My family medicine practice is located inside of an urgent care center. Many times, adolescent women coming into our office will tell us they are on the birth control pill (BCP) for heavy, irregular, or painful periods. Is this the BEST medical practice?
Menstrual difficulties in adolescent women are not unusual. It has been estimated that adolescents will have several anovulatory cycles a year, which will lead to “periods” (menses) that are either unusually heavy or unusually light—and cycles unusual in timing. Adolescents can have endometriosis—where endometrial tissue (the cells inside the uterus) is found outside the uterus. This condition is found in 45% (maybe more) of teens with painful menses.
So what is a young woman (and her parents) to do? Most teens presenting with these symptoms would walk out of their doctor’s office with a BCP prescription. Is this really the answer?
A doctor’s first calling is to do no harm (or at least as little as possible) when treating patients. Did you know that a woman’s risk of breast cancer increases by over 50% from what it would have been if she takes the Pill for more than 4 years before having her first child? Teens fall into this risk group.
There is an association between women taking the Pill as teens and being diagnosed later with deep infiltrative endometriosis. It’s not yet known if the Pill used caused the endometriosis to be invasive—more study is needed. But it does tell us that even if the menses become less painful, the underlying disease has not gone away.
A kindler, gentler, and extremely effective way of treating menstrual issues in teens (or anyone) is to find out what the underlying issue is and treat that with targeted therapy, not BCPs which can cover up symptoms and don’t treat them. Good places to find doctors who can help you are www.naprotechnology.com or www.omsoul.com or www.catholicpediatrics.com.
Board Certified, American Board of Family Medicine
Natural Family Planning Medical Consultant
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