Menstrual Disorders - Medications

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Oral Contraceptives

Oral contraceptives (OCs), commonly known collectively as "the Pill," contain combinations of an estrogen and a progestin (either a natural progesterone or the synthetic form called progestogen). (Patch Contraceptives are now available in other forms, including patches and vaginal rings, but they may increase the risk for menstrual cramping.)

Click the icon to see an image of hormone-based contraceptives.

OCs are often used to regulate periods in women with menstrual disorders, including menorrhagia (heavy bleeding), dysmenorrhea (severe pain), and amenorrhea (absence of periods). Oral contraceptives are as effective for treating pain from endometriosis as the more potent gonadotropin releasing hormone agonists. They also protect against ovarian and endometrial cancers.

High-dose OCs have been specifically helpful for adolescents with severe dysmenorrhea. Studies with low-dose OCs are also showing promise in reducing menstrual pain for adolescents and adults. Some of the specific drugs used in these contraceptives are estradiol and levonorgestrel, drospirenone, and desogestrel.

Combination pills are sold in 21-day or 28-day packs:

• Each pill in the 21-day pack contains the necessary estrogen and progestin.
• The 28-day pack adds seven differently colored "reminder" pills; they are inactive and do not contain hormones, but help the user maintain her daily routine during seven days between active pill use.

OCs may be taken in cycles that include pills of the same or different strengths. These are categorized as monophasic (one-phase), biphasic (two-phase), or triphasic (three-phase).

• Monophasic regimen (Alesse, Brevicon, Demulen, Desogen, Genora, Levlen, Levlite, Loestrin, Lo/Ovral, ModiCon, Necon, Nordette, Norethin, Norinyl, Ortho-Cyclen, Ortho-Novum, Ovcon, Ovral, Yasmin, Zovia.) A 21-day pack uses tablets that are one strength and one color for 21 days. (A 28-day pack adds seven inactive tablets of a different color.)
• Biphasic regimen (Mircette, Necon, Nelova, Ortho-Novum). A 21-day pack consists of tablets of one strength and color taken for 7 or 10 days, then a second tablet with a different strength and color for the next 11 or 14 days. (A 28-day pack adds seven inactive tablets of a third color.)
• Triphasic regimen (Estrostep-21, Ortho-Novum 7/7/7, Ortho Tri-Cyclen, Tri-Levlen, Tri-Norinyl, Triphasil, Trivora). This pack consists of tablets with three different colors and strengths. In the first phase, there are tablets of one color for 5 to 7 days. For phase two, a second color and strength tablets is taken for 5 to 7 days. For phase three, a third color and strength tablet is taken for 5 to 10 days. The difference in duration of each phase depends on the brand. (A 28-day pack includes a fourth color inactive tablet for the last 7 days.)