Concerns About Side Effects of Birth Control Pills for Irregular Periods

Concerns about the side effects of taking Minerva for menstrual regulation?

Hello, doctor.
At the beginning of September, I went to see a gynecologist because I had light bleeding for 8 days during my menstrual period.
During the examination, it was found that my uterine lining was too thin, which was causing the bleeding to continue, and there was a small polyp (but it didn't seem to be the cause of the ongoing bleeding).
The doctor mentioned that I might be too fatigued due to recent stress and advised me to go to bed earlier and avoid staying up late.
They prescribed some hormonal medication to thicken the uterine lining, which should stop the bleeding.
After taking 3 pills, the bleeding stopped, but I also developed a lot of acne, so I stopped taking the medication on my own.
Unfortunately, after 5 days, I started bleeding again (brown with red streaks).
Upon returning for another check-up, the doctor found that my uterine lining was still very thin and needed to be thickened to prevent further bleeding.
This time, they prescribed a combined oral contraceptive pill for me to take for 21 days, which should be less likely to cause acne, and I could start taking it that evening.
However, when I got home, I noticed on the information leaflet that there was a risk of thrombosis.
After researching online, I found that some individuals have experienced thrombosis, which made me very anxious.
Since I am over 35 years old and have a smoking habit, it seems that using contraceptive pills is not recommended.
However, the doctor did not ask me about my smoking habits during the consultation, which has left me unsure whether I should continue taking the medication or if I should consider seeing a traditional Chinese medicine practitioner instead.

Mi Ma, 40~49 year old female. Ask Date: 2023/09/22

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Please consult the original attending physician.
Thank you.

Reply Date: 2023/09/22

More Info

When it comes to concerns about the side effects of birth control pills, particularly in the context of irregular periods, it is essential to consider both the benefits and potential risks associated with hormonal contraceptives. In your case, the use of birth control pills was prescribed to help thicken the uterine lining and manage the irregular bleeding you experienced due to a thin endometrial lining.
Birth control pills, particularly those containing estrogen and progestin, are commonly used to regulate menstrual cycles and can be effective in treating conditions like irregular periods. They work by providing a steady level of hormones that can help stabilize the menstrual cycle and promote the thickening of the uterine lining, which is crucial for a healthy menstrual cycle and can prevent excessive bleeding.

However, your concerns about the risk of blood clots are valid, especially considering your age and smoking habits. The risk of venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is indeed higher in women who smoke and are over the age of 35 when taking combined hormonal contraceptives. The prescribing guidelines for birth control pills typically advise against their use in women who smoke and are over 35 due to this increased risk.

Given your situation, it is crucial to have an open and honest discussion with your healthcare provider about your smoking habits and any other risk factors you may have. Your doctor should evaluate your overall health, including your smoking status, family history of blood clots, and any other medical conditions that could increase your risk. If you feel uncomfortable or if your doctor did not address your smoking during the consultation, it may be beneficial to seek a second opinion or consult a different healthcare provider who can provide a comprehensive assessment of your situation.

If you are concerned about the side effects of the birth control pills, including the potential for blood clots, you might consider discussing alternative treatment options with your healthcare provider. These could include non-hormonal methods for managing your irregular periods or other hormonal treatments that may carry a lower risk of thromboembolic events.

Additionally, lifestyle modifications, such as quitting smoking, can significantly reduce your risk of complications associated with hormonal contraceptives. If you are considering alternative medicine, such as traditional Chinese medicine (TCM), it is essential to ensure that any treatments you pursue are safe and do not interfere with your current medications or health conditions.

In summary, while birth control pills can be an effective treatment for irregular periods, it is vital to weigh the benefits against the potential risks, especially in light of your smoking habits and age. Open communication with your healthcare provider is key to finding the most suitable and safe treatment plan for your individual needs. If you have any lingering concerns or feel uncertain about your current treatment, do not hesitate to seek further medical advice or explore alternative options. Your health and well-being should always come first.

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