Endometriosis is primarily treated by firstly removing lesions via laparoscopy (as the gold standard), followed by hormonal suppression. In many cases hormonal suppression is done instead. A bandaid solution that does address the underlying cause! This is definitely an outdated way of managing such a complex conditions such as endometriosis. It fails to address the fact that endometriosis is a chronic inflammatory condition of the immune system, primarily, that responds to cyclic hormones. In saying that, some synthetic hormonal treatments may provide symptomatic relief from endometriosis by slowing the growth of the lesions. But they may come at price...
You see, the pill isn't truly like our own estrogen and progesterone, which are super important for mood, bone & heart health, plus so much more! The pill can be made up of synthetic levonorgestrel, drospirenone and ethinylestradiol, which act as chemical messengers to shut down your hormonal system. Unfortunately, this may lead to ugly side effects. Real progesterone, for example, improves brain health, yet synthetic levonorgestrel leads to anxiety, depression, loss of libido, weight gain and hair loss.
Sometimes the side effects of these medications are actually worse than dealing with the symptoms of endo in the first place! I have personally experienced this after taking Yaz & Diane, and haven't been able to take any form of Oral Contraceptive Pill for many years for endometriosis symptoms. I simply would had rathered put up with endo any day of the week, than deal with the emotional mess that the pill made me!
Some facts about the Oral Contraceptive Pill
Pill bleeds are not periods - to have a period one must be able to ovulate. When you bleed while taking the sugar pills, this is considered a hormonal withdrawal bleed, not a true period.
The pill may not protect fertility. You might have heard this from a gynaecologist or Dr, because the pills stops ovulation, therefore eggs being released, but this is not necessarily true according to research. In some cases it can bring it on menopause even earlier.
The pill doesn't regulate periods! It simply puts them on hold for a while until you have to get off it. Then you still have the same issue you had to begin with. A bandaid solution.
Some women find that other hormonal drugs are better suited to help with endometriosis, such as the Mirena IUD because it does not suppress ovulation in all cases or oestrogen making it a "healthier choice" for your body, reducing some side effects associated with the Pill. These type of progestin only medications work in a more direct manner, suppressing the growth of lesions. I have found clinically that maybe 50% of women still experience side effects. Other women find bioidentical micronised progesterone cream or caps more beneficial since it mimics your body's own progesterone, giving less side effects. But again, this isn't suited to everyone!
While I'm not a massive advocate of the Pill, I'm all about quality of life and if someone is finding the pill to be helpful in reducing the symptoms and improving the quality of life, I will support them in whatever choice they make. There are ways that we can help the body to help to deal with side effects of these medications such as encouraging liver detoxification and also support gut health. The gut is a primary focus of mine in clinic, since the gastrointestinal system play such an important role in modulating the immune system; the primary system of the body that we need to focus on when there's chronic inflammation. Clinically I use nutraceuticals and specific dietary strategies to achieve this and we can get some pretty fab results!
The take home message:
The pill is a bandaid outdated hormonal treatment for endo
There may be some better hormonal options with fewer side effects
The pill doesn't treat the root cause or drivers of endo
I can support you in whatever choice you make
Do what is right & works for you!
Are you thinking about breaking up with the pill? It can take some time for your body to sort itself out. Reach out if you need some extra support.
Bec
xx
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