So I had a lap surgery due to a hemorrhaged ovarian cyst about 2 years ago, they found stage 1 endometriosis as well. I keep scaring myself out of birth control because of the fear of the side effects being worse than my pain. I start getting cramps (1-4/10 pain level) exactly 10 days before my period, then my first day of my period is extremely heavy bleeding paired with a couple hours of horrible cramps 5-6/10 pain. Advil and Tylenol helps, but I still get bad PMS, acne, and bloating before my period. PLUS the looming fear of having another cyst rupture which was 10/10 pain for sure. I’m finally seriously researching and considering birth control. I know that for endo the pill needs to have progestin. I’m worried about taking one with estrogen because I fear I already have high estrogen with all of my symptoms? Anyways I thought I’d get another opinion on which birth control might be best based on all my specific symptoms. Thanks so much!
Endometriosis
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Thank you for sharing this — your concerns are very understandable, especially after a cyst rupture.
The main goal of hormonal treatment in endometriosis is cycle stability and ovulation suppression, which helps reduce pain, heavy bleeding, PMS, and the risk of another ovarian cyst and its rupture.
Progestin is the key hormone that’s used for endometriosis. Combined oral contraceptive pills contain both progestin and estrogen. Modern pills use low, controlled estrogen doses, chosen to balance symptoms while supporting the progestin’s effect.
Because you are still experiencing pain and it has been 2 years since surgery, it would be very reasonable to consult an endometriosis specialist to exclude possible progression of disease and to individualize treatment. It’s also important to be aware that if deep endometriosis is present, it can sometimes still progress even while taking the pill, so symptoms should be regularly reassessed and not automatically attributed to hormones.
You should know that the first pill is not always the right one — sometimes it takes time to find the option that provides good symptom control with minimal side effects. This is normal.
Many women with symptoms like you have experience significant improvement in pain, bleeding, and overall quality of life with the right pill.