Birth Control Pills: Medical Uses

Teens and young adults are often prescribed birth control pills for irregular or absent menstrual periods, menstrual cramps, acne, premenstrual syndrome (PMS), endometriosis, primary ovarian insufficiency (POI) and polycystic ovary syndrome (PCOS). Teens 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, or hormonal pills) contain one or two types of synthetic (artificial) 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?

Birth control pills are used to treat many different conditions including:

Polycystic Ovary Syndrome (PCOS): is a hormonal imbalance, which can cause irregular menstrual periods, acne, and excess hair growth. For girls whose menstrual periods are irregular (too few or not at all), birth control pills work by lowering certain hormone levels to regulate menstrual periods. When hormones are at normal levels, acne and hair growth often improve.

Endometriosis: Most teens with endometriosis have cramps or pelvic pain during their menstrual cycle. Birth control pills are often prescribed continuously to treat endometriosis and work by temporarily pausing periods. Since periods can cause pain for teens with endometriosis, stopping periods will usually improve cramps and pelvic pain.

Lack of periods (“amenorrhea”) from low weight, stress, or excessive exercise: Birth control pills may be prescribed to replace estrogen, which helps to regulate the menstrual cycle. Normal estrogen levels and healthy weight are important for healthy bones. If lack of periods is caused by low weight or an eating disorder, the best treatment is weight gain to a normal healthy weight and counseling to address body image and health.

Painful Periods (“Dysmenorrhea”): 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, weight gain, bloating, and acne, can occur up to 2 weeks before a teen’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.

Primary Ovarian Insufficiency (POI): Birth control pills may be prescribed to teens who have ovaries that don’t make enough estrogen because of radiation and/or chemotherapy, a genetic condition such as Turner Syndrome, or other conditions. The goal of this treatment is to regulate the menstrual cycle and help keep bones healthy.

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 can take several months before you see an improvement with your skin.

Other Medical Benefits

Because there is less menstrual bleeding when taking birth control pills, you are less likely to get a medical condition called anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Birth control pills also 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 people have no side effects when taking birth control pills, but some women do have irregular periods, nausea, headaches, or bloating. Each type of pill can affect each woman differently.

Spotting or Irregular Periods: Very light bleeding (you just need a panty liner or light day pad) may occur during the first several weeks of taking the Pill and may continue for several cycles, but this is not serious. Irregular bleeding is common if you are late taking your pills or you miss a pill. If the bleeding is new and you are sexually active, get checked for Chlamydia infection. 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 teens can feel nauseated (feeling like you need to throw up), 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, teens 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, they 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 get better.

Mood changes: Feeling up and down emotionally can 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 should 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 teens feel they get acne from certain kinds of birth control pill.

Sore or enlarged breasts: Your breasts may become tender or may get larger. Usually the symptoms go away in a couple of months; if not, talk to your primary care provider about a lower dose pill.

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 teen thinks they have gained 5-10 pounds, but when their 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 (months). 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?

Most teens who take birth control pills have few or no problems. However, birth control pills with estrogen may cause a slight increase in the risk of developing blood clots in the legs, eyes, and lungs. If you develop any of the following problems, go to the closest emergency room:

Remember: ACHES

• 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)

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

• If you miss 1 active Pill:

• Take the pill as soon as you remember and then continue taking your pills at the usual time each day.
• You may take 2 pills on the same day (one at the moment you remember and the other at the regular time) or even 2 at the same time.

• If you miss 2 or more active pills in a row:

• Take the most recently missed Pill as soon as possible.
• Throw away the other missed pills.
• Continue taking the rest of your pills at the usual time each day.
• You may take 2 pills on the same day (one at the moment you remember and the other at the scheduled time).

• If you missed the active pills in the third week or row (days 15-21 for the 28 day pill pack), throw the inactive pills away and finish taking the active hormone pills.
• Then start a new pack right away.
• If you are sexually active and missed 2 pills, don’t have sex or if you do have sex use condoms every time until you’ve taken active (hormone) pills for 7 days in a row.
• Talk to your health care provider about whether you should use emergency contraception (EC), especially if you missed pills the first week of your pill pack, or had unprotected sex the past 5 days.

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.

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 infections. ALWAYS use protection against STI’s such as condoms or dental dams when having sexual intercourse..

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Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.