Post-Surgery Birth Control: Managing Continuous Use of Diane 35

Undergoing laparoscopic surgery for ovarian cysts and taking birth control pills for management?

Hello Doctor: I have been experiencing menstrual pain, and after an internal examination, it was confirmed that I have a 4 cm cyst and polycystic ovaries.
After surgery, my attending physician prescribed me the birth control pill Diane (21-day regimen) to take continuously without interruption, meaning I do not need to take a break for seven days before starting the next pack.
I am currently on my third pack, but this month I have experienced bleeding similar to the first day of my period, which has lasted for five consecutive days.
Therefore, I have the following questions: (1) Given the current flow of bleeding (without any heavy bleeding), should I stop taking the medication and then resume, or should I continue taking it as usual and discuss it with my doctor during my next appointment? (2) Will continuous use of birth control pills without interruption cause any side effects on my body? What is the typical purpose of this method of use? Thank you for your assistance.

Xiao Mei, 20~29 year old female. Ask Date: 2017/07/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have issues with dysmenorrhea, and after a pelvic examination, it was confirmed that I have a 4 cm ovarian cyst and polycystic ovaries.
After surgery, my attending physician prescribed me the birth control pill, Diane (21-day regimen), with instructions to take it continuously without any breaks, meaning there is no seven-day pause before starting the next pack.
I have now completed three packs, but this month I experienced bleeding similar to the first day of menstruation, which has lasted for five consecutive days.
Therefore, my current questions are as follows: (1) Given the current flow of bleeding (without any heavy bleeding), should I stop taking the medication and then resume, or should I continue taking it as usual and discuss it with my physician during my next appointment? (2) Will continuous use of the birth control pill without interruption cause any side effects on my body? What is the typical purpose of this method of administration?
Answer: Please have the attending physician respond, as they have the obligation to do so.

Reply Date: 2017/07/03

More Info

After undergoing surgery for a 4 cm ovarian cyst and polycystic ovary syndrome (PCOS), it is understandable that you have concerns regarding the continuous use of Diane 35, a combined oral contraceptive pill. Let's address your questions one by one.

1. Current Bleeding and Medication Continuation: Given that you are experiencing bleeding that resembles the first day of your menstrual cycle, it is important to assess the situation carefully. If the bleeding is light and not accompanied by severe pain or heavy flow (i.e., soaking through a pad or tampon every hour), it may be a breakthrough bleeding, which can occur with continuous use of hormonal contraceptives. In this case, you might consider continuing the medication as prescribed and discussing the bleeding with your healthcare provider during your next appointment. However, if you experience heavy bleeding or any other concerning symptoms, it would be prudent to consult your doctor sooner rather than later. They may recommend a temporary pause in the medication or an evaluation to rule out any complications.

2. Continuous Use of Birth Control Pills: Taking Diane 35 continuously without a break can be beneficial for certain conditions, such as managing symptoms of PCOS, reducing menstrual pain, and controlling endometriosis. The primary purpose of this regimen is to maintain stable hormone levels, which can help alleviate symptoms associated with hormonal fluctuations. Continuous use can also lead to fewer menstrual cycles, which some patients find advantageous for managing their symptoms.

However, it is essential to be aware of potential side effects. Continuous use of combined oral contraceptives can lead to breakthrough bleeding, as you are experiencing, as well as other side effects such as nausea, breast tenderness, mood changes, and potential weight gain. Long-term use of hormonal contraceptives may also increase the risk of certain conditions, such as blood clots, particularly in women who smoke or have other risk factors. Therefore, it is crucial to have regular follow-ups with your healthcare provider to monitor your health and adjust your treatment plan as necessary.

In summary, while continuous use of Diane 35 can be an effective strategy for managing PCOS and associated symptoms, it is essential to monitor your body's response to the medication. If you experience any significant changes or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and management. Regular communication with your doctor will ensure that your treatment plan remains safe and effective for your specific health needs.

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