Home > Health Guides by Topic > Gynecology & Reproductive Health > Endometriosis > Continuous Hormonal Pills Continuous Hormonal Pills for the Treatment of Endometriosis:
A Guide for Teens
Combination hormonal treatment is very effective for treating endometriosis. Hormonal pills don't "cure" endometriosis but they may help with controlling pain by stopping your periods and preventing endometriosis from getting worse. These pills can also be known as "birth control pills" but are used for many reasons other than trying to prevent pregnancy.
What are hormonal pills?
Hormonal pills, also known as "combination oral contraceptive pills," contain the hormones estrogen and a progestin similar to the hormones that are normally made by the ovaries. One type of pill contains only one hormone, progestin, and is called either the "progestin-only pill," or the "mini-Pill."
How does hormonal treatment work?
These pills work by temporarily turning off your ovaries so you don't ovulate (make eggs). When you don't ovulate you don't have a regular period, and when you take the pills continuously you should have periods rarely or not at all. Since periods can cause pain for anyone with endometriosis, stopping it improves pain.
How do I know if hormonal treatment is right for me?
Not everyone should take hormonal pills. You will be asked questions about your medical history. For example, you will be asked if you or anyone in your family has a history of blood clots. There are different doses of hormones in different hormonal pills. Your gynecologist may prescribe a progestin-only pill if there is a medical reason why you should not take estrogen. If you don't have any medical problems that would put you at risk for medical complications, your health care provider will decide which pill is the right one for you.
Are there other medical benefits of hormonal treatment?
Yes. If you are taking hormonal pills continuously (no inactive or placebo pills) then you probably won't have a period. Hormonal pills also lower your chance of getting endometrial (lining of the uterus) cancer and ovarian cancer, ovarian cysts, and breast lumps and may protect you from osteoporosis (brittle bones). Hormonal pills may also improve acne.
Are there different kinds of hormonal pills?
Yes. There are many different hormonal pills that come in a lot of different packages. The shapes and colors of the packages may be different but there are just two categories of pills: combined estrogen and progesterone pills (these have both estrogen and progesterone hormone medicine in them), and progestin-only pills that contain just progesterone. Hormonal pills can come in either a 21-day pill pack or a 28-day pill pack. The 21-day pack contains all hormone pills and the 28-day pack contains 3 weeks of hormone pills and 1 week of inactive or placebo pills. The last row of pills in the 28-day pack is usually a different color.
What is the difference between "active" and "inactive" hormonal pills?
Active pills contain hormone medicine. If your pill pack is in the shape of a rectangle, the pills will be in 4 rows (7 pills in each row). The active pills are in the first 3 rows of your pill pack. The Inactive pills are in the last row of the 28/day pill pack and DO NOT contain hormone medicine. If your pill pack is round, the pills will be in a circle. The active pills are the first 21 pills and the last 7 pills are the inactive ones, and are usually a different color.
If you are using a 21/day pill pack, ALL the pills are active. When treating endometriosis you will take an active pill every day in a continuous pattern.
What does "cyclic" use and "continuous" use mean?
Cyclic use means taking all the pills in the 28-day pack then starting the next pack. This method results in periods and is not routinely used for the treatment of endometriosis.
Continuous use means taking active hormone pills every day without a break. Your health care provider may prescribe either the 28-day pill pack or the 21-day pill pack. If you are using the 28-day pill pack, you will take 1 pill a day for 3 weeks (3 complete rows) then start your next pill pack. You will not take the last row of pills; throw them away. If you are prescribed the 21-day pill pack, finish the entire pack (3 rows) and then start your next pill pack the next day. Do not skip any days between pill packs. Most likely you will not have a period while you taking the pill continuously.
Do I need to take the hormonal pills at the same time every day?
Yes. Take the hormonal pill at exactly the same time everyday. A good time to take the pill is at 6, 7, or 8pm everyday. It is not a good idea to take the pill "when you wake up" or "before going to sleep" as those times probably vary on school nights and weekends.
You may have slight nausea the first month, but this usually goes away with time. Some teens like to take the hormonal pill first thing in the morning but they are more likely to have nausea, especially if they skip breakfast. Many teens find creative ways to remember to take the pill like; writing a reminder on a calendar, setting an alarm or cell phone, or keeping the pill pack next to their toothbrush. Try to think of a special way to remember to take your hormonal pill.
What if I forget to take one or more hormonal pills?
If you are late taking a pill: Take it as soon as you remember. Take your next pill at the regular time.
If you do not remember until the next day, take two pills that day about 12 hours apart (for example: 8am and 8pm)
If you miss more than 1 pill: Take 2 pills as soon as you remember and also take 2 pills the next day. Take them about 12 hours a part. Stay on your regular schedule after this.
If you don't know what to do about hormonal pills you have missed, take 1 active pill each day until you talk to your health care provider. If you continue to miss pills, you may want to consider using another type of hormone medicine that you don't have to remember to take every day.
