I used to listen to my friends' period woes with the kind of removed sympathy of someone who had only experienced consistently mild symptoms her entire post-pubescent life. That all changed two years ago when suddenly, my body decided to make up for all that easy living in one fell swoop. Over the course of just a few cycles, my cramps suddenly became unbearably painful and my skin went haywire. But the most debilitating side effect of all was a heavy flow that made me self-conscious enough to go running to my ob-gyn for answers. She recommended that I get an IUD to help mitigate it all, and I've been virtually symptom-free ever since.
While it was ultimately the right one for me, the decision to go on hormonal birth control is highly personal and doesn't necessarily breed universally positive results. Our bodies are all different, after all. But if you do suffer from a heavy flow, it's definitely an option worth discussing with your doctor.
"When taking hormonal birth control, a woman's endometrial lining is often thinner, and as a result, some women may bleed less when menstruating," explains Lakeisha Richardson, MD, a noted ob-gyn who works as a consultant for Allergan's Know Your Birth Control campaign. Still, it's important to remember that this common side effect shouldn't be construed as a cure-all. "Most oral contraception is approved for pregnancy prevention—not heavy periods—and may not be for everyone, and so women should speak with their healthcare providers to determine what birth control option may be right for them," she says.
What Exactly Is a Heavy Period?
It might seem pretty self-explanatory, but we asked Luu Ireland, MD, MPH, family planning specialist, fellow with the American College of Obstetricians and Gynecologists, and assistant professor at the University of Massachusetts Medical School what kind of flow would warrant treatment or a consultation with your gynecologist. "Heavy periods—or how we refer to it in the medical field—heavy menstrual bleeding, is defined as any monthly vaginal bleeding that affects a person's quality of life," she says. "If it's impacting your quality of life, your ability to go out, your ability to enjoy your normal routines, then that's enough to warrant treatment. Birth control is certainly the lowest risk and best option as first-line therapy to treat heavy menstrual bleeding."
What Are My Birth Control Options for Heavy Periods?
"Fortunately we live in a time when we have a lot of different birth control options. So the pills are very frequently used to treat heavy menstrual bleeding, but we also have a plethora of other options including IUDs, the birth control shot, patch, and ring to deal with heavy bleeding," Ireland says.
What you choose all depends on your personal preference and what you're comfortable with. Ireland walked us through some of them:
IUD: "The most effective birth control option to treat heavy menstrual bleeding is the hormonal IUD. The hormonal IUD has a small dose of a hormone called levonorgestrel. And it's a nice device because it sits inside the uterus. There's no daily pill to take because it's sitting in the uterus at the site of action. The amount of hormone that goes through your bloodstream is actually very, very low, so the side effects with this device are very minimal. Now, not every person will be comfortable with a device inside the uterus, which is why we're thankful to have other options."
The Pill, Patch, Ring: These methods have two hormones: estrogen and progestin. "In terms of effectiveness, the pill, the birth control patch, the birth control ring—all of them I would say are pretty equivalent in terms of how effective they are. And all of them work pretty well as long as they're used consistently. All birth control methods are pretty effective at treating heavy menstrual bleeding," Ireland says.
Unlike the IUD, which can last for years, you'll have to remember to take a pill every day, switch out a new ring or patch, or get a shot after a certain period of time (normally a few months).
How Long Does It Take to See Results?
It won't exactly happen overnight, but you might see a difference after a few cycles. "Most women will see pretty quick results in the first one or two months. However, every body is different, and some bodies take longer to get used to the hormones in contraception. So we tell people by three to six months is when you really should see a difference, though most women will see the results sooner," Ireland says.
The bottom line? It's up to you and your doctor to decide which one will work best for you and your lifestyle. "All birth control methods, regardless of what type you choose, will make bleeding better, will improve the flow of your period," Ireland says. "That being said, there are some methods that have kind of an initiation period, in which your bleeding can be irregular before you see the full benefit of the birth control method. And those would be Depo-Provera, the birth control shot, or Nexplanon, the birth control implant. After about a year, most people will be satisfied with the changes in their periods, but you know, sometimes you can have a rocky start until you get there."
One thing to note is that you should consult with your doctor about why you're having heavy bleeding in the first place. "People who are in their late 30s and 40s, before they start birth control to treat heavy bleeding, they really should see a doctor to rule out any bad reasons for having heavy bleeding," Ireland recommends. "Sometimes somebody might have something like fibroids or polyps inside the uterus. Even though it is rare, uterine cancer can sometimes manifest as heavy bleeding. So it really is important to rule out the bad stuff, or the easily reversible stuff, before you move on to jumping on a birth control method."
This post was updated by Sarah Yang.