Is My Teenage Daughter Too Young To Start Taking Hormone Pills?

Hormone pills or oral contraceptive pills (OCP), more commonly known as birth control pills, provide many medical benefits in addition to providing contraception. In our pediatric and adolescent gynecology clinic we commonly prescribe them for medical purposes to help with dysmenorrhea (menstrual cramps), menorrhagia (heavy cycles), and irregular menstrual cycles, among other indications.
Many parents express concern regarding the use of these medications for medical conditions. The most common concerns include: safety, interference with growth, weight gain, negative impact on the ability to have children, and increased chances of starting sexual activity. In the absence of medical contraindications, there is no evidence to suggest that these medications are less safe in this age group compared to their adult counterparts. While OCPs have been associated with an increased risk of developing venous thromboembolism (“blood clots in the legs”), this increased risk is still extremely low in otherwise healthy patients without contraindications. In fact, pregnancy carries a significantly higher risk of developing blood clots compared to the risks with OCP use. OCPs do not increase the risk of developing cancer and their use has been associated with a decreased risk of developing colon, ovarian and uterine cancers. Studies have also failed to show that OCPs cause weight gain. OCPs do not affect growth. Once a female has gone through normal puberty and first menses she has attained most of her adult height, and starting OCPs after this time does not interfere with this process. OCPs do not interfere with the ability of a female, teen or adult, to have children in the future. These medications have a short-term effect on the body, which makes compliance necessary for appropriate response. Once they are discontinued, their effect on ovarian function quickly dissipates. The use of OCPs by adolescents does not increase sexual activity. The decision to engage in sexual activity is a complex one. That decision will most likely be independent of the fact that she is taking OCPs for medical indications. Anticipatory guidance and discussion between the teenager and her parent are encouraged as important elements for good decision-making about reproductive health. In many different situations, whether heavy menses with anemia or painful menstrual cramps, the benefits of OCPs clearly outweigh the risks. We strongly encourage parents to ask their health care provider to address all of their concerns regarding the use of these medications. Please see our Pediatric and Adolescent Gynecology website for additional information.