By Melinda Young
EXECUTIVE SUMMARY
Contraceptives can help patients who are experiencing other conditions, including menstrual pain, endometriosis, heavy menstrual bleeding, menopause, and disabilities.
- Hormonal intrauterine devices (IUDs), contraceptive implants, injection, patch, vaginal ring, and combined birth control pills can help alleviate the severe pain people experience from endometriosis.
- IUDs can be especially helpful for multiple conditions. If state or federal governments end Medicaid coverage of IUDs or even ban the devices, it could be a big loss for women who seek that option.
- Stopping menses can help patients with menstrual pain, heavy bleeding, and managing hygiene — particularly among those with disabilities for whom self-care is challenging.
As debates continue over access to contraception and abortion care nationwide, it is important for providers to inform patients and enlighten the public about all of the noncontraceptive uses of contraception. This includes talking about methods that are increasingly under attack by the same ideological groups that convinced more than a dozen state legislatures to ban or severely restrict access to abortion care.
Contraceptive side effects that have positive impact are referred to as noncontraceptive benefits, something extra that birth control can do for patients beside preventing pregnancy, according to Contraceptive Technology.1 For example, hormonal intrauterine devices (IUDs), along with contraceptive implants, injection, patch, combined birth control pills, and ring, can help alleviate pain and other symptoms of endometriosis.
The IUD can keep the endometrial lining in the uterus so there is not as much bleeding during the period, and this prevents retrograde menstruation where material goes back in the tubes, says Jen Kaiser, MD, MA, MSCI, an assistant professor — family planning and Ryan Residency Program Director at ASCENT Center for Reproductive Health at the University of Utah in Salt Lake City.
“Another way the IUD helps is by suppressing endometrial lesions in the pelvis,” Kaiser explains. “This is hard to prove, but we know from many studies that levonorgestrel IUD can really help people who have painful periods related to endometriosis.”
For this reason, OB/GYNs can recommend the levonorgestrel IUD to people with frequent and painful periods, she adds.
People who experience endometriosis are among many potential people affected by government policies that restrict access to IUDs because of misinformation about how they work.
“We are seeing unprecedented attacks on reproductive healthcare in our country,” Kaiser says. “In some circles, there is a concern that IUDs are an abortifacient, which they are not. So, there is potential legislative action around these things even if it is not for contraceptive benefit.
If the U.S. Congress or the president’s administration decides to undo the Affordable Care Act’s contraceptive mandate, IUDs may no longer be affordable to many people who rely on Medicaid and other types of insurance. It also is possible that some states will outright ban IUDs and emergency contraception. Courts would challenge the laws, but women could lose access as the legal fight continues.
“I just hope that we as physicians can continue to advocate for our patients to be able to use the medications that help them treat their conditions,” Kaiser says. “I want patients to access the kind of contraception they want and that works for them.”
Physicians can use contraceptives to help older women taking hormone therapy, as well. “When women get to be 35 to 50, they may take estrogen-replacing therapy,” says Robert Hatcher, MD, MPH, the founding author of Contraceptive Technology, as well as the consulting editor of Contraceptive Technology Update.
“Only, estrogen can cause problems, so they need a progestin, and an IUD is a great way to get it,” Hatcher adds. “Once the IUD is in place, it can be left in [long-term]. It has a dramatic protective effect against ovarian cancer.”
Physicians also may prescribe contraceptives for patients with multiple disabilities and who desire menstrual suppression, says Kathryn Brown, MD, a complex family planning fellow at the University of Utah, obstetrics and gynecology, in Salt Lake City.
Contraceptive treatment can help people with developmental delay and decreased mobility and who need a lot of help with self-care, she adds. “Stopping menses can be helpful with managing hygiene and pain because sometimes they have difficulty communicating if they’re in pain or don’t know where it’s coming from,” Brown explains. “An IUD can be a nice option for those folks because we have hormonal IUD options that last up to eight years without needing any maintenance or repeated dosing; it doesn’t cause side effects like weight gain.”
Here are some additional ways contraceptives can be used for medical treatment unrelated to pregnancy prevention:
Menstrual Pain and Endometriosis
“I counsel my patients to think about endometriosis as a chronic condition that needs chronic maintenance therapy — like high blood pressure and diabetes,” Brown says.
“Surgical options in certain circumstances can be really helpful for short-term relief and also for fertility,” she adds. “But over the long term, it’s the medication that can help us obtain that long-term control and remission of their symptoms.”
Any hormonal contraceptive, including hormonal IUDs, the implant, injection, patch, and ring, could be beneficial to treating endometriosis, Kaiser says.2
Endometriosis is stimulated by internal cycling of hormones. The menstrual cycle promotes growth of endometrial linings within the uterus and also growth of endometriosis implants — patches of tissue that grow outside of the uterus. They are similar to the uterine lining and can look like lesions or nodules.
“Combined hormonal birth control suppresses ovulation and the big swings that the internal, native hormones make during the menstrual cycle, as progestin rises to a greater extent,” Kaiser explains. “Before the period starts, those hormones decrease quite significantly, and that triggers a period and triggers implants to inflame and become painful inside the pelvis.”
