Should I Stop Taking Birth Control Pills? Managing Side Effects and Concerns

Oral contraceptives

In 2014, I underwent surgery for an ovarian chocolate cyst, and at that time, my doctor recommended that I take a medication called Letrozole to prevent recurrence.
During my last follow-up appointment, I asked the doctor how long I should continue taking it, and he said it depends on me, suggesting that it would be best to continue until I want to get pregnant, encouraging me to have children sooner rather than later.
As a result, I have been taking it for four years now without any significant issues.
However, recently, I have been experiencing severe headaches a week before my menstrual period, along with frequent dizziness and nausea.
I almost feel nauseous every morning upon waking, which has started to affect my daily life.
Should I stop taking the medication? I'm concerned about the risk of recurrence and whether my body might not adapt well to stopping it, but I currently have no plans for pregnancy.
I would appreciate your advice.
Thank you.

Niming, 20~29 year old female. Ask Date: 2018/10/19

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In 2014, I underwent surgery for an ovarian chocolate cyst, and at that time, my doctor recommended that I take a medication called "Yueji" to prevent recurrence.
During my last follow-up appointment, I asked the doctor how long I should continue taking it, and he said it depends on me, suggesting that it would be best to continue until I want to get pregnant, and he encouraged me to have children sooner.
As a result, I have been taking it for four years now without any significant issues, until recently.
A week before my period, I experience severe headaches, and I often feel dizzy and nauseous.
Almost every morning, I wake up feeling sick, which has started to affect my daily life.
Should I stop the medication?
Answer: I suggest stopping the medication for one month to observe if the headaches and nausea improve.
I am concerned about the risk of recurrence and potential withdrawal effects, but since I do not plan to get pregnant in the near future, I would appreciate your advice, thank you.

Reply Date: 2018/10/19

More Info

When considering whether to stop taking birth control pills, especially after a history of ovarian chocolate cysts, it's crucial to weigh the benefits and potential side effects of continuing the medication. Birth control pills, particularly those containing hormones, can be effective in managing conditions like endometriosis and preventing the recurrence of ovarian cysts. However, they can also lead to side effects that may significantly impact your quality of life, as you've described with your recent experiences of severe headaches, nausea, and dizziness.

Firstly, it's important to understand that hormonal birth control can cause a range of side effects. Common side effects include headaches, nausea, mood changes, and gastrointestinal issues. In your case, the timing of your symptoms—occurring a week before your menstrual period—suggests that they may be related to hormonal fluctuations. This is often referred to as premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), which can be exacerbated by hormonal contraceptives in some individuals.

Given your history of ovarian chocolate cysts, it's understandable to be concerned about the risk of recurrence if you discontinue the pills. However, the decision to stop taking birth control should be made in consultation with your healthcare provider. They can help assess whether your current symptoms are indeed related to the birth control pills or if they might be indicative of another underlying issue.
If you decide to stop taking the pills, it's advisable to do so under medical supervision. Your doctor may suggest a gradual tapering off rather than an abrupt stop, which can help your body adjust and minimize any potential withdrawal symptoms. Additionally, they may recommend alternative methods of managing your symptoms, such as lifestyle changes, dietary adjustments, or even non-hormonal medications that can help alleviate PMS symptoms.

It's also worth discussing the possibility of switching to a different form of contraception if you wish to continue preventing pregnancy but are experiencing intolerable side effects. There are various options available, including non-hormonal methods (like copper IUDs) or different hormonal formulations that may have a more favorable side effect profile for you.

In summary, while the birth control pills have been effective in managing your ovarian cysts, the recent side effects you're experiencing warrant a discussion with your healthcare provider. They can help you evaluate the risks and benefits of continuing the medication, explore alternative contraceptive options, and develop a plan that prioritizes both your reproductive health and overall well-being. Remember, your comfort and quality of life are paramount, and there are often multiple pathways to achieve your health goals.

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