TREATMENT OF MENSTRUAL PAIN: THE PILL AND THE OVERWEIGHT WOMAN
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I had incredible menstrual cramps along with irregular periods, so I went to my doctor and he put me on birth control pills. Everything was fine for a while, but three months ago I started to get cramps all over again, and they were worse than before. I know I'm overweight—S'4" and 150 pounds—and I wonder if that has something to do with it. I've often heard that if you are overweight you shouldn't be on the pill. Is this true? I'm only twenty years old and I don't want to do anything that's going to stop me from being able to get pregnant.
—M.J.
Seattle, Washington
As long as a woman does not smoke or have diabetes or high blood pressure, even if she is overweight she can take birth control pills. However, it is very important that her blood pressure be checked at least twice a year. Overweight women tend to have high blood pressure and this is one reason why she should try to lose weight. If her blood pressure goes up, she must stop the pill immediately.
Now her cramps could have become worse recently because women who are overweight have a lot of fatty tissue, which produces the hormone estrogen —which increases the thickness of the uterine lining during the menstrual cycle. So even though she is on the pill, the increased uterine lining could make her periods heavy again, boost the prostaglandins, and along with them, the pain.
She might try Midol along with the birth control pills two days before menstruation. If Midol doesn't ease the pain, she should see a physician for a prescription for Motrin, Anaprox, or Ponstel. It is perfectly safe to take prostaglandin-blocking drugs in addition to birth control pills. However, I would also recommend that this woman try to lose weight. If she is thinner she will not have to worry so much about her blood pressure, her estrogen level will drop, and most likely her cramps will go away too.
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Women's Health
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