<s>[INST] My daughter who is now 22 years old has been on numerous birth control pills since the age of 16. The original intent was to stop the severe cramping and heavy bleeding. A pill might work for 3-4 months and then the heavy bleeding and severe cramps come back. She would just like to find one she can stay on for a long time. Any suggestions? [/INST] HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your query, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1.First of all do not panic.2. Instead of trying various types of birth control pills, I will suggest that she should have low dose pill like OVRAL L and  she can safely take it in the future. She should regularly take tablets for 21 days and 7 days off.3.Also,a healthy diet and regular exercise is advisable.Supplements of Vitamin B 12,Folic acid, Iron and Calcium will be helpful. 4. I will suggest to get a good USG done to know if there is any structural cause in the uterus and ovaries for her heavy and painful periods. I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam S Neurgaonkar </s>