Q1. My 12-year-old started her period two months ago. As expected, her periods are very irregular, sometimes coming every two weeks and lasting for ten days. Our GP put her on birth control to regulate her periods. Should I be concerned about how this will affect her body since she is so young?
Alexis, birth control pills are very well tolerated in the teenage years. In fact, the side effects we worry about like blood clots are much more of a concern in older women. However, it is very common for periods to be irregular the first year after menstruation begins. Birth control is usually not used during this time to regulate periods, because that naturally occurs with time. Besides the obvious contraceptive role of birth control pills, many teens that are not sexually active are started on the pill for heavy or prolonged bleeding, or severe cramping. It seems like your daughter was put on the pill to regulate her period by her doctor, but perhaps she was having other symptoms that would also benefit from birth control pills. I encourage you to talk to your daughter about how she feels on and off the pill, and then talk to the GP about your questions.
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Q2. I am 32 years old. I have been taking birth control pills for nearly 16 years. I have only been off the pill twice during this time to have my children. I recently did not get my pills refilled because I frankly did not have the money to do so. During that time, I felt SO MUCH BETTER. It is very hard to explain, but I just felt better. I didn't feel bloated, my mood was great, just overall better. I eventually got them refilled and started taking them again. Once again, I feel cranky and irritable. Is there a connection between the pill and my mood?
– Rhonda, North Carolina
There may be. The birth control pill can affect some women's moods, both for better and for worse. Many women will experience some mood elevation and mood stability from the pill because it basically suppresses ovulation, thereby stabilizing hormone levels from one cycle to the next, and eliminating the normal variability that occurs in your cycle. For women who are very sensitive to these hormonal changes, the stability provided by the pill is helpful. But it sounds like you are not tolerating some component of the pill that you are on.
Ask your doctor to consider changing the pill formulation that you take — some have different forms of estrogen, (the main hormone), and progesterone. Other types of pills are derived from plant-based sources that you may tolerate better, and some pills even contain a low dose diuretic (water pill) to prevent bloating. It seems that your symptoms are related to your pill, but you may not have to give up the birth control pill altogether because of them. Work with your doctor to find the type that works with you. Or, consider using a different form of birth control, such as the diaphragm. My advice: Discuss the options with your doctor sooner rather than later.
Q3. I'm 21 years old, and I have been taking the birth control pill for about seven months. I plan to have children in the future. Will having taken the pill make it harder to get pregnant later on? Will it take longer? How long does it take after stopping the medication before I can become pregnant?
Birth control pills will temporarily stop ovulation, but they should not make it more difficult to get pregnant in the future. For most women, it will take one to two months to begin ovulating again after stopping the pill.
You can use a home ovulation kit to check your ovulation pattern after stopping the pill or have your doctor do some simple blood tests. If you can't get pregnant within a few months after stopping the pill, be sure to see your doctor.
Q4. My daughter is 10 years old and started her menses about three months ago. She gets her period every 10 to 14 days, bleeds for more than a week, and has started having very bad cramps. Her doctor put her on birth control pills. I'm worried that she's too young to be taking these. Do you think she's too young to start birth control? Can there be any repercussions? Is there anything else she can do to control her periods?
You can rest assured that your daughter is not too young to start birth control pills to help regulate her periods. Also, there should not be any long-term repercussions from using this medication. That said, it is important to look for other causes for your daughter's heavy, frequent bleeding before this method is used, since things such as cysts and polyps can also lead to such bleeding. I recommend that she get a careful workup for hormonal and bleeding disorders before starting birth control pills.
If no abnormalities are found, then the use of the pill is safe, even for such a young person. Since there aren't really any other effective alternatives to control menstrual periods, birth control pills may be your daughter's best bet.
Q5. How effective is the birth control patch? I've been taking the pill for about two years, and I'm tired of the mood swings and low libido. I read a report stating that the patch is just as effective as the pill but has fewer side effects. Also, is it true that you only need to use one patch a week? What would you recommend?
Most patches are applied once a week for the first three weeks of a month. You don't apply a patch the last week, after which time you get your period. From a contraceptive standpoint, the patch is just as effective as the pill. The absorption of the medication is steady, and some women find that they have fewer mood swings on this form of contraception. Its effect on libido, however, is not generally different from the pill's effect.
I recommend that you ask your gynecologist if you can try the patch for two to three months to see whether your side effects are diminished.
Q6. What birth control methods are okay for a woman in her forties to use? Are there any methods are that better than others at this age? Are there methods I should avoid?
Women in their forties can use any form of birth control, including the pill, barrier methods like condoms, and the IUD. When choosing a method of birth control, though, it is important to review the following with your gynecologist: your risk profile with regard to exposure to sexually transmitted diseases (STDs), whether you still desire any pregnancies, and your family history.
Regarding particulars, the pill is still safe for nonsmoking women in their forties who do not have an increased risk for blood clots. IUDs, especially ones with hormones that are gradually released, are also a good choice for women who no longer wish to have more children. Finally, barrier methods are useful at any age and, of course, are the most reliable way to prevent STDs.
Learn more in the Everyday Health Sexual Health Center.