Endometriosis is a chronic inflammatory disorder. It occurs when tissue that lines your uterus, called endometrium, grows outside of your uterus. This includes places like the ovaries, fallopian tubes, and outer surfaces of your intestines.
This tissue can grow and bleed like the tissue in your uterus. It can also form endometrial lesions, which can cause inflammation and scarring, leading to:
- painful periods
- pelvic pain before your periods
- pain during sexual intercourse
- painful bowel movements or urination
- heavy menstrual bleeding
It’s also possible to have no symptoms at all.
Endometriosis is estimated to affect 6 to 10 percent of women of childbearing age. There is also no cure for the condition, but there are treatments that can help manage your symptoms.
One option is birth control therapy, such as oral contraceptives or an intrauterine device (IUD).
Read on to learn about birth control for endometriosis and how they work.
Endometriosis involves various reproductive hormones. Birth control is used to treat endometriosis by targeting some of these hormones. This includes gonadotropin releasing hormone, or GnRH, and estrogen.
GnRH is produced by the hypothalamus in your brain. GnRH triggers the pituitary gland to release:
- Follicle stimulating hormone (FSH). This hormone stimulates the production of estrogen, a female reproductive hormone.
- Luteinizing hormone (LH). This hormone triggers ovulation, or when an egg is released from your ovary.
During the first phase of your menstrual cycle, FSH causes estrogen to rise. This helps thicken your endometrial lining, preparing your body for pregnancy.
After ovulation occurs, the second phase of your menstrual cycle takes place. If a fertilized egg hasn’t implanted in the endometrium, your estrogen quickly drops. Your uterus sheds the lining, and you have your period.
During your menstrual cycle, it’s normal for estrogen to fluctuate in this way. However, in endometriosis, it’s common to have excess estrogen. This can cause endometrial tissue to overgrow inside and outside your uterus.
In turn, a doctor might suggest birth control, which stops estrogen production. The goal is to decrease the growth of endometrial tissue and relieve pain.
Other types of birth control may work by suppressing GnRH production. Since GnRH causes estrogen to rise, this treatment also reduces estrogen levels.
When treating the symptoms of endometriosis with birth control, there are several types to choose from. However, there isn’t one option that works best for everyone.
The best choice depends on factors like:
- your age
- the severity of your symptoms
- whether you want to have children
A doctor can determine which is the optimal choice for you.
Types of birth control for endometriosis include:
Progestin is a hormone that’s similar to progesterone, a female reproductive hormone. It works by thinning the uterine lining, which prevents regular periods. It also reduces endometrial tissue growth.
This form of birth control is available as:
Combined hormonal contraceptives
Combined hormonal contraceptives, also known as combined hormonal therapy, use estrogen and progestin. They’re the first-line birth control treatment for endometriosis.
This treatment thins the uterine lining, which can ease endometriosis pain. It’s available as:
Due to the estrogen in combined hormonal contraceptives, this option is not recommended if you have heart disease or a high risk of blood clots. In this case, your doctor may advise you to take progestin-only birth control. That said, not all progestin contraceptives are safe to take with a history of clotting. Read the label carefully before purchasing and using it.
GnRH agonists reduce estrogen by suppressing the release of GnRH. This puts the body in temporary menopause, which stops menstruation and endometrial growth.
GnRH agonists are available as:
These treatments should only be used for 6 months. If used for a longer period of time, it can increase the risk of osteoporosis.
Danazol is a synthetic steroid that’s similar to testosterone, a male reproductive hormone. It works by preventing the release of estrogen, which reduces endometrial growth and pain.
The medication is available as tablets in various doses. The best dosage depends on the severity of your endometriosis. The tablets are taken twice a day for 6 to 9 months.
Danazol can also harm developing fetuses, so it’s important to avoid getting pregnant while taking this medication.
Birth control for endometriosis is only available by prescription. Additionally, not all types of birth control are appropriate for everyone. A doctor can determine the best option for your situation.
You can obtain birth control at:
- health centers
- family planning clinics
- your doctor’s office
In addition to birth control, there are other treatments for endometriosis. This includes:
If your symptoms are mild, your doctor may recommend pain medication.
This may include nonsteroidal anti-inflammatory drugs (NSAIDs), which are available over the counter at drugstores and grocery stores.
For more severe symptoms, your doctor may prescribe stronger pain relievers.
If you have severe endometriosis, you may need surgery. This involves removing endometrial lesions, which reduces pain.
Though surgery can help relieve endometriosis pain, the effects are temporary. The pain will likely return within 2 years. This can happen if some of the endometrial lesions could not be fully removed during surgery.
In this scenario, you’ll likely need birth control therapy as well.
If you have endometriosis, birth control may help manage your symptoms. Birth control works by reducing estrogen, which slows down the growth of endometrial tissue. This can relieve the pain and other symptoms associated with excess tissue.
The best birth control for endometriosis depends on your age, symptoms, and whether you want to have kids. A doctor may recommend progestin-only therapy, combined hormonal contraceptives, GnRH agonists, or danazol. In severe cases, you might also need surgery.