<s>[INST] Hello doctor,My doctor prescribed me ZOVIA 1/50E–28 for my birth control. I have very heavy bleeding during my menstrual cycle with irregular periods and really bad cramps. I am 23 years old and I am pretty much flat chested with 32AA breast with a 28 in the waist and 30 inches hips. I did not know if having smaller hips could cause a more painful menstrual cycle and if a higher dose would help with this. [/INST] Hi. Zovia 1/50E is a high dose of an Estrogen-containing birth pill, though commonly lower dosage of 30/35 is used. Please ensure you do not have high blood pressure, migraine, history of thrombosis, liver disease, undiagnosed vaginal bleeding, etc., when using these. Painful periods have multiple reasons like endometriosis, distorted uterine anatomy, big clots passage due to heavy bleeding. Hips are no reason. A higher dose might increase the problems. As per your weight, you can work out with a lower dosage to prevent your problem of irregular, heavy painful periods. Birth control pills have a good effect on all of your problems. By the way, did your doctor specify, why your menarche was so late? </s>