In ITP, is it okay to use birth control pills to control heavy menstrual bleeding?

In a woman with ITP who has not had a history of blood clots, we have no objections to birth control pills.  We also have no objections to the levonorgestrel (progestin) IUD which REDUCES menstrual blood flow from the uterus, although it does not prevent ovulation, and ovarian cysts can still form.  We DO object to the copper IUD, which increases menstrual blood.  Most women do not see an effect on their counts and benefit from having their menstrual bleeding controlled when they are not trying to become pregnant.

Andra James, MD, MPH
Director/Founder of the Women's Hemostasis and Thrombosis Clinic
Duke University Medical Center
Professor of Obstetrics & Gynecology
Duke University School of Medicine
Durham, NC