Should You Continue Birth Control Pills After Uterine Fibroid Surgery?

After uterine fibroid surgery, is it advisable to take contraceptive pills to prevent recurrence?

Hello Doctor: I am married with two children and turned 40 last year.
I underwent my second laparoscopic surgery (to remove uterine fibroids) at the beginning of last year; the first surgery was during college, so I have a history of uterine fibroids.
After the surgery last year, my doctor advised me to take a hormonal contraceptive (Diane-35) to regulate my menstrual cycle and reduce the amount of menstrual bleeding, thereby decreasing the risk of recurrence.
I have been taking it for over a year now without any adverse effects or discomfort.
However, I would like to ask the doctor if I need to continue taking the hormonal contraceptive indefinitely to prevent the recurrence of uterine fibroids.
Is there any concern about long-term use of contraceptive pills? Thank you for your response.

Xiao Qi, 40~49 year old female. Ask Date: 2017/08/06

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I am a married individual with two children, and I turned 40 last year.
At the beginning of last year, I underwent my second laparoscopic surgery to remove uterine fibroids; the first surgery was during college, so I have a history of uterine fibroids.
After the surgery last year, my doctor advised me to take a hormonal contraceptive (Diane-35) to regulate my menstrual cycle and reduce the amount of menstrual bleeding, thereby decreasing the likelihood of recurrence.
I have been taking it for over a year now, and I have not experienced any adverse effects or discomfort.
However, I would like to ask the doctor if I need to continue taking the hormonal contraceptive indefinitely to prevent the recurrence of uterine fibroids.
Is there any concern with long-term use of contraceptive pills?

Reply Date: 2017/08/06

More Info

After undergoing uterine fibroid surgery, the decision to continue taking birth control pills, such as the one you mentioned (likely a hormonal contraceptive), should be carefully considered in consultation with your healthcare provider. Here are some important points to consider regarding the use of birth control pills post-surgery, particularly in relation to uterine fibroids:
1. Purpose of Birth Control Pills: Birth control pills can help regulate menstrual cycles and reduce menstrual bleeding, which is particularly beneficial for individuals with uterine fibroids. By managing these symptoms, hormonal contraceptives can potentially decrease the risk of fibroid recurrence. In your case, since your doctor has recommended them to help manage your menstrual flow and reduce the likelihood of fibroid regrowth, it seems that they are serving a therapeutic purpose beyond contraception.

2. Long-term Use of Birth Control Pills: While many women take hormonal contraceptives for extended periods without significant issues, long-term use can have potential side effects. These may include an increased risk of blood clots, especially in women over 35 who smoke, as well as potential impacts on bone density and other hormonal balances. However, if you are otherwise healthy and have not experienced adverse effects, the benefits may outweigh the risks. Regular check-ups with your healthcare provider can help monitor any potential side effects.

3. Monitoring and Follow-up: It is crucial to have regular follow-up appointments with your healthcare provider to monitor your health and the status of your fibroids. If you experience any new symptoms or side effects from the birth control pills, you should discuss these with your doctor. They may recommend imaging studies, such as ultrasounds, to assess the condition of your uterus and any fibroids.

4. Alternative Options: If you are concerned about the long-term use of hormonal contraceptives, discuss alternative options with your healthcare provider. There are non-hormonal options available, such as the copper IUD, which can also help manage heavy menstrual bleeding without the hormonal component. Additionally, lifestyle changes, such as diet and exercise, may also play a role in managing fibroid symptoms.

5. Personal Health Factors: Your age, overall health, and personal and family medical history should also be taken into account when deciding on the duration of birth control pill use. If you have any risk factors for complications, your doctor may suggest a different approach.

6. Fertility Considerations: Since you have two children and may not be planning for more, the need for contraception may be less critical. However, if you are considering future pregnancies, it is essential to discuss how long you should continue taking the pills and when it would be appropriate to stop.

In conclusion, while continuing birth control pills after uterine fibroid surgery can be beneficial in managing symptoms and reducing the risk of recurrence, it is essential to have ongoing discussions with your healthcare provider to ensure that this approach aligns with your health goals and personal circumstances. Regular monitoring and open communication about any concerns will help you make informed decisions about your reproductive health.

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