Getting pregnant after stopping endometriosis medication
Medications typically used to mange endometriosis type pain and painful periods are contraceptive: like birth control pills and Depo Provera. Some women take leuprolide acetate to mange their pain. Patients need to stop these medicines when it is time to get pregnant.
The pain and symptoms will return without those medications so the goal is to get pregnant as soon as possible after stopping the medicines. Pregnancy hormones work like the medications, and most women don’t have this pain again until after delivery.
Where to Start
We suggest the following things, mostly in the following order.
- Take 400 mcg folic acid daily. You can get this amount of folic acid in a prenatal vitamin OR in any regular drug-store brand or supermarket-brand daily vitamin. Prenatal vitamins can be harder on your stomach, without any additional benefits over a regular vitamin.
- Stop your hormonal pain medicine. This means stop the oral contraceptives OR do not get your next Depo Shot.
- Begin to keep a calendar of your bleeding and your pain. We need to know which days you have bleeding and which days you have pain, in order to manage things during the “trying to get pregnant” time.
- Make an appointment to see us approximately three months after stopping your medicine. The purpose of this appointment is to review your bleeding/pain calendar. We may need to discuss how to manage your pain, and to be sure you are having ovulatory cycles.
- We may need to consider clomiphene citrate to make you ovulate. Patients who used Depo Provera, and women whose periods were irregular BEFORE beginning the “hormonal pain medicine” may not expect ovulatory/monthly periods to return “soon.” And without ovulation, pregnancy will be delayed.
- We may arrange for a hysterosalpingogram; a test for the Fallopian tubes. Women with painful periods and endometriosis may have scar tissue around the Fallopian tubes. This can cause an ectopic pregnancy OR infertility.
- Women may need to take pain medicine to manage the pain until pregnancy. Potential medicines include acetaminophen, ibuprofen, Tylenol with Codeine, Percocet/oxycodone or Vicodin/hydrocodone. We will use such medicine carefully, and only until pregnancy is achieved.
- Follow the information under the Getting Pregnant section.
Other Types of Medication
You should discuss all other types of medication you are taking with your doctor prior to becoming pregnant to assure it is safe for you and the baby. If you have questions about other types of medications please contact us to schedule an appointment.