Best Birth Control To Treat Endometriosis Choices for Fibroids: What to Eat and Avoid

September 13, 2025

Best Birth Control to Treat Endometriosis, Choices for Fibroids, and What to Eat and Avoid

Endometriosis and uterine fibroids are two of the most common gynecologic conditions, and they often travel together. Both can cause painful, heavy periods, anemia, and fertility challenges. Birth control can be a powerful tool to control symptoms, and smart nutrition can support your treatment plan. Below, we break down the best contraceptive options for endometriosis, how management changes when fibroids are in the mix, and what to eat (and avoid) to feel your best.

Quick takeaways

For endometriosis, continuous combined pills or progestin-only options (including the levonorgestrel IUD) often reduce pain and bleeding.
For heavy bleeding from fibroids, the levonorgestrel IUD is a leading option if the uterine cavity is suitable. Copper IUDs can worsen bleeding.
Some non-contraceptive medicines (e.g., GnRH antagonists) can help endometriosis or fibroid symptoms but are not birth control—you’ll need reliable contraception while taking them.
A plant-forward, iron- and omega-3–rich diet, with limited red/processed meat and alcohol, can support symptom control and reduce anemia.

Best birth control options for endometriosis

Hormonal contraception doesn’t cure endometriosis, but it can suppress ovulation and stabilize or thin the uterine lining, reducing inflammatory prostaglandins and pain. Common options include:

Combined hormonal contraceptives (CHCs: pill, patch, ring)

How they help: Continuous or extended-cycle use (skipping placebo pills) often decreases period frequency and cramping, easing endometriosis-related pelvic pain and dysmenorrhea.
Notes: Not appropriate for everyone. Avoid estrogen-containing methods if you have certain risk factors (e.g., migraine with aura, history of blood clots, certain cardiovascular risks, or if you smoke and are over 35). Discuss with your clinician.

Progestin-only options

Progestin-only pill (including norethindrone acetate): Can reduce pain by suppressing endometrial growth.
Depot medroxyprogesterone acetate (DMPA) injection: Often decreases pain and bleeding; some patients experience amenorrhea (no periods) over time.
Etonogestrel implant: May improve dysmenorrhea for some; data for endometriosis-specific pain are supportive but more limited compared with IUDs and pills.

Levonorgestrel intrauterine device (LNG-IUD)

How it helps: Reduces menstrual bleeding and cramping; many users have much lighter periods or amenorrhea, which can reduce endometriosis-related pain.
Notes: Provides long-acting contraception for 3–8 years depending on the device.

What to avoid or use cautiously

Copper IUD: Non-hormonal and highly effective for contraception, but it commonly increases menstrual bleeding and cramping—often a poor fit if pain or heavy bleeding is an issue.

Beyond contraception, other medicines can help endometriosis pain (e.g., elagolix, a GnRH antagonist), but they are not contraceptives and require effective birth control during use. Discuss options and monitoring with your clinician.

If you also have fibroids: how birth control choices shift

Fibroids (benign uterine muscle tumors) vary in size and location. Symptoms include heavy menstrual bleeding, pelvic pressure, and anemia. When fibroids coexist with endometriosis, the goal is often to control heavy bleeding and pain while maintaining safety and contraceptive efficacy.

Top considerations

LNG-IUD: A leading choice to reduce heavy bleeding from fibroids and endometriosis-related pain. It doesn’t remove fibroids, but it often decreases bleeding dramatically. Important: If fibroids significantly distort the uterine cavity—especially submucosal fibroids—an IUD may be difficult to place or more likely to expel. An ultrasound-based evaluation can help determine suitability.
CHCs (pill/patch/ring): Can reduce bleeding and pain but generally do not shrink fibroids.
DMPA injection: Can reduce bleeding and cramping. Evidence on fibroid size is mixed; some patients see modest size reduction.
Etonogestrel implant: May lighten periods and improve cramps for some; individual responses vary.

Therapies that are not birth control but may be part of care

GnRH antagonists/agonists: Short-term courses can reduce bleeding and fibroid size (e.g., elagolix/estradiol/norethindrone acetate; relugolix/estradiol/norethindrone acetate). These combinations are not contraceptives—use reliable non-hormonal birth control and follow monitoring recommendations for bone health and other risks.
Tranexamic acid: A non-hormonal medicine taken only during menses to reduce heavy bleeding; not a contraceptive.

Procedural options (e.g., uterine artery embolization, myomectomy) may be considered if medications don’t control symptoms or if fertility is a priority. A gynecologist can help tailor the plan based on your goals and anatomy.

What to eat and avoid: nutrition to support symptom control

Diet won’t cure endometriosis or fibroids, but it can help reduce inflammation, support iron levels, and may influence risk. Evidence-based strategies include:

Emphasize

Iron-rich foods to counter heavy bleeding: lean red meat in moderation, poultry, fish, beans/lentils, tofu, leafy greens, and iron-fortified cereals. Pair with vitamin C sources (citrus, berries, peppers) to boost absorption.
High-fiber, plant-forward meals: Vegetables, fruits, whole grains, legumes, nuts, and seeds support a healthy microbiome and help with estrogen metabolism.
Omega-3 fats: Fatty fish (salmon, sardines), flax, chia, and walnuts may help temper prostaglandin-mediated pain and inflammation.
Vitamin D and calcium: Adequate vitamin D is associated in some studies with lower fibroid risk; dairy or fortified alternatives plus safe sun exposure/supplementation as advised by your clinician.
Green tea (EGCG): Early studies suggest green tea extract may improve fibroid-related bleeding and quality of life; discuss supplements with your clinician to avoid interactions.

Limit or avoid

Red and processed meats: Higher intake has been associated in observational research with increased fibroid risk; choose poultry, fish, or plant proteins more often.
Alcohol: Limit to moderate levels or less; higher intake may worsen menstrual symptoms and overall health risks.
Ultra-processed, high-sugar foods: These can promote systemic inflammation and weight gain, which may worsen symptoms.
Sodium-heavy foods: Can worsen bloating and water retention.
Caffeine: Evidence is mixed; moderate intake is generally reasonable unless you notice it worsens cramps or anxiety.

Consider a daily multivitamin with iron if you are anemic (confirm with lab testing), and talk to your clinician before starting supplements. Aim for regular physical activity and weight management, which support hormone balance and overall well-being.

Putting it together: common scenarios

Primary goal: endometriosis pain relief with reliable contraception – Consider continuous combined pills or a progestin-only method. LNG-IUD is a strong long-acting option; the implant or DMPA can help as well. Avoid copper IUD if cramps or heavy bleeding are prominent.
Primary goal: control heavy bleeding from fibroids – If the uterine cavity is suitable, an LNG-IUD is often first-line. Alternatives include CHCs, DMPA, or non-contraceptive options like tranexamic acid. GnRH antagonist combinations may be considered short-term but require separate, reliable contraception.
Trying to conceive soon – Short-term use of medications for symptom control may be reasonable, but discuss fertility-preserving strategies (e.g., myomectomy for cavity-distorting fibroids) and timing with a specialist.

When to see a specialist

Seek care if you have very heavy bleeding (soaking a pad/tampon hourly, passing large clots), symptoms of anemia (fatigue, shortness of breath, dizziness), severe pain unrelieved by OTC medications, fertility concerns, or if an IUD has expelled or is difficult to place. A gynecologist can tailor imaging, labs, and treatment to your goals and medical history.

This article is informational and not a substitute for medical advice. Always discuss personal risks, benefits, and alternatives with your clinician.