Hormonal birth control is a treatment option for endometriosis. It may relieve pain and reduce the growth of lesions. Options include either estrogen and progesterone combined or progesterone only.
Endometriosis causes tissue that is similar to what grows inside the uterus to grow elsewhere, such as around the bladder and intestines. This creates lesions. With each menstrual cycle, this tissue swells and then breaks down, causing significant pain.
Birth control is one type of hormonal therapy that doctors can prescribe for endometriosis. It is often the first-line treatment and
Read on to learn more about birth control for endometriosis, including how it works, the types available, and how long it takes to work.
- making periods lighter and shorter
- decreasing the growth of endometrial-like tissue outside the uterus
- reducing inflammation related to the menstrual cycle
- altering someone’s perception of pain
Hormonal contraceptives stop the menstrual cycle from working as it usually does. Typically, a person ovulates halfway through their cycle. After this, the lining of the uterus grows and swells. If a person does not become pregnant, it breaks down.
Hormonal birth control can stop the hormones that cause this from fluctuating, often preventing ovulation entirely. It cannot remove existing lesions or adhesions, but it may prevent new ones from forming.
However, according to a
If this happens, doctors can try other types of endometriosis treatment.
Birth control affects people in different ways, so there is no best type that will suit everyone. The type a person tries can depend on their unique circumstances. Here are some things to consider.
Combined vs. progesterone-only
There are two broad types of hormonal birth control. The first involves a combination of estrogen and progesterone, while the second only includes progesterone. Progesterone-only options
A 2018 systematic review found that both combined and progesterone-only types were significantly better than a placebo at reducing painful periods for those with endometriosis. Both also reduced pain that was not related to menstruation. No evidence suggested that one type was better than the other.
Some people cannot take estrogen-containing medications, so it is important to discuss any other health conditions with a doctor.
Hormonal contraceptives are available in many formats. People can get combination products in pills, patches, and vaginal rings. Progesterone-only products are available as pills, injections, implants, and intrauterine devices (IUDs).
The type a person chooses can depend on several factors, such as their personal preference, lifestyle, and any effects they experience. For example, a person who often forgets to take a pill may prefer something that requires less maintenance.
Usually, a person using a combined pill takes one daily for
Other types of birth control, such as the implant, involve no break. They release hormones continuously. It is also possible to take several birth control pill packs without a break if a doctor says this is OK.
Polycystic ovary syndrome (PCOS) causes high levels of androgen hormones, which are the male sex hormones. Hormonal birth control is one of the treatment options for this condition, too, so a person may find that hormonal birth control helps with both PCOS and endometriosis.
However, some types of birth control can increase androgen levels, which
For endometriosis relief, it usually takes around 3–6 months before people can tell if birth control is helping, according to the National Institute for Health and Care Excellence. However, people may start to feel improvements before this point.
If birth control is not helping to reduce endometriosis symptoms, a doctor can recommend other treatments.
Not everyone experiences side effects from birth control. The potential side effects that can happen vary slightly depending on the type of contraceptive. People may experience:
- irregular bleeding
- breast tenderness
- mood changes
Progesterone-only medications may also cause weight changes, hair loss, acne, or a low sex drive. Sometimes, these side effects diminish after the first few months. In other cases, people may need to try different types until they find one that suits them.
- over-the-counter pain medications, which people can take alongside hormone therapy
- gonadotropin-releasing hormone (GnRH) agonists or antagonists, such as leuprorelin (Lupron) or elagolix (Orilissa)
- aromatase inhibitors, which lower estrogen production
- Danazol, which doctors prescribe for severe symptoms
- surgery, such as laparoscopy to remove lesions
Hormonal birth control can be an effective treatment for many people with endometriosis. Although it cannot cure the condition, it can prevent the growth of new lesions, provide pain relief, and regulate the menstrual cycle.
There is no best option that works for everyone, so a person may need to try several types to find one that suits them. If hormonal birth control does not appear to help, a doctor can provide information on the other treatment options available.