Birth Control Pills: A Guide for Parents

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birth control pillsIf your daughter has recently started taking birth control pills or is thinking about taking them, you probably have some questions and worries of your own. Adolescent girls and young women are frequently prescribed birth control pills (also called oral contraceptive pills, hormonal pills, or simply “the Pill”) for irregular or heavy menstrual periods, menstrual cramps, acne, PMS, Primary Ovarian Insufficiency (POI), endometriosis, and hormone replacement therapy. For example, girls diagnosed with Polycystic Ovary Syndrome (PCOS) – a hormone imbalance which causes irregular menstrual periods, acne, and excess hair growth, are prescribed birth control pills to lower their hormone levels (to the normal range) and regulate menstrual periods. Girls with acne that are not responding to simple measures are often prescribed birth control pills. Girls whose ovaries are not producing enough estrogen (due to the effects of radiation or chemotherapy, a genetic condition such as Turner Syndrome, or stress) may take birth control pills to replace estrogen. If the lack of periods are caused by low weight or an eating disorder, the best treatment is healthy nutrition to restore a normal weight. Girls with endometriosis are also often prescribed birth control pills, in cycles or continuously, to suppress the condition. Normal estrogen levels and healthy weight are important for healthy bones. Last but not least, birth control pills are used for birth control.

Does the birth control pill have health benefits?

Yes. The Pill has many health benefits, such as:

  • Regulation of menstrual periods
  • Decreased menstrual cramps
  • Treatment for acne
  • Treatment for polycystic ovary syndrome (PCOS)
  • Lowered risk of anemia
  • Lowered risk for cancers such as ovarian and uterus cancer

Are there any serious side effects from the Pill?

Most young women who take birth control pills have few or no problems. However, birth control pills with estrogen cause a slight increase in the risk of developing blood clots in the legs, eyes, and lungs. If your daughter develops any of the following problems, call her health care provider right away or take her to the closest emergency room:

  • 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

Does the birth control pill cause blood clots?

There is a very slight risk of developing blood clots in the legs, but much less than the risk during pregnancy. Among adolescent girls who do not take the Pill, 1-10 in 100,000 will develop blood clots each year. Among girls who take combined oral contraceptive pills, the risk increases 3-5 fold or to 5-50 per 100,000 per year. For women who are pregnant, the risk of developing blood clots is twice as high as Pill users and 4-10 fold compared to nonusers.

Is there any way my daughter can lower her risk of getting blood clots while taking the Pill?

Make sure you let your daughter know (and her health care providers) if any of her blood relatives have had blood clots, especially when they were young (in their 20s, 30s, or 40s). There are other factors that can contribute to the likelihood of whether a teen or adult woman develops blood clots such as a diagnosis of Factor V Leiden, trauma, or surgery, being overweight and smoking.

If your daughter smokes, encourage her to quit. If she is planning a flight or long car ride (especially if 6-8 hours or longer), remind her to get up and walk around and drink lots of fluids to lessen the risk of blood clots. If she is having surgery (and will be immobilized and on bed rest for a period of time), talk to her health care provider about whether she should go off the Pill 3-4 weeks before the surgery.

Does the birth control pill cause heart attacks or strokes?

There is no increase in the risk of heart attack or stroke in healthy young women who take birth control pills and don’t smoke. If your daughter is a smoker, encourage her to quit smoking. She can still take the Pill if she smokes, but if she quits smoking, she’ll be healthier for life and her risks from taking the Pill will be less.

Does the birth control pill cause cancer?

The truth is that the Pill actually protects against cancer of the ovaries and cancer of the lining of the uterus. A woman is half as likely to get cancer of the uterus or ovaries if she has taken birth control pills. Most experts believe that taking the Pill does not cause any increased risk of getting breast cancer. Even girls with a family history of breast cancer can take the Pill.

Does the birth control pill cause birth defects?

Birth control pills do not cause birth defects or affect the health of future children.

Is there any trouble getting pregnant after using the birth control pill?

There is no change in fertility with using the birth control pill. Regular periods and ovulation usually start up again right away. However, girls who were very irregular before starting the pill may be irregular after they stop the pill. Girls who have PCOS or lose weight on the pill are particularly likely to be irregular, not because of the Pill, but because of their medical condition.

