How To Effectively Use Birth Control To Treat Endometriosis?

The lining of a uterus is the endometrium. This lining consists of endometrial cells. In women, these cells are found in the pelvic region and lower abdomen. These regions where endometrial cells are found include ovaries. The bladder, fallopian tubes, ureters, kidneys, intestine, and colon. In every ovulation cycle, the uterus grows the endometrium. This is to prepare for the attachment of a fertilized egg. If the fertilized egg fails to implant on the uterine lining, then the hormone level falls and causes the shedding of the endometrium. 

Now endometriosis is an inflammatory disease, where the endometrial cells grow outside the uterus. This condition affects at least 10% of females who are of childbearing age.

  • When it is the time for the endometrium to shed, the lining or cell growing at the place they do not belong, liquefy, and bleed.
  • So when this blood comes in contact with body tissues and other organs, it leads to inflammation, irritation, and pain.
  • It also causes the formation of scar tissues at the position of the renegade endometrial cells.

What Are the Complications Caused By Endometriosis?

20% to 40% of all females with infertility also have endometriosis. Infertility occurs due to the scarring of the ovaries and fallopian tubes. Scarring in pelvic regions may also increase the risk of certain cancers. Another complication could be an ectopic pregnancy. This is because when fallopian tubes are scarred. The fertilized egg does not implant in the uterus. Rather, it remains in the fallopian tube where it grows. This increases the risks to an ectopic pregnancy, which needs to be eliminated by surgery.

What Are the Causes and Symptoms of Endometriosis?

There are several causes of endometriosis. Usually, this is because of retrograde menstruation. Here, the endometrial tissues flow back and travel through fallopian tubes. The tissues then reach the abdominal cavity during menstruation. This causes abnormal growth of the cells and tissues. On the other hand, your genetic predisposition and immune system also play a role in this condition. 

Endometriosis symptoms are cyclical i.e. you may experience it during or after your periods. But some females may experience the symptoms all month long.

Some of the symptoms are:

  • Pain during intercourse
  • Severe abdominal pain during or before menstruation
  • Nausea, diarrhea, or constipation
  • Pain during urination
  • Pain during bowel movements
  • Issues with fertility

How to Treat Endometriosis with Birth Control?

This condition can be diagnosed with laparoscopy surgery. It is an invasive procedure. However, it is also expensive and only suggested as one of the last resorts. The first line of treatment is rather hormonal birth control pills.  Endometriosis responds to progesterone and estrogen. Both these hormones regulate a female’s menstrual cycle. The rise and fall in the levels of these hormones influence the activity of endometriosis. The fluctuation in hormone levels increases the symptoms.

  • Thus, doctors may prescribe subsequent doses of progestin, estrogen, or other medicine which will decrease the flared up production of the hormone, causing endometriosis.
  • The birth control and medicine suppress your period and relieve pain related to this condition.
  • These also restrict the development of abnormal cell and tissue growth and reduce it over time.

Continuous Therapy through Progestin/Estrogen

Birth control pills containing a combination of progestin and estrogen. Are often prescribed to control your periods. The doctor can suggest a contraceptive vaginal ring or a skin patch containing both these hormones as well. These hormonal products suppress the activity of endometriosis. The treatment has to be continued for a good amount of time for best results. Here, you use the active pill, patch, or ring daily. After this, you skip it for one week, basically the hormone-free time. This is when you will normally get your periods.

  • Birth Control Pills: You need to take one active pill every day. The pills have to be taken consistently every day at the same time.
  • Skin Patch: You have to use a new patch every week.
  • Vaginal Ring: You have to use a new vaginal ring every 3 to 4 weeks.

To use the pill pack continuously, you have to skip the inactive pills. In case of a patch/ring, you have to replace it during the time of removing the old one. This way, the number of bleeding days will reduce. The treatment will prevent and reduce the pain associated with your menstruation cycle.

Benefits and Precautions of Birth Control for Endometriosis

Most women are able to tolerate the treatment of endometriosis with continuous estrogen and progestin therapy. This therapy also protects against unwanted pregnancy. But it is not effective to prevent transmission of sexually transmitted diseases or infections. So to protect against STIs and STDs, you may want to use a condom. Birth control pills reduce the symptoms of this condition, especially relief from pain in the pelvic and abdominal areas.

  • The most common issue of taking contraceptive treatment is spotting or breakthrough bleeding. However, this reduces with continuous use of hormone treatment.
  • You must take the pill at the same time every day. Do not miss any dose so that it is possible to prevent breakthrough bleeding.
  • If you are at a higher risk of stroke or blood clots, then the doctor will suggest another line of treatment than hormonal birth control.

Continuous Therapy with Progestin Hormone

Birth control pills or methods that contain only the progestin hormone are used for endometriosis treatment. These are also effective as treatment with combined hormonal contraceptives. When taken for long-term, progestin can effectively combat the symptoms of endometriosis. It sheds the uterine lining and stops regular periods. Reduces the chances of spotting and breakthrough bleeding. It also works against endometriosis lesions.

  • The synthetic form of progesterone is progestin. The progestin-only pill must be taken daily. It is referred to as a birth control pill or a mini pill.
  • You need to schedule the intake of the medication every day and at the same time to lessen the chances of pain and spotting.
  • There are two long-acting contraceptive options with progestin-only. These are levonorgestrel intrauterine devices and injectable medroxyprogesterone. These are also prescribed to treat the symptoms of endometriosis.

These methods make your periods less frequent and lighter. It may even stop the periods altogether. The treatment option is effective. Well-tolerated, and safe for females. Some of the side effects are depressive symptoms, bloating, and weight gain. But these may lessen over time. Other common effects as discussed above include breakthrough bleeding. However, these reduce with longer use of the birth control medication.

Hormonal Suppression Therapy

GnRH agonists and antagonists are medicines responsible to block the pathways of hormones between the ovary and brain. These are taken to prevent hormonal changes. That occurs in the menstrual cycle. The functions include gonadotropin-releasing hormone (GnRH), agonists, and antagonists.

  • The hormone, GnRH is produced in the brain. It plays a role in signaling the ovaries to produce estrogen. The medicines in question stop this signal. This is done by competitive binding or blocking of the GnRH receptors.
  • In the absence of the signal, the ovaries do not produce estrogen. Thus, ovulation does not happen. As there is no estrogen production, the uterus lining does not proliferate or grow.
  • This also disallows the growth or formation of endometrial-like tissues outside the uterus. The medication works by putting your body into a low estrogen (hypoestrogenic) state.

However, it may cause a few serious side effects such as vaginal dryness, hot flashes, bone material loss, and mood swings. The doctor may provide an ‘add-back’ estrogen therapy to counter these side effects. These shall be used in combination with the GnRH agonists.

Final Thoughts

Not all types of birth control methods are well tolerated by women. Certain females may not be able to tolerate hormonal options because of health conditions such as diabetes, hypertension, blood clots, age over 35 and a smoker, etc. For such women, the doctor may suggest an alternate treatment. It is best to discuss the benefits and disadvantages of particular hormone and birth control therapies for endometriosis before you select the one that is right for you and your health.