Dr. Rachel Rubin

That when women take birth control pills, that tissue can get red.

It can get irritated.

It can get painful.

And when you examine it, you find a source of pain.

And so women have pain with tampons.

They have pain with sex.

Said, oh, I was fine until I started my birth control pill.

And then everything went south.

And so for those patients, we get their story, we talk to them, we examine them, and we say, huh, could this be your birth control pill?

Could we switch to something like a Mirena IUD, a hormonal IUD, which actually is not a combined, doesn't shut ovulation off, so you still can make your own hormones.

And we find that is a lot better for contraception for these patients who are prone.

And not every patient that takes birth control has these side effects, but those who do, they may have improvement.

Now, we also add back some local hormones, whether it's vaginal DHEA or topical estrogen or a topical estrogen testosterone that gets compounded, right?

Those are treatments that we have seen work for these patients.

And pelvic floor physical therapy, which all of those combined can be life-changing.

Not to say that also sex therapy also is wonderful because if something hurts you all the time, why would you ever want to do it?

And you got to work on those aspects as well.

So birth control, it has side effects like any other medication.

And we should not dismiss those patients who say they have side effects.

And we should be counseling women just like before they have surgery.