Combined methods like the implant, injection, and birth control pills can stop that rise and quick drop, she adds. “They even out internal hormonal fluctuations, and you avoid having a drop in hormones,” Kaiser says. “You hold things steady so you don’t get that pain, and you’re avoiding a period.”
Patients with endometriosis could take a birth control pill and use it continuously — not stopping it for a placebo week because that could trigger bleeding and endometriosis pain.
“They’re always on a steady state of hormones in the pill, and Opill would help too. It doesn’t have to have estrogen; progestin-only options also work,” Kaiser says.
Physicians should talk with their patients and discuss the pros and cons of different treatments for endometriosis. Most patients have tried some form of birth control and know what they like and what they are looking for.
“So, start with the person and say, ‘Often, we treat endometriosis with some kind of hormone, and almost all are birth control. Is there something you’ve had in the past that you liked or didn’t like?’” Kaiser suggests. “Give people autonomy to make that decision and avoid just saying the IUD is the best thing and that’s what we’re doing.”
Clinicians can leave the door open to patients changing their minds. “Say, ‘Let’s try this, and if it doesn’t work for you — give it three or four months, and then you can come back, and we can talk about something else. There are lots of options,’” she adds. The same strategy works for patients experiencing menstrual pain that is not caused by endometriosis, Kaiser says.
Heavy Menstrual Bleeding
“The most common noncontraceptive use that I encounter is for abnormal bleeding,” Brown says. “People are experiencing either irregular periods, or — more commonly — very heavy periods or very painful periods.” For any of these issues, hormonal treatments, such as hormonal contraceptives, are the first-line treatment in terms of symptom management.
The problem with heavy menstrual flow is that it can be very disruptive to people’s lives, especially if the timing of their periods is unpredictable and heavy. Heavy bleeding can cause pads to soak through, staining clothing, and sometimes requires people to carry additional supplies with them. This can make it difficult to go out in public or to a workplace or school because of the uncertainty and stigma of menstruation if there are obvious signs of blood stains.
“Some of these folks may end up with secondary problems like iron deficiency anemia and fatigue,” Brown explains. “Patients may want to stop the bleeding altogether or just decrease the bleeding,” Brown says. Treatment can include birth control pills or a hormonal IUD.
“At six months, with the [levonorgestrel] IUDs, there is a 90% reduction in the amount of bleeding that people experience,” Kaiser notes. “It’s quite dramatic.”
Other hormonal methods also can help. But the contraceptive implant is less preferred because one-third of people who use it can have unpredictable or prolonged episodes of bleeding, she adds.
Bleeding irregularities are the most common reason people ask to have the implant removed, but up to 20% of patients with normal menstrual cycles before using the implant reported amenorrhea after using the implant, continuously, for a year.3
Also, the copper IUD does not reduce or stop menstrual bleeding, so it is not a solution for people with menstrual pain and heavy bleeding.
“The [levonorgestrel] IUD can be a really nice option, especially for folks concerned about the hormonal side effects because it has minimal systemic side effects,” Brown explains. “If they’re dealing with really heavy periods, we talk about how hormonal options are a really effective way to manage bleeding symptoms, and they have a high satisfaction rate and are the least invasive option.”
For those who have heavy bleeding and/or fibroids, surgical options may be preferred, but OB/GYNs could talk about trying noninvasive treatment first.
In addition to menstrual pain and heavy bleeding, there are several conditions where patients may benefit from treatment with hormonal contraceptives, including the following:
Acne
Hormonal therapies are highly effective treatment for acne, and many doctors underappreciate how common adult acne is in women, says Howa Yeung, MD, MSc, an associate professor of dermatology at Emory University School of Medicine in Atlanta.
“It’s very common and affects people’s self-esteem and quality of life,” Yeung says. “We have a lot of different treatments for acne, some topical, and some antibiotics, but hormonal therapies, such as contraceptives, can help and are — in my opinion — underutilized.”
A new study found that different brands of combined oral contraceptives have similar efficacy in treating acne and should be discussed in shared decision-making with patients.4
Some dermatologists do not prescribe oral contraceptives to their patients even though some brands are approved for treatment of acne by the Food and Drug Administration (FDA), Yeung says. Ortho Tri-Cyclen, Estrostep, and Yaz are all FDA-approved for treating acne and should be considered by dermatologists, he adds.
“Sometimes, clinicians are intimidated because there are some risks involved, and there is personalized decision-making you want to engage patients in discussing in choosing contraception.”
Also, OB/GYNs may not always tell patients about the noncontraceptive benefits, including the ability to reduce acne, of some forms of birth control, Yeung says. “I wish OB/GYNs would talk with patients about how contraception could help them with acne, and I wish primary care physicians could talk more about the benefits of this treatment,” he adds.
Hormonal therapy does not work as quickly as some other treatments, but it can be a good, long-term treatment, Yeung says. An oral antibiotic works quickly, but within three to six months of treatment, contraceptives are equally effective in treating acne as antibiotics, he explains.
