Birth Control Pill for Treatment of Endometriosis

Birth control pill


The combined oral contraceptive pill (BCP) is often used in the treatment of endometriosis.  There are many different brands of the Pill on the market with different levels of hormones.  Birth control pills use synthetic versions of estrogen and progestin (a man-made form of progesterone). Combined pills typically contain low daily doses of estrogen—ranging from 10 to 50 micrograms of estradiol combined with a daily amount of progestin.  This treatment approach is usually the first to be suggested for the treatment of endometriosis.  It is one way to ‘buy time’ and to help relieve the pain symptoms.

While there haven’t been any absolute findings, some women with endometriosis appear to do better with pills that have higher levels of progesterone.

Dr. Robert N. Taylor, M.D., Ph.D., who is a professor of Reproductive Endocrinology and Infertility at the University of Utah Health quotes, “For patients with endometriosis, I tend to select birth control pills that are high progestogenic and more androgenic. This seems to suppress endometrial growth more effectively.”

Taylor says birth control can be an effective means of managing or suppressing endometriosis, even in young patients, who aren't ready to consider invasive surgical measures. 

The combined contraceptive pill, or mini-pill is basically made up of different combinations of synthetic estrogen and progesterone, which has the effect of mimicking pregnancy, causing the lining of the womb, along with endometrial deposits to shrink. 

When used to treat endometriosis, it is usually taken continuously.  It is recommended to take low estrogen or progesterone only pill, because estrogen dominance will encourage further development of the endometrial growths.


Who is it usually prescribed for?

It is often prescribed to teenagers and young women with a mild form of the disease, and sometimes to women who have recurring ovarian cysts.

Who can’t take it?

  • women with high blood pressure
  • women who are at risk of developing blood clots
  • smokers and women over the age of 35 are more at risk if the take the Pill over a long period of time.


Possible side effects

Often there are side effects when using the birth control pill. The more common ones include irregular vaginal bleeding, fluid retention, abdominal bloating, weight gain, increased appetite, nausea, headaches, breast tenderness and depression.

Nausea and breast tenderness usually settle after 1–2 months of treatment. The remaining side effects usually disappear within a few weeks after you stop taking the pill, and you will usually start ovulating and menstruating again within 4–6 weeks of taking the last tablet.


The BCP (Birth Control Pill) is usually taken continuously for four to six months without the usual seven-day break which you have when taking it for contraceptive purposes. 

The success of the BCP for treatment of endometriosis is not as effective as with other hormone drug treatment.  Many women find they have problems with break-through bleeding on the BCP, and some say it does not get rid of the pain symptoms.


The BCP can deplete vital nutrients

Taking the BCP can deplete much needed nutrients and vitamins that are vital to good health.  Ideally, it is advised to come off the pill and try to get your natural hormones back in balance. 

While the BCP can help suppress some symptoms of your endometriosis, your hormones are striving to sustain their normal balance.  Taking drugs then throws a curve-ball and upsets your body, this then causes side-effects as your body becomes out of balance.

Nutrients depleted by the BCP

B Vitamins

  • Vitamin B6 (Pyridoxine): Crucial for mood regulation and hormone balance; the pill significantly accelerates its breakdown.
  • Folate (Vitamin B9): Vital for DNA synthesis and cellular health, often heavily depleted during use.
  • Vitamin B12 & B2 (Riboflavin): Levels can drop due to altered metabolic processes and increased excretion. 

Minerals

  • Magnesium: Important for muscle relaxation, nerve function, and energy; blood levels commonly lower during use.
  • Zinc: Essential for immune response and skin health, which experiences reduced absorption.
  • Selenium: Important for thyroid function and antioxidant defense pathways. 

Antioxidant Vitamins

  • Vitamin C & Vitamin E:  Both work together to protect cells from oxidative stress, but the pill can lower their systemic stores


If you are suffering from side-effects of using the BCP it may be prudent to considering coming off the pill, not only due to the side effects but also because the pill is depleting your nutrient stores. Fortunately, you can stop the BCP at any time and there is no need to wean off like you would with other drugs.


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Reference:

https://www.endofound.org/all-birth-control-pills-arent-created-equal-in-managing-endometriosis-say-experts

https://endometriosis.org/treatments/oral-contraceptive-pill/

https://youngwomenshealth.org/2014/08/01/endometriosis-continuous-hormonal-pills-ocps/

https://www.ncbi.nlm.nih.gov/pubmed/30664383





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