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How the Birth Control Pill and Birth Control Ring Can Help Manage Endometriosis

The birth control pill is one of the most popular birth control methods in the United States. With typical use, the birth control pill is 91% effective at preventing unwanted pregnancies. But while the pill is mostly used to avoid pregnancy, it also offers women an array of different health benefits. For women who suffer from hormonal imbalances or other gynecologic health issues, the pill can be a godsend. About 14% of women who are on the pill in the U.S. ONLY use the birth control pill for other health-related reasons.

What types of health conditions can the birth control pill, patch, and ring treat?

  • Unpredictable, irregular periods
  • Heavy menstrual bleeding
  • Cramps
  • Lowers the risk of certain cancers (endometrial and ovarian)
  • Endometriosis

What is endometriosis?

Managing endometriosis with the birth control pill

Approximately 10% of women in their childbearing years have endometriosis.  The lining of the uterus is called the endometrium and is made up of endometrial cells.

Every month, the uterus builds/grows the lining/endometrium in preparation for a fertilized egg. If a fertilized egg does not implant in the lining in a given month, then hormone levels will fall, triggering the lining/endometrium to shed.

In women with endometriosis,  however, some endometrial cells grow outside of the uterus in places they don’t belong. When the body triggers the endometrium to shed, those renegade cells will liquify and bleed, and when the blood touches other organs or body tissues, it causes irritation, inflammation, and pain. Scar tissue can form where the renegade endometrial cells form. 

Where can endometrial cells appear?

Theoretically, endometrial cells can appear anywhere in the body. But for most women, these cells are found in the lower abdominal and pelvic regions.

  • Ovaries
  • Fallopian tubes
  • Bladder
  • Kidneys and ureters
  • Colon
  • Intestine

What are the complications of endometriosis?

It is estimated that 20% to 40% of all women with infertility have endometriosis. Scarring of the fallopian tubes and the ovaries can cause infertility.

If the fallopian tubes are scarred, a fertilized egg can fail to implant in the uterus, and instead, stay within the fallopian tube and grow. This increases the chances of a potentially fatal ectopic pregnancy. Scarring can also increase the risk of certain cancers.

What causes endometriosis?

Several things can cause endometriosis. In some cases, a woman can experience what’s called retrograde menstruation, where the endometrial tissues can travel through the fallopian tubes and end up in the abdominal cavity when a woman gets her period. Researchers have found that almost all women have retrograde menstruation, but not every woman gets endometriosis. Researchers theorize that a woman’s immune system and her genetic predispositions for the condition may play a role in which women with retrograde menstruation will get endometriosis and which will not.

It is also possible that the cells outside of the uterus can change into endometrial cells, which may explain why women can have endometrial cells on their knees or other joints and organs that are far from the womb. In women who have cesarean sections, it is possible for the endometrial cells to attach to the incision, and she can experience symptoms of endometriosis within the surgical scar.

What are the symptoms of endometriosis?

Endometriosis symptoms are usually cyclical, in that they happen right before and during menstruation. However, some women can experience endometriosis symptoms all month long.

The most common symptoms of endometriosis include:

  • Severe abdominal pain before and during menstruation
  • Pain during sex
  • Issues with fertility
  • Painful urination during periods
  • Painful Bowel Movements during periods
  • “Empathetic gastrointestinal upset” (the gut is empathetic with the uterus and being upset) : diarrhea, constipation, nausea

How is endometriosis diagnosed?

A doctor can only definitively diagnose endometriosis during surgery called a laparoscopy. But this is an invasive and expensive procedure. If endometriosis is suspected, doctors will often try to treat the symptoms with medications such as birth control to see if symptoms improve. If laparoscopy is done, the doctor will look for scarring and lesions that look similar to “cigarette burns” throughout the abdominal cavity which are patches of endometrial cells.
For mild symptoms, patients can take anti-inflammatory medications for the treatment of pain such as NSAIDs (ibuprofen, etc). In most cases, doctors will prescribe certain forms of birth control for endometriosis. Medications that release gonadotropin hormone agonists (Gonadotropin-releasing hormone (GnRH) agonists) can put women into a temporary menopause-like state so she will not experience endometriosis pain and symptoms. Some surgical procedures can also remove renegade endometriosis cells and lesions.

How can birth control help treat endometriosis?

Not all birth control pills are equally effective for treating endometriosis pain. Most birth control pills use a combination of synthetic estrogen and progestin hormones. For endometriosis, birth control pills that use high-levels of progestin are the most effective for stopping endometriosis pain. Continuous use of birth control pills (skipping the placebo/last week of 4 week pack) to prevent menstruation can stop endometrial cells from shedding and causing inflammation and irritation. Birth control pills that are monophasic, where they release a continuous, steady-dose of hormones each day of the month, are most useful for alleviating the symptoms of endometriosis.

The hormonal IUD (such as Liletta, Mirena, Skyla) can also be used in the treatment of endometriosis.

Birth control methods that decrease menstrual bleeding can prevent pain and scarring that’s associated with the condition.

However, women who are over 35 and smoke or have a risk of blood clots should not use the birth control pill with estrogen or the contraceptive ring because it has estrogen. It is not safe for women with these risk factors to take estrogen because estrogen increases your risk of blood clots. Progestin-only birth control methods are safe for women with those risk factors and progestin-only birth control pills are highly effective at treating endometriosis. 75% of women who use progestin-only birth control for endometriosis experience relief from symptoms using this type of birth control.

Are you suffering from endometriosis? The doctors at Pandia Health can prescribe safe and effective hormonal birth control pills or the contraceptive vaginal ring that can alleviate the symptoms of this painful condition. Representatives are standing by to assist you. Sign up for Pandia Health to explore your birth control options.