Tag Archives: endometriosis

Let’s Talk Contraception: Birth Control Pills — Not Just for Preventing Pregnancy

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pillThere has been a lot of political posturing recently about whether the government should require health insurance to provide birth control without a co-pay as part of a preventive health care package. So many people, including politicians, can only “see” the contraceptive side, which is pretty important, by the way. Approximately 15.8 in 100,000 women in the United States die from pregnancy or pregnancy-related issues yearly, and that number has doubled in the past 25 years. We have one of the worst maternal death rates of all developed nations, right near the bottom of the list.

Birth control pills can be used to treat a variety of conditions, including painful periods, acne, endometriosis, and uterine fibroids.

But putting all that aside, let’s look at the how oral contraceptives pills (OCPs) are actually used in this country, and for what reasons besides contraception. You may argue that many birth control pills are only approved for contraception purposes by the Food and Drug Administration (FDA), so other uses are not valid. But many drugs that may have narrow conditions of approved use are often prescribed off-label by physicians when they have data and information about how effective they can be for other conditions where not much else works.

According to a 2011 study using data from the 2006–2008 National Survey for Family Growth, the Guttmacher Institute reported that 14 percent of all women using birth control pills — that’s 1.5 million women — use them for purposes other than preventing pregnancy. Granted, 86 percent of OCP users report using them for birth control. But over the years, these OCPs have helped many people as treatments for dysmenorrhea, menorrhagia, endometriosis, menstrual-related migraines, acne, uterine fibroids, and polycystic ovarian syndrome. Continue reading →

Let’s Talk Contraception: Can I Use Birth Control to Skip a Period?

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In 2003, the FDA approved Seasonale, an extended-cycle birth control pill. This pill, a combination of estrogen and progestin, is taken daily for 84 days followed by one week of inactive (placebo) pills, allowing a woman to have her period once every three months — four times per year.

Since that time, several other extended-cycle birth control pills have been marketed, including Lybrel, released in 2007, which offers women continuous contraception coverage with only one period per year.


Using birth control to skip periods doesn’t result in side effects quite this exaggerated.

Prior to Seasonale’s debut, certain types of birth control pills could be taken back to back, allowing users to have period-free weddings and honeymoons, or to treat certain conditions, such as endometriosis. But there was no consensus about how to use birth control pills this way, and no actual product marketed specifically for this type of use. Early studies on extended-cycle pills reported that users were highly satisfied using pills to have fewer periods — and wanted to continue using these pills to reduce periods after the study was completed.

Can skipping periods be beneficial or harmful? Is this a lifestyle choice that’s not “natural”? How many “normal” periods do you need in a lifetime? Continue reading →

Endometriosis Treatment

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endo medsIt’s still March, so it’s still Endometriosis Awareness Month! Today we’ll be looking at endometriosis treatment questions and answers. If you missed the first two posts in this series, you can click to read more about an overview of endometriosis as well as info about diagnosing endometriosis.

Why are there so many treatment options? Which one is best?

There are so many options because there is no “magic bullet” option — that is, no single treatment that works best for everyone. The two main categories of treatment include medication and surgery, but each option has its own benefits and drawbacks. When deciding on the best option for a given individual, some helpful questions to consider might be:

  • Do I have any current health concerns that would render some treatments unsafe? What types of health risks are acceptable to me?
  • Am I currently trying to conceive, or will I be in the next six to 12 months? Will I ever want to be pregnant in the future?
  • Aside from significant health risks, what types of factors — side effects, treatment frequency or duration, cost — would make a treatment difficult for me? How long do I need this treatment to last before I can reevaluate?

For specific questions, your best bet is to check with your health care provider. Continue reading →

Diagnosing Endometriosis

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If you missed it, you can read the previous post explaining the basics of endometriosis here. In this post, we’ll look a little more at how endometriosis is diagnosed as well as some current barriers to diagnosis.

