Rethinking Birth Control to Treat Endo


I am 36 years old and was diagnosed with endometriosis at age 19. Had a laproscopy and – lost 1/2 of one ovary and one tube, also had a laprotomy. On Danazol (next three years) on and off for three six month treatments. Tried to conceive and was unable – have too much scar tissue. Was put on bc continuously until we were to try IVF. Off pill for six months, had IVF, had a set of healthy twins. Heavy periods, pain, clotting all returned right after I finished with breastfeeding. Went back on the bc continously. I have small fibroids, but doctor wants me to keep on BC. Just converted to Catholicism last year, was told that since it was medically necessary staying on bc was not an issue. However, with bc, still have mood swings, some cramping and no sex drive what-so- ever.
Recently heard of NFP and wonder if it’s something that will work for me and if I’ll still be able to function – the severe endo ruled my life before bc.

Thank you.



Dear Allie:

Endometriosis can be quite severe as you know and is associated with a host of associated processes. Among these are infertility, painful periods, pelvic pain, & hormonal dysfunction. In your case you have been suffering with all of these.

Fortunately there are treatments. Some physicians prescribe the birth control pill to regulate it. The pill has a combination of drugs that act on the estrogen and progesterone receptors in the body. The endometriosis, which is the lining of the uterus in places other than the uterus, is effectively stopped or shut down in its growth. However, the pill and other medical treatments such as Danazol can offer only temporary relief. Surgery has been shown to be superior in reduction of symptoms and improvement of fertility.

NFP would afford you many benefits in addition to conforming with Catholic teaching on sexuality. What is overlooked by most of the medical community is the enormous medical information that is produced by charting women’s physiological signs such as cervical mucus production. In your case, a large extent of your diagnosis is already known. However, you would have the benefit of possibly using progesterone in the luteal (post-ovulatory) phase of the cycle to help establish cycles. You quite probably have reduced progesterone which can contribute to “mood swings”. Loss of sex drive can be complicated but with charting your cycles, pinpointing cycle dysfunction may lead to understanding and treating this better. Anti-inflammatory medication could be used for painful periods.

Yet, endometriosis is a surgical disease. Surgically removing the actual blebs significantly reduces symptoms and improves overall fertility.

Surgery techniques have improved and “near-contact” laser treatment during laparoscopy has been shown to have the best results. This technique is taught in Omaha by Tom Hilgers, MD, an OB/Gyn who has been studying infertility and NFP for the past 40 years. He has trained many Ob/Gyn doctors around the country in this technique. Incidentally, he is of the Catholic faith and built his practice out of response to the teachings of the Church. Consequently, he has built quite a body of knowledge with the Creighton Model of Natural Fertility Care in conjunction with advanced medical and surgical techniques.

So yes, NFP would be of great benefit for you. Since you have a complicated medical history, I would recommend getting a second opinion from an Ob/Gyn who has been trained in the surgical techniques described above. CANFP can be of help in locating people in your area.

I hope that you will find this of benefit!

Gretchen V. Marsh, D.O

Answered By:

Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via

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