Introduction
Menorrhagia requires proper attention and treatment as it greatly influences the quality of life. Hormonal birth control pills are fruitful in treating various menstrual issues like menorrhagia. Though these pills are marketed for contraception, their efficacy in treating other issues, including menorrhagia, has been proven.
What Is Menorrhagia?
Menorrhagia is a condition marked by too much bleeding during menstruation. Menstruation accompanied by bleeding that lasts more than a week also comes under menorrhagia. Menorrhagia results in heavy blood loss, typically more than 80 milliliters in a single menstrual cycle. It can either be acute menorrhagia or chronic menorrhagia. Acute menorrhagia demands emergency medical attention, while chronic menorrhagia is a long-standing, persistent condition. If left untreated, it may result in anemia (dip in red blood cell count) and significantly affect the quality of life.
How Do Birth Control Pills Work for Menorrhagia?
Ovaries contain numerous follicles; during ovulation, one mature follicle breaks off and releases the egg. The follicle that releases the egg then gives rise to a gland-like body - corpus luteum - secretes the hormone progesterone. The inner lining of the uterus (womb) is technically known by the term endometrium. During every menstrual cycle, the endometrium expects a fertilized egg (egg after fusion with sperm) and keeps itself equipped for receiving it by growing new blood vessels.
Suppose the union of egg and sperm (fertilization) and settling of the fertilized egg into the uterus (implantation) does not happen. In that case, this gland-like structure will regress, creating a sudden dip in progesterone level that results in menstruation. Menstrual bleeding is the shredded endometrium that marks the beginning of periods.
Birth control pills contain factory-made versions of the hormones progesterone and estrogen. And they are responsible for thinning down the womb's inner lining, the so-called endometrium. That is how birth control pills work on controlling heavy bleeding that occurs during menstruation. Though the birth control pill's principal function is to prevent pregnancy, it works great for menorrhagia. Therefore, it is widely advised for the treatment of menorrhagia.
What Types of Birth Control Pills Work for Menorrhagia?
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Birth control pills can either be of a combination type or progestin-only type. Both oral contraceptive pills (OCP) work for menorrhagia; however, progestin-only pills are routinely prescribed for treating menorrhagia.
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Progestin-only pills contain only the factory-made version of progesterone - progestin. They are conventionally known by the name minipills. Progestin effectuates the atrophy of the inner layer of the womb (endometrium) and makes it thinner. Thinner endometrium reflects controlled bleeding in patients suffering from heavy menstrual bleeding (HMB). It is available in a single pack with 28 pills, and all the pills in progestin-only pill sets are active.
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Combination-type oral contraceptive pills are combined with manufactured estrogen and progesterone (progestin). This form of estrogen magnifies progestin's effects and adds to contraception and menorrhagia.
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In addition, it has some influence over the follicle-stimulating hormone (FSH). Combination-type OCP comes in different packings. Some are monophasic, multiphasic, extended, and continuous cycle pills. Both monophasic and multiphasic pills are designed for a 28-day cycle with 24 active and four inactive pills.
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In monophasic, as the name implies, the hormone dose remains the same for all the pills except the inactive pills that do not contain hormones.
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In contrast, multiphase pills are provided with varying hormone doses. Extended cycle pill sets are designed for a 13-week cycle with 84 active and seven inactive pills, while continuous cycle pill sets are designed for 365 days.
Are Birth Control Pills Effective for All Types of Menorrhagia?
Excessive bleeding reflected during menses can have different causes. Therefore, we have to understand the cause leading to the condition. Similarly, birth control pills may not work for all types of menorrhagia. However, studies have proven that birth control pills are as effective as other treatments for controlling menorrhagia that develops due to hormonal discrepancies. Still, at the same time, no conclusive study establishes the same for menorrhagia due to bleeding disorders or menorrhagia induced by certain medications.
What Are the Added Benefits of Using Birth Control Pills?
Apart from contraception and menorrhagia, oral contraceptive pills offer numerous other benefits.
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It is more beneficial to people who experience irregular periods. It significantly reduces discomfort, pain, and cramps associated with menstruation. It can also deal with certain physiological and emotional disturbances associated with menstruation, collectively known by the technical term premenstrual syndrome (PMS). Thereby greatly influencing their quality of life. Certain women are prone to develop acne due to hormonal fluctuations in menstruation.
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Oral contraceptive pills are hormones, and they can calm down acne attacks to a great extent. In addition, oral contraceptive pills can tackle some of the clinical manifestations of endometriosis.
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Hormonal changes associated with menstruation may bring about typical menstrual migraines in some women, which can be promptly handled with birth control pills.
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In addition, it substantially diminishes the risk of developing certain cancers like ovarian and uterine.
What Are the Other Treatment Modalities Available for Menorrhagia?
Though birth control pills are used for menorrhagia, they are not the sole treatment methodology. Quite a few effective interventions are available.
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Hormonal intrauterine contraceptive devices are certain hormone-releasing devices placed inside the womb. The mechanism of action of hormonal intrauterine contraceptive devices is similar to hormonal birth control pills.
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Hormone therapy.
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Desmopressin is in the form of a nasal spray specifically designed for menorrhagia resulting from bleeding disorders.
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Antifibrinolytic medications that check fibrinolysis (disintegration of the clot).
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Dietary iron supplements such as tablets or syrup to counteract the iron deficiency resulting from heavy bleeding.
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Dilation and curettage of the inner womb lining
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Procedure to remove pathologies in the uterus, which checks heavy bleeding (operative hysteroscopy).
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Procedure in which the womb is surgically removed (hysterectomy).
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As a measure to control the bleeding inner lining of the uterus, either as a whole or part is resected or removed (endometrial ablation or endometrial resection).
Who Should Not Use Birth Control Pills for Menorrhagia?
The reproductive age group seeking pregnancy should refrain from oral contraceptive pills even if it is advised for menorrhagia. In addition, patients suffering from hormone-sensitive cancers are advised not to use hormonal birth control pills as there are chances that the hormones may trigger the cancerous cells.
Conclusion
Menorrhagia is a condition that requires prompt medical attention, but women are reluctant to open up due to the taboo or social stigma attached to such conversation. Birth control pills are an effective strategy for excessive blood flow during periods.
