Thank you for the question.
The arenas around contraceptives and endometriosis do overlap. Sometimes oral contraceptive pills or the Mirena progesterone IUD are adjuncts that can be used to treat pain with endometriosis and to control bleeding that can be associated with it as well.
The standard and approved medical treatments for endometriosis are expensive medications. I have many patients who do not get coverage for these medications. Whether it's through plans at work or our Blue Cross here in Alberta, these will not cover our approved medications for endometriosis. Also, we really struggle with off-label treatment with other medications for it. We've talked a lot about surgical access and barriers there, but there are significant medical barriers to endometriosis to get pain under control—and it's not just pain. It's about preventing that disease from getting worse over time and trying to prevent that chronic pain state.
As Dr. Jolly mentioned earlier, getting that diagnosis early for that younger patient, and getting them on a medication to prevent some of the later complications from endometriosis will ultimately save our health care system money.