Accutane is highly effective as an acne treatment and to prevent scarring, but since female patients are required to use an oral contraceptive while taking the drug, it is possible that some patients would be helped enough with just the contraceptive.
“For most of my patients with moderate or severe acne, I will talk with them about combined oral contraceptives,” Yeung says. “For patients who can get pregnant and who desire contraception, this is something where you can kill two birds with one stone — both providing access to contraception as well as helping with their skin.”
Chronic Conditions and Epilepsy
OB/GYNs can use hormonal birth control methods to help patients with other cyclic symptoms that occur in the week leading up to menstruation.
These may include migraine headaches, inflammatory bowel disease, seizure activity, and symptom flares in people with autoimmune conditions, including Crohn’s disease and lupus, says Jen Kaiser, MD, MA, MSCI, an assistant professor — family planning and Ryan Residency Program Director at ASCENT Center for Reproductive Health at the University of Utah in Salt Lake City.
“Some people say they were tracing their cycles, and every four days leading up to [their period], their chronic condition gets worse. Then a few days after the period, it clears up again,” Kaiser says.
For a condition like catamenial epilepsy, in which seizures worsen during phases of a woman’s menstrual cycle, contraceptive medications can decrease seizure burden, says Kathryn Brown, MD, a complex family planning fellow at the University of Utah, obstetrics and gynecology, in Salt Lake City.
“It’s the same thing with menstrual migraines, which can be debilitating and cause people to miss work and school,” Brown adds. “Hormonal contraception can reduce that, but not the IUD, which is less helpful for [catamenial epilepsy and migraines] because the IUD doesn’t suppress ovulation.”
Premenstrual Dysphoric Disorder
Combined hormonal contraception, including the pill, patch, and vaginal ring, can help patients with cyclic mood problems, such as premenstrual syndrome and premenstrual dysphoric disorder.5
Premenstrual dysphoric disorder can be treated with combined contraceptives and progestin-only contraception, but not necessarily IUDs, Brown says.
Hormonal contraceptives, like birth control pills, also can help reduce severe symptoms of depression, irritability, and anxiety that occur before the period starts, Kaiser says.
Cancer
“Combined hormonal contraception has the benefit of protecting against ovarian, endometrial, and colorectal cancer,” says Robert Hatcher, MD, MPH, the founding author of Contraceptive Technology, as well as the consulting editor of Contraceptive Technology Update.
The benefits in reducing the risk of ovarian cancer have been reported since the 1970s, he adds. “There are many people who have no idea that birth control pills prevent ovarian cancer, and that’s one of their biggest benefits that we need to talk more about,” Hatcher says.
“Any hormonal birth control method will reduce the risk of ovarian cancer and reduce the risk of endometrial cancer,” Kaiser says. “The 52-mg levonorgestrel IUD has been shown to be beneficial in treating complex atypical hyperplasia and endometrial intra-epiphyseal neoplasia — a pre-cancer of the endometrium,” she adds. “Levonorgestrel contraceptives have been used to help manage that for people who do not want a hysterectomy and can also be used to treat early endometrial cancer for people who want to preserve fertility.”
Other hormonal methods, including birth control pills, injectables, implant, ring, and patch, also can reduce risk for endometrial cancer and ovarian cancer, Kaiser says.
For people who have frequent ovarian cysts, systemic hormonal birth control pills, patch, ring, implant, and injectable can help. Any hormonal birth control except the IUD would potentially provide benefit because there is not enough systemic hormone in the IUD, Kaiser says. Reduction in endometrial cancer risk is a noncontraceptive benefit of combined oral contraceptives.6
At a time when easier access to contraceptives is under threat, physicians and family planning leaders need to advocate for patients who need contraception for any reason, including pregnancy prevention and/or treatment of a medical condition. “My goal would be that any contraceptive method is available free of charge or copay to all patients,” Brown says. “Each person’s situation is unique in terms of their needs and goals and the reason they are seeking treatment.”
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
References
1, Cason P, Cwiak C, Edelman A, et al. Contraceptive Technology, 22nd ed. Jones & Bartlett Learning; 2025:161.
2. Cason P, Cwiak C, Edelman A, et al. Contraceptive Technology, 22nd ed. Jones & Bartlett Learning;2025:158.
3. Cason P, Cwiak C, Edelman A, et al. Contraceptive Technology, 22nd ed. Jones & Bartlett Learning;2025:268.
4. Smith CA, Gosnell E, Karatas TB, et al. Hormonal therapies for acne: A comprehensive update for dermatologists. Review Dermatol Ther. 2025;10.1007/s13555-024-01324-8. [Online ahead of print].
5. Cason P, Cwiak C, Edelman A, et al. Contraceptive Technology, 22nd ed. Jones & Bartlett Learning;2025:162.
6. Cason P, Cwiak C, Edelman A, et al. Contraceptive Technology, 22nd Edition. Jones & Bartlett Learning;2025:372.
Contraceptives can help patients who are experiencing other conditions, including menstrual pain, endometriosis, heavy menstrual bleeding, menopause, and disabilities.
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