Can doubling the hormonal contraceptive dose, specifically combined oral contraceptives (COCs), temporarily stop menstrual bleeding?

From the Guidelines

No, you should not double your birth control dose to stop menstrual bleeding. Increasing your birth control dose without medical guidance can lead to serious side effects including nausea, vomiting, headaches, breast tenderness, and increased risk of blood clots. If you're experiencing problematic menstrual bleeding, there are safer, medically approved options. For hormonal birth control pills, your doctor might recommend taking active pills continuously (skipping the placebo week) to prevent periods, as suggested by the U.S. Selected Practice Recommendations for Contraceptive Use, 2013 1. Alternatively, medications like tranexamic acid (Lysteda) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce heavy bleeding, as noted in the same recommendations 1. These approaches work by either maintaining stable hormone levels to prevent the uterine lining from shedding or by affecting blood clotting mechanisms.

Some key points to consider:

• The U.S. Selected Practice Recommendations for Contraceptive Use, 2013, suggest that if an underlying gynecologic problem is not found and the woman wants treatment, NSAIDs for short-term treatment (5–7 days) or hormonal treatment (if medically eligible) with low-dose COCs or estrogen for short-term treatment (10–20 days) can be considered 1.
• The same recommendations advise that if heavy or prolonged bleeding persists and the woman finds it unacceptable, she should be counseled on alternative contraceptive methods, and offered another method if it is desired 1.
• It's also important to note that extending the hormone-free interval is considered to be a particularly risky time to miss combined hormonal contraceptives, and seven days of continuous combined hormonal contraceptive use is deemed necessary to reliably prevent ovulation, as discussed in the U.S. Selected Practice Recommendations for Contraceptive Use, 2013 1.
• Always consult with your healthcare provider before making any changes to your birth control regimen, as they can recommend appropriate options based on your specific health needs and the type of birth control you're using.

From the FDA Drug Label

Breakthrough bleeding, spotting, and amenorrhea are frequent reasons for patients discontinuing oral contraceptives. Changing to an oral contraceptive with a higher estrogen content, while potentially useful in minimizing menstrual irregularity, should be done only if necessary since this may increase the risk of thromboembolic disease

Doubling the birth control dose short-term to stop menstrual bleeding is not recommended. The label suggests that changing to an oral contraceptive with a higher estrogen content may be useful in minimizing menstrual irregularity, but this should be done only if necessary due to the increased risk of thromboembolic disease. There is no direct information to support doubling the dose short-term to stop menstrual bleeding 2.

From the Research

Doubling Birth Control Dose to Stop Menstrual Bleeding

• There is no direct evidence to support doubling the birth control dose as a method to stop menstrual bleeding in the short term 3, 4, 5, 6, 7.
• The studies provided focus on comparing different types of birth control methods, such as levonorgestrel-releasing intrauterine systems (LNG-IUS) and oral contraceptives, in reducing menstrual blood loss and improving quality of life in women with menorrhagia 5, 6, 7.
• Some studies suggest that LNG-IUS is more effective than oral contraceptives in reducing menstrual blood loss and improving quality of life 5, 6, 7.
• However, these studies do not address the specific question of doubling the birth control dose to stop menstrual bleeding in the short term.
• It is essential to consult a healthcare provider for personalized advice on managing menstrual bleeding, as they can recommend the most suitable treatment options based on individual needs and medical history.

Birth Control Methods and Menstrual Bleeding

• Levonorgestrel-releasing intrauterine systems (LNG-IUS) have been shown to be effective in reducing menstrual blood loss and improving quality of life in women with menorrhagia 5, 6, 7.
• Oral contraceptives, such as those containing levonorgestrel or norethindrone, can also reduce menstrual blood loss, but may not be as effective as LNG-IUS in some cases 3, 4, 5.
• The choice of birth control method depends on various factors, including individual preferences, medical history, and lifestyle.

Important Considerations

• Menstrual bleeding can be a symptom of underlying medical conditions, and it is crucial to consult a healthcare provider to rule out any potential health issues.
• Doubling the birth control dose without medical supervision can lead to adverse effects and may not be effective in stopping menstrual bleeding.
• It is essential to follow the recommended dosage and usage instructions for any birth control method to ensure safety and efficacy.