Low-Dose Birth Control Pills Could Increase Pelvic Pain Risk

New study data show that low-dose (low estrogen) oral contraceptives (OCP) may increase a woman's risk for chronic pelvic pain symptoms (CPPS) and pain during sexual climax.

Investigators utilized data collected from an anonymous internet based survey of women 18–39 years of age within large university populations. Women who were pregnant or had a history of endometriosis or pelvic pain were not included in this study. Researchers gathered demographics, type of oral contraceptive, duration of use, and indication for usage for all participants. 

Participants were sorted into three groups: 1) not using an OCP 2) taking a low-dose of estrogen, or 3) taking a normal dose (>20mcg) of estrogen. A total of 932 participants were eligible for the study of which 605 were categorized as non-OCP users and 327 were categorized as OCP users, with 169 using low-dose and 171 using normal dose OCP.

Participants were classified as having CPPS if their total index pain score was ≥4. Significant differences in the incidence of individual pelvic pain symptoms between OCP users and non−users and further differences with low−dose use were found. Low-dose OCP users were more likely to report pelvic pain symptoms and more likely to have CPPS than non-users (27.1% vs. 17.5%, P=0.045). Normal dose OCP users were less likely to have pelvic pain symptoms than non OCP users. 

Low-dose OCP users also had almost twice the incidence of pain or discomfort during or after sexual climax compared to controls; there was no difference between normal dose OCP users and controls. The onset of pain was reported in 44% of participants after beginning OCP use and were more likely to fulfill CPPS criteria than those who had symptoms prior to OCP use (62%vs. 30.3%, P<0.001). 

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