Managing Ovarian Cysts: Birth Control Pills and What to Expect

Taking contraceptive pills for ovarian cysts?

Since the first day of my menstrual period, I have experienced severe abdominal pain.
Over a year ago, I visited a gynecology clinic for an examination, and an ultrasound revealed a cyst on my left ovary.
At that time, the clinic doctor only recommended medication and continued ultrasound monitoring (the doctor stated that the medication could help shrink the cyst).
However, earlier this year, I felt that the medication prescribed by the clinic was not very effective for the ovarian cyst, so I decided to go to a larger hospital for observation.
During my follow-up ultrasound appointment last month, the doctor suggested either surgery or taking a 28-day contraceptive pill.
I chose to take the medication and monitor my condition.

Starting from the evening of July 19, the first day of my menstrual period, I began taking one pill every night before bed, and I recorded my menstrual period until July 24.
By August 2, I started noticing signs of what seemed to be spotting; the first 3-4 days were dark brown, but since then, up until today (August 12), it has turned into bleeding with some small blood clots.
The amount is not heavy, and I can manage it with panty liners.
Since this is my first time taking contraceptive pills, I am concerned that this state has persisted for 11 days.
Is this normal? Should I complete the full 28 days of medication? (There are only 3 days of pills left.)

Gao Xiaojie, 20~29 year old female. Ask Date: 2023/08/12

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Please return for a follow-up evaluation.
Thank you.

Reply Date: 2023/08/12

More Info

Managing ovarian cysts, particularly in the context of using birth control pills, can be a complex issue that requires careful consideration of symptoms, medical history, and individual health goals. Based on your description, it seems you have been experiencing significant abdominal pain during your menstrual cycle and have been diagnosed with an ovarian cyst. The management options presented to you included surgery or hormonal treatment with birth control pills, and you opted for the latter.

First, it's important to understand the role of birth control pills in managing ovarian cysts. Birth control pills can help regulate your menstrual cycle and reduce the occurrence of ovarian cysts. They work by suppressing ovulation, which in turn decreases the stimulation of the ovaries and can lead to a reduction in the size or even resolution of existing cysts. Many women find that taking birth control pills alleviates symptoms associated with ovarian cysts, such as pain and irregular bleeding.

Regarding your current situation, it is not uncommon for women who start taking birth control pills to experience some irregular bleeding or spotting, especially during the first few months of use. This can manifest as light bleeding or spotting, which may be brown or red in color, and can sometimes include small blood clots. The fact that you have been experiencing this for 11 days may be concerning, but it is not necessarily abnormal for someone who is new to hormonal contraception.

In general, it is advisable to complete the entire 28-day course of the birth control pills unless otherwise directed by your healthcare provider. Stopping the pills prematurely can lead to further irregularities in your menstrual cycle and may not allow the medication to exert its full effect on the cyst. However, if the bleeding becomes excessively heavy, is accompanied by severe pain, or if you have any other concerning symptoms (such as dizziness or fainting), you should contact your healthcare provider immediately.

It is also worth noting that while some spotting can be expected, if it continues beyond the initial adjustment period of a few months or if you have any significant changes in your symptoms, it would be prudent to follow up with your healthcare provider. They may want to perform additional evaluations, such as an ultrasound, to ensure that the cyst is not causing any complications and that your overall reproductive health is being maintained.

In summary, while it is common to experience some irregular bleeding when starting birth control pills, it is essential to monitor your symptoms closely. Completing the 28-day course is generally recommended, but do not hesitate to reach out to your healthcare provider if you have any concerns or if your symptoms change significantly. Your health and comfort are paramount, and your provider can help tailor a management plan that best suits your needs.

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