a pill bottle opened with one small white pill hovering above it, mood swings

Trying (and Quitting!) The Mini Pill in the Hopes of Treating My Endometriosis

Like many of you, endometriosis isn’t my only chronic condition. I also have psoriatic arthritis and migraine disease. Because some of my migraine attacks are accompanied by an aura, neither my neurologist nor my gynecologist was comfortable prescribing a contraceptive option that had a combination of hormones. (This is because those who have migraine with aura have a slight risk of stroke, and hormones used in birth control can increase the chance of stroke in migraineurs who have auras.)

Evaluating my treatment options

In 2015, after my first laparoscopic surgery for endometriosis, my gynecologist at the time told me that, unless I wanted to try to conceive, the best chance of preventing the return of the condition would be to go on hormonal birth control. But there was a problem: the combination pill, the one she would recommend to most patients in my position, was a no-go due to my increase risk of stroke related to my migraine diagnosis.

Enter the mini pill, a progestin-only birth control pill that can prevent pregnancy if taken as prescribed. This was the one form of oral birth control my doctors could agree on, so I started it.

Surprising side effects

A few weeks after starting the mini pill, I was on a neighborhood walk with a good friend of mine. I told her how moody I’d been lately, how quickly I would burst into tears at the slightest thing. I told her about one of the most dramatic examples of this: my then-partner was in another room watching a TV show I had no personal investment in. I heard gunshots fired, and when I walked into the room, I saw that a character had been killed. This random, imaginary TV show character turned out to be someone minor in the story’s plot, not even a regular player in the drama—not that I knew, since I didn’t watch the show.

“I burst into tears,” I told my friend. “I don't even watch the show, yet this random guy’s death hit me like a ton of bricks.” I listed some other examples of my outsize reactions to different scenarios, and my friend asked me, “How long have you been like this?”. “Um... almost three weeks?”, I responded. “And how long have you been on the birth control pill?”, she asked. “Um... almost three weeks?” Whoa.

Despite hearing firsthand from girlfriends about the emotional havoc that birth control pill hormones can wreak, it was hard to wrap my brain around the idea that a teensy pill (a mini pill, after all) could be at the root of my dramatic sadness. I stuck it out for a little longer, but the moodiness showed no signs of disappearing.

It wasn’t just the reaction to TV show developments. I was having a hard time being in my own head during the time I took the mini pill. I didn’t like the effect it had on my thinking process or the way I just felt so down, moody, and unpredictable.

My decision to stop taking the pill

I asked my doctor what else I could do. She had no other recommendations. Despite that, I told her I wanted to stop taking the pill. I was unwilling to continue mustering through my life feeling the way the pill made me feel, even if it meant that endometrial tissue would likely grow back faster than it would if I kept taking it.

Within days (seriously!), I started feeling more like my regular self, mood-wise. Sure, I still got sad sometimes, and my temper flared occasionally. But my behavior felt much more in keeping with the Janet I know well, rather than the unpredictable crying machine who had temporarily taken over my body.

Years have passed since then, and there are more options for those of us with endometriosis. Despite that, I wonder if you ever tried taking the mini pill in the hopes of staving off worsening endometriosis symptoms and, if so, how it went for you. Please share below!

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