Hormonal Contraceptives as an Effective Endometriosis Treatment

Endometriosis is a condition in which the tissue that normally lines the inside of the uterus (the endometrium) grows in other areas of the body. It causes pain, irregular bleeding, and, in some cases, infertility.

Endometriosis is a common problem and probably begins about the time that regular menstruation begins. The Depo-subQ Provera 104 injection has been approved by the U.S. Food and Drug Administration (FDA) to help treat the pain associated with endometriosis. Other hormonal contraceptives may be helpful as well.

Hormonal contraceptives contain either progestin, estrogen, or both. Although more than 80% of American women will use hormonal contraception (like "the Pill") sometime during their reproductive years, many do not realize the non-contraceptive benefits of using this type of birth control.

Woman's hand holding birth control pills, cropped
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Using Hormonal Contraception to Treat Endometriosis

Some contraceptives have shown some ability to diminish endometriosis-related pain.

It is important to note that the main reason to use hormonal contraception is for birth control (to prevent an unintended pregnancy). The potential non-contraceptive benefits can be considered when deciding which hormonal birth control method may be best suited for you.

The following is a list of various prescription birth control methods that have been shown to be effective in relieving some of the pain associated with endometriosis.

Depo Provera and Depo-subQ Provera 104

Both Depo Provera and Depo-subQ Provera 104 have been shown to reduce pain caused by endometriosis. The Depo-subQ Provera 104 injection is the first new remedy in the last 15 years to be FDA-approved for the treatment of endometriosis-related pain.

According to research provided by Pfizer, the manufacturer of Depo Provera, Depo-subQ Provera 104 treats endometriosis pain as effectively as leuprolide, yet is associated with fewer vasomotor symptoms (like hot flashes or sweats) and significantly less bone loss.

In fact, Depo Provera provided pain relief statistically equivalent to that of leuprolide across all endometriosis-associated areas: pelvic pain, pelvic tenderness, dysmenorrhea, painful intercourse, and hardening and thickening of tissue.


Explanon, a contraceptive implant, has also been shown to reduce pain due to endometriosis.

Though it is not known precisely how the progestin (etonogestrel) in Explanon helps to relieve the symptoms of endometriosis, it is thought to work by suppressing the growth of endometrial implants, thus causing them to gradually diminish.

Progestin may also help reduce the inflammation in the uterus caused by endometriosis, thereby offering some relief from the pain.

Mirena and Liletta

The Mirena and Liletta IUDs have been shown to help in treating the dysmenorrhea and chronic pelvic pain associated with endometriosis, though it has not been FDA-approved for this use.

Given that these IUDs can be left in place for up to eight years, they can offer the potential to be a long-term endometriosis treatment for women who want to postpone pregnancy.

Several small clinical trials have investigated the effectiveness of these IUDs for the treatment of endometriosis. This research showed that they may be helpful in reducing period pain over three years, with most of the improvement being in the first 12 to 18 months.

Mirena and Liletta is thought to help reduce the amount of blood flow during a woman's period, which may help to reduce endometriosis-related pain. In fact, in women who wish to obtain intrauterine contraception, these IUDs are now FDA-approved to treat heavy periods for up to five years.

Extended Cycle Birth Control Pills

Continuous birth control pills (like Lybrel or Seasonique) may offer an additional benefit of elimination or reduction of periods and associated dysmenorrhea linked to endometriosis. However, there is limited data to suggest that combination birth control pills can reduce the severity of dysmenorrhea in women with endometriosis.


Orilissa (elagolix) is a prescription pill used to treat moderate to severe endometriosis pain. Orilissa is a gonadotropin-releasing hormone (GnRH) receptor antagonist that works by blocking GnRH receptors in the pituitary gland of the brain, thus reducing the signals to produce estrogen that your ovaries receive and preventing the body from making some of the hormones responsible for ovulation.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pharmacia Upjohn Company (Pfizer). Depo-subQ provera 104® medroxyprogesterone acetate injectable suspension 104 mg/0.65 mL.

  2. Tyrer L. Introduction of the pill and its impactContraception. 1999;59(1 Suppl):11S–16S. doi:10.1016/s0010-7824(98)00131-0

  3. Crosignani PG, Luciano A, Ray A, Bergqvist A. Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod. 2006;21(1):248-56. doi:10.1093/humrep/dei290

  4. Brigham and Women's Hospital. Medical treatments for endometriosis.

  5. Endometriosis.org. Mirena.

  6. Bayer HealthCare Pharmaceuticals Inc. Mirena prescribing information.

  7. Jensen JT, Schlaff W, Gordon K. Use of combined hormonal contraceptives for the treatment of endometriosis-related pain: a systematic review of the evidenceFertil Steril. 2018;110(1):137–152.e1. doi:10.1016/j.fertnstert.2018.03.012

Additional Reading
  • Jain, J. Contraception: Subcutaneous depot medroxyprogesterone acetate for birth control and endometriosis pain. OBG Management, Vol. 17, No 8. 2005.

  • Lockhat FB, Emembolu JO, Konje JC. The efficacy, side-effects and continuation rates in women with symptomatic endometriosis undergoing treatment with an intra-uterine administered progestogen (levonorgestrel): a 3 year follow-up. Hum Reprod. 2005;20(3):789-93. doi:10.1093/humrep/deh650.

  • Pfizer. Depo Provera: Contraceptive Injection."

  • Pfizer. Depo-SubQ Provera 104.

  • Schweppe, K-W. Current place of progestins in the treatment of endometriosis-related complaints. Gynecol Endocrinol 2001;15(S6):22–8. doi:10.1080/gye.15.s6.22.28.

  • Sullivan, M. New treatment approved for endometriosis pain. OB/GYN News. 2005.

  • Surrey ES. The role of progestins in treating the pain of endometriosis. J Minim Invasive Gynecol. 2006;13(6):528-34. doi:10.1016/j.jmig.2006.06.008.

  • Vercellini, P., Fedele, L., Pietropaolo, G., Frontino G, Somigliana, E., Corsignani, PG. Progestogens for endometriosis: Forward to the past. Hum Reprod Update 2003;9:387–96. doi:10.1093/humupd/dmg030.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.