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Do Birth Control Pills Really Work for Endometriosis?

Do Birth Control Pills Really Work for Endometriosis?

Endometriosis is a relatively common disease, affecting more than 10-20% of women of childbearing age1, totaling around 176 million people worldwide2. Many studies show that endometriosis often begins during adolescence, but it is frequently not diagnosed for many months or years.3 However, research shows that endometriosis affects 70% of young women with very painful periods and 50% of young women with ongoing pelvic pain.4

How is endometriosis treated?

Surgery to remove the endometrial lesions is one therapy for managing the endometriosis. However, even after surgery, most people experience recurrence (having endometriosis come back after surgery) within 5 to 10 years.5

Because endometrial tissue responds to hormones, therapies often include birth control pills, which regulate levels of female hormones. Different women respond differently to various kinds of birth control pills, and it can be frustrating to find a pill that works to provide relief for endometriosis symptoms.

To date, few studies have looked at the efficacy of different kinds of pills, or whether these pills can reduce endometriosis symptoms at all.5

Do birth control pills help?

A recent report looked at multiple studies to understand how well birth control pills help with endometriosis – in reducing pain, increasing quality of life, and reducing recurrence of the disease after surgery. The results provide important guidance for doctors and patients in the most effective treatments for endometriosis.6

In considering several studies from various scientific journals, the researchers came to a few conclusions: 6,7

  1. Combined oral contraceptives and progestin-only pills can reduce:
    • Period pain
    • Ongoing pelvic pain
    • Pain during sex
  2. Combined oral contraceptives and progestin-only pills can improve the overall quality of life for people with endometriosis.
  3. Only certain formulations of combined oral contraceptive pills can also reduce the risk of recurrence. These includes combination ethinylestradiol/levonorgestrel therapies.
  4. Progestin-only pills do not reduce the chance of endometriosis coming back after surgery.
  1. Rebecca Greene, Pamela Stratton, and Sean Cleary, et. al. Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis. January 2009. Volume 91 (Issue 1) pages 32-39. Available at: https://www.fertstert.org/article/S0015-0282(07)04085-X/fulltext. Accessed February 6, 2019.
  2. Facts about Endometriosis. World Endometriosis Society. May 27, 2017. Available at: http://endometriosis.org/resources/articles/facts-about-endometriosis/ Accessed February 8, 2019.
  3. Abby Ellin. Endometriosis Is Often Ignored in Teenage Girls. March 30, 2015. The New York Times. Available at: https://well.blogs.nytimes.com/2015/03/30/endometriosis-is-often-ignored-in-teenage-girls/ Accessed February 6, 2019.
  4. Ertan Saridoğan. Endometriosis in Teenagers. Volume: 11 issue: 5, page(s): 705-709 Article first published online: September 12, 2016; Issue published: September 1, 2015 Available at: https://journals.sagepub.com/doi/full/10.2217/whe.15.58 Accessed February 8, 2019.
  5. Endometriosis. Mayo Clinic. Updated July 24, 2018. Available at: https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656 Accessed February 6, 2019.
  6. Bob Kronemyer. Should ob/gyns prescribe hormonal contraceptives to reduce endometriosis pain? February 11, 2019. Modern Medicine Network. Available at https://www.contemporaryobgyn.net/endometriosis/should-obgyns-prescribe-hormonal-contraceptives-reduce-endometriosis-pain Accessed February 13, 2019.
  7. Giovanni Grandi, Fabio Barra, Simone Ferrero, et al. Hormonal contraception in women with endometriosis: a systematic review. Published online: 21 Jan 2019 Available at: https://www.tandfonline.com/doi/abs/10.1080/13625187.2018.1550576?journalCode=iejc20 Accessed February 13, 2019.

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