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Can the Pill Help in the Treatment of Dysmenorrhea?

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Updated June 10, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Can the Pill Help in the Treatment of Dysmenorrhea?
Dysmenorrhea is pain resulting from intense uterine contractions during menstruation triggered by the release of prostaglandin (natural substances made in the uterus that cause the uterine muscles to contract and help the uterus shed the lining that has built up during the menstrual cycle). The pain is severe enough to limit a woman’s daily activities during that time. Dysmenorrhea is the most commonly reported menstrual disorder, affecting up to 90% of young women. The Pill (as well as other hormonal contraceptives) can help in the treatment of dysmenorrhea.
Answer:

Although more than 80% of U.S. women will use hormonal contraception (like the Pill) sometime during their reproductive years, many do not realize the noncontraceptive benefits of using this type of birth control. Certain hormonal contraceptives have shown some ability to diminish dysmenorrheal pain. Please keep in mind that each woman may react differently to specific birth control methods, so this information is meant to be a general overview. It is also important to point out that the main reason to use hormonal contraception is for birth control (to prevent an unintended pregnancy) -- the potential noncontraceptive benefits can be considered when deciding which hormonal birth control method may be best suited for you.

The following is a list of various prescription birth control methods that have been shown to be effective in relieving some of the pain associated with dysmenorrhea:

  • Combination Birth Control Pills: By blocking the production of prostaglandin, combination birth control pills have been shown to relieve dysmenorrhea in up to 70–80% of women.


  • NuvaRing: In a randomized controlled trial, the vaginal ring was also shown to reduce dysmenorrhea from 17.4% to 5.9%.


  • Implanon: It appears that the use of Implanon can reduce dysmenorrhea in most users as well; one study reported a decrease in the number of women with dysmenorrhea from 59% at baseline to 21% after treatment. Additional research has revealed that 81% of women who reported a history of dysmenorrhea before using Implanon showed improvement while using this progestin contraceptive implant.


  • Mirena IUD: Data on the effects of the Mirena IUD for dysmenorrhea is limited; however, given that Mirena reduces or eliminates monthly periods for many women, in theory, this should make dysmenorrheal pain less likely to occur.


  • Ortho Evra Patch: Given that the contraceptive patch is similar to combination pills (it contains a synthetic estrogen and a progestin), it should also be expected to diminish the pain associated with dysmenorrhea.

Sources:

Croxatto HB. "Clinical profile of Implanon: a single-rod etonogestrel contraceptive implant." Eur J Contracept Reprod Health Care 2000;5(suppl 2):21–8. Accessed via private subscription.

Funk S, Miller MM, Mishell DR Jr, Archer DF, Poindexter A, Schmidt J, et al. "Safety and efficacy of Implanon, a singlerod implantable contraceptive containing etonogestrel. Implanon US Study Group." Contraception 2005;71:319–26. Accessed via private subscription.

Hendrix SL, Alexander NJ. "Primary dysmenorrhea treatment with a desogestrel-containing low-dose oral contraceptive." Contraception 2002;66:393–9. Accessed via private subscription.

Jamieson DJ, Steege JF. "The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices." Obstet Gynecol 1996;87:55–8. Accessed via private subscription.

Milsom I, Lete I, Bjertnaes A, Rokstad K, Lindh I, Gruber CJ, et al. "Effects on cycle control and bodyweight of the combined contraceptive ring, NuvaRing, versus an oral contraceptive containing 30 microg ethinyl estradiol and 3 mg drospirenone." Hum Reprod 2006;21:2304–11. Accessed via private subscription.

Varma R, Sinha D, Gupta JK. "Non-contraceptive uses of levonorgestrel-releasing hormone system (LNG-IUS)—a systematic enquiry and overview." Eur J Obstet Gynecol Reprod Biol 2006;125:9–2. Accessed via private subscription.

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