Contraception for endometriosis: professionals, cons, and options


  • Birth control can help manage some of the endometriosis symptoms, such as pain and heavy bleeding.
  • Estrogen-progesterone birth control pills are considered to be the best means of treating endometriosis.
  • Hormonal birth control can reduce pain, but it cannot treat endometriosis itself.
  • Check out Insider’s Insider Reference Library for more advice.

Endometriosis is a disease in which tissues similar to the lining of the uterus grow outside the uterus. Although incurable, endometriosis can be treated with hormonal contraception that includes pills, patches, injections, and even the progestin that contains IUDs. In fact, contraception is often used as the first line of treatment for endometriosis.

“There is no cure for endometriosis, but there are ways to treat symptoms like birth control,” said Benjamin Todd Thatcher, DO, and chief medical officer of Valley Behavioral Health. “Birth control pills often reduce the menstrual cramps and pelvic pain that can be associated with endometriosis.”

While birth control is a popular option for managing pain among people with endometriosis, it may not be the best long-term or even short-term treatment tool depending on your specific situation. In some cases, other medications or surgical treatments may be required.

For example, birth control can help manage pain if you’ve been diagnosed with endometriosis or if you have one or more symptoms associated with the disease, including, but not limited to, dysmenorrhea (painful periods), painful intercourse, or painful bowel movements or urination.

Does Birth Control Prevent Endometriosis From Growing?

While hormonal birth control doesn’t stop endometriosis from growing, it suppresses it. This is because hormonal contraceptives inhibit ovulation and lower the level of estrogen in the body.

“Estrogen is what causes endometriosis to grow and progress,” says Dr. Paul MacKoul, Laparoscopic GYN Surgeon and Co-Founder at the Center for Innovative GYN Care.

While hormonal birth control contains estrogen, it can slow endometriosis growth and control bleeding with menstrual cycles, MacKoul says. Additionally, some people can skip the placebo week when taking the pill, which helps them skip a period altogether.

Who Should Use Contraception For Endometriosis?

Before using birth control for endometriosis, your doctor should do a medical history check to make sure it is safe for you, as some people may not be able to use hormonal birth control due to a pre-existing condition.

Important: Hormonal contraceptives can relieve endometriosis pain, but they cannot treat the disease on their own.

Some experts may recommend that you have a laparoscopy – a surgical procedure used to diagnose endometriosis – before using birth control for endometriosis, while others may not

You may also find a doctor who prescribes birth control if you have any tell-tale signs of endometriosis that have not been officially diagnosed via laparoscopy. In fact, when you can’t afford or don’t have the time to have a laparoscopy, birth control is often a quicker, cheaper option to treat endometriosis symptoms.

People with one or more of the following conditions or symptoms should not take hormonal birth control pills or consult their doctor before taking:

You shouldn’t take birth control pills if:

  • Blood clots, a history of blood clots, or a bleeding disorder (e.g. factor V Leiden)
  • Coronary heart disease
  • History of stroke or heart attack
  • Cancer (including breast cancer, uterine, cervical, or vaginal cancer)
  • Unusual or unexplained vaginal bleeding
  • Suspected pregnancy
  • Lupus
  • Smoker over 35 years

Which birth control pills are best for endometriosis?

“Usually, estrogen-progesterone pills are best, but often only progesterone pills can be effective,” says MacKoul. “IUDs and other progesterone-only methods are also helpful for some patients with certain stages of the disease.”

Some other examples of birth control with progestin only include:

According to the Endometriosis Foundation of America, some people with endometriosis tend to respond better to high-progestin pills.

In a 2017 study, progestin pills were recognized for their effectiveness in treating endometriosis-related pelvic pain. The researchers also found that both norethindrone acetate and dienogest – oral contraceptives that contain only progestin – may be better options compared to combined estrogen-progestogen birth control pills.

Progestin-only contraception options:

Taking hormonal birth control can help with your pain, but depending on the type of birth control, you may experience side effects such as mood changes, headaches, or tender breasts.

What endometriosis feels like: ego accounts of people who live with and treat the disease

As you create your pain management plan, ask yourself: Do the benefits outweigh the disadvantages?

According to a 2003 review, progesterones are effective in treating pain associated with endometriosis in about three in four people. Even so, this method of pain relief is limited to those who do not want to have children in the short term.

Insider to take away

While birth control isn’t always the best treatment option, it does exist and is a viable option for treating pain associated with endometriosis. Depending on the person, birth control can be a successful way to manage endometriosis symptoms.

“Most importantly, it is important for patients to know the extent of the disease they are present and to work with their medical team to ensure proper treatment and management of the disease,” says MacKoul.

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