I don't get it

[givemeananswer]

I'm confused as to why birth control pills are prescribed to endometriosis sufferers. From what I've learned you still ovulate when on the pill, which means your still producing estrogen, also there is synthetic estrogen in the pill so compound estrogen. When estrogen is the producer of endometriosis.

[Impatient]

We endo ladies tend not to use the combi pills containing estradiol or oestrogens when we have endo. A few ladies do-but it is the exception, most do not.

The POP or progesterone only methods are the ones we try to stick with unless for some reason a woman cannot tolerate them, then the combi methods are better than nothing.

and no you don't always ovulate on the Progesterone or derivatives of progesterone.

The Mirena coil for example is a pop method, it can in some women stop ovulation. This is a bonus as it doesn't happen in every case. it is the lowest dose method of hormones to control periods and the longest lasting too, as mirena can last up to 5 years of stopping periods.

Oestrogen doesn't produce endo. The hormone signals the endo to be active in exactly the same way as it works on the uterus lining cells which are the same. Zero oestrogen will stop endobeing active. it doesn't kill it, it just will remain dormant until it gets a new oestrogen fix.

OEstrogen occurs naturallyin the ovaries, adrenal glands and tummy fat. You can eat foods and dinks and take meds to increase production of oestrogen. And of course cutting out thosefoods and drinks will reduce the oestrogen production. That's what the endo diet aims to do.

Endometriosis cells are in body anyway - they are supposed to only be found in the uterus making up the endometrium lining of the womb, which grows a menstrual lining each cycle and sheds as a period.

Long before we are born, these endo cells can accidentally get transferred to other parts of the body when we are a foetus. they remain dormant until the onset of periods when the body boosts the production of oestrogen causing these endo cells to react just like the cells in the womb, to grow a small mentrual lining which they then shed as a little individual period from wherever those cells are located. Each time they shed -there is the chance than some endo cells breakaway and drop with the blood onto new tissue where they can nest or take root and live happily and carry on developing as they did at their previous location.

Another route for transferring of the cells from the womb works in the same way. Obviously there are a lot more endo cells in the womb as that is where they are supposed to be.

But when you have a period the blood doesn't always flow down through the cervix and out via the vagina. Blood can also escape by flowing along the fallopian tubes - in the opposite direction to the way that a released egg from the ovary would travel to the womb for fertilising to become a baby, the wasted period blood (and a few endo cells included) will backflow along the tubes and out into the cavity in your tummy where various organs are located.

The ovaries, the fallopian tubes themselves, your appendix, bowel, colon, intestines, bladder, ureters, kidneys, stomach, liver, spleen, gall bladder etc are all held in a giant bag called the peritoneum under your rib cage.

This blood once it has ended up inside the tummy can nest anywhere it likes.

The first thing it will hit is the ovaries and if it does that and nests on the ovaries and causes scarring and adhesions that will prevent any hatched egg from the ovary from floating over to the fallopian tube and you won't be able to get pregnant naturally if both ovaries have a problem, or both fallopian tubes have been blocked with endo or scarring.

It doesn't automatically stick to the first thing it lands on and nest there.

It is quite possible for the cells and blood to fall down with gravity and drop to the lowest points inside your tummy. and that is what usually happens. Filling up the pouch of Douglas pocket with endo bleeds that cannot escape.

So having endo does not automatically mean that your fertility is under threat, it does depend on where the endo is nesting, and how much damage it is causing from those locations.

Once you have had surgery to remove all the existing endo cells from around the tummy organs, then stopping your periods is an excellent, indeed the only way that you can try and prevent new spread of endo from your womb using accidental the backflow of blood to carry those cells elsewhere in the tummy. It isn't the only way endo can spread, but it is the one you have most control over.

Besides which periods are extremely painful for most endo ladies, often very heavy and long lasting too, and who wants to put up with that when you can stop it and not be in pain or at least reduce the monthly or daily pains considerably.

it won't stop you feeling pains from the damage already caused in the past -but it is one less burden to worry about and deal with. That is why taking steps to manage or control your periods is an essential treatment plan for ladies with endo.

We cannot cure the disease or prevent it recurring after surgery has removed it all. There are no guarantees it wont spread some how at some point, so treatments are all about improving your quality of life and being as comfortable as you can be for as long as possible.

The methods or period controllers used for endo that do NOT include oestrogen or estradiols

are

Mirena Coil iud (lasts 5 years)

Skyla Coil iud (lasts 3 years)

Nexplanon arm implant (lasts 3 years) - stops ovulation in most cases about 97%

Depo-Provera injections every 3 months - stops ovulation

Norethisterone tablets 3 a day s long as you need to take them

POP or progesterone only pills

there is list of the various brand names for these drugs on wikipedia page

en.wikipedia.org/wiki/Oral_... and how they work too.

The pop methods work the reduce the growth of themestrual lining thereby reducing or lightening the bleeds till they stop, and also by building up extra cervical mucus to plug upthecervix and stop sperm getting in. This is white or clear discharge that you may notice inbetween periods.

It is very good at protecting the lining of the cervix from harm and erosion too. so the build up of that layer of mucus is beneficial even if you don't fullt stop bleeding on the POP methods.

Most ladies will stop periods - but some don't.

hope that explains things a bit better for you from an endo point of view.

[Impatient in reply to Impatient]

sorry for the typos- I'm trying to brush the dog and get sticky burrs out of his fur at the same time as typing.

