Initially a monophasic low-dose combined pill is recommended. This can later be changed to a lower dose. Pills with Norethisterone 1000 micrograms are useful to reduce bleeding. Premenstrual syndrome symptoms are often relieved by monophasic OCs. Breast feeding women should use progestogen only pills.
Oestrogen reduces milk output.
When oestrogens cause problems a progestogen only pill is a good alternative. However, this pill is inferior to combined oral contraceptives in control of bleeding and contraception. Breakthrough bleeding is common in the first three months after first starting the pill. If bleeding still persists a high dose of oestrogen is indicated. If bleeding still continues this should be investigated by a specialist.