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Endometriosis is a condition involving a person’s uterine lining, also called the endometrium. With this condition, the endometrium begins to grow similar tissue outside the uterine cavity and on the ovaries, bowel, and tissue lining the pelvis.

While anyone who menstruates can experience endometriosis, it’s most common in those who are in their 30s and 40s.

While the symptoms and effects of endometriosis can be unpleasant, your doctor may be able to help you find a solution to hopefully keep them at bay. Hormonal birth control is commonly prescribed to help reduce pain, and there are several options out there that could potentially fit your individual needs.

Endometriosis is a condition that occurs largely due to menstrual cycle changes affecting misplaced tissue outside of the uterine lining.

Affected areas can become inflamed and painful as the tissue grows, thickens, and breaks down before becoming trapped in the pelvis. This can lead to scar formation, irritation, inflammation, and adhesions that bind the tissue to your pelvic organs. Other possible outcomes can include severe menstrual pain and fertility problems.

Though rare, it’s also possible for this tissue to spread outside of the pelvic region. When this tissue grows outside of the uterus, it’s referred to as an endometrial implant.

Common symptoms

Endometriosis symptoms can vary by individual and range from mild to severe. However, your level of symptoms doesn’t necessarily mirror the severity of your disease. That’s why it’s important to get regular gynecological exams and maintain communication with your doctor as they monitor your condition.

Some symptoms include:

  • pelvic pain
  • painful periods
  • cramps around 1 or 2 weeks before menstruation
  • heavy menstrual bleeding or bleeding between periods
  • infertility
  • pain during sexual intercourse
  • discomfort with bowel movements
  • lower back pain that may occur any time during your menstrual cycle

Risk factors

While people who menstruate are at risk for endometriosis at any age, it is most common among those in their 30s and 40s.

Those with a family history of the disease may also be at an increased risk.

Meanwhile, Black, Hispanic, and Asian groups are less likely to receive a diagnosis, and more inclusive research is needed.

People who menstruate who have not had children are also at an increased risk of developing endometriosis. Pregnancy may temporarily suppress any symptoms of endometriosis. This is due to the way hormone changes affect the disease’s progression.

Menstrual cycle characteristics can also put you at higher risk for endometriosis. Talk with your doctor if you experience:

  • shorter periods
  • heavier periods
  • longer periods
  • menstruation at a young age

Hormonal birth control is often prescribed to treat and lessen the symptoms of endometriosis, according to a 2019 review. This is because hormonal contraceptives not only work to prevent pregnancy but can also put a stop to the monthly growth and buildup of endometrial tissue.

Many of these methods can also cause you to have shorter and lighter periods, or no period at all, which may be helpful for those who regularly experience painful periods. Common options include:

Nonhormonal IUDs are not known to help with endometriosis.

The below birth control methods are some of the most commonly prescribed treatments to ease endometriosis symptoms.

Vaginal ring

  • Type: This is a hormonal birth control method available under the brands NuvaRing and Annovera.
  • Price: It can cost up to $200 and may be completely covered by insurance.

The birth control ring is a form of contraception that is worn inside the vagina for up to 5 weeks before needing to be replaced. While the ring is inserted, your body absorbs the hormones estrogen and progestin through your vaginal lining, which works to stop ovulation.

Without ovulation, your ovaries won’t release an egg for sperm to fertilize. The hormones released by the ring also work to thicken your cervical mucus, which also helps to block sperm from swimming to an egg.

A prescription for the vaginal ring is available at telehealth platforms like Nurx, Lemonaid, and SimpleHealth.

Pros

  • It’s a highly effective form of birth control. The Centers for Disease Control and Prevention (CDC) says it’s 93 percent effective with typical use.
  • It’s easy to remove and insert.
  • Periods will likely be shorter and lighter.
  • It has fewer side effects than oral contraceptives.

Cons

  • It can cause side effects like mood changes, headaches, and spotting.
  • You’ll need a prescription to get it.

Birth control pills

  • Type: Birth control pills are available in two types: combination (containing estrogen and progestin) and progestin-only. Various brands are available, providing different doses and hormone levels. Your doctor will prescribe a brand based on your individual needs.
  • Price: They can cost up to $100 or more per month out of pocket, and anywhere from $0 to $50 with insurance.

Birth control pills work similarly to other hormonal contraceptives by releasing hormones to stop sperm from reaching and fertilizing an egg. These hormones also prevent ovulation, meaning there’s no egg available to fertilize.

They also thicken the cervical mucus to further block sperm by preventing it from swimming. The pill can aid with endometriosis because it often shortens or even eliminates your period, thins the endometrial lining, and can stop the pain that’s common with endometriosis.

Pros

  • Many options are available.
  • It’s one of the easiest methods to obtain from apps and other telehealth services.
  • Birth control pills can help with other issues such as acne and period regulation.
  • When taken correctly, they’re highly effective.

Cons

  • You have to remember to take it at the same time every day.
  • You may experience a range of side effects, including mood changes and blood clots.

Birth control patch

  • Type: Birth control patches are available under the brands Xulane and Twirla. They’re worn on the belly, back, buttocks, or upper arm. You change the patch out every week. After the third week, you can choose to have a hormone-free week and not wear the patch, which will start your period.
  • Price: It costs up to $150 and may be completely covered by insurance.