[givemeananswer in reply to Impatient]

Thank you Impatient, Where did you you get your wealth of education on this subject from, I sure hope you are employed in the medical community and I wish I had known you or had this forum back in the '90s when my journey began. I hope you realize that you have a gift that many of us do not, in that although we have studied the information many times over we don't necessarily have the talent to relay it to others such as you do so eloquently. I had adenomyosis and endometriosis and adhesions, multicystic ovaries,endometriosis on one ovary, cysts on my uterosacral ligaments, cul de sac, attached to the periteneum and also precancerous cell changes to my cervix due to HPV so had the uterus and cervix removed but kept my ovaries. And I still don't know exactly what goes on in the body but I seem to still have stages of pain and dormancy as though still having periods just without the bleed. I understand that as long as the ovaries are still producing as in my case, that there's still a possibility I could continue to develop the adhesions, endometriosis sites, and cysts. And I'm aware that although they cleaned up what was visible at the time of my hysterectomy that not existing sites are necessarily visual to the naked eye. Currently I am after a nice long stretch of dormancy experiencing pain again and still investigating the cause. I have been though a barage of xrays , bone scans, ultrasounds, an mri, blood tests and now seeing a physiotherapist. i was dignosed on this quest with high colestral and tryglycerides, a simple cyst on my kidney, oteopeia, bilateral ovarian cysts and a small amount of trichontric busitis of both right and left. The physiotherapist believes this amount of bursitis can be seen in just about anyone but diagnosed me with Sacroilliac joint dysfuntion. I tried a fluoroscopic cortisone injection for the SI joint dysfunction but it was unsuccessful. This forum has led my to a group of people who seem to have the same dilemma as I do and I thought I was alone thinking that all this is referral pain from gynocological issues that can only be detected via laporscopic surgery. I have yet to meet with the gynocologist that I was referred to as per my request months ago. Here in Alberta Canada I am not aware of any specially trained physicians in the industry such as you have there in the UK. Keep up the marvelous work, you are an angel among us.

[Impatient in reply to givemeananswer]

Nope not employed in the medical profession at all, never have been - wouldn't mind the salary though!!

I did study human biology to A level many many years ago, and I've had a catalogue of medical issues over the years resulting from a hiccup in my journey as a foetus when mum was very sick, and most of the organs in my trunk didn't quite grow and develop as they should. I look normal on the outside- but it is a riot going on inside .Deformed shapes, organs in the wrong places and so on.

So over the years as things went wrong which they did, and more difficulties were uncovered along the way I built up my knowledge of 'normal' human anatomy on the way. and with that as a foundation it is easier to pick up and understand roughly whats going on. I do read a lot of websites and research papers etc, because I want to understand my own self - quirky organs and all.

Plus i do have nice long chats with medical peeps because they are just as curious and fascinated with odd ball bodies like mine, as i am.

and i have been posting on this forum for a number of years, so it gets a bit easier to write things out in more normal language than the medical texts tend to use.

Many thanks for the compliments. You sure know how to raise a smile thousands of miles away Many thanks for that. Glad I can sometimes help others out, as others have helped me along the way too and continue to do.

[Impatient]

Combi pills are split in to different catagories - there are the ones which the active tablets in the packet have all got the same ingredients as all the others. Identical pills for 21 days then dummy pills for the last week.

These include the Microgynon that you are on. The pill packets colour code the tablets for the active and inactive ones. e.g. pink for active, green for the dummy pills.

Then there are another sort which change ingredients as you progress through the month. These must be taken in the correct order, and the doses of homones varies quite a bit through the course of the month.

That wiki website I put the link to above- lists the brands of and whether it is monophasic (all active tablets are identical) or multiphasic in which case it lists the numbers of tablets or every day ones.

as an example extradiol [oestrogen] valerate combined with dienogest [which is a progesterone derivative] (brand name in the UK is "Qlaira")

reads as follows:

2 tablets 3 mcg/0 mcg,

followed by 5 tablets 2 mcg/2 mcg,

17 tablets 2 mcg/3 mcg,

2 tablets 1 mcg/0 mcg,

and 2 placebos.

so that tells you that that the the first two pills are oestrogen only

the next 5 are progesterone in an equal dose with oestrogen

then 17 days where the progesterone is at a slightly higher dose than oestrogen

before it flips the other way for two days then two days of dummy pills

I have swapped the Mu symbol for micrograms, to mcg as this forum doesn't use the internet symbol for Mu and auto changed it to Mg instead (which is not the dose.)

Just incase anyone reading this was getting confused (or even noticed!!)

and to save time typing up how they work - the NHS has a fab and informative website nhs.uk/Conditions/contracep...

not only with advice for using it as a contraception but also advice in how to take the pill packets back to back to stop periods. Saves me typing it all out.

A lot of us have been on the combi pills in our lifetimes and probably in part because at the time we were not yet diagnosed with endo, or tried the POP ones and found that the side effects didn't suit.

It is your choice as to which you want to try and whether you want to switch to something else. Our bodies do change over the years and what may have suited for years may suddenly become a problem and we have to try and find something better for us.

As you can see from the wiki page there are so many choices, which does mean we are more likely to find something that works for us eventually.

Initially you will be probably take whatever your friends or perhaps your GP recommends to you. But once you start researching for yourself, then you may decide you want to give a different option a trial run.

The NHS will try and get as many ladies on the cheapest possible options -understandably as they are in the business of cost cutting, but that doesn't necessarily mean you are getting what is best for you from the outset.

Also if you have a family or personal medical history that would make the combi pill a safer option inspite of endo, then you could be offered the combi rather than the POP versions.

In a nutshell, try the POP methods once you know you have endo, and see if they can work for you and if they don't then switch to some other type for another trial run.