As I say to my patients: "Unfortunately, it's called 'birth control,' but it can be used to treat a lot of different things!" So many good reasons. Plus, pills these days have lower amounts of estrogen than before and even come in low dose formulations that are still effective as contraception!
  1. Painful menstrual cramps (dysmenorrhea), Endometriosis
    OCPs (oral contraceptive pills) make your periods lighter and less painful. They also decrease the stimulation of endometriosis implants in the pelvis. In addition, take ibuprofen prn (as needed) or even ATC (around the clock) for cramps as soon as your period starts. It's better to stay on top of the pain than to chase it. If OCPs don't work, consider the Mirena IUD.
  2. Heavy periods
    OCPs thin the endometrial lining of the uterus, which is what is shed during the menstrual period. Thinner lining = lighter periods. Ta-da! Active hormone pills (usually the first 3 rows of the pill pack) can be taken continuously (skip placebo pill week) so that you only have a period every three months. This is essentially Seasonale.
  3. Acne
    Acne is exacerbated by high levels of androgens (like testosterone) in the blood. The ovary makes some androgens. OCPs decrease the amount of androgens produced by the ovary and also increase the production of Sex Hormone Binding Globulin, which binds the active form of the androgen (the troublemakers). Certain OCPs are better for the skin, like Yasmin and Desogen.
  4. PMS symptoms
    My first line treatment: OCPs and Vitamin B6. If that doesn't work, we talk about adding Prozac if the patient actually has PMDD.
  5. Menstrual migraines
    Fluctuating levels of estrogen can trigger migraines. OCPs provide a steady level of hormones to prevent this. I'll also have my patients take Seasonale so they are at risk of menstrual migraines only 4 times a year.
  6. Ovarian cancer protection
    My healthy patients with the BRCA gene mutation (increases their risk of developing both breast and ovarian cancer) are advised to take birth control pills until they are done having children and are ready to surgically remove their ovaries.
  7. PCOS (Polycystic Ovarian Syndrome)
    Women with PCOS have infrequent periods and signs of elevated androgens (acne, increased hair growth in the face and body). OCPs regulate their periods and decrease androgen levels.
  8. Irregular periods
    Often times, skipping periods occur because they did not ovulate. The uterine lining builds up and when it finally sheds, it's heavy and prolonged. OCPs can regulate periods.