Timing to start combined pill for endo? - Endometriosis UK

Endometriosis UK

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Timing to start combined pill for endo?

Ishallwearmidnight profile image

I was recently referred to a gynae to investigate endometriosis following an ultrasound and relevant history. The gynae prescribed me the combined pill (microgynon 30) to try in the first instance. I'm taking it back-to-back for 4 months to stop my periods.

I've not been on any hormonal treatments before, so wasn't sure how they would affect me. I wasn't sure when in my cycle I should start taking them, and the package leaflet only had advice for people using it for contraception, to take it on the first day of your period.

In any case, that's what I did and it has been having some unexpected effects, I had a much longer period than normal, then spotting for another 10 days or so and all during that time up to now I've had pelvic pain and bloating - it is not as bad as the first day of my period, but is making me feel quite drained and I'm not sure how I would manage if I wasn't working from home and have a very low activity lifestyle at the moment.

I have seen my GP, who says it can take a couple of months for the body to adjust, so we are reviewing again in 4 weeks (or sooner if my symptoms get worse).

I was just curious to know if this reaction I've had might be because I started the pill at the wrong time in my cycle? If I had waited till my period stopped before taking it, would I not have had period-like cramps? I feel like it is almost keeping me in a period state, just without the bleeding if that makes sense.

I read a paper saying that GnRH agonists work better for endo if they are started in the luteal phase. I know that GnRH is a totally different substance to the combined pill, but it just made me wonder if there is any research or information about this for oestrogen and progesterone?

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Ishallwearmidnight
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6 Replies
Sleepy_Leopard profile image
Sleepy_Leopard

Hey, I have confirmed endometriosis, I personally found that pill had more negative side effects than positive ones for me. I struggled with how it affected mentally a lot aswell as severe pain in the withdrawal week. It isn’t for everyone, I think after 3 cycles you feel the maximum effect of the pill on your body. So it is up to you whether you stick it out a bit longer or come off it if it gets unbearable. Hope this helps in some way! x

eunha profile image
eunha

I started the pill in the first few days of my period. My bleeding stopped but my endo symptoms were really bad every day for the first 3months, slightly better but still bad until month 6 then okish. I still have pain some bloating/pressure etc but it was so much worse without the pill I really couldn't cope. I have other health issues going on too, and the pill helped with my pressure headaches and let my brain heal a bit and so around 6months on the pill my brain fog finally cleared up.I know everyones different tho.

I'm still too sick to function properly.Have my first lap scheduled in 2 weeks 😬

Hope the best for you 💕

Ishallwearmidnight profile image
Ishallwearmidnight in reply to eunha

Did the pain / bloating pressure etc come at times of the month when you didn't have those symptoms before? That's what is confusing me, I think I thought that on the pill I would feel the way I feel between periods when I don't have endo-associated symptoms, but it is the opposite.

eunha profile image
eunha in reply to Ishallwearmidnight

Yeah, instead of cycling with really bad days and a few good, it was just constant bad days. Its still constant but less severe than my bad days were w/o the pill

Heloo85 profile image
Heloo85

There is no timing to start the combined pill for Endometriosis! I was told to start at anytime! It’s to suppress periods! The reason you’re told to start at the first day of your period for contraception is because that’s the least likely time you’re going to get pregnant, and it gives it time to build up in your system to suppress ovulation!

It’s not about the time you started! It takes months to thin the endometrium to lower pain xx

Ishallwearmidnight profile image
Ishallwearmidnight in reply to Heloo85

Does the combined pill thin the endometrium? I thought it did the opposite and made it thicker... which was confusing me no end as that would seem to be the exact opposite of what you would want with endometriosis...but useful to know that it will do that eventually.

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