Managing Birth Control Side Effects: A 30-Year-Old's Experience

Question
I have been taking b.c. pills most of the time for about 10 years.  I am now 30.  In the past 6 months I have taken several different types of pills--Nordette, Mircette, Lev-Lite.  All of which have had negative side effects.  
I prefer taking the pill because without it I have bad cramping and long periods.

each pill is OK for about 3 months, then symptoms set in.  (breast tenderness, blemishes, headaches...)

I am a grad. student and relegated to use the school clinic.  There is not an OB/GYN on staff.
What can I ask my NP to try/ consider that she may be missing.  I feel that I am not getting competent care or knowledgable prescription of b.c.  Is there some set of questions I can ask to make this a less random process?
Thanks so much for your time
-Samantha

Answer
Headaches, breast tenderness, and blemishes are a function of the amount of estrogen in the pill. If you complain of these symptoms after three months on a pill, you might ask your doctor to try a pill that contains less estrogen and more progesterone than the ones you are using.  It has been proven that OrthoTriCyclen and OrthoTriCyclen-lo and Yasmin help prevent acne. Perhaps they are worth a try to prevent the blemishes your describe. If you have intractable headaches or migraine headaches that do not respond to analgesics, you may have to stop the pills.  There will always be a bit of breast engorgement while on any type of birth control pill. Have you tried the patch?  I'm sure, that if the doctor at the school clinic found that she is confronted with a problem beyond her expertise, she can refer you to a gynecologist (somewhere) who can evaluate you properly. Good Luck.