Wait. So you’re telling me that killer cramps of doom aren’t normal? If I did suspect I had endo, how would I go about getting diagnosed?

Endometriosis diagnosis is a tricky thing in that there’s no in-office procedure that can definitively determine whether someone has the condition or not. However, because the “gold standard” test is laparoscopy with biopsy — a surgical procedure — many health care providers prefer to do some in-office tests before recommending laparoscopy. The most common such procedures are pelvic exams and ultrasounds, which may allow a provider to see or feel if the endometrial lesions have formed cysts (known as “endometriomas”), but won’t pick up on smaller lesions.

Another complicating factor is that endometriosis isn’t the only cause of either dysmenorrhea or chronic pelvic pain. Other causes can include uterine fibroids, pelvic floor dysfunction, pelvic inflammatory disease, irritable bowel syndrome, and interstitial cystitis.

Even with laparoscopy, diagnosis isn’t necessarily straightforward. Not only is it a surgical procedure, which carries with it extra expense and risk, but even then, presence of the disease is often missed or underestimated. Seeking out a doctor who specializes in endometriosis can minimize this, but of course, due to geographic, cost, or other access issues, this isn’t always possible. Continue reading →

March Is Endometriosis Awareness Month

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As my ever-creative title suggests, March is Endometriosis Awareness Month. I have endometriosis (“endo” for short), and I like this month because I know plenty of people in my life who could definitely use some more awareness as to what endometriosis is and how it impacts the lives of those who have it.

So what is endometriosis, anyway?

Endometriosis is a condition where the endometrium, the lining of the uterus, grows outside the uterus — often on the ovaries, bladder, bowel, and/or lining of the pelvic area. This can be a problem for two reasons. One is that during menstruation, there’s nowhere for this “rogue endometrium” (not a technical term) to go, not having a way to the cervix and vagina and all. This can cause pain — most often pain during menstruation — as well as a buildup of tissue that remains throughout subsequent cycles, where even more “rogue endometrium” is added to it. The other is that the endometrial lesions can contribute to infertility, particularly if the endo obstructs the ovaries or fallopian tubes.

That doesn’t sound like fun. Is endometriosis rare?

Surprisingly, no. Exact numbers are hard to come by because a lot of cases are thought to go undiagnosed (which is part of the reason for this whole “awareness month” thing). But the estimate is that endo affects just over 10 percent of people with ovaries during their reproductive years — and about 30 to 50 percent of such people who have problems with infertility or pelvic pain. Odds are pretty good that you personally know someone with endometriosis, even if you don’t (or they don’t!) know they have it. Continue reading →

Let’s Talk Contraception: Depo-Provera Injections, Another Progestin-Only Option

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Progestin-only birth control pills (POPs), also called the mini-pill, are good options for those who cannot take estrogen. But for those who have lots of trouble remembering to take a pill every day at the same time, Depo-Provera shots may be the way to go. Depo-Provera is medroxyprogesterone, a hormone similar to progesterone. It is given as a shot in a doctor’s office or a health center such as Planned Parenthood, and lasts for three months to prevent pregnancy. Sometimes it is used to treat other conditions, like endometriosis.

One Depo-Provera shot lasts for three months.

The first shot is given five days after you start your period or, if you do not plan to breastfeed, in the first five days after giving birth. You must not be pregnant when you get the shot because its effects may damage the developing fetus. But it’s OK to use Depo-Provera when breastfeeding, as long as you wait six weeks after giving birth before getting the shot. It’s given in your buttock or upper arm. You need to use a backup method like a condom for seven days after getting your first shot. And if you miss getting your regular 12-week injection by only a few days, you may need to get a pregnancy test before getting your next shot.

While you are on Depo shots, your period may change. You may have spotting, bleeding, or even no bleeding. Fifty percent of people who have been on Depo-Provera for one year have no bleeding at all. After stopping the shots, menstrual bleeding returns. Also, after stopping the shots, it may take nine to 10 months to get pregnant. Continue reading →