Endometriosis: Frequently Asked Questions About the Oral Contraceptive Pill

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Do I need a pelvic exam before going on the oral contraceptive pill?

No. Although it is important for people to have checkups as part of their general health care, a pelvic exam is not needed for people with endometriosis in order to start oral contraceptive pills.

Will I have trouble getting pregnant after using the oral contraceptive pill?

There is no change in fertility with the use of the oral contraceptive pill. The pill does not hurt your ovaries or your uterus. However, if your period was were irregular before you started taking the Pill, it is likely that your periods will be irregular again when you stop taking it.

Does the oral contraceptive pill cause birth defects?

No. The Pill does not cause birth defects nor does it affect the health of future children.

Does the oral contraceptive pill cause cancer?

No. The Pill actually protects against cancer of the ovaries and cancer of the lining of the uterus. Most experts believe that taking oral contraceptive pills does not cause any increased risk of developing breast cancer. Even if you have a family history of breast cancer, you can still take the Pill.

How long can I be on oral contraceptives?

It is safe for you to be on the Pill for years and even decades, whether to regulate your menstrual cycle, treat your cramps, as hormone replacement, or birth control. It is important to be on hormonal treatment for endometriosis until you are ready to become pregnant, so that the disease does not progress.

Do I need to take a break from the Pill?

There is no medical reason that you need to take a “break” from the Pill.

 Where does the blood go?

When you are on the Pill continuously, the lining of your uterus does not build up. Therefore, you don’t get your period and there is no blood. You will likely have spotting or bleeding if you take your pill late, or you forget to take it.

Can I smoke if I’m taking the Pill?

It is NOT safe for you to smoke and take oral contraceptives. Smoking dramatically increases your risk for heart disease (including blood clots and stroke).

What if I am also using the oral contraceptive pill for birth control?

If you are also taking the oral contraceptive pill for birth control, you should know that oral contraceptive pills do not protect you from sexually transmitted infections (STIs). Condoms help to prevent most STIs, , and they are also an important backup method of birth control if you miss more than one Pill in a row, or if you are sick and throwing up. All of these factors can lower the effectiveness of the Pill. Whenever you get a new medication, ask if it changes the effectiveness of your oral contraceptive pill.

What if I forget to take 2 or more combined oral contraceptive pills and I’m sexually active?

If you have had intercourse during the time you missed your pills (and you don’t use condoms), talk to your GYN team about whether you should use emergency contraception. If you are 15 or older, you can buy “Plan B” without a prescription. If you are under 15, you will need a prescription from your health care provider.

How do I talk to my parents about taking the Pill?

If you are taking hormonal pills for the treatment of endometriosis, your parents may have some worries about you taking a pill that is also called the “birth control pill”. It’s best to talk openly with them about how the Pill will stop your periods and help lower your pelvic pain and other discomforts you may have. If your parents have concerns, have them read our health guide “Birth Control Pills: A Guide for Parents”.

How do I talk to my friends about taking the Pill?

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. When it comes down to it, you really don’t have to tell anyone except your GYN team 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.

The Pill does much more than prevent pregnancy. Adolescents are frequently prescribed the oral contraceptive pill just for its medical benefits. It is a very safe and effective treatment for many types of medical problems besides endometriosis including; irregular menstrual periods, menstrual cramps, acne, and PMS.