Heavy Bleeding? Birth Control Could be the Solution

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Highlights:

• Hormonal birth control can reduce the frequency and intensity of menstruation and is a safe option for adolescents to suppress their period
• Some providers are reluctant to prescribe birth control to teens due to various reasons, including concerns about sexual behavior and the need for parental consent
• Period suppression can be beneficial for individuals with painful or heavy periods, gender dysphoria, or medical conditions like lymphedema

Do you also experience heavy bleeding and get tired of it? Are you also on a prescription for birth control to suppress bleeding but wonder if it is safe to take it? Well, these scenarios have become quite common (1^✔).

Let's imagine a situation like this, you started with your period cycle, which has been going on for weeks, leaving you dizzy and weak. This alarms you to go to a hospital and see a primary care doctor, who diagnoses you with a bleeding issue and advises birth control to suppress menstruation.

‘There are various methods for utilizing birth control to stop your menstruation for weeks, months, or even years. Physicians refer to the phenomenon as menstrual suppression’

This is similar to what Shazia Choudary experienced.

"I only went 3 or 4 days out of the month without bleeding," said Chowdhury, who's now 18 and a student in New York City. "I can now sit comfortably instead of feeling my blood every time I sit down."

Birth Control Pills to Suppress Bleeding

"I'm glad I went on the pill because the bleeding was so overwhelming," she said. "My quality of life wouldn't have been great."

For decades, adolescents have been able to safely suppress their period with birth control. Hormonal birth control can reduce the frequency and intensity of menstruation, and it can sometimes end periods entirely. Yet, not every menstrual adolescent is made aware of this option.

"As an adolescent medicine physician, I can say with confidence that there are certain providers who are reluctant to prescribe birth control to teens," said Dr. Krishna Upadhya, MD, vice president of quality care and health equity at Planned Parenthood Federation of America.

Several primary care physicians who work with adolescents do not provide contraception as a usual part of their practice and instead direct these patients to OB/GYNs, she claims. "That's not a big concern for some young people," Upadhya added. "However, referring them out can create other barriers to care, such as finding a new provider, scheduling more medical appointments, and establishing rapport with someone new who may or may not be sympathetic to teenage contraceptive requirements."

According to Charles Thompson, MD, head of the obstetrics and gynecology residency program at Texas Tech University Health Sciences Center in Lubbock, some doctors may be hesitant to give birth control to teenagers if a parent or guardian does not agree. Some parents and doctors may feel uneasy with the concept of a teen using birth control, even if it is for period management rather than pregnancy prevention.

"Whether you like it or not, birth control tablets are associated with sexual behavior," Thompson explained. Teens, on the other hand, do not need their parents' consent to be prescribed birth control, according to a 1977 ruling by the United States Supreme Court that granted minors the right to contraception.

"I always recommend that if a parent or guardian is willing to engage in the conversation, it's good for the patient, but they don't have to," said Julia Cron, MD, chief of the Department of Obstetrics and Gynecology at NewYork-Presbyterian Lower Manhattan Hospital in New York City.

Making Life More Convenient by Suppressing Bleeding

Teens may request that their periods be suppressed if they have painful or heavy periods, especially if their period causes them to miss school or work. According to Sloane Berger-Chen, MD, a gynecologist specializing in pediatric and adolescent reproductive health at the University of California, San Francisco, patients with gender dysphoria may desire to suppress their period as a first step towards gender-affirming care.

"We try to say that menstrual cycles are a natural part of life, but your period should not hold you back," she says. This was the case for Sarah Bramblette, 45, who began her period at the age of 13.

"My bleeding was so heavy that I had to go to the emergency room to get things checked," said Bramblette, who is the board chair of the Lymphedema Advocacy Group and co-chair of the Obesity Action Coalition's Access to Care Committee in Miami.

She didn't seek period control until she was 18 and ended up in the emergency room with significant bleeding. She underwent a dilatation and curettage procedure, in which tissue from the uterus was removed to limit blood flow. She was referred to an OB/GYN, who prescribed birth control to keep her period at bay.

"It was pretty life-changing," Bramblette said. Birth control "completely stopped my periods."

Bramblette suffers from lymphedema, a persistent condition characterized by fluid buildup in the arms or legs. She dresses in tight compression clothes to allow surplus fluid to circulate through her limbs. Bramblette finds it difficult to change sanitary goods in public facilities since the garments are difficult to remove, especially in small areas. Although she attempts to manage both illnesses, suppressing her menstruation with birth control allows her to avoid sanitary issues. Her doctor was afraid that hormonal birth control would weaken her bones over time, so she has her skeletal health checked annually to reduce the possibility of fractures.

Period Suppression in Action

Birth control methods function in different ways, and some are more effective than others in terms of period suppression. The �pill,' which is usually a mix of progesterone and estrogen, thins the uterine lining, lowering the volume of blood lost. Individuals who purchase a 28-day supply of birth control tablets receive three weeks of hormonal pills and one week of placebos. The non-hormonal pills, which typically include sugar or iron, are intended to keep individuals on track with their regimen until the cycle begins again.

In the lack of progesterone, the body begins to bleed. Taking placebo pills for a week allows the body to experience progesterone withdrawal symptoms. People who do not take the placebo pills may experience period suppression since they do not receive the signal to have a period.

Although intrauterine devices (IUDs) can induce some period suppression, the frequency of bleeding is not as predictable as with the pill, according to Berger-Chen.

People question if skipping the placebo week is safe, but the withdrawal bleeding that many experiences while taking placebo medications is not medically essential, according to Cron. Skipping the non-hormonal tablets has no long-term consequences.

She went on to say that some young people, their parents, and certain doctors may believe that using birth control on them will affect their fertility, height, or health in some other way.

Nevertheless, by the time they reach their first menstrual cycle, most teenagers have reached 95% of their complete adult height, according to Berger-Chen. Most girls will only gain 2 to 3 inches following their first period.

Birth control pills may modestly raise the risk of breast cancer, but after a patient discontinues use, the risk returns to normal. Beginning the pill at a young age will not affect their long-term risk.

Another common myth about birth control and infertility is that many women use it for years. Fertility is already on the decline when women reach their 30s or 40s. Some patients may feel that their reproductive problems are the result of years of birth control.

"The concern is that being on the pill for a long time is what is potentially producing fertility troubles," Cron says. "But, it's more likely a person's age than the duration of the pill."

According to Berger-Chen, the benefits exceed the hazards for many people. Prolonged ovulation suppression with birth control can reduce your total lifetime risk of ovarian and colon cancers and has been shown to alleviate the estrogen fluctuation that can trigger migraines in menstrual patients before or during their period.

Adolescents require "nonjudgmental sexual and reproductive health care from physicians who can listen to their concerns and help them access the resources they need to live healthy lives," according to Upadhya.

Reference:

1. What are the treatment options for heavy periods? - (https:www.ncbi.nlm.nih.gov/books/NBK279293/)

Source: Medindia

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