If your daughter was using the Pill for birth control, she should use another birth control method right away if she doesn’t want to get pregnant. She should talk to her health care provider before she actually stops taking the birth control pill.

How long is it safe for my daughter to be on birth control pills?

It’s safe for your daughter to be on the Pill for years, whether she’s on it to regulate her menstrual cycles, cramps, hormone replacement, or if she’s simply using it for birth control.

Does my daughter need to take a break from the Pill?

There is no medical reason that your daughter would need to take a “break” from the Pill. There are no medical benefits from taking a break. If your daughter were to stop taking the Pill and then go on it again, she could have the same side effects that she already experienced during the first few months of pill use. Also, your daughter would not experience the many medical (non-contraceptive) benefits that the Pill offers.

Will my daughter gain weight from taking birth control pills?

It’s unlikely that your daughter will gain weight on the Pill. Research studies have not shown a connection between birth control pills and weight gain. Some teens gain weight, some lose weight, but most teens stay exactly the same weight when they are taking the birth control pill. Sometimes a young woman thinks she has gained 5-10 pounds, but when weight is actually measured, there’s no change. If your daughter thinks she may have gained weight due to the Pill, she should see her health care provider and get her weight measured. Encourage your daughter to eat a healthy diet. Suggest that she eat 5-7 servings of fruits and vegetables a day, eat normal portion sizes, avoid fast foods and simple carbohydrates such as cookies, cake, sugary cereal, etc. Also, encourage her to be active and exercise or take part in an activity that she enjoys.

Will the birth control pill have any negative effects on my daughter’s growth?

No, the birth control pill will not affect or hinder your daughter’s growth if she has already started her period. By the time she has her first period, she is already at 95% of her final height. A girl grows about 2 inches in the 2 years after her first menstrual period.

Will the Pill make my daughter’s cramps better?

For girls who experience severe menstrual cramps and over-the-counter medications do not help, birth control pills may be the solution. Birth control pills can help to decrease menstrual cramps. Because the combined birth control pills prevent ovulation, they also get rid of pain that your daughter may experience with ovulation in the middle of her menstrual cycle.

Will the Pill make my daughter’s menstrual periods more regular?

For girls whose menstrual periods are irregular (too often or too late), birth control pills can help to regulate the menstrual cycle to every 28 days. Birth control pills can also reduce the amount and length of menstrual bleeding.

What if my daughter’s period is very light while she’s taking birth control pills?

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

Will the birth control pill make my daughter’s acne better?

Birth control pills usually improve 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 birth control pill can help stop acne from forming. It doesn’t usually matter which type of birth control pills your daughter takes, since most of them can be used to treat acne. Encourage your daughter to be patient though, since it may take several months to see a difference with her acne.

What if my daughter has PCOS? How do birth control pills help?

If your daughter has PCOS, you’re probably already aware that PCOS can cause irregular menstrual cycles, excess hair growth, and acne. One of the treatments prescribed for PCOS are birth control pills (oral contraceptives), because the hormones (estrogen and progestin) in the pill regulate menstrual cycles. Birth control pills allow the endometrial lining to be shed every four weeks so your daughter’s menstrual period will be regular. Because birth control pills cause women to menstruate regularly and shed the endometrial lining on time, they reduce the risk of endometrial cancer. Birth control pills also improve acne and lessen excess hair growth, which is another reason they are used to treat PCOS.

What if my daughter has endometriosis? How do birth control pills help?

Hormonal treatment such as birth control pills either taken in cycles or continuously are felt to relieve symptoms associated with endometriosis in 8 out of 10 patients. The Pill does not cure endometriosis, but when prescribed continuously, it will stop your daughter’s period along with the pain that is often associated with it and lessen the chance of the endometriosis growing.

Will my daughter start having sex if she goes on birth control pills for acne or any other medical reason?

Your daughter will most likely not start having sex if she goes on the Pill for reasons other than birth control. If she goes on the Pill for one of the medical reasons, she is probably just thinking about treating whatever the problem is. Her decision to have sex will likely be completely independent from her decision to go on the Pill at this time. Your daughter will choose to start having sex when she is ready, which involves much more than just when birth control is available.

What other medical benefits does the pill have?

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