Sexual Health: Your Questions Answered

Marie Stopes is the leading sexual and reproductive healthcare charity in the UK. Janet Pearce, a nurse from Marie Stopes International, answered questions from the iVillage Community on periods and sexual health

1. Endometriosis management

Omnopop wrote: I have had Endometriosis for about 12 years. In between my two pregnancies, I luckily had a very welcome break from most of my symptoms. However, my periods returned after my second baby eight months ago and the endometriosis has returned. I have been experiencing a lot of pain, heavy periods and often pain around ovulation too.

I took Microgynon for six weeks (which worked well at reducing all symptoms) but then experienced nasty side effects, so have recently stopped and am waiting for the side effects to clear out of my system before we try something else.

I have been advised to try the Mirena, but am not sure about it, especially as I believe it has the same hormone as Microgynon (albeit at a lower level), or to try another pill.

Just wondering what your advice would be for managing the endometriosis? We don't want any more children, but the treatment doesn't necessarily need to involve contraception, as we are happy to use condoms. I am 38, slightly on the heavy side for my height and am generally in good health.

Janet Pearce: I think the suggestion to give the Mirena intra uterine system (IUS) a try is very good advice. Mirena does contain pregestogen like Microgynon, however it does not contain oestrogen which is the hormone that can cause side effects in some women.

Mirena acts locally on the lining of the womb and has been one of the major advances in contraception that is of particular benefit to women with endometriosis. It is also one of the most effective forms of contraception available at 99.8 per cent. It reduces or in many cases stops period pain and blood loss during a period.

Mirena is effective for five years but can be removed at any time and fertility returns immediately. Condoms are good for preventing sexually transmitted infections and helping to prevent a pregnancy but do require thought and planning.

I'd advise you to visit your GP or local family planning clinic to talk through your contraceptive options.