You may have break through bleeding (spotting) if you forget to take your pill on time; some people are so sensitive that they will bleed if they are only 30 minutes late. If you miss pills you may get an extra menstrual period. Call your health care provider if you do not get your menstrual period. |
What if I don't get my menstrual period while I'm on "the pill" or it's really a light flow?
If you are taking the pill continuously, you will probably not have a period (this is the goal of taking hormonal pills continuously). Some girls may have light spotting caused from breakthrough bleeding. The spotting may last a few hours or up to 2-3 weeks. The bleeding is usually lighter than a normal period but could be as heavy as normal period. If you have breakthrough bleeding, continue taking the pill as the bleeding is expected 3-4 times per year and will most likely go away on its own.
What are the side effects of hormonal pills?
Most women and teens have no side effects when taking the hormonal pill, but some people may experience some side effects. Each type of hormonal pill can affect each woman or teen differently.
Nausea: You may have nausea, but this may go away if the hormonal pill is taken with a meal or a snack at bedtime. If the nausea doesn't go away, your health care provider or gynecologist may prescribe a pill with less estrogen.
Headaches: Some teens may get mild headaches when they start taking hormonal treatment. Although headaches usually happen because of stress or other reasons, be sure to let your health care provider know. If the headaches are severe or they continue, let your health care provider know right away.
Mood changes: Mood changes or mood swings can happen when taking hormonal treatment. Exercise and a healthy diet may help, but if they don't, you may need to get a change in the type of pill you are taking.
Acne: Usually hormonal treatment helps cure acne, but some teens may get acne from a particular pill.
Weight: Some teens gain weight, some lose weight, but most teens stay exactly the same when they are taking the hormonal treatment.
Spotting: Breakthrough bleeding between periods may occur while taking the first three weeks of hormone pills, but this is not serious. This usually occurs during the first two or three cycles. You should call your health care provider if the bleeding is heavier than a light flow or lasts more than a few days.
Other side effects: Some teens may have mild breast tenderness or breast enlargement. Your appetite may increase, and a few teens feel bloated.
Most often, side effects go away within the first 3 to 4 months of taking the hormonal pill. If you experience side effects, you should talk to you health care provider. If the side effects are really bad or if they don't go away after three cycles, your health care provider may switch you to a different hormonal pill or talk about other types of hormonal treatments for your endometriosis. |
Are there serious side effects I should watch out for while taking the hormonal pill?
Most young women who take hormonal pills have few or no problems. But if you have any of the following problems, call your health care provider right away!
Remember: ACHES
Are there any reasons why I shouldn't take hormonal treatment?
There are only a few reasons that your health care provider may feel that you should not take hormonal medicine to treat your endometriosis.
How do I talk to my parents about taking hormonal pills?
Even if you are taking hormonal pills as a treatment for your endometriosis, your parents may have some worries about you taking a pill that is also called the "birth control pill." It's best to be open with them as they will be able to help you if you have any questions or concerns. Talk with your parents about how the hormonal pill will help your pelvic pain and other discomforts related to your endometriosis. If your parents still have concerns, have them read this: Oral Contraceptive Pills and Teens: A Guide for Parents.
How do I talk to my friends about taking hormonal pills?
You may not want to tell your friends that you are taking hormonal pills for the treatment of endometriosis. Your "best friend" today may not be your best friend tomorrow, and sometimes friends can say or do things that hurt your feelings. Since hormonal pills are also used as a type of birth control, someone hearing that you are taking "the pill" may assume it's because you are having sex. This could put you in a very uncomfortable situation.
What it comes down to is that you really don't have to tell anyone except your parents and doctors about your medical treatment. Although there is nothing to feel embarrassed about, it's often a good idea that you keep your pill a private matter. |
What if I'm not happy with the hormonal treatment that I'm taking?
If you are not happy with the hormonal pills that you are taking and the effects they have on your body, talk to your health care provider. Don't just give up and stop taking the pills. Most likely your provider will be able to give you a prescription for a different type of hormonal pill or another type of hormone medicine. There are many types of hormonal pills and they affect people differently. Some you will like and some you won't. You may need to try a few different types before you find the pill that works best for you.
Hormonal pills can be an effective treatment for endometriosis. Ask questions before you decide to take the pill and if you have side effects, discuss them with your health care provider. It may also be helpful to talk with other teens with endometriosis. The Center for Young Women's Health offers a monthly chat for teens and young women with endometriosis. Click here to learn more - www.youngwomenshealth.org/chat.html |
Updated 3/12/2006
Related Information:
|
Looking for other health info? Check our A-to-Z Index. ©1998-2008 Center for Young Women's Health Children's Hospital Boston. All rights reserved.
About Us Health Guides By Topic
|
Printer Friendly
