Effects of Contraception as Treatment for Gynecologic Disorders

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Topic Description

Post Date: September 10, 2025

Expiration Date: August 29, 2026

Contraceptives have potential benefits in the treatment of a range of gynecologic conditions including, but not limited to, polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and dysmenorrhea. There are at least 200 marketed contraceptive options currently on the market in the United States. These contraceptives are used safely by most women for contraception and safety has improved as estrogen doses have been modulated and lowered to maintain contraceptive effect while lowering risks or side effects. However, many combined estrogen-progestin or progestin-only products (pills, patches, implants, intrauterine devices (IUDs), rings) referred to collectively as “hormonal contraception” are used long-term, often off-label, to treat gynecologic conditions. In the treatment regimens prescribed for gynecologic conditions, there is a paucity of information in the literature to help inform and drive provider and/or patient choice.

CDC data from 2023 indicate that 52.6 million women had ever used the pill and 13 million women had ever used an IUD, and, between 2009 and 2019, IUD use tripled. Uptake of newer delivery technologies like patches, injectables, implants, and rings is also rising. The mix of methods utilized is changing as longer-acting, lower dose options become available and options with no cold-chain storage and increased discretion are introduced. Amidst this progress and robust contraception literature, there has been little advancement in examining how these drugs may be used optimally for off-label treatment of gynecologic conditions. 

In addition to infertility, these disorders have been associated with considerable psychosocial burden including diminished self-esteem, interpersonal difficulties, and depression. These conditions also impose a substantial financial burden through both direct healthcare expenditures and indirect economic costs, with endometriosis and fibroids collectively costing the United States an estimated $81 to $265 billion annually, based on 2022 and 2024 analyses. Contraception can be therapeutic, regardless of reproductive status, and the scientific literature is inadequate as to relative effectiveness of contraceptive treatments in the context of gynecologic disease outcomes.

This invites researchers to suggest treatment guidelines to aid patient outcomes and satisfaction while generating data to drive best practices and obtain insight into drivers of contraceptive choice in treating gynecologic conditions.

Central Scientific Contact:
Leigh Allen, PhD
[email protected]

Participating ICOs

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NICHD seeks research to enhance understanding of the etiology, pathophysiology, or natural history of these conditions and/or develop more effective management strategies for gynecologic conditions. Scope excludes reproductive tract malignancies or primary focus on fertility impact. 

Interests include but are not limited to:

  • Using AI/ML to analyze treatment outcomes from medical records
  • Combining provider/patient education to determine if outcomes differ by what is accessible
  • Identifying biomarkers linked to better outcomes with contraception use
  • Clinical trials of different estrogens/progestins or continuous vs. cyclic contraceptive use for gynecologic conditions
  • Evaluating hormonal contraception effectiveness for pelvic pain or dysmenorrhea in endometriosis patients
  • Applying -omic technologies to address gynecologic conditions
  • Leveraging existing datasets and/or specimens to study pathophysiology at molecular and cellular levels
ICO Scientific Contact:
Leigh Allen, PhD
[email protected]

Office of Research on Women's Health (ORWH)

The areas of interest of the Office of Research on Women’s Health (ORWH) include:

  • Generate data on long-term use of hormonal contraceptives for gynecologic disorders to inform best practices and optimize treatment strategies.
  • Study factors influencing contraceptive choice in patients with gynecologic conditions and their impact on health and quality of life.

This office does not award grants. Applications must be relevant to the objectives of at least one of the participating NIH Institutes and Centers listed in this topic.

ICO Scientific Contact:
Elena Gorodetsky, M.D., Ph.D.
[email protected]

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