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Endometriosis and Birth Control: What You Need to Know

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 10/08/2020

Endometriosis is a common disorder that occurs when the tissue that lines your uterus starts to grow outside the uterus. Dealing with endometriosis can be a painful, uncomfortable experience that affects everything from your general wellbeing to your ability to get pregnant.

More than 11 percent of women between the ages of 15 and 44 are affected by endometriosis, making it a common health problem. Endometriosis often becomes particularly problematic as you enter your 30s and 40s, when it can seriously affect your fertility.

While endometriosis can’t be cured, it can be treated. Birth control pills, such as the combined and progestin-only pill, are one of the most effective treatments for managing the symptoms of endometriosis.

Below, we’ve explained how and why endometriosis develops, the most common symptoms, as well as how you could potentially use hormonal birth control to manage pain, spotting and other common symptoms caused by endometriosis.

What is Endometriosis?

Endometriosis is a disorder that causes your endometrium, the natural lining that forms inside your uterus, to grow outside your uterus. 

If you have endometriosis, the endometrium can grow inside your fallopian tubes, in the outer section of your uterus, on your ovaries and even in areas such as your bowel, bladder, vulva, rectum and abdominal wall. 

Although very uncommon, endometriosis can also affect parts of your body far away from your uterus, such as your brain and lungs. 

Endometriosis can cause a range of symptoms. Depending on its severity, you may notice one or several symptoms. The most common symptoms of endometriosis include:

  • Pain in the vagina and lower abdomen. Endometriosis can cause severe discomfort in the pelvis and lower back, especially after and during sex.

  • Menstrual cramps. Cramps before and during your period are a common symptom of endometriosis. These cramps often get worse as the disorder develops, causing severe discomfort during your period.

  • Intestinal pain and/or painful bowel movements. Endometriosis can cause pain in your intestines, bladder and pelvic area, especially while you’re urinating or passing a bowel movement.

  • Bleeding between periods (spotting). Spotting, a form of bleeding between your normal period, is a common symptom of endometriosis. However, this can often be caused by other factors, such as your use of hormonal birth control.

  • Diarrhea, constipation and other digestive issues. These and other digestive issues are especially common during your period, when endometriosis symptoms are typically at their worst

  • Infertility. When endometriosis affects your fallopian tubes and other important parts of the reproductive system, it can negatively affect your fertility. Even after treatment, the scarring from endometriosis can make it difficult for you to become pregnant.

  • Inflammation and cysts. Endometriosis can cause blood flow to become trapped inside your fallopian tubes and reproductive system. This can lead to inflammation, discomfort and the development of cysts. 

What Causes Endometriosis to Develop? 

Currently, scientists don’t know exactly what causes endometriosis to develop. However, there are several factors that are closely linked to endometriosis:

  • Genetics. Endometriosis tends to run in families, making it important to pay attention to the potential symptoms of endometriosis if your parent, grandparents or any other family members have been diagnosed.

  • Estrogen. Endometriosis responds to hormonal signals, particularly from the hormone estrogen. This is because estrogen plays a role in causing your uterine lining to thicken during your menstrual cycle.

  • Menstrual blood flow issues. Research indicates that Retrograde menstrual flow, or the backwards flow of menstrual blood, could cause shed uterine lining to spread into other areas of the pelvis, causing endometrial growth outside the uterus.

  • Abdominal surgery. Surgery that affects your abdominal area, such as a hysterectomy, can cause uterine lining to spread into the pelvic and abdominal area, potentially causing endometriosis to develop or worsen.

  • Immune system disorders. Disorders that cause your immune system to become less effective, as well as certain cancers, may be linked to the development of endometriosis.

Endometriosis can affect you at any age, from your teens until menopause. However, it’s most common as you enter your 30s and forties. 

While there are no definite signals that you’ll develop endometriosis, there are a few common warning signs. These include:

  • Medical issues that affect your menstrual blood flow

  • A short period that lasts for less than seven days

  • A menstrual cycle of 27 days or less

  • A family history of endometriosis

If you’re concerned about endometriosis, the best approach is to talk to your healthcare provider. They’ll be able to diagnose endometriosis using a pelvic exam or imaging procedure such as an MRI test or ultrasound scan. 

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How to Treat Endometriosis

Endometriosis treatment can be pursued a couple different ways, generally either through medication and/or surgery. A common type of medication used in endometriosis treatment is hormonal birth control, such as the hormonal IUD or the pill. 

The Birth Control Pill

The birth control pill’s main use may be pregnancy prevention, but did you know endometriosis and birth control sometimes work well together? If you have severe pain, abdominal cramps or other discomfort during your period as a result of endometriosis, your healthcare provider might prescribe you an extended or continuous-cycle combined birth control pill to delay or prevent your period. 

Extended-cycle birth control pills, such as Seasonique® and LoSeasonique®, allow you to control your period so that it only happens four times per year. This means you’ll deal with issues such as pain, cramps and other discomfort less frequently.

The continuous-cycle birth control pill goes even further, allowing you to continually stop your period. This type of pill uses a combination of levonorgestrel and ethinyl estradiol to prevent ovulation and prevent you from having a period.

Although these pills won’t get rid of endometriosis, they can make it far easier to manage by stopping you from getting your period. Because these pills are hormonal contraceptives, they will also prevent you from becoming pregnant during treatment. 

If you’re planning to become pregnant or don’t respond to hormonal treatments, your healthcare provider might recommend another treatment option. 

Pain Medication

Endometriosis is often treated using pain medication, which can make cramps and discomfort easier to tolerate. Common treatments for endometriosis include over-the-counter painkillers and nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen. 

These drugs are often used as a first line of treatment for endometriosis, before hormonal birth control and other treatments. Pain medication can also help to manage endometriosis if you’re planning to become pregnant and do not want to use hormonal birth control.

Endometriosis Surgery

Most of the time, the pain, cramps and discomfort caused by endometriosis can be managed using hormonal birth control. However, if you have severe endometriosis that doesn’t seem to respond to hormonal birth control, you may need to have the endometrium surgically removed.

Endometriosis is usually removed through laparoscopic surgery, also known as keyhole surgery. Although surgery can provide relief from symptoms and a significant improvement, it’s still possible for endometriosis to reoccur in the future without hormonal treatment. 

Finally, severe cases of endometriosis can be treated via a hysterectomy. This type of surgery prevents you from becoming pregnant in the future and is only used if you have no intention of getting pregnant.  

It’s important to remember that there’s no “best” treatment for every case of endometriosis. If you’re concerned about endometriosis, the best option is always to talk to your doctor about treatment options and their potential benefits for you.

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access to birth control shouldn’t feel like an obstacle course.

Learn More About the Birth Control Pill

From preventing you from becoming pregnant to treating acne, endometriosis and a wide range of other health conditions, the birth control pill has a huge variety of benefits.

Our guide to birth control and acne goes into detail on how the birth control pill can prevent acne breakouts, while our guide to birth control side effects covers the most common and uncommon potential side effects of hormonal birth control.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.