Birth Control for Endometriosis: Does it Work?

Birth control for endometriosis is a conventional hormone-based treatment prescribed by doctors. Hormonal therapy is often the first treatment doctors recommend for endometriosis. It helps reduce the pelvic pain and bloating caused by the disease and may help prevent it from progressing further.

Why use birth control for endometriosis?

Endometriosis is a chronic gynecological condition that causes uterine-like tissue to grow outside the uterus, covering or infiltrating other organs and tissues in the pelvic and abdominal regions. 

These lesions act like endometrial tissue, but because they’re unable to leave the body with the menstrual flow, they build up and cause inflammation and pelvic pain. They can also cause scarring and cysts, called endometrial lesions.

Since endometriosis is affected by hormone levels, doctors use birth control pills and other hormone-based therapies for treatment. By controlling your hormone levels, you can reduce the symptoms caused by your endometriosis and better control the growth of endometrial lesions.

Birth control for endometriosis: How it works

Birth control reduces the body’s production of reproductive hormones to regulate menstruation and ovulation and control the symptoms of endometriosis. 

Birth control treats endometriosis by:

• Reducing the growth of endometrial tissue and lesions.
• Decreasing inflammation.
• Making menstrual periods shorter, lighter, and more manageable.

Hormonal birth control reduces the body’s production of estrogen and gonadotropin-releasing hormone (GnRH). This prevents hormone fluctuation during the menstrual cycle as well as ovulation. As a result, endometrial tissue growth is inhibited, both inside and outside the uterus.

Types of ovarian suppression therapy for endometriosis

Not all types of birth control work the same way. You may have to try several different types of ovarian suppression therapy to find the one that works best for your symptoms. 

The side effects of hormone therapies depend on the type you’re prescribed. Your doctor will prescribe the best treatment for endometriosis based on your age, whether you’re planning to become pregnant, and the severity of your symptoms and disease.

The types of hormonal therapy available include:

Combination hormonal therapy treatment

Combination hormonal contraceptives contain estrogen and progestin and are often the first type of birth control women with endometriosis try. These treatments are available as oral contraceptives in pill form and as skin patches and vaginal rings. 

Side effects from combination therapy vary but can include:

• Breast tenderness
• Changes in mood
• Headaches 
• Bloating
• Nausea 
• Break-through bleeding

Hormonal therapy with estrogen is not recommended for people who have a history of blood clots or those at high risk of developing them. You may also want to avoid combination therapy if you have heart disease or are above 35 and a smoker; your doctor may prescribe progestin-only birth control instead.

Progestin-only hormone treatments

Progestin is a synthetic hormone that’s similar to the reproductive hormone progesterone. Medications containing progestin thin the uterine lining and reduce the growth of endometrial tissue. 

Progestin-only treatments may be a better choice for many people with endometriosis. Because there’s no estrogen to feed it, the uterine lining doesn’t grow as thick.

Progestin-only treatments are available in various forms, including:

• Oral contraceptive pills
• Intrauterine devices (IUDs)
• Devices implanted under the skin
• Patches for your skin
• Injectables

Side effects from progestin-only medications are similar to combination hormone treatment, but they may also cause weight gain, acne, hair loss, and a reduced sex drive. These side effects may decrease over time, but some people need to change medications to find one that doesn’t have intolerable side effects.

Progestin-only treatments are an excellent choice for those looking to avoid estrogen in their medications and those who can’t take combination hormonal therapy due to another medical condition. 

However, not all progestin-only treatments are safe for people who are prone to blood clots. If that’s an issue for you, your choices may be limited. 

GnRH agonists

GnRH agonists reduce estrogen levels by preventing the release of gonadotropin-releasing hormone, or GnRH. They completely stop menstruation and the growth of endometrial lesions. GnRH agonists are highly effective because they induce temporary menopause. Once the medication is stopped, menstrual periods resume normally. 

GnRH treatments should be used for no longer than six months because they can cause osteoporosis with long-term use. This treatment is generally reserved for people suffering from more severe forms of endometriosis. People who are trying to get pregnant should not use GnRH treatments.

Androgens

Androgen-based therapies such as danazol are synthetic steroids similar to testosterone. They limit the growth of lesions and reduce endometriosis-related pain by preventing the body from releasing estrogen. This medication can harm fetuses, so it shouldn’t be used by women who are pregnant or may become pregnant.

Research has shown that these forms of hormone therapy are equally effective at treating the pain and symptoms of endometriosis. When choosing a hormonal treatment, people should consider their lifestyle, age, personal preference, and medical conditions. 

Complementary and integrative therapies for endometriosis can help

Conventional hormonal therapies can help reduce your endometriosis pain and the growth of lesions but may not alleviate your symptoms completely. Many people find that a combination of medication and complementary or integrative (also called alternative) therapies works best to manage symptoms. 

Several integrative therapies have been proven by research to be helpful for people with endometriosis. They include: 

• Acupuncture
• Behavioral therapy
• Diet and nutrition therapy
• Herbal medicine
• Homeopathy
• Mind-body practices
• Pelvic floor physical therapy

For details about each of these therapies and how they can help with endometriosis symptoms, see this blog post.

How Sound Cycle can help

People with endometriosis don’t have to rely on birth control alone to treat their symptoms. Sound Cycle can help you find practitioners who can treat your chronic symptoms in a variety of non-pharmacological ways.

Visit our provider directory to find integrative therapists near you who specialize in women’s health concerns.