Expert: Norman Solberg - 11/29/2009

Question
I have severe endometriosis and have been on the Lupron Depot injection for the past 12 months.  I need a birth control pill now that I am going off the Lupron that will keep my pain away- any suggestions?  Thanks for your help.

Answer
Hello lisa,

There are many pills, and almost all of the combined (estrogen plus progestin) pills will work well.  What I would suggest is to take the pill continuously, rather in the usual 3 week on and 1 week off manner.  It will have a better suppression effect on endometriosis that way.  It may take a while to be able to do that, and you'll probably still end up with some periods.  I would start the pill at the time that the Lupron Depot is wearing off, then take only active pills one daily.  You'll likely start bleeding at some point, so when it seems like your period just wants to come, stop the pills for 4 days, then restart and keep taking them every day until your period needs to come again, then so the same.  Eventually you'll have hardly any periods, and your endometriosis will be quite suppressed.  Best wishes.