I am 27 and have a five-year history of endometriosis. I have had two laparoscopic surgeries which were both followed by 6 months of Lupron Depot treatment. In between the Lupron, I am on continuous birth control. In December 2007 I experienced my first endometrial cast. I had no idea what it was, but I was very scared and it was extremely painful! I did not think to save the tissue, so my doctor at the time assumed it was a miscarriage. However, after a negative pregnancy test, she decided it was about time I start seeing a specialist anyway. My new doctor explained that it was probably an endo cast, but not to worry because they are extremely rare and would probably not ever happen again. Unfortunately, it did. The next occurrence was in June 2008. This time I saved the tissue and it was sent to a pathologist, where it was confirmed as an endo cast. While surprised to see this happen again, my doctor again reassured me that it was still unlikely to happen a third time.

Fast forward to 2010 - I've passed an endo cast in April, June and July. Ridiculous, in my opinion.

For several years I was using the Nuva Ring - and loved it. However, this April, after the 3rd cast, my doctor decided it was time to try a different birth control. I switched to Lo/Ovral in May. After passing the 4th and 5th casts, my doctor has decided to switch again. This time, I am going to try a pill with more estrogen - something he and the pathologist thought would solve the problem. So I will be starting Necon 1/35 tomorrow.

A couple of questions - my doctor keeps telling me that there is nothing to worry about, in the long term, as far as the repeated occurrence of these casts. I'm freaked out, however, because if they are so rare, then how is the long term effect truly known? Also - I'm worried about what side effects I might notice once I switch to an estrogen dominant bc... anything specific? And, I'm not a doctor - but isn't the best treatment for endometriosis a continuous suppression of estrogen? So that a low-estrogen bc pill is best?