Hormonal IUD Coverage for Endometriosis Takes Effect

On October 1, health insurance plans became required to cover the hormonal IUD for women with endometriosis who cannot use combined oral contraceptives or who do not tolerate them. The measure, approved by the National Supplementary Health Agency on September 18, provides greater access to a treatment that reduces inflammation and pain.

Hormonal IUD coverage by health plans

The coverage requirement is part of a new perspective on the disease, which goes beyond menstrual cramps and can cause fatigue, sleep disturbances, and emotional suffering. The mandate benefits those who have contraindications or difficulty adhering to daily pill use.

How the hormonal IUD works in endometriosis treatment

The device releases a hormone that causes atrophy of the endometrium both inside and outside the uterus, decreasing hormonal stimulation of lesions and, consequently, inflammation and pain. According to gynecologist Thaíssa Tinoco, advantages include no daily routine, a minimum five‑year duration, and less impact on libido compared with oral hormones.

Symptoms and diagnosis of endometriosis

The disease occurs when endometrial tissue implants outside the uterus, in the pelvic cavity, and responds to the monthly hormonal cycle. Symptoms vary and may include severe cramps, umbilical pain, lower‑back pain radiating to the legs, fatigue, and sleep changes. Diagnosis today is clinical, based on the patient’s history, and no longer requires surgery, although confirmation still takes on average about ten years worldwide.

Treatment options beyond the IUD

Hormonal blockade can be offered orally or via a vaginal ring. For those using the public health system (SUS), oral blockade is the most common alternative. Surgery remains indicated in cases of clinical treatment failure, large ovarian cysts, involvement of organs such as the intestine or bladder, or infertility after other causes have been excluded.

Importance of medical listening and lifestyle changes

According to the physician, sensitive listening is the key to identifying the disease, preventing the normalization of pain that is often passed down through generations. Lifestyle changes—anti‑inflammatory diet, regular physical activity, and supplementation—are recommended as complements to hormonal blockade.

Cases like Maria, 14, who felt umbilical and leg pain since her first menstrual year, show that early diagnosis is still rare. She needed oral treatment to control severe bleeding and now combines coagulation medication, nutrition, and exercise. Rita de Cássia Siqueira, 44, waited about 25 years for a diagnosis; after surgery, she reports no longer feeling the pains that once limited her daily life.

With information from A Gazeta.