Contraceptive Pearl: Oral Contraceptive Pills and Endometriosis

For decades, birth control pills have been used to treat the symptoms of endometriosis. Does evidence support this?

The Cochrane Collaborative updated its review of this topic in May, 2018. Reviewers found 5 clinical trials that examined the use of oral contraceptives to control endometriosis pain. Of these 5 trials, three met criteria for analysis. Two of these trials compared oral contraceptives with placebo, and one compared oral contraceptives with goserelin (a gonadotropin releasing hormone agonist that causes decreased estrogen production).

Cochrane reviewers concluded that all three studies were at risk of bias. The two studies comparing oral contraceptives to placebo were funded by pharmaceutical companies. Drug companies participated in study design and data analysis. Due to high risk of bias and poor design, reviewers concluded that the evidence in this area is insufficient, and that further research is needed.

Birth control pills are widely used to control endometriosis pain – but they should be continued only if they provide clear benefit to the individual patient (either for contraception or symptom control).


Helpful Resources

Medical Eligibility Criteria for Initiating Contraception



Brown J, Crawford TJ, Datta S, Prentice A. Oral contraceptives for pain associated with endometriosis. Cochrane Database of Systematic Reviews. May 2018;5. doi: 10.1002/14651858.CD001019.pub3. 



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

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