Hormonal contraceptives are used to manage endometriosis symptoms, with options tailored to individual needs. These fall into two main categories: combined hormonal contraceptives and progestin-only methods. A healthcare provider helps determine the best choice based on overall health and symptom severity.
Types of Hormonal Contraceptives Used
Combined hormonal contraceptives (CHCs) contain both estrogen and progestin. They are commonly available as oral birth control pills, which can be taken cyclically or continuously to eliminate periods. Eliminating periods is often recommended for endometriosis management, as it prevents the cyclical shedding and bleeding of endometrial-like tissue. Other CHC forms include vaginal rings, inserted for several weeks, and skin patches, changed weekly.
Progestin-only options are another class of contraceptives used for endometriosis, especially for those who cannot tolerate estrogen. These methods deliver progestin, a synthetic progesterone, which thins the uterine lining and reduces endometrial-like tissue growth. Progestin-only pills, or “mini-pills,” are taken daily.
Long-acting reversible contraceptives (LARCs) are also progestin-only options. These include the hormonal intrauterine device (IUD), such as Mirena, which releases levonorgestrel for up to five years. The contraceptive implant, like Nexplanon, is a small rod inserted under the upper arm, releasing progestin for up to three years. The contraceptive injection, such as Depo-Provera, is a shot administered every three months, preventing ovulation and suppressing endometrial activity.
Long-Term Outlook and Discontinuing Treatment
Hormonal contraceptives effectively manage endometriosis symptoms but do not cure the condition. They primarily suppress endometrial-like tissue activity and control pain, rather than eliminating misplaced tissue. If hormonal contraception is discontinued, endometriosis symptoms are likely to recur as natural hormonal cycles resume.
For those considering pregnancy, discontinuing hormonal birth control is necessary to allow ovulation and menstruation to resume. Endometriosis can affect fertility, with 30% to 50% of those with the condition experiencing difficulties conceiving [1]. While birth control manages symptoms, it does not directly improve fertility; instead, it pauses the reproductive cycle.
Managing endometriosis is a long-term journey requiring ongoing strategies for symptom control and improved quality of life. Hormonal contraceptives are a key tool within this broader management plan, which may also include pain relievers or surgical interventions. Regular follow-ups with a healthcare provider are important to adapt the treatment strategy as symptoms evolve or life circumstances change.