Medical Uses of the Oral Contraceptive Pill

 

Adolescent girls and young women are frequently prescribed oral contraceptive pills for irregular or absent menstrual periods, menstrual cramps, acne, PMS, PCOS, endometriosis, and hormone replacement therapy.

 

What are oral contraceptive pills?

Oral contraceptive pills (also called the “Pill”, OCP’s or hormonal pills) contain two types of synthetic (man-made) female hormones; progestin and estrogen. These hormones are normally made by the ovaries. There are many different types of oral contraceptives.

 

What kinds of medical conditions can be helped with the oral contraceptive pills?

Polycystic Ovary Syndrome (PCOS) - is a hormone imbalance which causes irregular menstrual periods, acne, and excess hair growth. Oral contraceptive pills work by lowering certain hormone levels to regulate menstrual periods. When hormone levels are back to normal, acne and hair growth often improve.

 

Endometriosis - Most girls with endometriosis have cramps or pelvic pain during their menstrual cycle. Oral contraceptive pills are often prescribed to treat endometriosis and work by temporarily turning off the ovaries so ovulation does not happen. 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. Oral contraceptive 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), oral contraceptive pills can help to regulate the menstrual cycle to every 28 days and provide the body with normal amounts of estrogen to keep bones healthy.

 

Menstrual Cramps - When over-the-counter medications don’t help with severe cramps, oral contraceptive pills may be the solution because they prevent ovulation and lighten periods.

 

Premenstrual Syndrome (PMS) - Symptoms of PMS such as mood swings, breast soreness, bloating, and acne can occur up to 2 weeks before a young women’s period. Oral contraceptives pills are often prescribed to stop ovulation and keep hormone levels even. Symptoms usually improve, particularly when the OCP’s are prescribed continuously.

 

Heavy Menstrual Periods - Oral contraceptive pills can reduce the amount and length of menstrual bleeding.

 

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

 

Other Medical Benefits

Because there is less menstrual bleeding with the use of oral contraceptive pills, you are less likely to get anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Oral contraceptive pills decrease your chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts.

 

Are there side effects from taking the oral contraceptive pill?

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

 

Spotting between periods may occur during the first three weeks of taking hormone pills, and can continue for up to three cycles, but this is not serious. You should call your health care provider if the bleeding is heavier than a light flow, or lasts more than a few days.

 

Some women have nausea, but this usually goes away if the pill is taken with a meal or a snack at bedtime. Sometimes a pill with less estrogen is prescribed if the nausea doesn't go away.

 

Sometimes, women may experience headaches when they start taking oral contraceptive pills, but headaches usually happen because of stress or other reasons. If your health care provider thinks they are related to the pill, he/she may prescribe an oral contraceptive pill with a lower dose of estrogen or may sometimes take you off the oral contraceptive pill.

 

Mood changes can occur while taking the oral contraceptive pill. Exercise and a healthy diet may help, but if they don't, you may need to talk to your health care provider and try a different kind of oral contraceptive pill. Your breasts may become tender or may get larger. Your appetite may increase, and a few teens feel bloated.

 

Some teens gain weight, some lose weight, but most teens stay exactly the same when they are taking the oral contraceptive pill. Many times a young woman thinks she has gained 5-10 pounds, but when her weight is actually measured, there is no change. If you think you may have gained weight due to the Pill, you should see your health care provider and get your weight checked. If you do gain weight, or you want to prevent gaining weight, you should make sure that you eat a healthy diet. Eat plenty of fruits and vegetables every day, avoid fast food, and get enough exercise! If these ideas don't help, talk to your health care provider.

 

Are there any risks if I take the oral contraceptive pill?

Oral contraceptive pills with estrogen may cause a slight increase in the risk of developing blood clots in the legs. Among women who do not take the Pill, 5 out of 100,000 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. And if you are a smoker, try to quit as soon as possible.

 

Written by the CYWH Staff at Children's Hospital Boston

 

Updated: 7/28/2010

 

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