birth control is desired.
Birth control pills may be used after a laparoscopy to help prevent the recurrence of pelvic pain.

How Well It Works

Effect on menstrual period symptoms
Menstrual periods are usually less painful with lighter flows.
Young women with very painful menstrual periods and minimal to mild endometriosis usually report improvement when taking oral contraceptives continuously for 15 weeks without breaks for menstrual bleeding.
Effect on fertility
Pregnancy rates may not improve after treatment with birth control pills is stopped.1

Recurrence
Female pelvic pain may return when you stop taking birth control pills.

Side Effects

Birth control pills have been studied extensively and are considered very safe.

More common side effects include changes in menstrual periods, such as very light or skipped periods or spotting (bleeding between periods).

Less common side effects include:

Nausea and vomiting, especially in the first month of use. This side effect usually goes away after the first few months of use or can be prevented by taking the pill with a meal.
More frequent or more severe headaches. Migraine headaches may get worse.
Weight gain.
Breast tenderness for the first few months.
Depression or mood changes.
Darkening of the skin on the upper lip, under the eyes, or on the forehead (chloasma). This may slowly fade after the woman stops taking the pills, but in some cases, it is permanent.
Decreased interest in sex.
Rare but serious side effects
The following symptoms, called ACHES, are rare but serious and should be reported to your health professional immediately.2

Abdominal pain may be a sign of blood clots (thrombophlebitis) in the pelvis, liver blood clots or tumors, or gallbladder disease.
Chest pain may be a sign of blood clots in the lungs (pulmonary embolism), heart attack or heart disease, or breast tumors. Smoking increases this risk.
Headaches that are severe may be a sign of stroke, migraine, or hypertension. Smoking increases this risk.
Eye problems, such as blurred vision or loss of vision, may be a sign of migraine, eye blood clots, or a change in the shape of the cornea.
Severe leg pain may be a sign of leg blood clots (thrombophlebitis) or deep vein thrombosis (DVT).
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Birth control pills may control the progression of female pelvic pain, but they do not cure it. They may not reduce symptoms in all women. You may use birth control pills until menopause is completed, if no risk factors are present. Birth control pills are generally not recommended if you have any of the following conditions:

Uncontrolled high blood pressure
Liver disease
History of blood clots in a vein (deep vein thrombosis) or lung (pulmonary embolism)
History of stroke
A clotting disorder
Birth control pills are generally not recommended for women over the age of 35 who have diabetes or who smoke.