The birth control patch works similarly to other hormonal methods because it prevents ovulation and thickens the cervical mucus. Similar to other methods, it can help with endometriosis by thinning the endometrial lining and aiding your body in having lighter, shorter, and less painful periods.

You can get a prescription for Xulane or Twirla through telehealth services that will ship it straight to your door.

Pros

  • Once you place it on your body, you won’t have to worry about it for 1 week.
  • You can wear it discreetly.
  • It’s easy to use.

Cons

  • It may irritate your skin, causing redness and itching.
  • It may fall off if not worn correctly.
  • You have to replace it weekly.

Other options to consider

Hormonal IUD

Hormonal IUDs are a form of long-acting reversible contraception, available under the brand names Mirena, Skyla, and Liletta. They can also aid in relieving endometriosis symptoms.

Hormonal IUDs work by releasing the hormones levonorgestrel and progestin. The hormones prevent pregnancy by thickening the mucus on your cervix to block sperm from reaching an egg. They can also shorten or eliminate your periods, which can in turn negate symptoms of endometriosis.

Once inserted by a healthcare professional, they can last anywhere from 3 to 7 years, depending on which brand you have. However, since you have to have it inserted by a medical professional, you can’t get it through any telehealth or app services. Hormonal IUDs can cost up to $1,300. But if you have insurance, they may be completely covered by your network.

Depo-Provera shot

Similarly, the Depo-Provera shot has been shown to effectively mitigate endometriosis symptoms as well. It’s another method that needs to be administered by a doctor. It also works to prevent ovulation by releasing progestin and causes the cervical mucus to thicken and block sperm from reaching an egg.

While it can help to relieve endometriosis symptoms like heavy and painful periods, one of the biggest drawbacks is that it can cause weight gain in some people.

You can use telehealth sites to meet with a doctor and figure out the best birth control pill for you. Some options include:

  • Nurx. Nurx, you’ll first fill out a questionnaire about your medical history. A Nurx medical professional will review your information and write a prescription. Medical consults cost $15 and, depending on your insurance coverage, birth control deliveries will cost $0 to $15.
  • Lemonaid. With Lemonaid, you’ll fill out a medical questionnaire and a doctor or nurse practitioner will get back to you within 1 day. Some states require a phone consultation. After that, Lemonaid will ship 3-month supplies of birth control to your door for $15 per pack. Yearly medical consultations cost $25.
  • SimpleHealth. Fill out a medical consultation with SimpleHealth, add your payment details, and a doctor will review your details and write you a prescription. It’s $15 for a one-time consultation, while birth control is as low as $0 depending on your insurance coverage. SimpleHealth will send your birth control straight to your door.

If you don’t get an in-person pelvic exam, you can still receive a birth control prescription, refills, or switch to another method via a telehealth visit. You can schedule appointments on apps such as Nurx, Lemonaid, and SimpleHealth, and even use those services to order your prescriptions.

Other options, like the IUD and the shot, have to be administered by a doctor.

When to see a doctor in person

Visit your gynecologist regularly if you have endometriosis. This way, they’re able to monitor both the severity of your symptoms and the condition itself. If your method of birth control is not helping your symptoms or it’s causing others that are affecting your quality of life, your gynecologist can work with you to find another option.

On the whole, health experts agree that it’s safe to use birth control to mitigate endometriosis symptoms. Still, it’s important to maintain communication with your doctor in case your symptoms worsen and your prescribed method isn’t proving to be effective.

Your doctor can help determine if further treatment, such as surgery or other hormone therapy, is needed.

Another alternative to hormonal birth control for endometriosis is hormone therapy. Hormone therapy can help your body regulate the hormonal changes that affect the progression of the disease.

In more severe cases where birth control hasn’t proven to help your endometriosis, your doctor may recommend surgery. A minimally invasive laparoscopy can remove endometrial and scar tissue with a knife, heat, or a laser. Laparotomy can remove endometrial and scar tissue with surgical tools.

When should I see a doctor?

Contact a doctor if your symptoms change or worsen. Your doctor can help to determine if your disease has worsened, or if another birth control method or treatment option may be better for you.

Which birth control pill is best for treating endometriosis?

Birth control needs can vary by person, due to the types and levels of hormones in each one. Your doctor can help to determine which type is best for you.

Does birth control get rid of endometriosis?

While birth control is not known to cure endometriosis, it can help to substantially decrease severe symptoms like painful and heavy menstrual periods, giving you a better quality of life.

Will insurance cover birth control for endometriosis?

Most insurance plans at least partially cover most methods of birth control. In fact, many options are completely covered by insurance.

Can birth control make endometriosis worse?

While birth control isn’t believed to directly worsen endometriosis, your disease may still progress while taking it if the prescribed method simply isn’t working for you. Talk with your doctor if your symptoms don’t improve, as they can potentially help you find a better option.

All in all, a wide range of birth control options have been shown to be effective in reducing endometriosis symptoms.

Be sure to talk with your gynecologist to receive an appropriate diagnosis and monitoring of your condition. They can help you choose the right treatment option for you.


Emilia Benton is a freelance writer and editor based in Houston, Texas. She’s also a nine-time marathoner, avid baker, and frequent traveler.