Members of MyEndometriosisTeam sometimes ask about oral contraceptive (birth control) pills and whether they effectively help with symptoms of endometriosis. “Does anyone take birth control pills? Does it help?” wrote one member.
Research has found that, although oral contraceptives may help reduce many of the symptoms of endometriosis, they do not cure the condition nor stop its progression. This article will look more closely at the potential benefits and drawbacks of using oral contraceptive pills as a treatment for endometriosis. Before starting this or any other treatment, ask your health care provider.
Oral contraceptive pills, often called birth control pills, are hormone-based medications that help prevent pregnancy. Birth control pills prevent pregnancy by causing several changes to the body:
There are two types of hormonal oral contraceptive pills: combination pills and progestin-only pills.
Combination birth control pills contain progestin (a synthetic form of the hormone progesterone) and estrogen. Combination pills can have varying estrogen and progestin levels, depending on the brand. A conventional pack of birth control pills contains 21 active pills and 7 inactive pills to maintain the typical 28-day menstrual cycle.
Some combination pills reduce the number of periods in a year by using continuous dosing. Continuous dosing — or extended-cycle oral contraceptives — entails using 84 active pills (and seven inactive pills) instead of 21 to reduce the number of menstruation cycles a person experiences. The increase in active pills decreases the total number of periods to only four times a year. There is also a combination pack that includes 365 active pills, which can stop the menstrual cycle or significantly reduce bleeding.
Some birth control pills only contain progestin, the synthetic form of progesterone. Progestin-only pills are often called the minipill. Unlike combination packs, minipill packs contain only active pills. Progestin-only pills contain a lower dose of progestin than the amount found in the combination packs. Unlike the combination pills, progestin-only pills do not completely block ovulation. Instead, they slow the egg’s progress through the fallopian tubes, thin the endometrium in the uterus, and thicken the mucus of the cervix.
The endometrium is a thin layer of tissue that normally lines the inside of the uterus. This tissue thickens, breaks down, and bleeds during each menstrual cycle. People with endometriosis — sometimes simply called “endo” — have endometrial-like tissue that grows outside of the uterus. It may cover other reproductive organs such as the ovaries and fallopian tubes, or even grow on the outside of the bowels.
The endometrial-like tissues that grow outside the uterus (also called endometriotic lesions) can cause severe pain during the menstrual cycle. Other common symptoms of endometriosis include:
Most people with endometriosis experience worsening symptoms during their menstrual period. Hormonal oral contraceptives thin the lining of the uterus, which can lighten menstrual bleeding and reduce endometriosis pain associated with menstrual periods.
Many MyEndometriosisTeam members have used birth control medications to help reduce the symptoms of endometriosis. One team member wrote, “Only way my pain and bleeding stopped was going [on] progesterone. I was bleeding 24/7 for over a year-and-a-half, then I went on progesterone and it all went away. Once in a while I have pain, but like every other month for one day.”
Another member also commented on the pain reduction due to taking birth control pills, “Feel as though the birth control pills control my pain, and as soon as I stop them it‘s so much worse.”
Hormonal birth control pills provide several benefits. They can reduce the risk of developing ovarian cysts. Additionally, combination pills can reduce the risk of colorectal and ovarian cancer. Combination pills and progestin-only pills may also reduce the risk of endometrial cancer (cancer of the uterine lining).
Hormonal pills also can reduce menstrual flow, and result in lighter periods — which can also reduce cramping, pelvic pain, and the chance of developing anemia (a low red cell blood count, which can cause weakness and fatigue).
Individuals who take oral contraceptives and later decide they want to become pregnant can stop taking them and become fertile again. The amount of time it will take to become fertile depends on the type of pill used: Those taking combination pills will normally resume their menstrual cycles in as little as one to three months. Those taking minipills may be able to become pregnant within days or weeks.
All medications have some side effects. Some of the negative side effects of birth control pills include:
Furthermore, the minipill is not as effective as combination pills in decreasing ovarian cysts, and combination pills with higher estrogen levels can increase the risk of blood clots.
Birth control pills should be taken at the same time every day. Skipping pills can increase the chance of pregnancy or result in breakthrough bleeding (bleeding in between menstrual periods). The pill does not protect against sexually transmitted infections.
While oral contraceptives help reduce many of the symptoms of endometriosis in some people, they do not cure endometriosis or stop its progression.
While oral contraceptive pills are the most common contraceptive, there are other hormone-based therapies that can be used to help prevent pregnancy, regulate periods, and treat the symptoms of endometriosis. Other hormonal contraceptives have been shown to treat the symptoms of endometriosis include:
Gonadotropin-releasing hormone (GnRH) agonists are a family of injected hormone therapies that help control menstrual cycles. Leuprolide — sold under brands such as Lupron Depot and Eligard — is a GnRH agonist that the U.S. Food and Drug Administration (FDA) has approved for managing endometriosis and uterine fibroids. It is not a contraceptive.
It is important to note that some treatments help with some symptoms but have other negative side effects. One team member wrote, “I was on Lupron for a year and it was the only thing that helped my endometriosis. There’s some side effects like night sweats and hot flashes but they’re manageable.” Another team member commented, “The IUD definitely cut down on the pain and bleeding, but the ovary pains have begun coming back.”
Some team members use a combination of treatments to help alleviate their endometriosis pain. One member wrote, “I am on an IUD and a norethindrone pill. I no longer have a period which really helps my pain.”
It is important to seek medical advice from a health care professional about your symptoms and needs to determine the best treatment options to help manage the symptoms of endometriosis. Sometimes a doctor may recommend trying different therapies to find the best treatment option for you.
There are several nonhormonal treatment options for the various symptoms of endometriosis. Over-the-counter and prescribed pain medication may be appropriate. Surgical procedures may also be recommended.
Each treatment option will have some benefits and some drawbacks. It is important to speak with your gynecologist about whether you plan to get pregnant to help determine which treatment options will help address your needs.
Learn more about treatments for endometriosis.
MyEndometriosisTeam is the social network for people with endometriosis and their loved ones. On MyEndometriosisTeam, more than 122,000 members come together to ask questions, give advice, and share their stories with others who understand life with endometriosis.
Are you living with endometriosis and using oral contraceptives as part of your treatment plan? Share your experience with oral contraceptives in the comments below, or start a conversation by posting on your Activities page.