Adenomyosis: Why Birth Control Isn't Stopping My Periods

Q: Adenomyosis: Why Birth Control Isn't Stopping My Periods

Hello, the user： Taking regular birth control pills will still result in menstruation. <br>If your symptoms during the menstrual period do not show significant improvement, it is advisable to discuss with your physician to evaluate whether other treatment options should be consid

Adenomyosis: Continuous menstruation despite taking birth control pills?

Hello Dr.
Chang, I have heavy menstrual bleeding, needing to change my sanitary pad every hour, and I have anemia.
In March of this year, I was diagnosed with adenomyosis in the gynecology department, with a size of 12 cm.
My CA125 level was 14.
The doctor prescribed me oral contraceptives and instructed me to take them continuously without a break to suppress my menstruation.
I started taking them in mid-March, and my period was due in early April, but it did not come.
However, starting in mid-April, I began to have my period again, and the flow was still heavy.
Since then, I have been menstruating for almost six months.
In July, the bleeding was very heavy, and there were blood clots.
Shouldn't my period have stopped with the contraceptive pills? Why am I still bleeding? I have been on the pills for six months now; should I stop taking them or continue?

Xiao Guai, 30~39 year old female. Ask Date: 2015/09/18

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the user: Taking regular birth control pills will still result in menstruation.
If your symptoms during the menstrual period do not show significant improvement, it is advisable to discuss with your physician to evaluate whether other treatment options should be considered.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2015/09/18

More Info

Adenomyosis is a condition where the tissue that normally lines the uterus (the endometrium) grows into the muscular wall of the uterus. This can lead to heavy menstrual bleeding, severe cramping, and other symptoms that can significantly impact a woman's quality of life. In your case, it seems that despite being on oral contraceptives, you are still experiencing heavy menstrual bleeding, which is concerning.

Oral contraceptives are often prescribed to manage symptoms of adenomyosis by regulating the menstrual cycle and reducing the amount of menstrual bleeding. However, they do not work for everyone, and there can be several reasons why you are still experiencing heavy periods despite being on the pill.

1. Hormonal Response: Each individual's body responds differently to hormonal treatments. Some women may not achieve the desired effect from oral contraceptives, especially if the adenomyosis is severe. The hormonal balance may not be sufficient to suppress the endometrial tissue effectively.

2. Dosage and Type of Contraceptive: The specific type of oral contraceptive and its dosage can also play a significant role. Some formulations are more effective than others in managing heavy bleeding. If the current contraceptive is not adequately controlling your symptoms, your healthcare provider may consider switching you to a different formulation or a higher dose.

3. Underlying Conditions: Other underlying conditions, such as fibroids or endometriosis, can also contribute to heavy menstrual bleeding. If these conditions are present alongside adenomyosis, they may need to be addressed separately.

4. Compliance and Timing: It’s essential to take the medication as prescribed without missing doses. Missing doses can lead to breakthrough bleeding, which might be mistaken for a regular menstrual period.

5. Duration of Treatment: Sometimes, it may take a few months for the body to adjust to hormonal treatments. However, if you have been on the pill for six months and are still experiencing heavy bleeding, it is crucial to follow up with your healthcare provider.

Given your situation, it is advisable to consult with your gynecologist. They may want to perform further evaluations, such as an ultrasound or additional blood tests, to assess the status of your adenomyosis and rule out other potential causes of your symptoms. They can also discuss alternative treatment options, which may include different hormonal therapies, intrauterine devices (IUDs), or even surgical options if the symptoms are severe and unmanageable.

In the meantime, managing your anemia is also crucial. Heavy menstrual bleeding can lead to significant blood loss, resulting in anemia, which can cause fatigue and other health issues. Your doctor may recommend iron supplements or dietary changes to help manage your iron levels.

In summary, while oral contraceptives are a common treatment for adenomyosis, they do not work for everyone. It is essential to communicate openly with your healthcare provider about your symptoms and treatment effectiveness so that they can help you find the most suitable approach to manage your condition effectively.

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